The ministry said today that Medsafe and Pharmac had changed the rules to allow GPs and nurse practitioners to take on these responsibilities, beginning in February.
Royal College of General Practitioners NZ medical director Dr Luke Bradford said GPs were now upskilling to be able to be able to provide the new service.
The rule change would improve access to diagnosis, he said. But it was a complicated field and patients should not expect quick answers.
“It’s not going to be, I’m going to the doctor about my sore knee, and by the way, I always thought I’m not very good at concentrating. Do you think I’ve got ADHD? Can I have some Ritalin? That’s not what is going to happen.”
He expected specialist GPs would need at least an hour with patients seeking a diagnosis, and further time to complete their assessments. The market would determine the price of these consultations, but he expected them to be more affordable than seeing a specialist.
One of the college’s main motivations for getting involved in the sector were reports of the inflated costs being charged by some specialists - in one case $2500.
GPs were also witnessing high demand for diagnosis, especially among women.
Pharmac’s acting director advice and assessment, Catherine Epps, said that over time more GPs and nurse practitioners would be able to diagnose and start adults on treatment for ADHD.
Nurse practitioners working within child health or mental health services would be able to diagnose and treat the condition.
“The decision, which is based on feedback from psychiatrists, paediatricians, GPs, nurse practitioners and patients, is one of many changes we are making to increase access to ADHD medicines,” Epps said.
“It follows our decision last year to remove the two-yearly renewal criteria for these medicines, making it easier to access ongoing treatment.”
Medsafe Group manager Chris James said a number of family doctors and nurses were already working closely with specialists to treat patients with ADHD.
“Implementing this change will mean they can do this work more quickly and efficiently without needing to wait for approval from a specialist.
“It’s important we ensure a high quality of ADHD assessment, and that people can expect to receive appropriate care and support. We have been working closely with sector representatives to develop a clinical framework which will set out principles for diagnosing and treating ADHD, including the appropriate clinical care required of healthcare practitioners.”
Consultant clinical psychologist Dr Melanie Woodfield welcomed the decision to keep ADHD assessment of young people within child health or mental health services.
“Assessing ADHD in children is a complex process that aligns well with specialist expertise and resources,” she said.
“Of course, we must balance comprehensive, high-quality assessments with timely, appropriate support and this can be challenging given the demands on both specialist and primary care services.
“However, assessing ADHD in children requires a thorough understanding of the child’s functioning across different settings (looking wide) and developmental history (looking back).
“This approach acknowledges that many conditions — such as hearing loss, trauma, or anxiety — can mimic or occur alongside ADHD symptoms in children.”
Associate Health Minister Matt Doocey applauded the change by Pharmac and Medsafe.
“This is a common-sense change that will make a meaningful difference in many lives of New Zealanders,” he said.
“I have heard stories of many people with ADHD who have been unable to get a diagnosis and treatment in a timely manner because of long wait times and costs associated with seeing a specialist.”
Isaac Davison is a senior reporter who covers Auckland issues. He joined the Herald in 2008 and has previously covered the environment, politics, social issues, and healthcare.
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