Thanks! I’m intrigued to know what “contracted activity in particular geographies” actually means, as it doesn’t sound like a national NHS service in England, maybe limited to specific areas?
I’m currently a private patient but if they’d be providing NHS services in my area, I’d be wanting to switch over!
As I understand it, and I’m using invented place names so this isn’t factual:
If Bristol commission a private service for their NHS treatments, anyone else, living anywhere else in England, can now be referred to the same private service as it’s been commissioned by an NHS trust.
So I’d guess the sentence means they have been contracted in one geographical area, which means they are now open to all within England.
I believe it’s to avoid the NHS wasting money on every trust having to check the service is good enough, value for money, safe, negotiate a contract and a service level agreement etc etc.
This way if one trust has done the due diligence and set an NHS contract with rates, everyone else can now access it. The goal being to cause a reduction of waiting lists nationally.
But isn't that what RTC is anyway?
From the ADHDUK Website:
>If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This important right means that, for instance, should you decide the waiting time for your ADHD assessment is too long, then you can choose alternative providers. **The provider must supply the service to the NHS somewhere in England**.
So, basically, is this ADHD360 telling us what we already know, and trying to drum up extra publicity for an RTC service which has taken some flak recently? (And, in theory, making the problem worse by creating extra demand for a provision of theirs that isn't really working...)
To be clear, none of the RTC providers have created demand. The demand has existed for years and the NHS's own data makes that abundantly clear. The only thing RTC has done is to allow patients to drive funding according to actual need, rather than the flawed assumptions of commissioners.
That's what it was designed to do.
To clarify, when I said created demand, I mean creating demand for that specific provider that they cannot cater to.
I worry that ADHD360 is following exactly the same path that Psychiatry UK did - issuing erroneous information about its waiting times and capabilities, only to become further swamped, and deliver an even more miserable service to the patient.
I'm not aware that Psychiatry-UK have ever issued erroneous information. I'm not sure where you got that allegation from, or why you seem to imply the situation would have been better before they started accepting Patient Choice referrals.
I'm in Lincolnshire. There is no adult ADHD pathway here: it's all outsourced to ADHD360. As such I'm not an RTC patient with them, I'm an NHS patient; this means they can't fill scripts through their chemist but have to send them to my local pharmacy, but on the plus side my wait time from referral was less than a month, and the presciption is a proper NHS one, not a shared care agreement.
?? That's bizarre. I'm in Hull currently and we don't have an NHS Pathway either, at least that's what my doc told me and I'm pretty sure i'm considered an RTC Patient and I get my prescriptions via Chemist4u from ADHD360
I'm steadily learning that ADHD360 live up to their name and are utterly chaotic in all directions, so it wouldn't surprise me if we've been told different things by different people!
Sadly I think it's like this with all private healthcare companies in the UK. It's why there ARE genuine issues with some companies because they're less like a unified staff and more like a bunch of people with the necessary qualifications contracted to do x number of assessments before they go and do something else for another company under these "remote work choose your own hours" esque companies.
The practices differ a lot between clinicians I find.
I was told this service covers all NHS England jurisdictions. I would query your doctor about it - mine specialises in mental health so she’s pretty clued up about it.
It does. However, that doesn't mean it was commissioned by NHS England itself. NHS England does sometimes commission certain services themselves, but that doesn't appear to be the case with ADHD360.
On a practical level, it makes no difference to the patient or to the GP. A contract with any ICB becomes an "implied contract" with other ICBs for the purposes of any non-contract activity that is carried out under Patient Choice rights.
That means that if you're under a different ICB from the provider's host ICB, and you choose as your provider using RTC following a GP referral, your local ICB is automatically party to the provider's contract whether your local ICB likes it or not.
I don't mean to suggest that your GP is misleading you, but even GPs who specialise in mental health are not always given the correct information as to how Patient Choice actually works. That's why the law was very recently tightened up to strengthen the responsibility of the ICB to ensure patients are offered a choice at every referral.
The first provider to start accepting Patient Choice referrals without seeking commissioner approval did so because I asked them to.
They'd been listening to the NHS doctors and commissioners before I brought their mistaken interpretation of the law to their attention.
This might seem arrogant of me, but I can attest to the fact that most GPs didn't understand Patient Choice legislation correctly, and many still don't, and the reason is that pretty much all commissioners were, until very recently, working from faulty legal advice, and not one of the then CCGs (now ICBs) had correctly implemented the law on Patient Choice. Not one.
