Service description
Adult ADHD
Our service is designed to provide assessments for people suspected of having Attention Deficit Hyperactivity Disorder as an adult, and to provide treatment in the form of medication where appropriate.
What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong neurodevelopmental disorder affecting 3% of adults but may not have been diagnosed in childhood. There are different subtypes of ADHD:
- Combined presentation – a wide range of inattention and hyperactivity/impulsivity symptoms present
- Inattention presentation – mainly inattention symptoms (e.g. being easily distracted or having difficulties with organising tasks) present.
- Hyperactivity/Impulsivity presentation – mainly hyperactivity symptoms (e.g. fidgetiness, restlessness, constantly on the go) present
- ADHD in partial remission – some ADHD symptoms after a previous diagnosis, but does not meet the full criteria anymore.
People without ADHD may experience ADHD symptoms, but for people with ADHD this happens often and interferes with the person’s ability to do the things they want and need to do in everyday life.
People with ADHD may also experience mental health difficulties including mood and anxiety issues.
Find out more:
Patient Journey
If you are seeking a referral, you will be asked to complete a self assessment questionnaire, to gauge whether the symptoms you have match up to standard ADHD symptoms. Based on your responses, and any other information they have, a staff member at your GP surgery may refer you into our services.
Anyone over the age of 17 years and 5 months seeking a referral to ADHD for assessment or treatment should speak to their GP Practice – some Practices do not require you see a GP to be referred, and may have other clinical staff, such as Mental Health Facilitators or Mental Health Practitioners, able to refer into our services.
Please speak to the staff at your own GP Practice for help.
Once submitted, your referral will go through a triage process within our clinical team to check whether you need a full assessment, can go direct to treatment, or, if you are already on treatment, we will send you to our Annual Review clinic. As soon as your referral has been reviewed, we will write to you with information on the next steps.
More information on the different parts of your possible journey are detailed below.
Assessment
If you need to be assessed, you will receive a pack of questionnaires to help us gather some more detailed information. These questions will look at both your current symptoms, and the symptoms you had before you were 12 years old. You’ll be asked to complete one set of the questionnaires yourself, and to get another adult to complete the other set. This helps us see how other people perceive your symptoms, and it’s best if the person knew you well when you were a child – such as a parent.
Please note: if you are struggling to find another person to complete your questionnaires, please call us! We understand that not everyone is able to ask a parent for this support, and our team is happy to help support you to find alternative arrangements.
Once you’ve returned these, we’ll add you to our waiting list to be seen.
If you would like to know the current length of our waiting list, please contact our team.
When you reach the top of our waiting list, you’ll be contacted to book an appointment. You might be asked to bring another person with you to the appointment at this point.
Currently we perform assessments over video calls, as well as in person. If you agree to be seen over a video call, we may be able to see you sooner. We will try to book an appointment room close to your home wherever possible if you wish to be seen in person, but this might add delays to your appointment.
Your appointment will last roughly 2 hours, and the ADHD professional will ask you to both answer lots of questions, and provide evidence to support your previous symptoms where possible. They will go through an assessment document with you, and make notes while you answer – this will help “score” your different symptoms, and calculate a diagnosis for you.
If you are given an ADHD diagnosis, this may be ADHD which tends towards hyperactivity, or towards inattentiveness, or even both. Your diagnosis will be explained to you at the time, but you can read more in our Help, Support and Resources section**LINK WHEN LIVE*. You’ll have time at the end of your appointment to talk through your options for treatment. If you decide to progress to treatment, you can read more about this part of your journey in the Treatment section below.
If you are not given a diagnosis of ADHD, the professional who has assessed you will explain why, and potential reasons for your symptoms. You might need to be referred to another service for support, and you’ll be supported with the options available to you at this point.
Treatment
If you’re moved onto treatment, you’ll receive information about the treatment options available to you. You’ll also be asked to sign a form to say you consent to the treatment. In some circumstances you may be sent for some additional physical health tests to make sure medication is safe for you to take, and we’ll wait for the results for these before booking your first treatment appointment.
Depending on our availability, there may be a wait until your first treatment appointment.
At your first treatment appointment, the information you’ve been given will be discussed to make sure you understand the associated risks of each medication. The appointment will take about an hour, and the ADHD professional you see will check your physical health by performing some simple tests, such as checking your blood pressure.
Once you’ve agreed together which medication seems the most appropriate for you (based on your lifestyle, needs, and health) the professional will issue a prescription for you, and book you in for a review appointment 3-4 weeks from when your prescription is issued. They’ll provide you with instructions on how, when, and how often to take the medication.
