Common use of Specialist responsibilities Clause in Contracts

Specialist responsibilities. Arrange comprehensive assessment of the child and be responsible for making the diagnosis and considering alternative diagnoses, co-morbid diagnoses and cautions/ contra-indications to treatment. • Initiate treatment with stimulants. Prescribe by brand for modified release preparations. Inform the GP promptly about changes in treatment or dosage, any important adverse events or if other interacting medicines are prescribed/recommended. • Monitor the patient's condition and response to treatment regularly and keep the GP informed. • Provide a comprehensive baseline physical assessment as recommended in the NICE guidelines, and ensure that height, weight, blood pressure, pulse and appetite are monitored at the recommended time intervals using the chart in the appendix. Communicate the results of tests to the GP as soon as possible. • Explain the possible side effects of the drug and interactions to parents. • Provide written guidance for parents (at specialist’s discretion). • Be available for back-up advice on any of the above during working hours. • Report all suspected adverse drug reactions (in children under 18 years of age), to the Medicines and Healthcare Regulatory Agency (MHRA) via xxx.xxxx.xxx.xx/xxxxxxxxxx • Send a letter and shared care agreement form to the GP to obtain consent to share prescribing and monitoring responsibilities. • Advise GP’s of any dosage adjustments required, when to refer back, and when and how to stop treatment. • Ensure clear arrangements for back up, advice and support. ESCA for ADHD- Methylphenidate Page 3 of 8 Version 1.0 December 2018 General Practitioner responsibilities • Prescribe Methylphenidate once notified by the specialist.• Prescribe by brand for sustained release preparations. • Ensure that the treatment is not continued if the patient fails to attend the specialist clinic for over a year. • Check that patient is being monitored as specified in section on specialist responsibility. • Report to and seek advice from the specialist on any aspect of patient care that is of concern to the GP and may affect treatment. • Refer back to the specialist if the patient’s condition deteriorates. • Monitor the patient for side effects and report all suspected adverse drug reactions (in children under 18 years of age), to the specialist and to the MHRA via xxx.xxxx.xxx.xx/xxxxxxxxxx • Stop the treatment if advised by the specialist. Parent/carers role • Ask the specialist or GP anything he or she does not understand about the treatment. • Try to put into practice any behavioural or psychological programmes and report back to the specialist about their effectiveness. • Report any adverse effects to the specialist or GP.• Attend agreed review appointments. SUPPORTING INFORMATION Licensed indications Attention Deficit Hyperactivity Disorder (ADHD) is a heterogeneous behavioural syndrome characterised by the core symptoms of inattention, hyperactivity and impulsivity. ADHD should only be diagnosed by a specialist psychiatrist, paediatrician, or other healthcare professional with training and expertise in the diagnosis of ADHD. Diagnosis of ADHD should be made according to DSM-IV criteria or the guidelines in ICD-10 and should also be based on a complete history and evaluation of the patient, including a full clinical and psychosocial assessment, full developmental and psychiatric history, and assessment of mental state. Diagnosis cannot be made solely on the presence of one or more symptom. Methylphenidate is licensed for the treatment of ADHD in the UK. It should form part of a comprehensive treatment programme for ADHD that includes psychological, behavioural and educational advice and interventions. The indication for drug treatment is the presence of impairment resulting from ADHD. Therapeutic Use The aim of stimulant medication as part of a comprehensive treatment programme is to stabilise children with a behavioural syndrome characterised by symptoms which may include chronic history of short attention span, distractibility, emotional lability, impulsivity and moderate to severe hyperactivity. ESCA for ADHD- Methylphenidate Page 4 of 8 Version 1.0 December 2018 METHYLPHENIDATE

Specialist responsibilities. Arrange comprehensive assessment of the child and be responsible for making the diagnosis and considering alternative diagnoses, co-morbid diagnoses and cautions/ contra-indications contraindications to treatment. • Initiate treatment with stimulants. Prescribe by brand for modified sustained release preparations. Inform the GP promptly about changes in treatment or dosage, any important adverse events or if other interacting medicines are prescribed/recommended. • Monitor the patient's condition and response to treatment regularly and keep the GP informed. • Provide a comprehensive baseline physical assessment as recommended in the NICE guidelines, and ensure that height, weight, blood pressure, pulse and appetite are monitored at the recommended time intervals using the chart in the appendix. Communicate the results of tests to the GP as soon as possible. • Explain the possible side effects of the drug and interactions to parents. • Provide written guidance for parents (at specialist’s discretion). • Be available for back-up advice on any of the above during working hours. • Report all suspected adverse drug reactions (in children under 18 years of age), to the Medicines and Healthcare Regulatory Agency (MHRA) via xxx.xxxx.xxx.xx/xxxxxxxxxx • Send a letter and shared care agreement form to the GP to obtain consent to share prescribing and monitoring responsibilities. • Advise GP’s of any dosage adjustments required, when to refer back, and when and how to stop treatment. • Ensure clear arrangements for back up, advice and support. ESCA for ADHD- Methylphenidate Dexamfetamine Page 3 of 8 Version 1.0 December 2018 General Practitioner responsibilities • Prescribe Methylphenidate Dexamfetamine once notified by the specialist.