Standard operating procedure

Physical Health Monitoring Procedure

How [Organisation Name] carries out baseline assessment and ongoing physical health monitoring for patients prescribed stimulant and non-stimulant medication for attention deficit hyperactivity disorder (ADHD), and ensures prescribing is not continued without monitoring

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What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Procedure
  • 6. Monitoring schedule
  • 7. Records
  • 8. Related documents
  • 9. Review and version control
  • 10. Disclaimer

Legislation & standards it maps to

  • National Institute for Health and Care Excellence, Attention deficit hyperactivity disorder: diagnosis and management - NICE guideline NG87 (2018, updated 2019)
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 12 (Safe care and treatment)
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 17 (Good governance)
  • British National Formulary (BNF) and British National Formulary for Children (BNFC), current edition
  • Summary of Product Characteristics (SmPC) for each prescribed product, as published on the electronic medicines compendium (emc)
  • General Medical Council, Good practice in prescribing and managing medicines and devices (2021)
  • Human Medicines Regulations 2012 (SI 2012/1916, as amended)
  • Data Protection Act 2018 and the UK General Data Protection Regulation (UK GDPR)

Who it applies to

All prescribers (consultant psychiatrists, specialty doctors, non-medical prescribers and ADHD specialist nurses with prescribing responsibilities), clinic nurses and healthcare assistants who take physical measurements, pharmacists, administrative and recall staff, the Registered Manager and Clinical Governance Lead, and any locums or trainees working at [Organisation Name]

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Anaphylaxis
A severe, life-threatening allergic reaction needing immediate emergency treatment.
Atomoxetine
A non-stimulant medicine used to treat ADHD that can raise heart rate and blood pressure.
Attention deficit hyperactivity disorder (ADHD)
A condition affecting attention, activity levels and impulse control that can be treated with stimulant and non-stimulant medicines.
Baseline assessment
The set of physical health measurements and history taken before ADHD medication is started, against which later results are compared.
British National Formulary (BNF) / British National Formulary for Children (BNFC)
The standard UK reference works giving up-to-date guidance on choosing, prescribing and giving medicines, with a children's edition.
Cardiology opinion
Specialist advice from a heart doctor on whether a treatment is safe for a patient's heart and circulation.
Cardiovascular
Relating to the heart and blood vessels.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Centile
A position on a growth chart showing how a child compares with other children of the same age and sex; for example, the 95th centile means only 5 in 100 are higher.
Clinical Governance Lead
The person responsible for overseeing the quality and safety of clinical care, including audit and learning from incidents.
Contemporaneously
Recorded at the time the event happens or immediately afterwards, rather than written up later.
Contraindication
A specific situation in which a medicine should not be used because it could be harmful.
Data Protection Act 2018
The UK law, alongside the UK General Data Protection Regulation, that governs how personal information must be handled.
Dexamfetamine
A stimulant medicine used to treat ADHD.
DNA (did not attend)
A record that a patient did not come to a booked appointment.
Electrocardiogram (ECG)
A simple, painless test that records the heart's electrical activity to check its rhythm and function.
Electronic medicines compendium (emc)
The official online library where the approved prescribing information for medicines is published.
Failsafe
A built-in safety control designed to catch a problem (here, overdue monitoring) before it can cause harm.
Faltering growth / growth suppression
A sustained slowing of expected gain in height or weight, or a fall across growth centiles, that may be associated with ADHD medication.
First-degree relative
A parent, brother, sister or child of the patient.
General Medical Council (GMC)
The body that registers and regulates doctors in the UK and sets the standards they must follow.
General practitioner (GP)
The patient's family doctor, usually their first point of contact for general health care.
Growth chart
A UK reference chart on which a child's height and weight are plotted over time to track their growth.
Guanfacine
A non-stimulant ADHD medicine that can lower heart rate and blood pressure and should not be stopped abruptly.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The regulations setting out the fundamental standards that providers must meet, including Regulation 12 on safe care and treatment and Regulation 17 on good governance.
Human Medicines Regulations 2012
The main UK law controlling how medicines are licensed, supplied, prescribed and labelled.
Hypertension / hypertensive range
Blood pressure that is persistently higher than the healthy range.
Lisdexamfetamine
A stimulant medicine used to treat ADHD.
Methylphenidate
A commonly used stimulant medicine for treating ADHD.
National Institute for Health and Care Excellence (NICE)
The national body that produces evidence-based guidance on treatments and care, including NICE guideline NG87 on ADHD.
Non-medical prescriber
A trained professional who is not a doctor, such as a nurse or pharmacist, who is qualified to prescribe medicines.
Non-stimulant
An ADHD medicine such as atomoxetine or guanfacine that works differently from the stimulant medicines.
Paediatric
Relating to the care of babies, children and young people.
Palpitations
An awareness of the heart beating fast, hard or irregularly.
QT interval
A measurement on an ECG; if it becomes too long, it can increase the risk of a dangerous heart rhythm.
Registered Manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Risk assessment
A structured check identifying what could cause harm and what is being done to prevent it.
Safeguarding
Protecting people's health, wellbeing and rights and keeping them safe from abuse, harm or neglect.
Single assessment framework
The structure the regulator uses to judge a service, built around quality statements and five key questions (safe, effective, caring, responsive, well-led).
Stadiometer
A fixed measuring device used to record a person's height accurately.
Standard Operating Procedure (SOP)
A written, step-by-step instruction setting out exactly how a particular task is to be carried out.
Stimulant
An ADHD medicine such as methylphenidate, dexamfetamine or lisdexamfetamine that can raise heart rate and blood pressure.
Summary of Product Characteristics (SmPC)
The regulator-approved document for a specific medicine setting out how it should be used, including doses, cautions and monitoring.
Syncope
A temporary loss of consciousness, commonly known as fainting.
Tachycardia
An abnormally fast heart rate.
Tics
Sudden, repeated movements or sounds that a person finds hard to control.
Titration
Gradually adjusting the dose of a medicine up or down to find the amount that works best with the fewest side effects.
Treatment break
A planned, time-limited period off medication (sometimes called a drug holiday), considered for example to assess growth or continued need.
UK General Data Protection Regulation (UK GDPR)
The UK's main data-protection law governing how personal information is collected and used.

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Related documents

PolicyADHD Assessment Policy£54.99
PolicyMedication Management Policy£54.99
PolicySafeguarding Children Policy£54.99
PolicyConsent & Capacity Policy£54.99

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