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Gov to review how mental health medication is prescribed to children

Gov to review how mental health medication is prescribed to children

Friday 16 February 2024

Gov to review how mental health medication is prescribed to children

Friday 16 February 2024


The Government is reviewing the way controlled drugs are prescribed to young islanders struggling with their mental health after a recent report found that the current prescribing model is "not sustainable".

A recent inspection of Child and Adolescent Mental Health Services (CAMHS) by the Jersey Care Commission raised concerns over the fact that only CAMHS clinicians are authorised to prescribe medication for service users.

This has “a considerable impact on the capacity and workload of the clinicians responsible for prescribing”, according to the report.

The review highlighted "several challenges related to capacity and workload if this arrangement continues for the limited clinicians that prescribe and undertake six monthly medication reviews".

The Care Commission felt there should be a collaboration with GPs to share the responsibility of prescribing and medication reviews to "alleviate pressure on the CAMHS clinicians".

It was suggested that the current arrangement may also impact the service's ability to recruit and retain the clinical roles "due to the high workload, level of pressure, and responsibility".

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Pictured: The report raised concerns over the fact that only CAMHS clinicians are authorised to prescribe medication for service users.

The Care Commission found that “this model is not sustainable, and collaboration with local GP services is necessary to share the responsibility of prescribing”.

However, CAMHS said that “this is not an improvement area CAMHS can control the delivery of”, as the prescribing of controlled medication is a “law issue” in Jersey.

CAMHS explained that any change in prescribing would require Pharmaceutical Benefits Advisory Committee and later Minister for Social Security approval to add medication to the approved whitelist on the Health Insurance Fund.

It would also require development of shared care guidelines, as well as GP agreement and funding. 

In the report, CAMHS confirmed it had "supported an application for shared prescribing" which was presented to the Pharmaceutical Benefits Advisory Committee on 7 February 2024.

The PBAC will now hold a further meeting to consider the application in detail.

The Government confirmed that the prescribing process in respect of CAMHS clients is under active review at present.

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Pictured: It is hoped that collaboration with GPs to share the responsibility of prescribing would "alleviate pressure on the CAMHS clinicians".

The Care Commission's report also raised related concerns that young people who are prescribed medication for their mental health can currently only collect it from the Hospital pharmacy, which is closed on weekends.

"It can also be a long wait at this pharmacy, and it does not offer the option of delivery," the report said.

"E-prescriptions have recently been introduced. However, families must still go to the hospital and take a physical paper copy of a prescription with them when receiving medication that is classed as controlled medications."

Rachel Tippettwho runs the not-for-profit support group ADHD Jersey recently criticised the long waits and limited opening hours of the Hospital pharmacy for being "not accessible" to those who struggle with mental health or neuro-developmental issues.

She explained that the lunchtime rush and long queues are particularly problematic for patients with ADHD who often struggle with patience or have a hard time standing in lines for extended periods.

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Pictured: The queue at the Hospital pharmacy at 15:00 on a Friday in November. 

Deputy Catherine Curtis – Chair of the Children, Education and Home Affairs Scrutiny Panel – said at the time that she was aware of some of the challenges for ADHD patients and that her panel would be keeping an eye on this.

"We are told that the [CYPES] Department has been working to create a shared prescribing scheme with GPs to take over regular prescriptions of ADHD medication," she said.

"This would both free up CAMHS clinicians for diagnostic work and make it easier for people to collect their medication.

"The department has stated they expect to complete this work during quarter one of 2024.

"The panel will be able to follow this up with the new Minister."

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