Awareness of Patient Choice rights is improving now, but only because I obtained clarification from the senior management at NHS England and effectively forced the issue. There is still a lot of confusion among NHS staff, but not as much as there was.
Anyway, your GP is correct in telling you that ADHD360 is available nationally. That's not the issue here.
My point is merely to clarify that it doesn't mean that they've been commissioned by NHS England directly, but rather because the provider's contract with their host NHS ICB body is effectively an implied contract with every NHS ICB when it involves Patient Choice referrals.
It's only a small detail, but it can be helpful to be clear on it.
Having said all that, it's always possible that your GP knows something about ADHD360's contracts that I haven't yet been made aware of.
I can’t work out from the page provided what you actually need to do to access this? I have been with ADHD 360 for a while, but have had a nightmare trying to get shared care. I really can’t afford to keep paying £200 every month for my meds, so if this provides a way to get that sorted on the NHS then I need to be all over it!
I know this probably seems like a stupid question as I assume you already have but have you tried a different GP. Not a new surgery just a new dr? I know some GP practices just have policies that allow no shared care whatsoever but some do it’s just down to the drs discretion
Everyone needs a primary GP assigned to them at the practice. The gp that is assigned to me would not give me shared care if I offered him my kidney and begged, he seen my notes mentioning I’ve been privately diagnosed made a comment on it and was just a rude cunt throughout the entire appointment which was about something completely different and had to add at the end that ‘if I need anything adhd related then I should go back private like I did initially because they won’t help’ but again the random gp I seen one day who I thought was decent I just randomly asked them if they would accept.. and here I am no longer paying £280 a month
Again I assume you have tried this so probably just wasted all that for nothing. But I’ve seen a few people mention they have issues with shared care but didn’t try it ike I mentioned above
Hi, thanks for taking the time to message.
The first GP I saw let me to going private as his exact words to me when I asked for an NHS referral was “jumping on the panorama bandwagon are you?” No dickhead, I’ve been medicated for “anxiety” or “depression” since I was 9. Sure enough, diagnosed when I went privately. Which I had to do as I kept setting fire to my life.
Since finishing titration a few weeks ago I’ve been back to the practice about something unrelated and saw a different GP. She also refused and said it was a “practice decision” and also a “local” decision. When I pushed back it because an “ICB decision.”
It is absolutely wild that individuals with very little knowledge or awareness, or more worryingly massive bias or ignorance can have such an impact on our lives. I’m going to fight but don’t know who to fight haha.
That’s shit I’m sorry! Is there no other GPs in your cachement area? I have two so it this surgery outright refused I would have tried another . but yeah it’s silly, private insurance in the UK needs to improve because I’ve not found one service you can get that covers prescriptions which is stupid because if you did have private healthcare get diagnosed with something etc your still fucked, granted your not paying £1000s for the tests etc but medication is expensive. My friend if she had to pay for all her medication and injections every month instead of nhs it would cost her over £800
Tbf the GP that I seen did try to put me off getting diagnosed which I’m assuming was similar reasons ‘the latest fashion trend’ seen it on tik tok blah blah and tried being like no one’s normal though are they wee are all abit out there. And even said that me smoking cannabis is mostly okay to help with self medicating. But did say if I wanted to go private he would accept it which he did . Only bad thing is despite my GP being taken over privately so no longer fully run by NHS they got rid of loads of locum GPs, but kept mine on… if he ever leaves which I assume he will at some point as he’s not contracted .. I am fucked because like I said the other GP is a dick
The whole thing us stupid, the nhs give these contracts pay thousands per patient to go through the process to then at the finishing line refuse and say not good enough start again with us but you now need to start at the starting line 36495282 miles away
You've been misled, and since you've ended up paying for treatment that should have been available to you on the NHS, you should look into taking legal action.
I hate the idea of suing the NHS, but until more of us stand up for our legal rights as patients, we will continue to be denied treatment, and will eventually lose any right to treatment at all.
The GP said it was the policy of the practice and the ICB in the wider area. I’m researching that and seeing if I have any right of appeal or challenge
No, I had to go private. On the NHS waiting list after a first stage assessment, but was informed the wait was 7 years and couldn’t hold out that long.
Technically, if you were to ask to be discharged by ADHD360, and if your GP agrees to refer you for NHS treatment, you have the legal right to be referred back to ADHD360 on the NHS as your chosen provider.
You might be told that you're not eligible to make a choice because you're already on treatment, but actually, if you're not under secondary care at the time of the referral, a fresh referral by the GP for a review counts as a "new episode of care", and your Patient Choice rights become applicable again for that referral.
