We have reviewed our prescribing policy for ADHD medication, in line with NICE and national Psychiatry guidelines.
Moving forward as a practice we will only prescribe ADHD medication for patients who have had a formal diagnosis under an NHS specialist clinic. In order for the GP to be able to continue prescribing ADHD medication there must be a sharded care agreement in place and the patient must also be reviewed annually by the specialist clinic.
For further information on our prescribing policy for ADHD medication please see below.
We have recently received a number of requests to prescribe ADHD medications in situations when it has not been possible to do so. Therefore, we thought it might be helpful to have a section describing the general approach to specialist medicines.
Recent media coverage of undiagnosed ADHD in adults has led many patients to question if they could have ADHD. This has led to an increase in patients coming forward requesting referral for an assessment. We understand that getting clarification and potentially a diagnosis of ADHD is important. Unfortunately, because of the huge increase in adults with suspected ADHD, the waiting times for assessments on the NHS has become very long (up to 5 years). Waiting times for children are fortunately much less but still significant. Understandably some patients are reverting to private assessments which often result in a request for us to start prescribing stimulant ADHD medications.
Unfortunately, as a practice we are unable to accept any new private ADHD medication prescriptions in line with the below NICE and national Psychiatry guidelines,
Specialist’s should be trained in excluding other causes, such as general or specific learning difficulties; anxiety disorders; depressive disorder; autistic spectrum disorder, personality disorder, conduct disorder, abuse, trauma, oppositional defiant disorder, other neurodevelopmental disorders, neurocognitive disorder, disruptive mood disorder, bipolar disorder, reactive detachment disorder, disruptive mood dysregulation disorder or rarely, medical conditions, such as unsuspected hearing problems or epilepsy.
In practice, the most appropriately qualified specialist to exclude the above listed alternative conditions with overlapping symptoms (and in doing so confirm the ADHD diagnosis) is someone with the level of experience of a consultant psychiatrist specialising also in ADHD.
As per the NICE guidelines it will only be possible to routinely enter into (and prescribe under) a shared-care agreement when a patient is under the care of an NHS specialist ADHD team.
In many cases previously what was portrayed as “shared care” has in fact been a complete transfer of care into primary care, leaving patients unwell and unsupported on potent medications and the practice unsupported and prescribing contrary to local guidelines and, potentially, the best interests of the patient.
For further information on ADHD please visit the NHS website
https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd
We have taken this position after careful consideration to have a clear and consistent approach that is based on quality and the safety of our patients.