Information on ADHD Assessment and Treatment

• ADHD ASSESSMENT AND TREATMENT SERVICE
• ADHD ASSESSMENT FOR AGE 18 AND ABOVE – COSTS 1200 POUNDS
• IMPORTANT CONSIDERATIONS BEFORE THE ASSESSMENT
• AFTER THE ASSESSMENT
• ADHD MEDICATION TITRATION PACKAGE (COST 1200 POUNDS)
• PRESCRIPTION INFORMATION
• FREQUENTLY ASKED QUESTIONS

ADHD ASSESSMENT AND TREATMENT SERVICE

Dr Baig offers ADHD assessment and treatment for individuals aged 18 and above.

There are two separate packages available:

1. ADHD Assessment Service – Cost: £1200
2. ADHD Treatment Package: This package is specifically designed for patients who have been diagnosed with ADHD following an assessment by Dr Baig. The package includes treatment initiation and titration over three months via six 15-minute remote follow-up appointments at weeks 0, 2,4, 6, 8 and 12. It also provides private prescriptions for three months, email support, and assistance in setting up a shared care agreement with the GP (subject to the GP's agreement) after the completion of 12 weeks - provided that a stable dose has been reached. The cost of this package is £1200.

Please note that all costs mentioned above are in pounds (£).

ADHD ASSESSMENT FOR AGE 18 AND ABOVE – COSTS 1200 POUNDS

The ADHD assessment is designed to determine whether your difficulties are due to ADHD or if there may be another explanation. The symptoms of restlessness, inattention, impulsivity, hyperactivity, and disorganisation can have various causes, including ADHD.

The assessment aims to establish whether one or a combination of factors contribute to these symptoms and guide the development of a personalised treatment plan if an ADHD diagnosis is confirmed. The assessment includes a comprehensive psychiatric evaluation as well as a specialised evaluation for ADHD.

Please note that this assessment does not include a formal diagnostic opinion on the presence or absence of autism. A separate comprehensive assessment is required for that purpose. However, based on the results of the ADHD assessment, it may be recommended that you undergo further evaluation for autism if it is considered a possibility.

If you prefer, there is also an option for a joint Autism and ADHD assessment package available for 2500 pounds.

An ADHD assessment does not always result in an ADHD diagnosis as the assessment may conclude that there are other explanations for your symptoms, which can be caused by a range of mental health difficulties. Even if you strongly believe that an ADHD diagnosis should be reached based on your own research or those expressed by your family or other professionals involved in your care, Dr Baig's service may or may not align with your expectations. Any diagnostic opinion provided by Dr Baig reflects his professional judgment and adherence to established standards; he cannot alter his practice or opinion to accommodate specific expectations.

The cost for the standalone ADHD assessment is 1200 pounds, and it follows this structure:

a.     We will agree on an appointment date and ask you to complete a booking form. We will also request your consent to access your GP summary records. Any additional documentation related to your past mental health and any assessments would also be useful. You can upload this information on the booking form.

b. We will email you some pre-appointment questionnaires for completion. These questionnaires include psychometric and clinical questions that are designed to provide essential baseline information. This helps ensure we can focus on key areas requiring a detailed evaluation during the appointment.

c. As part of the ADHD assessment process, we will ask for details about someone close to you who knows you well - ideally from childhood until adulthood - in your booking form. Obtaining information from someone close is important, especially with a specific focus on early life experiences. We will email them a relative feedback form as part of the assessment. Completing the form usually takes around 30 minutes of their time. If they cannot complete the online form, one of Dr Baig's team members can phone them to gather this information.

d. Once the above has been completed, the third part of the assessment involves meeting with Dr Baig for 90 minutes. The assessment involves the completion of a structured ADHD assessment interview and a discussion of conclusions from the assessment process. This part of the assessment is focussed on the information and review with you only and does not require the presence of or information by a relative.

e. In some cases where difficulties are complex or more information is needed, the completion of extra questionnaires may be required. If so, this may lead us to schedule another appointment after the initial consultation. This additional step, if required, does not incur any extra charges.

The assessment can be conducted online or in person, although in-person appointments are preferred for assessments and follow-ups. Please indicate your preference when booking the appointment.

IMPORTANT CONSIDERATIONS BEFORE THE ASSESSMENT

The diagnosis of ADHD requires a specific, structured diagnostic assessment and cannot be made in a standard 50-minute psychiatric consultation.

