ADHD Management

Navigating ADHD Care in NSW & Frenchs Forest: Key Challenges, New GP Pathways and How We Can Help

ADHD affects both young people and adults, and can have a significant impact on daily life, including focus, organisation, emotional regulation, and relationships. While public awareness of ADHD has grown significantly across Australia, many people still face considerable hurdles when seeking a diagnosis or treatment. Long waiting lists, substantial specialist costs and the ongoing requirement for repeat prescriptions can turn ADHD management into an exhausting and costly process.

We're here to support children, teenagers and adults living with ADHD — from assessment and diagnosis through to ongoing care and treatment — and their families, via comprehensive, compassionate, and evidence‐based care.

Our practice offers a team-based approach to ADHD care, with experienced professionals working together to provide support tailored to each patient's needs, with the goal of making ADHD support more accessible and integrated into your ongoing health care.

Fortunately, recent healthcare reforms in New South Wales are helping to streamline access to care. By expanding the role of suitably trained General Practitioners (GPs) in the long‐term management of ADHD, these changes enable patients to receive accessible, affordable and continuous support closer to home.

Our services include:

• GP ADHD care: Our GPs provide ongoing medication and support for patients from 6 years of age.
  • Continuing prescribing of ADHD medication (for patients the GP deems suitable)
  • Coordination of care with psychiatrists, paediatricians, and psychologists
  • Ongoing support — we work together as a team to make ADHD care as simple, coordinated and supportive as possible.
• Psychology: Our psychologists provide ADHD assessments, diagnosis, psychological support and detailed reports when needed.
• Access to Developmental paediatrics: Specialist care for children and young people with ADHD and other developmental concerns.
• Access to Psychiatry care: Specialist psychiatric assessment and support for ADHD and associated emotional, behavioural or mental health concerns.

There are now three distinct pathways to access ADHD medication in NSW. These reflect major reforms introduced in September 2025 and expanded throughout 2026, designed to improve access while ensuring complex cases continue to receive specialist care.

Pathway	Who provides care?	Can diagnose ADHD?	Can initiate stimulants?	Can continue stimulant prescriptions?
Specialist	Psychiatrist, paediatrician, neurologist	Yes	Yes	Yes
GP Continuation Prescriber (introduced Sept 2025)	GP with NSW‐approved training and authority	No	No (unless under an approved co‐management arrangement)	Yes
GP Endorsed Prescriber (introduced 2026; limited availability)	GP with advanced NSW endorsement	Yes	Yes	Yes

These changes help:

• Improve appointment availability
• Reduce the cost and barriers to accessing care
• Provide continuity with your trusted GP

This means your family GP — who knows you best — can be more involved in supporting your ADHD management.

Please note that not all patients will be suitable for GP‐led ADHD care.

Specialist (Traditional Model)

Consulting a specialist remains the primary pathway for patients who present with:

• a request for a new or initial ADHD assessment
• diagnostic uncertainty or significant co‐occurring psychiatric conditions
• treatment‐resistant ADHD or complex medication needs
• active substance use disorders
• severe cardiovascular risks
• pediatric or adult cases requiring complex multidisciplinary care.

Under this pathway, specialists are responsible for:

• conducting comprehensive assessments and diagnosing ADHD
• initiating stimulant therapy and fine‐tuning (titrating) dosages
• prescribing both stimulant and non‐stimulant treatments
• managing any complex side effects.

In standard cases, psychiatrists and paediatricians continue to prescribe under NSW class authorities without requiring individual patient approvals.

GP Continuation Prescriber

Launched on 1 September 2025, this pathway reduces the need for stable patients to attend frequent, routine specialist appointments. To qualify as a continuation prescriber, a GP must:

• complete NSW‐endorsed post‐graduate training in ADHD management
• apply for formal authorization through NSW Health
• obtain General Authority approval and adhere strictly to state prescribing guidelines.

