PRISONERS, young adults and those with drug or alcohol misuse issues could be prioritised for ADHD assessments as health officials try to manage an “unmanageable” waiting list, it has emerged.
Documents presented at Thursday’s meeting of the Health Advisory Board, which oversees the Health Department, revealed that 924 adults were currently waiting for an ADHD assessment — with a waiting time of at least four years.
This means around one in 50 adults in Jersey is on the list.
With demand continuing to rise, members of the health board have discussed whether to stop accepting new referrals and instead focus on those with the greatest need — an approach that has already been taken in parts of the UK — although no final decisions have been made locally.
The issue of closing the waiting list has been discussed twice before, with the Health Minister previously pledging to explore “all possible actions” before making a final decision.
A report prepared for the board read: “Closing the waiting list would help manage the current demand and ensure that resources are focused on those with the most urgent needs.
“However, this is a complex and sensitive issue and closure of the waiting list is a political decision that needs to be discussed with the minister.”
The quality committee also recommended “focusing on those most affected by ADHD, such as individuals in prison, pre-sentencing adults, young adults transitioning from childhood ADHD, and those with drug and alcohol use issues”.
Currently, just one consultant psychiatrist and one junior doctor are responsible for handling hundreds of cases – a situation described as “unmanageable” by officials.
The papers noted that Health is considering whether to recruit more staff or allow GPs to prescribe ADHD medication in an attempt to ease the backlog and the strain on staff.
Shared prescribing, where GPs are allowed to prescribe ADHD drugs after a patient has been diagnosed by a specialist, has long been suggested as a way to reduce waiting times by freeing up specialist time to do assessments and referrals rather than filling out hundreds of repeat prescriptions every month.
However, plans to add ADHD medication to the shared prescribing list were scuppered last year due to national shortages of the drugs and concerns from local GPs.
Health Board non-executive director Dame Clare Gerada, for example, has pointed to the risks involved with GPs prescribing ADHD medication and has urged the department to find a different approach.
The health expert also raised concerns in the meeting about the “high” number of ADHD diagnoses in Jersey compared to other regions and called for an external review or “deep dive” to investigate why this was the case and whether anxiety or stress was sometimes being misdiagnosed as ADHD.
Dame Claire said: “I think it’s about understanding the demographics of who’s on the list. It’s about understanding the reasons for referrals.
“With an almost indefinite waiting list and a 600% increase of people on these being diagnosed with this condition, we have to do something rather than just say it’s going to go away. It’s not going to go away.
“I’m not sure it would take a staggering amount of resources, and it’s about actually getting public confidence in this so the public understands what’s going on, rather than just hide behind the figures.”
However, mental health director Andy Weir told the board meeting that it was “not the right time to do an external review”, adding that the best time would be in three months.
He said: “We need to do a bit more work before we ask someone to come in and have a look at where we are.
“We’re concerned that if we pay to get someone in, we will end up just telling ourselves what we already know.”