1. The diagnostic assessment aims to establish current difficulties associated with ADHD and whether these meet the minimum symptom threshold in DSM-5 and ICD-10 and whether the origin of symptoms can be attributed to ADHD. The process also requires that these symptoms are not better explained by another mental health condition. An ADHD diagnosis is unlikely to be made when severe symptoms of anxiety, depression, suicidal ideation, Bipolar Affective Disorder, or significant alcohol and recreational drug use are present. This is because it becomes challenging to distinguish between lifelong, pervasive ADHD symptoms and acute mental health difficulties that overlap significantly with ADHD symptoms, affecting emotions, impulsivity, concentration, organisation and executive function. The diagnostic process requires this distinction to be made with certainty. There is a possibility that an ADHD assessment conducted without adequate management of these acute symptoms may not result in an ADHD diagnosis, even if underlying ADHD is present. We recommend seeking support for acute mental health problems first. Once these conditions have stabilised and your functioning has returned to a stable baseline, you may then request an ADHD consultation. Additionally, ADHD treatment options are not appropriate in the presence of severe acute mental health problems or high alcohol or recreational drug use.
2. The ADHD assessment and treatment are two separate considerations. Treatment details are noted separately. The assessment aims to reach a diagnostic conclusion on ADHD; no specific medication treatments are initiated or recommended as part of this assessment, though the assessment will make general recommendations on whether medication treatment is likely to be helpful, along with noting lifestyle interventions.
3. Following the assessment as a private psychiatrist, Dr Baig cannot request any NHS service to provide treatment, even if an ADHD diagnosis is confirmed.
4. Please consult your GP and inform them that you are opting for an ADHD assessment. You may wish to discuss if the assessment concludes with an ADHD diagnosis and medications are prescribed, whether the GP would be willing to consider a shared care agreement. This agreement means that your GP practice can continue with prescriptions after the medication titration period, which typically takes around three months. Details of the shared care arrangement are noted later in this document.
5. An ADHD diagnosis does not automatically lead to a prescription for ADHD medications. There are separate thresholds for medication treatment, including considerations of severity, impact, and whether lifestyle interventions should play a primary role. The clinician must also be satisfied that prescription is a safe and appropriate option in the context of your current physical and mental health. This remains a matter of clinical judgement.
6. Please be aware that there is currently a significant shortage of ADHD medications. Any future treatment planning may be affected by these shortages. This may also influence your GP's agreement to shared care arrangements due to the limited availability of medications.

AFTER THE ASSESSMENT

A written report will be sent to within two weeks of the assessment. Please note that there may be occasional delays in this timeframe due to commitments such as annual leave or sickness. You are welcome to share this report with anyone who needs to be informed about your condition.

If you require additional letters for third parties related to work, education, or travel purposes, these can also be provided as part of the initial assessment. However, please note that these letters will only confirm the diagnosis for specific purposes. For example, you can request a diagnosis statement for your employer or college or a letter if you need to travel with controlled drugs.

If you are a higher-education student, obtaining a confirmation letter of your diagnosis can support your claim for the Disabled Students Allowance (DSA). This entitlement may include extra time during exams and assignments, separate rooms for studying and taking exams, additional breaks if needed, and mentorship support services tailored towards individuals with ADHD-specific study skills.

It's important to mention that these reports do not cover any specific adjustments required in work environments, as they would need an individual occupational assessment which addresses workplace-related questions separately.

The report will also include information about self-help materials to enhance your knowledge and expertise in managing ADHD.

The cost associated with the assessment includes everything mentioned above but doesn't cover treatment interventions, which are part of a separate ADHD treatment package. The assessment and treatment are two separate considerations, and the assessment process would only provide diagnostic clarity on ADHD. As per established guidelines for ADHD treatment, initiation and monitoring of medication should be done by a specialist and Dr Baig can not ask your GP or NHS services to prescribe. The medication titration process involves gradually adjusting the dosage while closely monitoring both efficacy and side effects. The dose titration usually takes up to three months, but in some cases, it may take longer if the initial medication response requires changing the treatment. Follow-up appointments during this period are mandatory and will be scheduled at weeks 0, 2, 4, 6, 8 and 12 weeks as 15 min video appointments. Following the three-month titration period, once a stable dose of medication has been reached, Dr Baig can request a GP for a shared care agreement under which GPs take over prescribing and physical health monitoring with mandatory yearly reviews with Dr Baig. However, this is at the discretion of the GP, and they can refuse shared care agreements. Dr Baig will happily continue prescribing if a shared care agreement is not in place. If you would like to discuss this with your GP, please do so before booking the assessment to ensure that your GP is happy to prescribe under a shared care agreement once titration has been completed.