To be eligible for this pathway, patients generally must:

• be aged 6 years or older
• have a formal, documented ADHD diagnosis and a clear treatment plan
• already be established on a stable medication regimen.

What Continuation Prescribers CAN do:

• Prescribe dexamfetamine, lisdexamfetamine (Vyvanse) and methylphenidate formulations
• Prescribe approved non‐stimulant medications
• Perform ongoing reviews, check side effects and monitor vital signs (blood pressure, heart rate and weight)
• Issue repeat prescriptions for ongoing management.

What Continuation Prescribers CANNOT do independently:

• Diagnose new cases of ADHD
• Start a new patient on stimulant medication
• Make significant changes to complex medication regimens outside approved protocols.

Patients will still require occasional follow‐up reviews (typically every 6 to 12 months) with their specialist or GP, depending on their individual care agreement. Dr Sharmila Raju and Dr Tatiana Levina are accredited GP Continuation Prescribers.

GP Endorsed Prescriber

Representing a major step forward in the 2026 reforms, this pathway allows select GPs who have completed advanced clinical training to independently diagnose and manage uncomplicated ADHD. Currently, only a very small number of practitioners hold this high‐level endorsement.

What Endorsed Prescribers CAN do:

• Diagnose ADHD and initiate stimulant therapy
• Adjust medication dosages and manage ongoing care
• Independently care for patients with straightforward, uncomplicated ADHD.

Endorsed prescribers will still refer patients back to a specialist if the presentation becomes clinically complex or falls outside their authorized scope of practice.

Co‐Management Models

Many patients will benefit most from a shared‐care arrangement between their specialist and GP:

• Initial Stage: A psychiatrist or paediatrician confirms the diagnosis, initiates medication and stabilizes the dosage.
• Ongoing Stage: An authorized GP Continuation Prescriber takes over regular monitoring and repeat prescribing.
• Specialist Re‐evaluation: The patient returns to their specialist if symptoms worsen, troublesome side effects emerge or medication adjustments are required.

NSW Health explicitly supports these transfer‐of‐care and co‐management models once all clinical criteria have been satisfied.

Non‐Stimulant vs. Schedule 8 Stimulant Prescribing

It is important to note that non‐stimulant ADHD medications (such as atomoxetine, guanfacine and clonidine) are not held to the same strict permit restrictions as Schedule 8 psychostimulants. They can be prescribed under standard general practice guidelines.

Conversely, Schedule 8 stimulant prescriptions require strict adherence to NSW regulatory rules, including:

• valid NSW Health authorization (via general or class authority)
• an official approval number printed on the physical or electronic script
• compliance with legal repeat interval requirements
• thorough pharmacist verification prior to dispensing.

Is GP Care Suitable for You?

GP continuation care is suitable if you have:

• a confirmed ADHD diagnosis and a stable medication regimen
• well‐controlled symptoms requiring standard routine monitoring
• no major psychiatric comorbidities or unmanaged cardiovascular concerns.

Specialist‐led care remains necessary in cases involving:

• diagnostic uncertainty
• co‐occurring mental health conditions (e.g., bipolar disorder, psychosis, severe depression or acute anxiety)
• active substance dependence or complex polypharmacy
• a history of unsuccessful stimulant trials or treatment resistance
• significant underlying cardiovascular disease.

Summary of the Tiered NSW Model:

• Specialists: Manage complex conditions, perform comprehensive assessments and initiate treatment.
• GP Continuation Prescribers: Handle ongoing routine care and repeat scripts for stable, previously diagnosed patients.
• GP Endorsed Prescribers: Offer end‐to‐end diagnosis, initiation and maintenance for uncomplicated cases (as access expands).

Key benefits of this model for patients include:

• Fewer expensive specialist visits for standard repeat scripts
• Enhanced continuity of care with a regular family doctor
• Greater appointment availability and reduced travel times
• Lower overall healthcare costs over time.

Please note: Not all GPs are authorized to prescribe stimulant medications. Eligibility depends on both your GP's accreditation status and your specific clinical history.