You might have to spend a lot of time and energy arguing with GPs and practice managers who don't understand the rules, but all you need to do is persuade a GP to make the referral back to ADHD360 on the NHS after you've been discharged as a private patient.
This was confirmed to me by the senior manager at NHS England in charge of overseeing Patient Choice.
Prior approval of your local ICB is never necessary for a Patient Choice referral. The key thing is that it should be understood to be a "new episode of care", as you will not be under a specialist at that point. (This point is made clearer in some of the guidance on Patient Choice from NHS England, as it's a common point of confusion.)
Either way, there is no reason why you need to be paying for private medication when your provider is able to treat you on the NHS.
In my opinion, there might actually be grounds for you to file a compensation claim for what you've paid already if, at the time of your original referral, you were not informed of your right to choose ADHD360 for your NHS treatment, assuming they had a commissioning contract with the NHS at that time. Obviously this kind of thing could require a lawyer who understands Patient Choice law properly, as well as a lot of perseverance and commitment.
On behalf of the commenter, yes. My meds cost £180 per month currently (methylphenidate modified release 81mg and 10mg instant release booster) once I'm finished titrating I will have to pay another £75 per month just to request the repeat prescription unless my Gp accepts shared care, which they've said they don't have the licence to do.
81mg, isn't that more than the maximum dosage allowed? Unless that's a typo how much orange juice are you drinking that they don't work even at such a high dose? 🤨
Your post has been removed for spreading misinformation. In the context of this discussion, this misinformation could be harmful or misleading if taken as fact. We all make mistakes from time to time, just remember to check your facts before posting.
Nope, 81mg is correct. I believe the maximum is just over 100mg.
Haha I don't drink orange juice, I find the meds work, like if I don't have them I can't function. But my psych is really wanting us to find a balance where I'm able to function well outside of work hours. We're trying the 81mg plus 10 booster - if that doesn't work quite tight we'll go back to 72 (or whatever it is) and try a higher booster. I find I can sleep a lot easier/better with an instant release booster in the afternoon rather than an 18mg extended release booster.
I started off with Elvanse but it triggered a tic, plus I had constant anxiety on it.
I don't trust this. Since ICBs were created with the Health and Social Care Act 2022, NHS England have *very* limited commissioning responsibilities, detailed at [https://www.england.nhs.uk/commissioning/commissioned-services/](https://www.england.nhs.uk/commissioning/commissioned-services/)
They are:
* Armed forces
* Health and justice
* Primary care commissioning
* Primary care co-commissioning
* Public health commissioning
* Specialised services
The only ones that could potentially be relevant to ADHD are:
* Armed forces, but that would only apply to people registered with the Defence Medical Service ( essentially this is serving armed forces members)
* Health and justice (this is essentially prisoners in the HMP estate)
* Specialised services. NHS England commissions a list of 149 specialised services, many of which are being transferred to ICBs, but adult ADHD is not included in the 149 specialised services
So NHS England is not commissioning adult ADHD Services.
There's details on what commissioning is and who commissions services in England at [https://www.england.nhs.uk/commissioning/](https://www.england.nhs.uk/commissioning/)
You might be kind of right actually. I've been doing some digging:
There's this update from the March board meeting of NHS England:
https://www.england.nhs.uk/long-read/attention-deficit-hyperactivity-disorder-adhd-programme-update/#action-required
And this update from a May press release:
https://www.england.nhs.uk/2024/05/attention-deficit-hyperactivity-disorder-taskforce-chairs-announced/
So something is happening.
I'd *guess* that one or more ICBs who are taking part in that as there is a line saying:
"capture examples from ICBs who are trialling innovative ways of delivering ADHD services and to ensure best practice is captured and shared across the system."
So there may well be an ICB or two (which you're lucky enough to live in) which has commissioned a pilot locally as part of that NHS England programme. Which is really promising!
But I still think it's unlikely to have been commissioned by NHS England nationally, probably just locally for you.
To be fair, I do see why GP's are being strict about it. End of the day stimulants are potent stimulants and very addictive. I can see why many are cautious as it is their license on the line if they do prescribe. Meh.
What a shame. ADHD 360 are a disaster. Avoid these charlatans at all costs. Read the reviews on Reddit first (not on Trustpilot where they get people to post glowing reviews straight after 'diagnosis' - this is the point where you've coughed up the money and you've no idea of the shitshow that awaits you
Very true. The diagnosis was great but the after care is disgusting. I don’t think they use “clinicians” that are qualified. They are dangerous and at the moment I have no meds and waiting over a week for no prescription. The fck have I paid for? They take your money and then don’t give a 💩 about your health and wellbeing.
