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Clinical Duties
•    Specialist assessment and diagnosis of adult ADHD using structured clinical interviews and validated tools (e.g., ACE+/DIVA‑5) alongside developmental history, collateral information and differential diagnosis. Assess risk and capacity as required.
•    Formulation and treatment planning using a biopsychosocial approach; provide psychoeducation; advise on reasonable adjustments and occupational/educational support; signpost to psychological interventions and coaching where available.
•    Medication initiation and optimisation (e.g., lisdexamfetamine, methylphenidate, atomoxetine; dexamfetamine where indicated), including:
o    Baseline evaluation (cardiovascular risk, blood pressure/pulse, weight/BMI; ECG if indicated) and physical health monitoring schedule.
o    Dose titration to clinical response and tolerability, with systematic monitoring of efficacy, side effects (including sleep, appetite, cardiovascular parameters, mood/anxiety), and misuse/diversion risk.
o    Safe and lawful prescribing of controlled drugs with accurate record‑keeping and reconciliation; work with pharmacy and ICB on formulary adherence.
•    Comorbidity management & liaison: screen for common psychiatric comorbidities (anxiety, depression, bipolar disorder, personality difficulties, substance use, ASD, tic disorders) and relevant physical health issues (e.g., hypertension, diabetes, cardiovascular and other physical health conditions); coordinate care with CMHT, IAPT/psychology, substance misuse, primary care and other relevant clinicians/services.
•    Shared care and discharge planning: prepare comprehensive shared‑care letters; transfer stable patients to GP under formal shared‑care arrangements; provide advice for primary care and accept re‑referrals if instability occurs.
•    Perinatal and reproductive health: provide pre‑conception and pregnancy counselling regarding ADHD and medicines; liaise with perinatal mental health services as required.
•    Driving and safety advice: document discussions regarding fitness to drive and DVLA guidance; provide occupational risk advice (e.g., operating machinery, safety‑critical roles).
•    Records and information governance: maintain contemporaneous electronic records; complete outcome measures and mandated datasets; ensure high standards of documentation for titration and monitoring.
•    Mental Health & Capacity legislation: apply the Mental Capacity Act; contribute to MHA processes where relevant; support colleagues with Section 5(2)/MHA queries (note: detentions are uncommon in ADHD pathways but legal literacy is expected).
•    Urgent care interface: collaborate with crisis and liaison services for patients presenting with acute risk, severe comorbidity or medication‑related concerns.

Management, Leadership & Service Development
•    Contribute to clinical governance, QI, service evaluation and audit (e.g., waiting time reduction, titration pathway efficiency, medicines safety, outcome monitoring).
•    Participate in MDT meetings, case discussions, and clinical huddles; support trauma‑informed and neuroaffirming practice.
•    Provide clinical advice to GPs and partner agencies; contribute to pathway and protocol development (assessment standards, shared‑care, physical health monitoring, safeguarding, equality of access).
•    Support safe medicines management including controlled‑drug governance, FP10/EPMA processes, stock reconciliation and incident reporting.
•    Assist the service in delivering key performance indicators (e.g., assessment volumes, RTT, follow‑up standards, physical health monitoring compliance).

Education & Supervision
•    Offer supervision/teaching to medical students, junior doctors, NMPs and the wider MDT; contribute to induction and in‑service training (e.g., assessment tools, titration, comorbidity, risk management).
•    Engage in CPD and maintain a reflective portfolio; participate in peer groups and journal clubs; present at academic/QI meetings.