EC Paediatrics

Background: Children and young people receiving pharmacological treatment for attention deficit hyperactivity disorder (ADHD) require regular monitoring of growth parameters, cardiovascular observations, and clear communication with families, schools, and primary care providers. NICE guideline NG87 emphasises structured monitoring and documentation to ensure treatment safety and effectiveness. However, variability in clinical practice and incomplete documentation may compromise the quality of care and patient safety in community paediatric settings.

Aim: To assess compliance with NICE NG87 monitoring and communication standards within a community paediatric ADHD service and to evaluate the impact of targeted quality improvement interventions through a completed audit and re-audit cycle.

Methods: A retrospective audit of clinic records was conducted between June 2023 and May 2024, reviewing 38 children receiving ADHD medication. Data were collected on growth monitoring, pulse and blood pressure recording, centile plotting, and documentation of communication with parents, schools, and general practitioners. Following identification of gaps, targeted interventions were introduced, including staff education, reinforcement of NICE guidance, and structured clinical documentation templates. A re-audit was undertaken between September 2024 and February 2025 involving 41 patients, using the same data collection standards to assess improvement.

Results: The initial audit identified deficiencies in growth centile plotting, blood pressure centile documentation, and consistent communication records. Following implementation of targeted service improvements, the re-audit demonstrated substantial enhancement in clinical practice, with 10 of 11 monitored standards achieving 100% compliance. Growth monitoring, pulse and blood pressure recording, and communication with parents, schools, and general practitioners showed full adherence to NICE NG87 recommendations. Blood pressure centile plotting improved significantly compared to baseline but remained below optimal compliance at 73.2%, highlighting an area for continued quality improvement.

Conclusion: Structured interventions, including education and improved documentation tools, led to marked improvements in compliance with national ADHD monitoring standards. Regular audit cycles remain essential in sustaining high-quality, safe, and standardised care within community paediatric ADHD services.

 Keywords: NICE NG87; Attention Deficit Hyperactivity Disorder (ADHD); Children

1. National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management (NG87). London: NICE; 2018. Updated 2019.