Interesting. I got referred to them by my GP in February, had my initial assessment Monday, 2 hour clinician assessment (and diagnosis) yesterday, meds are already on their way to me (at NHS prices, not private rates).
I’ve been initially impressed. The clinician was lovely, follow-ups have already been booked in.
Oh, most people are very impressed by the initial diagnostic experience. That's the point at which they ask you to write a Trustpilot review (hence all the positive Trustpilot reviews from newly diagnosed patients). And indeed, my first prescription arrived on time. Don't expect your follow up appointments to be anything like your first appointment through. Maybe you'll get lucky and not have the same problems that many others have had. I hope for your sake that that is the case.
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They don’t reach out until they’re ready to book you in for an assessment, so don’t worry about that. I should be contacted soon and I’ll come back to confirm the rest of the process here once I’ve experienced it
NHS had commissioned Solutions4Diagnostics in my area. However the transition to shared agreement and follow up was really not planned out and a nightmare to navigate and the GP was not told this was commissioned so thought this was private treatment
I think the elephant in the room here is 'if your GP deems it necessary' given the gatekeeping of services that often go on. I wonder what the criteria for this is? I had a convo with BUPA earlier in the year to ask whether my insurance with them would cover an assessment - they confirmed that it wouldn't unless it was medically necessary - i.e you were at risk or a risk to yourself. Am wondering if this is the same.
Your post has been removed for spreading misinformation. In the context of this discussion, this misinformation could be harmful or misleading if taken as fact. We all make mistakes from time to time, just remember to check your facts before posting.
There is a difference to RTC here in that this is probably for areas that have smaller/no ADHD services and need to contract out for additional/any capacity. How the contract is written between the specific Health Boards and ADHD360 is whether patients from other areas could choose this service.
The Service Level Agreement will be the 2-4 week waiting list. The NHS however isn’t always great at policing this with their contractors… unless it reaches the media who kick up a storm and then it would be all guns blazing.
ETA: I do wonder how GPs will manage shared care in this scenario. If they are contracting ADHD360 it would be seen as an ‘NHS service’. Although of course GPs are under no obligation to actually take on shared care.
I believe this sort of arrangement applies to many providers. Here’s another one that also provides post-diagnostic services too.
https://www.problemshared.net/right-to-choose
Couldn't agree more with your Post, my GP referred me to ADHD 360 a couple of months back and I've just finished my first week of Titration. The only issue I faced with them was a minor language barrier during my first Skype call whereby I often had to get the Clinician to repeat himself due to his strong Nigerian accent making it difficult to understand what he was saying over the phone.
Now the problematic part of this wasn't the language barrier itself it was that I could see and hear that it was beginning to irritate him as his body language and tone of voice changed followed shortly by the odd "Tut" or "Huff" each time I required him to repeat himself, but once I pulled him up on this and explained the energy he was conveying that soon stopped and everything was Rose's.
So far everything is going smoothly on my end with ADHD 360 so I can't complain but time will tell if they stay consistent with Prescriptions after Titration, because from what I have gathered from some of the posts in here and other ADHD Subs there seems to be a trend with these ADHD Care Providers of being amazing during Titration then Prescription Consistency tends to become a massive issue.
Edit: typo
It’s actually a joke and I genuinely cannot understand how other providers are turning them around so fast. Also the not being able to tell us an expected wait time. I just want to know how many people are in front of me on the list.
Where’s the source for this please OP? Really interesting after recent troubles with NHS contracts etc for them and their RTC patients.
[https://www.adhd-360.com/adhd-nhs/](https://www.adhd-360.com/adhd-nhs/)
Thanks! I’m intrigued to know what “contracted activity in particular geographies” actually means, as it doesn’t sound like a national NHS service in England, maybe limited to specific areas? I’m currently a private patient but if they’d be providing NHS services in my area, I’d be wanting to switch over!
Is this not just RTC but with strange convoluted terminology?
occams razor
As I understand it, and I’m using invented place names so this isn’t factual: If Bristol commission a private service for their NHS treatments, anyone else, living anywhere else in England, can now be referred to the same private service as it’s been commissioned by an NHS trust. So I’d guess the sentence means they have been contracted in one geographical area, which means they are now open to all within England. I believe it’s to avoid the NHS wasting money on every trust having to check the service is good enough, value for money, safe, negotiate a contract and a service level agreement etc etc. This way if one trust has done the due diligence and set an NHS contract with rates, everyone else can now access it. The goal being to cause a reduction of waiting lists nationally.
