STOMP for Learning Disability and Autism: NHS England's Overmedication Programme Explained

STOMP — Stopping Over Medication of People with a learning disability, autism or both — is a distinct NHS England programme from the dementia-focused antipsychotic medication review covered in our guide to STOMP and antipsychotic medication review in dementia care. Same acronym, different population, and a different clinical driver: STOMP for learning disability and autism responds to a well-documented, long-standing pattern of psychotropic overprescribing that isn't primarily about managing dementia-related behavioural symptoms, but about medication being used — often inappropriately — as a response to behaviour that challenges.

The scale of overprescribing, in NHS England's own figures

NHS England's own data on this is stark: people with a learning disability are prescribed antipsychotic medication at 16 times the rate of the general population, and autistic people are prescribed antipsychotics at 7 times the general population rate. These figures are the foundation of why STOMP exists as a dedicated national programme rather than being left to general psychotropic prescribing guidance — the scale of disparity pointed specifically to systemic overprescribing rather than appropriately targeted clinical need.

The core principle: right reasons, lowest dose, shortest time

STOMP's guiding principle is explicit: people should only be given psychotropic medication for the right reasons, at the lowest effective dose, for the shortest appropriate time. Importantly, STOMP is not a blanket anti-medication position — the programme is explicit that its aim is optimisation of prescribing, not elimination of medication that's genuinely clinically necessary. For staff supporting someone on psychotropic medication, the practical distinction is between medication prescribed following proper assessment and review, and medication that has continued by default without regular reassessment of whether it's still needed.

What STOMP actually asks services to do

NHS England's STOMP guidance sets out specific service expectations: exploring non-pharmacological alternatives before medication is prescribed, ensuring staff genuinely understand the psychotropic drugs being used and their side effects (not just that a medication has been prescribed), providing medication information in accessible formats for the person taking it, making reasonable adjustments to appointments so reviews are genuinely accessible, maintaining accurate health and behavioural records that support proper review, following NICE guidance on medication initiation, review and cessation, and working in partnership with families, carers and the wider healthcare team rather than making prescribing decisions in isolation.

The annual structured medication review, from age 14

People with a learning disability are entitled to an annual health check that, from age 14 onwards, includes a structured medication review. STOMP is explicit that this review should be holistic and person-centred — genuinely weighing side effects against therapeutic benefit, and actively considering non-pharmacological alternatives, rather than functioning as a formality that simply continues an existing prescription. For services supporting someone on long-term psychotropic medication, confirming this annual review has actually taken place — and that it was substantive, not a brief sign-off — is a specific, checkable compliance point.

STAMP: the same principle, for children and young people

STAMP (Supporting Treatment and Appropriate Medication in Paediatrics) extends STOMP's principles specifically to children and young people with a learning disability, autism or both. The underlying concern is the same — psychotropic medication being used as a behavioural management tool rather than a carefully considered, reviewed clinical intervention — but STAMP recognises that paediatric prescribing decisions carry additional considerations around development and long-term treatment planning that an adult-focused programme doesn't fully address.

Why this is genuinely distinct from dementia-focused STOMP work

It's easy to assume "STOMP" training covers this ground once a service has already trained staff on antipsychotic review in dementia care, but the populations, the typical reasons medication was started, and the review structures are different. Dementia-related antipsychotic use is often tied to managing symptoms of advancing cognitive decline in later life; learning disability and autism-related psychotropic prescribing more often traces back to behaviour support decisions made earlier in life, sometimes years or decades before the current structured review standard existed. Services supporting both populations need genuinely separate training content, not one STOMP module assumed to cover both.

Frequently asked questions

Does STOMP apply only to antipsychotics, or other psychotropic medication too?
While antipsychotics are the headline figures, STOMP's principles apply to psychotropic medication more broadly, including other medications sometimes used to manage behaviour that challenges.

Who is responsible for initiating the annual structured medication review?
This typically sits with the person's GP or the clinician leading their learning disability annual health check, but care and support staff play a key role in providing accurate behavioural and health information that makes the review meaningful.

Is STOMP connected to Oliver McGowan training?
They're related but distinct — our guide to Oliver McGowan Mandatory Training covers broader learning disability and autism awareness and understanding, while STOMP addresses the specific clinical governance of psychotropic prescribing.

Medication governance for learning disability and autism services is a distinct, named CPD area. Explore Learnsignal's CPD courses to keep this training current.