responsibility cannot be identified ■ Or the person with parental responsibility is incapacitated ■ Or if the person with parental responsibility does not appear to be acting in the best interests of the child in regard to treatment decisions ■ Or there is a dispute between those with parental responsibility. The National Institute for Health and Care Excellence (NICE, 2009) has indicated that there is evidence to show that levels of concordance and family relationships are negatively affected in these circumstances. In accordance with the NMC’s (2015) Code, nurses should ‘always practise in line with the best available evidence’—this is also supported by the NMC’s Standards of proficiency for nurse and midwife prescribers (NMC, 2006). Consequently, when medication is indicated as the best treatment option but is not prescribed, prescribers are likely to feel uncomfortable about not being able to provide the most effective, evidence-based intervention. When medication is not prescribed owing to parental non-agreement, alternative treatment interventions often need to be given greater consideration. More time may need to be spent delivering nonpharmacological interventions, such as cognitive behavioural therapy, family therapy, parenting support, social skills development and anger management (Hamrin et al, 2010).