ADHD and ASD (Autism) Referrals

If you are concerned that you, or a child you care for, may have Attention Deficit Hyperactivity Disorder (ADHD) or Autistic Spectrum Disorder (ASD), there are several ways to arrange a referral depending on your needs and the services that are available locally.

Please see the links at the bottom of the page for the information relevant to your specific needs.  If you wish to arrange assessment for both ADHD and ASD, you will need to read the information at both links and complete both forms.

If you are considering a Right to Choose (RTC) referral you should also read the information below to ensure you understand how this differs from an NHS assessment.  If you think you may need medication for ADHD, please also read the section on Shared Care Agreements (SCAs) which explains who can provide your prescriptions.

Please note that Haresfield and Kempsey Surgeries can only provide prescriptions for ADHD medication under a shared care arrangement if this request comes from the local NHS Children’s ADHD Service or an accredited Right to Choose Provider (see below).

 

Right To Choose (RTC)

If you need a referral for a physical or mental health condition, in most cases you have the legal right to choose which hospital or service you go to.  The service may also be a private organisation (provider), but it must have a contract with the NHS to supply services to it within England.  There are now many private clinics offering RTC ADHD and ASD assessments. However, the nature and extent of the service that each provider offers is variable and often not clear to either the patient or the GP completing the referral.  Below are some important points to explore if you are considering a RTC referral;

  • What level of qualification will the clinician you see have? 

  • Does the organisation have robust policies and procedures in place?

  • If medication is needed can the service start medication and monitor it regularly? 

  • Will you regularly need to travel long distances to be seen or have tests done?

  • Is there a separate waiting list to commence treatment once you have been seen for diagnosis?

  • Is the organisation well established and likely to be viable for the many years over which your treatment may continue?

Locally in Herefordshire & Worcestershire the Integrated Care Board (the organisation that plans and oversees health services in the area) have established an accreditation process for ADHD RTC providers, to assist the patient and their GP in making this choice.  Accredited providers are guaranteed to be CQC registered, to be able to start and stabilise medication and to have robust procedures in place for the ongoing monitoring and follow-up of patients, including a clear shared care agreement.  At present there are only a few accredited providers (see below), but the ICB are in the process of approving more. There is no accreditation process for ASD RTC providers currently.

 

Shared Care Agreements (SCA)

A SCA is a contract between a specialist and a patient’s GP that transfers responsibility for the day to day prescribing of a medication to the GP whilst the specialist retains overall responsibility for the patient’s care and their treatment plan.  The GP must feel sufficiently familiar with the medication to prescribe it safely but is not expected to have a specialist level of knowledge about it or the condition it is prescribed for.  These agreements rely on both services fulfilling their obligations under the contract and clear lines of communication between both parties. Ultimately, the GP carries the professional responsibility for any prescriptions issued in their name, even if under the guidance of a specialist.

GPs are not obliged to accept SCAs if they do not feel sufficiently experienced, or if workload pressures mean that to do so would impact upon their core services. If the GP cannot accept, then the responsibility for prescribing rests back with the specialist who has recommended the medication. 

Due to the huge variation in the services available, the nature of the medications involved, the lack of any robust SCA policies, difficulties in getting hold of the relevant specialists when issues arise and the significant workload that the administration of these arrangements has involved, Haresfield and Kempsey Surgeries have taken the difficult decision that we can no longer enter into SCAs for ADHD medication with providers other that the local NHS services and the RTC providers accredited by the ICB.

We do not provide shared care for privately funded care for any condition.

This does NOT affect your right to choose.  You can still be referred to any provider with an NHS contract for diagnosis and treatment, but if medication is required it must be prescribed by the specialist rather than via your GP.  You will need to check that your chosen RTC provider is willing to do this.  

 

List of accredited RTC providers

·        Adults (aged 18 and over) - Quay Healthcare
https://quayhealthcare.org/adhd/adult-adhd-service/

 

We will update this notice as more providers are approved. 

 

The links below provide all the information you need to arrange a referral for ADHD or ASD assessment. 

You will need to print and complete the relevant forms, mark the envelope ‘FAO The Secretarial Team’ and drop it into Haresfield or Kempsey Surgery reception.  Please contact the surgery if you do not have access to a printer.