133 Molesworth Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000
20 March 2026
Elspeth Baker-Vevers
By email: [FYI request #33110 email]
Ref:
H2025076445
Tēnā koe Elspeth
Response to your request for official information
Thank you for your request under the Official Information Act 1982 (the Act) to the Ministry of
Health – Manatū Hauora (the Ministry) on 3 December 2025 for information regarding
ownership, governance, classification, as well as operational rollout of the ADHD Clinical
Principles Framework. The response timeframe was extended on 22 January 2026, and a
decision was issued on 17 February. The Ministry acknowledges that it has not met the required
deadline and apologises for any inconvenience caused by the delay in providing you this
information.
After receipt of your request, the Ministry contacted you to arrange a meeting to clarify and
discuss your request. On 16 December 2025, you declined this meeting. X
The Ministry notes that you have made multiple requests on the same topic (H2025076364,
H2025076972, H2025076281, and H2025076277 refers), which has resulted in some overlap
in subject matter across the documents identified. To avoid unnecessary repetition or
reproduction of the same material, these are instead referenced in the appropriate releases as
referenced in Appendix 1.
To address parts of your information request and to support your understanding of the material
set out below, I have first outlined some background and broader context before responding to
your specific questions.
Ownership and classification of the ADHD Clinical Principles Framework
The ADHD Clinical Principles Framework (the framework) is owned and authorised by the
Ministry. The Ministry authored the framework, in partnership with a Clinical Reference Group.
The Clinical Reference Group comprised representatives with clinical expertise in ADHD from
health professional bodies as well as people with lived and family experience of ADHD.
The framework is a clinical framework that incorporates principles from international evidence-
based clinical guidelines for the assessment, diagnosis, and treatment of ADHD. The framework
describes expected standards for the assessment, diagnosis, and treatment of ADHD within the
New Zealand context, representing the consensus views of the Clinical Reference Group and
the Ministry.
Clinical frameworks exist to describe standards for care, support evidence-based care, and to
promote clinical quality and safety to guide registered health professionals in their clinical
practice. Clinicians are stil required to use their clinical judgement to tailor care to an
individual’s circumstances, while taking into account evidence-based clinical guidelines and
frameworks.
The framework was published by the Ministry in July 2025. It can be viewed here:
www.health.govt.nz/publications/new-zealand-clinical-principles-framework-for-attention-deficit-
hyperactivity-disorder
The framework was updated on 6 October 2025 to include all psychology scopes (see ‘General
Principles’, page 6). Greater emphasis has been placed on competence as the over-arching
consideration in line with consultation feedback.
Commissioning and planning of health services for ADHD
The Ministry does not hold any documents relating to commissioning or planning of changes to
service delivery for ADHD services by Health New Zealand. Members of the Implementation
Working Group – a group of officials from the Ministry of Health and Pharmac supporting the
implementation of the changes across the health sector have met with Health New Zealand
clinical leads as a key stakeholder for implementation of the changes to the prescribing rules for
ADHD stimulant medicines. Health New Zealand has been included in online stakeholder
meetings hosted by the Implementation Working Group.
Workforce development, training, and referral pathways
The Ministry and Pharmac Implementation Working Group has met with education and training
providers to discuss opportunities for professional development, including the Royal New
Zealand College of General Practitioners, Nurse Practitioners New Zealand, the Royal
Australian and New Zealand College of Psychiatrists, the Goodfellow Unit, and others. I refer
you to these providers for details regarding clinical educational and training opportunities for
ADHD care.
Escalation and referral pathways are an important part of health sector readiness for the
upcoming changes, particularly for the management of complex cases. The Implementation
Working Group has engaged with HealthPathways to ensure readiness in the clinical pathways
relating to ADHD care in preparation for the prescribing changes. The HealthPathways are an
online resource that set out pathways for referral and escalation between primary and specialist
services for the management of specific conditions in the local context, including ADHD.
Competence
ADHD care wil continue to be delivered by registered health practitioners under the Health
Practitioners Competence Assurance Act 2003. Under this Act, all health professionals must
practise within their scope and maintain competence. The regulatory authorities that are
responsible for ensuring competence and investigating issues of competence for the general
practitioner and nurse practitioner workforces are the Medical Council of New Zealand and
Nursing Council of New Zealand.
