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The Croydon, Lambeth and Lewisham Adult Attention Deficit Hyperactivity Disorder (ADHD) and Autism Service is also known as the 3 Brough Service.

This service is a local, specialist outpatient service for adults registered with a GP in Croydon, Lambeth and Lewisham. Referrals can be made by GPs or NHS secondary mental health teams.

The team offers diagnostic assessment for adults who have suspected a ttention d eficit h yperactivity d isorder (ADHD) and/or a utism. Initiation and titration of ADHD medication and reviews for ADHD are also offered. Following a positive diagnosis from our service (ADHD and/or a utism), patients may be offered some brief post-diagnostic psychoeducation. Appointments are available face to face or virtually via Microsoft Team s, offered based on patient preference and clinical need.

The service is non-urgent and does not case/risk manage. If you or someone you know is experiencing a mental health crisis, you can find helpful advice here; How to get help in a mental health crisis .

The 3 Borough Service has experience unprecedented demand and are booking appointments for patients that have been waiting 4 years and 8 months [Updated November 2025 ] . Please be assured that our organisation is actively implementing initiatives to reduce waiting times. We are hopeful that these efforts will lead to shorter waits in the near future. Thank you for your continued understanding and trust in our care.

Service Borough Covers: Croydon, Lambeth, Lewisham Treatment type: Outpatient
Contact the service
Site Location: Services at other sites Known As: Three Borough Service Email: 3Breferrals@slam.nhs.uk Phone Number: 020 3228 8469
Disabled Access: Locations still to be confirmed
Address: Administration office
Bethlem Royal Hospital
1st Floor
Monks Orchard House
Monks Orchard Road,
Beckenham,
London,
BR3 3BX

Other essential information

Conditions: Croydon, Lambeth and Lewisham Adult Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) Service

Clinic address

The Norbury Health Centre
3 Borough ADHD and Autism Service
2nd Floor, 2B Pollards Hill
Norbury
London
SW16 4NL

Clapham Family Practice
89 Clapham High Street
London
SW4 7DB

How to refer

The 3 Boroughs Service accepts referrals for adults registered with a GP in Croydon, Lambeth and Lewisham. Referrals can be made by GPs or NHS secondary mental health teams only. We do NOT accept self-referrals.

If you are referring from Lambeth or Lewisham (SEL ICB) for new ADHD Diagnostic assessment, all referrals need to be sent to the ADHD Referral Triage Service who will triage and then forward all appropriate referrals to ourselves. The 3 Borough Service is unable to process any direct ADHD diagnostic referrals from GPs in Lambeth and Lewisham. All other referrals (including Autism Assessments, ADHD Medication referrals and new ADHD Diagnosis from Croydon GPs) should be sent to the 3 Borough Service directly to 3BReferrals@slam.nhs.uk, using our referral form.

If referring a patient who has an existing ADHD diagnosis, we will only accept referrals that provide a full diagnostic report. If this is not available, then the clinical team may decide that a full diagnostic assessment is required.

Please be aware that we have received an unprecedented number of referrals over the last number of years which has far exceeded the service’s capacity. The demand continues to exceed our clinical capacity, and we are actively working within South London and Maudsley NHS Foundation Trust, and with commissioners and partners to try and improve this situation.

We understand that your situation might have changed during the time you’ve been waiting. Please keep us updated with any change of circumstances, including change of address, contact details, GP or if you have accessed an assessment through another provider.
We appreciate this situation is far from ideal and can only offer our apologies at this time. We have developed resources and signpost on this website which we hope you will find useful while you are waiting for support from our service.

As a non-urgent outpatient service, we are not able to prioritise patients and book appointments from our waiting list in chronological order.
Individual waiting times are variable and unfortunately, we cannot give specific times for individual waits. Please do not contact the clinic to enquire about waiting times as we cannot provide any more information than is provided within this web page. We are currently contacting patients to begin the assessment process who have been waiting 4 years and 8 months.

The 3 Borough Service does not accept referrals for patent with moderate to severe mental health co-morbid needs, acute mental health needs, a moderate or severe Learning Disability or ongoing substance misuse/alcohol dependency issues.

Please review the National Adult ADHD and Autism Outpatient Clinic if your patient requires a tertiary level service.

