How does ADHD co-management and shared care work in NSW?
Since the 2025 NSW reforms, your ADHD care no longer has to sit with one psychiatrist. It can be shared between a specialist, a trained GP and your usual GP, with each doing the part they are best placed to do. Here is how the arrangements work, and how Rosedale fits in.
Three ways ADHD care can be shared
All three are recognised under the NSW framework. Which one fits depends on where your diagnosis came from, how stable your treatment is, and how far you live from us.Co-management with your psychiatrist
Your psychiatrist or paediatrician keeps oversight of the diagnosis and treatment plan and reviews you at the interval they set, often yearly. Between those reviews a Rosedale continuation prescriber GP writes your prescriptions, checks blood pressure, heart rate and weight, and manages day-to-day issues.Fits when: you are stable on medication and want fewer specialist visits, but your specialist prefers to stay involved.
Transfer of care to a GP
Your specialist confirms the diagnosis, the medication and that you are stable, then hands ongoing prescribing to a Rosedale continuation prescriber GP. You only go back to a specialist if something changes, such as a significant dose change or a new concern.Fits when: your treatment has been stable for at least three months and your specialist is comfortable stepping back.
Rosedale prescribes, your usual GP observes
For patients who cannot attend West Pennant Hills in person. A Rosedale Specialist GP holds the ADHD prescribing role and reviews you by video telehealth. Your usual GP, or your treating psychiatrist, provides the in-person observations and looks after your general health. Your usual GP does not need continuation authority.
Fits when: you live outside the Hills, in regional NSW, or cannot travel for in-person reviews.
Who does what
Shared care only works when everyone knows their part. This is how Rosedale sets it up.
| Task | Co-management | Transfer of care | Rosedale prescribes, usual GP observes |
|---|---|---|---|
| Diagnosis and treatment plan | Psychiatrist or paediatrician | Psychiatrist or paediatrician (confirmed in writing) | Existing specialist report |
| Ongoing prescriptions | Rosedale continuation prescriber GP | Rosedale continuation prescriber GP | Rosedale Specialist GP by telehealth |
| Blood pressure, heart rate, weight | Rosedale GP at each review | Rosedale GP at each review | Your usual GP or psychiatrist, in person |
| Routine reviews | Rosedale GP, commonly every 3 to 6 months | Rosedale GP, commonly every 3 to 6 months | Rosedale GP by video, commonly every 3 to 6 months |
| Specialist review | At the interval the specialist sets | Only if needed | Only if needed |
| General health and other prescriptions | Your usual GP | Your usual GP | Your usual GP |
What you need before shared care can start
Rosedale needs enough evidence to prescribe safely and legally. Send it at least 48 hours before your first appointment.
- A formal ADHD diagnosis from a psychiatrist, paediatrician or other recognised prescriber
- A specialist letter dated within the last 12 months confirming diagnosis, medication, dose and stability
- Evidence the dose has been stable for at least three months
- Your current medication list and recent prescribing records
- For co-management, a note from your specialist that they are happy to share care
- For Model 3, the name and contact details of the GP or psychiatrist who will provide in-person observations
A prescription is not guaranteed at the first visit. Further records or a NSW authority may be needed first. If your medication has stopped, or you were diagnosed but never started medication, shared care is not the right entry point: see our restart and initiation pathways.
Telehealth, Medicare and what it costs
Models 1 and 2 usually run in person at West Pennant Hills, with video telehealth available for eligible adults once care is established. Model 3 runs by video from the start, because the in-person part is done by your usual GP or psychiatrist.
Medicare has its own rule for telehealth. A rebate applies only if you have seen a Rosedale GP in person within the last 12 months or are registered with Rosedale through MyMedicare. Shared care does not change that rule. So for new patients, Model 3 telehealth is privately billed without a Medicare rebate until one of those conditions is met.
The initial 30-minute continuation consultation is $290.38, with a Medicare rebate of $87.10 where you are eligible. Routine 15-minute reviews are $188.60. Current fees are always on the continuation care page.
How to start
Choose the option that matches how you will attend. No referral is needed, but your specialist records are.
I can attend West Pennant Hills in person
Book an in-person continuation appointment with a Rosedale Specialist GP. This suits co-management and transfer of care. Bring photo ID, your Medicare card and your specialist correspondence.
Book in person →I cannot attend in person
Book a video telehealth appointment. Rosedale holds the prescribing role and your usual GP or psychiatrist provides the in-person observations. Privately billed for new patients.
Book telehealth →Questions patients ask about shared care
What is ADHD co-management?
Co-management means two clinicians share responsibility for your ADHD care under an agreed arrangement. In NSW this usually means a psychiatrist or paediatrician keeps oversight of the diagnosis and treatment plan while a trained GP handles routine prescribing and reviews between specialist appointments.
What is the difference between co-management and transfer of care?
Under co-management the specialist stays involved and reviews you periodically. Under transfer of care the specialist hands ongoing prescribing to a NSW continuation prescriber GP entirely, and you only return to a specialist if something changes. Both are recognised models in the NSW GP reforms.
Does my usual GP need special ADHD training for shared care with Rosedale?
No. If a Rosedale Specialist GP holds the prescribing role, your usual GP does not need continuation authority. They provide in-person observations such as blood pressure, heart rate and weight, and look after your general health. Rosedale manages the ADHD medication.
Can shared care be done by telehealth?
Yes for the Rosedale part. Your usual GP or psychiatrist provides the in-person component locally, and Rosedale reviews and prescribes by video telehealth. For new patients this telehealth is privately billed without a Medicare rebate, because Medicare requires an in-person visit with the practice in the last 12 months or MyMedicare registration.
Do I still need to see my psychiatrist?
Under co-management, yes, at the interval your psychiatrist sets, commonly every 12 months. Under transfer of care, only if your GP considers specialist input is needed, for example a significant dose change, a new diagnosis or a safety concern.
Keep your specialist. Stop travelling for every script.
Rosedale Medical Practice has looked after West Pennant Hills since 1997. Our Specialist GPs are trained NSW continuation prescribers, and Dr Jaspreet Saini is a NSW Health-endorsed ADHD prescriber. Send your records, choose how you will attend, and we will set up the arrangement with your specialist or usual GP.