The Royal Australian College of GPs (RACGP) and Royal Australian and New Zealand College of Psychiatrists (RANZCP) have called on the Victorian Government to urgently consult on announced plans for the Victorian Virtual Emergency Department (Virtual ED) to prescribe ADHD medication through telehealth consultations.
The colleges have raised serious concerns with the Government's plans, which would allow patients to access up to six months of ADHD medication without a consultation with their GP or psychiatrist through the Virtual ED, a Victorian public telehealth service for non-life-threatening emergencies.
This follows an announcement by the Victorian Government, RACGP, and RANZCP to allow patients to access ongoing ADHD care through their usual GP.
The RACGP and RANZCP urgently called on the Victorian Government to consult with them on the plan.
Quotes attributable to RACGP Victoria Chair Dr Anita Muñoz
"Renewing a stimulant medication prescription for six months without an appropriately structured physical and psychological review or an in-person consultation does not provide continuity of care and risks missing the emergence of adverse side effects, including cardiovascular harms and symptoms of psychosis or mood elevation.
"GPs and psychiatrists managing or co-managing patients with ADHD take stimulant medications' risks seriously. Regular review by a member of your ADHD care team is essential, and a patient potentially going six months without one following a telehealth appointment is deeply concerning.
"To prescribe stimulants for ADHD, GPs must have a valid permit and a co-management arrangement with the diagnosing medical specialist, including guidance on suitable medication types and ceiling doses, potential risks, and non-medical interventions.
"The Victorian Virtual Emergency Department website is clear that it 'is an emergency care service and does not do routine prescription refills.' This announcement sends mixed messages to the community that the VVED is now available for routine scripts and chronic disease management.
"The RACGP and the Victorian branch of the RANZCP have been collaborating with each other and the Victorian Government to design an approach that supports patients to receive ongoing ADHD care from a team of clinicians who knows them and them and their medical history, like a specialist GP or psychiatrist.
"We made a commitment to work with the Victorian Government to improve access to ADHD care safely, and would welcome consultation on this plan. That this has not happened before this announcement on VVED is very disappointing."
Quotes attributable to RANZCP Victorian Branch Chair Associate Professor Simon Stafrace
"We have had longstanding concerns about existing barriers to accessing ADHD care for Victorians, including limited options to accessing specialist care in public health system within the community.
"However, the policy announced today removes treating GPs, psychiatrists and paediatricians who know their patients from their continuing care.
"Without strong safeguards, this model risks fragmenting care and creating new safety concerns for people with ADHD, including inappropriate prescribing and unmonitored side effects of stimulant medications.
"It can also delay proper assessment, diagnosis and treatment of emerging mental health conditions, and may divert valuable resources away from genuine emergencies.
"ADHD medication prescribing requires knowledge of the patient's treatment history, response to medication, side effects, and any other conditions. A single, short virtual consultation cannot provide this context.
"ADHD symptoms can overlap with a wide range of other psychiatric and physical conditions. Stimulants may not always be the right treatment, and this may only become clear over time.
"Today's announcement is inconsistent with yesterday's commitment to stakeholder consultation. Less than 24 hours after announcing a measured approach to ADHD reform, the government has announced another significant policy change without consulting medical colleges or ADHD experts.
"Continuity of care with clinicians who know their patients is key. Victoria needs a shared care model for ADHD built together with doctors on the frontline.
"We know accessing ADHD care is hard for many Victorians. But the answer is making sure people can see psychiatrists, paediatricians and GPs, and building specialist ADHD care capacity and accountability within the public health system.
"We're calling on the government to work with RANZCP, the Royal Australian College of General Practitioners (RACGP) and other stakeholders to create safe pathways so people with ADHD get treated by someone they trust, someone who knows them and their health."
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