Adult ADHD Services
In scope: adults aged over 18 years old with suspected ADHD.
Out of scope: children and adolescents with suspected ADHD/ASD – follow the Neurodevelopmental Assessment Pathway (ASD and ADHD).
Introduction
Attention deficit hyperactivity disorder (ADHD) is neurodevelopmental disorder characterised by a persistent and pervasive pattern of inattention, hyperactivity and/or impulsivity that causes significant functional impairment. These core symptoms are excessive, i.e. outside of the normal expected range, and must have been present since before the age of 12. It is often not diagnosed until adulthood.
Examination and Investigations
Prior to secondary care medication initiation/titration, not necessarily required for referral:
- BP and HR
- Weight/BMI
- Cardiac assessment
- Personal and family history of cardiac disease
- ECG – on request from Adult ADHD Service
- Blood tests are not routinely required, unless a specific clinical concern exists
Management
If ADHD is suspected, while awaiting specialist assessment:
- Provide patient information.
-
Signpost to useful resources:
- The National Attention Deficit Disorder Information and Support Service: 0208 952 2800
- ADHD Foundation
- ADHD UK
- YoungMinds: 0808 802 5544 (helpline for parents)
Advice and Guidance
There is no advice and guidance service available.
Referral
A diagnosis of ADHD should only be made by a secondary specialist service.
CFT Cornwall Adult ADHD Service
Monday – Friday 9-5pm
T: 01726 873 305
Referral Criteria:
-
Adults, aged over 18 years old:
- with suspected ADHD
- from out-of-area on an existing NHS ADHD prescription
- previous diagnosis of ADHD, including in childhood, who are no longer on treatment, requiring assessment to see whether their ADHD is persisting
- Young people whose care is being handed over from CAMHS when turning 18yr old
Exclusions:
- Where there is not enough evidence of possible ADHD
- Where insufficient information has been given about the onset, severity, persistence and pervasiveness of functional impairment, as well as symptoms
- Transfer from private provider
Referral process:
-
Refer via eRS using either:
- The CFT Adult ADHD Referral Form, or
- A letter containing the information highlighted in the referral form
Required information:
- Corroborative information from friends or family
- If out-of-area patient, please include supporting clinical notes and/or correspondence etc.
Monitoring/shared care agreement:
After diagnosis, CFT Cornwall Adult ADHD Service will initiate and titrate pharmacological treatment where indicated.
After successful titration, shared care will be requested in line with existing guidelines: this document outlines the recommended observations needed to monitor the safety of prescribing.
If there are any concerns about safety or effectiveness of treatment whilst in shared care, the service can be contacted for advice by telephone or email. Reviews can be brought forward at the request of the GP or the patient.
Annual Reviews:
Patients in shared care must have annual reviews from the CFT Cornwall Adult ADHD Service to ensure continued prescribing is appropriate.
If patients do not attend Annual Reviews, CFT Cornwall Adult ADHD Service recommend to stop prescribing.
Right to Choose (RTC) ADHD providers
Patients also have the option to be referred via Right to Choose (RTC) for an ADHD assessment. Please see the NHS Choice Framework for further information.
Supporting Information
For professionals:
NICE CKS: Attention deficit hyperactivity disorder
For patients:
Royal College of Psychiatrists: ADHD in Adults
References
CFT Adult ADHD Service Shared Care Guidelines: Shared care guideline for the treatment of Attention Deficient Hyperactivity Disorder in adults
Page Review Information
Review date |
16 January 2025 |
Next review date |
16 January 2027 |
GP speciality lead |
Dr Laura Vines |
Contributors |
Mark Jay, Clinical Nurse Specialist Adult ADHD Service CIOS ICB Commissioner for Adult Mental Health, LD and Autism |