Will the NHS prescribe after a private ADHD diagnosis?

Why people worry about this

For many adults weighing up a private ADHD assessment in Scotland, the assessment itself is not the main source of anxiety — it is what happens afterwards. Will an NHS GP prescribe the medication a private psychiatrist recommends, or does going private mean paying for prescriptions indefinitely? Online forums are full of accounts of GPs declining, and the worry is understandable: ADHD medicines are controlled drugs, and taking on their prescribing is a serious clinical commitment.

The concern has a real basis. No national scheme obliges a Scottish GP to take over prescribing after a private diagnosis, and practice varies between health boards and between individual GP surgeries. But the full picture is considerably more reassuring than the forum threads suggest, and it is set out in national guidance that surprisingly few patients — or providers — have actually read.

What the national guidance actually says

The key document is guidance published in April 2022 by the National Autism Implementation Team (NAIT), titled Prescribing ADHD medication to adults following private sector diagnosis in Scotland. It was developed in consultation with practising psychiatrists, the Royal College of Psychiatrists, the Royal College of General Practitioners and people with ADHD, and it is the document the Scottish Government itself cites when asked about ADHD shared care — most recently in a 2025 freedom of information response (FOI 202500484282).

Crucially, the guidance does not tell GPs to refuse. It states plainly that “where indicated, General Practitioners may be asked to prescribe medicines for ADHD”. Because the prescriber carries the clinical risk of any prescription, it asks GPs to assure themselves that the diagnosis, the pre-treatment checks and the long-term monitoring were — and will continue to be — carried out in line with national or local guidance. And it confirms that “GPs may elect not to prescribe when they feel that assessment or ongoing management is not adequate”.

The guidance is also candid about why GPs are sometimes cautious, describing “variability and unpredictability” in private practice. Some providers assess but never prescribe. Some let patients believe the NHS will automatically take over once a diagnosis is made. Some assessments look only for ADHD, so conditions that might better explain the picture risk being missed. A GP handed a thin report, with no monitoring plan and no way of verifying how the diagnosis was reached, is being asked to carry prescribing risk with nothing to stand on. Read in that light, GP caution is not obstruction — it is patients being protected from poor-quality assessment.

The quality bar: what GPs are told to look for

NAIT lists the considerations an NHS clinician should weigh when deciding whether a private assessment was robust. They double as a useful checklist for choosing a provider in the first place — questions worth asking anyone, including us, before you spend any money:

• Was the diagnosis made in line with national guidelines, drawing on collateral information from someone who knows you and evidence of childhood presentation — school records, family accounts or similar?
• Was a full medical and psychiatric history taken, with co-occurring conditions — including mental health difficulties and substance use — genuinely considered rather than screened past?
• Were your cardiac and family medical history reviewed before treatment, with an ECG where indicated, and your current medication checked for interactions?
• Is it clear who will carry out long-term monitoring, what it will cost you over time, and who holds responsibility for spotting misuse or diversion of any stimulant medication?
• Will your GP receive a report detailed enough to review the assessment against NHS standards?

If a provider cannot answer these questions clearly before you book, the risk is not simply that your GP declines shared care later — it is that the national guidance positively directs them to. Our quality standards page sets out how each of these points is handled at Caledonian Psychiatry.

Shared care is voluntary — and varies by area

A shared care agreement is a formal arrangement between a patient, their GP and a specialist service, under which prescribing passes to the GP while the specialist continues regular reviews and remains available for advice. The NAIT guidance is blunt about entitlement: “a recommendation from a private specialist for a particular medicine does not entitle the patient to NHS prescriptions for that medicine”.

There is no national NHS Scotland policy requiring a GP to enter shared care, and positions differ between health boards and between individual practices — variation the Scottish Government’s 2025 freedom of information response and its released correspondence make clear. What consistently improves the odds is the quality of the paperwork: a thorough, NICE-aligned report gives a GP the evidence base the guidance asks them to look for. Our shared care page describes the whole process, including the honest parts about what cannot be promised.

What Caledonian Psychiatry sends — and says up front

The guidance sets expectations of private providers too: robust paperwork the NHS team can review, honesty with patients before assessment about prescribing arrangements and the absence of any guarantee, clarity about the treatments on offer, and evidence of ongoing monitoring with named clinical responsibilities.

This page is part of meeting that standard. Caledonian Psychiatry does not promise that any individual GP will agree to shared care — no honest provider can. What it does instead is build every assessment so that the NAIT considerations are answered before a GP ever needs to ask: a two-session, NICE-aligned assessment with developmental and collateral history; pre-treatment physical health baselines; a detailed written report your GP can review against NHS standards; and ongoing specialist review for as long as prescribing continues, with clinic letters copied to your GP from the start.

Sample document

Shared care application: prescribing agreement

This is an example of the shared care application we send to your GP once you have been stabilised on medication. You do not need to send this yourself.

And if your GP still declines? Prescribing simply continues privately at £25–£30 per prescription plus the pharmacy cost of the medicine — the medication cost guide sets out typical monthly figures. A declined request can also be revisited: after a period of stable treatment, with a further letter addressing the specific concerns raised, or with a new practice if you move. Nobody who is assessed here is left without a route forward.

Booking an assessment built to clear the bar

Caledonian Psychiatry is regulated by Healthcare Improvement Scotland (reg. no. 03427) and provides remote assessments to adults across Scotland and the wider UK. Assessments are carried out by Dr David Crocker, a psychiatrist (MRCPsych) experienced in adult ADHD, autism and general psychiatric assessment.

No referral is required — you can book directly. A private ADHD assessment is £800 across two 60-minute consultations, including the written report described above. The fees page lists the full schedule, and our guide to private ADHD assessment in Scotland covers what to expect step by step.