ADHD Clinical Lead Nurse (V300 Independent Prescriber)

The successful candidate will provide senior clinical support across our adult and children and young people's ADHD services, working directly with the Consultant Psychiatrist and Registered Manager.

The role will involve undertaking approximately two ADHD diagnostic assessments each week, alongside managing complex medication titrations and providing specialist prescribing advice to colleagues.

A significant part of the position will involve reviewing and responding to clinical enquiries received from patients, parents, GPs and other healthcare professionals, particularly where concerns relate to medication, treatment decisions or clinical risk.

The postholder will participate in multidisciplinary team discussions, provide clinical guidance and supervision to other clinicians, and assist with reviewing complex cases that require additional clinical input.

They will also support the investigation of clinical complaints, review incidents and contribute to clinical audits, patient safety and ongoing improvements to our assessment and prescribing pathways.

The position requires an experienced and confident clinician who can work independently, prioritise clinical concerns and recognise when matters require escalation.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Essential criteria
- 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
- 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
- Comprehensive knowledge of ADHD diagnostic criteria, differential diagnosis and recognised assessment methods
- Detailed understanding of NICE NG87 and current clinical guidance for ADHD assessment and treatment in adults and children and young people
- Strong knowledge of ADHD medication, including pharmacology, titration, adverse effects, contraindications, drug interactions and relevant physical health monitoring
- Ability to independently assess and manage complex ADHD presentations and make appropriate clinical decisions
- Ability to provide specialist prescribing advice and clinical guidance to other healthcare professionals
- Ability to review and respond to complex clinical enquiries from patients, parents, GPs and other professionals in a clear and timely manner
- Excellent written communication skills, including the ability to prepare accurate clinical reports, professional correspondence and responses to clinical concerns
- Ability to contribute effectively to MDT discussions and communicate complex clinical information to colleagues
- Sound understanding of safeguarding, clinical risk management and appropriate escalation procedures for adults and CYP
- Ability to prioritise competing clinical responsibilities and manage a varied workload independently
- Ability to recognise professional limitations and seek appropriate senior medical advice when required
- Strong organisational skills and competence using electronic patient record systems, secure email and remote consultation platforms
- Ability to work collaboratively with the Consultant Psychiatrist, Registered Manager and wider clinical team
- Willingness and ability to attend the Manchester office during the working week when reasonably required by the service
- Commitment to maintaining high standards of patient safety, confidentiality, professional conduct and evidence based clinical practice

Desirable criteria
- 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
- 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
- Familiarity with structured ADHD assessment tools, including DIVA 5, QbCheck or QbTest
- Knowledge of NHS shared care arrangements and ongoing ADHD medication monitoring requirements
- Understanding of CQC clinical governance requirements and quality standards within independent healthcare
- Experience supporting clinical service development and improving assessment or prescribing pathways
- Ability to identify recurring clinical issues and recommend practical improvements to patient care and clinical processes

- This position offers the opportunity to take on a senior clinical role within an established and developing service, with flexible working arrangements and close involvement in clinical leadership.