Patient caps and funding - what GP ADHD prescribing looks like in practice

Dr Andrew Leech said he had almost reached his capacity for taking on patients with ADHD after completing the WA ADHD training program.

The program, developed by the RACGP Australasian ADHD Professionals Association, saw 64 GPs qualify to diagnose and prescribe stimulant medications in children over the age of 10.

“The biggest challenge I am facing is it is capped at 50 patients per GP, so already I am close to that within just three months of offering it," Dr Leech told Medical Forum.

“It sounds like a lot, but it does not go far and quickly fills up.”

Dr Leech said his patients were a mix of those who had come to get assessed and those whose condition had been “very stable for a long period but had to keep seeing their paediatrician every year”.

He said being able to pick up management of these cases gave paediatricians more capacity to take on more complex cases requiring their attention.

Dr Andrew Leech says he has almost reached capacity for ADHD diagnosing and prescribing.

While NSW GPs taking part in a similar pilot program are to be provided $600 per patient to cover related administration costs, Dr Leech said that was not currently the case in WA.

“We were paid a token amount to do the training and accreditation, from there the actual governance and running of your assessment is independent to the individual GP," he said.

Dr Leech said the amount of work involved in assessment for ADHD meant many GPs would be choosing not to bulk bill such patients.

“There’s no specific Medicare item number, I assume the government was counting on us using the longer consult numbers like 44 and 123, however even then the amount of time involved and the level of history and screening that we do is not really covered.

“For the time involved it almost has to be private fee paying."

However, even with private billing, the costs associated with diagnosis and treatment via a GP would be far less than through specialist care, and would likely not have lengthy waitlists.

Fairer access to ADHD care was one of the issues GPs raised with MPs at WA’s Parliament house on August 18.

Left: Dr Jan Fonseca and Health Minister Meredith Hammat. Right: Premier Roger Cook and RACGP WA Co-Deputy Chair Dr Julia Rawlinson.

The RACGP's annual ‘GPs at WA Parliament’ health check-up acts as an opportunity to remind MPs of the essential role GPs play in the health system.

GPs provided MPs with a complimentary health check, giving them the chance to hear directly from practising GPs.

RACGP WA Co-Deputy Chair Dr Julia Rawlinson was among those who attended the event. She described it an an opportunity to have constructive conversations with MPs about the practical changes that can make a real difference for patients and take pressure off hospitals. 

The RACGP called for an additional $350,000 in funding to continue delivering the GP ADHD training. It said that funding would give 100 more GPs the opportunity to undertake the training.

It would like the government to boost the number of GPs able to diagnose and manage the condition to 164 by June 2027.

Health Minister Meredith Hammat has said additional GP ADHD training opportunities would become available in the coming months, but no further detail has been provided.

Also raised at Parliament was the RACGPs proposal for establishing a Chief GP Advisor within the WA Department of Health and how to reduce unplanned hospital admissions by incentivising GP care post-discharge.

Medical Forum has previously asked the Department of Health whether it would consider establishing a Chief GP role in WA - after it was raised at last year's RACGP parliamentary check-up - but no commitment was made.

A spokesperson said at the time that general practitioners were employed within senior clinical leadership and advisory roles in the department which ensured GP expertise were “embedded within core decision-making structures”. 

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