What is shared care for ADHD medication?

Shared care is an NHS arrangement where, once your child’s ADHD medication is stable, their specialist hands routine prescribing and monitoring to your GP. In 2026 it stays voluntary, so GPs can decline. The specialist here means the consultant or other clinician with ADHD expertise who diagnosed your child and set the dose. Under NICE rules a GP cannot start ADHD medication, only continue it.

What shared care actually transfers

It does not start the day your child is diagnosed. Shared care begins only after titration (the dose-finding period where the specialist adjusts the medication and confirms it is working and tolerated) and after the dose has stayed stable, usually for around twelve weeks. Once that point is reached, NICE recommends the routine prescribing and monitoring pass to primary care under a formal Shared Care Protocol agreed between the specialist and the GP. In practice that means:

• Your GP issues the repeat NHS prescriptions, so you collect the medication on the usual NHS basis rather than paying a private clinic.
• Your GP does the routine physical monitoring: roughly six-monthly checks on height, weight, blood pressure and pulse.
• The specialist stays available for advice, reviews the medication when needed, and takes back any decision that falls outside the routine arrangement.

Why your GP is allowed to say no

This is the part most search results skip. Shared care is a recommendation, not a duty. NICE says prescribing should move to primary care after stabilisation, but the BMA treats shared care as a non-core, voluntary activity that a practice can decline. A GP can legitimately refuse on grounds such as not having the capacity, not feeling competent with the specific medication, or not being satisfied that ongoing specialist support is in place. If your GP declines, the duty does not vanish: the specialist who started the medication stays responsible for prescribing and monitoring it.

Whether shared care goes ahead also depends on where you live. Each area has its own shared-care protocol set by the local NHS commissioners (your integrated care board, or ICB), and individual practices set their own policies on top of that. The route to your child’s diagnosis matters too. The arrangement is the same whether the diagnosis came through the NHS, Right to Choose or a private clinic, but practices are now more likely to decline shared care for private and Right to Choose diagnoses, which is why an NHS prescription does not automatically follow.

So if you have just been told the prescription will not move to your GP, that is not a mistake or a loophole. It is the system working as designed: a GP can say no, and where they do, the specialist keeps prescribing. The practical questions are who carries on prescribing and whether you face private costs in the meantime. See why a GP might not prescribe after a private diagnosis and how to get a private ADHD diagnosis recognised by the NHS.

This page is general information, not clinical or legal advice.