Objectives To investigate the reasons for the failure of uptake of shared-care arrangements for prescribing in attention deficit hyperactivity disorder.

Methods A questionnaire was sent to 140 randomly selected general practitioners (GPs) in our local commissioning group area, and semistructured interviews were carried out with five GPs.

Results Thirty-five questionnaires were returned, giving a response rate of 25%. The results indicate multifactorial reasons for failure to accept shared care. Three main factors were identified, namely GP concerns about the robustness of the diagnosis, lack of availability or uptake of non-pharmacological treatments and a perception that secondary-care physical monitoring was inconsistent.

Conclusions Our recommendations for facilitating uptake of shared-care partnerships include improving documentation on how the decision to initiate medication is made, enhancing access to and communicating use of non-pharmacological treatments and ensuring communication of the results of physical monitoring and follow-up.