Psychiatry

ADHD Assessments

What is ADHD?

ADHD is a behavioural disorder characterised by a combination of difficulties with inattentiveness, restlessness and impulsivity. Many people experience these difficulties to some degree but for individuals with ADHD the symptoms can have a big impact on day to day life, self-esteem, personal well-being, relationships with others and work performance.

Signs of ADHD can include:

• Difficulty focusing on or paying attention to tasks

• Struggling to manage time effectively

• Mood swings or difficulties managing feelings such as anger or frustration

• Easily distracted or unable to concentrate

• Impulsiveness

• Difficulties with organisation

• Forgetfulness

• Anxiety

Symptoms of ADHD start in childhood with difficulties persisting into adulthood, although the presentation may change over time. For some, ADHD is not identified or diagnosed until later life. ADHD can affect both males and females.

ADHD can co-exist with a range of other difficulties. It is important therefore to work closely with a psychiatrist to identify how your treatment should be best targeted.

Diagnosis and treatment

There is no single test, screening tool or ADHD assessment for identifying the condition.  We conduct our ADHD assessments in the following way: 

• A 30 minute initial consultation is held to talk through your concerns, observations and discuss whether a full ADHD assessment is the right choice for you/your child. The cost for this is £100.

• If recommended after an initial consultation, our full ADHD assessments cost £1400.

• Prior to the assessment, an evaluation tool called the Conners scale is then completed by a child’s parent or guardian and someone else who knows them (usually a teacher at school). This will then have the results interpreted and be looked at by the psychiatrist.

• You will then attend an 120 minute appointment with the Psychiatrist, this will be for both parents and the young person when someone under the age of 18 is being assessed. A full ADHD assessment will then be undertaken which will  include information about physical health, family history, talking about symptoms and any previous diagnosis, and discussing any previous treatment you have tried.

• You will get feedback during the appointment about whether the psychiatrist believes a diagnosis is appropriate. This will be followed by a full written report within two weeks. 

• Following the ADHD Assessment and diagnosis, your Psychiatrist will consider your individual needs and devise a personalised treatment plan. Although ADHD cannot be ‘cured’, with support it is possible to lessen the impact of many of the symptoms and difficulties experienced..

• Possible treatment routes include medication, talking therapies (e.g. CBT) and lifestyle adaptations. A combination of these is usually most effective and your Psychiatrist will talk to you about these. Your Psychiatrist may refer you on to another professional in our team for further support, for example to a psychologist or psychotherapist.

Please note that should you wish to consider medication this will need to be done in a  further package of care.  We require that this is purchased as a block in order to ensure clinical oversight and effective follow up and support. The cost for this is £1000 for the private prescription, initial appointment and two 30 minute follow ups at one month intervals.

An ADHD Initial Consultation is the first step towards a Child ADHD Assessment. This is a 30 minute online appointment held between a parent/carer and one of our Psychiatry Nurse Prescribers. This appointment costs £100. If you would like to book an ADHD Initial Consultation please contact our reception team on reception@thefamilytreatmentservice.com or via phone on 020 7183 9323

If recommended after the initial consultation, a Child ADHD Assessment with us is £1400

Once you have booked the assessment, you will be sent two questionnaires (SRS and Connors). Both forms must be completed by a parent/carer and your child's school before you can select a date for your assessment. When we receive the completed questionnaires, we will then contact you to book your child's assessment date. 

During the 2 hour assessment appointment, the Psychiatrist will undertake a full ADHD assessment including information about physical health, family history, description and impact of symptoms, any previous ADHD diagnosis or treatment approaches and any co-occurring mental health conditions.  At the end of the assessment, the Psychiatrist will inform you of the outcome of the assessment. If your child is provided with a diagnosis of ADHD, the Psychiatrist will provide you with some support options, and details of our prescribing service if you would like to explore medication options for your child. 

Please note that medication will not be discussed in the assessment appointment. Further information on our Prescribing Service can be found in our FAQs.

Following your assessment, after 2 weeks you will be sent a clinical report with further outcome details and recommendations. Your Psychiatrist will consider your child's individual profile of need and symptom management when devising a treatment plan that is completely personalised to them. Your Psychiatrist may refer you on for further support for example to a psychologist or therapist.

If you have any further questions that are not answered in our FAQs, please email us with your queries.

