Prescribing of ADHD Medication Policy

1. Purpose

This policy sets out the Practice's position on the prescribing, monitoring and dose adjustment of medication for Attention Deficit Hyperactivity Disorder (ADHD) in adults and children. It is intended to ensure patient safety, appropriate clinical oversight, and clarity for patients, carers and staff regarding where prescribing responsibility sits.

2. Policy statement

West Gorton Medical Centre does not take on the initiation, prescribing, monitoring or dose adjustment of ADHD medication (including but not limited to methylphenidate, lisdexamfetamine, dexamfetamine, atomoxetine and guanfacine).

Responsibility for prescribing, monitoring and dose adjustment of ADHD medication remains with the diagnosing ADHD service or specialist provider (NHS or private), for as long as the patient requires this medication.

3. Rationale

This position is based on the following considerations:

• ADHD medications are specialist drugs which carry risks (including cardiovascular and psychiatric risks) requiring specialist assessment, titration and monitoring.
• Safe prescribing requires ongoing access to specialist expertise, baseline and interval monitoring (e.g. height, weight, blood pressure, pulse, and where indicated ECG), and specialist review of dose changes or side effects.
• General practice does not hold the specialist training, capacity or diagnostic oversight required to safely manage titration and dose adjustment of these medications.
• National guidance (NICE NG87) recommends that ADHD drug treatment is usually initiated by a specialist, with ongoing prescribing only transferred to primary care where a formal shared care agreement is in place and has been agreed to by the GP.

4. What this means for patients

• Prescriptions for ADHD medication should continue to be obtained through the ADHD specialist service or private provider that diagnosed and initiated treatment.
• The Practice is unable to issue interim, emergency or bridging prescriptions for ADHD medication on behalf of a specialist or private provider.
• Any queries about dose changes, side effects or ongoing monitoring should be directed to the specialist service, not the Practice.
• Patients will be signposted back to their specialist/private provider if they contact the Practice requesting an ADHD prescription outside an agreed shared care arrangement.

5. Communication

Patients affected by this policy will be informed in writing (letter, text message or via consultation, as appropriate) of the Practice's position and signposted to their specialist or private provider for ongoing prescribing.

6. Review

This policy will be reviewed every two years, or sooner in light of updated national guidance (e.g. NICE guidance on ADHD) or significant local service changes.