Dr Baig will only start prescribing medications once the treatment package has been agreed upon and paid for and mandatory follow-up appointments have been booked. Dr Baig cannot request your GP to begin prescribing as ADHD treatment is considered specialist care, and GPs are unable to initiate or monitor ADHD treatment.

ADHD MEDICATION TITRATION PACKAGE (COST 1200 POUNDS)

ADHD assessment and ADHD medication treatment are two separate considerations. The assessment cannot make any recommendations on the medication options as ADHD treatment involves gradual medication titration, monitoring for efficacy and side effects, and making changes as appropriate. This can take up to three months and can only be initiated and supervised by specialists.

Dr Baig cannot request GPs or other NHS services to initiate ADHD treatment.

The package covers ADHD medication titration for 3 months, including:

• Initial discussion of medication options in the first meeting
• Follow-up appointments at baseline and then at week 2,4, 6, 8 and 12 to monitor efficacy and side effects. These are 15 minute remote appointments offered on Sundays only.
• Prescriptions for a period of three months (The cost of a private prescription is included, The cost of medication is payable to the pharmacy and is not included)
• Email support for any urgent enquiries and side effects related to medications without additional clinical admin charges
• Requesting GP for a shared care agreement

We advise all patients to check with their GP before booking an assessment to ensure they will be happy to issue prescriptions and carry out physical health monitoring under the shared care agreement once a stable dose of medications has been achieved. This is at the GP’s discretion.

Please note that this service is only available for patients diagnosed with ADHD by Dr Baig. If a different professional made the diagnosis, Dr Baig cannot offer the treatment package or medication prescription without carrying out a new ADHD assessment. Typically, consultant psychiatrists cannot prescribe based on diagnoses made by other psychiatrists or healthcare professionals. This also applies if you were diagnosed with ADHD as a child and have been previously prescribed medications but require a review or consideration of changing or reinitiating medications - in these cases, a new assessment may be necessary.

Please note that all titration appointments must be agreed upon and paid for before medication titration can commence.

• Physical observations, including BP, Pulse and weight readings, will be required before the first titration appointment and then before every dose adjustment. Please ensure that you have these readings available at the start of the meeting. The titration meeting can not proceed in absence of these readings. You can buy a weighing scale and blood pressure monitor from Amazon for a total price of less than 40 pounds. A potential side effect of medication is an increase in pulse and blood pressure as well as weight loss, and it is crucial able to monitor it at home, especially during the early treatment period.
• A baseline ECG or blood tests may also be required in some situations where medical history warrants it.

When initiating new medication treatments, we are professionally obligated to copy both the assessment letter and the treatment plan to your GP. We can only prescribe the medication if you want your GP to be informed.

Email support will also be available for urgent queries outside of scheduled appointments. The response time is up to 72 hours.

Blood tests are not typically required for assessment or monitoring unless indicated in certain situations. Please note if blood tests are recommended as part of the assessment process, they are not included in the standard cost. You would need to complete them with your GP or an alternative private provider. If these tests occur during a private appointment, your NHS GP may view them as private treatment costs. We can provide contact details for the GP practice we work with; additional costs should be paid directly to them. Alternatively, you can choose your provider for blood tests and have the results forwarded to us.

Please remember that this ADHD treatment package does not cover the cost of medications - these must be paid separately at a pharmacy. Controlled drug prescriptions are issued using private CDFP10s and must follow controlled drug regulations. The cost of private prescriptions is higher than the NHS prescriptions and is subject to fluctuant individual pricing.

At the end of three months (if medication dosage has been stable), Dr Baig is happy to request an NHS GP shared care agreement:

• The agreement allows GPs to take over medication prescriptions and physical health monitoring.
• Psychiatric reviews will continue annually or as needed with Dr Baig.

Note: Shared care agreements require formal documentation signed by the psychiatrist (Dr Baig) and the GP.

GPs hold discretion regarding whether they accept responsibility for prescribing medications under these agreements; if declined by a GP, follow-up prescriptions & monitoring would need continued management with Dr Baig instead. Setting up a shared care agreement is included in this service's cost; however, Dr Baig cannot direct GPs into accepting prescribing responsibilities if they choose not to do so. Some GPs may prefer ongoing private prescriptions under the supervision of the psychiatrist for treatments initiated in private care.

