In the UK, medicines for chronic conditions in children and young people (CYP) are typically initiated within secondary or tertiary care, with responsibility for ongoing supply often then passed to the child’s general practitioner (GP) and community pharmacist. The patient should then be reviewed in regular specialist clinics, with two-way communication for any changes in medications or clinical status undertaken between primary and secondary/tertiary care. This arrangement allows long-term medications to be obtained close to home.
Although this is what parents expect, the reality is often messy, with families regularly needing to source some medicines from the GPs and others via hospitals or homecare services. In addition, these arrangements are not uniform, they vary across different areas of the UK and depend on individual GP or hospital prescriber acceptance. When neither primary, secondary or tertiary care accepts it is their responsibility to prescribe, or patients are under multiple specialists, families often feel left to navigate this complex and variable supply system themselves. Obtaining a prescription is only the start of the process for families as dispensing from a community pharmacy can also be challenging.
In this article, we set out the barriers and potential solutions to this complex issue. We use the term specialist prescribers to include not only paediatricians but all other specialists looking after CYP including child and adolescent psychiatrists, ophthalmologists, dermatologists, surgeons, etc, as well as non-medical prescribers.
- child health services
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Collaborators The Joint RCPCH/NPPG Medicines committee is a collaborative standing committee with joint membership between the Royal College of Paediatrics and Child Health (RCPCH) and Neonatal and Paediatric Pharmacists Group (NPPG).
Contributors YT conceived the article and produced the initial draft. All authors, being members of the Joint RCPCH/NPPG Medicines committee, revised and approved the final article.
Funding KidzMed was funded jointly by the Academic Health Science Network North East and North Cumbria, and the Great North Children’s Foundation. This article includes summaries of independent research carried out at the National Institute for Health Research (NIHR), Alder Hey Clinical Research Facility.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health, the RCPCH or NPPG.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.