A surprise announcement has caused concern for the colleges over safe ADHD care in the garden state.
Victoria’s health bodies have criticised the state government’s newest proposal for ADHD care.
The latest initiative will allow the Virtual Emergency Department to provide ADHD prescription refills starting September this year.
Both the RACGP and the The Royal Australian and New Zealand College of Psychiatrists Victorian branch have described it as a misuse of the Virtual ED.
Virtual ED would be able to provide one-off refill services for Schedule 8 controlled substances which the colleges have argued will increase “the risks of misuse and diversion of stimulant medications if the safeguards are not robust”.
Victoria’s premier, Jacinta Allan, has responded to the backlash, saying the intent of the initiative is to make ADHD care more accessible, “even if that means breaking a few conventions”.
“Some people don’t want change, but parents do.”
“It’s too hard to get ADHD care for you or your child when you need it, especially if you need a top-up script last minute.”
The announcement for this initiative came in the wake of yesterday’s announcement to commit to allowing GPs to diagnose and prescribe for ADHD in alignment with RANZCP standards. It was a surprise to both colleges.
Fragmentation of care was a key concern, with the RANZCP saying the use of the Virtual ED would disrupt continuity of care between patients and their GPs, psychiatrists and paediatricians.
“We were taken by surprise by the initiative, because it was never part of the discussions that we’ve had,” RANZCP Victoria chair Dr Simon Stafrace told The Medical Republic.
“We believe that patients do better if they’re treated by the doctors who know them and who know their health and who understand their healthcare needs.
“If people can get their scripts from whoever and whenever, that’s convenient.
“But when it comes to medications like stimulants and conditions like ADHD, we believe that continuity of care, coordinated care, actually is better.”
The RACGP echoed those sentiments, saying the risks associated with ADHD medications could be addressed and regulated through continuity of care with practitioners that had the patient’s history.
“We do spend a lot of time as clinicians prescribing drugs of addiction, and a lot of what we do is making sure that those medications are prescribed and used safely,” RACGP Victoria chair Dr Anita Muñoz told TMR.
“What we want as clinicians and patients alike is to commit to good clinical governance and oversight to make sure that these medications are treated with the respect that they deserve, which includes getting these scripts from a trusted doctor who offers you continuity of care.
“We have spent more than a decade trying to educate the Victorian public that our emergency services are for emergencies only, in efforts to ensure that we have a sustainable health system.”
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Dr Muñoz also pointed out that current information on the Virtual ED information website notes that the service is not to be used for routine scripts or chronic care.
“VVED is an emergency care service and does not do routine prescription refills or medical certificates,” the website reads.
“Please contact alternative providers for these needs.”
The lack of consultation with the colleges has generated concern.
The RACGP was especially worried about the VVED’s training, given that additional training was a major focus in the rollout for GP ADHD care.
“Prescribing drugs of addiction is a serious thing to do, and these medications can cause harm and they can be diverted,” Dr Muñoz told TMR.
“The signal that’s coming out to the community, which is any script, any time, does not reflect my views about the responsibility I take when I provide a prescription for these substances.
“Our approach is a person takes out a permit for a medication because they are willing to take on the responsibility of surveillance that the medications are used correctly and safely and that no harm is done to the patient.
“At no time has the RACGP or the College of Psychiatrists entertained the idea of doing it any other way than with appropriate clinical governance, follow up and the principles of safe use of medicines.”
