Where to start with STOMP?

In the last of four blogs to mark the launch of today’s drive by NHS England urging doctors and other healthcare professionals to sign up to a national pledge to Stop the Over Medication of People with a learning disability, autism or both (STOMP), a Senior Policy Advisor for the Voluntary Organisations Disability Group reflects on promoting the STOMP pledge for social care: 

Over the last year a number of organisations have begun implementing STOMP by engaging their top team and, in some instances, their board.

As a result, STOMP is seen as a priority in these organisations and accountability for delivering results is built into existing reporting mechanisms. These organisations know how well they are doing because they regularly collect data on practice and outcomes.

My question to these organisations is: will your staff teams retain a focus on STOMP when, inevitably, the attention of the top team is diverted elsewhere?

Other providers have begun by engaging the people they support, typically using a conference for people with a learning disability, autism or both as an opportunity to present the STOMP campaign. This results in slower progress, both organisationally and in terms of positive change for people.  But it is an approach which wins hearts and minds and potentially could drive sustained culture-change.

My question to these organisations is: how will you ensure accountability for implementing STOMP?

A third group of providers has begun with their middle managers. This means managers can tailor their actions to circumstances and practice in their area of responsibility. These organisations ask their middle managers to produce a STOMP action plan; in theory, local plans are then combined into one organisational plan. Within these organisations there are pockets of real success, evidenced by case studies demonstrating excellent support. However, so far, no provider has successfully developed an organisation-wide implementation plan in this way.

My question to these organisations is: how will you ensure consistent implementation of STOMP?

So, where should organisations start?

Firstly, I suggest that an organisation committed to STOMP needs a lead person who sees driving implementation as a core responsibility.

In all my examples providers are making progress in tackling over-medication, but STOMP is best embedded in organisations where people in all roles understand and own the campaign. This means that organisations need to be talking about STOMP to the people they support and their families, staff, managers and their top team. Messages are meaningful when they are tailored to each audience.

To illustrate this here are some of those tailored messages:

  • For people with a learning disability, autism or both and their families – why is it important to only take the medication we really need?
  • For staff – how STOMP will change the way we work.
  • For managers – resources and systems that are available to support implementation.
  • Executive team and board – what is the change we are aiming to deliver? How will we measure performance?

There is no one right way to implement STOMP. Much depends on what makes sense in each organisation. However, we can share what has worked well and learn from each other.

The Voluntary Organisations Disability Group is committed to supporting shared learning about tackling over-medication through our website and our e-bulletin, STOMP news for social care.

Jill Parker

Jill Parker is the senior policy advisor for the Voluntary Organisations Disability Group and leads on STOMP in social care.

Much of her work involves supporting social care providers to implement STOMP in a way that makes sense in their organisation and achieves the best possible outcomes for the people they support.


  1. Tina Newbury-Smith says:

    JILL, thank you so much for your commitment to this initiative!
    As a parent of a 9 year old with Autism and a Nutritional Medicine Consultant (forgive me for asserting my BSc qualification, but I feel it’s necessary so as not to be dismissed as a “complementary therapist”!), I agree that over-prescription of all kinds of medication is rife for children with Learning Difficulties. I hear of it all the time from parents at my son’s special school-mainly Ritalin and melatonin. I have particular concern about melatonin, as I haven’t heard of one child that’s been prescribed this that has had their melatonin levels assessed, and I believe that many of these sleep issues may be attributed to other causes such as bowel discomfort or even sleep training. It appears that GPs are very quick to make assumptions and diagnoses based upon what the textbooks say: Autism, sleep problems, possible melatonin secretion issues. It’s lazy and I applaud you for addressing it!

    • NHS England says:

      Hello Tina,

      Thank you for replying to Jill’s blog and sharing your experience about medication use. It is this type of scenario that STOMP is hoping to challenge and we are actively working with specialist service providers in adult and children’s services to raise awareness of STOMP and to challenge organisations to commit to action. There is some work happening in the North West specifically in relation to use of ADHD and melatonin medications in children. The concept of a melatonin holiday is well documented and being challenged within this work. If you are interested we could link you to the relevant parties for more information, If you have any links to local learning disability and autism teams if would be worth challenging them about the STOMP pledge to hear of any plans they may have. We are actively promoting the concept of challenge from all interested parties as a way to promote engagement. Challenge from families and people with a learning disability, autism or both is a very powerful force for change.

      Kind Regards
      NHS England

  2. Andrew Paxton says:

    I’d like to sign up to STOMP as a Pharmacist.. How could this be arranged?

    • dave gerrard says:

      Hi Andrew,

      It would be good to know in which sector of pharmacy you are working. For specialist services the STOMP healthcare provider pledge would be a useful starting point. This can be accessed by visiting and looking for the healthcare provider pledge

    • NHS England says:

      Hi Andrew, thanks for your interest in STOMP. If you work within secondary care please visit the NHS England STOMP page and look for details on how to sign up to the pledge. We are looking for board level sign off ensuring all the organisation is committed to delivering STOMP.

      If you are working in a different sector we could link you to the resource page on STOMP which you can use to run awareness sessions. We can also link you to one of the team if you would like more information.

      Kind regards
      NHS England