Regional variation on shared-care arrangements for ADHD medicine prescribing must be addressed to ensure equitable access, say researchers.
A survey of 750 people from across the country, including commissioners, healthcare professionals and people with lived experience of ADHD has highlighted specific challenges that GPs face in prescribing medication.
Reporting in the British Journal of General Practice, the team from the University of Exeter said NICE guidelines recommend shared care arrangements are in place between adult mental health services and primary care.
Yet while 90% of commissioners said that at least some shared care protocols were in place in their region, only 79% of healthcare professionals agreed.
The results showed variation around the country with the highest rates of respondents reporting shared care arrangements were in place in London (100%) compared with the South East at 72%.
Responses also highlighted that even when some protocols are in place, GPs may not feel sufficiently supported to prescribe for ADHD.
Without appropriate support in place, some GPs may not prescribe ADHD medication due to concerns around insurance and liability, the researchers said.
The results suggested this could be a particular problem for patients with a private diagnosis of ADHD.
Overall, 95% of healthcare professionals working in primary care reported that prescribing was done for adult ADHD patients. But there were much higher prescribing rates reported for NHS patients at 90% than those who had received a diagnosis privately which was 49%.
When patients asked if they had received prescriptions for ADHD medications, only 64% said they had.
The survey results also highlighted lengthy waiting lists in many areas of the country with 40% of responders reporting a wait of two years or more. There was also stark variation in waiting lists around the country.
It shows that GPs across England need ‘better and more consistent support’ to enable appropriate prescribing for patients with ADHD via primary care, the team concluded.
They noted that it would be overly simplistic to conclude that GPs should be better trained, more aware, and more willing to prescribe for patients with ADHD.
Instead, a coordinated approach is needed to address systemic issues such as availability of adult services, and standardisation of shared care agreements.
This could include digital information resources, tailored to provide essential information at the point of need and standardised share care templates to support primary care in prescribing, they added.
In July, the NHS Business Services Authority said there had been a 28% rise in medications prescribed for adults with ADHD in 2023/24.
NHS England has announced the establishment of a taskforce and a major review of ADHD services to meet the growing demand for care.
Study leader Dr Anna Price, senior research fellow at the University of Exeter, said: ‘Our findings highlight the need for a coordinated approach to address problems that lead to a postcode lottery for patients trying to access treatment for ADHD.
‘GPs and other primary care professionals really need better support so that they can provide shared care prescribing of ADHD medication in line with UK guidelines.’
This headline seems to imply that there must be a good patch somewhere?
Perhaps we could encourage our patients to move there?