Policies

Adult ADHD and Mental Health Clinic Website Policies, Terms and Patient Information.

1. Cancellation and Rescheduling Policy

We understand that circumstances can change. Please provide as much notice as possible if you need to cancel or reschedule an appointment.

Our cancellation and refund arrangements are:

Notice given	Refund
72 hours or more	100%
48 hours to less than 72 hours	75%
24 hours to less than 48 hours	50%
4 hours to less than 24 hours	25%
Less than 4 hours	No refund

Where an appointment is missed without notice, the appointment will normally be treated as a cancellation with less than four hours’ notice.

Any exceptional circumstances will be considered at the clinic’s discretion.

If we need to cancel or reschedule an appointment, we will provide as much notice as reasonably possible and will offer an alternative appointment where appropriate.

2. Confidentiality

We take patient confidentiality seriously and will keep information about you secure and confidential in accordance with applicable legal, regulatory and professional requirements.

Information will normally only be shared where:

• you have given appropriate consent;
• sharing is necessary for your ongoing care;
• sharing is required or permitted by law; or
• there is a serious and relevant risk to you or another person that justifies disclosure.

Where appropriate and clinically necessary, information about your diagnosis, treatment or medication may be shared with your GP or other healthcare professionals involved in your care.

We will seek to respect your preferences regarding information sharing wherever this is compatible with our legal, professional and clinical responsibilities.

3. Data Protection and Privacy Notice

We process personal information in accordance with applicable UK data protection legislation, including the UK General Data Protection Regulation and the Data Protection Act 2018.

Health information is special category personal data and will only be processed where an appropriate legal basis and, where required, an additional condition for processing special category data applies.

We use personal information to:

• provide assessment, diagnosis and treatment;
• maintain appropriate clinical records;
• prescribe and monitor medication where clinically appropriate;
• communicate with you about your care;
• communicate with other healthcare professionals where appropriate;
• manage appointments and payments;
• respond to complaints and concerns;
• meet legal, regulatory and professional obligations; and
• maintain the safety and quality of our services.

Further information about the categories of information we collect, how information is used, how it is protected, your rights and how long information is retained is provided in our Privacy Notice.

4. Terms and Conditions

By booking an appointment or using our services, you agree to comply with these terms and conditions.

We will:

• provide services within the scope of our registration and professional competence;
• provide care in accordance with applicable professional, legal and regulatory requirements;
• maintain appropriate clinical records;
• protect patient confidentiality and personal information;
• explain relevant treatment options and obtain appropriate consent;
• provide information that is reasonably necessary for you to understand your care; and
• maintain appropriate arrangements for responding to complaints and concerns.

We may decline, postpone or discontinue an assessment or treatment where this is clinically necessary, where the requested service is outside our scope of practice, or where safe and appropriate care cannot be provided.

5. Your Responsibilities

Patients are expected to:

• provide accurate and complete information about their medical history, medication and relevant circumstances;
• inform us of relevant changes in their health or medication;
• attend appointments at the agreed time;
• participate in recommended monitoring;
• follow agreed treatment and prescribing arrangements;
• provide relevant information requested from their GP or other healthcare professionals where appropriate;
• tell us if they are receiving treatment from another clinician that may affect their care;
• treat staff and clinicians respectfully; and
• inform us as soon as possible if they cannot attend an appointment.

Failure to provide relevant information or participate in required monitoring may affect our ability to provide safe treatment.

6. Appointments

Appointments are provided at the time and in the format agreed with you.

You are responsible for ensuring that you attend appointments on time and have access to any information or documentation requested before the appointment.

If you arrive late, the clinician may be unable to complete the full appointment safely and may need to shorten or reschedule the appointment.

Appointments are subject to the cancellation and rescheduling policy.

7. Remote Online Appointments

Remote appointments are conducted using a secure video-conferencing platform.

Details of how to access your appointment, including any link or joining instructions, will be provided before the appointment.

