From what age is an adult referral?

Adult referrals are from 16 years and above.

Can I be referred to a service in Derby?

ASD

Adults from 18 years old who are suspected of having autism, do not have a learning disability and have given their consent, can be seen in Derbyshire by the ASD service. Unfortunately, the wait time to be seen by this team is a couple of years and you will need to complete an AQ-50 form and referral form.

The service covers the whole of Derbyshire. For more information about this service please see their leaflet Once you have completed their AQ-50 form , you can either contact them directly on 0300 1234574 or contact the surgery to arrange an appointment with the GP.

ADHD

Adults who suspect they may have ADHD unfortunately cannot be seen in Derbyshire as there is no service commissioned by the ICB. The ICB have a contract with Sheffield Neurodevelopment service to see our patients for an assessment/review. Unfortunately the wait for this service is around 3-5 years, and we can refer patients from 17+.

For more information about this service please visit Sheffield Adult Autism and Neurodevelopmental Service To be referred to this service please email overdale.reception@nhs.net detailing the reason you believe you have ADHD and the impact this is having on your life.

Please can you also confirm that you had these symptoms prior to the age of 12, and detail if you have any mental health difficulties / drug or alcohol problems.

If you are under the age of 25 you may benefit from attending a neurodivergence hub. You do not need a formal diagnosis to access this support. Please follow this link for more information. Derby & Derbyshire – Emotional Health & Wellbeing

Is there an alternative with shorter wait times?

Patients also have the ‘right to choose’ to go to another provider for ASD / ADHD diagnosis. These providers often offer a remote service and often have shorter wait times. Before being referred you will need to decide which provider/clinic you would like to be referred to. This is called ‘Your right to choose’

If you are based in England you now have the legal right to choose your mental healthcare provider and your choice of mental healthcare team, this includes for referrals relating to Autism or ADHD assessments. This right means that, you will need to research via the internet what service you would like to be referred to and where within England this service is. You may choose an alternative provider that has a shorter wait times or it may be more convenient for you and your family.

This service is offered through the NHS and is free, however if you would like to have medication prescribed following your referral then please ensure you read the information below.

What providers offer Right to Choose Assessments?

There are a number of clinics throughout the UK that can offer Right to Choose ADHD and/or ASD assessments. To become a Right to Choose provider, the clinic must supply the same service to the NHS somewhere in England, they cannot be a private only clinic. The list of providers is constantly changing. The website Right to Choose – ADHD UK has a lot of information regarding providers, but there will be others, and we would recommend that you contact them to find out the most up to date wait times. The providers website is usually a good place to start to find out if they offer the service you need.

Who completes the referral?

You, the patient, will need to complete an assessment form. This can be overwhelming and you may find it helpful to ask a family member or friend to support you with this.

What happens when you have chosen the provider/clinic?

Each provider/clinic will have their own questionnaire and/or referral form. These forms will be on their website, and you should be able to download and send directly to them.

If you are not able to print and complete the referral please contact the surgery to let us know which services you would like to be referred to and one of our secretaries will be able to assist you with this.

The practice is unable to advise you on which service you should be referred to.

Process for requesting a Right to Choose referral from your GP

If you are sure that you want this referral then you can submit the appropriate forms to our secretaries via email at ddicb.overdalesecretaries@nhs.net and we will organise this.

If you are over 18 and would like more support in understanding this diagnosis and the difficulties that you are facing then you can book an appointment with our mental health practitioner, Lisa Kenny, or our social prescribing team can help support you navigate this process (although they cannot advise you about where to attend).

Before you are referred you need to sign a prescribing disclaimer, click for attached document.

Things to consider about Right to Choose

Waiting times:

These can differ between each provider and will often depend on whether the provider is able to offer medication, should you need it. A general guide for Right to Choose referrals is that assessments can be in as little as 12 weeks and as long as 12 months, which is much quicker than the NHS alternatives.

Medication:

The biggest difficulty faced by patients who are referred via right to choose, is accessing medication for their condition, if you so wish.

It is important to note that many of the clinics can offer diagnosis but may not offer medication tritration. If they do offer this, then we may not be able to prescribe your medication, and even if we can you will need to remain under the clinic for us to be able to prescribe.

Please note that we cannot refer to our NHS Services for this medication, following a referral under ‘right to choose’ as they are not commissioned to do this.

As you proceed with the ADHD assessment, the responsibility for the initial prescribing of medication, any assessments needed prior to the decision to prescribe, and the monitoring and prescribing during the titration period until you are stable on your medication, all fall under the responsibility of the provider conducting the assessment. This includes any follow-up appointments, adjustments to medication dosage and relevant monitoring tests during that time.

