What if your GP declines shared care

One ICB states Right to Choose covers ongoing prescriptions when a practice declines. NHS England's final ADHD Taskforce report says many shared care arrangements are no longer in place, so plan for both answers.

The short version

NHS South West London ICB states that Right to Choose covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol.
That coverage includes first prescriptions used to help stabilise medication.
NHS West and North London ICB warns that the NHS may not pay for private prescription costs.
You still pay the ordinary English prescription charge at the counter unless you are exempt.
NHS England's final ADHD Taskforce report records shared care arrangements failing nationally, with a Right to Choose case study where a refusal delayed medication.

This is the question that decides whether a diagnosis turns into treatment, and the answer depends entirely on which route produced the diagnosis. It is worth knowing which answer applies to you before the situation arises.

On the Right to Choose pathway

NHS South West London ICB is specific. The cost of any ADHD prescriptions, from both NHS and private organisations, will be covered by Right to Choose. This includes first prescriptions to help stabilise medication. It also covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol.

In that board's area, the stated effect of a refusal is on who pays and who writes the prescription rather than on whether a prescription exists. That is one board's published position about its own area. Boards differ, and no national rule was found that settles it, so the first thing to establish is what your own board has published.

The precondition is that the provider prescribes at all. The same ICB warns that not all Right to Choose providers can start medicine or prescribe it, and that some only offer an assessment or diagnosis. A provider that does not prescribe cannot fall back on this.

What the national picture looks like

NHS England published the final report of the independent ADHD Taskforce in November 2025. It says shared care protocols for ADHD have been available for many years but these have become more problematic in recent years with many arrangements no longer in place, and it lists the reasons given, including time, training, capacity and remuneration, and concerns about the quality of ADHD diagnosis from some providers.

The same report carries a case study of a woman in her forties who was assessed through Right to Choose, responded well to medication and then found that her practice had not agreed to shared care. The report says that resulted in long delays in her getting access to ADHD medication. Its own summary line for that case is that a failure of shared care means she cannot access treatment despite a good response to ADHD medication.

So one board states the cost is covered, and the national body states the arrangement frequently fails. Both are true at once, and the second is the reason to ask your practice early rather than to assume the first applies to you.

On a wholly private route

NHS West and North London ICB raises it among the careful considerations to be made about follow-up care: ongoing responsibility for the costs of any medication and prescribing, because the NHS may not pay for private prescription costs.

A declined shared care agreement there leaves you paying for prescriptions privately, indefinitely, or joining an NHS waiting list to be reassessed. The same ICB material notes that transferring into NHS care generally means joining at the beginning of the waiting list and that a new assessment may be required.

What you still pay either way

The counter charge is unaffected by who writes the prescription. The National Health Service sets a single prescription charge of £9.90 per item in England, checked on 15 September 2026, and a 12-month prepayment certificate costs £114.50.

What to do now

Ask your practice whether it enters shared care agreements for ADHD medication, and ask your chosen provider what it does if the practice declines. Two questions, both answerable before a referral is sent.

If you have already been diagnosed and are stuck, the useful facts to put in front of your provider are that at least one ICB states Right to Choose covers ongoing prescriptions where shared care is declined, and that your practice has declined. Check whether your own board has published the same position, because that is the part that varies.

Questions people ask about this

Who prescribes my ADHD medication if my GP refuses shared care?

NHS South West London ICB states that Right to Choose covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol, including first prescriptions used to stabilise medication, so in that ICB's area the specialist provider keeps prescribing. Two things decide whether that reaches you: whether your own board takes the same position, since boards differ and no national rule was found that settles it, and whether the provider prescribes at all, since some only assess.

Will the NHS pay for private ADHD prescriptions?

NHS West and North London ICB warns that the NHS may not pay for private prescription costs, and raises ongoing responsibility for medication and prescribing as a careful consideration about the private route. That is a different position from the Right to Choose pathway, where an ICB states ongoing prescriptions are covered even if shared care is declined.