• Prescribe by brand for sustained release preparationsspecialist. • Ensure that the treatment is not continued if the patient fails to attend the specialist clinic for over a year. • Check that patient is being monitored as specified in section on specialist responsibility. • Report to and seek advice from the specialist on any aspect of patient care that is of concern to the GP and may affect treatment. • Refer back to the specialist if the patient’s condition deteriorates. • Monitor the patient for side effects and report all suspected adverse drug reactions (in children under 18 years of age), to the specialist and to the MHRA via xxx.xxxx.xxx.xx/xxxxxxxxxx • Stop the treatment if advised by the specialist. Parent/carers role • Ask the specialist or GP anything he or she does not understand about the treatment. • Try to put into practice any behavioural or psychological programmes and report back to the specialist about their effectiveness. • Report any adverse effects to the specialist or GP.• GP. • Attend agreed review appointments. SUPPORTING INFORMATION Licensed indications Attention Deficit Hyperactivity Disorder (ADHD) is a heterogeneous behavioural syndrome characterised by the core symptoms of inattention, hyperactivity and impulsivity. ADHD should only be diagnosed by a specialist psychiatrist, paediatrician, or other healthcare professional with training and expertise in the diagnosis of ADHD. Diagnosis of ADHD should be made according to DSM-IV criteria or the guidelines in ICD-10 and should also be based on a complete history and evaluation of the patient, including a full clinical and psychosocial assessment, full developmental and psychiatric history, and assessment of mental state. Diagnosis cannot be made solely on the presence of one or more symptom. Methylphenidate Dexamfetamine is licensed for the treatment of ADHD in the UK. It should form part of a comprehensive treatment programme for ADHD that includes psychological, behavioural and educational advice and interventions. The indication for drug treatment is the presence of impairment resulting from ADHD. Therapeutic Use The aim of stimulant medication as part of a comprehensive treatment programme is to stabilise children with a behavioural syndrome characterised by symptoms which may include chronic history of short attention span, distractibility, emotional lability, impulsivity Adverse events should be reported. Reporting forms and moderate to severe hyperactivity. ESCA for ADHD- Methylphenidate Page 4 of 8 Version 1.0 December 2018 METHYLPHENIDATEinformation can be found at

Specialist responsibilities. Arrange comprehensive assessment of the child and be responsible for making the diagnosis and considering alternative diagnoses, co-morbid diagnoses and cautions/ contra-indications contraindications to treatment. • Initiate treatment with stimulants. Prescribe by brand for modified sustained release preparations. Inform the GP promptly about changes in treatment or dosage, any important adverse events or if other interacting medicines are prescribed/recommended. • Monitor the patient's condition and response to treatment regularly and keep the GP informed. • Provide a comprehensive baseline physical assessment as recommended in the NICE guidelines, and ensure that height, weight, blood pressure, pulse and appetite are monitored at the recommended time intervals using the chart in the appendix. Communicate the results of tests to the GP as soon as possible. • Explain the possible side effects of the drug and interactions to parents. • Provide written guidance for parents (at specialist’s discretion). • Be available for back-up advice on any of the above during working hours. • Report all suspected adverse drug reactions (in children under 18 years of age), to the Medicines and Healthcare Regulatory Agency (MHRA) via xxx.xxxx.xxx.xx/xxxxxxxxxx • Send a letter and shared care agreement form to the GP to obtain consent to share prescribing and monitoring responsibilities. • Advise GP’s of any dosage adjustments required, when to refer back, and when and how to stop treatment. • Ensure clear arrangements for back up, advice and support. ESCA for ADHD- Methylphenidate Page 3 of 8 Version 1.0 December 2018 General Practitioner responsibilities • Prescribe Methylphenidate Dexamfetamine once notified by the specialist.• Prescribe by brand for sustained release preparationsspecialist. • Ensure that the treatment is not continued if the patient fails to attend the specialist clinic for over a year. • Check that patient is being monitored as specified in section on specialist responsibility. • Report to and seek advice from the specialist on any aspect of patient care that is of concern to the GP and may affect treatment. • Refer back to the specialist if the patient’s condition deteriorates. • Monitor the patient for side effects and report all suspected adverse drug reactions (in children under 18 years of age), to the specialist and to the MHRA via xxx.xxxx.xxx.xx/xxxxxxxxxx • Stop the treatment if advised by the specialist. Parent/carers role • Ask the specialist or GP anything he or she does not understand about the treatment. • Try to put into practice any behavioural or psychological programmes and report back to the specialist about their effectiveness. • Report any adverse effects to the specialist or GP.• GP. Attend agreed review appointments. SUPPORTING INFORMATION Licensed indications Attention Deficit Hyperactivity Disorder (ADHD) is a heterogeneous behavioural syndrome characterised by the core symptoms of inattention, hyperactivity and impulsivity. ADHD should only be diagnosed by a specialist psychiatrist, paediatrician, or other healthcare professional with training and expertise in the diagnosis of ADHD. Diagnosis of ADHD should be made according to DSM-IV criteria or the guidelines in ICD-10 and should also be based on a complete history and evaluation of the patient, including a full clinical and psychosocial assessment, full developmental and psychiatric history, and assessment of mental state. Diagnosis cannot be made solely on the presence of one or more symptom. Methylphenidate Dexamfetamine is licensed for the treatment of ADHD in the UK. It should form part of a comprehensive treatment programme for ADHD that includes psychological, behavioural and educational advice and interventions. The indication for drug treatment is the presence of impairment resulting from ADHD. Therapeutic Use The aim of stimulant medication as part of a comprehensive treatment programme is to stabilise children with a behavioural syndrome characterised by symptoms which may include chronic history of short attention span, distractibility, emotional lability, impulsivity and moderate to severe hyperactivity. ESCA for ADHD- Methylphenidate Page 4 of 8 Version 1.0 December 2018 METHYLPHENIDATE.

