Service alerts and updates

NHS England is considering capping the amount of money its Integrated Care Boards (ICBs) spend on elective services. This includes neurodevelopmental (ND) assessments through Right to Choose. The consultation proposes tighter financial controls by effectively limiting the number of assessments each provider can complete. It is important to remember that the proposed changes are still at consultation stage and that no decisions have yet been made.

While this is a developing situation, we will:

• Continue our services as normal. If you are currently enrolled or active in our service, your status remains unchanged, and we are providing assessments and post-diagnostic treatment and support as per usual.  

• Submit a formal objection to the proposed changes by February 28^th as a relevant provider.

• Engage with our NHS Trust partners, other providers and third-sector organisations.

For clients referred by our insurer partners or directly by their NHS Trust, any potential change to RTC legislation will not impact your journey.

We ask you to please understand that our customer service teams will likely be under increased strain until the NHS provides us with further clarity. We kindly ask you to refer to our FAQs below and please refrain from contacting us unless necessary.

We will keep you updated as we learn more. Our commitment to providing high quality mind health support remains unchanged.

We understand that this news can be distressing, if you are at risk to yourself or others, please dial 111 or go to your nearest Emergency Department. You can also visit this page on our website to find out about how to access support in an emergency.

The British Medical Association (BMA) and GP Committee England (GPCE) have recently voted to support GP collective action which is linked to the negotiation on their contracts with NHS England.

Collective action is different from industrial action but it does mean that some GPs may stop or reduce certain work.

It is unknown how many GP practices will participate in collective action and it is therefore hard to judge the impact this will have on clients across England. However, our ADHD medication clients should be aware that collective action may:

• Limit or reduce shared care arrangements between GPs and providers such as NHS hospital doctors and private businesses such as ProblemShared.
• Lead to a reduction in the number of GPs offering ongoing monitoring services required for the continued prescribing of certain medication – specifically the management of ADHD, such as ECGs and blood pressure measurements.

We continue to experience disruptions in the national supply of ADHD medications.

Given the widespread nature of the shortages, we are unable to start both new and existing clients on certain brands of medication.

• If you are a new client, your prescribing team will start you on the most appropriate available medication.
• Due to the range of medications impacted, it may not be possible to re-titrate you to an alternative if your current medication becomes unavailable. This is because as one brand goes out of stock there is an increase in demand for another, causing a ripple effect of supply constraints.

In both cases, your prescribing team will explain your options to you and ensure you are fully supported. Below is the current information on medication availability. Please note that this is subject to change, and we will continue to monitor supplies and provide regular updates.

• Lisdexamfetamine (Elvanse/Elvanse Adult): All strengths have good stock available.
• Affenid XL, Concerta XL, Delmosart MR, Xaggitin XL, Xenidate XL, Equasym XL: Stock levels are very low. Clients are advised to use their medication sparingly, take breaks whenever possible, and extend their current supply as long as they can.
• Medikinet XL, Meflynate XL: Stock is limited but currently stable.
• Guanfacine MR (Intuniv) (not licensed in adults): Stock remains stable.
• Atomoxetine: Stock has become stable again following a recent medication recall.

New clients can access our medication service, however, availability of some ADHD medications continues to fluctuate. As one brand goes out of stock there is a huge increase in demand for another, causing a ripple effect.

Currently several Methylphenidate medications (Concerta, Xenidate, Xaggitin) are out of stock from the 3 largest UK pharmaceutical suppliers.

Their teams have informed us that they will receive supply from the manufacturers at some point, but this is all the information they are able to provide.

If you are on an ADHD medication that goes out of stock, your prescribing team will explain your options to you and ensure you feel supported. We continue to monitor supplies and provide our clients with regular updates.

New clients can access our medication service, however, supplies of certain medications remain unstable so we are unable to start both new and existing clients on certain brands of medication. 

We continue to monitor supplies and provide our clients with regular updates. 

Improved supplies of Lisdexamfetamine (Elvanse) and Atomoxetine (Strattera) - 29/04/24

We have received assurance that stock levels of Lisdexamfetamine (Elvanse) and Atomoxetine (Strattera) are improved, however there is a possibility that this may change in the future.

We continue to monitor supplies and will provide our clients with regular updates. New clients can continue to access our medication service.

New clients can access our medication service, however, supplies of certain medications remain unstable so we are unable to start both new and existing clients on certain brands of medication.

We continue to monitor supplies and provide our clients with regular updates.

The supply of some medications remain unstable as demand fluctuates, and as a result we remain unable to start clients on certain brands of medication.

We continue to monitor supplies and receive regular updates around the types of medication that are currently available.

We will continue to provide our clients with regular updates.

The supply of some Methyphenidate have stabilised so for that reason we have begun to prescribe these medications to new clients.

The supply of Lisdexamfetamine (Elvanse) and Atomoxetine (Strattera) continues to remain uncertain, as a result we will not be prescribing these until supplies stabilise.

As always, we will continue to monitor ongoing supplies and will keep our clients updated during this time.

Long term supplies of certain ADHD medication still remain uncertain and as a responsible healthcare provider, we are following government guidance, which has not changed since the shortage began.

This means that we are still not prescribing medication to any new clients. We are in regular contact with manufacturers and continue to monitor the situation closely.

We will continue to update our clients on a regular basis.

We have contacted each of our clients individually, and discussed the possibility of switching their medication where appropriate.

Long term supplies of Lisdexamfetamine (Elvanse) and Atomoxetine (Strattera) remain uncertain.

As a responsible healthcare provider, we are following government guidance, which has not changed since the shortage began. This means that we are still not prescribing medication to any new clients.

We have received assurance this week that the stock levels of Methyphenidate (Concerta XL, Xenidate XL, Matoride XL, Xaggitin, Equasym XL, Medikinet XL) have stabilised.

Unfortunately, there are still supply issues with Lisdexamfetamine (Elvanse) and Atomoxetine (Strattera). 

What does this mean for you or your child?

We are looking to resume prescribing medication as soon as we are able:

1. If you have been prescribed Methylphenidate by us, and currently have your treatment on hold, we will call you next week to book in a review appointment. At your review appointment, your prescriber will discuss the options available to you, depending on your specific circumstances.

2. If you have been prescribed Lisdexamfetamine or Atomoxetine by us, and your treatment is on hold, we will call you to book in your next review appointment. During this appointment, your prescriber will discuss with you whether switching to another medication is a clinically appropriate alternative for you.

3. If you are waiting to have a treatment planning appointment, this will go ahead as normal. Your options will be fully explained to you in the appointment. However, please be aware that we are still unable to resume prescribing for any new clients, in accordance with the government safety alert. 

There is a global shortage of the following ADHD medications:

• Lisdexamfetamine (Elvanse)
• Atomoxetine (Strattera)
• Methyphenidate (Concerta XL, Xenidate XL, Matoride XL, Xaggitin, Equasym XL, Medikinet XL)

As a result, supply reliability is significantly affected. In order to maintain clinical safety, ProblemShared will be advising all clients to take a break from medication. We will not be prescribing ADHD medications until reliable provision of medication can resume.

Please be assured that every effort is being made to find a resolution. While the issue is out of our control, we will do everything we can to support you through this time.

If the medication shortage affects you or your child, you will have received email communication from us advising you on how to proceed with alternative treatment options. For further information, please read the FAQs further down this page, or download our guide to navigating the ADHD medication shortage.