What is "Adult ADHD"?
Although ADHD in the UK is strictly a paediatric diagnosis (and therefore only applicable to patients under 16years of age), we are now beginning to see adult patients with ADHD.
The "graduate" population are patients who were diagnosed with ADHD when they were under 16years, and have grown older. Naturally, for some patients, their problems do not stop just because they reach 16years of age.
We do occasionally see patients who are over 16years when they first get diagnosed with ADHD, despite having problems since childhood.
Adult ADHD services
In Cambridge we are lucky that the NHS psychiatry team (part of Cambridge and Peterborough NHS Foundation Trust) run an adult ADHD clinic.
However it is a very busy service. Unfortunately patients can often wait more than 6 months for their initial assessment. However it is a fantastic service, with a great deal of expertise, having looked after patients from Cambridge and its University for many years. The doctors in the ADHD clinic have worked together with local GPs for many years, and therefore been able to establish good connections and very safe patient-centred care.
In other parts of the country, the waiting time for an assessment for ADHD can be much longer.
Tablet Treatments for ADHD
The drug treatments for ADHD are stimulant drugs, related to amphetamine.
In England, these are controlled drugs and so are subject to strict prescribing regulations. It is not illegal to possess these medications provided that they have been prescribed for you. However they can only be prescribed by specialists (psychiatry). The GP can only prescribe them under a "shared care agreement" with the specialist.
We work for our local NHS (The Cambridge and Peterborough CCG) who have set up a shared care agreement with our local NHS adult ADHD clinic. The agreement is made for each individual patient, once the ADHD clinic have finished establishing the patient on the correct treatment and dose. The agreement will set out the responsibilities of the specialist, GP and the patient. For example, the patient must make sure we have 6monthly recordings of weight, height, pulse and blood pressure whilst on treatment. If the conditions of the agreement are not met, the GP cannot prescribe.
We are only able to enter into Shared Care with our local adult ADHD clinic and NOT
other NHS specialist teams elsewhere in the country
private specialists whethether or not they are in Cambridge, or work for the NHS as well
We cannot prescribe ADHD medications to adults who are not currently under the care of our local NHS adult ADHD clinic.
That unfortunately includes
- Patients who are under the care of a specialist clinic elsewhere in the UK, even if they are established on treatment
- Patients who have been prescribed ADHD medications by doctors abroad, even if they are established on treatment
- Patients who have seen ADHD specialists in the private sector, even if they are established on treatment
- Any patient who has not yet been prescribed medication by the Cambridge NHS Adult ADHD clinic, no matter how sure we are of the diagnosis
We are happy to refer anyone who we suspect may have ADHD and of course anyone who has already been diagnosed, particularly those who are already on treatment. Please contact your usual GP as soon as possible. Unfortunately we cannot prescribe until you have been seen by CPFT's Adult ADHD clinic.
Attention Deficit Disorder (ADD) and patients coming from abroad
The classification of mental health diagnoses is different in different countries.
Many countries (including the USA) recognise the term Attention Deficit Disorder (ADD), not ADHD.
ADD is not the same as ADHD, although it is very similar. Many patients who have been diagnosed with ADD abroad will meet the diagnostic criteria for ADHD in the UK.
ADD is also treated with amphetamines, which abroad may not have the same prescribing restrictions placed on them (see above).
Every year we get a significant number of new patients who are taking prescribed amphetamine medications for ADD, diagnosed abroad (often the USA). It is understandable that a patient who has been taking medication for ADD, perhaps for many years, should expect to be able to get the same medication from their NHS GP in the UK.
However we cannot prescribe for them until they are under the care of our local NHS adult ADHD clinic (see above). We are happy to refer these patients, but we can only do so after they have registered with us, which means after they move to Cambridge.
The problem is, there is a long wait to be seen by the ADHD specialist clinic.
If this is you, make sure you are prepared. You might consider bringing medication with you or having it sent to you, but you must be aware of the UK LAW surrounding amphetamines, including possession and customs issues. Unfortunately we are not able to advise on these.