We do not provide Psychological support for patients with an existing ADHD and/or Autism Diagnosis. If your patient would benefit from direct and indirect short to medium term psychological support for adult ADHD and/or autism please review the referral criteria for the National Adult ADHD and Autism Psychology Service.

ADHD QI Leaflet - electronic version.pdf

Use this leaflet if you are seeking an ADHD assessment and live in Croydon

QI Leaflets-ADHD-electronic version - SEL.pdf

Use this leaflet if you are seeking an ADHD assessment and live in Lambeth or Lewisham

QI Leaflets-autism - electronic version.pdf

Use this leaflet if you are seeking an Autism assessment and live in the boroughs of Croydon, Lambeth or Lewisham.

ADHD Medication

The 3 Boroughs Service offers a number of different interventions for patients that have already received an ADHD diagnosis outside of our service;

Extended Review – for all new patients to our service who have already received a diagnosis of ADHD, the clinical team will need to complete an Extended Review, getting an up-to-date picture of your symptoms and how they impact your life.

Transition Reviews – for patients transitioning from CAMHS services to adult services, our clinicians will complete a review appointment. Only SLaM CAMHS teams can refer patients for this type of appointment.

Initiation and Titration of ADHD Medication – following a diagnostic assessment within our team or an Extended Review appointment, you may be added to the waiting list for Initiation and Titration of ADHD medication. This involves a number of appointments with 3 week gaps to start and then gradually increase the dose of ADHD medication, monitoring any improvements and/or side effects. Once at a stable dose you will be discharged from the team, either under Transfer of Care to your GP, or under Shared Care with your GP, depending on local agreements and clinical need.

Annual Reviews – these will only be completed for patients who have been reviewed within our service and have been discharged under Shared Care.
We will not be entering into Shared Care agreements and completing Annual Reviews for patients that we have not reviewed.

We are unable to provide waiting times for treatment due to the individualised response to medication. We are only able to see a finite number of patients who must be seen regularly until their treatment is completed. Once an individual completes treatment then another patient can be offered a treatment slot. The recent and ongoing difficulties with global demand and supply of ADHD treatments has further prolonged the treatment process for some individuals.

Please be assured we are working to our maximum capacity and will contact people who are nearing the top of our waiting list to ensure that treatment slots are not wasted.

ADHD medication supply disruptions: Advice for General Practitioners

On Friday 27th September 2023 the Department of Health and Social Care issued a National Patient Safety Alert regarding supply disruptions with many of the medication prescribed for ADHD (Equasym XL, Xaggatin XL, Concerta XL, Xenidate XL, Lisdexamfetamine, Guanfacine). This disruption has been attributed to a combination of manufacturing issues and increased global demand. Please see the prescribing guide for information about treating patients whilst the medication shortage continues: Prescriber Guidelines (PDF)

Immediate Action Required

Effective immediately, prescribers are advised “not to initiate new patients on products affected by this shortage until the supply issues resolve”. At present, the supply disruptions are expected to resolve at various dates between October and December 2023.

Affected Medications

The following medications are currently subject to supply disruptions:

Methylphenidate:

Equasym XL® 10, 20, and 30mg capsules
Xaggitin XL® 18 and 36mg prolonged-release tablets
Concerta XL® 54mg prolonged-release tablets
Xenidate XL® 27mg prolonged-release tablets

Lisdexamphetamine

Elvanse® 20, 30, 40, 50, 60 and 70mg capsules
Elvanse® Adult 30, 50 and 70mg capsules

Guanfacine

Intuniv® 1, 2, 3 and 4mg prolonged-release tablets

Recommendations for Ongoing Prescribing

For cases involving ongoing prescribing, it is essential that prescribers liaise with local pharmacies to verify the availability of existing stock. Alternative medications such as methylphenidate immediate-release tablets or dexamfetamine tablets remain accessible. Thus, prescribers can make appropriate adjustments to the medication regime to align with the overall therapeutic dose.

Please be advised that a new shared care document is not required for this action.

Please do keep in mind that existing stocks may not be sufficient to meet the increased demand caused by other shortages.
We sincerely apologise for any inconvenience this disruption may cause.

Autism

The 3 Boroughs Service offers autism diagnostic assessments for adults registered with GPs in Croydon, Lambeth and Lewisham. Autism is a neurodevelopmental condition linked to social and communication differences and repetitive and restricted behaviours and interests.

