Prescribing for ADHD, and shared care, in children.

We are often asked to prescribe medication for children with a diagnosis of ADHD, who are currently diagnosed by, and seen outside the local NHS commissioned service for children.  Cheshire and Merseyside ICB commission a service for ADHD in children with our local community paediatric team.  This team oversees the child, the condition and the prescribing of the regulated medicine associated with this condition.  Those who seek a diagnosis outside of that NHS commissioned service for children and have follow-up appointments with private providers need to be aware that we do not prescribe in this situation or agree to a shared care agreement with the private provider. Therefore, all prescribing is retained by the specialist.  The reason for this is multi-factorial and includes the concern regarding some providers as highlighted in the Panorama report, as well as the need for that specialist service initiating the medication to see and review the child regularly up until the age of 18 years minimum.  The NHS service for ADHD provides a robust, clearly defined and safe shared care policy which in our opinion is lacking within some private organisations. As a practice we realise this is not ideal for our patients who are trying to seek help in managing their condition,  however we do not think moving outside the commissioned service is the answer.   We want to see a better local ADHD service commissioned for children up to adulthood and so we continue to put pressure on the ICB for that local service for our patients.