What’s Changing in 2026? New Guidelines for ADHD Assessment and Medication in Adults in Aotearoa

In July 2025, Te Whatu Ora released a new national framework for the diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Aotearoa New Zealand. These changes, effective from February 2026, aim to improve access to care while ensuring that ADHD assessments and prescribing are safe, evidence-based, and consistent nationwide.

Unfortunately, some of the media coverage and public discussion around these changes has led to confusion. Many people have interpreted the announcement as meaning they can now visit their regular GP or nurse practitioner (NP), get assessed for ADHD, perhaps in a single short appointment, and leave with a prescription for stimulant medication. But the reality is more nuanced.

One thing I have found to be disappointing about the published framework is that it is not compulsory to follow, and from additional information I have received, there is no planned monitoring of how GPs and NPs are applying, or not applying, the framework. While training and supervision are encouraged, it is not mandated, and no funding is allocated for training. This is a high-trust model, meaning that GPs and NPs are being trusted to assess their own competence in this area and to seek training, guidance, or supervision as they deem necessary in order to work within their scope of practice. Hopefully, this will work for the vast majority of GPs and NPs, but we won't know that until some way into the new scenario.

Below, I report aspects of the framework that apply to adults seeking assessment and treatment. This is currently based on one document, which is admittedly short on some facts. I have done the best I can here and will update this blog post as new information becomes available.

The Goal of the New Framework

The Clinical Principles Framework is designed to:

• Provide clearer guidance to clinicians about best practices in ADHD assessment and treatment.

• Expand access to ADHD care, especially for adults who have historically faced long waitlists or limited specialist availability.

• Ensure prescribing of stimulant medication is done safely and appropriately.

Can GPs and NPs Now Diagnose and Prescribe for ADHD?

Well, technically, they could, because again, there is no mandated training.

Under the new framework:

• Initial ADHD diagnosis should be made by a clinician with recognised expertise in ADHD. This may include psychiatrists, paediatricians, clinical psychologists, nurse practitioners, or GPs who are working within their scope of practice in relation to ADHD.

What GPs and NPs Will Be Able to Do

From February 2026, GPs and NPs will be able to continue prescribing ADHD medication in certain circumstances, provided the following conditions are met:

1. The diagnosis was made by an ADHD-trained prescriber, such as a psychiatrist, paediatrician, or qualified GP or NP.

2. A treatment plan has already been established by the diagnosing clinician, including the appropriate medications.

3. The GP has received a handover plan from the diagnosing prescriber. This plan must include sufficient information to allow safe ongoing prescribing and monitoring.
   

This means that once a patient is stabilised on ADHD medication, their GP or NP will likely take over prescribing. This is already how many GPs and NPs in New Zealand operate. But the difference will be that a GP can also prescribe a new stimulant without the agreement of a pediatrician or psychiatrist, which could speed up the process of trialling meds. I expect there will be more GPs and NPs who are happy to prescribe than there are who will be happy to assess and diagnose.

What GPs and NPs Are Not Being Asked to Do

• GPs and NPs are not expected to carry out ADHD assessments or initiate stimulant prescribing if they don't have the training or confidence to feel comfortable doing this. They may refer to other GPs who have a special interest in ADHD, as is the case with other areas such as gender affirming care or menopause care.

• GPs are encouraged to prescribe with a formal diagnosis and treatment plan from a qualified clinician, who may not be themselves.

So How Do You Get an Adult ADHD Diagnosis?

The framework wants assessments be be done by a clinician who has expertise in ADHD. This could include:

• A psychiatrist or other ADHD-trained medical specialist.

• A psychologist with experience in adult ADHD (who may work in collaboration with a medical prescriber).

• GPs and NPs who have ideally upskilled and received supervision in assessment and diagnosis.

The pathway might include:

1. Initial screening (which could be done by a GP or psychologist).

2. Comprehensive assessment, including clinical interview, review of developmental history, and collateral information.

3. Diagnosis and treatment planning by an appropriately qualified clinician.

4. Handover to GP for ongoing medication management if appropriate.

What This Means for Adults Seeking Help

If you’re an adult suspecting you may have ADHD, the process should still involve an assessment. Your usual GP or NP can be an important ally in that process—by referring you, supporting access to services, or helping with screening questionnaires—but they may not be comfortable with performing an assessment themselves.

If you want to access assessment and treatment through your GP or NP, I recommend you ask them what they will offer from February 2026. I can envisage GP clinics devoted to ADHD assessment, or GPs going into private practice focusing on ADHD.

How Much Will This Cost?

One point of confusion that’s arisen is the belief that these changes will make ADHD assessment quick and inexpensive—something that can be sorted with a brief GP or NP appointment. That’ unlikely to be the case. An adult ADHD assessment is still a time-intensive process requiring a comprehensive clinical interview, developmental history, and often collateral input from others (for my ADHD assessments, I budget between 7 and 9 hours of clinical time between direct assessment and report writing, depending on the complexity of a client's presentation).

Even if more GPs and NPs choose to diagnose ADHD in future, they will ideally undertake a comprehensive assessment process (although likely not as long as my own). Given that GPs and NPs can charge $300 and above per hour for unsubsidised appointments in private practice, any expectation of a cheap and rapid diagnosis is likely to be misplaced. These changes may improve access to treatment in the long term, but they shouldn't remove the need for a thorough and professional diagnostic process. Perhaps there will be funding pathways to help subsidise assessments, but that is unknown at this stage.

Final Thoughts

This new framework is a step forward in making ADHD care more accessible and consistent, especially in underserved adult populations. But it shouldn't mean a free-for-all on 15-minute appointments leading to stimulant prescriptions (I really hope it doesn't). ADHD remains a complex neurodevelopmental condition that requires careful assessment, intervention, and monitoring.

You can read the full Clinical Principles Framework here: New Zealand Clinical Principles Framework for ADHD (PDF)