Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition affecting an estimated 2.5% of adults and 5% of children in the UK. NHS ADHD services provide assessment, diagnosis, and treatment through publicly funded healthcare pathways at no direct cost to the patient, commissioned by Integrated Care Boards (ICBs) and delivered through NHS mental health trusts, CAMHS services, and increasingly approved independent providers under Right to Choose arrangements.

NHS ADHD services typically cover:

• Structured ADHD assessments conducted by qualified specialists
• Formal ADHD diagnosis where criteria are met
• Prescribing of licensed ADHD medications including stimulants and non-stimulants
• Ongoing monitoring and medication review appointments
• Shared Care Agreement facilitation for ongoing GP prescribing

The NHS ADHD assessment pathway typically begins with a GP referral to a local specialist ADHD service or, under the NHS Right to Choose framework in England, a patient-initiated referral to an approved independent ADHD assessment provider.

NHS ADHD waiting times are among the most frequently discussed aspects of ADHD care in the UK. Demand for ADHD assessments has increased substantially in recent years, driven by greater public awareness and an increase in adults seeking assessment for conditions that were not identified in childhood. Waiting times vary significantly depending on location, service demand, and local NHS resources, and differ between regions, providers, and patient age groups.

Several factors contribute to this variation: local NHS commissioning priorities, the availability of trained ADHD specialists within each Integrated Care Board area, population size relative to service capacity, whether Right to Choose pathways have been implemented locally, and different referral thresholds between services.

Private ADHD treatment in the UK follows a similar clinical pathway to NHS provision in terms of diagnostic standards, but operates outside NHS commissioning. Private ADHD assessments are conducted by consultant psychiatrists, specialist ADHD clinicians, or accredited assessment services, and must adhere to NICE guidelines for ADHD diagnosis and treatment.

ADHD medications in the UK are predominantly Schedule 2 controlled drugs under the Misuse of Drugs Regulations 2001. This applies to methylphenidate preparations (including Concerta XL, Ritalin, Medikinet, and Equasym XL), lisdexamfetamine (Elvanse), and dexamfetamine (Amfexa). Non-stimulant alternatives such as atomoxetine and guanfacine are not controlled drugs but are similarly regulated as prescription-only medicines. Because most ADHD medications are controlled drugs, prescribing and dispensing are subject to specific regulatory requirements regardless of prescription type.

Shared Care Agreements for ADHD are formalised clinical documents that set out the respective responsibilities of the specialist and the GP in managing a patient's ADHD treatment. They are particularly important because ADHD medications, as Schedule 2 controlled drugs, require careful ongoing clinical oversight that benefits from clearly defined prescribing responsibilities between secondary and primary care.

A Shared Care Agreement typically covers the specific medication and dosage, the responsibilities of the specialist (initiation, titration, review), the responsibilities of the GP (ongoing prescribing, monitoring, reporting), monitoring requirements, and escalation criteria requiring specialist review.

The transition from private ADHD care to NHS Shared Care is increasingly common, as more patients access private assessment to reduce waiting times before seeking to formalise NHS support for ongoing management. The feasibility and process varies between NHS regions and depends on local commissioning policies.

Key requirements for transitioning typically include:

• A formal ADHD diagnosis from a suitably qualified specialist, whether NHS or private
• Evidence of an appropriate titration period with documented medication response
• A completed clinical assessment summary from the private prescriber
• A willing GP practice able to enter into a Shared Care Agreement
• Compatibility with local Integrated Care Board commissioning policies

During any transition, Pharmazon HomeCare can provide continuity of medication supply, ensuring patients do not experience supply gaps that disrupt their treatment. Our team works with both the private specialist and the GP practice to coordinate prescriptions throughout the process.

Whether a patient is managed through NHS or private channels, the pharmacy processes underpinning ADHD prescription fulfilment are governed by the same regulatory framework. ADHD medications as Schedule 2 controlled drugs require specific dispensing procedures, documentation, and supply chain compliance regardless of prescription type. The key differences relate to the prescription document used, the cost structure, and the dispensing channel.

Pharmazon HomeCare is a GPhC-registered specialist pharmacy homecare provider supporting patients across both NHS and private ADHD treatment pathways. We work directly with specialist ADHD clinics, consultant psychiatrists, independent prescribers, NHS services, and GP practices operating under Shared Care Agreements. We deliver medication same-day in London and next-day across the UK.