ADHD Pathfinding
@adhdpathfinding.org.uk
Working towards a society where ADHD is understood, supported, and never a barrier to thriving
medium.com/adhd-pathfinding
medium.com/adhd-pathfinding
Day 31: Lack of national ownership, accountability and strategy.
The last day of ADHD Awareness Month!
We’ve shared one systemic barrier a day and saved the biggest till last: A lack of national ownership, accountability and strategy for ADHD.
We’ve also published a post summarising the month’s findings.
📅 Part of ADHD Awareness Month. Day 31 of 31
We’ve shared one systemic barrier a day and saved the biggest till last: A lack of national ownership, accountability and strategy for ADHD.
We’ve also published a post summarising the month’s findings.
📅 Part of ADHD Awareness Month. Day 31 of 31
31 Days, 31 Barriers to ADHD Care
What ADHD Awareness Month taught us
medium.com
November 1, 2025 at 9:11 AM
Day 31: Lack of national ownership, accountability and strategy.
Day 30: Fear of stimulant medication.
Parents are often warned that ADHD meds are “controlled drugs” and “very strong.”
That framing breeds fear instead of understanding. These medications are safe and effective when properly prescribed but stigma still shapes care decisions.
📅 Part of ADHD Awareness Month. Day 30 of 31
That framing breeds fear instead of understanding. These medications are safe and effective when properly prescribed but stigma still shapes care decisions.
📅 Part of ADHD Awareness Month. Day 30 of 31
November 1, 2025 at 9:11 AM
Day 30: Fear of stimulant medication.
Day 29: Costing blind spots in flexible dosing.
NHS ADHD cost models assume daily dosing at the same level for years.
But many people use flexible or “as needed” dosing. That misunderstanding inflates budgets and limits access to treatment that fits real life.
📅 Part of ADHD Awareness Month. Day 29 of 31
But many people use flexible or “as needed” dosing. That misunderstanding inflates budgets and limits access to treatment that fits real life.
📅 Part of ADHD Awareness Month. Day 29 of 31
November 1, 2025 at 9:11 AM
Day 29: Costing blind spots in flexible dosing.
Day 28: Costs of untreated ADHD not captured.
The NHS doesn’t capture the real costs of untreated ADHD: from accidents to unemployment to mental health crises.
Without data, ADHD looks expensive to treat but cheap to ignore. In reality the opposite is true.
📅 Part of ADHD Awareness Month. Day 28 of 31
Without data, ADHD looks expensive to treat but cheap to ignore. In reality the opposite is true.
📅 Part of ADHD Awareness Month. Day 28 of 31
November 1, 2025 at 9:11 AM
Day 28: Costs of untreated ADHD not captured.
Day 27: Locally commissioned services underfunded.
Some areas fund ADHD Locally Commissioned Services, but the budgets are so small they can’t train staff or sustain delivery.
These schemes look good on paper, but collapse in practice. Another postcode lottery in action.
📅 Part of ADHD Awareness Month. Day 27 of 31
These schemes look good on paper, but collapse in practice. Another postcode lottery in action.
📅 Part of ADHD Awareness Month. Day 27 of 31
November 1, 2025 at 9:11 AM
Day 27: Locally commissioned services underfunded.
Day 26: Primary care not commissioned for ADHD.
ADHD is treated as a “specialist-only” condition.
GPs manage diabetes, asthma, depression. But not ADHD.
It’s one of the only long-term conditions left out of primary care.
📅 Part of ADHD Awareness Month. Day 26 of 31
GPs manage diabetes, asthma, depression. But not ADHD.
It’s one of the only long-term conditions left out of primary care.
📅 Part of ADHD Awareness Month. Day 26 of 31
November 1, 2025 at 9:11 AM
Day 26: Primary care not commissioned for ADHD.
Day 25: GPs refuse SCAs from non-psychiatrists.
Many GPs won’t accept Shared Care Agreements unless the prescriber is a psychiatrist, even when the clinician is a qualified specialist.
That means patients with valid NHS diagnoses are denied GP prescriptions and have to pay £100-150/month privately.
📅 Part of ADHD Awareness Month. Day 25 of 31
That means patients with valid NHS diagnoses are denied GP prescriptions and have to pay £100-150/month privately.
📅 Part of ADHD Awareness Month. Day 25 of 31
November 1, 2025 at 9:11 AM
Day 25: GPs refuse SCAs from non-psychiatrists.
Day 24: Patients unaware of SCA risks.
Most people don’t know moving house can void their Shared Care Agreement.
They find out only when their new GP refuses to prescribe, leaving them abruptly without medication or support.
It isn’t patient error, it’s system failure.
📅 Part of ADHD Awareness Month. Day 24 of 31
They find out only when their new GP refuses to prescribe, leaving them abruptly without medication or support.
It isn’t patient error, it’s system failure.
📅 Part of ADHD Awareness Month. Day 24 of 31
November 1, 2025 at 9:11 AM
Day 24: Patients unaware of SCA risks.
Day 23: SCAs not transferable across Trusts.
Moving house? Lose your Shared Care Agreement.
Across England, SCAs don’t transfer between NHS Trusts. Even stable patients have to start again and be reasessed, re-titrate, or go private to stay on medication. It’s disruptive, unsafe, and avoidable.
📅 Part of ADHD Awareness Month. Day 23 of 31
Across England, SCAs don’t transfer between NHS Trusts. Even stable patients have to start again and be reasessed, re-titrate, or go private to stay on medication. It’s disruptive, unsafe, and avoidable.
📅 Part of ADHD Awareness Month. Day 23 of 31
November 1, 2025 at 9:11 AM
Day 23: SCAs not transferable across Trusts.
Day 22: ADHD meds classed as Amber.
