Face to face at Centennial Medical Care - 90 minutes

• Dr Banham reads and summarises any previous assessments before the initiation appointment

• Family complete SNAP-IV questionnaires pre-appointment to measure impact of ADHD symptoms

• Height, weight, pulse and BP measured in clinic

• At the appointment we will:

  • Explore the impact of ADHD symptoms on functioning

  • Discuss approaches to manage ADHD symptoms that don’t require medication

  • Complete a detailed medical and family history to assess the safety of using stimulant medication for ADHD

  • Discuss the topic of medication for ADHD; 

    • practicalities about taking medication

    • how the medication will improve symptoms

    • possible side effects

    • how to monitor the medication at home (home blood pressure monitoring, height, weight, side effects)

  • Agree shared goals; how will we know medication is making a difference 

  • Start medication if all in agreement (paper prescription issued; medication can be collected from CMC Pharmacy, if desired)

• Dr Banham writes a summary letter to family, GP and/or referrer

• Young person trials medication

• Family monitor pulse and blood pressure and share pulse/BP readings via email

• Dr Banham responds to any questions or concerns over email

online or face to face - 30 minutes

• Review side-effects from medication (the small starting dose is used to assess how tolerable the medication is)

• Consider whether the medication has had a positive effect on symptoms.

• If there are no side effects, we may increase the dose further

• Dr Banham issues a prescription

• Dr Banham writes a summary letter to family, GP and/or referrer

• Young person trials medication

• Family monitor pulse and blood pressure and share pulse/BP readings via email

• Dr Banham responds to any questions or concerns over email

online or face to face - 30 minutes

• Review side-effects and impact on symptoms from medication

• If there are no/few side effects but further symptom control is needed, we may increase the dose.

• Dr Banham issues a prescription

• Dr Banham writes a summary letter to family, GP and/or referrer

• Young person trials medication

• Family monitor pulse and blood pressure and share pulse/BP readings via email

• Family/school may be asked to complete a SNAP questionnaire to measure any symptom change.

• Dr Banham responds to any questions or concerns over email

online or face to face - 30 minutes

• Review benefits/side-effects from medication

• Review BP/pulse/height/weight

• If there are no/few side effects, and significant positive effects from the medication, either increase or continue dose

• Dr Banham issues a prescription, as needed.

• Dr Banham writes a summary letter to family, GP and/or referrer

• Discussion re when a shared care agreement with GP would be appropriate.

  • If the GP agrees, then subsequent prescriptions can be issued on GP repeat prescription. If not, Dr Banham can continie to issue private prescriptions

• If appropriate, we can move to 3-6 monthly follow-up appointments.

This can be face to face or online and would be 45 minutes

• Dr Banham will review height, weight, BP/pulse

• Dr Banham will review symptom control and side-effects and adjust medication as needed.

• Dr Banham will write a summary letter to family, GP, referrer

• Dr Banham will issue a private prescription

• This frequency of review will continue until the child/young person is 18 or until there is handover to another supervising clinician such as NHS CAMHS