Long waiting lists for adult ADHD services have led one GP practice to set up its own service, enabling patients to access diagnosis, titration and alternative prescriptions in the case of shortages through primary care. The Pharmacist spoke to one practice pharmacist involved.

Kelvin Chan, a GP pharmacist based in Brighton, became interested in the work the practice was doing around ADHD after he joined two years ago and spotted the condition on the practice’s lead pharmacist’s reference website, he tells The Pharmacist.

‘The more I looked at it, the more interested I got into it,’ he says.

Kelvin undertook more research and spoke to patients, increasing his confidence and understanding of the topic, before attending a diagnosis and treatment training course run by the UK adult ADHD network.

The practice’s ADHD team, under the lead of a pharmacist partner, are able to conduct ADHD assessments and titrate medication where appropriate.

And where medication isn’t the best option, or patients don’t respond well, the team can share self-care advice or signpost patients to specialist therapists.

‘We understand in terms of titration wise in terms of side effects, what to look out for how to increase doses gradually, and what to look out for in terms of reviews and follow ups,’ Kelvin says.

And a team of specialist practitioners, including doctors and mental health practitioners, are on hand within the practice to support clinicians.

He says patients describe the service as ‘life changing’.

‘There's always been a very big demand for ADHD/autism assessments. You hear a lot of horror stories that patients are really struggling with typical symptoms,’ he says.

‘I have patients that come to me and say: “I have been waiting for this diagnosis for three years and I've been living in hell. I've been really struggling for the past few years.”’

‘The [phrase] that they always use is “life changing”. The majority of them, probably seven to eight patients out of 10 would tell me: “Kelvin, it’s life changing. It's made my life so much more manageable, and I can actually function better.”’

'Sadly the situation with the national shortage of ADHD stimulant medication is still ongoing, with no end date in sight,' Kelvin adds.

'I have been swapping patients on different doses since summer 2023. Luckily our patients have been very accommodating and recognised the situation we are in,' he says, adding: 'We really do hope the manufacturers can sort this out as soon as possible, so patients' welfare will no longer be compromised'.

But while the ADHD clinic is a draw for local patients joining the practice, Kelvin explains that because it is not an NHS specialist service, the practice does not receive specific funding for it.

As well as seeking local funding for the service, the team continues to refer patients into a specialist ADHD service, which has a lengthy waiting list, while being able to initiate and titrate medication in the meantime.

Kelvin says the practice’s approach has been successful in providing care for patients who have ‘really been struggling’ and who may have previously faced stigma around considering an ADHD diagnosis.

But he says he’d ‘definitely’ want to see more government investment in ADHD services.

And he tells pharmacists with an interest in the condition to explore further training and the possibility of providing a similar service.

‘It's not for everybody. But if you've got the interest, definitely do. This was not my particular interest [to begin with], but when I started doing it the interest and my passion grew with it as well.’