GPs in England don't have to agree to shared care, even after a Right to Choose diagnosis. If yours declines, your medication can usually continue through the provider, so don't let it run out while this is sorted.
What shared care is
Shared care is an agreement where your GP takes over prescribing ADHD medication once the specialist has found the right dose. The specialist stays involved and reviews you, often once a year.
Right to Choose gives you the right to choose who assesses you. It doesn't oblige a GP practice to prescribe or to sign a shared care agreement (Londonwide LMCs guidance, 2026).
Why GPs decline
- The practice isn't comfortable monitoring a medicine started by a provider outside the local area.
- The ICB or practice has a local policy on shared care with Right to Choose providers.
- Workload or lack of local monitoring arrangements.
What to do
- Ask for the reason in writing.
- Ask your provider what happens next. Some providers continue prescribing when a GP declines. For example, Psychiatry-UK says it will continue to prescribe. Ask whether there's any cost to you.
- Ask about local services. In some areas, prescribing can move to the local NHS ADHD service.
- Ask your ICB about its position on shared care with Right to Choose providers (find your ICB on nhs.uk).
Best tip: ask about shared care before you choose a provider. Ask each provider how they handle it if your GP says no.
Related guides
- Right to Choose ADHD in Birmingham and Solihull
- Right to Choose ADHD in London
- How to get an ADHD diagnosis as an adult in England
- Right to Choose vs private ADHD assessment
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