If a shared care agreement is completed after three months, only yearly appointments with Dr Baig or requested earlier appointments will be necessary. The ADHD treatment guidelines require that there is an annual review with the specialist to determine whether continuing ADHD prescription is still appropriate, and this is an essential condition for ongoing treatment and the shared care agreement. These yearly appointments are 25 minutes long and involve a review of your functioning and deciding whether continuing the prescription of ADHD medication is still appropriate. These sessions will be charged at the standard follow-up appointment rate, applicable at the time of the appointment. We will request you to complete pre-appointment questionnaires.

Dr Baig can also arrange individual therapy with one of the therapists at his practice, either as part of an agreed treatment option together with medications or without them. Patients are free to choose their preferred therapist if they wish to do so. Similarly, Dr Baig would happily organise an occupational therapy assessment for environmental modifications. These costs are in addition to the ADHD treatment costs.

For follow-up care beyond the three-month package, additional costs (not covered by the package) are as follows:

• Prescription during a follow-up appointment: Free
• Controlled drug prescription outside an appointment: £75
• Non-controlled drug prescription outside an appointment: £25
• 25-minute follow-up appointment (in person/phone/video call): £225

Email/Phone support/Administrative work involving additional letters required will be charged at Dr Baig's discretion but would not exceed 60 pounds per 10 minutes of clinical administration work. The minimum chargeable time is 10 minutes.

PRESCRIPTION INFORMATION

Please note that after the initial titration appointment under the ADHD treatment package, the agreed prescription will be available to you in a week. All controlled drug prescriptions are posted via tracked delivery in keeping with controlled drug regulations. Any lost or misplaced prescriptions may not be re-issued and will result in treatment interruption.

Dr Baig issues prescriptions once a week, which are posted by Thursdays (electronically prescribed if non controlled drug). Please request a prescription so that you have plenty of time to receive the prescription and get medication from the pharmacy, considering the weekly posting day of Thursday. For prescriptions to be posted on Thursdays, all requests must be received by Monday.

Please email prescription requests by completing the prescription request form.

Please note the charges above for prescriptions outside follow-up appointments when not covered by the 3-month titration package. Non-controlled drug prescriptions are issued electronically, and you will receive a prescription in your email, which a pharmacy can dispense.

At present, there is an acute shortage of ADHD medications in the market, and supply remains subject to significant fluctuations.

FREQUENTLY ASKED QUESTIONS

What is Dr Baig’s approach to ADHD diagnosis?

When diagnosing ADHD, Dr Baig takes a thorough approach that goes beyond simply checking off a list of symptoms. The process of psychiatric diagnosis is complex and involves understanding the challenges a patient is facing and what could be causing them. This includes considering the possibility of other psychiatric issues, as well as taking into account what is considered normal human personality and coping mechanisms. Dr Baig's goal is to establish the nature and origin of a patient's difficulties, so the assessment process involves reviewing the patient as a whole and considering input from someone who knows them well.

According to the DSM-5, ascertaining the diagnosis of ADHD in adults involves determining:

• The presence of ADHD symptoms during both childhood and adulthood.
• The onset of these symptoms occurs during childhood.
• A lifelong persistence of characteristic symptoms up until the current evaluation.
• No other mental health problem explains these symptoms.
• Symptoms are associated with significant clinical or psychosocial impairments in two or more life situations.

Since ADHD starts in childhood but persists throughout adulthood, it becomes necessary to evaluate:

1. Symptoms - their course, level, and associated impairment during childhood using retrospective interviews for childhood behaviours.
2. Information gathered from patients was supplemented by information provided by informants (usually parents or close relatives) who knew them as children.

To diagnose ADHD, it must also be ensured that no other primary mental health issue can better explain these symptoms; however, it's possible for individuals to have both ADHD symptoms and other mental health issues simultaneously.

Are there other mental health conditions that can cause symptoms like ADHD?

Yes, several mental health conditions can lead to difficulties with inattention, organisation, restlessness, impulsivity, and hyperactivity. As part of the ADHD assessment process, a comprehensive psychiatric review is conducted to identify these conditions. These problems can occur with or without ADHD. Some common mental health issues that can result in ADHD-like symptoms include:

• Mood Disorders such as bipolar affective disorder, cyclothymia, or depression
• Anxiety Disorders
• Dissociative Disorders
• Other neurodevelopmental conditions, such as autism
• Emotional regulation disorders like emotionally unstable personality disorder or other personality difficulties
• Alcohol or substance use disorders
• Normal variations of human personality and cognition

If ADHD is the diagnosis, would I be prescribed stimulant medications only?