Can My GP Diagnose ADHD?

For most people, an initial diagnostic assessment by a psychiatrist or paediatrician is still required before starting stimulant treatment.

However, as NSW continues to roll out its primary care reforms, a growing network of advanced‐trained GPs will gain the authority to diagnose and initiate treatment under defined criteria. Because these regulations are evolving, your GP can guide you on the best path forward based on current state guidelines.

How Dr Sharmila Raju, Dr Tatiana Levina, & Frenchs Forest Doctors Can Help

At Frenchs Forest Doctors, Dr Sharmila Raju and Dr Tatiana Levina are accredited GP Continuation Prescribers dedicated to providing compassionate, patient‐centred care. For patients who already have an established diagnosis from a specialist, Dr Raju and Dr Levina work in close partnership with your treating specialist to manage your ongoing care locally.

Your ongoing ADHD management consultations will typically involve:

• evaluating treatment effectiveness and overall wellbeing
• monitoring vital health parameters (blood pressure, heart rate and weight)
• assessing and managing any medication side effects
• issuing repeat prescriptions where appropriate and in line with NSW Health rules
• coordinating ongoing communication with your treating specialist.

ADHD appointments are charged at $285 per session. Medicare rebates are accessible for these sessions. This fee reflects:

• the complexity of ADHD consultations,
• the additional training required for prescribing rights, and
• the responsibility involved in overseeing ongoing ADHD care.

Frequently Asked Questions

Can adults be diagnosed with ADHD?
Yes. Many adults in Australia are diagnosed later in life after experiencing long‐standing difficulties with focus, time management, organization or emotional regulation.

Does ADHD present differently in women?
Yes. Women and girls are more frequently diagnosed with the inattentive subtype of ADHD. Because these symptoms are less overtly disruptive than hyperactive traits, women are often diagnosed later in life.

Can the GPs at Frenchs Forest Doctors diagnose me?
Our GPs can evaluate your symptoms, rule out other underlying health conditions and organize specialist referrals. At present, the team at Frenchs Forest Doctors does not perform initial diagnostic assessments or start new patients on stimulant medication.

Can my GP handle my ongoing prescriptions?
Yes, provided specific requirements are met. As an authorized NSW Continuation Prescriber, Dr Sharmila Raju can provide ongoing repeat prescriptions for eligible patients who have a confirmed diagnosis and a stable treatment plan from their specialist.

Are stimulant medications addictive?
When taken as prescribed under proper clinical supervision, stimulant medications are safe, highly effective and carry a low risk of addiction. Your doctor will review all benefits, risks and monitoring requirements prior to treatment.

Will I need to stay on medication forever?
Not necessarily. Treatment plans are tailored to the individual. While some patients benefit from long‐term medication, others may adjust their dosage or explore non‐pharmacological management over time under medical supervision.

Can ADHD be managed without medication?
Yes. Psychological therapies, occupational support, ADHD coaching and lifestyle adjustments are all valuable components of a comprehensive care plan, with or without medication.

Is ADHD genetic?
Yes. ADHD has a high rate of heritability and commonly runs in families.

What should I bring to my initial consultation?
Please bring any past psychiatric or psychological reports, school reports ( if available), a list of current medications and your specialist referral letter. These help us establish your medical history and streamline your care.

How can Frenchs Forest Doctors assist if I already have a diagnosis?
If you have a formal diagnosis from a specialist and are on a stable treatment plan, our practice can collaborate with your treating doctor to provide routine monitoring, health checks and ongoing prescriptions locally.

If you suspect that you or your child may have ADHD, or if you already have a diagnosis and need convenient local monitoring, the team at Frenchs Forest Doctors is here to support you. We are committed to offering compassionate, evidence‐based care tailored to your health goals.

Whether you need an initial medical evaluation, a specialist referral or long‐term medication management, we welcome you to get in touch with our clinic today.