Doctors and Shared Care
What is a shared care agreement?
A shared care agreement is when a GP (doctor) and a specialist (for example, a psychiatrist) agree to share responsibility for your ongoing treatment — such as prescribing ADHD medication.
This means the specialist starts your treatment, and your GP continues to prescribe and monitor it locally once everything is stable.
Is there a shared care agreement for neurodivergence on the Isle of Man?
At present, there is no formal shared care agreement in place on the Isle of Man for ADHD, Autism, or other neurodivergent conditions.
This means that GPs are not currently required to take over prescriptions or ongoing care from a private or off-island specialist.
What does this mean in practice?
If you receive a diagnosis or medication plan privately or off-island, your GP may not be able to continue the prescription locally.
In some cases, GPs may choose to support your care on a case-by-case basis — but it is entirely at their discretion until an official agreement is introduced.
Why is there no shared care agreement?
The Isle of Man Government has acknowledged that adult diagnostic and support pathways are under development.
Establishing a shared care agreement requires collaboration between Manx Care, the Department of Health and Social Care, and medical professionals — and is something that Isle of Neurodiversity is actively advocating for as part of our mission.
My GP doesn’t seem familiar with ADHD or Autism services — what should I do?
GPs on the Isle of Man may not yet have access to consistent training or local referral options for neurodivergent adults.
If you find this is the case:
You can bring information about your diagnosis or treatment plan to your appointment.
Politely explain your needs, and that you understand there is currently no shared care arrangement.
Ask for any support your GP can offer, such as signposting to mental health or wellbeing services.
What is being done to improve this?
We’re actively engaging with the Isle of Man Government and Manx Care to:
Advocate for a formal adult diagnostic pathway
Support the introduction of a shared care agreement for neurodivergent conditions
Encourage training and awareness for healthcare professionals about neurodiversity and reasonable adjustments
Reasonable Adjustments in Healthcare: GP Appointments, Clinics, and Hospital Visits
Healthcare environments can be overwhelming for many people — and particularly for neurodivergent adults. Appointments are often time-limited, sensory-heavy, unpredictable, and emotionally charged.
Reasonable adjustments in healthcare are about making care accessible, not about special treatment. Small changes can make a significant difference to how safe, understood, and supported someone feels.
An Important Thing to Know
You do not need a formal diagnosis to ask for reasonable adjustments in healthcare.
On the Isle of Man, equality and reasonable adjustment duties apply based on need, not labels. If something would help you access care more effectively, it is reasonable to ask for it.
Before Your Appointment
Preparation can reduce stress and improve communication.
Possible adjustments may include:
Requesting longer appointments
Asking for the first or last appointment of the day to reduce waiting
Requesting information about what will happen in advance
Submitting a written summary of concerns before the appointment
You are allowed to use notes, scripts, or prompts.
Waiting Areas and Sensory Environment
Waiting rooms can be one of the most difficult parts of healthcare.
Helpful adjustments might include:
Waiting in a quiet space or outside until called
Being allowed to use headphones, sunglasses, or comfort items
Reduced lighting or seating away from busy areas
Being called promptly to reduce waiting time
These adjustments reduce sensory overload and anxiety.
During the Appointment
Communication adjustments can make a huge difference.
You may find it helpful to ask for:
Clear, direct language
One topic at a time
Extra processing time
Written instructions or summaries
Permission to record information or take notes
A support person to attend with you
You can also ask clinicians to pause, repeat, or rephrase information.
Written Communication Strategies
If verbal communication is difficult:
Hand over a written note explaining your needs
Ask for follow-up instructions in writing
Request test results or next steps by email or letter
Written communication reduces pressure and helps avoid misunderstandings.
Hospital Visits and Procedures
Hospitals can be particularly challenging due to unpredictability and sensory load.
Possible adjustments include:
Clear explanations of procedures in advance
Visual timetables or step-by-step explanations
Familiar staff where possible
Quiet waiting areas or side rooms
Adjustments to ward placement where feasible
Flexibility around visiting arrangements
Additional reassurance before procedures
You are allowed to ask what will happen next.
Emergency Departments
Emergency settings are high-stress by nature, but adjustments can still be requested.
These might include:
Waiting in a quieter area where possible
Clear explanations of delays
Regular updates
Support persons staying with you
Written communication if verbal processing is difficult
It is okay to explain that you are neurodivergent or that you need adjustments — briefly and without justification.
Aftercare and Follow-Up
Discharge and follow-up can be confusing.
Helpful adjustments include:
Written discharge summaries
Clear next steps and who to contact
Avoiding last-minute information overload
Follow-up appointments arranged in advance
You are entitled to understand your care.
Advocating Without Burning Out
You do not need to:
Explain your entire life story
Educate every professional
Push when you are overwhelmed
It is okay to:
Ask someone else to advocate with you
Pause conversations
Request adjustments gradually
Focus on what matters most
Advocacy should not come at the cost of your wellbeing.
If You Feel Dismissed
If you are not heard:
Ask for clarification
Request a second opinion
Ask for your concerns to be documented
Follow up in writing if needed
Being dismissed is not a reflection of your validity.
A Final Word
Healthcare should work with you, not against you.
Needing adjustments does not make you difficult.
Struggling to navigate systems does not mean you are failing.
You deserve care that is accessible, respectful, and humane.