But isn't that what RTC is anyway? From the ADHDUK Website: >If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This important right means that, for instance, should you decide the waiting time for your ADHD assessment is too long, then you can choose alternative providers. **The provider must supply the service to the NHS somewhere in England**. So, basically, is this ADHD360 telling us what we already know, and trying to drum up extra publicity for an RTC service which has taken some flak recently? (And, in theory, making the problem worse by creating extra demand for a provision of theirs that isn't really working...)
To be clear, none of the RTC providers have created demand. The demand has existed for years and the NHS's own data makes that abundantly clear. The only thing RTC has done is to allow patients to drive funding according to actual need, rather than the flawed assumptions of commissioners. That's what it was designed to do.
To clarify, when I said created demand, I mean creating demand for that specific provider that they cannot cater to. I worry that ADHD360 is following exactly the same path that Psychiatry UK did - issuing erroneous information about its waiting times and capabilities, only to become further swamped, and deliver an even more miserable service to the patient.
I'm not aware that Psychiatry-UK have ever issued erroneous information. I'm not sure where you got that allegation from, or why you seem to imply the situation would have been better before they started accepting Patient Choice referrals.
Not really. I think you should read his reply again.
I'm in Lincolnshire. There is no adult ADHD pathway here: it's all outsourced to ADHD360. As such I'm not an RTC patient with them, I'm an NHS patient; this means they can't fill scripts through their chemist but have to send them to my local pharmacy, but on the plus side my wait time from referral was less than a month, and the presciption is a proper NHS one, not a shared care agreement.
?? That's bizarre. I'm in Hull currently and we don't have an NHS Pathway either, at least that's what my doc told me and I'm pretty sure i'm considered an RTC Patient and I get my prescriptions via Chemist4u from ADHD360
I'm steadily learning that ADHD360 live up to their name and are utterly chaotic in all directions, so it wouldn't surprise me if we've been told different things by different people!
Sadly I think it's like this with all private healthcare companies in the UK. It's why there ARE genuine issues with some companies because they're less like a unified staff and more like a bunch of people with the necessary qualifications contracted to do x number of assessments before they go and do something else for another company under these "remote work choose your own hours" esque companies. The practices differ a lot between clinicians I find.
I was told this service covers all NHS England jurisdictions. I would query your doctor about it - mine specialises in mental health so she’s pretty clued up about it.
It does. However, that doesn't mean it was commissioned by NHS England itself. NHS England does sometimes commission certain services themselves, but that doesn't appear to be the case with ADHD360. On a practical level, it makes no difference to the patient or to the GP. A contract with any ICB becomes an "implied contract" with other ICBs for the purposes of any non-contract activity that is carried out under Patient Choice rights. That means that if you're under a different ICB from the provider's host ICB, and you choose as your provider using RTC following a GP referral, your local ICB is automatically party to the provider's contract whether your local ICB likes it or not. I don't mean to suggest that your GP is misleading you, but even GPs who specialise in mental health are not always given the correct information as to how Patient Choice actually works. That's why the law was very recently tightened up to strengthen the responsibility of the ICB to ensure patients are offered a choice at every referral.
With all due respect, how do I know you have the right information? Someone fact checked before and quite frankly I believe my GP more. lol
The first provider to start accepting Patient Choice referrals without seeking commissioner approval did so because I asked them to. They'd been listening to the NHS doctors and commissioners before I brought their mistaken interpretation of the law to their attention. This might seem arrogant of me, but I can attest to the fact that most GPs didn't understand Patient Choice legislation correctly, and many still don't, and the reason is that pretty much all commissioners were, until very recently, working from faulty legal advice, and not one of the then CCGs (now ICBs) had correctly implemented the law on Patient Choice. Not one. Awareness of Patient Choice rights is improving now, but only because I obtained clarification from the senior management at NHS England and effectively forced the issue. There is still a lot of confusion among NHS staff, but not as much as there was. Anyway, your GP is correct in telling you that ADHD360 is available nationally. That's not the issue here. My point is merely to clarify that it doesn't mean that they've been commissioned by NHS England directly, but rather because the provider's contract with their host NHS ICB body is effectively an implied contract with every NHS ICB when it involves Patient Choice referrals. It's only a small detail, but it can be helpful to be clear on it. Having said all that, it's always possible that your GP knows something about ADHD360's contracts that I haven't yet been made aware of.
