Psychiatry-UK is an online company, and communication is carried out via a secure online portal. This will be your primary method of communication with us, and use of the portal is required for all patients who choose our services. You will therefore need to have access to the internet.
If you have not previously been diagnosed with ADHD, or you have not had treatment for more than one year, you will need to complete some forms, which are an important part of your assessment.
These forms can be completed online by logging into your portal, where you will see links on your portal dashboard. These pre-screening questionnaires are an important part of your ADHD assessment and will help to ensure that your consultation keeps to schedule without the need for an extended appointment, which could delay any potential diagnosis and treatment.
Your psychiatrist will review your forms before they meet you, so it is important to complete them as soon as possible before your appointment is due to take place. Your psychiatrist will also ask you to show photo ID on meeting you at the start of your appointment, so please ensure that you have this with you.
Your Assessment
Your assessment appointment will take place via video call, so you can attend from the comfort of your own home. You will be assessed by a consultant psychiatrist. A psychiatrist is a medical doctor who specialises in mental health. The assessment will typically last 50 minutes. Please note that the role of our clinicians is solely to assess whether an ADHD diagnosis is present. It is not a therapy session.
In this time, your psychiatrist will undertake a structured medical assessment of your mental health and take a full psychiatric history. This means that the doctor will look at other health conditions, especially mental health conditions, which may either exist alongside possible ADHD or exist instead of ADHD.
They will also expand on questions asked within the pre-assessment forms. Part of this assessment is to ask for details about your past. For some people, past experiences can be upsetting to talk about. If there is anything your psychiatrist asks that you are not comfortable answering, please say so. Your psychiatrist will not force you to answer or reveal anything you are not comfortable with.
Due to the time constraints of the appointment, the meeting will stick to a structure in order to ensure that all diagnostic criteria are assessed. This means that, unfortunately, there is little opportunity to discuss details in too much depth. If there is any additional information that you would like your clinician to be aware of, you can add these details into a case note on your portal for the attention of your clinician before the appointment. If there are any points that arise in the assessment which you would like to develop, please let your clinician know that you will be adding this information to a portal note following the appointment, and that you would like this to be taken into consideration for your diagnosis.
Your psychiatrist will then discuss with you what they think your diagnosis is. Alternatively (or additionally) your psychiatrist may need further information or investigations before they can offer a diagnosis. They will discuss this with you. After diagnosis, your psychiatrist will discuss the recommended treatment.
Your psychiatrist will write a letter to your GP after seeing you, as any other doctor would do. If there is any information you do not want your psychiatrist to include in this letter, please tell them during the appointment. It can be omitted so long as it is not relevant to your diagnosis (this will be up to your clinician’s discretion). You will have access to a copy of this letter, and if you identify any errors in the letter, please inform us immediately so we can amend it. A letter does need to be shared with your GP in order for us to safely prescribe medication.
Right to Choose
If you are registered with a GP in England, you may be able to get your ADHD assessment and treatment funded by the NHS. You can ask your GP to refer you to us for an ADHD assessment under the Right to Choose legislation.
Referrals must come from your GP – you cannot self-refer.
Your Right to Choose referral covers appointments with your consultant to discuss ADHD. It also covers either titration of ADHD medication or a psychosocial needs assessment.
If you move out of England, you will no longer be covered under Right to Choose. In this case, you would either be able to continue your treatment with us privately or speak to your new GP about the local services that are available to you.
Treatment under Right to Choose
Treatment under Right to Choose is funded by the Integrated Care Boards (ICBs), and we are only commissioned for certain things. If you miss two appointments, we will need to discharge you from our care. To resume treatment, you will need to be re-referred back to us by your GP. Due to the number of patients under our care, we cannot guarantee that you will be able to resume your treatment straight away or have a new appointment in the near future. If you disengage from treatment for more than 56 days without explanation, we will also need to discharge you.
If you are unhappy with the outcome of your assessment, we are unfortunately unable to provide second opinion appointments under Right to Choose. However, these may be considered on a case-by-case basis.
Right to Choose funding allows patients to have medication treatment only. Sometimes additional input is needed for patients, and we can arrange a psychosocial needs assessment. Any recommended therapy from this assessment would need to be either: sought from your local NHS service, sought from us with an IFR (individual funding request) made to your local NHS ICB, or paid for privately.
We are only able to offer treatment for ADHD under Right to Choose, and all other assessments and treatments would need to be discussed with your GP and local services. Our psychiatrists could undertake further appointments, assessments and treatments for other mental health conditions you might have on a private basis only, if deemed appropriate and at the discretion of your psychiatrist.
Apply for Right to Choose here
What is Titration?
During your assessment with the Consultant, you may discuss whether medication would be appropriate to help you manage your ADHD symptoms. If you decide that you might find this beneficial, you will be referred to our Titration Service, a team of highly experienced independent prescribers with experience and expertise in ADHD.
Titration is the process that introduces your body to medication safely. During this period you will have regular contact with your prescriber, who will adjust and monitor the treatment until you reach a stable or ‘optimised’ dose to help you achieve the maximum benefit with minimum side effects.
There is a delay between referral to the titration service and being contacted by them. (The delay varies due to demand for the service – please check this page for updates). Many people find this short period of time useful to reflect on the diagnosis and to read information about ADHD. You can also access information and support from our wellbeing support team and our ADHD forum by putting a request on the portal for the attention of the customer support team.
