Sixteen Bay of Plenty GPs who are interested in providing attention deficit hyperactivity disorder services are upskilling in their own time at personal cost.
GPs and nurse practitioners could begin diagnosing attention deficit hyperactivity disorder (ADHD) in adults from February 1.
Previously, GPs and nurse practitioners could only prescribe ADHD medicines to patients with a written recommendation from a paediatrician or psychiatrist, or after someone had already been diagnosed and had their first prescription, a Ministry of Health statement said.
Pharmac announced the change in June, citing easier access for people to be diagnosed and prescribed treatment for ADHD.
A mother who hopes to get a diagnosis says the change is “great”, but her GP practice hasn’t “trained anyone up”.
It comes as one doctor says “most” Western Bay of Plenty clinics have received inquiries from patients seeking a diagnosis but warn ADHD services “will take time to happen” as GPs complete training.
A Bay of Plenty mother, who spoke on the condition she not be named to protect her family’s medical privacy, said she and her husband believed they had ADHD and hoped to get a diagnosis from their GP.
“My husband has gone through the process of trialling SSRIs [selective serotonin reuptake inhibitors] that are also used for ADHD because that’s the only thing he can access. He can’t access stimulants without a diagnosis, obviously.
“Unfortunately, what I’ve heard from a lot of people, and is the case at least at our GP practice, is that they haven’t trained anyone up.
“They don’t know if they will. It’s a huge, costly thing for them.”
She said their son was diagnosed with ADHD and had been on medication since October.
“Seeing the change in our son, [we] believe it could make an amazing difference.”
This included “being able to focus on things” and “not go from zero to 100 straight away”.
Specialist GP Dr Alison Fawdry said she helped form a local peer support group with 16 Bay of Plenty GPs.
“We all have a personal interest in upskilling and providing this service. Many members have lived experience of ADHD themselves or within their whānau.
“All of us are upskilling in our own time and at our own expense because we are passionate about improving access.”
The Bay of Plenty ADHD peer group lead said the group was focused on finding a way to provide assessment for people who faced barriers to care.
“However, this work sits outside normal primary care and is not publicly funded.”
She said a GP-run diagnosis would likely be less expensive than private models, “but there will still be a cost”.
“While we work to make this service available within our community, we will also continue to advocate for it to be publicly funded.”
Fawdry said ADHD services in general practice would be “a few more months” away.
Western Bay of Plenty Primary Health Organisation clinical director and GP Dr Claire Isham said clinicians could choose whether they had the time, capacity and training to offer ADHD services.
Isham said adults had historically faced long waits and high costs because of a reliance on psychiatrists.
Expanding the range of clinicians able to diagnose and manage ADHD would improve access to services, “but this will take time to happen” as they completed training and gained experience, she said.
Isham said ADHD services were not part of a standard 15-minute consultation and an assessment typically took 90 to 120 minutes over multiple appointments.
She said “most” clinics had received ADHD inquiries since February 1.
Royal New Zealand College of General Practitioners president and Tauranga GP Dr Luke Bradford said he thought there was “somewhat of a perception” that every GP would immediately start doing ADHD clinics.
“That’s just not the case. These [were] always going to be special interest clinics.”
He spoke of one benefit for patients with ADHD who had not seen a psychiatrist within two years and could not restart their stimulant medication.
“Those patients can now all be put back on to medicines by their GPs.”
Bay Paediatrics managing director Freddie Bennett said it had received an uptick in inquiries in February at its private paediatric clinic specialising in ADHD.
He believed it was from parents who did not know the change did not apply to children.
“We already have high demand, but ... we’ve seen even more inquiries from people across the country.”
Bennett said he had also spoken to people who had been assessed and diagnosed by their GP with ADHD last month.
“We are seeing, in some cases, the system is working.”
A Ministry of Health spokesperson said while no new funding accompanied the change, widening who could diagnose and initiate treatment was “a practical step to improving access”.
The spokesperson said assessment, diagnosis and initiation of medicines for ADHD was a specialist service and not part of standard general practice care.
In line with other specialist clinics such as menopause clinics, clinicians would set their own fees.
By creating opportunities for more clinicians to offer ADHD services, “we expect availability to increase over time and for patients to have more choice in the market”.
The spokesperson said it was encouraging to see GPs working together to support uptake of the opportunity.
“This reflects the intent of the changes to allow GPs to expand their practice and to create more options for patients.”
Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.