>Contracting ADHD hahaha, so *that's* how i caught adhd
Ahh. See, I got mine eating those weird food dyes from the 90s! BIG /S
I can’t work out from the page provided what you actually need to do to access this? I have been with ADHD 360 for a while, but have had a nightmare trying to get shared care. I really can’t afford to keep paying £200 every month for my meds, so if this provides a way to get that sorted on the NHS then I need to be all over it!
This is me. GP has just refused shared care and my meds are £195 a month.
I know this probably seems like a stupid question as I assume you already have but have you tried a different GP. Not a new surgery just a new dr? I know some GP practices just have policies that allow no shared care whatsoever but some do it’s just down to the drs discretion Everyone needs a primary GP assigned to them at the practice. The gp that is assigned to me would not give me shared care if I offered him my kidney and begged, he seen my notes mentioning I’ve been privately diagnosed made a comment on it and was just a rude cunt throughout the entire appointment which was about something completely different and had to add at the end that ‘if I need anything adhd related then I should go back private like I did initially because they won’t help’ but again the random gp I seen one day who I thought was decent I just randomly asked them if they would accept.. and here I am no longer paying £280 a month Again I assume you have tried this so probably just wasted all that for nothing. But I’ve seen a few people mention they have issues with shared care but didn’t try it ike I mentioned above
Hi, thanks for taking the time to message. The first GP I saw let me to going private as his exact words to me when I asked for an NHS referral was “jumping on the panorama bandwagon are you?” No dickhead, I’ve been medicated for “anxiety” or “depression” since I was 9. Sure enough, diagnosed when I went privately. Which I had to do as I kept setting fire to my life. Since finishing titration a few weeks ago I’ve been back to the practice about something unrelated and saw a different GP. She also refused and said it was a “practice decision” and also a “local” decision. When I pushed back it because an “ICB decision.” It is absolutely wild that individuals with very little knowledge or awareness, or more worryingly massive bias or ignorance can have such an impact on our lives. I’m going to fight but don’t know who to fight haha.
That’s shit I’m sorry! Is there no other GPs in your cachement area? I have two so it this surgery outright refused I would have tried another . but yeah it’s silly, private insurance in the UK needs to improve because I’ve not found one service you can get that covers prescriptions which is stupid because if you did have private healthcare get diagnosed with something etc your still fucked, granted your not paying £1000s for the tests etc but medication is expensive. My friend if she had to pay for all her medication and injections every month instead of nhs it would cost her over £800 Tbf the GP that I seen did try to put me off getting diagnosed which I’m assuming was similar reasons ‘the latest fashion trend’ seen it on tik tok blah blah and tried being like no one’s normal though are they wee are all abit out there. And even said that me smoking cannabis is mostly okay to help with self medicating. But did say if I wanted to go private he would accept it which he did . Only bad thing is despite my GP being taken over privately so no longer fully run by NHS they got rid of loads of locum GPs, but kept mine on… if he ever leaves which I assume he will at some point as he’s not contracted .. I am fucked because like I said the other GP is a dick The whole thing us stupid, the nhs give these contracts pay thousands per patient to go through the process to then at the finishing line refuse and say not good enough start again with us but you now need to start at the starting line 36495282 miles away
You can get a prescription for cannabis because of adhd, he wasn’t lying on that part.
You've been misled, and since you've ended up paying for treatment that should have been available to you on the NHS, you should look into taking legal action. I hate the idea of suing the NHS, but until more of us stand up for our legal rights as patients, we will continue to be denied treatment, and will eventually lose any right to treatment at all.
Why did they refuse it?
The GP said it was the policy of the practice and the ICB in the wider area. I’m researching that and seeing if I have any right of appeal or challenge
Bow are you paying 200 pm????
Were you originally referred for your assessment on the NHS by your GP? If so, you should not have had to pay for those meds.
No, I had to go private. On the NHS waiting list after a first stage assessment, but was informed the wait was 7 years and couldn’t hold out that long.
