When it's a
blanket ban

Your GP didn't decide about you. They decided about everyone. That's the part that doesn't hold up.

England only · Last updated August 2026

Use this when — and only when

Not first. Escalate when all three are true:

Your GP has refused shared care
The refusal is a blanket policy, not a clinical judgement about you
You've asked in writing and got either a policy answer or silence

If the refusal is genuinely about your clinical situation, this is the wrong tool and you'll look like you're flailing.

Who you're actually complaining to

Integrated Care Boards. Forty-two of them, replacing the old CCGs on 1 July 2022 under the Health and Care Act. Each covers between roughly 500,000 and 3.5 million people, and commissions most NHS services in the area.

Why they're the right target: if your practice is following a commissioning policy set by the ICB, the ICB is the correct body to complain to. The decision started with them, not your GP.

Do this first — it sometimes ends the whole thing

Find your ICB's shared care policy. Search "[your area] ICB shared care ADHD policy".

Some ICBs have explicitly told GPs they should accept shared care for ADHD. If yours is one of them, quote it back to your practice before escalating anything. That alone has flipped decisions.

Then get three things in order:

The refusal in writing, with the reason, and whether it applies to you or everyone
Your specialist's shared care agreement and clinical summary
Every letter, email, and dated note of every phone call — who, when, what was said

That last one feels excessive right up until the moment it isn't.

The letter

[YOUR NAME] [ADDRESS] · [POSTCODE] Date of birth: [DD/MM/YYYY] · NHS number: [NHS NUMBER] [DATE] [ICB NAME] — Patient Experience Team Dear Sir or Madam, Re: Patient choice complaint — shared care refusal for ADHD medication, [PRACTICE NAME] I am raising a formal complaint about [PRACTICE NAME]'s refusal to enter a shared care arrangement for my ADHD medication. Background I was diagnosed with ADHD by [PROVIDER] in [MONTH, YEAR] following [NHS / Right to Choose / private] assessment. Titration is complete and I am stable on [MEDICATION AND DOSE]. My specialist has provided a shared care agreement and clinical summary to the practice. I requested shared care on [DATE]. The practice declined on [DATE]. Correspondence is attached. Grounds 1. The refusal appears to rest on a general practice policy rather than any assessment of my individual circumstances. The practice stated: "[QUOTE]." My understanding is that shared care decisions are expected to be made on an individual patient basis. 2. [If applicable] [ICB NAME]'s own shared care guidance states "[QUOTE]." The practice's position appears inconsistent with it. 3. The practical effect is that I must fund private prescriptions indefinitely — currently around £[AMOUNT] per month — for a stable, licensed treatment for a diagnosed condition, on a dose my specialist has already settled. 4. [If applicable] Despite a written request on [DATE], the practice has not provided written reasons. What I'm asking for - Confirmation of the ICB's shared care position for ADHD medication, and whether [PRACTICE] is applying it correctly - A review of whether my request was considered individually rather than under a blanket policy - Advice on the options available to me if the practice's position stands - Written acknowledgement within the statutory NHS complaints timescale Attached: [LIST]. Yours faithfully, [YOUR NAME]

What happens next

Acknowledgement normally within three working days
Free NHS Complaints Advocacy exists in every area, funded by your ICB. Almost nobody knows this. It's independent, it's free, and they do this all day. Use it.
Unhappy with the ICB's final response? Parliamentary and Health Service Ombudsman, within 12 months.
Your MP can raise it with the Secretary of State. Do this alongside, not instead.

The honest bit

Shared care is voluntary for GP practices. No letter forces a yes. Anyone telling you otherwise is selling you something.

What this does is make a blanket refusal expensive to maintain, and put the decision in front of someone whose actual job is checking whether policy is being applied properly. GPs have reversed decisions after formal complaints. It happens.

And if it doesn't work: change practice. It's the fastest fix, plenty of people do it, and there is no shame in it whatsoever. You are not obliged to spend two years educating one surgery.

Sources

Health and Care Act 2022 — ICB structure, 42 ICBs from 1 July 2022
NHS Complaints Advocacy — commissioned by local authorities, free at point of use
Parliamentary and Health Service Ombudsman — 12-month limit from becoming aware of the issue

Spot something out of date? DM me on Instagram and I'll fix it and credit you.

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Self-advocacy information for NHS England pathways — not legal or medical advice. Policies vary by ICB and change often. Never stop or change medication without your prescriber.

Independent. Not affiliated with, endorsed by, or part of the NHS.

Questions, or spotted something wrong? Message me on Instagram → @adhd.homecoming

When it's ablanket ban