News

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GPs to play key role in ADHD care under landmark reforms

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People in New South Wales living with attention deficit hyperactivity disorder (ADHD) will soon find it easier and more affordable to access treatment, with the State Government set to empower GPs to diagnose and manage the condition.
 
Under the new measures, GPs will be able to provide ongoing prescriptions for children and adults on stable doses of ADHD medication, without requiring a formal agreement with a non-GP specialist.
 
A smaller cohort of specially trained GPs will also be able to diagnose ADHD and initiate medication when clinically appropriate.
 
State Health Minister Ryan Park called the move the ‘single biggest reform’ for the treatment of ADHD in NSW.
 
‘All of us across the community know how highly trained and highly skilled our GPs are,’ he said.
 
‘What this is, is providing them with the information and resources to get on and do the job and provide the care that we know they can.’
 
The landmark reform aims to address long-standing issues of cost and access. Currently, most patients seeking a diagnosis or medication for ADHD must see a non-GP specialist, which can involve long wait times and significant out-of-pocket costs.
 
It has been informed and backed by the RACGP, which has been strongly advocating for GPs nationwide to have a greater role in ADHD diagnosis and management, arguing that increasing GPs’ scope of practice can reduce treatment delays and costs, particularly benefiting those in rural and regional areas.
 
NSW is now following in the footsteps of Queensland, where GPs have been able to prescribe certain ADHD medications for children without prior approval since 2017.
 
The Western Australia Government is also slated to introduce changes, with work beginning on the roll-out of a recent election promise aimed at enabling specifically trained GPs to both diagnose and treat the condition.
 
RACGP NSW&ACT Chair, Dr Rebekah Hoffman, said the reform will have ‘life-changing impacts’ when it comes to accessing timely and affordable ADHD care for families across her state.
 
‘This will mean that ADHD is one more diagnosis, one more thing that we manage as part of normal care. It’s no longer a diagnosis that will have a stigma attached to it,’ she said.
 
‘It’s not something that you’ll have to wait three years to see a paediatrician or spend really large amounts of money to see a psychiatrist.
 
‘It means that your GP, who looks after your pregnancy, your childhood vaccinations, your bullying at school, your other mental health, will also manage this as well. And for our patients, we are so excited about this step.’
 
The reforms will be introduced in stages, with an initial focus on supporting prescriptions for children, in recognition of the long-term developmental impact of delayed diagnosis, followed by care for adults.
 
Dr Hoffman said this staged approach is important, as ‘early intervention is vital’ when it comes to ADHD.
 
‘Being able to access appropriate therapy and medications from a young age helps kids thrive at school and at home,’ she said.
 
‘So, enabling GPs with specific skills to initiate prescriptions for ADHD medications will stop many children from languishing on outpatient waiting lists.’
 
Adjunct Associate Professor John Kramer, Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity, also welcomed the reform, but emphasised that keeping GP participation optional is vital.
 
‘Bring it on, but don’t force GPs who don’t want this type of work to do it,’ he told newsGP.
 
‘Private billing will be essential to make it viable from a business perspective. However, GPs also know that some of these patients will need sympathetic billing practices.’
 
This was reiterated on Monday by Minister Park. While he said the aim will be that consultations are bulk billed to make them as accessible as possible, he noted that it will depend on the GP and practice.
 
‘We’ve already got a payroll tax rebate in place to try and encourage high rates of bulk billing, but that’ll be a matter for the GP and their individual practice,’ he said.
 
‘But certainly, they will be able to be [bulk billed].’
 
L-R: Paediatrician Dr Sarahn Lovett , NSW Health Minister Ryan Park, and RACGP NSW&ACT Chair Dr Rebekah Hoffman. (Image: Supplied)

To support the new model, up to 1000 GPs will be offered government-funded accredited training, mentorship, and access to clinical resources, with GPs set to be invited to express their interest in training in the coming months.
 
Two levels of accredited training or registration will be made available:

• Tier 1: enabling GPs to continue prescribing for patients already stabilised on medication
• Tier 2: authorises GPs to assess, diagnose and initiate treatment for ADHD

Training is expected to begin later this year, with GPs able to start providing ongoing prescriptions for children from early 2026.
 
Minister Park said the aim of starting with 1000 GPs is to ensure the state gets the transition right for patients and their families.
 
‘We believe that that’s a number that will get us good coverage,’ he said.
 
‘We’ll have a look mid-next year to see how it’s going. We’ll get feedback from organisations like the RACGP and our friends in the psychiatry area.
 
‘We’ll make sure that things are going the way they should. But we’re confident we’ve got the framework to get this right.’

RACGP President Dr Michael Wright said these changes build on previous work in other states, including WA and Queensland.
 
‘It’s great to see these reforms in NSW – I know they're going to make a big difference for many patients, and they will be a great help for GPs,’ he told newsGP.
 
‘The RACGP has been working around the country to support this, to support the state and territory faculties in advancing access to appropriate ADHD care, and we are calling for nationally uniform rules that will make this simpler.
 
‘In NSW, this is just one step, but it’s a great step.’
 
The changes align with growing calls from the medical community, including GPs, for a more integrated and accessible approach to ADHD care – calls backed by the Federal Government in response to a Senate inquiry into ADHD assessment and treatment barriers.
 
However, some GPs expressed uncertainty. In a newsGP poll from February, 60% of the 1797 respondents said they do not feel confident diagnosing ADHD and initiating treatments.
 
Associate Professor Kramer anticipates that most GPs will feel ‘relatively unprepared’, but that’s where he says the training comes in.
 
‘NSW Health is only planning on starting with 1000 GPs, so it will be the enthusiasts first, which means they really want to do it,’ he said.
 
‘The best forms of training are still being identified, but the college already has two excellent ADHD modules in gplearning.’
 
In addition to specialised training, Associate Professor Kramer foresees GPs needing a number of other supports in place, including ‘good systems, guidelines, templates and audit tools’, as well as ‘good use of relevant Medicare item numbers’.
 
Asked how he envisages the change impacting clinical workflow, he said successful implementation will require a ‘systems approach’.
 
‘GPs will have to efficiently utilise their practice teams to help with the workload, especially practice nurses,’ Associate Professor Kramer said.
 
‘It will require a systems approach, efficient templates, and use of artificial intelligence.’
 
The move comes amidst a severe psychiatry services shortage in NSW, following the resignation of more than 200 psychiatrists from the state’s public hospital sector earlier this year in a dispute over pay and working conditions.
 
However, NSW Mental Health Minister Rose Jackson refuted claims the reform is a band-aid solution for the shortage, saying that is a separate issue.
 
‘GPs are incredibly valuable members of local communities,’ she said.
 
‘They care for and treat a range of population health conditions, and ADHD should be one that can be managed at the general practice level.
 
‘This is about increasing access to diagnoses and prescriptions to manage that particular condition.’
 
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ADHD attention deficit hyperactivity disorder children’s health prescribing

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