Doctors warn children in England with ADHD at risk from poorly regulated clinics
Private providers are accused of providing young patients with stimulant prescriptions without proper examination
Doctors have warned that poorly regulated private clinics are prescribing powerful stimulants to children with ADHD without conducting physical examinations.
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Remote-only ADHD assessments have grown, with more and more children being diagnosed and medicated via video link.
Health authorities in Greater Manchester have been forced to overhaul prescribing rules following clinical warnings.
Face-to-face checks will now be mandatory in order to protect the safety of children.
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It has emerged that young patients with potential underlying heart conditions have been prescribed stimulants by national online providers without a single in-person check-up.
Rashad Nawaz, a consultant paediatrician with clinics in Manchester and Liverpool, sounded the alarm, writing to national regulators and health bodies to alert them to the issue.
He said that in the last year he had identified three children with previously unknown heart murmurs.
One of the children was already taking ADHD medication.
Stimulants such as methylphenidate, of which the best-known brand is Ritalin, can be prescribed by doctors, alongside non-stimulant alternatives.
According to a study from the University of Southampton, the benefits of taking such drugs in order to treat attention deficit hyperactivity disorder outweigh the impact of increases in blood pressure and heart rate.
However, the National Institute for Health and Care Excellence guidelines state that a full physical assessment is mandatory before treatment begins.
This includes checking cardiovascular history and a physical examination of the heart.
The NHS is struggling with a record demand for ADHD services.
Often, families will opt for the “Right to Choose” scheme, which provides access to private care funded by the NHS.
Some senior clinicians have argued that some private companies lack the infrastructure to properly ensure patient safety.
NHS Greater Manchester has implemented a new “safety first” pathway in response to warnings of insufficient checks. The new system maintains the right to choose, but it effectively bars providers from initiating treatment in the region unless they can prove a thorough, in-person clinical assessment has occurred.