Guide
Can my GP refuse shared care for ADHD medication?
Yes. Shared care prescribing in the NHS is voluntary. The British Medical Association describes it as a voluntary, non-core activity that a practice can decline, and there is no contractual requirement for a GP to enter a shared care agreement, including with a private ADHD provider. If shared care is declined, prescribing and monitoring stay with the service that started the medication, which usually means continuing to pay for private prescriptions. This is information, not medical advice.
Information only, not medical advice and not a diagnosis. Never start, stop or change prescription medication without advice from your prescriber. Speak to your GP about your own situation.
What shared care means
Shared care is an arrangement where a specialist starts and stabilises a medication, then a GP takes over routine prescribing and monitoring under an agreed protocol. For ADHD this often comes up after a private or NHS Right to Choose assessment and titration, when the question becomes who prescribes long term. A shared care agreement can move that to NHS prescriptions, but it has to be agreed by the GP first.
Why it can be declined
The British Medical Association is clear that all shared care arrangements in the NHS are voluntary and can be declined if a practice does not feel it is safe or manageable. There is no contractual obligation to take on prescribing started elsewhere. Practices weigh factors such as:
- Clinical governance and responsibility for the medication.
- Capacity to carry out the monitoring a shared care protocol requires.
- Local commissioning policy, which varies between areas.
What happens if your GP says no
If a practice declines shared care, the BMA position is that responsibility for ongoing prescribing remains with the initiating provider. In practice that often means continuing to pay private prescription and review fees, which can be the largest long-term cost of going private. It is worth asking your private provider and your GP how this would work before you commit, and checking any local ADHD shared care policy. Our do you need to pay tool and the NHS vs private guide set out the routes and their costs.
Sources: British Medical Association, Principles for shared care prescribing; General Medical Council, prescribing guidance. Last reviewed June 2026.
Frequently asked questions
Is a GP obliged to agree shared care?
No. The British Medical Association describes shared care prescribing as a voluntary, non-core activity that a practice can decline. There is no contractual requirement for a GP to enter a shared care agreement, including with a private ADHD provider.
What happens to my prescription if shared care is declined?
If a practice declines shared care, responsibility for ongoing prescribing and monitoring stays with the service that started the medication, which may be your private provider or the specialist. That usually means continuing private prescription and review costs. Ask both sides how it would work before you commit.
Why might a GP say no?
Practices may decline on grounds such as clinical governance, monitoring capacity, or local commissioning policy. The BMA position is that the decision rests with the individual GP or practice and that it must be safe and manageable for them. This is general information, not medical advice.
Editor, ADHD Helper
Adam leads ADHD Helper's editorial coverage of adult ADHD, and he writes it from lived experience: Adam has ADHD himself, diagnosed as an adult, and has been through the assessment routes and the daily workarounds this site covers. He is the founder and managing director of Muswell Rose and researches the plain-English explainers on getting an ADHD assessment through NHS Right to Choose or privately, and on the products and tools people use to manage ADHD, drawing on guidance from the NHS, NICE and the Royal College of Psychiatrists. He is clear that the site is information, not medical advice, and that diagnosis is for a registered clinician.
Last reviewed: 27 June 2026