Turning to your request, you asked:
Page 2 of 11
This request covers the period from 1 January 2022 to the date this request is received.
1. Ownership, stewardship, and classification
A. Ownership and responsibility
Please confirm which agency holds ownership, stewardship, or responsibility for the
ADHD Clinical Principles Framework (2025), including responsibility for implementation,
rollout, updating, governance, and monitoring.
If responsibility for any function has been assigned to another agency, please provide the
documents recording that assignment and name the responsible agency.
B. Classification of the document
Please confirm whether the Framework has been formally classified as any of the
following:
-a clinical guideline
-a national standard
-a mandated service-delivery requirement
-a commissioning specification
-an operational protocol
-an advisory document
-a non-binding clinical framework
If no formal classification exists, or if the document is considered non-binding, please
confirm this.
C. Please provide any documents describing who had authority to approve, endorse, or
finalise the Framework on behalf of Manatū Hauora.
If no such documents exist, please confirm this.
Please refer to the above background and broader context, as well as, Document 18, for
information captured within scope of this part of your request.
2. Governance of the Clinical Reference Group (CRG)
Please provide:
a. Any terms of reference, governance diagrams, role descriptions, or internal instructions
describing the Ministry’s role in convening, supporting, overseeing, or approving the CRG.
b. Any documents describing how members were selected, including criteria, invitations,
acceptances, and any records of groups or individuals who were identified but not
approached.
c. Any documents describing decision-making processes within the CRG (e.g.,
consensus, majority, clinical lead sign-off).
d. Any records noting identified gaps in Māori, Pacific, Rainbow+/Takatāpui, or lived-
experience representation.
If no such documents exist, please confirm this.
A prior response under the Act has been published on the Ministry’s website for information
relating to the ADHD Clinical reference group, which can be viewed here:
www.health.govt.nz/information-releases/adhd-clinical-framework-0. As such section 18(d) of
the Act applies to this part of your request.
3. Implementation planning and the February 2026 rollout
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Please provide any documents, project plans, timelines, briefs, internal advice, scoping
documents, or communications describing how the Framework is intended to be
implemented or operationalised as part of the February 2026 ADHD prescribing changes.
This includes any documents discussing:
-expectations for sector behaviour change
-planned implementation phases
-risks, barriers, or dependencies
-whether implementation is mandatory or optional
-any decisions that rollout activity wil be symbolic or guidance-only
If no such documents exist, please confirm this.
Please refer to Documents 5, 6, 7, 8, 9, 10 for information captured within scope of this part of
your request. .
4. Commissioning, service delivery, and expectations for Te Whatu Ora
Please provide any documents describing:
-planned or proposed changes to ADHD service delivery
-commissioning plans or service specifications for ADHD care in primary or specialist
settings
-instructions, expectations, or requests provided to Te Whatu Ora regarding
implementation
-any agreements, memoranda, or handovers between Manatū Hauora and Te Whatu Ora
relating to the Framework
-any impacts on GP, PHO, NGO, or specialist roles
If no such documents exist, please confirm this.
Please refer to Documents 1, 2, 3, 5, 7, 8, and 13 for information captured within scope of this
part of your request.
5. Workforce development, training, and capability
Please provide any documents describing:
-training or capability-building for GPs, nurses, psychologists, or allied health
-any planned or implemented professional development related to ADHD assessment or
treatment
-supervision structures, escalation pathways, or safety standards
-cultural-safety expectations relating to Māori, Pacific, or Rainbow+/Takatāpui populations
If no such documents exist, please confirm this.
Please refer to Documents 3, 4, 5, 7, 8, 11 and 18 for information captured within scope of this
part of your request.
6. GP competence: determination, verification, and support
Please provide any documents, advice, internal correspondence, or planning materials
describing how general practitioner competence to assess, diagnose, or manage ADHD
wil be determined, verified, supported, or monitored as part of the February 2026
changes.
This includes any documents that:
-define or describe the expected competencies for GPs
-outline any training, credentialing, or verification requirements
-discuss how competence wil be assessed prior to prescribing
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-address medicolegal or safety considerations relating to competence
-assign responsibility for determining or overseeing GP competence
-note any gaps, risks, or limitations in current competence systems
If any part of competence determination has been assigned to another agency, please
provide the documents recording that assignment and name the responsible agency.
