Repeat prescriptions and shared care

Once your medicine and dose are settled, getting more of it turns into a routine: order, collect, repeat. With ADHD medicines, that routine comes with a few extra rules. Knowing them ahead of time makes it less likely the month ends with an empty box and a scramble.

Who prescribes, and when that changes

The NHS says ADHD medicines must be started and monitored by an ADHD specialist. So in the early months, while the dose is being worked out, your prescriptions usually come through the specialist team.

After that, prescribing can move to your GP surgery. NICE guidance asks that, once the dose has been worked out and is stable, prescribing and monitoring of ADHD medication move to “Shared Care Protocol arrangements with primary care”.

What shared care means

The NHS puts it simply: a GP may be able to take over prescribing ADHD medicines, “but only if there is a ‘shared care agreement’ between the GP and the ADHD specialist”. It’s an agreement between two teams, so both have to sign up to it.

NHS England has published template shared care protocols for adult services, covering methylphenidate, lisdexamfetamine, dexamfetamine, atomoxetine and guanfacine. They’re templates rather than rules. NHS England says “There is no legal obligation nor mandatory requirement to use the SCPs”, and they’re designed to be adopted and adapted locally. That’s why how shared care is set up, and whether it’s offered, can look different from one area to the next.

Shared care doesn’t mean the end of reviews. NICE guidance describes a review of ADHD medication at least once a year by a healthcare professional with training and expertise in managing ADHD.

If you’re not sure who prescribes for you now, or who does your yearly review, your ADHD specialist or GP can tell you more. The NHS England protocols cover England. In Scotland, Wales and Northern Ireland, your GP surgery can tell you how prescribing is shared where you live.

The extra rules are about the medicine, not about you.

Controlled drugs: shorter dates, smaller amounts

Some ADHD medicines are controlled drugs. The NHS says methylphenidate “is a controlled drug, which means that you may have to prove your identity when collecting your prescription”. Lisdexamfetamine is on the Home Office’s list of controlled drugs too. If you’re not sure about your own medicine, your doctor or pharmacist can tell you whether yours contains a controlled drug.

Controlled-drug prescriptions also have a shorter life. The NHS says most prescriptions are valid for 6 months, but prescriptions for most controlled drugs are valid for 28 days. For methylphenidate, the NHS says you “have to collect your prescription within 28 days”. A prescription that sits in a drawer for a few weeks can expire before you get to the pharmacy.

The amounts tend to be smaller as well. Home Office guidance notes that “many controlled drugs are not normally prescribed in quantities of greater than 1 month’s supply”. In practice, that can mean ordering roughly once a month, every month.

Planning the month

The NHS says it’s important to request a repeat prescription up to 5 working days before you need your medicine. In England, you can order through the NHS App or the NHS website, through another online service your surgery uses, or by contacting the surgery. Your surgery can tell you which ways it accepts.

Monthly ordering is a lot of small deadlines, and small deadlines are easy to lose. A few things can take the pressure off.

Set a reminder for when there’s about a week’s supply left, not the day it runs out. That leaves room for a slow reply, a bank holiday or a busy week.

Ring or message your pharmacy before collection day to check they have your medicine in. If they don’t, you’ve found out while there’s still time to sort it.

Take your ID when you collect. With a controlled drug, you may be asked to prove who you are.

If you pay for prescriptions in England and expect to need a lot of them, the NHS says a prescription prepayment certificate (PPC) “may be cheaper” than paying for each item.

In England, NHS 111 online has an emergency prescription service for a repeat medicine you’ve completely run out of, but it says it can’t be used to get “controlled drugs that require identification to collect”. The NHS says you can call your GP surgery, and that outside its usual opening hours it should have details of its out-of-hours service recorded on its answering machine.

And if a gap happens anyway, it happens. Logging “Couldn’t get my meds” in Trace keeps a note of when it happened and for how long. Your report can show it at your next review, so the people prescribing for you can see the whole picture.

General information, not medical advice. Talk to your prescriber or doctor about your own treatment. How we write

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