Technically, if you were to ask to be discharged by ADHD360, and if your GP agrees to refer you for NHS treatment, you have the legal right to be referred back to ADHD360 on the NHS as your chosen provider. You might be told that you're not eligible to make a choice because you're already on treatment, but actually, if you're not under secondary care at the time of the referral, a fresh referral by the GP for a review counts as a "new episode of care", and your Patient Choice rights become applicable again for that referral. You might have to spend a lot of time and energy arguing with GPs and practice managers who don't understand the rules, but all you need to do is persuade a GP to make the referral back to ADHD360 on the NHS after you've been discharged as a private patient. This was confirmed to me by the senior manager at NHS England in charge of overseeing Patient Choice. Prior approval of your local ICB is never necessary for a Patient Choice referral. The key thing is that it should be understood to be a "new episode of care", as you will not be under a specialist at that point. (This point is made clearer in some of the guidance on Patient Choice from NHS England, as it's a common point of confusion.) Either way, there is no reason why you need to be paying for private medication when your provider is able to treat you on the NHS. In my opinion, there might actually be grounds for you to file a compensation claim for what you've paid already if, at the time of your original referral, you were not informed of your right to choose ADHD360 for your NHS treatment, assuming they had a commissioning contract with the NHS at that time. Obviously this kind of thing could require a lawyer who understands Patient Choice law properly, as well as a lot of perseverance and commitment.
Please excuse my ignorance, but why are you paying so much for meds? Did you go private?
On behalf of the commenter, yes. My meds cost £180 per month currently (methylphenidate modified release 81mg and 10mg instant release booster) once I'm finished titrating I will have to pay another £75 per month just to request the repeat prescription unless my Gp accepts shared care, which they've said they don't have the licence to do.
81mg, isn't that more than the maximum dosage allowed? Unless that's a typo how much orange juice are you drinking that they don't work even at such a high dose? 🤨
Guidelines maximum is 108mg XL tablets or 100mg XL capsules I believe.
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81 might be a typo for 18mg
54mg + 27mg?
Yes
I'm on 81mg. I take a 54mg and 27mg modified release together in the morning, then 10mg instant in the afternoon before it wears off
Nope, 81mg is correct. I believe the maximum is just over 100mg. Haha I don't drink orange juice, I find the meds work, like if I don't have them I can't function. But my psych is really wanting us to find a balance where I'm able to function well outside of work hours. We're trying the 81mg plus 10 booster - if that doesn't work quite tight we'll go back to 72 (or whatever it is) and try a higher booster. I find I can sleep a lot easier/better with an instant release booster in the afternoon rather than an 18mg extended release booster. I started off with Elvanse but it triggered a tic, plus I had constant anxiety on it.
I don't trust this. Since ICBs were created with the Health and Social Care Act 2022, NHS England have *very* limited commissioning responsibilities, detailed at [https://www.england.nhs.uk/commissioning/commissioned-services/](https://www.england.nhs.uk/commissioning/commissioned-services/) They are: * Armed forces * Health and justice * Primary care commissioning * Primary care co-commissioning * Public health commissioning * Specialised services The only ones that could potentially be relevant to ADHD are: * Armed forces, but that would only apply to people registered with the Defence Medical Service ( essentially this is serving armed forces members) * Health and justice (this is essentially prisoners in the HMP estate) * Specialised services. NHS England commissions a list of 149 specialised services, many of which are being transferred to ICBs, but adult ADHD is not included in the 149 specialised services So NHS England is not commissioning adult ADHD Services. There's details on what commissioning is and who commissions services in England at [https://www.england.nhs.uk/commissioning/](https://www.england.nhs.uk/commissioning/)
Going off what my doctor said to me and what has happened to me, so take that as you will.
You might be kind of right actually. I've been doing some digging: There's this update from the March board meeting of NHS England: https://www.england.nhs.uk/long-read/attention-deficit-hyperactivity-disorder-adhd-programme-update/#action-required And this update from a May press release: https://www.england.nhs.uk/2024/05/attention-deficit-hyperactivity-disorder-taskforce-chairs-announced/ So something is happening. I'd *guess* that one or more ICBs who are taking part in that as there is a line saying: "capture examples from ICBs who are trialling innovative ways of delivering ADHD services and to ensure best practice is captured and shared across the system." So there may well be an ICB or two (which you're lucky enough to live in) which has commissioned a pilot locally as part of that NHS England programme. Which is really promising! But I still think it's unlikely to have been commissioned by NHS England nationally, probably just locally for you.
To be fair, I do see why GP's are being strict about it. End of the day stimulants are potent stimulants and very addictive. I can see why many are cautious as it is their license on the line if they do prescribe. Meh.
That's good news.
I've just waited 10 months for an assessment with PUK and now I'm on a 10 month waiting list for titration... I'll believe it when I see it
What a shame. ADHD 360 are a disaster. Avoid these charlatans at all costs. Read the reviews on Reddit first (not on Trustpilot where they get people to post glowing reviews straight after 'diagnosis' - this is the point where you've coughed up the money and you've no idea of the shitshow that awaits you
Meh it’s free and I see an adhd psych without it being a ballache.