If no such documents exist, please confirm this.
The Ministry and Pharmac have published an Information Sheet that responds to frequently
asked questions about the changes to prescribing rules for ADHD stimulant medicines that took
effect from 1 February 2026. The document titled, ‘Changes to the Rules for Prescribing
Medicines for ADHD Information Sheet’ is available on the Ministry’s website and linked in
Appendix 1 as document 11.The Information Sheet addresses many of the matters raised in
your request.
7. Funding, resourcing, and budget considerations
Please provide any documents that describe or quantify:
-funding allocated for the rollout or implementation of the Framework
-any business cases, budget bids, financial planning, or cost modelling
-any financial risk assessments
-any funding provided to Te Whatu Ora, PHOs, NGOs, or other providers relating to
implementation
If no such documents exist, please confirm this.
Please refer to Documents 11, 12 and 14 for information captured within scope of this part of
your request.
8. Monitoring, evaluation, and equity accountability
Please provide any documents describing:
-how the February 2026 rollout wil be monitored or evaluated
-any proposed indicators, KPIs, or outcomes measures
Some initial scoping analysis to test use of datasets for understanding the effectiveness of the
changes has been completed. Work to determine an approach to monitoring and evaluating the
regulatory change is ongoing.
-any plans to track ADHD service delivery or outcomes through national datasets or the
IDI
Initial work has been done in the IDI to draw a baseline for monitoring, but given gaps that exist
in service delivery data, this focusses on pharmaceutical dispensing (as an indicator of
diagnosis and diagnosis service access and use).
The pharmaceutical national collection contains claim and payment information from
pharmacists for subsidised dispensing. PRIMHD is the single national source of mental health
and addiction service activity and outcomes data for health consumers. Further information
relating to PRIMHD is available at:
www.tewhatuora.govt.nz/for-health-professionals/data-and-
statistics/nz-health-statistics/national-collections-and-surveys/collections/primhd-mental-health-
data.
-any equity monitoring (including for Māori, Pacific, Rainbow+/Takatāpui populations)
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Work to determine an approach to monitoring and evaluating the regulatory change is ongoing
with no formal decisions made yet. However, initial scoping analysis has included investigating
discrepancies between genders, ethnicity and deprivation.
Understanding the distribution and equity implications of the changes wil be considered in
developing a monitoring or evaluation approach.
-any internal assessments of system impact, risk, or inequity
Initial scoping analysis has included investigating discrepancies between gender, ethnicity and
deprivation. Please refer to Documents 16 and 17 for information captured within scope of this
part of your request.
9. Communications, engagement, and public messaging
Please provide any internal or external communications, media lines, stakeholder briefs,
sector updates, or messaging plans relating to:
-the February 2026 rollout
-how the Framework wil be communicated to clinicians, PHOs, Te Whatu Ora, NGOs, or
the public
-any statements describing expected changes to ADHD care
If no such documents exist, please confirm this.
Please refer to Documents 1-11 and 14 for information captured within scope of this part of your
request.
10. Absence of information
If Manatū Hauora does not hold:
-an implementation plan
-a commissioning plan
-a service specification
-a workforce or training plan
-monitoring or evaluation documentation
-funding documentation
-a communications plan
-or any documents assigning responsibility
please confirm this.
Please refer to Document 6 for the implementation plan for the 1 February 2026 ADHD
changes, Document 3 for the engagement plan and Document 14 for funding documentation.
Where information is withheld under section 9 of the Act, I have considered the countervailing
public interest in release in making this decision and decide that it does not outweigh the need
to withhold at this time. Information deemed out of scope of your request has been removed
and noted in the Appendix as well as in the document itself.
If you wish to discuss any aspect of your request with us, including this decision, please feel
free to contact the OIA Services Team on:
[email address].
Under section 28(3) of the Act, you have the right to ask the Ombudsman to review any
decisions made under this request. The Ombudsman may be contacted by email at:
[email address] or by calling 0800 802 602.