Psychiatry assessments can be very useful to diagnose and think about treatment for a wide range of mental health difficulties including:

• Anxiety

• Depression

• Mental health conditions associated with autism

• Bi polar disorder Personality Disorders Eating Disorders

• Post Traumatic Stress Disorder

Your psychiatrist will work with you to gain an understanding of what you or your child has been experiencing by asking questions about mental state and wellbeing. This includes observing behaviour, discussing thoughts and feelings, and evaluating cognitive and emotional functioning. They will also gather information about family and personal history in order to gain a deeper understanding to provide appropriate treatment recommendations.

During a 90 minute appointment with the psychiatrist they will undertake a full assessment including information about physical health, family history, description and impact of symptoms and any previous child or adult diagnosis or treatment approaches.

You will get feedback during the appointment about whether the psychiatrist believe a diagnosis is appropriate

This will be followed by a full written report within 2 weeks

Following the assessment your Psychiatrist will consider your individual profile of need and symptom management when devising a treatment plan that is completely personalised to you.

Possible treatment routes include psychiatric treatment to target specific symptoms, psychological intervention (e.g. CBT) and lifestyle adaptations. A combination of these is usually most effective and your Psychiatrist will tailor a treatment plan specifically to your individual presentation. Your Psychiatrist may refer you on for further support for example to a psychologist or psychotherapist or family therapist.

This service is available to clients who have completed an ADHD Assessment within our service. If you have completed an ADHD assessment elsewhere, please contact our reception team who can advise the best steps for you to access the service. If you need to book an ADHD assessment please submit an ADHD Assessment Booking Request Form and we will be in touch to help arrange this.

If your child has a diagnosis of ADHD and you would like to consider medication options, you will need to book an ADHD Prescribing package for £1000. This consists of 1 x 45 minute appointment to discuss medication options and 2 x 30 further appointments held every 25 days to discuss and review your ADHD medication. You can book the ADHD Medication Package by completing an ADHD Prescribing Confirmation Form. 

Please note, that you can only access our prescribing service via this route.

In your appointment, if a medication is agreed upon, an online prescription will be processed and delivered directly to you via our online pharmacy Cloud RX. Please note you must bring valid photo ID to this appointment for a medication order to be placed.

This medication will be reviewed in your following medication review appointments. 

Depending on how the medication and dose suits your child, you may need to attend medication reviews every 4 weeks until your prescriber agrees this is no longer necessary and the review period will be changed to every 3-6 months, which will be agreed with you and the prescriber. 

Please note that if you and your prescriber are happy with the agreed course of medication, you may be required to pay for your prescriptions continually. Please see details of a GP shared care agreement in our ADHD Service FAQs prior to booking an ADHD Medication Package.

If you have any further questions that are not answered in our FAQs, please email us with your queries.

How to book an ADHD assessment?

The first step to arranging an assessment is by first booking an ADHD Initial Consultation. You can do this by contacting our reception team on reception@thefamilytreatmentservice.com or via phone on 02071839323

What happens after I book my ADHD initial consultation?

Once your initial consultation is booked, you will be sent questionnaires to complete before your appointment. These must be completed prior to the consultation to ensure we have sufficient information to complete the appointment.

What happens after the ADHD Initial Consultation?

Your Psychiatry Nurse Prescriber will inform you of whether they recommend a full ADHD Assessment is carried out. If they do recommend the assessment, you will be contacted to book the assessment. The cost of this is is £1400. If they do not recommend an assessment, you will be advised on other routes to access support that may be helpful.

What happens when I book my assessment?

Once you have paid for the assessment, we will send you two questionnaires that must be filled out by a parent/carer and your child’s school before we can book your assessment date with the psychiatrist. This is to ensure we have all the information we need to correctly complete the assessment. 

How long is the ADHD assessment and who should be there?

The assessment will last around 2 hours, and a parent/carer is required to be present for the duration of it.  You may like the opportunity to speak to the psychiatrist without your child present.  If this is the case we would require you to bring an additional adult with you if your child is under 14, as they are not allowed to be left alone in the clinic at any time.  

When will we be given a diagnosis?

The psychiatrist will discuss their thoughts, and whether they are making a diagnosis of ADHD at the end of the 2 hour assessment. If you do receive a diagnosis of ADHD, you will be provided with details and information on the next steps available to you. 

Whether you receive a diagnosis or not, you will be sent a clinical report 2 weeks after your assessment, with details and results of your assessment process. 

What happens if I would like to access ADHD medication?

If you would like to consider ADHD medication after a diagnosis with our service, this is prescribed as part of a medication package. This consists of 3 appointments which are all booked at the same time. 