ADHD meds are often classed as “Amber” prescribing guidance. That makes shared care optional for GPs. Many say no.
It’s one reason why patients remain stuck between secondary care and Right to Choose providers, unable to get repeat prescriptions.
📅 Part of ADHD Awareness Month. Day 22 of 31
It’s one reason why patients remain stuck between secondary care and Right to Choose providers, unable to get repeat prescriptions.
📅 Part of ADHD Awareness Month. Day 22 of 31
November 1, 2025 at 9:11 AM
Day 22: ADHD meds classed as Amber.
Day 21: “Specialist” undefined.
NICE says ADHD meds must be started by a “specialist” but doesn’t define who that is.
The result? Inconsistent practice, bottlenecks, and patients waiting months while systems debate semantics.
📅 Part of ADHD Awareness Month. Day 21 of 31
The result? Inconsistent practice, bottlenecks, and patients waiting months while systems debate semantics.
📅 Part of ADHD Awareness Month. Day 21 of 31
November 1, 2025 at 9:11 AM
Day 21: “Specialist” undefined.
Day 20: Unsafe titration windows.
Some Right to Choose ADHD contracts incentivise speed: seven-week titration, minimal follow-up, quick discharge.
Fast isn’t always safe. Medication adjustments need time, not tick-boxes.
📅 Part of ADHD Awareness Month. Day 20 of 31
Fast isn’t always safe. Medication adjustments need time, not tick-boxes.
📅 Part of ADHD Awareness Month. Day 20 of 31
November 1, 2025 at 9:11 AM
Day 20: Unsafe titration windows.
Day 19: Ageism in treatment.
If ADHD meds aren’t suitable, there’s often nothing else offered. No coaching, no ND-specific therapy, no alternative plan.
Care ends where medication stops. That gap will only grow as people age and contraindications increase.
📅 Part of ADHD Awareness Month. Day 19 of 31
Care ends where medication stops. That gap will only grow as people age and contraindications increase.
📅 Part of ADHD Awareness Month. Day 19 of 31
November 1, 2025 at 9:11 AM
Day 19: Ageism in treatment.
Day 18: Cost-driven prescribing.
In some areas ICBs push clinicians to start adults on cheaper methylphenidate first, even when lisdexamfetamine may work better.
That’s not NICE guidance, it’s cost driven and can lead to longer titration, poorer outcomes, and frustration for patients.
📅 Part of ADHD Awareness Month. Day 18 of 31
That’s not NICE guidance, it’s cost driven and can lead to longer titration, poorer outcomes, and frustration for patients.
📅 Part of ADHD Awareness Month. Day 18 of 31
November 1, 2025 at 9:11 AM
Day 18: Cost-driven prescribing.
Day 17: medication blocked.
Even after diagnosis, many can’t access ADHD medication.
GPs say they’ll prescribe, but local rules, unclear shared-care policies, or ICB restrictions block it.
On paper, access exists. In reality, people go without.
📅 Part of ADHD Awareness Month. Day 17 of 31
GPs say they’ll prescribe, but local rules, unclear shared-care policies, or ICB restrictions block it.
On paper, access exists. In reality, people go without.
📅 Part of ADHD Awareness Month. Day 17 of 31
The ADHD Prescribing Gap
Why GPs say yes, but patients still hear no
medium.com
November 1, 2025 at 9:11 AM
Day 17: medication blocked.
Day 16: Prescribing restricted to formulary.
ADHD meds are treated like opioids. 28-day expiry. No repeats. No emergency refills.
Rules meant to prevent misuse often do the opposite: stable patients fall off medication, relapse, and end up back in crisis care.
📅 Part of ADHD Awareness Month. Day 16 of 31
Rules meant to prevent misuse often do the opposite: stable patients fall off medication, relapse, and end up back in crisis care.
📅 Part of ADHD Awareness Month. Day 16 of 31
Why ADHD Medication Is So Tightly Controlled
And What Sweden’s Data Tells Us
medium.com
November 1, 2025 at 9:11 AM
Day 16: Prescribing restricted to formulary.
Day 15: ICB contracts inconsistent.
People diagnosed through Right to Choose or privately are often told their ADHD assessment “doesn’t count.”
That means people are told to start over, waiting years again for the same answer. Wasteful, unfair, and deeply demoralising.
📅 Part of ADHD Awareness Month. Day 15 of 31
That means people are told to start over, waiting years again for the same answer. Wasteful, unfair, and deeply demoralising.
📅 Part of ADHD Awareness Month. Day 15 of 31
Why ADHD Diagnoses Get Rejected
And what needs to change
medium.com
November 1, 2025 at 9:11 AM
Day 15: ICB contracts inconsistent.
Day 14: Lived experience excluded from contract design.
Clinicians with ADHD understand the system from both sides: patient and practitioner.
But they’re almost never included in service design or contract discussions. Their insight could make services fairer, safer, and more user-centred.
📅 Part of ADHD Awareness Month. Day 14 of 31
But they’re almost never included in service design or contract discussions. Their insight could make services fairer, safer, and more user-centred.
📅 Part of ADHD Awareness Month. Day 14 of 31
November 1, 2025 at 9:11 AM
Day 14: Lived experience excluded from contract design.
Day 13: RTC and NHS can’t collaborate.
If someone under a Right to Choose ADHD provider develops another health condition, they can fall through the cracks.
RTC and NHS teams often can’t collaborate, even when both agree treatment is safe. The system divides care that should be joined up.
📅 Part of ADHD Awareness Month. Day 13 of 31
RTC and NHS teams often can’t collaborate, even when both agree treatment is safe. The system divides care that should be joined up.
📅 Part of ADHD Awareness Month. Day 13 of 31
November 1, 2025 at 9:11 AM
Day 13: RTC and NHS can’t collaborate.