You are responsible for ensuring that you have:

• a suitable internet connection;
• a compatible device;
• a functioning camera and microphone where required; and
• access to a quiet and private environment.

You should attend the appointment from a location where confidentiality can reasonably be maintained.

For clinical and regulatory reasons, patients must be physically located within the UK when receiving a remote clinical consultation from the clinic.

If you are outside the UK at the time of your appointment, the appointment may need to be cancelled or rescheduled and the cancellation policy may apply.

The clinician may terminate, cancel or reschedule a remote appointment where adequate privacy, confidentiality, communication or clinical safety cannot be maintained.

If you experience technical problems, please contact the clinic as soon as possible.

8. Personal Data

We collect and process information necessary to provide safe and appropriate healthcare.

This may include:

• identification and contact details;
• GP and other healthcare-professional details;
• medical history;
• psychiatric and psychological information;
• ADHD assessment information;
• medication and prescribing information;
• physical health information relevant to treatment;
• correspondence and reports;
• appointment information;
• payment information; and
• information relating to complaints or concerns.

We take appropriate technical and organisational measures to protect personal information against unauthorised access, loss, alteration or disclosure.

9. GP Details

Where appropriate, we may request your GP’s details so that relevant clinical information can be communicated to your GP.

You should provide accurate and up-to-date GP information.

Depending on the nature of your treatment and prescribing arrangements, we may need to communicate with your GP regarding diagnosis, medication, monitoring, treatment recommendations, shared care or other aspects of your clinical care.

Where information is shared without consent, this will only be where there is an appropriate legal, professional or safeguarding basis for doing so.

10. Confidentiality, Consent and Information Sharing

We will normally seek your consent before sharing information with another healthcare professional where consent is required.

However, confidentiality is not absolute. Information may need to be disclosed without consent where required by law or where there is a sufficiently serious risk of harm to you or another person and disclosure is justified.

We will share only information that is relevant and necessary for the purpose for which it is being disclosed, subject to applicable legal and professional requirements.

11. Retention of Medical Records

We maintain appropriate clinical records of the assessment, treatment and care we provide.

Our records may include clinical notes, assessment information, correspondence, reports, treatment and prescribing information, and other information relevant to your care.

We retain clinical and personal information in accordance with applicable data protection legislation, professional requirements and relevant health and social care records-management guidance.

The retention period may vary depending on the type of record and the nature of the care provided.

Providing you with a copy of an assessment report or other correspondence does not mean that the underlying clinical record is deleted.

We will retain records for at least the applicable minimum period and will not retain personal information for longer than is necessary, unless a longer period is required or justified by applicable legal, regulatory, professional or clinical requirements.

Before records are securely destroyed, they will be reviewed in accordance with our records-management procedures.

Records may need to be retained for longer where there is an ongoing clinical, safeguarding, complaint, legal, regulatory or other legitimate requirement.

Further information about how we collect, use, protect and retain your personal information is provided in our Privacy Notice.

12. Zero-Tolerance Policy

We are committed to providing a safe and respectful environment for patients, clinicians and staff.

We will not tolerate:

• verbal abuse;
• threatening or intimidating behaviour;
• harassment;
• discriminatory behaviour;
• violence or threats of violence;
• abusive or offensive communications;
• deliberate damage to property; or
• behaviour that places patients, staff or clinicians at risk.

This applies to behaviour in person, by telephone, email, online communication, video consultation and other forms of communication with the clinic.

Where behaviour creates a safety or confidentiality concern, we may end a consultation, restrict communication, require communication through a nominated channel, or take other appropriate action.

Serious incidents may be reported to the appropriate authorities where necessary.

13. Assessment and Diagnosis

Assessment and diagnosis are based on the information available to the clinician, including clinical history, assessment findings, information provided by the patient and, where appropriate, information from other sources.

An assessment does not guarantee a particular diagnosis or treatment outcome.

A diagnosis will only be made where the clinician considers that the available evidence supports the diagnosis.