It is crucial to note that these services are not covered by the practice. Therefore, your GP will not be responsible for prescribing ADHD medication or overseeing the associated monitoring until you are stabilized on medication, whether you are seeing a specialist under the NHS Right to Choose or if you are privately funding your assessment.

At the point of being stable on medication, if the provider, whether an NHS or Private provider, wishes to enter into a Shared Care Agreement with your GP Practice, then it may be possible for the practice to take on the prescribing. Under this agreement, you will need to continue with regular reviews with the ADHD clinic, and only if this is continuing will the GP Practice agree to provide prescriptions. We do this because the prescribing of ADHD is beyond the clinical scope of General Practice, and we need to know that your specialist is overseeing your treatment. We will only agree to take on the prescribing if the Shared Care Agreement is equivalent to the agreement that we have with our usual NHS providers.

Please be aware that if you are under the care of a Private Provider, this will mean that you will need to continue to pay for follow up appointments with the specialist overseeing your care, for the duration of the time that you are on medication or until you transfer to NHS services.

If you choose to be referred to a clinic that only provides assessments for ADHD and not prescriptions, then unfortunately we are unable to provide prescriptions for you on their behalf.

Locality and assessments:

Under the Right to Choose you can chose a provider anywhere within England. Some services do insists on a face to face assessments where others only require a phone/video consultation.

Why would I choose a Right to Choose referral if I cannot easily obtain medication at the clinic that way?

Many patients feel a diagnosis would be enough to request further support / considerations from school or employers and some patients may not require medication for these conditions at all

When can you not use Right to Choose?

There are some restrictions on which patients are eligible for a Right to Choose assessment and the below is a list of the reasons you would not be eligible (please note some of these are not relevant to children):

· You need urgent or emergency treatment – this is often not relevant as there are rarely times when this type of referral is considered urgent, but is still worth noting here

· You already receive care and treatment for the condition you are seeking an assessment for

· The organisation or clinical team you’ve chosen does not provide the right care for the condition or for your age group

· You are a prisoner or on temporary release from prison

· You are detained in prescribed accommodation such as a court, secure training centre, immigration removal centre or young offender’s institute

· You are detained in a secure hospital setting

· You are detained under the Mental Health Act 1983 (as amended in 2007)

· You are a serving member of the armed forces

What happens after I have sent the referral?

If you have sent the referral direct to your provider you should hear back directly from them.

If the GP practice have sent your referral to your chosen provider, there is no need for you to have a GP appointment. You will receive a confirmation text message from the practice.

If you haven’t heard within three weeks of submitting your paperwork, please contact the surgery.

Once you have seen by the chosen provider

If you are started on medication following your assessment you will need to remain under the care of your chosen provider, as we are unable to prescribe this medication without specialist input.

For further help and support?

Please see below a list of websites and resources, to help you on your Right to Choose journey:

Information on ADHD:

• ADHD UK: A charity offering free advice and information on ADHD and Right to Choose referrals
• ADHD Foundation: The UK’s leading neurodiversity charity, offering services for those who live with ADHD, Autism, Dyslexia, DCD, Dyscalculia, OCD, Tourette’s Syndrome and more
• NHS Website
• Mind: ADHD and mental health

Information on ASD

• National Autistic Society: offer support and advise for autistic people in the UK and their families
• Autism Speaks: Autism Speaks is dedicated to creating an inclusive world for all individuals with autism throughout their lifespan
• NHS Website
• Mind: Autism and mental health

What if I have more questions not answered previously?

Below we have compiled some frequently asked questions, however if you still have a question please contact the surgery and ask to speak with one of our GPs or their secretary.

Frequently asked questions

Where can I be referred to?

You as the patient need to choose what provider you would like to be referred to by searching the internet for NHS Right to Choose ADHD or ASD assessments. The GP practice is not able to suggest or advise you on which to chose

How long is the waiting list?

This will largely depend on which provider you have chosen. The practice are not able to state how long the waiting list is but we do think this should be a consideration when choosing your provider.

Can I chose more than one provider?

You are not able to be referred to more than one provider at one time.

What forms should I complete?

Once you have found the provider you would like to be referred to, you should complete the form required on the providers website. This should then be emailed to us at ddicb.overdalesecretaries@nhs.net or dropped into the surgery.

Do I need a GP appointment?

No, an appointment at the surgery is not necessary. Once the referral has been received the secretaries can complete a referral direct to your chosen provider

Can I be referred to the same place as my child

Not all providers accept adult and children referrals. Therefore, this will need to be a consideration when choosing your provider.