Autism & ADHD

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ADHD and Autism/ASD referrals

If you decide to proceed with a referral for diagnosis of ADHD and ASD, or medication initiation/changes for ADHD you will have to be referred under the NHS Right to Choose (RTC) legislation.

At Beaumont Elms Practice we only make referrals to RTC providers who been approved by our commissioners, the local ICB (Integrated Care Board), as meeting their quality criteria. Please see the ICB website for an up to date list of approved providers.

If you are a registered BEP patient and wish to pursue a possible diagnosis of ADHD, or Autism the first step is to fill in a contact form we will then get back to you with the next steps, including whether or not you need an appointment with one of our GPs.

Please be aware that we cannot offer appointments for checks your provider may require prior to initiation of ADHD medication – these will need to be arranged by the provider – we strongly advise you check this with them in advance.

Participation in Shared Care

If your right to choose provider requests shared care for prescribing of ADHD medication this may well be something we can help with. The key factors are that the request is from a GMC registered doctor who has personally assessed you and the treatment is in line with local shared care protocols which your provider agrees to work in line with. If you are likely to want shared care prescribing, please check your chosen provider will meet these criteria at the time of choosing who you want to be referred to.

Evidence that you meet priority criteria for referral

Thames Valley ICB have introduced Prioritisation Criteria for ADHD Right To Choose referrals and this means not everyone requesting a referral can be referred. You can read more about this on their website.

This list is the information we have been given by the ICB regarding suitable written evidence. With the exception of Safeguarding and Long term conditions (both of which will be evidenced in the records we hold for you) you (and or your educational institution/employer) will need to provide us with the relevant written evidence for the criteria you are applying under:

Safeguarding

• Evidence that the patient is a parent/carer of a child subject to a Child Protection Plan or previously on the Child Protection Register.
• Safeguarding referrals or concerns.
• Risk assessments or safety plans.
• Child or adult safeguarding plans.
• Evidence of involvement with relevant safeguarding processes, such as MASH or MARAC.

Long-term Conditions

• Evidence that suspected or potential ADHD is having a significant impact on the management of an existing long-term condition.
• For example, difficulties with medication adherence, attending appointments, self-management or maintaining treatment plans, resulting in poor control of the long-term condition (e.g. poor diabetic control).

Criminal Justice System

• History of convictions or current/recent involvement with the criminal justice system.
• Police involvement.
• Probation records or reports.
• Licence conditions or other relevant documentation.

Educational Difficulties

• School or college reports.
• Education, Health and Care Plans (EHCPs) or SEN documentation.
• Educational psychologist reports.
• Evidence of additional educational support, reasonable adjustments or persistent difficulties with attendance, organisation, concentration or educational attainment.
• Patient/school or educational setting to provide supporting evidence where appropriate.

Employment

• Employer letters or reports.
• Occupational health reports.
• Disciplinary or absence records.
• Evidence of workplace adjustments or support.
• Evidence of difficulties sustaining employment or repeated difficulties in the workplace that may be associated with suspected ADHD.
• Patient to provide supporting evidence where appropriate.

Caring Responsibilities

• Evidence that the patient has significant informal caring responsibilities.
• Evidence that difficulties associated with potential ADHD are affecting their ability to undertake, organise or sustain their caring responsibilities.
• Where available, a carer's assessment or other relevant supporting documentation.

Where relevant, and not already in your NHS GP records, it would be helpful to have the following:

• Previous ADHD assessments or assessment reports.
• Historic clinical letters documenting ADHD-related symptoms, assessment or diagnosis.
• Previous treatment records, including medication trials and response to treatment.
• Documentation from previous ADHD or mental health services outlining assessment, treatment and ongoing management.
• Evidence of previous involvement with specialist services, where relevant.

Exclusion criteria for ADHD RTC referral

Please be aware you cannot use Right to Choose if you are:

• already receiving mental health care following a referral for the same condition
• referred to a service that is commissioned by a local authority, for example a drug and alcohol service
• accessing urgent or emergency (crisis) mental health care
• detained in a secure setting. This includes people in or on temporary release from prisons, courts, secure children’s homes, certain secure training centres, immigration removal centres or young offender institutions
• serving as a member of the armed forces (family members in England have the same rights as other residents of England).

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