Where the available information is insufficient, further assessment, information or investigation may be required.

The clinic may recommend another healthcare service where a patient’s needs fall outside the scope of the service.

14. Emergency and Out-of-Hours Care

The clinic is not an emergency or crisis service.

If you are experiencing an immediate or life-threatening emergency, call 999 or attend the nearest Emergency Department.

If you are experiencing an urgent mental health crisis, contact the appropriate NHS urgent mental health service, NHS 111 where applicable, or another appropriate emergency service.

Do not rely on email, routine appointments or messages to the clinic for emergency assistance.

If you believe that you or someone else is at immediate risk of serious harm, seek emergency assistance immediately.

15. NHS and GP Involvement

Private assessment or treatment does not automatically transfer responsibility for your care to the NHS or your GP.

Your GP may decide whether they are able or willing to become involved in your ongoing care.

A GP may also require specific information, monitoring or arrangements before considering NHS prescribing or shared care.

We cannot guarantee that an NHS GP will accept responsibility for prescribing, monitoring or ongoing treatment following private assessment or treatment.

Where appropriate, we will provide relevant clinical information to support communication with your GP.

16. Prescriptions and Medication

Medication will only be prescribed where the clinician considers it clinically appropriate and safe to do so.

The clinician may consider:

• your diagnosis;
• medical and psychiatric history;
• current medication;
• previous treatment;
• relevant physical health information;
• potential interactions and contraindications;
• treatment response;
• adverse effects; and
• appropriate monitoring information.

A prescription is not guaranteed simply because medication has previously been prescribed elsewhere.

Medication may be changed, reduced, stopped, withheld or not prescribed where the clinician considers this clinically appropriate.

Prescribing decisions remain the responsibility of the prescribing clinician.

Private prescriptions may result in pharmacy and medication costs that are separate from the clinic’s fees.

17. ADHD Medication Monitoring

Patients receiving ADHD medication from the clinic must participate in appropriate monitoring.

Depending on the medication and individual circumstances, monitoring may include:

• weight;
• blood pressure;
• pulse or heart rate;
• effectiveness of treatment;
• adverse effects;
• adherence;
• physical health;
• mental health;
• sleep;
• substance use where clinically relevant; and
• other investigations where clinically indicated.

For adults receiving ADHD medication, weight is generally monitored every six months.

Blood pressure and heart rate should be assessed before and after dose changes and at appropriate intervals during ongoing treatment.

The exact monitoring requirements will depend on the medication, dose, clinical circumstances and clinician’s assessment.

Where the clinic remains responsible for prescribing because shared care has not been agreed, the clinic will ensure that appropriate monitoring arrangements are in place.

Monitoring may take place at the clinic, through another appropriately qualified healthcare professional, or through another clinically appropriate arrangement where reliable information is available.

Patients may be asked to provide recent measurements or attend for monitoring.

If required monitoring is not completed, the clinician may be unable to safely continue prescribing and may need to review, modify or suspend treatment until adequate information is available.

18. Repeat Prescriptions

Repeat prescriptions are subject to clinical review and are not automatically issued.

The clinician must be satisfied that:

• the medication remains clinically appropriate;
• the patient is receiving appropriate monitoring;
• there are no relevant new contraindications or safety concerns;
• the treatment remains effective and tolerated; and
• prescribing can be undertaken safely.

Requests for repeat prescriptions should be made sufficiently in advance to allow appropriate clinical review and processing.

The clinic cannot guarantee same-day or urgent prescription requests.

19. Delivery of Prescriptions

Where prescriptions are issued electronically or through another approved method, the clinic will provide them in accordance with the prescribing arrangements in place at the time.

The clinic is not responsible for delays caused by pharmacies, postal services, electronic prescribing systems or circumstances outside the clinic’s reasonable control.

Patients should ensure that they allow sufficient time for prescriptions to be processed and medication to be obtained.

