ADHD care needs clearer regulation and fewer pills

Letters report delays in Care Quality Commission registration that are preventing a psychiatrist from offering regulated ADHD assessments, and a parent describes a short NHS assessment that led quickly to stimulant and later antidepressant prescriptions.

Two letters published in response to reporting on NHS ADHD spending raise concerns about regulation and treatment approaches. Dr Vicky Cleak, a UK-trained consultant psychiatrist, says an ongoing Care Quality Commission registration process has prevented her from providing regulated ADHD assessments in an independent setting. She reports that some providers delivering NHS ADHD contracts did not have CQC registration and that some professional arrangements may fall outside CQC oversight. Another reader describes a brief NHS assessment that led to stimulant medication, later dose changes and antidepressant prescribing, and says therapy was not offered. Key points: - A consultant psychiatrist reports an eight-month CQC registration delay that has legally prevented her from seeing patients in the private setting she described. - The letter states that some organisations holding NHS ADHD contracts lacked CQC registration and that some care arrangements may not be covered by CQC regulation. - A parent describes a one-hour NHS assessment followed by stimulant prescription, later dose escalation and antidepressant treatment, and reports that a request for therapy was declined. Summary: The letters highlight concerns about fragmented regulation and an apparent reliance on medication in some ADHD pathways. The psychiatrist's CQC registration is reported as still pending, and broader regulatory arrangements and treatment patterns are described as matters of concern. Undetermined at this time.