ADHD Assessment Process

 

Assessment process

Ishbel will complete the assessment at pre-arranged outpatient appointments. A full initial assessment will consist of a general mental health assessment and a detailed evaluation of ADHD symptoms (including using standardised rating scales). Following the assessment, a detailed report will be forwarded to the patient’s GP.

Patients are encouraged to bring a friend or family member to the appointment, who can provide valuable childhood and background history. but this is by no means compulsory.  Patients are also encouraged to bring any additional information such as school reports/employment reports, if available.

Treatments

If an ADHD diagnosis is confirmed, then treatment options will be discussed and finalised in consultation with the patient. It is very likely that treatment will reduce symptoms/ impairment and improve the person’s quality of life.

Medication

Medication is recommended on the basis of guidelines set out by the National Institute of Clinical Excellence (NICE). People with ADHD taking such treatments often report feeling calmer, more focused with reduced symptoms of inattention, hyperactivity and impulsivity, which consequently reduces the degree of impairment in functioning in various aspects of life including employment and relationships. Other benefits include greater mood stability and improved self confidence.

Before starting any medication a review of significant physical, personal and family history will be undertaken, and baseline physical health checks, such as blood pressure, heart rate and weight are completed. If it is agreed to start medication, then a plan will be formulated and communicated with the patient’s GP. Reviews of medication will take place usually using a combination of face to face and telephone consultations. It usually takes 6-12 weeks to reach a stable maintenance dose of medication.

Psychological therapy and other approaches

Specific psychological therapies, such as CBT can be useful particularly for other mental health difficulties, and advice about to how to access such treatments will be provided.

Titration

Following a patient being diagnosed and commencing medication, in order to get them on the correct dose and refer them into shared care, they will need to be titrated. This takes a period of time increasing the dose of medication and potentially switching medication until we get the correct levels that work for you.

 

This can be done one of two ways,

The first appointment is on our ‘titration clinic’ these are a medical review where we are assessing you physically and dispensing your prescription.

These slots are up to 30 minutes in the face to face clinic (with additional administration required following each appointment)

The second option is that following the initial appointment as above, you then commence in therapy with our team, using a CBT approach and amalgamating this with a brief titration review. The benefit of this is that you are able to access both parts of treatment to support your new diagnosis and how to manage this.

We have made this option as cost effective as possible for you to engage with as we believe it is the best management of an emotionally charged diagnosis.

(Please note all patients must be initiated in the medical review clinic and must have an ECG to commence medication whether this is carried out by ourselves or your GP)

Assessment categories

New assessment for ADHD (no previous diagnosis)

Including face to face consultation, review of medical records, obtaining relevant history from other sources, as appropriate, and preparation of a full report.

Re-assessment (for patients with a previous diagnosis of ADHD)

This assessment will take less time if a previous comprehensive diagnostic assessment has been completed.

Follow up appointments

Follow up appointments would be a combination of

Face to face appointments

and/or Telephone/ Video call consultations

FAQ

What do I need to bring with me to the assessment?

We request that you bring someone who knows you well to your assessment, if possible. This may be a family member or a friend. As part of the assessment will involve gathering information about your younger years, many people find it helpful to bring a parent.

If you have copies of school reports or work appraisals, do bring them to the assessment as these can also provide valuable additional information.

What can I expect from an ADHD assessment?

An initial assessment will take approximately up to 90 minutes. Often it is possible to reach a decision about whether or not you have ADHD after this first appointment, but occasionally it may be necessary to have a second appointment to complete the assessment.

What happens if I am given a diagnosis of ADHD or ADD (Attention Deficit Disorder)?

If a diagnosis of ADHD or ADD is made, then medication options will be discussed if this is something that you would like to consider. Your GP may be willing to prescribe medication according to a recommended treatment plan. In this case, you may not need many follow-up appointments with IStraker Consultants.

Most GPs are willing to take over prescribing of ADHD medications, once the dose has been stabilised, under a Shared Care Protocol. In this situation, you may require only a few follow up appointments with IStraker Consultants to ensure that you are on the correct medication, at the correct dose. Your ADHD medication will be prescribed as a private prescription until your GP is able to take over prescribing. Once stabilised, you will require a follow up appointment at least once a year either with IStraker Consultants or your local NHS ADHD service.

Some GPs will not prescribe ADHD medication at all. In this situation you will need to attend follow up appointments with IStraker Consultants whilst your dose of medication is stabilised. Once we find the right medication at the right dose for you then you will only need to attend for a follow up appointment with IStraker Consultants every 6 months so that your weight, pulse and blood pressure can be monitored in line with national guidance. Private prescriptions will be issued by IStraker Consultants. Please note there is a fee for issue of private prescriptions.

What happens after the assessment?

Once the assessment is completed, a copy of the report will be sent to your GP, usually within 2 weeks. If you would like to also receive a copy of the report, this can be emailed or posted out to your home address.

If a diagnosis of ADHD or ADD is confirmed, then we will also recommend that your GP refers you to your local NHS ADHD service, if this has not already been done.

Where do I get my ECG?

After you have been diagnosed with ADHD and have made a decision to use medication as treatment, you will need to have an ECG. This can be done for free via you GP. If for some reason it is not convenient to wait for your NHS appointment then you can have your ECG carried out at our clinic. This will cost £100.

How much does a prescription cost?

Our prescriptions are £25

What are the charges I may face when I attend the pharmacy?

 

How long does the journey from diagnosis to shared cared with my GP take?

This can vary from client to client but usual timeframes are between 8-12 weeks.

What if I am not diagnosed?

What are the next steps if I receive a diagnosis?

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