ADHD Medication Prescribing in Adults and Children
ADHD Medication prescribing in adults
Dear patients,
We have recently had to reject several new requests for ADHD medication prescribing in adults. This letter is aimed at explaining the reasons for it.
What should be happening?
The NHS ADHD service is commissioned to assess, diagnose, start medication, titrate medication and provide post-diagnostic reviews.
Once a patient is stable, the ADHD specialist enters a ‘shared care agreement’ (SCA) with the GP for ongoing prescribing to take place whilst still leading the care of the patient.
SCA is a carefully crafted, well-established and pre-arranged agreement with defined responsibilities for both specialist and GP
What is the problem?
National guidance expects long term involvement of specialists in reviewing ADHD patients and their medical treatment, but this does not currently happen in Oxfordshire. This then leaves GPs in a difficult position if we agreed to prescribe medications that we are not trained or funded to monitor. It is for this reason the practice has taken the decision not to accept any new requests from specialists, be it NHS or private, to prescribe ADHD medications to adult patients. This is in keeping with our Local Medical Committee’s recommendation.
Please be advised we will not be able to make any exceptions to this decision.
Care of adults already receiving ADHD treatments remains under careful review.
What then?
Patients may be able to access the care they need outside of the NHS, for instance by seeking a referral to a private provider.
Oxford Health that provides the NHS Adult ADHD service in Oxfordshire is not taking new referrals. The only NHS option for adult ADHD assessment is through the” right to choose” provision. Should you choose to go down either of these routes though, any prescriptions for medication will have to be provided by the specialist themselves.
We recognise the distress this might cause ADHD sufferers but sadly GPs cannot be expected to take on additional medico-legal risk because of a lack of NHS specialist provision. If you wish to raise this issue, then you may want to contact the “planned care team” at TVICB, tvicb.plannedcare@nhs.net , and/or your MP
Yours sincerely
Dr.T.Hurst
Dr.S.Ramani
Dr.C.Rose
Dr.K.Kommu
Dr.J.McGillvray
ADHD MEDICATION PRESCRIBING IN CHILDREN AND ADOLESCENTS
Child and adolescent NHS ADHD services in Oxfordshire are currently open to new referrals, but there are lengthy waiting lists to be seen. Where appropriate, we will consider sharing care with Oxfordshire CAMHS under a NHS shared care agreement,as long as they abide by the conditions set out in the agreed NHS shared care policy. When they are discharged from CAMHS aged 18 this shared care agreement comes to an end. At this point the named CAMHS consultant will be responsible for transferring their ongoing care, if still required, to adult services.
Due to the long NHS wait times a number of parents are seeking assessment for their children from private organisations. Unfortunately we are no longer able to enter into “shared care agreements” with private providers and therefore will be unable to prescribe any ADHD medication in this situation. This applies to Right to Choose providers as well and any referral made under the scheme will be for a diagnostic assessment only. The prescriptions of ADHD medications already being received by children remains under review.
Patients should not be left without the care they need, due to a lack of comprehensive NHS funding.Our local representatives have raised this issue with local funding and decision-making groups. If you also wish to raise this issue, you may want to contact the “planned care team” at the local Integrated Care Board, tvicb.plannedcare@nhs.net , and/or your MP
