People registered with a GP in England have the Right To Choose (RTC) an approved non-NHS organisation for their ADHD assessment if the waiting list for consultant-led treatment in their Integrated Care Board (ICB) is longer than 18 weeks. (RTC is not available in Wales, Scotland or Northern Ireland.)
If you’ve read this far and you’re an ADHD-er, let me congratulate you on your tenacity and invite you for a wee nap as we both take a rest before we learn more! Or, if I’ve just awoken your hyperfocus, let’s dive deep with all our attention!
What’s Changing in NHS Shared Care Agreements?
The pressure on funds for ADHD assessment and treatment is forcing change. With more awareness comes more demand for assessment and medical support. But the funds for those services are not dramatically increasing. So, the next step for the NHS is to allow some restrictions to maintain some level of care without completely depleting their resources and leaving everyone without any ADHD support.
Strategically, I can see why they might do this. On the ground level, however, it’s a different story. It’s forcing change on people who have not chosen it. If you are looking for ways to support yourself with ADHD, this might feel like quite a blow. For us, change can be hard to adapt to if demand avoidance is high in our spiky profile, especially if we have not been involved in choosing the change.
How This Affects ADHD-ers
On top of that, if we are already on a waiting list, the process is far from quick or straightforward. Titration (the process for starting a new medication and gradually increasing the dose to the most effective and safe dosage) takes a bit of time. During those weeks, patients sometimes experience side effects that make it necessary for their clinician to explore the use of a different medication and start the titration process from scratch. So once people have landed on the right ADHD medication and the right dose with the right chemical release rate, very often the parts of ADHD that were making life very difficult become more manageable and life settles or improves. Not everyone can take ADHD medication and not everyone has the same results from it either.
If at this point meds are making a difference, they can become an integral part of being well and functioning in the way we want to.
Great, I hear you say! Let’s do that! Get a Right To Choose ADHD assessment, go through titration and, hey presto, life’s grand. Except not every ICB offers ADHD shared care agreements (paying for meds prescribed by an RTC organisation) and now the NHS is offering individual ICBs the option to impose more restrictions on how RTC is managed. Some ICBs are limiting the approved service providers that they will accept assessments from. This results in longer waiting lists with approved providers because of the bulk of assessments they are then forced to take on. Of course, you could still use a non-approved supplier to do this faster, but you will be responsible for the cost of assessment, reviews, and prescriptions. None of these are cheap. The people doing reputable assessments are highly qualified professionals who need to charge appropriately. The meds are restricted because they can be misused, and they cost a lot. No problem if this is something you can afford, but not everyone can, and the NHS changes are making this support even harder to access.
What Can You Do?
This is the point where we could choose to put our heads in the sand if these changes don’t apply to us. But I know that is not how many ADHD-ers operate. For many of us, the injustice driver is very strong. When we see people disadvantaged, it’s hard for us to sit by idly and let it happen. So, if this applies to people in your ICB, you could write to your MP. If you are keen to support countrywide action, you could sign government petitions for Right to Choose for ADHD. What we do makes a difference, whether it is at grassroots or at a high level. See the resource section below for options for action.
If you are in the camp of people whose prescription costs for NHS ADHD medication will no longer be supported by your ICB, you could choose to challenge it. And there is anecdotal evidence of that working in places.
But if you decide to channel your energy into supporting yourself in drug-free ways, you can. This applies to people for whom the meds don’t work, or do use meds, but would like to have additional supports in place, or choose not to take medication.
Mindfulness for ADHD-ers is such a support. However, it is not a magic quick fix. It takes around 8 weeks to learn and implement a daily practice and builds insight and support over time. The more you engage with it regularly and over time, the deeper the self-knowledge grows and the easier it becomes to let go of patterns that don’t serve us and choose new ones. The most effective courses are offered in groups to grow the understanding of how many similarities we all share and to offer opportunities for compassion to and from others. If you can find a mindfulness course specifically for ADHD-ers, it is more likely that your focus will settle with your own experience, instead of needing the hypervigilant and masking techniques that we often employ to fit in with mainly neurotypical groups.
If you wanted to dip your toe into some very easy short informal practices, you could use my free downloadable mindfulness guide. It also gives you access to my newsletters which keep you up to date on any ADHD-related mindfulness activities I’m involved in, and dates and details of upcoming courses. If you only want the free guide, you are of course free to unsubscribe from the newsletter immediately after downloading the guide if you wish.
https://rewiretherapy.co.uk/free-mindfulness-guide
Resources and Support
References
BSW Together (2024) Right to Choose – Frequently Asked Questions (FAQs).
Available at: https://bswtogether.org.uk/medicines/documents/right-to-choose-frequently-asked-questions/ (Accessed: 21 February 2025).
Hastings and Rother Healthcare (2024) Understanding Shared Care – NHS, Right to Choose and Private Providers.
Available at: https://hastingsandrother.healthcare/wp-content/uploads/2024/08/Shared-Care-Right-to-Choose-and-Private-providers-July-2024.pdf (Accessed: 21 February 2025).
UK Government Petitions
Review NHS approach to shared care for ADHD medication.
Available at: https://petition.parliament.uk/petitions/700214 (Accessed: 21 February 2025).
Reinstate ADHD shared care plans to ensure access to essential medication.
Available at: https://petition.parliament.uk/petitions/710530 (Accessed: 21 February 2025).
Review management of ADHD assessments and increase funding.
Available at: https://petition.parliament.uk/petitions/597840 (Accessed: 21 February 2025).
Finding Your MP
To find out who your MP is, use the UK Parliament’s “Find Your MP” service.
Available at: https://members.parliament.uk/FindYourMP (Accessed: 21 February 2025).
For more information on contacting your MP, visit the UK Parliament’s guide:
https://www.parliament.uk/get-involved/contact-an-mp-or-lord/contact-your-mp/ (Accessed: 21 February 2025).