20. Pharmacy Charges

Medication costs, dispensing charges and other pharmacy charges are separate from the clinic’s professional fees unless expressly stated otherwise.

Pharmacies set their own charges and the clinic cannot guarantee the price charged by a pharmacy.

Patients may wish to contact their chosen pharmacy in advance to confirm medication availability and cost.

21. Shared Care

Where clinically appropriate, Adult ADHD and Mental Health Clinic may propose a shared-care arrangement with the patient’s GP or another appropriate primary-care prescriber once ADHD medication has been titrated and stabilised and the patient’s treatment is considered stable and predictable.

Shared care is a formal arrangement and is subject to the agreement of the primary-care prescriber.

A GP or other primary-care prescriber is not obliged to accept a shared-care arrangement, and prescribing or monitoring responsibility does not transfer unless the primary-care prescriber has formally agreed to the arrangement.

Where shared care is proposed, we will provide the primary-care prescriber with relevant clinical information, which may include:

• diagnosis;
• relevant clinical history;
• treatment history;
• baseline information and relevant results;
• current medication and dose;
• treatment plan;
• monitoring requirements;
• review arrangements;
• respective prescribing and monitoring responsibilities;
• arrangements for communication; and
• arrangements for returning care to the specialist where necessary.

The shared-care arrangement will clearly identify which aspects of prescribing, monitoring and clinical review remain the responsibility of the specialist and which are undertaken by primary care.

Shared care will only commence once the primary-care prescriber has agreed to the arrangement.

Sending clinical information or a shared-care request to a GP does not itself establish shared care or transfer prescribing responsibility.

Where shared care is accepted, patients must comply with the monitoring and review requirements of the agreed arrangement.

Where shared care is not accepted, the clinic will not assume that the GP has responsibility for prescribing or monitoring.

If the clinic continues to provide prescribing and clinical care, the clinic will ensure that appropriate monitoring arrangements are in place.

Patients should not assume that a GP will accept shared care. If future NHS prescribing or monitoring is important to a patient’s treatment plans, patients are encouraged to discuss this with their GP.

22. Specialist Review During ADHD Treatment

The clinic requires a specialist clinical review at least every six months while it is actively managing ADHD medication.

This six-month review requirement is a clinic policy and should not be interpreted as a statement that six-monthly specialist review is the minimum requirement set by NICE or Welsh legislation.

Clinical review may be required more frequently depending on the patient’s circumstances, medication, treatment response or safety considerations.

The specialist review does not replace routine physical and clinical monitoring.

Current clinical guidance recommends that ADHD medication is reviewed at least annually by a healthcare professional with appropriate expertise in ADHD.

Failure to attend required clinical reviews or provide necessary monitoring information may result in prescribing being paused, modified or discontinued where the clinician considers this necessary for safe care.

23. Inactive Patients

A patient may be considered inactive where they have not attended required reviews or have not maintained contact with the clinic for an extended period.

Where clinically appropriate, the clinic may close an episode of care where ongoing specialist treatment is no longer being provided.

If a patient later wishes to restart treatment, a new assessment or clinical review may be required.

A new appointment or assessment does not automatically result in continuation of previous medication.

24. Complaints and Concerns Procedure

We aim to provide safe, respectful and high-quality care. We welcome feedback and encourage patients to raise concerns as soon as possible so that we have an opportunity to address them.

How to make a complaint

A complaint may be made verbally or in writing.

Where possible, patients are encouraged to provide:

• their name and contact details;
• details of the service or appointment concerned;
• a description of the concern;
• relevant dates;
• the outcome they are seeking, where applicable; and
• any supporting information they consider relevant.

Complaints should be directed to the person responsible for managing complaints within the clinic, using the clinic’s published complaints contact details.

A patient will not be disadvantaged in their care because they have made a complaint in good faith.

Handling complaints

Complaints and concerns will be recorded and handled in accordance with the clinic’s complaints procedure.

