ADHD Clinical Lead Nurse (V300 Independent Prescriber)

Job Purpose
Harley Street Mental Health is seeking an experienced ADHD Clinical Lead Nurse and V300 Independent Prescriber to provide senior clinical support across our services, primarily the NHS Right to Choose pathways for adults and children and young people (CYP).

The postholder will report to the Consultant Psychiatrist for clinical matters and the Registered Manager for operational and governance matters. This is a full time role of 40 hours per week, with flexible remote working and attendance at our Manchester office when required during the working week.

The role combines a small caseload of ADHD assessments with complex medication titrations, clinical enquiries, MDT discussions, supervision, complaints and quality improvement. The successful candidate must exercise sound independent clinical judgement, work within their competence and escalate concerns appropriately.

ADHD Assessments
The postholder will ordinarily undertake two comprehensive ADHD assessments per week, primarily in adults, with CYP assessments where appropriately trained and competent. This includes obtaining developmental, psychiatric, medical and psychosocial histories; reviewing screening measures, collateral information and relevant medical records; applying recognised diagnostic criteria and structured tools where appropriate; considering differential diagnoses and coexisting conditions; assessing risk and functional impairment; providing diagnostic feedback; and preparing clear clinical reports. Complex or uncertain cases must be discussed with the Consultant Psychiatrist or MDT where indicated.

Medication Management and Complex Titrations
The postholder will independently prescribe within their verified competence and provide specialist support for complex ADHD titration cases across adult and CYP services. Responsibilities include:

• Initiating, adjusting and reviewing stimulant and non stimulant medication in accordance with NICE guidance, prescribing standards and agreed protocols.
• Managing cases involving poor response, adverse effects, medication intolerance, treatment interruption or coexisting mental and physical health conditions.
• Advising clinicians on medication choice, formulation changes, dosing, interactions and contraindications.
• Reviewing baseline and follow up physical health information, including cardiovascular history, blood pressure, pulse, weight and growth monitoring where relevant.
• Assessing concerns involving palpitations, mood changes, sleep, appetite, substance misuse, diversion or other medication risks, and arranging suitable escalation or further medical review.
• Undertaking complex titration appointments, reviewing cases returning to treatment and supporting clinically appropriate shared care arrangements.
• Providing specialist advice on CYP medication management, with independent prescribing for this group limited to the postholder's demonstrable paediatric or CAMHS competence.

Clinical Leadership and Supervision
Act as a senior point of contact for assessment and prescribing clinicians. Offer case based advice on diagnostic uncertainty, risk and treatment planning. Provide clinical supervision and support induction and competency development as agreed with the Consultant Psychiatrist. Review clinical records, assessment reports and prescribing practice through agreed quality assurance processes. Identify training needs, address concerns about clinical standards and contribute to clinical guidance and protocols.

Clinical Enquiries and Correspondence
Take day to day responsibility for triaging and responding to clinical enquiries received through designated email channels. These may come from patients, parents, carers, GPs, pharmacists, colleagues or other professionals and include medication questions, adverse effects, titration difficulties, treatment suitability, physical health findings and changes in mental state.

Prioritise enquiries according to clinical urgency, provide clear and appropriately documented advice, and identify cases requiring an appointment, safeguarding response, urgent external care or Consultant Psychiatrist review. Support administrative staff in distinguishing clinical from non clinical matters. Ensure that significant correspondence and decisions are recorded in the patient record.

Multidisciplinary Working
Attend regular MDT meetings, present complex assessment and prescribing cases and offer specialist nursing and prescribing advice. Contribute to decisions regarding diagnosis, treatment, safeguarding, risk and suitability for remote care. Coordinate or chair discussions when delegated, record agreed plans and follow up actions where required.

Clinical Complaints, Incidents and Governance
Work with the Registered Manager and Consultant Psychiatrist to review the clinical aspects of complaints and incidents. Examine relevant records and correspondence, provide balanced clinical findings and contribute to draft responses for senior approval. Recognise and promptly escalate significant patient safety concerns. Participate in incident reviews, prescribing and documentation audits, and improvements arising from complaints, audits or clinical feedback. The Registered Manager retains oversight of formal complaints and regulatory processes.

