Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential implications for his policies of local medical committees advising GPs to withdraw from ADHD shared care agreements; and what steps his Department plans to take to ensure there is uninterrupted access to essential medications and care for patients with ADHD.

Shared care arrangements between a specialist service and the patient’s general practice (GP) cover a number of clinical areas. Guidance is in place to help GPs decide whether to accept shared care responsibilities, with further information available at the following link:

https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-care

National Health Service clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing remains with the specialist clinician, and this applies to both NHS and private medical care. However, a GP who had previously agreed to, and had been deploying, a shared care agreement would need to demonstrate clear reasoning as to why they can no longer support this, and they have a responsibility, along with the specialist clinician, to secure continuity of care for their patient.

Where possible, we encourage patients to raise any concerns directly with their GP in the first instance, as this is usually the fastest method of resolution, and can help to build a practice patient relationship.

The Department has been working hard with industry and NHS England to help resolve the supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.

We are continuing to work to resolve the supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. To improve supply and resiliency, we are also working with prospective new suppliers of methylphenidate prolonged-release tablets to expand the UK supplier base.

In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.