Dr Baig will discuss management options with you as part of the ADHD treatment. The diagnostic assessment would make a general recommendation on whether medication treatment is likely to be helpful, but no particular treatment can be recommended or initiated in the assessment appointment itself. Stimulants are usually the first line of treatment. Still, they may not be appropriate in certain situations where non-stimulant medications are recommended, especially if there are co-existing mental health or physical health problems that make stimulants unsuitable. Some patients may also choose to work with psychological interventions, either alongside medications or as the sole treatment.

After the assessment, can you write to the GP with prescription recommendations?

Assessment and treatment are separate considerations. After the assessment, a written report will be sent to both you and your GP. However, ADHD treatment can only be initiated by a specialist, and GPs cannot start or monitor it until a stable dose has been reached - which typically takes around three months on average and is covered by the separate treatment package. This can only happen under a shared care agreement if your GP agrees.

Would GPs be able to take over prescriptions after three months under a shared care agreement?

Most GPs will take over prescriptions provided a shared care agreement exists and access to psychiatric follow-up for mandatory annual reviews or more frequent follow-ups if needed. Additionally, there should have been stability in symptoms and achieving a stable dose of medication before transitioning care to the GP. However, GPs are not obligated to take over prescriptions and are not guaranteed to do so. Some GPs may ask that private prescriptions continue under private care. Dr Baig would happily continue providing private prescriptions and follow-ups if this happens. This makes it important to check with your GP before opting for an ADHD assessment.

What is the medication cost, and is it included in the ADHD treatment package?

The cost of medication is variable. Private prescriptions are not the same as NHS prescriptions. The cost is determined by the type of medication, current supply of medication and pricing set by a particular pharmacy. The ADHD titration package covers the cost of writing a prescription. The cost of the medication is payable to the pharmacy. For most people, the cost range is roughly 50 -150 pounds per month.

Would my ADHD assessment be accepted by my GP/educational institution/employer?

ADHD assessment reports aim to provide a clinical opinion on diagnosis and offer treatment recommendations that Dr Baig can facilitate in private care if both parties agree. However, it's important to note that other professionals or institutions may have their own policies when deciding their actions and are not required to accept Dr Baig's professional opinion and act accordingly.

A private assessment cannot expedite access to NHS care, nor is it intended to facilitate such access. Additionally, GPs cannot initiate or prescribe ADHD treatment unless done so under a shared care agreement. NHS ADHD services only offer treatment pathways for patients they have assessed.

While Dr Baig does not initiate or prescribe treatment based on ADHD assessments done by other professionals, this does not mean he does not accept the validity of such assessments. Psychiatrists typically prescribe based on their own clinical assessments, and responsibility for prescribing and initiating treatment usually remains within the same setting unless both parties agree otherwise.

It's important to understand that by offering an ADHD assessment, Dr Baig does not guarantee acceptance of his opinions as valid by all institutions and professionals.

‌

Can Dr Baig facilitate access to Psychological Therapy?

Dr Baig can assist in providing access to experienced CBT Therapists for individual weekly therapy sessions. However, it's important to note that you have the freedom to choose whether or not you want to work with a therapist recommended by Dr Baig; you can make your own arrangements if you prefer.

Do I need to inform DVLA if I am diagnosed with ADHD?

According to the law, it is necessary for you to inform DVLA if you believe that your ADHD or any medications you are taking may affect your driving, either in your own opinion or as advised by your clinician. This situation is uncommon when proper treatment is received since substantial evidence suggests that appropriate treatment improves road safety. Additionally, if any medication prescribed for ADHD causes side effects that could potentially affect safe driving, it should also be reported. Discussing alternative medication options with a healthcare professional would be advisable if this occurs.

Could I have a letter for my employer asking for workplace accommodations?

Dr Baig can provide a "To Whom It May Concern" letter outlining the diagnosis and general recommendations on how people with ADHD might benefit from workplace accommodations. However, specific recommendations tailored to your specific workplace require an evaluation of your work environment and the nature of the work itself. This evaluation falls under occupational health opinions aimed at assessing and implementing adjustments in the workplace.

Do I need regular physical health monitoring while undergoing ADHD treatment?

Yes, it is mandatory for individuals receiving treatment for ADHD (particularly those on stimulant medication) to undergo physical health checks every six months. This includes measuring weight, pulse, blood pressure, and liver function tests, if taking atomoxetine. These check-ups can be conducted by your GP once a shared care agreement has been established. If any blood tests are needed before starting treatment, your GP or a private provider can help complete them before starting treatment.