Risk and Safeguarding
Support clinicians in assessing risk, including suicidal ideation, self harm, psychiatric deterioration, substance misuse and safeguarding concerns involving adults or CYP. Recognise when remote management is inappropriate and when urgent intervention or referral is needed. Follow safeguarding policies, seek specialist input where necessary and document assessments, decisions and escalation clearly.

Service Development
Help improve ADHD assessment, titration and monitoring pathways, clinical correspondence processes and documentation standards. Contribute to clinical audit, staff development, policy updates and quality improvement. Work with senior colleagues to identify recurring problems and implement practical changes to patient care and safety.

Professional Requirements
Maintain current NMC registration and V300 independent prescribing annotation. Work in accordance with the NMC Code, NICE NG87, relevant prescribing legislation, data protection requirements and organisational policies. Maintain accurate records, complete safeguarding and mandatory training, undertake continuing professional development and recognise the limits of personal competence. Work respectfully with colleagues and patients and undertake other reasonable duties consistent with the seniority of the position.

Working Arrangements
This is a 40 hour per week position, mainly remote with some attendance at our Manchester office according to service needs. The postholder must be available to support clinical enquiries and the wider clinical team during agreed working hours. Clinical matters are escalated to the Consultant Psychiatrist and operational or governance concerns to the Registered Manager as appropriate.

Qualifications
Essential

• Current registration with the Nursing and Midwifery Council as a Registered Nurse
• V300 Independent Prescribing qualification with active prescribing annotation on the NMC register
• Recognised nursing degree, diploma or equivalent professional nursing qualification
• Evidence of relevant continuing professional development in ADHD assessment, diagnosis and medication management
• Current safeguarding training and competence appropriate to working with adults and children and young people

Desirable

• Postgraduate qualification in mental health, advanced clinical practice, neurodevelopmental conditions or a related clinical discipline
• Formal training in ADHD diagnostic assessment, including the use of structured assessment tools such as DIVA 5
• Recognised qualification or training in clinical supervision, mentorship, teaching or clinical leadership
• Additional training in child and adolescent mental health or paediatric ADHD management

Experience
Essential

• Minimum of five years of relevant post registration nursing experience in mental health, ADHD, neurodevelopmental or related specialist clinical services
• Minimum of two years of experience conducting comprehensive ADHD diagnostic assessments in adults
• Minimum of two years of experience independently prescribing, initiating and titrating ADHD medication
• Demonstrable clinical experience of ADHD assessment or treatment in children and young people, including appropriate knowledge of CYP prescribing and medication monitoring
• Experience managing complex ADHD medication titrations, including treatment resistance, adverse effects, medication changes and coexisting mental or physical health conditions
• Experience prescribing and monitoring stimulant and non stimulant ADHD medication
• Experience providing senior clinical advice, supervision, case review or professional support to other clinicians
• Experience working within a multidisciplinary clinical team and contributing to complex clinical decisions
• Experience assessing and managing clinical risk, including mental health deterioration, safeguarding concerns and prescribing safety
• Experience preparing comprehensive diagnostic reports, clinical correspondence and treatment plans
• Experience working independently and making appropriate clinical decisions within professional competence

Desirable

• Previous experience in a Clinical Lead, Senior Specialist Nurse, Advanced Nurse Practitioner or equivalent senior clinical position
• Experience working within NHS Right to Choose ADHD services or an NHS commissioned independent healthcare provider
• Experience working within CAMHS or specialist paediatric ADHD services
• Experience investigating clinical complaints, reviewing incidents or contributing to clinical governance processes
• Experience conducting clinical audits, reviewing prescribing standards or supporting quality improvement
• Experience providing remote ADHD assessments, medication titration and clinical consultations
• Experience developing clinical protocols, supporting service improvements or contributing to clinical training

Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

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