Page 6 of 11
Please note that this response, with your personal details removed, may be published on the
Ministry website at:
www.health.govt.nz/about-ministry/information-releases/responses-official-
information-act-requests.
Nāku noa, nā
Dr Joe Bourne
Chief Medical Officer
Strategy and Policy | Te Pou Rautaki
Page 7 of 11
Appendix 1: List of documents for release
# Date
Document
Document details
Decision on
release
1
September Ministry of Health ADHD This is a draft document
Released in full.
2025
prescribing Changes
prepared by a Pharmac official
Implementation
to describe the purpose and
Stakeholder Group –
scope of the Ministry of Health
Draft Purpose and
and Pharmac Implementation
Scope
Working Group (referred to in
the document as the
Implementation Stakeholder
Group). This document was
reviewed and used as a
reference document by the
Implementation Working
Group, It was never finalised.
2
2 October Weekly report item:
Update to Minister Doocey
Some information is
2025
Supporting the
withheld under
upcoming regulatory
section 9(2)(a) of the
prescribing changes for
Act, to protect the
Attention Deficit
privacy of natural
Hyperactivity Disorder
persons.
(ADHD) medicines
Released as an
excerpt in
accordance with
section 16(1)(e) of
the Act.
Some information
has been deemed
out of scope.
3
14
Engagement Plan –
This document was prepared
November ADHD implementation by Ministry of icials to set out
2025
the communications and
engagement approach to
supporting communication to
the health sector and public
about the ADHD changes. The
approach includes planning for
three stakeholder hui tailored
for different stakeholder groups
and the creation of an
information sheet for the public.
4
Draft minutes: Preparing A copilot generated summary of Withheld in full under
for ADHD prescribing Session 1 and was produced section 9(2)(g)(i) to
changes – Information- by a Pharmac official after the maintain the effective
sharing session for key first stakeholder hui. These
conduct of public
implementation
Minutes were not finalised and affairs through the
stakeholders
go into greater detail than
free and frank
5
29 October Session 1 Agenda and standard minutes. These were expression of
2025
Minutes
intended for internal use only. opinions by or
between or to
Ministers and officers
and employees of
Page 8 of 11
any public service
agency.
6
29 October Stakeholder Hui 1
This powerpoint was presented Released in full.
2025
PowerPoint
by the Implementation Working
presentation: Preparing Group to attendees and invited
for ADHD Prescribing speakers at the first online
Changes
stakeholder hui.
Implementation Leads
Information-Sharing and
Insights Session
7
24
Session 2 Agenda:
This is the agenda prepared by
November Preparing for ADHD
the Implementation Working
2025
Prescribing Changes: Group for the second online
Health Sector update stakeholder hui.
8
Stakeholder Hui 2
This powerpoint was presented
PowerPoint
by the Implementation Working
presentation: Preparing Group and invited speakers to
for ADHD Prescribing attendees at the second online
Changes
stakeholder hui.
Health sector update
9
1
Session 3 Agenda:
This is the agenda prepared by
December Preparing for ADHD
the Implementation Working
2025
Prescribing Changes: Group for the third online
Implementation update stakeholder hui.
for Consumer
representatives
10
Stakeholder Hui 3
This powerpoint was presented
PowerPoint
by the Implementation Working
presentation: Preparing Group and invited speakers to
for ADHD Prescribing attendees at the third online
Changes
stakeholder hui
Update for ADHD and
Neurodiversity
Advocacy Groups
What’s changing, what it
means, and how we can
work together
11 December Changes to the Rules This document was writ en to This document has
2025
for Prescribing
provide clear information to the been published on
Medicines for ADHD – public about the changes and the Ministry’s website
Information Sheet
to respond to frequently asked at:
questions.
www.health.govt.nz/n
ews/changes-to-
adhd-prescribing-
rules-from-1-
february-2026. As
such, section 18(d) of
the Act applies.
12 9 April
Neurodiversity –
This document was writ en to Some information is
2025
upcoming regulatory
provide the Minister with
withheld under
prescribing changes to context on the changes to
section 9(2)(a) of the
ADHD stimulant
prescribing stimulant
Act.
medications
medications, and that the
change itself would not
Page 9 of 11
increase diagnosis and
treatment for ADHD, but
resourcing and training for
primary care can enable this.
