Consultant Child and Adolescent Psychiatrist, appointment types and fees
Consultant psychiatrists are very highly qualified and experienced and have usually led whole teams in NHS CAMHS services. They are well placed to assess your child’s mental health, help you to understand what is going on and to provide treatment and support.
Psychiatrists are expert medical doctors who have specialised for many years in mental health. As such they are uniquely positioned to understand the link between mental health and physical health.
Dr Felix de Carvalho is an experienced and compassionate consultant child and adolescent psychiatrist in London. He has worked for many years as a child psychiatrist in both inpatient and outpatient CAMHS. He has a deep understanding of and experience in managing both complex and simpler mental health issues, with a particular focus on assisting young people diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).
Felix offers appointments at both our Chiswick and Central London clinics as well as online appointments.
Felix does not accept private health insurance directly. Nonetheless, you may have the option to seek reimbursement from your insurance provider for his services.
Priority for appointments is always given to existing Harwood Child Psychology families.
Table of contents
- ADHD medication initiation when assessment NOT completed by Harwood Child Psychology’s consultant psychiatrist
- ADHD medication initiation when assessment IS completed by Harwood Child Psychology’s consultant psychiatrist
- Specialist mental health assessment with consultant child and adolescent psychiatrist, Dr Felix de Carvalho
- Shared Care
- Ongoing medication costs and prescription requests
- Consultant Psychiatry Costs Summary
ADHD medication initiation when assessment NOT completed by Harwood Child Psychology’s consultant psychiatrist
This type of appointment is for when you want to consider ADHD medication for your child but have not completed your assessment with Dr Felix de Carvalho at Harwood Child Psychology. We accept diagnostic reports from other clinics as long as they are completely gold standard and follow NICE guidelines. Consultant psychiatrists are one of the few clinicians who can safely prescribe medication for ADHD. GPs will not prescribe this unless under the supervision of a consultant psychiatrist. GPs can take over medication prescription once we achieve a good ADHD symptom control which therefore indicates that child/young person’s response to the medication is adequate. See shared care below.
It is difficult to predict, but we usually require 3 appointments to start seeing the maximum potential of the medication. It’s all about ‘fine tuning’ the medication to the child/young person’s needs and find the best response at the lowest effective dose.
Appointment 1
1 hour – ideally face to face, usually parent and child
- Psychiatrist reading previous assessment reports in advance.
- Psychoeducation about ADHD for child/young person and family.
- Medication initiation explaining medication pros and cons, different formulations, mechanism of action, side effect profile; and answering all questions.
- Mental health review.
- Focused Medical history and physical observations (HR, BP, weight/height)
- Prescriptions (medication dispensed separately by pharmacy, see medication costs below) and explaining controlled medication safety rules.
- Treatment plan.
- A summary letter.
- Cost of appointment 1 = £550 (external clinic referrals), £450 (existing Harwood Child Psychology families).
Appointment 2
30 to 40 minutes – online, approximately 4 weeks after appointment 1, usually parent and child
- Follow up appointment with consultant psychiatrist to check progress, monitor side effects, and dosage suitability.
- Review mental health.
- Optimisation of ADHD symptom control.
- Problem shooting, common questions.
- Outline plan.
- Cost of appointment 2 = £250
Appointment 3
1 hour – ideally face to face, approximately 6 weeks after appointment 2, usually parent and child
- Mental health check.
- Medical review including physical observations.
- Review medication, dosage, associated side effects and type of medication.
- Review ADHD symptom control – with collateral information from home and school changes.
- Summary letter covering plan going forward.
- Cost of appointment 3 = £350
- Ideally by appointment 3 your child is likely to be on the correct dose and preferable formulation of the medication. It is important that the child/young person, parents and clinician are all happy with the dosage, the impact of the medication and management of any lingering side effects. As with all medications, response varies from person to person, as it depends of their ADHD symptom severity but also their own metabolism rates which makes harder to predict when optimal therapeutic effect is achieved. If your child needs to try a different dose or medication following appointment 3, we would need to extend our planned reviews further which will be carefully discussed and planned in advance. (can usually be completed online and would have same cost as appointment 2).
Ongoing medication costs and prescription requests
Private prescriptions and medication can be an expensive ongoing cost, so we feel it is important you are aware of these costs before starting the process, which is why we are trying to make all costs as transparent as possible.
- Unlimited prescriptions = £300 per year
- Pay as you go prescriptions = £60 per prescription
The unlimited package means you pay a fixed fee regardless of how many prescriptions you require over the course of the year. You request the prescription and we send it. This is usually much better value and easier to manage. The pay as you go option may be better value if you think there will be long periods where you will not need a prescription. To arrange the unlimited package speak with Felix during your appointment or speak with our office.
How do I request a private prescription?
Note, it is required that you request a prescription from us, even if it is a regular prescription. It is not considered clinically safe to send prescriptions to people without them requesting they still want it.
- Dr Felix sends out prescriptions twice per week. 12pm on a Monday and 12pm on a Thursday. Any requests received after that cut off will be processed in the next slot.
- All prescriptions are sent out by Royal Mail 1st class post. Royal Mail state 82% of first class post is delivered the next working day. We will always post on the same day but we cannot guarantee next day delivery.
- All prescription requests need to be sent to prescriptions@harwoodchildpsychology.co.uk. Please make sure your child's full name is clearly written in the email.
Medication costs are not set by us and are paid to the pharmacy that dispenses your medication. Harwood Child Psychology do not receive any compensation or payback for medication costs. All prescriptions requested within appointments are included within the cost of the appointments.
ADHD medications are controlled medications and therefore we send the prescription to your house and you have to take the prescription to a pharmacy to collect the medication. All other medications will be delivered directly to your house.
