RACP ADHD Roundtable

The RACP hosted a virtual ADHD Roundtable on 25 August, with discussions covering the current landscape, jurisdiction proposals, key issues, models of safe shared care, how to support timely and equitable ADHD care for children and adolescents, advocacy needs/opportunities, and Government supports.

Difficulties with access to paediatricians and psychiatrists was acknowledged, noting long wait lists, workforce shortages, and distribution deserts. However, also noted was the existence of concerns specifically about missed or misdiagnoses and potential harms from increased stimulant use.

The RACP stands ready to collaborate and recommends the States/Territories pause on their individual announcements and rollouts to consult further with us and progress the commitment at the June Health Ministers Meeting. (viz., 'Ministers agreed to discuss options to achieve national harmonisation of ADHD prescribing practices at the next HMM meeting, and other opportunities to improve patient care, affordability and access to diagnosis'). 

The RACP supports shared care models with GPs, and for GPs to continue ongoing ADHD care that is initiated by a paediatrician or psychiatrist. However, without clear and standardised national guidelines that address complexity, especially in children, expanding GP scope of practice to assess, diagnose and initiate treatment is high risk.

The key outcomes from the Roundtable for RACP members to note:

• Governments must engage the medical colleges on programs to enable fit-for-purpose initiatives to be supported and successful.
• A nationally consistent approach with the RACGP online education modules is required.
• The RACP recommends these modules are formally reviewed and endorsed by the RACP and RANZCP; completed by GPs who wish to expand their scope of practice with ADHD management (or potentially mandate completion), and the same for all jurisdictions.
• Commonwealth and State/Territory government support is sought for:

1. a national approach to a safe, shared model of care enabling improved access to care through staged rollout of a ‘tiered model’ and appropriate referral pathways including appropriate assessment processes for accurate diagnosis, complexity and age range determination for GP management, and management beyond medication
2. funding for public services to ensure equitable access for all children and adolescents, inclusive of multidisciplinary team members, such as through community hubs with multi-specialties practicing
3. establishing formal ‘Communities of Practice’ encompassing GPs, paediatricians and psychiatrists.

• Commonwealth and State/Territory governments must commit to data collection, monitoring and evaluation of the roll-out.
• Commonwealth Government must deliver the Senate Inquiry “Assessment and support services for people with ADHD” report recommendations.
• Longer term commitment to MBS item changes, particularly for paediatricians, and research funding. 

We thank all who attended, which included representatives from Royal Australian College of General Practitioners (RACGP), Royal Australian and New Zealand College of Psychiatrists (RANZCP), Australian College of Rural and Remote Medicine (ACRRM), Australasian Society for Developmental Paediatrics (ASDP), Australian Paediatric Society (APS), Australasian ADHD Professionals Association (AADPA), ADHD Australia, Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) and Department of Health, Disability and Ageing.