Shared care in Scotland

What shared care is, your rights, and what to do if your GP refuses

What is shared care?

Shared care is the process by which your NHS GP takes over responsibility for prescribing ADHD medication that a private specialist has recommended. Once a Shared Care Agreement (SCA) is in place, your GP issues regular prescriptions on the NHS, meaning you no longer pay privately for your medication each month.

The model exists because ADHD medication requires ongoing monitoring. Under shared care, your private specialist retains clinical responsibility for oversight and dose adjustments, while your GP handles the prescriptions. Regular reviews with your specialist continue.

All NHS prescriptions in Scotland are free at the point of dispensing, so shared care can represent a significant saving compared to private prescribing.

Your rights under NHS Scotland

NHS Scotland clinical guidance supports shared care for ADHD medication where a private specialist has made a diagnosis and established a stable prescription. GPs are not required to accept every request, but they should not routinely refuse without clear clinical grounds.

In practice, acceptance varies enormously: between health boards, between practices within the same board, and even between individual GPs at the same practice. This is one of the most significant structural problems in ADHD care in Scotland.

How clinical correspondence affects shared care decisions

GPs are not ADHD specialists, and when considering a shared care request they rely on the clinical letter or report they receive from the diagnosing provider. The quality and clarity of that correspondence can make a difference.

A letter that explains the diagnostic reasoning clearly, outlines how the patient's history was considered, and sets out the monitoring arrangements is easier for a GP to act on than one that provides limited clinical context. This is not about length. It is about whether the correspondence gives the GP enough information to feel confident taking on the prescribing role.

When choosing a provider, it is worth asking what their shared care letters typically include and whether they have experience supporting shared care arrangements with Scottish GPs.

What to do if your GP refuses

  1. Ask for their reasons in writing. This creates a record and sometimes prompts reconsideration
  2. Ask your private specialist to write directly to your GP. A detailed clinical letter explaining the diagnosis, the medication, and the monitoring arrangements often makes the difference. Many good providers do this proactively; others will do it if asked
  3. Ask another GP at the same practice. If one GP refuses, a colleague may be more familiar with ADHD shared care and willing to take it on
  4. Contact Patient Advice and Support Service (PASS) for free, independent advice on your NHS rights in Scotland
  5. Ask your health board. Some Scottish health boards have formal pathways for NHS follow-up after private diagnosis; others do not. It is worth asking directly
  6. Continue with private prescribing for now. If your GP continues to refuse without clinical grounds, your private specialist can continue prescribing while you work through the steps above

Shared care is not permanent by default

A shared care agreement is not a permanent arrangement that carries over automatically. It is worth understanding the circumstances in which it can end:

  • Your GP leaves the practice. A new GP is not automatically bound by an agreement their predecessor entered into. If the practice does not have a clear protocol, it may not be renewed without prompting
  • You move to a new GP practice. Shared care does not transfer automatically. You will need to request it from your new practice, and they may decline. Starting the process early, before you move, gives you the best chance of a smooth transition
  • The practice changes its policy. Some practices have quietly moved away from new shared care arrangements, sometimes without informing existing patients until a prescription is due

If you are on shared care, keep a copy of the agreement letter and the contact details for your private specialist. If it lapses, you will need to re-establish it, potentially from scratch.

What to look for when choosing a provider

Not all private providers take an active role in supporting shared care. Before you commit, ask:

  • Will you write a personalised shared care letter to my GP?
  • Do you have experience supporting shared care arrangements with Scottish GPs?
  • What does your shared care letter include? Does it cover clinical history, monitoring plan, and prescribing guidance?
  • If my GP declines, can you continue to prescribe, and at what cost?

Our Compare providers tool shows which providers include shared care support as part of their service.

If shared care is declined: what private prescribing costs

If you cannot access shared care, you will need to continue with private prescriptions. The cost has two components: the private prescription fee charged by your clinic or prescriber (costs vary; some Scottish providers charge from around £30, others more) and the cost of the medication itself at a pharmacy.

Private prescriptions can be dispensed at any pharmacy, including standard high street pharmacies, not only specialist private ones. Medication costs vary between pharmacies and it is worth comparing. You are not required to use a pharmacy your clinic recommends.

Useful contacts

ADHD Scot is an independent, non-clinical information project. Nothing here is medical advice. Always speak to your GP or specialist about your own prescribing arrangements.

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