Existing diagnosis

Picking up where others left off

If you have already been diagnosed with ADHD or autism but feel that your care has fallen short, you are not alone. Many patients come to us after being diagnosed elsewhere, sometimes alongside co-occurring conditions such as depression or anxiety, only to find that ongoing support has been limited, medication has not been properly optimised, or communication with their GP has broken down. Some have been discharged from NHS services with a diagnosis but no clear follow-up plan. Others have been managed in primary care and want a specialist review.

At Caledonian Psychiatry, we offer a dedicated service for adults with an existing neurodevelopmental diagnosis who are looking for a fresh start with their treatment. This is particularly common for patients with ADHD, where the gap between receiving a diagnosis and getting effective, well-managed care can be significant. If you are still weighing up where to move your care, our guide to transferring your ADHD care sets out what to look for in any new provider.

ADHD: the most common reason people come to us

The majority of patients who use this service have an existing ADHD diagnosis. Common reasons include:

• You were diagnosed privately but the assessing service does not offer ongoing prescribing or follow-up.
• Your NHS shared care arrangement has broken down or your GP is unwilling to prescribe.
• You are on ADHD medication but have never had a proper titration or review.
• You feel your current dose or medication is not working well and want a specialist opinion.
• You have moved to Scotland and need to re-establish psychiatric care.
• You were diagnosed as a child and want adult-focused management.

We will review your existing diagnosis, assess your current treatment, and work with you to develop a clear management plan. Where appropriate, we will initiate or adjust medication, establish shared care prescribing with your GP, and provide structured follow-up to make sure things are working.

What you can expect from us

• The same psychiatrist throughout. Every appointment (the initial review, any titration and each follow-up) is with one named psychiatrist who knows your history. Most patients transfer to Dr David Crocker; you can also choose Dr Abderahman Kamaledeen, whose clinical focus includes exactly this work: ADHD medication titration, annual review and shared care handover.
• Reviews that are consultations, not checklists. Follow-up appointments are 30-minute consultations (£130) shaped around how you are actually doing, not a form to complete.
• Every fee published up front. There is no subscription or membership: the fee schedule lists everything, and the medication costs page shows typical pharmacy prices drug by drug.
• Your choice of pharmacy. Prescriptions can be dispensed at any pharmacy; controlled ADHD prescriptions are posted by Royal Mail Tracked 24, with the tracking number sent to you by SMS.
• Shared care as the goal. Once your treatment is stable, we approach your GP about shared care, so routine prescribing can move to the NHS.

Quality of previous assessments

Before taking over your care, we need to be satisfied that your original diagnosis was made to an appropriate clinical standard. Most assessments from reputable providers are perfectly adequate, but unfortunately this is not always the case. Some patients come to us with diagnoses based on brief screening questionnaires, without a proper clinical interview, or without collateral information where it would normally be expected.

If we have concerns about the quality or reliability of your original assessment, we will discuss this with you openly. This is the fault of the original provider, not yours. Where the report has gaps but a genuine assessment took place, we usually offer a discounted ADHD assessment: a single 90-minute appointment at £680, which builds on the work already done. Where the original assessment gives very little to build on (for example, a diagnosis based on screening questionnaires alone, with no clinical interview or childhood history), a full ADHD assessment (two 60-minute appointments, £800) is needed instead, and we will explain why. Patients who need to start from the beginning can read about our full ADHD assessment process.

Diagnosed outside the UK

We look after many patients whose diagnosis was made overseas: international students beginning university in Scotland are a familiar example, often arriving mid-treatment and needing their care to continue without interruption. An overseas diagnosis is not a barrier: what matters is the quality and the rigour of the assessment behind it. We judge these assessments based on UK standards, but we are cognisant of cultural differences, and we will do everything we can to work with you as far as possible. We do ask for translated copies of any medical records that are not in English (or Arabic), and, as with every transfer involving controlled medication, you will need to be registered with either a private or NHS GP whilst living and studying here in the UK. For students, the university health service is usually the quickest route. Our guide to transferring your ADHD care has more on how the process works.

Other conditions

Many adults with ADHD or autism also carry a diagnosis of depression, anxiety, OCD or a mood disorder, and those conditions are part of the picture we review. Where they sit alongside a neurodevelopmental diagnosis we are already treating, your psychiatrist will consider them together rather than in isolation. Common reasons for seeking a review include:

• Medication that has stopped working or was never properly optimised.
• Side effects that have not been adequately addressed.
• Uncertainty about whether your diagnosis is correct.
• A desire for an independent second opinion.
• Difficulty accessing timely psychiatric care through the NHS.

Our focus is neurodevelopmental psychiatry: ADHD and autism in adults. If your difficulties are unrelated to either, we are probably not the right service, and we will say so rather than take a booking we cannot help with.

What to expect

Your first appointment is a 60-minute consultation by secure video link. This will include:

• A thorough review of your existing diagnosis, including the quality and findings of the original assessment and any supporting documentation.
• A detailed medication history covering what you have tried, what has worked, and what has not.
• An assessment of your current symptoms, functioning, and treatment goals.
• A clear plan for next steps, which may include medication changes, a new shared care request to your GP, or further investigation if the original diagnosis needs revisiting.

After the appointment

You will receive a written summary of the consultation, including any changes to your treatment plan, addressed to you and your GP. Where medication changes are made, follow-up appointments are arranged to monitor progress, manage titration, and ensure a smooth transition to shared care prescribing where appropriate.

Fees

Initial review appointment (60 minutes): £350.

Follow-up appointments (30 minutes): £130.

Private prescriptions: £30 per prescription for controlled medications (ADHD stimulants such as methylphenidate and lisdexamfetamine), or £25 for non-controlled medications. The cost of the medication itself is paid directly to your dispensing pharmacy and varies depending on the drug and dose. See our medication cost guide for typical prices, and our fees page for the full schedule of appointment charges.