13 September NZ ADHD Consensus This document was prepared Released in full.
2024
document: Project
by a Ministry official for internal
Charter
reference. It describes the
approach to developing the NZ
Clinical Principles Framework
for ADHD. Content relates to
the establishment of the ADHD
Clinical Reference Group, the
intended purpose and scope of
the framework, and the project
timeline.
14 July 2025 Reactive Q&As: NZ
This document was prepared
Clinical Principles
by the Ministry communications
Framework for ADHD team to support the Associate
Minister of Health and the
Ministry respond to media
queries related to the
publication of the NZ Clinical
Principles Framework for
ADHD
15 26 August Weekly report item:
This document was written by a Some information is
2025
Supply of stimulant
Ministry of icial to provide an withheld under
medicines for the
update on the supply of
section 9(2)(a) of the
treatment of ADHD
stimulant medicines to the
Act.
Associate Minister of Health.
The item was included in the Released as an
Weekly Report to the Minister. excerpt in
accordance with
section 16(1)(e) of
the Act.
16 July 2025 Changes in ADHD
This is a PowerPoint
Released in full.
medication users over presentation to an internal
time
network of data analysts in the
Ministry of Health. It takes
snapshots of key findings from
document 19 which has been
released to you in a separate
request.
17 July 2025 ADHD graphs
This is a snapshot of two
graphs from document 19
(released to you in a separate
request). This is provided to
demonstrate the initial analysis
the Ministry has done to
understand equity in access to
ADHD medication.
18 4 July 2025 Memo: Publishing the This document was prepared
New Zealand Clinical by Ministry of icials to provide
Principles Framework information to the Director
General of Health about the
Page 10 of 11
for Attention Deficit
publication of the NZ Clinical
Hyperactivity Disorder Principles Framework for
ADHD. The document provides
background information and
considerations for its
publication.
19
ADHD medication
N/A
Provided to you in
dispensing: the impact
the Ministry’s
of changes and the
response to you
characteristics of the
through a separate
population being
OIA (H2025076277
dispensed drugs
refers).
20
Outline for IDI analysis
Provided to you in
on ADHD medication
the Ministry’s
users, and tentative
response to you
timelines
through a separate
OIA (H2025076277
refers).
21 10 October Briefing for information:
Provided to you in
2024
Understanding impacts
the Ministry’s
of proposed changes to
response to you
diagnosing and
through a separate
prescribing practices for
OIA (H2025076972
ADHD (H2024050136)
refers).
22 12 March Briefing for information:
Provided to you in
2025
Further analysis to
the Ministry’s
understand the impacts
response to you
of changes to ADHD
through a separate
diagnosing and
OIA (H2025076277
prescribing practices
refers).
(H2025062661)
23 10 October Briefing for information:
Provided to you in
2024
Understanding impacts
the Ministry’s
of proposed changes to
response to you
diagnosing and
through a separate
prescribing practices for
OIA (H2025076277
ADHD (H2024050136)
refers).
Page 11 of 11
Document 1
Ministry of Health ADHD prescribing Changes Implementation
Stakeholder Group – Draft Purpose and Scope
From 1 February 2026, regulatory and funding changes will allow a wider range of health
professionals to initiate the prescribing of stimulant medicines for ADHD. This represents a
significant shift for prescribers and may affect how patients access treatment.
The Ministry of Health and Pharmac wish to convene a short series of sector meetings to
acknowledge this change, share information, and support alignment across the health system.
Purpose
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The group will exist to:
• Acknowledge the upcoming regulatory and funding changes to support a wider range of
ACT health
professionals to initiate treatment and its implications for prescribers, pharmacists, consumers,
and the health sector.
• Share information and increase visibility of sector readiness activities already underway and
planned.
• Enable coordination between stakeholders to reduce duplication and identify gaps.
• Support consistent messaging to clinicians and consumers.
• Develop a shared, high-level view of key risks and monitoring priorities, with an equity and
safety lens.
INFORMATION
Scope of the group
The focus of this group is practical preparation for the regulatory and funding changes taking effect
on 1 February 2026, within the constraints of existing budgets, services, and capacity. The
emphasis is on clarity for prescribers and pharmacists, and on consistent, accessible information for
OFFICIAL
consumers and whānau.
