Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Answer of 15 June 2026 to Question 7594 on Migraine: Medical Treatments, whether the Getting It Right First Time programme's remit includes governance arrangements for identifying and acting on patient psychiatric history, psychotropic medication use and previous psychiatric adverse drug reactions at the migraine prescribing interface.

The Get It Right First Time (GIRFT) programme is a clinically led improvement programme which aims to reduce unwarranted variation in care by using data, peer review, and best practice guidance across a range of specialties, including neurology. While GIRFT supports improvements in prescribing practice and clinical decision-making, it does not set formal governance requirements or mandate for the assessment of specific clinical factors, such as a patient’s psychiatric history, use of psychotropic medicines, or previous adverse drug reactions. Instead, the GIRFT Neurology workstream focuses on improving the care pathway for migraine patients by reducing variation in National Health Service care, improving outpatient waiting times, and building better pathways between general practitioners and hospital specialists.

Clinical responsibility for considering these factors rests with individual healthcare professionals, who are expected to assess the full clinical picture when initiating or reviewing treatment, including at the migraine prescribing interface. National Institute for Health and Care Excellence guidance, including that on headache and migraine, supports safe prescribing by emphasising the importance of taking into account co-morbidities, potential drug interactions, and patient history when selecting treatments.

NHS England also promotes a multidisciplinary, patient-centred approach to care, particularly where there is clinical complexity, including mental health comorbidity. GIRFT complements this by identifying opportunities to improve pathways and consistency of care, but governance arrangements for clinical assessment and prescribing decisions are determined locally by providers and commissioners, in line with national guidance and professional standards.