# Coordinating ADHD Care With Other Mental Health Services in London Canonical: https://rehablondon.uk/coordinating-adhd-care-london/ Publication: Rehab London Updated: 2026-10-17 Coordinating ADHD care in London means agreeing how the ADHD clinician, GP, and any other treating professionals will work together. A diagnosis or first prescription does not complete that process. The patient needs to know who monitors treatment, who responds to problems, and how support for anxiety, depression, substance use, or another condition fits alongside ADHD care. This guide focuses on life after, or alongside, assessment. For the diagnostic pathway, see [adult ADHD treatment in London](https://rehablondon.uk/adult-adhd-treatment-london/). The aim here is to turn separate appointments into a usable plan, particularly when private and NHS services or more than one London borough are involved. ## Keep the whole clinical picture in view The [NHS adult ADHD information](https://www.nhs.uk/conditions/adhd-adults/) notes that other conditions, including anxiety, depression, and addictions, can coexist with ADHD. A new diagnosis can help explain longstanding difficulties without necessarily explaining every current symptom. The treatment plan should distinguish what each professional is addressing and which questions remain open. The [Royal College of Psychiatrists' 2026 ADHD explanation](https://www.rcpsych.ac.uk/news-and-features/blogs/detail/the-rcpsych-blog/2026/08/19/adhd--your-questions-answered) emphasizes a formulation that considers mental, physical, social, and developmental factors together. For ongoing care, this means checking whether a difficulty reflects ADHD, another condition, a medication effect, or several interacting influences. It should not be reduced to repeatedly increasing one treatment whenever concentration worsens. Consider an illustrative example: a person reports worse attention after starting a demanding job, sleeping poorly, and becoming depressed. Their clinicians may need to examine all three changes. The useful question is not simply whether the ADHD diagnosis was correct, but what now explains the change in function and which part of care needs attention. Give each treating professional an accurate account of the others involved. Include therapy, medication, substance use treatment, and relevant physical health care. If one clinician proposes a change, ask who needs to know and whether another prescriber should be consulted before the plan is altered. ## Separate treatment adjustment from routine prescription supply Finding a suitable medication and dose involves assessment of benefit and unwanted effects over time. Once treatment is stable, routine prescribing may move into an agreed shared care arrangement. [NICE's ADHD guideline](https://www.nice.org.uk/guidance/ng87/chapter/recommendations) describes specialist involvement in starting and adjusting medication, with shared care arrangements after stabilization. A repeat prescription is not the same as a comprehensive treatment review. The first keeps an agreed supply going; the second considers whether the treatment remains appropriate. Ask who does each job. If the person issuing repeats is different from the ADHD specialist, establish how concerns are communicated between them. It can help to describe benefit in terms of ordinary activities. Can you start a task, follow a conversation, manage a journey, or complete necessary paperwork more reliably? Also describe what has not changed. “The medication works” is less informative than an account of both improvements and remaining difficulties across the day. ## Shared care must be accepted, not assumed The [GMC's shared care guidance](https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-care) requires agreement and clarity about responsibilities. A specialist letter requesting shared care does not itself establish that a GP has accepted prescribing responsibility. Patients need a confirmed plan rather than being told to approach the GP only when the current prescription is nearly finished. The [BMA's prescribing principles](https://www.bma.org.uk/advice-and-support/gp-practices/prescribing/prescribing-in-general-practice/principles-for-shared-care-prescribing) explain that shared care is voluntary for GP practices and depends on matters such as capacity, competence, and continuing specialist support. This can affect NHS and private pathways. Paying for a private assessment does not guarantee that subsequent prescriptions or monitoring will move to an NHS GP. Before committing to a pathway, ask the specialist what happens if shared care is declined. Establish who can continue prescribing, what reviews are required, and any ongoing private costs. Ask the GP about the proposed arrangement directly rather than relying on a provider's general statement that it “works with GPs.” If disagreement arises after treatment starts, ask both services for a written account of the issue and the interim plan. Is the problem missing assessment information, the monitoring arrangement, or the absence of continuing specialist input? Knowing the reason makes it easier to identify an appropriate next step than repeatedly forwarding the same prescription request. ## Monitoring should connect physical health and daily experience Medication monitoring can include physical measurements and discussion of appetite, sleep, mood, and functioning. For example, the [NHS methylphenidate information](https://www.nhs.uk/medicines/methylphenidate-adults/side-effects-of-methylphenidate-for-adults/) describes possible appetite changes, sleep difficulties, and increases in pulse or blood pressure. The relevant checks depend on the medicine and the individual's health. Ask who takes the measurements, who reviews them, and how to send results if appointments are remote. A