Specialist responsibilities.  Arrange comprehensive assessment of the child and be responsible for making the diagnosis and considering alternative diagnoses, co-morbid diagnoses and cautions/ contra-indications contraindications to treatment. •  Initiate treatment with stimulants. Prescribe by brand for modified sustained release preparations. Inform the GP promptly about changes in treatment or dosage, any important adverse events or if other interacting medicines are prescribed/recommended. •  Monitor the patient's condition and response to treatment regularly and keep the GP informed. •  Provide a comprehensive baseline physical assessment as recommended in the NICE guidelines, and ensure that height, weight, blood pressure, pulse and appetite are monitored at the recommended time intervals using the chart in the appendixintervals. Communicate the results of tests to the GP as soon as possible. •  Explain the possible side effects of the drug and interactions to parents. •  Provide written guidance for parents (at specialist’s discretion). •  Be available for back-up advice on any of the above during working hours. •  Report all suspected adverse drug reactions (in children under 18 years of age), to the Medicines and Healthcare Regulatory Agency (MHRA) via xxx.xxxx.xxx.xx/xxxxxxxxxx •  Send a letter and shared care agreement form to the GP to obtain consent to share prescribing and monitoring responsibilities. •  Advise GP’s of any dosage adjustments required, when to refer back, and when and how to stop treatment. •  Ensure clear arrangements for back up, advice and support. ESCA for ADHD- Methylphenidate Page 3 of 8 Version 1.0 December 2018 General Practitioner responsibilities •  Prescribe Methylphenidate Dexamfetamine once notified by the specialist.• Prescribe by brand for sustained release preparationsspecialist. •  Ensure that the treatment is not continued if the patient fails to attend the specialist clinic for over a year. •  Check that patient is being monitored as specified in section on specialist responsibility. •  Report to and seek advice from the specialist on any aspect of patient care that is of concern to the GP and may affect treatment. •  Refer back to the specialist if the patient’s condition deteriorates. •  Monitor the patient for side effects and report all suspected adverse drug reactions (in children under 18 years of age), to the specialist and to the MHRA via xxx.xxxx.xxx.xx/xxxxxxxxxx •  Stop the treatment if advised by the specialist. Parent/carers Patient's role •  Ask the specialist or GP anything he or she does not understand about the treatment. •  Try to put into practice any behavioural or psychological programmes and report back to the specialist about their effectiveness. •  Report any adverse effects to the specialist or GP.• GP.  Attend agreed review appointments. SUPPORTING INFORMATION Licensed indications Attention Deficit Hyperactivity Disorder (ADHD) is a heterogeneous behavioural syndrome characterised by the core symptoms of inattention, hyperactivity and impulsivity. ADHD should only be diagnosed by a specialist psychiatrist, paediatrician, or other healthcare professional with training and expertise in the diagnosis of ADHD. Diagnosis of ADHD should be made according to DSM-IV criteria or the guidelines in ICD-10 and should also be based on a complete history and evaluation of the patient, including a full clinical and psychosocial assessment, full developmental and psychiatric history, and assessment of mental state. Diagnosis cannot be made solely on the presence of one or more symptom. Methylphenidate Dexamfetamine is licensed for the treatment of ADHD in the UK. It should form part of a comprehensive treatment programme for ADHD that includes psychological, behavioural and educational advice and interventions. The indication for drug treatment is the presence of impairment resulting from ADHD. Therapeutic Use The aim of stimulant medication as part of a comprehensive treatment programme is to stabilise children with a behavioural syndrome characterised by symptoms which may include chronic history of short attention span, distractibility, emotional lability, impulsivity and moderate to severe hyperactivity. ESCA for ADHD- Methylphenidate Page 4 of 8 Version 1.0 December 2018 METHYLPHENIDATE.