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Prescribing of Lisdexamfetamine, and Guanfacine

Reference: 23-24318

Date response sent: 14/11/2023

Details of enquiry

  1. Did your Trust receive the above NatPSA? If so, on what date was it received?
  2. Assuming that the answer to the first part of question 1 is yes, was the NatPSA forwarded to relevant specialist teams within your Trust? Which specialist teams was the NatPSA forwarded to?
  3. The NatPSA states that ‘prescribers should not initiate new patients on products affected by this shortage until the supply issues resolve.’ Have any new patients under your care who would ordinarily have been prescribed the affected products not been given prescriptions because of this required action? If so, how many?
  4. Where appropriate did specialist teams within your Trust ‘identify all patients currently prescribed these products’, as required by the NatPSA? If so, how many patients were identified and by what date was this action carried out?
  5. Where appropriate did specialist teams within your Trust ‘make early contact with patients to establish how much supply they have remaining’, as required by the NatPSA? If so, how many patients did you attempt to contact? How many patients were successfully contacted?
  6. Assuming that the answer to the first part of question 5 is ‘yes’, and that some patients were successfully contacted, how many patients were identified as having insufficient supplies to last until the re-supply date?
  7. The NatPSA states that healthcare professionals should ‘contact patient’s specialist team[s] for advice on management options’. Have any specialist teams within your Trust been contacted by other healthcare professionals seeking such advice? If so, what advice were specialist teams able to provide?
  8. Have specialist teams within your Trust ‘[supported] primary care teams seeking advice for patients currently prescribed the affected products’, as required by the NatPSA? If so, how?
  9. Have specialist teams within your Trust provided individualised management plans, either to primary care teams or directly to patients? If so, how many?
  10. Have specialist teams within your Trust recommended alternative products in line with NICE guidance, where appropriate? If so, how many such recommendations have been made?
  11. What policy, if any, exists within your Trust for ensuring compliance with National Patient Safety Alerts? If such a policy exists, please provide a copy of it.

Response sent

Please note that at this Trust, the Tavistock and Portman NHS Foundation Trust, we do not have specialist ADHD Teams, though we do provide treatment for some children and young people with ADHD.

The specialist team in Camden dealing with ADHD is the Royal Free Hospital Trust.  Nevertheless, we have answered your questionnaire as follows:

  1. Did your Trust receive the above NatPSA? If so, on what date was it received?

Yes, it was received on 27/09/23

  1. Assuming that the answer to the first part of question 1 is yes, was the NatPSA forwarded to relevant specialist teams within your Trust? Which specialist teams was the NatPSA forwarded to?

As already explained in our opening paragraph above, this Trust does not have specialist ADHD Teams, but does provide treatment for some children and young people with ADHD.

To Family Mental Health Team (FMHT), South Camden, North Camden Community Team (NCCT) and Autism and Learning Difficulties (A&LD)

  1. The NatPSA states that ‘prescribers should not initiate new patients on products affected by this shortage until the supply issues resolve.’ Have any new patients under your care who would ordinarily have been prescribed the affected products not been given prescriptions because of this required action? If so, how many?

None

  1. Where appropriate did specialist teams within your Trust ‘identify all patients currently prescribed these products’, as required by the NatPSA? If so, how many patients were identified and by what date was this action carried out?

No, in some cases it was decided to wait until affected patients contacted us, as not all experienced problems accessing the medication

  1. Where appropriate did specialist teams within your Trust ‘make early contact with patients to establish how much supply they have remaining’, as required by the NatPSA? If so, how many patients did you attempt to contact? How many patients were successfully contacted?

See our response to question 2 above, with regards to specialist teams.  Our teams reactively deal with all incoming queries from patients/parents experiencing supply issues, and we successfully advised them how to get around this shortage, by taking more of lower dose medications

  1. Assuming that the answer to the first part of question 5 is ‘yes’, and that some patients were successfully contacted, how many patients were identified as having insufficient supplies to last until the re-supply date?

Around 10 patients

  1. The NatPSA states that healthcare professionals should ‘contact patient’s specialist team[s] for advice on management options’. Have any specialist teams within your Trust been contacted by other healthcare professionals seeking such advice?

See our response to question 2 regarding specialist teams.  No we have not been contacted by other teams.

  1. Have specialist teams within your Trust ‘[supported] primary care teams seeking advice for patients currently prescribed the affected products’, as required by the NatPSA?

No

  1. Have specialist teams within your Trust provided individualised management plans, either to primary care teams or directly to patients? If so, how many?

No, other than to prescribe lower strengths and asking pharmacies to make up to the total daily dose prescribed..

  1. Have specialist teams within your Trust recommended alternative products in line with NICE guidance, where appropriate? If so, how many such recommendations have been made?

See our response to question 9 above

  1. What policy, if any, exists within your Trust for ensuring compliance with National Patient Safety Alerts? If such a policy exists, please provide a copy of it.

No written policy is in place, but NPS alerts are routinely brought to the attention of the Deputy Chief Medical Officer and the Health and Safety Manager and then escalated internally, as appropriate.

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