AADD-UK
Clinical Guidelines
In England and Wales, ADHD has its own clinical guidelines (recommendations based upon best available evidence for the care & treatment of people with ADHD within the NHS) which were developed and provided by the National Institute for Clinical Excellence (NICE) in September 2008. Our guidelines are called CG72 or Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults.
NICE has also helpfully published a commissioning guide to support implementation of adult ADHD services by local authorities. Unfortunately, many local authorities don’t seem to have read this guide, but as NICE points out commissioners and providers have a responsibility to implement this guidance in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity (you’ll find more information about the Equality Act 2010 below).
And now here are links to free downloadable copies of the guidelines:
1. CG72 ADHD Patient Version
2. CG72 ADHD Recommendations for Health Professionals
3. CG72 ADHD Full Version (664 pages)
4. Service for the diagnosis and management of ADHD in adults: commissioning guide
Equality Act 2010
On 5th April 2011, the public sector equality duty (the equality duty) came into force in England, Scotland and Wales. This duty replaces the existing race, disability and gender equality duties. This means that public authorities (e.g. health & social care providers) must have due regard when designing and commissioning services (such as ADHD services) to the need to comply with the following 3 aims:
1. Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act.
2. Advance equality of opportunity between people who share a protected characteristic and those who do not by
a. Removing or minimising disadvantages suffered by people due to their protected characteristics.
b. Taking steps to meet the needs of people from protected groups where these are different from the needs of other people.
c. Encouraging people from protected groups to participate in public life or in other activities where their participation is disproportionately low.
3. Foster good relations between people who share a protected characteristic and those who do not by
a. Tackling prejudice
b. Promoting understanding between people from different groups.
c. Compliance with the duty may involve treating some people more favourably than others
Glossary
Discrimination: There are two kinds
Direct discrimination: This refers to less favourable treatment because of a person’s protected characteristic.
Indirect discrimination: This is when a provision, criterion or practice is applied in a way that creates disproportionate disadvantage for a person with a protected characteristic as compared to those who do not share that characteristic, and is not a proportionate means of achieving a legitimate aim.
Disability: A person has a disability if s/he has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.
Protected characteristics: age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation. These are also referred to as protected groups. The duty also covers marriage and civil partnerships, but not for all aspects of the duty.
Guides to the Equality Act 2010
Here are some links to guides to the Equality Act published by the Equality and Human Rights Commission:
1. Your rights to equality from healthcare and social care services
2. Your rights to equality from local councils, government departments and immigration
3. Your rights to equality from the criminal and civil justice systems and national security
More information is available from the Equality & Human Rights Commission here and also from the Government Equalities Office here.
Consensus Statements
1. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 2010 10:67 – The objectives of this consensus statement are to increase awareness of the following: (1) That ADHD often presents as an impairing lifelong condition in adults, yet is currently underdiagnosed and treated in many European countries; (2) That instruments for screening and diagnosis of ADHD in adults are available; (3) That appropriate treatments exist. Three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3)How should ADHD in adults be effectively treated?
2. Young SJ, Adamou M, Bolea B, Gudjonsson G, Müller U, Pitts M, Thome J, Asherson P. The identification and management of ADHD offenders within the criminal justice system: a consensus statement from the UK Adult ADHD Network and criminal justice agencies. BMC Psychiatry. 2011 Feb 18;11:32
3. Nutt, D.J. Fone, K. Asherson, P. et al. Evidence-based guidelines for the management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology: 2006.
NHS Constitutution
This Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this Constitution in their decisions and actions.
1. The NHS Constitution: the NHS belongs to us all (8 March 2010)
2. The Handbook for the NHS Constitution for England (8 March 2010)
Review date: 15/04/2011
Next review due: 15/04/2012
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