by Arch-TK | 2025-10-06 20:40:44+00:00
In the UK, currently, adult ADHD care is basically broken.

The NHS will accept you on waiting lists, if you're in one or two lucky regions, you have to wait a few weeks, otherwise you have to wait years. If you are in a very unlucky region, you can randomly get dropped from the waiting list, and effectively barred from ever getting back on it, because someone looked at the referral and diagnosed you as not having ADHD. Under the NHS you are not entitled to a second opinion (hence why you don't get to go back on the list).

So the NHS has this system called "Right to Choose" (RTC) where private care providers can register to offer services to NHS patients, charged to the NHS. You go to your GP and you say: "Hi, I noticed that if I go on the NHS waiting list for an ADHD diagnosis, it's uncertain if it will come before or after the heat death of the universe. Can you please refer me to this private provider of my choice instead?" And if your GP knows what RTC is, you get on the private provider's waiting list which is often between to 2w and 1y.

Cool, so that solves it right? Okay, but what happens once you're diagnosed? If you decide to go with the medication route (somehow it's either Meds or therapy but not both - what?), they give you a prescription. You take it to your local pharmacy to fulfil, and you fulfil it at the NHS prescription cost (currently just under £10 per prescription). You do this for a few months, trying different things until you find something that works for you. Now what?

Most providers will tell you to move to a "Shared Care Agreement". They contact your GP and say: "Hi, this person needs meds, they're stable on these meds, can you take over prescribing them." and for a while some GPs would be like: "Sure, that seems like the right thing to do in this situation."

Recently the advice has been for GPs to drop SCAs for ADHD medication. Why? I honestly have no complete picture. But the gist seems to be that it costs the GP practice time and money, that the NHS doesn't reimburse. IDFK. To me it sounds like people with ADHD are being used as a pawn in some idiotic game of chess between the regional NHS authorities and whatever higher-ups set the budgets for those regional NHS authorities. The current move is "People with ADHD get fucked+". I guess we're waiting for the reply from the higher ups. This is a conference chess game and who knows if the privately owned Royal Mail is going to actually deliver the letters in a timely fashion.

So now people who have been stable on medication for months to years are suddenly being told that they have 6 months to get an NHS diagnosis (which in most cases takes at least a year) or switch to a private provider that the practice likes (whose waiting list is now almost inevitably close to a year because everyone else is in the same shoes).

So now that you've successfully managed to deal with a bunch of bullshit, get a diagnosis, deal with the pains of titration etc, you are suddenly told you have 6 months before you'll undoubtedly become unproductive and struggle to hold your job.

And on the Nth day, the devil started creating Hell, and then stopped 5 minutes later because he realised that the UK already existed and would suffice.