ADHD medication initiation when assessment IS completed by Harwood Child Psychology’s consultant psychiatrist
See above Appointment 1, 2 and 3 (when assessment not completed by our psychiatrist) for the exact same details, however medication initiation takes place in the 1.5 hour assessment feedback session as part of your assessment with Dr Felix. This appointment happens at the end of your child’s assessment. This means that appointment 1- medication initiation and the first prescription is included in the assessment cost. Follow up appointments to check medication effectiveness (appointments 2 and 3) are not included in the assessment cost.
Specialist mental health assessment with consultant child and adolescent psychiatrist, Dr Felix de Carvalho
Dr Felix will meet you and your child to complete a comprehensive mental health assessment. Consultant psychiatrists are very highly qualified and experienced and have usually led whole teams in NHS CAMHS services. They are well placed to assess your child’s mental health, help you to understand what is going on and to provide treatment and support.
Psychiatrists are expert medical doctors who have specialised for many years in mental health. As such they are uniquely positioned to understand the link between mental health and physical health.
• Appointment time – 1.5 hours – child and parent/s.
• Full expert mental health assessment covering current concerns, past psychiatric history, family history as well as a brief developmental history.
• Identify mental health difficulties, develop working diagnosis.
• Physical health screen.
• Risk assessment and safety plan.
• Discuss suitable interventions including medication options.
• Prescriptions requested within appointment time included in cost.
• Detailed clinical letter.
• Note - Medication costs are controlled and charged by your dispensing pharmacy.
Cost of consultant psychiatrist comprehensive mental health assessment = £675.
Cost of mental health follow up appointments after initial assessment = £375 (these will be arranged and frequency agreed in collaboration with your psychiatrist).
Note – this is a mental health assessment. If it is thought that your child might also be struggling with undiagnosed neurodevelopmental conditions e.g. autism spectrum condition, ADHD or learning difficulties, further assessment will be required. Diagnosing neurodevelopmental conditions cannot be completed in 1.5 hours and requires multiple clinicians conducting different parts of the assessment. Harwood Child Psychology specialise in these comprehensive assessments. If Dr Felix believes your child would benefit from this kind of assessment, he will make a plan with you for further assessment.
Shared care
Once medication treatment has achieved satisfactory results for all parties involved, and if it is deemed clinically appropriate, Dr. Felix will initiate a shared care protocol. In this arrangement, the responsibility for prescribing the medication will be transferred to your GP. Please note that GPs are authorised to prescribe certain mental health medications only under the supervision of a consultant psychiatrist. At this stage, you have two options: you can either transition to a psychiatrist within the NHS Child and Adolescent Mental Health Services (CAMHS) for continued monitoring of the medication (your GP can assist in coordinating this transition), or you can opt to have Dr. Felix continue as the consulting CAMHS psychiatrist for your GP. Should you choose to retain Dr. Felix for your child's psychiatric care, it will be necessary for him to see your child at least once every six months. Dr. Felix is available to elaborate on this entire process, should you require further clarification. Cost of 6 monthly reviews =£375.
We must clarify that we cannot guarantee that NHS CAMHS or your GP will be able to accommodate your family or provide specific wait times, as these factors are beyond our control. Some GP practices are also very strict and will not accept shared care at all. We have a good success rate with initiating shared care but GPs in some areas don't accept shared care from anyone. In those instances you have the option to continue requesting prescriptions from Harwood Child Psychology, but then you will have to self fund the prescription costs and medication costs. See below for details.
Ongoing medication costs and prescription requests
Private prescriptions and medication can be an expensive ongoing cost, so we feel it is important you are aware of these costs before starting the process, which is why we are trying to make all costs as transparent as possible.
- Unlimited prescriptions = £300 per year
- Pay as you go prescriptions = £60 per prescription
The unlimited package means you pay a fixed fee regardless of how many prescriptions you require over the course of the year. You request the prescription and we send it. This is usually much better value and easier to manage. The pay as you go option may be better value if you think there will be long periods where you will not need a prescription. To arrange the unlimited package speak with Felix during your appointment or speak with our office.
How do I request a private prescription?
Note, it is required that you request a prescription from us, even if it is a regular prescription. It is not considered clinically safe to send prescriptions to people without them requesting they still want it.
- Dr Felix sends out prescriptions twice per week. 12pm on a Monday and 12pm on a Thursday. Any requests received after that cut off will be processed in the next slot.
- All prescriptions are sent out by Royal Mail 1st class post. Royal Mail state 82% of first class post is delivered the next working day. We will always post on the same day but we cannot guarantee next day delivery.
- All prescription requests need to be sent to prescriptions@harwoodchildpsychology.co.uk. Please make sure your child's full name is clearly written in the email.
Medication costs are not set by us and are paid to the pharmacy that dispenses your medication. Harwood Child Psychology do not receive any compensation or payback for medication costs. All prescriptions requested within appointments are included within the cost of the appointments.
ADHD medications are controlled medications and therefore we send the prescription to your house and you have to take the prescription to a pharmacy to collect the medication. All other medications will be delivered directly to your house.
Consultant Psychiatry Costs Summary
| Appointment type (see above for details) | Appointment cost |
|---|---|
| Specialist Mental Health Assessment | £675 |
| ADHD medication initiation appointment 1 | £450 (internal), £550 (external) |
| ADHD medication initiation appointment 2 | £250 |
| ADHD medication initiation appointment 3 | £350 |
| ADHD medication 6 monthly reviews | £375 |
| Mental Health follow up appointments | £375 |
| Parent only consultations | £350 |
| Prescription costs | £300 per year or £60 per prescription |
| Medication costs | Determined by Pharmacy |
| Report writing outside of agreed appointment documentation | £350 per hour |
