At ADHD Direct, we fully acknowledge and respect that the General Medical Services (GMS) contract does not place a contractual obligation on General Practitioners (GPs) to work directly with independent or private healthcare providers.
We also recognise the significant workload pressures that primary care teams face.
Currently, the prescribing of ADHD medication in the community falls almost exclusively to GPs, with limited development of alternative NHS services to support this demand.
We are aware that there are many other qualified prescribers—such as pharmacists and nurse prescribers—yet there is an unfortunate lack of momentum to develop prescribing services within the NHS that would alleviate the burden currently placed solely on GPs.
A Patient-Centred Perspective
From a patient care perspective, it is essential to acknowledge the broader challenges that individuals with ADHD face in accessing timely, appropriate care. ADHD is associated with increased risks of morbidity and early mortality.
It often coexists with psychiatric conditions such as depression and substance misuse and is linked to risky behaviours, accidents, and chronic illness. Poor educational attainment and increased contact with the criminal justice system further compound these adverse outcomes.
In our view, ADHD is a significant public health issue.
As a hidden disability, it frequently goes unmanaged, with both professionals and the public underestimating its severity.
Early recognition, consistent support, and sustained intervention are critical to reducing its long-term impact on individuals and society.
The evidence base for early diagnosis and treatment is irrefutable.
A National Crisis in ADHD Care
Across the UK, thousands of children and adults with ADHD are facing unacceptable delays in accessing assessment and treatment through NHS services.
In some areas, waiting times for an initial assessment exceed five years, with further delays to treatment even after a diagnosis has been confirmed. In several regions, adult ADHD services have been suspended altogether, leaving patients without a clear care pathway.
This has created a situation in which patients are falling through the gaps—left to manage debilitating symptoms without adequate support.
Given that ADHD is recognised as a disability under the Equality Act 2010, the lack of accessible services raises critical questions about how we support and protect this population.
A Call for Compassionate, Collaborative Practice
While the GMS contract does not legally require GP collaboration with private providers, as doctors, we hold an ethical duty of care. This includes the principle of “first, do no harm”, which encompasses not only avoiding direct harm but also preventing foreseeable deterioration through inaction.
“Make the care of your patient your first concern.”
(General Medical Council (GMC), 2024. Good medical practice. London: General Medical Council. p.1)
Our Commitment to Quality and Accountability
ADHD Direct is fully regulated by Healthcare Improvement Scotland (HIS), ensuring that our services meet high standards of safety, governance, and clinical effectiveness. Our assessments and treatment pathways are delivered by experienced, qualified professionals with specialised expertise in ADHD.
We provide:
- Comprehensive diagnostic documentation
- Transparent titration and treatment protocols
- Reports designed for shared care agreements
- Responsive communication with GPs and other healthcare professionals
- A whole of life service including Patient and public education , outreach and Patient support groups
We believe that GPs should have full confidence in the quality of care provided by services regulated by HIS or equivalent UK regulators, such as the Care Quality Commission (CQC).
We also strongly advocate for a tiered approach to private ADHD assessments.
ADHD Direct offers a full pathways of care—including diagnosis, prescribing, and follow-up
The Patient Experience and Ethical Responsibility
Patients often turn to private care out of necessity, not preference.
Many are left with no choice but to spend upwards of £150 -£220 a month to obtain medication that enables them to function in daily life, support their mental health sustain employment, or succeed in education.
Without shared care agreements, this treatment becomes unaffordable or inaccessible, increasing inequality and contributing to worsening mental health outcomes.
It is nothing short of a profound failure of our country’s healthcare system when individuals are forced to make the heart-wrenching decision to stop treatment—not because it isn’t working, but because they simply cannot afford it.
These are not luxury treatments or elective options—they are life-changing, often life-saving interventions that allow people with ADHD to function, to thrive, to hold jobs, pursue education, care for their families, and live with dignity.
Imagine knowing that there is something out there—something proven, something within reach—that could ease the chaos in your mind, help you focus, lift the weight of constant struggle… and still having to walk away from it. Not because it doesn’t exist, but because the system that is meant to support you has turned away.
This is the painful reality for far too many people in the UK right now.
We have created a system where ability to pay dictates access to basic mental healthcare.
We have left behind those who are already vulnerable, asking them to choose between managing their condition or paying rent, feeding their children, or simply surviving. It is unjust, it is inhumane, and it should not continue.
No one should have to live with the knowledge that help exists—but that it’s behind a paywall they will never be able to climb.
Finally….
While GP practices are not legally required to enter shared care arrangements with private providers, we urge NHS colleagues and the Scottish Health Department to consider the wider ethical, clinical, and legal responsibilities—especially at a time of limited NHS capacity.
Where private services, such as ours, are independently regulated and staffed by qualified professionals, shared care can be both safe and appropriate, ensuring that no patient is left behind.
There is no justifiable reason, in today’s NHS, for the burden of prescribing to rest solely on the shoulders of GPs—especially when multidisciplinary teams are already in place, full of skilled professionals more than capable of sharing that responsibility.
But what is most heartbreaking is that, while professionals debate roles, contracts, and responsibilities, the patient is the one caught in the crossfire.
They have no say in these decisions, no power to influence the system that governs their care.
They are already doing everything they can just to stay afloat—managing symptoms, battling stigma, navigating a world that often misunderstands them. And yet, even when they finally find the courage to seek help, they’re told the system can’t help them because of red tape.
It sends a devastating message: if you have ADHD, your life will be different—not just at school, not just at work, but even in healthcare, where compassion and support should be a given. Instead of a lifeline, the system becomes another barrier. And that is not just wrong. It is profoundly unjust.
It is the responsibility of the NHS to ensure fair and consistent care for all patients diagnosed with ADHD. At present, this is not happening, and it is not acceptable.
ADHD Direct remains committed to collaborative, transparent, and regulated care.
We welcome open communication with all healthcare professionals to ensure patients receive the support they deserve; and for those Primary care Clinician who are happy to provide shared care we are happy to work with you.