South West London and St George's Mental Health Trust One of the partners working with NHS Improving Quality on the Winterbourne Medicines Programme Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014 Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge

1. CAMHS Complex Learning Disability Team
• Tier 3 CAMHS service for children and young people with
moderate to profound intellectual disability
• 3.9 WTE including 0.5 consultant psychiatrist, 0.8 clinical
psychologist, 2 clinical nurse specialists, 0.4 SALT, 0.2 social
worker for a case load of 136 patients
• Serves inner London borough of Wandsworth (330,000
general population) and other boroughs on a case by case
basis
• Range of interventions offered including functional
assessment and positive behaviour support as well as
medication!
• Close links with special schools, local authority disabled
children’s team and community paediatric services

2. What are our current issues?
• Medication sometimes seen as ‘the answer’
• Lack of clear pathway for initiation and monitoring of
psychotropic medication
• Current resource constraints and their impact on safe and
appropriate prescribing
• Timely reviews of patients placed out of borough
• Lack of evidence base- what do we tell parents and carers?
• Ensuring flow through the service- discharging back to the GP

3. What would we like to achieve?
• Clear auditable care pathway for initiation and monitoring of
medication as part of an overall management plan
• Development of structures/ systems to support timely reviews
of medication use
• Promote wider understanding of appropriate use of
medication amongst parents , carers and other agencies
• Develop literature and monitoring tools to support self-management
when appropriate