The person responsible for complaints will review the concern and determine the appropriate course of action.

Where appropriate, the clinic may:

• seek further information;
• speak with the patient or relevant staff member;
• review relevant clinical or administrative records;
• arrange a discussion with the patient;
• identify actions to address the concern; and
• review whether improvements to the service are required.

Acknowledgement and response

We aim to acknowledge complaints promptly and normally within 3 working days of receipt.

We aim to provide a full written response within 28 days where reasonably practicable.

If a complaint requires longer to investigate, we will explain the reason for the delay and provide an indication of when a substantive response is expected.

Where appropriate, patients will be offered an opportunity to discuss the outcome.

Advocacy and support

Patients may seek independent support or advocacy when making or pursuing a complaint.

The clinic will provide information about appropriate advocacy arrangements where relevant.

Escalating concerns about the service

Because the clinic is an independent healthcare provider registered with Healthcare Inspectorate Wales (HIW), patients may also share concerns directly with HIW.

HIW does not normally investigate individual complaints about independent healthcare providers. Instead, HIW can consider information about concerns to assess whether the service is meeting the regulations and standards associated with its registration.

HIW contact details are:

Healthcare Inspectorate Wales

Welsh Government

Rhydycar Business Park

Merthyr Tydfil

CF48 1UZ

Telephone: 0300 062 8163

Email: hiw@gov.wales

Current information about contacting HIW is available through its website.

Making a complaint to the clinic does not prevent a patient from contacting HIW.

Where a concern relates to NHS-funded care provided under an NHS arrangement, the applicable NHS Wales complaints process may instead apply.

25. Liability

We will provide services with reasonable care and skill and in accordance with applicable professional, legal and regulatory requirements.

However, healthcare outcomes cannot be guaranteed.

We cannot guarantee:

• a particular diagnosis;
• a particular treatment outcome;
• that medication will be effective or tolerated;
• that a prescription will always be issued;
• that a GP will accept shared care;
• that an NHS service will accept or continue treatment; or
• that a pharmacy will have medication in stock.

Nothing in these terms is intended to exclude or restrict liability where such exclusion or restriction would be unlawful.

26. General Terms

These policies and terms are intended to explain the arrangements under which the clinic provides services.

The clinic may update its policies where necessary to reflect changes in legislation, regulation, professional guidance, technology or service arrangements.

Where a material change affects existing patients, the clinic will communicate the change where appropriate.

If any provision of these terms is found to be unlawful or unenforceable, the remaining provisions will continue to apply to the extent permitted by law.

These terms should be read together with the clinic’s Privacy Notice, Patient Guide, Statement of Purpose and other applicable policies.

27. Patient Declaration

By booking an appointment with Adult ADHD and Mental Health Clinic, you confirm that:

• you have read and agree to these Terms and Conditions;
• the information you have provided is, to the best of your knowledge, accurate, complete and up to date;
• you understand that additional information, investigations or specialist assessments may be required before treatment can commence;
• you understand that a diagnosis of ADHD is not guaranteed following assessment;
• you understand that prescribing decisions are made by the treating clinician based on clinical assessment and safety considerations;
• you understand that your GP or other healthcare professionals may need to be involved in your care;
• you understand that your GP is not obliged to enter into a shared-care agreement;
• you understand that where shared care is not accepted, the clinic may remain responsible for the prescribing and monitoring associated with treatment it provides;
• you understand that you must participate in the monitoring required for safe ADHD treatment;
• you understand that specialist reviews may be required at intervals determined by the clinic and your clinical circumstances;
• you understand that emergency and crisis care is not provided by the clinic;
• you understand that clinical records will be maintained and retained in accordance with applicable legal, regulatory, professional and clinical requirements; and
• you understand that where your appointment is with one of our practitioners, that practitioner is responsible for the clinical care they provide to you.

By providing your contact details and booking an appointment, you also agree that we may contact you using the details you have provided in relation to your appointment, assessment and ongoing care.