Due to the number of patients under our care, we require a certain level of autonomy during titration. We are unable to send out reminders for prescriptions or send them automatically. You will need to send a note via the portal requesting a new prescription when you are due.
A prescription note is sent via Royal Mail to our partner pharmacy the Private Pharmacy Group (PPG), unless you inform us otherwise. A courier service then delivers the medication to your home address. To avoid delays, we advise that you submit a prescription request approximately 10 days before you are due to run out.
NOTE: Please ensure that your contact details are up to date on the portal, including your home address and GP surgery. This will ensure that all prescriptions or letters are sent to the correct address.
Our clinicians have a duty of care and need to be sure that they are prescribing medication to you safely. You will be required to submit your BP, weight, height and pulse readings before you begin titration, as well as regularly during titration. If the readings fluctuate or are cause for concern, we may require further investigations before we can continue prescribing. We may also require your GP to carry out an ECG or require input from a cardiologist before we can safely prescribe. We understand that it can be frustrating if your medication is delayed or stopped, but please understand that this is for your personal safety.
Following medication treatment, once no further changes to your medication are needed, you will be seen again by your psychiatrist for a 25-minute appointment. If appropriate, your psychiatrist will then request your GP to take over prescribing on a Shared Care Agreement.
If you receive a diagnosis of ADHD, the DVLA advises that you only need to inform the DVLA if you feel that your ADHD impacts your ability to drive safely. If you are not sure if this is the case, please discuss it with your psychiatrist. It is also advisable to inform your insurance company – this is unlikely to affect your premium.
The Portal
We communicate with patients via an online secure portal, which uses two-factor authentication. This is used to ensure that patients’ clinical and confidential information is kept as securely as possible. Patients will need to have access to the internet and will need to provide us with a phone number and email address to access our services. Two-factor authentication will require a device that can receive text codes or a device that can use an authenticator app, such as a smartphone or tablet.
The portal is essential for contacting us throughout your assessment and treatment, and if you experience difficulties in accessing the portal please contact our 24/7 support centre for technical support.
Response Times
Due to the number of patients under our care, we cannot always respond to patient requests immediately. We aim to respond to patient notes on the portal within 2-3 days. Sometimes the note will need to be passed on from the customer support team to the relevant team member, which means that it may take slightly longer to get a reply from the designated reader. If requests are time-sensitive, please call us so we can pass on the message or action the request as quickly as possible.
Please note that we are not an emergency service and cannot offer emergency medical services for urgent or crisis situations, or for patients who are acutely ill. If you need urgent assistance, please follow our advice here.
Already Diagnosed with ADHD?
If you already have an ADHD diagnosis and have been treated within the past year (evidence required), you will generally not require a full assessment. After your existing diagnosis has been reviewed, one of our clinicians will carry out a review appointment, where you can discuss your assessment and any medications you have previously been on/ are currently on. If medication is recommended, your psychiatrist will refer you to our titration service.
Fees
Fees are only payable by private patients. If you are registered with a GP in England, you may be able to get your ADHD assessment and treatment funded by the NHS through Right to Choose (see above).
You do not need a GP referral if you are not seeking NHS funding.
Please note that we do not distinguish between private and Right to Choose patients in terms of waiting times or quality of service. Paying privately for ADHD care will not reduce waiting times.
Below is an illustration of the fees you might expect to pay, from initial assessment to the completion of titration follow-up meeting:
Illustration of Fees
| Description | Fee |
|---|---|
| Initial assessment (50-minute online assessment with consultant psychiatrist, opinion, recommendations, suggested treatment plan and report). Please note that you will be asked to pay this fee at the time of booking. | £360.00 |
| Additional letters which you may require | £30.00 |
| Each minute of online consultation time after first hour | £6.00 per minute |
| Each minute of additional time spent communicating with you/reviewing notes etc. beyond what is deemed reasonable (this is at the clinician’s discretion) | £6.00 per minute |
| Monthly titration fee (including the cost of a monthly prescription and weekly contact with a specialist prescriber through the portal) | £105.00 per month |
| Additional prescriptions/non-ADHD medications (you will be asked to pay for the cost of the medication at your local pharmacy*) | £25.00 |
| 25-minute follow up appointment at the end of titration, or any other time you need one | £180.00 |
| Communication with your consultant and prescriber via the portal | Free |
*Your medication can be obtained from a local pharmacy, which you will pay for as a private prescription. Medication costs can vary considerably, both between pharmacies and between medications.
Alternatively, you can receive your prescription from our specialist online pharmacy, with the medication delivered to you by courier, wherever you want it delivered.
Occasionally, patients feel they need to have their condition managed more intensively by having frequent consultant appointments, with the psychiatrist managing their titration. Those who choose this option can message their consultant between appointments to receive additional advice and support.
If you feel you need this service, please raise it with your consultant in the initial consultation and you will receive a bespoke quotation, setting out a treatment plan, based on a fee of:
£180 per 25-minute appointment, one month apart, until you’re on the best treatment for you (typically 2-5 appointments).
With a bespoke plan, your psychiatrist will also take charge of sending out your prescriptions.