In May 2025, we received messages from parent carers stating that there was confusion about accessing melatonin. It was not clear if you needed a “diagnosis of sleep disorder” and who could prescribe the medicine, including the liquid version. As melatonin is accessed by a number of different families in our area, we brought these concerns to the Designated Clinical Officer, Pippa Czarnowska to clarify if there were any changes to the provision and also request information about “shortages”.

In South West London the Medicines Optimisation Committee oversees the pharmaceutical issues and so Pippa attended their meeting and brought up our concerns. It should be noted there has been a new “melatonin prescribing guidance” – which we can share here. However, it should benefit families. Historically it was shared care so that a consultant would stabilise use of the medication and then a GP could accept the care, with consultant reviews annually. In March 2025, the new guidance was put in place so it is now an “Amber 2” service. This means melatonin does not need ongoing specialist involvement to monitor use once there is an initial clinical decision that this is the appropriate medication. The terms here are explained in the leaflet attached but for the purposes for parent carers, it is just necessary to know that they are a description of how a prescription is issued.

What was very clear was that there does need to be a clinical decision to access medication and other issues have to be understood first.  The consultant paediatrician or psychiatrist would identify the need for this medication. The reason this is important to understand is that there are some barriers that parents face. 

• Where a child has a diagnosed condition such as autism spectrum disorder they are signed off by the paediatricians, therefore if sleep is not identified at that time, the child they will need to be re-referred to a service by the GP (in Kingston most likely paediatricians at Moor Lane or CAMHS)
• The waiting lists to access services can cause delays for this
• Parent carers seeking private reports may have an issue. An NHS GP must accept the clinical decision and be confident that there is a need. This is not guaranteed. The GP has to take full responsibility.

In addition to explaining this, the DCO was able to explain what should happen if a medication is prescribed but is not available as some people were talking about shortages. The prescription would then go back to the GP who has been provided with prescribable alternatives. In this instance, the pharmacist may also 

Provided here is a simplified flow chart, provided to support understanding but much more detail is available in the leaflet shared above.