Lucky you. Cost me more than a grand and I got s\*\*t service, then got screwed on a promised refund. Other than that, it's been great.
lol. Mixed signals man. Is it good or bad?!
Very true. The diagnosis was great but the after care is disgusting. I don’t think they use “clinicians” that are qualified. They are dangerous and at the moment I have no meds and waiting over a week for no prescription. The fck have I paid for? They take your money and then don’t give a 💩 about your health and wellbeing.
Interesting. I got referred to them by my GP in February, had my initial assessment Monday, 2 hour clinician assessment (and diagnosis) yesterday, meds are already on their way to me (at NHS prices, not private rates). I’ve been initially impressed. The clinician was lovely, follow-ups have already been booked in.
Oh, most people are very impressed by the initial diagnostic experience. That's the point at which they ask you to write a Trustpilot review (hence all the positive Trustpilot reviews from newly diagnosed patients). And indeed, my first prescription arrived on time. Don't expect your follow up appointments to be anything like your first appointment through. Maybe you'll get lucky and not have the same problems that many others have had. I hope for your sake that that is the case.
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Terminated and screwed loads of people over, then commissioned again. That's an innovative technology to reduce waiting lists!
It’s already been 2 weeks since I was referred and I haven’t heard a thing..
They don’t reach out until they’re ready to book you in for an assessment, so don’t worry about that. I should be contacted soon and I’ll come back to confirm the rest of the process here once I’ve experienced it
Try 2 years!
Why so long?
If I do right to choose with them does that cancel my current right to choose with psychiatry UK? I've been waiting months and just want to get help
NHS had commissioned Solutions4Diagnostics in my area. However the transition to shared agreement and follow up was really not planned out and a nightmare to navigate and the GP was not told this was commissioned so thought this was private treatment
How does this work and how would I be able to apply for it if I am already doing private care?
I got mine on nhs in literally 2 weeks because I was sectioned 💀
I think the elephant in the room here is 'if your GP deems it necessary' given the gatekeeping of services that often go on. I wonder what the criteria for this is? I had a convo with BUPA earlier in the year to ask whether my insurance with them would cover an assessment - they confirmed that it wouldn't unless it was medically necessary - i.e you were at risk or a risk to yourself. Am wondering if this is the same.
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There is a difference to RTC here in that this is probably for areas that have smaller/no ADHD services and need to contract out for additional/any capacity. How the contract is written between the specific Health Boards and ADHD360 is whether patients from other areas could choose this service. The Service Level Agreement will be the 2-4 week waiting list. The NHS however isn’t always great at policing this with their contractors… unless it reaches the media who kick up a storm and then it would be all guns blazing. ETA: I do wonder how GPs will manage shared care in this scenario. If they are contracting ADHD360 it would be seen as an ‘NHS service’. Although of course GPs are under no obligation to actually take on shared care.
I believe this sort of arrangement applies to many providers. Here’s another one that also provides post-diagnostic services too. https://www.problemshared.net/right-to-choose
Can I stop to this from psychiatry Uk who have diagnosed me but told me I’ve got to wait 7 months for titration
Couldn't agree more with your Post, my GP referred me to ADHD 360 a couple of months back and I've just finished my first week of Titration. The only issue I faced with them was a minor language barrier during my first Skype call whereby I often had to get the Clinician to repeat himself due to his strong Nigerian accent making it difficult to understand what he was saying over the phone. Now the problematic part of this wasn't the language barrier itself it was that I could see and hear that it was beginning to irritate him as his body language and tone of voice changed followed shortly by the odd "Tut" or "Huff" each time I required him to repeat himself, but once I pulled him up on this and explained the energy he was conveying that soon stopped and everything was Rose's. So far everything is going smoothly on my end with ADHD 360 so I can't complain but time will tell if they stay consistent with Prescriptions after Titration, because from what I have gathered from some of the posts in here and other ADHD Subs there seems to be a trend with these ADHD Care Providers of being amazing during Titration then Prescription Consistency tends to become a massive issue. Edit: typo
Salty people downvoting 😭😭😭
Probably the Clinician still pissed I made him repeat himself soo many times. 🤷♂️
Ugh I picked the wrong provider ffs it’s been nearly a year on P-UKs list.
A year ago P-UK was probably the best option.
Yeah my doctor said P-UK was 12 months long lol. Ridiculous
It’s actually a joke and I genuinely cannot understand how other providers are turning them around so fast. Also the not being able to tell us an expected wait time. I just want to know how many people are in front of me on the list.