How popular are ADHD reforms?

Almost 3000 patients have already been prescribed attention deficit hyperactivity disorder (ADHD) medications by a GP, just months after reforms came into effect in New South Wales.
 
New State Government data, released on Tuesday, shows that since 1 September, 560 GPs across NSW have undertaken specialist training and are now approved as ‘continuation prescribers’, allowing them to issue scripts for patients aged over six with a previous ADHD diagnosis.
 
From those new GP continuous prescribers, 6373 scripts for psychostimulants have been filled through pharmacies for 2953 patients.   
 
RACGP NSW&ACT Chair Dr Rebekah Hoffman says the data shows the success of the reforms.
 
‘The numbers are really promising,’ she told newsGP.
 
‘It shows that GPs in NSW have embraced this opportunity, that GPs want to be working in this space – and not only do they want to, that they can.
 
‘Also, more importantly, it’s popular with the patients, they see the value in it and they’re calling out for some more GPs to do this as well.’
 
Of the GPs who have so far undergone training, more than 200 are based outside metropolitan Sydney, with free online training available through the college.
 
Dr Hoffman said she found the course ‘excellent’ and ‘straightforward’ and urged other GPs in the state to do the same.
 
‘I really found [the training] worthwhile for me in being able to confidently take the next step,’ she said.
 
‘This is what we do all day, every day for our patients – ADHD is just one more diagnosis that we’re then going to be able to manage.
 
‘It’s no more difficult or complicated than a number of other things that we already do as GPs.
 
‘What it really does is simplify the process both for ourselves with our paperwork, and for our patients and their ability to get managed in the community.
 
‘For me, it’s a no brainer – the paperwork makes it easier for me and easier for my patient.’
 
Dr Will Errington, a Sydney GP and Deputy Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity, said the reforms also improve the ability of GPs to work with other specialists.
 
‘With ADHD, early intervention is essential to ensure patients are set up for success, and specialist GPs are well-placed to support patients with regular, accessible, and holistic support at every stage of their lives,’ he said.
 
‘A key aspect of patient care is for GPs to continue to work closely with a patient’s psychiatrist or paediatrician and their care team, particularly where a patient lives with other complex conditions such as autism spectrum disorder.
 
‘These reforms ensure GPs are better placed to do this.’


NSW Health Minister Ryan Park, RACGP Specific Interest ADHD, ASD, and Neurodiversity Deputy Chair Dr Will Errington, and RACGP NSW&ACT Chair Dr Rebekah Hoffman.

Meanwhile, NSW Mental Health Minister Rose Jackson said the figures are ‘exactly what good reform looks like’.
 
‘We are building a system where ADHD care is based on need, not income,’ she said.
 
‘No more waiting lists just to refill your script.
 
‘Within just a few months, we’ve seen thousands of people save time and money by getting their scripts at the GP.
 
‘That’s also thousands of specialist appointments freed up for people who actually need them.’
 
The next phase of the reforms in the state will support GPs to diagnose ADHD and start medication, with details of training requirements expected by the end of this year.
 
‘I’m really excited about that,’ Dr Hoffman said.
 
‘We’re hoping to ensure that GPs are supported and mentored by our non-GP specialist colleagues, who are already doing this every day – because we want every GP to be able to confidently say “yes, I can diagnose and initiate ADHD medication”.
 
‘Our NSW Government has agreed that they’re happy to fund that.’
 
ADHD continues to be a major area of reform across the country for general practice.
 
This month, in an Australian first, the Queensland Government announced that every GP in that state will be able to diagnose and treat adults with ADHD from 1 December without requiring any extra training.
 
Of almost 1500 respondents to a newsGP poll this month, 43% said other jurisdictions should follow Queensland’s lead and allow all GPs to initiate, modify and continue ADHD medication for adults, while 46% said they should not and the rest were unsure.
 
In a position statement published earlier this year, the RACGP called for consistent legislation across the country ‘to enable specialist GPs to initiate, modify and continue psychostimulant medications for adults and children with ADHD’.
 
GPs with queries about NSW ADHD reforms can contact MOH-ADHDreforms@health.nsw.gov.au.

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ADHD attention deficit hyperactivity disorder NSW