An Autism Diagnostic assessment consists of 3 stages. The first is a Questionnaire pack that will be sent to you so you can complete this at home. We also ask that a separate pack be completed by someone who knew you well as a child, if you have someone available. When we have received this information, we will arrange your first appointment with a clinician. We have 2 different types of appointments we can offer at this stage, a structured interview with someone who knew you well as a child and an appointment with yourself that involves different tasks. You can have one of these appointments or both, depending on the availability of someone who knew you well as a child and on clinical need.

Following this/these appointments a Clinical Interview will be arranged in which a clinician will have a discussion with you and then pull all this information together to be able to give you a diagnostic outcome.

People who are currently being offered an appointment have waited: 4 years and 8 months [last updated November 2025]

We have been working with the Recovery College to delivery Webinars designed for people waiting for an assessment called “What to Expect from the Adult Autism Diagnostic Assessment Journey”. This has been co-produced with Experts by Experienced. If you would like to express your interest in attending this webinar please complete this form;

Adult Autism Expression of Interest Form

Enhanced diagnostic assessment

The 3 Boroughs Service offers ADHD diagnostic assessments for adults registered with GPs in Croydon, Lambeth and Lewisham. ADHD is a lifelong neurodevelopmental condition that is associated with differences in regulating attention and energy.

An ADHD Diagnostic assessment consists of 3 stages. The first is a Questionnaire pack that will be sent to you so you can complete this at home. We also ask that a separate pack be completed by someone who knew you well as a child, if you have someone available. When we have received this information, we will arrange your first appointment with a clinician to conduct a semi-structured interview. Following this appointment a Clinical Interview will be arranged in which a clinician will have a discussion with you and then pull all of this information together to be able to give you a diagnostic outcome.

Through the assessment process the clinician will ask for information about your childhood. When preparing for your assessment please consider involving someone who knew you well as a child to attend appointments and complete Questionnaire packs. We understand that as an adult service, not everyone will have someone available, in which case we ask for any documents you may have that relates to your childhood, including things like school reports. The availability of this information is not a barrier to an assessment but may make a diagnostic outcome harder to reach.

People who are currently being offered an appointment have waited: 4 years and 8 months [last updated November 2025]

We have been working with the Recovery College to deliver Webinars designed for people waiting for an assessment called “What to Expect from the Adult ADHD Diagnostic Assessment Journey”. This has been co-produced with Experts by Experienced. If you would like to express your interest in attending this webinar please complete this form;

Adult ADHD Expression of Interest Form

Psychoeducation

Psychoeducation is available for patients who have received a diagnosis from our service.

We run psychoeducation groups for people who have received a diagnosis of ADHD or autism with our service and would like to know more about what this means and how it may impact them. Psychoeducation means to provide psychologically based information to support an individual’s knowledge about and acceptance of their diagnosis . We offer two post-diagnostic support groups: 

ADHD psychoeducation group – this group helps people with a diagnosis of ADHD to better understand their condition. It provides people with an opportunity to meet other people with ADHD and provides a safe space to strengthen and develop strategies to cope with living with ADHD as an adult.
Autism psychoeducation group – this group helps people to start to understand more about or strengthen their existing knowledge of being autistic. It provides an opportunity to meet other autistic people and to develop and strengthen strategies to live a more fulfilling life.

These post-diagnostic groups are 90 minutes long and are delivered weekly on the same day and same time.  

Before accessing post-diagnostic support, you will have the opportunity to speak to a member of the post-diagnostic psychology team to discuss what post-diagnostic support would be most helpful for you. If you are not able to attend a group, please let us know at this session and we can discuss alternatives. We may also be able to help you to think about other services that might be useful to you whilst waiting for support from our service. 

We currently have waiting lists for our post diagnostic psychoeducation. The date you are diagnosed and recommended for post diagnostic support is the date you are referred for psychoeducation. We aim to offer a post-diagnostic follow-up appointment within six months of diagnosis. Following this appointment, if you choose to accept the psychoeducation offer, you will be added to the appropriate wait list and provided with any signposting or resources that may be discussed at the time.

We are currently contacting service users who were diagnosed in May 202 3 for the psychoeducation programme . Not everyone offered a slot will be able to attend depending on their own personal circumstances. Where this occurs, we will offer the next person on the list the slot.

If you have been diagnosed prior to May 202 3 and have been waiting for psychoeducation and have not received a triage appointment, please contact the team.