number entered into a form should reach someone responsible for interpreting it. If there is a new symptom, explain when it began and any other changes rather than waiting for the next scheduled routine review. Keep one current medication list with names, formulations, and prescribing instructions, including nonprescription products. The [NHS interaction guidance](https://www.nhs.uk/medicines/methylphenidate-adults/taking-methylphenidate-for-adults-with-other-medicines-and-herbal-supplements/) advises checking other medicines and supplements with a clinician or pharmacist. An ADHD appointment and a separate consultation for another condition should not each proceed with an incomplete list. Do not change doses or combine formulations because a different schedule seems more convenient. If work hours change or a pharmacy cannot supply the prescribed item, ask the prescriber or pharmacist about the next step. Tell them what supply remains so that the problem can be addressed before an unplanned interruption. ## What one London ADHD service actually offers [Tower Hamlets ADHD Service](https://www.elft.nhs.uk/services/tower-hamlets-adhd-service), based at Mile End Hospital, describes assessment and treatment optimization for residents aged 18–65. Its current treatment offer includes medication and some psychoeducation. Referrals are initiated through a GP, and some people have additional screening through neighborhood mental health teams. The service specifically asks patients to check whether their GP will share care. This illustrates why prescribing arrangements belong in the initial conversation. It also shows why an ADHD service should not be assumed to provide every form of psychological therapy or ongoing support that a patient might need. Other London services have their own catchments, age criteria, and treatment scope. When contacting one, say whether you need a first assessment, medication review after an established diagnosis, transfer from another service, or help with a new problem. Those requests may follow different routes even within the same organization. ## Coordinate therapy around specific difficulties NICE recommends considering nonmedication treatment in appropriate circumstances, including when difficulties remain despite benefit from medication. The plan may include a structured psychological intervention focused on ADHD. Ask what it targets: organizing tasks, managing avoidance, understanding emotional responses, or addressing another clearly defined difficulty. If anxiety or depression is also being treated, the therapist should know about ADHD-related barriers to the work. A patient may understand an exercise but struggle to remember it, start it, or organize materials between sessions. That calls for a practical adjustment rather than an assumption that they are uninterested in treatment. Examples to discuss include a brief written session summary, fewer simultaneous tasks, reminders in an agreed format, or dividing a large exercise into manageable steps. The best arrangement is one the patient can actually use. Adding several new tracking applications at once may create more administration instead of solving the original problem. For substance-related concerns, our [ADHD and substance use guide](https://rehablondon.uk/adhd-substance-use-treatment-london/) explains why both areas need attention. Tell the ADHD prescriber and substance use team about each other. The plan should address prescribing safety and engagement together, without leaving the person to reconcile contradictory advice about treatment. ## Make records and communication manageable A short care summary can contain the diagnosis, current medication, key monitoring arrangements, relevant other conditions, and contact details for the clinicians involved. Keep it current rather than collecting an ever-growing bundle without knowing which letter reflects the latest decision. Ask for correction if a factual error could affect care. Decide how reminders and appointment instructions should arrive. If unread messages or missed forms repeatedly disrupt care, tell the service what happens and request an accessible alternative. An agreed communication method is part of making the treatment workable, especially when the condition being treated itself affects organization and follow-through. If a partner or family member helps with appointments, agree their role and information-sharing boundaries. Their observations may be useful, but the patient should still have space to speak privately. Assistance with reminders should not quietly become responsibility for clinical decisions or disputes between providers. ## Plan transitions before the handover date Moving across boroughs, changing GP practices, leaving university, or transferring from children's to adult services can alter access and prescribing arrangements. Ask which service will accept the transfer, what records it needs, and who remains responsible until acceptance. A new address does not automatically transfer a specialist caseload or a shared care agreement. Keep assessment reports, treatment history, and the latest review available for the receiving clinician. If the original diagnosis was made privately or overseas, ask what documentation and further assessment are required. The purpose is to support a safe, informed continuation of care, without promising that every service will adopt the previous plan unchanged. Our [guide to coordinated mental health and substance use care](https://rehablondon.uk/integrated-dual-diagnosis-treatment-london/) covers the wider issue of multiple teams. For ADHD, a useful endpoint is a plan in which the patient can name the current prescriber, the next review, the monitoring owner, and the route for a problem. Clear responsibilities make it easier to focus on treatment and daily life.