End of Titration

At the end of the titration process, you will receive an appointment for an end-of-titration review. Your doctor will then write to your NHS GP to request a Shared Care Agreement (SCA).

Your ongoing care

Your ongoing treatment plan

At the end of the titration process, you will be sent an appointment for an end-of-titration review to discuss your future treatment plan, which may include psychosocial support in addition to medication.

Your clinician will then write to your GP, with details of your treatment to date, such as whether the treatment is within NICE guidelines, the clinical response, mental state examination and other pertinent details.

They will request your GP’s agreement to take over the prescribing of your medication for the following 12 months, but you remain ‘open’ to Psychiatry UK (as your care is ‘shared’). This means that ongoing prescriptions will be issued by your GP surgery. There is an expectation that your blood pressure, pulse and weight will be reviewed by your GP at 6-monthly intervals (in between your annual reviews).

We are contactable any time via email/letter from your GP/primary care team if they feel that specialist advice or an earlier review is needed. You are NOT ‘discharged’ from Psychiatry UK if you are on a shared care agreement (unless you are specifically informed of this as per the local ICB/NHS arrangement). Please do contact your GP in the first instance if you have any issues with your ADHD medication or treatment.

You will also be offered an annual review by Psychiatry UK – or perhaps by another service, such as your local NHS team.

Some GPs do decline to prescribe ADHD medication:

  • In some locations the recommended medication is not funded by the local ICB.
  • Sometimes the local mental health service insists that they review a patient before accepting a diagnosis from any other location or service.

We will always do our utmost to encourage your GP to accept a shared dare arrangement with us. However, we do advise patients to talk to their GP before they commence treatment with us to ensure that they will be willing to take on a Shared Care Agreement at the end of the titration process.

When we write to your GP to request a SCA, your MedQare portal will be updated to ‘View only’ status. You will still see all your notes and will be able to view/download any attachments, but will no longer be able to contact us via portal note.

Your clinic letter will contain a link to additional resources. Further information may also be found in the guides below.

What to do if you need urgent assistance

Please follow our guidance for urgent assistance.

Further advice and support

Please find below some helpful guides to help you understand and manage your ADHD.

ADHD Wellbeing Pack

PUK – Discharge pack

You may also like to visit our Resources area for additional information and support.

 

What to do if you need urgent help

Please follow our guidance for urgent assistance.

Download our guide to seeking urgent help.

Frequently Asked Questions

  • If your GP accepts shared care, your ongoing prescriptions will be issued by your GP surgery.
  • Your blood pressure, pulse and weight will need to be monitored every 6 months.
  • We will contact you directly to arrange an annual review appointment. If a review is required before this is due, we will require a written request from your GP before a booking can be made.
  • Please note: If you are a patient with a local ADHD service, you will be transferred back to that service for shared care, and they will arrange annual reviews, or any other follow-up that is needed.
  • A copy of your clinic letter and Shared Care Agreement (SCA) will be sent to your GP. They will be requested to return a signed copy of the SCA. If we do not receive this within 4 weeks, we will contact your GP for their decision. We will inform you once we have had a response from your GP.
  • If you need a prescription while your shared care request is being processed, please request this from your prescriber as  you have done during titration. If you are having trouble requesting a prescription, please contact us via our live web chat service.
  • We would advise that you contact your GP directly as well to find out if they are accepting shared care, as they will not necessarily reach out to you.

Most referring GPs are happy to take on a Shared Care Agreement (SCA), but there is no obligation for them to do so. There are also some areas of England where certain medications cannot be prescribed by a GP, and they are legally unable to accept the SCA. In these cases, we would continue to prescribe for you and invoice the ICB.

If your GP declines shared care prescribing, we will require a letter or email from your GP to confirm this. Psychiatry UK will then continue to provide your repeat prescription.

Please note: If you are a patient with a local ADHD service, you will be transferred back to that service for shared care. If your GP declines shared care, your local service will take over your prescribing.

Please contact us via our Virtual Assistant service. This is available from our website, portal or Companion app (we are open Mon-Fri 8am-6pm).