Shared care for ADHD medication, and what to do if your GP says no

What shared care is

The NHS says a GP may be able to take over prescribing ADHD medicines, but only if there's a shared care agreement with your ADHD specialist.

NHS England describes shared care as local arrangements for a GP to take on prescribing and monitoring. They're agreed with the specialist who started the treatment.

NICE guidance says:

• ADHD medicine should only be started by a professional with training and expertise in ADHD.
• After the dose is worked out and stable, prescribing and monitoring should be done under shared care with your GP.
• A specialist should review your medicine at least once a year.

The BMA, which represents doctors, says the stable period before handover is set by the agreement, and is often 3 months.

Does my GP have to agree?

No. NHS England's guidance says a GP should only take on prescribing if they feel clinically confident to. The Ombudsman said in August 2026 that accepting shared care for ADHD medicine is "a clinical judgement rather than an obligation".

The BMA tells practices that shared care is voluntary work they can decline. It also says any refusal should be consistent, and not discriminate against particular groups of patients.

Two things to know in 2026:

• Fewer arrangements. The ADHD Taskforce reported in November 2025 that many ADHD shared care arrangements are no longer in place.
• GP collective action. Since 1 July 2026, the BMA has asked GP practices in England to refuse informal requests for new shared care. It asks them to accept only agreements that are appropriately resourced and safe. It didn't single out ADHD, but it may affect new requests.

Right to Choose and private diagnoses

Right to Choose providers are NHS-funded. From April 2026, NHS England payment guidance says their ADHD reports should be accepted by NHS-funded titration services, unless there's a clear clinical reason not to. Titration services start and adjust ADHD medicine. It doesn't oblige a GP to take on prescribing.

Private diagnoses are different. The BMA says shared care with private providers isn't recommended, because NHS and private care should be kept separate. We haven't found a national rule that makes the NHS accept a private diagnosis for NHS prescribing. It seems to be decided locally.

Paying for private care doesn't take away your right to NHS care.

If your GP says no

You have options. Try them in this order.

1. Ask why. NHS England's guidance says a refusal should be talked through, so extra information or support can be offered, or other arrangements made.
2. Ask your specialist to keep prescribing. The guidance says the specialist should keep prescribing until the handover is agreed.
3. Ask your provider what happens next. From April 2026, an NHS-funded provider can be paid to keep managing your medicine. That applies if your GP says no, or doesn't reply within 21 days. Not every provider will, so ask yours.
4. Complain if you think it's wrong. You can complain to the GP practice. Or you can complain to the organisation that pays for the service, usually your integrated care board (ICB). Free NHS Complaints Advocacy can help you. The Ombudsman is the final step in England.

You can also say no to shared care yourself, if you decide it isn't right for you.

If you're running low on medicine

Some ADHD medicines, including methylphenidate and lisdexamfetamine, are controlled drugs. NHS 111 online can't give emergency supplies of controlled drugs that need ID to collect. A pharmacist usually can't either.

So contact your prescriber early, before you run out. If you can't get your usual medicine, talk to your pharmacist and your prescriber about what to do.

Questions about doses, side effects or switching medicines are for your prescriber or a pharmacist. You can also call NHS 111.