ADHDaptive guide to shared care plans (SCP)

A Shared Care Plan is an agreement between you and your GP and your private consultant. It effectively enables the care and treatment you receive for a specific health condition to be shared between your private provider and GP. This will only happen with your agreement and when your condition is stable or predictable.
 

At a practical level, this means that your GP will be able to prescribe your medication through the NHS as any other prescription for as long as the agreement is in place, although you remain under the care of your private provider.
 

Other key benefits include efficient management of care, and the potential for a shorter waiting time compared to solely relying on public mental health services.

 A Shared Care Agreement contains information about things like: 

• Your medicine
• Guidance on prescribing
• Monitoring your health
• The responsibilities of your provider, your GP and you. 

Private Provider:

Prepare the shared care plan, ensure the timely sharing of relevant information with the GP, provide the necessary documentation for the agreement, and cooperate with the GP's requests for changes or modifications. 

The GP:

Coordinate care, monitor health, and ensure effective communication between the private provider and the patient. 

The Patient:

Patients have the right to be actively involved in their care decisions, to provide accurate information, and adhere to the agreed-upon treatment plan. It is important they are actively engaged with the shared care plan.

Many GPs are reluctant to take on shared care agreements, given they become jointly responsible for your care with a third party and have to accept the risks this brings them professionally should things go wrong, however many are sympathetic, given the crisis in the NHS resulting in seven-year waiting lists for ADHD diagnosis.

If you are thinking of a diagnosis and possibly medication from a private provider and you would like your GP to support the ongoing care and medication then there are some things you should do to ensure things go as smoothly.

Talk to your GP:

• Consider using your Right to Choose and ask to be referred to Psychiatry UK (Which has a shorter waiting list than mental health services)
• Talk to your GP
• Tell them what you are planning on doing
• Ask them if they would be prepared to take on a shared care agreement in these circumstances.

As a last resort, if you are not satisfied with the response, remember you can always use your right to choose and register with another GP.

Research your private provider - thoroughly!:

• Is your consultant a GMC registered Psychyatrist? Check their registration with the GMC website https://www.gmc-uk.org/
• Do they have a good reputation – for example, published scientific papers or work with the NHS or other government agencies. 
• Were they featured on the recent BBC Panorama documentary  BBC One - Panorama, Private ADHD Clinics Exposed 
• Check them on LinkedIn, Google and look for reviews.
• Ask them if their Shared Care Plan will adhere to NICE Guidelines
• Try and use a private provider who has been recommended
• Ask how much a Shared Care Plan will cost
• Ask them how they will maintain confidentiality. What will they share with your GP or others and when? 

If you are not satisfied with any of the responses, discuss with your provider before proceeding with an assessment, and remember there are many reputable private clinics that may be a better match. It is important that you are comfortable with your provider.

Keep your GP up to date, send them a copy of any diagnosis for your record and inform them if you are prescribed medication. It is important that your GP record is kept up to date. Private providers don’t generally send this information directly, due to confidentiality concerns.

You can request access to your online GP record - speak to your GP.

• Once you have stabilised and have completed your titration period, ask your private provider to complete a shared care agreement and send to your GP. They may charge for this, probably in the region of £100. 
• After a few days, follow up with your GP to check they received it and are processing it.
• Your GP may request some changes, this will be directly with your private provider. This is a good sign, as it shows that they will likely sign the agreement, with some changes.
• Your GP will send you a letter, asking you to agree to the agreement. They may want to see you for a routine examination or to discuss the agreement.Once all parties have signed, your GP will be able to take on your care and prescribe your medication, and set up a repeat prescription. 
• If they decline the agreement, speak to your GP
• If they still decline, your options are an NHS referral (ask for Psychyatry UK under your right to choose), continue under the care of your private provider (this will be expensive). 

• Be aware that your pharmacist will most likely need to order your medication as many ADHD medications are controlled drugs and they don’t keep them in stock, therefore you will need to order them in plenty of time to avoid running out. Try to do this a week in advance.
• Attend all reviews and checkups requested by your GP or private provider
• Tell your GP and Provider if you notice any change in your health
• If you are discharged from the care of your private provider, your shared care agreement will end.
• If your medication changes, a new shared care plan will need to be put in place.

Please remember, this information is provided as is, don’t take any actions based on this alone. It is based solely on my experience to help others understand the process and what they may expect.

Always refer to your GP and private provider who will provide you with the best advice for your situation. 

Further Information
 

ADHDAdultuk – More information about shared care plans
GMC Website

NHS Right to Choose

NHS Dorset – Shared Care Plan Guidelines for ADHD

BBC One - Panorama, Private ADHD Clinics Exposed