In your first appointment you will discuss medication options and if suitable, you will be prescribed ADHD medication. You will then attend two review appointments after 4 week intervals in order to discuss how you are finding the medication and dosage. 
If the medication is working well, the dosage is right and the prescriber is happy to continue prescribing you this medication, you will then need to come in every 3-6 months for medication reviews or whenever your dose is changed. The frequency of the reviews are decided on a case by case basis. 

What if I decide that medication is not the treatment for me?

If you decide that medication is not for you, and you do not need to continue to see our prescriber, we will offer a refund of £300 per follow up appointment that is not used. Our appointment fees are structured to cover the psychiatrists time, so we cannot refund any appointments that have already taken place.

What if the medication is not suited to me after my 2 medication review appointments?

If the medication you have been prescribed does not seem like the right fit, and you would like to amend the dosage or type of medication, you will continue to be seen every 4 weeks until you and the prescriber are happy with the medication and dosage. This is to ensure the medication you are prescribed is the most suitable and effective for you.

How do I get my medication?

You will need to bring valid photo ID to your initial medication appointment. Your prescription will then be sent to an online pharmacy ‘Cloud RX’. They will process the prescription, and you should expect the medication to be delivered directly to your home address at least 2 working days after your prescription has been provided. You will not be provided with paper prescriptions, as our current pharmacy is online.

Why are there such strict rules in relation to prescribing and medication? 

The types of medicines prescribed for ADHD, for example Methylphenidate and Lisdexamfetamine are categorised as “controlled drugs” which means they are more regulated than other drugs. 

These regulations mean that we need to adhere to certain rules, and also to be sure that the dosage and medication type is managed carefully in order to make sure you get the most benefit from it.

A prescription for stimulant medication must be dispensed directly by the pharmacy within 28 days of the prescription being written, and there are restrictions on how much can be prescribed at a time.  You will always need a prescription to be able to get the medication. 

Will I always need to pay for my medication?

You might not be in a position to always be able to pay for your medication, and may want to consider accessing the medication from your GP instead. Whether your GP is willing to enter a ‘shared care agreement’ with a private service, to enable your medication to be accessed through them is at the complete discretion of your GP. If they do not want to enter into a shared care agreement, you will be required to continue paying for your medication continuously. We advise that you give some thought prior to choosing to access ADHD medication as to whether you are willing to maintain the payments yourself. 

Can I get my medication from my GP?

These medications need to be prescribed initially by a psychiatrist who is a specialist in these types of medicines and the correct dosage.  When the best prescription for you has been established and they are happy that everything is going well they may feel able to hand over prescribing to your GP, if your GP is happy to do so.  This is called a “shared care agreement.”  Following this you will just pay the normal prescription charge at your pharmacy.

If we are able to obtain a shared care agreement with  your GP, you will still be required to come for yearly reviews at The Family Treatment Service. This is to ensure your medication and dosage is still a good fit, and so the psychiatrist can support the GP with your care..

What happens if the pharmacy does not have my medication in stock?

Currently there are frequent shortages of ADHD medication that  may cause delays to you getting your medication at the right time. Our prescribers will aim to prescribe medication that ‘Cloud RX’ has available in stock, however at times they may become out of stock after the prescription has been sent out. If you are informed by Cloud RX that your medication is out of stock, please initially discuss with Cloud RX if there is anything they can do to help. If not, please get in touch with the clinic to discuss your options. It may be that the prescriber needs to consider prescribing you another medication, which may require another medication review appointment. 

How long will my medication last for?

You will initially be provided with medication for  28 days. It is essential that you attend your follow up appointments every 28 days, otherwise your next course of medication will not arrive on time.  At each review you will be provided with a prescription.  If you choose to move to shared care then you will get your prescription from your GP, if you remain at The Family Treatment service you can request repeat prescriptions in between reviews. 

What happens if there are problems with my prescription?

There may be times when Cloud RX has questions about your prescription which could delay you getting your medication on time. We will try our best to work with Cloud RX to clarify any details needed and get your medication to you as soon as possible. 

What if my medication hasn’t arrived?

Please check any delivery/medication enquiries with Cloud RX prior to speaking with the clinic as we do not manage the delivery/ordering service. You can do this by contacting them on 0113 531 2942 or emailing pharmacy@cloudrx.co.uk. 

If I have an ADHD diagnosis from another service can I access medication through The Family Treatment Service?

If you have received a diagnosis from another service, you may be able to be prescribed medication through our service, but you will be required to attend a short assessment appointment, and send us any previous reports, prior to booking the ADHD medication package.  Please contact us to discuss this.