ADHD Team

ADHD is characterised by several symptoms. These can be experienced by many young people but those who receive a diagnosis of ADHD experience these to a greater extent, duration and level of impairment.

These can include:

• Inattentiveness: not being unable to concentrate for very long or finish a task, being disorganised, often losing things, being easily distracted and forgetful and unable to listen when people are talking
• Hyperactivity: being fidgety, overactive, unable to sit still, talking constantly and having difficulty doing quiet activities
• Impulsivity: speaking without thinking about the consequences, interrupting others and being unable to wait or take turns

See our Support and Advice pages for more information on supporting a child or young person with ADHD, and you can also find lots more interesting information in our Blogs.

Initial referral

You may be referred to the ADHD team after having an initial assessment with a clinician from our CYPF Hub, or another one of our CAMHS teams. You may also be referred by someone you already know in CAMHS. 

The assessment

Initially, questionnaires for you and your school teacher are sent out, to help us see which areas of your life you are having difficulties with. You may be invited to one of our clinics to complete a computer-based test called a QB test, as part of the assessment.

Most new assessment or review appointments will be online or telephone appointments to help us get to know you better and discuss some of the difficulties you’ve been experiencing. Some children and young people will be invited in to attend appointments, mainly for height/weight/blood pressure and pulse checks when these are needed and cannot be taken at home.

In order to help us, if you have a Blood Pressure Monitor, have access to scales and are able to take your child’s height we would be grateful if this could be done prior to the booked telephone/video review. Please see this guidance on how to do this. You may also find this video on taking a blood pressure reading helpful.

A school observation or interview with your teacher may also be carried out.

Some young people with similar symptoms to ADHD may have other underlying difficulties, and after the initial appointment a referral to another team in CAMHS or a more appropriate local service may be made.

What happens after the assessment

We will discuss the outcome of the assessment with both you and your parent/carer. You may receive individual support to help you manage difficult feelings or behaviours. It may be that your parent/carer finds behavioural support in the form of parenting interventions helpful. This may vary according to your local authority.

If it is felt appropriate you may be offered a trial of medication. This may help young people with severe ADHD concentrate, focus, and think about things before doing them. There are different types of medication, with different effects and strengths. We will discuss these with you and your parent/carer to make sure they are the best fit for you. Once we have found a helpful routine of medication, a clinician from our team will check how you are getting on every six months.

Our interventions

Interventions depend on the findings of the assessment and level of impact on the child or young persons life.

They will usually include:

• Recommendations for behavioural strategies at home and at school
• Signposting to targeted ADHD parenting programs and parenting support in the community. Visit Parenting Special Children for information on workshops available locally for parents and carers.
• Psychoeducation
• Consideration of medication to manage symptoms in the most severe cases
• Medication reviews.

What happens to my NHS care if I am considering paying for a private assessment?

You are still entitled to free NHS care if you choose to pay for additional private care and this will not affect your position on the NHS waiting list.

We recommend that you research private providers and ask them if their ADHD assessment is in line with NICE Guidance (National Institute for Health and Care Excellence). NICE guidelines are evidence-based recommendations for health and care in England. We would also advise a full discussion about the costs, including the costs for ADHD treatment should this be started by the private provider.

You may want to check with your GP whether they would accept a shared care agreement with your private provider. A shared care agreement means that your child’s care and treatment will be shared by your private provider and your GP. Your GP would take over prescribing although you would still need to pay for any review appointments needed with the private provider up until the time we can offer an appointment and take over care. If your GP will not accept a shared care agreement with a private provider then you will need to continue to pay privately for the medication as well as for the medication reviews.

If your child receives a diagnosis privately, and you would like us to consider taking over medication at a later stage then we will review the assessment report. For us to prescribe without needing to complete further assessment there is certain information we need, to ensure we provide safe and effective care for your child. You can find more information on what is required here and would recommend you share this with your private provider.

What happens if my child does not get an ADHD diagnosis after a private assessment?

 If this is the case, please update us and we can discharge the referral.

What happens if my child receives a private ADHD diagnosis but we do not want to consider medication?

If this is the case, please update us and we can discharge the referral. If you would like us to add the diagnosis to your child’s records, please send us a copy of the report.

If your child has received an ADHD diagnosis and at a later stage you want to consider medication, please make a parent/GP/school referral online here (opens in new window), explaining that your child has a private diagnosis of ADHD. Please include a copy of the report (if this has not been sent previously) and state that you would like to consider medication.

What happens if we want to consider a trial of medication with the NHS after a private ADHD diagnosis?

The team will review the assessment report to ensure it contains the information we need to be able to start medication if it is appropriate.

Unfortunately, we are not able to prioritise on the basis of a private assessment and appointments are allocated based on those who have waited the longest and those with the highest level of clinical need. This means that a referral to the team after a private assessment would in theory have the same wait as any other new referral – although sometimes we are able to offer an appointment to discuss medication sooner than an assessment appointment.   

If the report does not contain the information required, then we will consider the best way forward. We may be able to obtain the additional information required from the private provider or we may offer some further assessment. We will always do our best to avoid repeating any parts of the assessment and will only do this when essential.

What happens if my child is prescribed ADHD medication privately and we would like to transfer care to the NHS?

You can return to the NHS for ongoing care once your child has been stabilised on medication, a process known as titration. Titration is the process of safely stabilising a person on medication to establish the most suitable medication and the dose which has maximum benefits with minimal side effects.

Unfortunately, we are not able to prioritise appointments on the basis of a private provider having started ADHD medication. When a private provider initiates medication, the responsibility for monitoring and reviewing this remains with them until we can see the child or young person.

Our team will review the assessment report and medication letters to make sure they contain the information we need to be able to take over the monitoring and review of medication that has been prescribed. If this is the case, we will write to your GP to confirm we have accepted the referral and ask them to kindly take over prescribing the medication for your child. 

If the report/letters do not contain the required information or we have any concerns about the type of medication prescribed, then we will not be able to ask the GP to take over prescribing. This does not happen often, and we will always contact you to discuss this and the way forward. Please note that we are unable to take over review of medication during the stabilisation period (titration).

We have a shared care agreement with GPs, which means that GPs will prescribe medication if this has been started by a specialist in our team and the right dose has been established (known as titration completed). Treatment within our team is in line with recommended medicines and we recommend you discuss this with a private provider if you might want to transfer back to the NHS. We recommend that your private provider considers this and refers to the guidance below. This will mean more consistency in treatment.

Bracknell, Slough, Windsor and Maidenhead medication guidance (opens in new window)

Newbury, Reading, Wokingham medication guidance (opens in new window)

Please note that this is a shared care agreement with our team and GPs, so private providers are not covered by this; although some GPs will take over prescribing (when asked to do so by a private provider) and/or when our team asks them to and we have confirmed that we have reviewed the assessment and treatment.

You can read the guidance from the NHS here (opens in new window)

Before making a referral to us please read the following:

• Where there are concerns about the possibility of ADHD or ADD, the school special educational needs coordinator (SENCO), should be involved in the first instance.
• A support plan should be put in place and monitored for up to 10 weeks. Make notes including any changes and patterns in their behaviour (this must include difficulties with their concentration, impulsiveness, and activity levels). If the concerns continue, are evident across different settings and have a moderate or severe impact, then please make a referral for assessment.
• Please read the ADHD referral criteria document for more in depth information.