Frequently Asked Questions

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Firstly you will need to have been diagnosed with ADHD. This may have been done by the team at Clearly Focused, or externally. If you have been assessed externally we will need a copy of your diagnosis REPORT.

Secondly, our prescribing pharmacist will need a copy of your Summary Care Record. This is a record of all of your current medications, a list of your diagnosed medical conditions, your allergies and other information which our pharmacist might need to ensure that medication is safe for you to use, or to allow her to decide which medication will be most suitable for you. This is something which a GP receptionist should be able to print out for you, without needing an appointment.

Finally, we will need your GP practice to  perform a cardiac assessment to check your height, weight, blood pressure and pulse and listen to your heart and lungs. This is recommended by NICE before starting ADHD medications. You may also need an ECG, depending on your current health, medications  and family cardiac health history.This assessment can be done by a private GP if your practice will not help.  Once we have this information we can proceed to treatment.

  No, during treatment, our pharmacist will ask for updated weight, blood pressure and pulse before each prescription. She will also ask about any side effects that you have experienced, ensuring that none could relate to any cardiac complications. If there are any concerns it is recommended that you stop taking any stimulant medication and seek medical support. Non stimulant medication should be continued whilst seeking support, as these should not be stopped suddenly.

Yes, after an initial assessment to assess suitability. Patients who are still actively using drugs or alcohol may need to be seen by another service due to the associated risks and need for appropriate support. Issues with alcohol and drug misuse are more common within the ADHD community due to differences in brain chemistry. ADHD brains receive more positive reinforcement in the form of dopamine to these agents than a neurotypical brain. ADHD medications may have scope for misuse if not taken within prescribed limits, and this would quickly mean treatment would be discontinued by our pharmacist. The doses of stimulant used to treat ADHD are however low compared with those used recreationally and neurodivergent brains tend to find them calming as opposed to causing a ‘high’. Appropriate ADHD treatment can also lead to a reduction in drug or alcohol seeking behaviours, by balancing the chemical messengers in the brain and reducing impulsivity, making recovery easier.

Yes, after an initial assessment. Stimulant medication can be an appetite suppressant, so we closely monitor the weight of clients prescribed this medication. Anorexia Nervosa is an eating disorder associated with an intense fear of gaining weight and strict calorie restriction. Whilst some ADHD patients with severe emotional dysfunction concerns may go on to develop anorexia, research appears to indicate that ADHD patients are more susceptible to developing bulimia nervosa or binge eating disorder. They are also more susceptible to obesity and the health concerns associated with it.

Clients tend to find that when their ADHD is treated .they binge less and make healthier choices when it comes to food, as they are no longer looking for high-sugar and fat foods which increase dopamine in their brain. Elvanse, one of the ADHD stimulant medications, is also licensed in the US to treat binge eating disorder. 

All of these issues can be discussed with our pharmacist to enable you to find the best medication for you.

Since the COVID pandemic, and the increased awareness of ADHD in adults that followed, there have been issues with ADHD medication supply globally. This does not however mean that these medications are not available. Currently the drug methylphenidate is unavailable in its slow release tablet form. It is however available in its slow release capsule form. Or in its immediate effect tablets form. Before this Lisdexamfetamine was unavailable for months, but its immediate release form dexamfetamine was still readily available.

This situation is very distressing for clients, especially having found something to help symptoms which has profoundly affected them for years. Whilst we are hopeful the situation will soon improve, we continue to work flexibly and cost-effectively with clients to find the best available treatment option for them.

Shared care is traditionally an agreement between a GP, an NHSgeneralist in medical terms and a consultant, an NHS specialist.

The specialist would start a patient on a medication that may require some expert knowledge in prescribing, or considerable monitoring in the form of blood tests etc. The patient would receive these medications directly from the hospital after each hospital appointment. As the specialist is prescribing, the responsibility for patient outcomes legally and ethically is entirely on him.

Once the patient has found the medication beneficial, has had minimal side effects and all testing and monitoring has repeatedly come back normal, the specialist may send a shared care request to the patient's GP.

This request would ask the GP to provide the patient with monthly prescriptions and take over the routine monitoring, for example blood tests every three months or in the case of ADHD medication, regular checks on weight, blood pressure and pulse rate. The GP would then take over the responsibility in legal terms for the patient’s care. The specialist consultant would review the patient's progress at agreed intervals, perhaps every six or twelve months, and the GP would refer the patient straight back to the specialist service should any of the monitoring be abnormal of if the patient was having problems. Changing doses is outside the GPs range of competence and would need to be done by the specialist service.

Even between an NHS GP and and NHS specialist, the GP can refuse shared care if they do not feel comfortable prescribing the medication. They are not obliged to accept and the patient would need to keep going back to the hospital to receive their prescription.

As with the cardiac assessments discussed above ,your GP has no obligation to agree to the requests of a private clinic. Your care with us is private, so if they are following NHS guidance to the letter, they do not need to accept our requests for shared care or issue you with prescriptions for your medication under the NHS. Shared care requests are only meant to be between NHS services.

GP practices work in groups called Primary Care Networks (PCN). Sometimes a client’s practice’s PCN may have made a ruling to refuse all private shared care requests, whether this is for ADHD medication or other classically private clinic-led medications such as hormone replacement therapy or gender reassignment drugs. Somewhat frustratingly, the GP may be prescribing these same medications for patients seen by an NHS specialist service. In other places, these decisions are made higher in the infrastructure of the NHS, by the ICB who overseas GP practices for a whole region, meaning simply moving practices does not improve the chances of having a shared care request agreed.

Many GPs are however sympathetic to the needs of their patients forced to seek private treatment. Currently, 80% of Claire’s requests for shared care are accepted nationwide. We would suggest that you discuss this matter with your GP before starting your medication journey, in order to reduce the risk of a nasty surprise once you are stabilised and happy on medication.

This is always a difficult situation to be in but there are things that you can do.

We would suggest as soon as you have been diagnosed that you take your report to the GP and discuss your options. Often GP practices will accept your private diagnosis and use this to ‘queue jump’ the waiting list so that you are no longer behind those needing diagnosis and treatment, just those that require treatment from the NHS. Wait times for medication titration services can still be well over a year in most places but it is worth being in the system. It might be that you require medication as soon as possible or for a specific reason, such as pending GCSEs, A levels or university study, so waiting is not possible. Being on the NHS waiting list would enable you to consider private treatment as a necessary, short-term solution until the NHS can step in and pick up where we have left off.

Other options may be seeking out another GP practice in your area that accepts shared care from private clinics, possibly one in a different PCN to your current practice, or if you live near to a border, a different ICB.

Finally, if needed you would still be able to get monthly prescriptions from us without needing to book in for a full consultation, saving you money compared to costs whilst you were titrating doses.

Following your consultation, you will be sent a prescription form via Royal Mail. This is valid for 28 days. This needs to be taken to a pharmacy for them to dispense and costs vary greatly. Our pharmacist is mindful of the financial costs of treatment and will always recommend the most cost-effective suitable product. She does also however need to take current supply problems in to account. Some medications may cost you £25 a month, more expensive treatment regimens may cost over £150. The costs are dependent on what is prescribed and what is prescribed is dependent on your needs.

It is also worth noting that pharmacies will charge different mark ups on their medications. We have had clients quoted £80 for treatment they obtained for £20 and another quoted £136 for medications they obtained for £54 delivered. Please ask the pharmacy for the price before you agree because once they have ordered stock in specifically for you, it is unlikely they would return your prescription to you to try elsewhere.