Now you’ve got your first prescription, you’re entering the Titration period. This is where we closely monitor your reaction to the medication, and may change your prescription at every appointment to make sure you’re getting the best symptom relief possible, with the least side effects. Normally, this will be a dose change for the same medication, but sometimes you’ll try a few different medications during titration if the first ones don’t suit you.
Every two weeks during titration you’ll have a 30 minute appointment – often by phone – with a member of the ADHD clinical team. This will normally be the same person the whole way through your treatment, but might occasionally change based on our staffing needs. You’ll be asked to make sure you have access to a blood pressure monitor to give up-to-date readings at each appointment. You can purchase home monitors from pharmacies, or online – but your GP surgery may be able to either arrange to take your blood pressure regularly while on titration, or lend you a blood pressure monitor until you’re settled on your medication. More information on this can be found in the Help, Support and Resources section.**LINK WHEN LIVE**
You’ll be given access to our On-Call Duty Nurse, who you can call at any time if you are worried about your medication or symptoms. Details of how and when to contact them will be given to you at your first appointment, and you’ll still be able to speak to them after the GP takes over your care if you need specialised support.
When you’re stabilised on medication, we’ll organise for your GP to add a repeat prescription to your record. They’ll issue your medication for you on a regular basis for the next 12 months, and take back over your general care. You won’t need to come back to see us again until it’s time for your Annual Review, which is a check up we do every year to make sure the medication is still effective and not causing unwanted side effects. More information on the Annual Review can be found below.
Annual Review
If you’ve had a repeat prescription in place with the GP for 12 months, you’ll be due an Annual Review. This is a yearly check up to make sure your medication is still right for you, and you’ll get one every year that you’re on medication.
You’ll be booked in for an appointment with an ADHD professional, who will check on how your physical health has been, whether the medication is still helping, and any side effects you’ve had over the last month or so. If you’re happy with your medication, and there are no physical health concerns, we’ll organise for the GP to renew your repeat prescription for the next 12 months, and see you again next year.
If, however, there are concerns over your physical health, the side effects you’re having, or whether the medication is still helping – we’ll review your treatment again. This will be the same as when we first placed you on treatment – and you can read the Treatment section above for more details on how this works.
Stopped taking your medication?
If you stopped taking your medication before your annual review was due, we won’t need to see you. This is just a check up that the medication isn’t causing side effects, and still helps. If you aren’t taking it, there’s nothing for us to review.
When you want to start your medication back up, speak to you GP about it first. They’ll be able to agree the best course of action, and organise a referral back to our treatment team if you need one.
Please make sure you dispose of any left over medication appropriately. Always return unused medication to the pharmacy to be disposed of correctly.
Transitioning from Children's Services
If you, or your child, are under the CAMHS or Paediatric services, and are ready to begin “transitioning” into Adult services, your current care team will have sent us a referral.
Depending on which care team you are under we will either organise a joint appointment with your current care team, or an individual appointment with a member of our care team, to discuss the changes you’re likely to see. The appointment will last between 1 and 2 hours, and we’ll spend part of the appointment completing an Adult Assessment.
After this appointment, your care will be returned to the GP, and they’ll continue to prescribe the medication that you’re on. You’ll be called back to us for an Annual Review in a years time. For more information on the Annual Review process, please see the above section.
Why do I need an Adult Diagnosis?
ADHD is a Neuro-Developmental Disorder. This means that, while you won’t magically stop having ADHD, your symptoms and support needs will likely change over the next few years. Your assessment and diagnosis are based on your symptoms and support needs – so what we’re really assessing is whether your adult symptoms still match our criteria for offering support.
Your transition appointment is also your chance to talk through how you would like to go about treating your ADHD in the future.
Will my medication be stopped or changed?
Normally we wouldn’t stop or change your medication as part of a transition appointment.
If you would like to stop or change your medication, we can discuss this at the time and make a plan together.
Referral criteria
Please look through the form below.
If you feel that you have ADHD symptoms which impair your life, please speak to your GP surgery to consider a referral to Adult ADHD. You can take a completed copy of this form with you to help with discussions.
If you did not have these symptoms in childhood (before you were 12 years old), then it is unlikely that your symptoms are ADHD related. You may wish to speak to someone at your GP Surgery about other potential causes for your symptoms.
Referrals can be received from
GP Practices via PRISM, Central Access Point (CAP), CAMHS, Paediatric Services, Community Mental Health Teams, Prison services