Practice pharmacists have an opportunity to expand their clinical role in managing ADHD, particularly through structured medication reviews and shared care, an exclusive event hosted by The Pharmacist has heard.

Dawn Best, senior medicines optimisation lead pharmacist (mental health) at Frimley Health and Care ICS, said ADHD represents a key area for professional development in general practice, especially given long waits for specialist services and increasing demand.

Speaking during the inaugural GP Pharmacy virtual event on Tuesday, Ms Best said: ‘This is a gap. Traditionally, we've gone into hypertension, we've gone into diabetes, respiratory, but in the mental health arena, there's a big gap. And I think, if you're interested in this, this is an area where you could upskill and you could make it your own.’

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Ms Best stressed that pharmacists do not need to diagnose or initiate treatment to play a meaningful role.

‘After titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under a Shared Care Protocol arrangement with primary care, and I think that's where most of us sit,’ she said.

Using the example of Frimley ICS, Ms Best explained: ‘We have an enhanced locally commissioned service where we have provided training to our primary care practices, where they are able, via a template, to provide the annual medication review for our adults.’

She added: ‘We did this because here's an opportunity, because we knew that our patients were not getting timely medication reviews, and therefore we thought, how can we help with this?’

‘We could provide that medication review for our stable adults, while [specialist services] could see new patients.’

Ms Best noted that pharmacists are already well-equipped to carry out this work. ‘Reviewing and monitoring, an annual medication review – we're good at that,’ she said.

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‘We're used to doing that for so many areas. We're pharmacists. We understand medication. At what point could we not do this just with some upskilling, some education?’

Ms Best also commented on a newly published report from the NHS England ADHD Taskforce that found that long waits are pushing patients towards unregulated private providers, highlighting the need for a rapid shift to more accessible community-based models, including in primary care.

‘The report called on NICE to reconsider that ADHD always requires a highly specialised secondary care workforce,’ said Ms Best.

‘So, NICE should clearly define the meaning of what they mean by “specialist” to enable greater involvement of primary care.’

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Looking ahead, she encouraged pharmacists to reflect on how they could fill current gaps in care.

‘Are you the medicines expert in your practice? Are you building on your skills so that you are the go-to person for the medicines in your practice? Because as pharmacists, this is where we can fit in, and this can be our space in primary care,’ she said.