Out of scope for the group:
THE
• Planning or delivering clinical services, clinical pathways, or referral systems.
• Commissioning, funding, accrediting, or endorsing training programmes or providers.
• Credential ing, regulation of practice, or oversight of clinical decision making.
UNDER
• Designing new service models or changing capitation or payment structures.
• Creating new data col ections or analytics beyond light use of existing datasets.
• Endorsing specific commercial products, platforms, or courses.
Roles
Ministry of Health: Host and convene the meetings, send invitations, own the shared pack of
RELEASED
materials. Lead engagement with other government agencies.
Pharmac: Provide medicines and funding context, support session planning and administration,
contribute to consumer and prescriber resources including responsible use messages, and support
the development of equity insights that relate to medicines and funded access
Medsafe: Participate in a technical capacity to clarify regulatory settings and update on
amendments, as appropriate.
Document 1
Other stakeholders:
Stakeholders are defined as representatives of groups that are directly affected by or involved in
implementation of the regulatory and funding changes for prescribing of stimulant medicines. These
groups are expected to contribute updates, resources, and practical insights.
These include:
Health New Zealand, professional colleges and bodies, PHOs, HQSC, Health Pathways, Healthify,
pharmacy groups, consumer and lived experience organisations, Māori and Pacific partners, and
/professional development providers.
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Participation
Invitees will be those directly connected to implementation of the regulatory and funding changes.
ACT
•
Session 1 (mid-October): Health sector stakeholders only (professional bodies, prescriber
groups, pharmacy, training providers) to align on technical and operational considerations.
•
Session 2 (tbc): Includes consumer and lived experience representatives, so they can
engage with clear, agreed messages and avoid unnecessary confusion from early technical
discussions.
•
Session 3 (tbc): Includes primary health organisations, providers and wider health
INFORMATION
professionals group.
Optional check-in in January if useful.
Approach and Format
How sessions will be designed
OFFICIAL
• MoH and Pharmac will design the sessions based on preliminary conversations with some
stakeholders, and using our current knowledge of sector readiness. We will also ask
THE
about preferred format, duration and accessibility needs to inform the sessions.
• The agenda, expectations and scope will be communicated in advance of the session.
What we will ask people to prepare before the sessions
UNDER
• Activities already underway and the perceived role of each organisation that is in scope of the
regulatory change.
• Priority questions, risks and concerns that are in scope.
• Key queries coming from members, networks and whānau.
What success will look like
RELEASED
•
Single source of truth. A short, agreed set of messages that states what changes on 1
February 2026, what does not, and where authoritative information will live for clinicians,
pharmacists, consumers, and whānau. May include FAQs, consumer facing web-copy, and
signposting to sector-led training and guidance available.
•
Visible coordination. A summary of sector activities already underway or planned, identifying
clear owners for each item
Document 1
•
A light monitoring view. A short list of indicators for equity, safety, and supply, with clarity on
who observes what, how often, and how issues will be escalated to the appropriate owner.
Appendix A: Stakeholder list
Meeting 1 and 2
• Health Pathways
•
bpacnz
• Goodfellow
1982
• RNZCGP
• NPNZ
ACT
• GPNZ
• GenPRO?
• Private specialists (individuals/practice groups/organisations) providing ADHD diagnostic and
treatment services – eg, GP groups, psychologists, psychiatrists
• Are there any Māori, Pasifika, of other focused service providers.
• Health NZ commissioning (general practice)
• Pharmaceutical Society
• Pharmacy Guild
INFORMATION
My not sure about (and what they would bring for this focused exercise):
• HDC
• HQSC
OFFICIAL
THE
Meeting 2
• Healthify
• ADHD New Zealand
•
UNDER
Aroreretini
RELEASED
Document 2
Out of scope
1982
ACT
s
INFORMATION
OFFICIAL
THE
UNDER
RELEASED
Document 2
1982
ACT
INFORMATION
Ministry lead
Dr Joe Bourne, Chief Medical Officer, Strategy and Policy,
OFFICIAL
s 9(2)(a)
Out of scope
THE
UNDER
RELEASED
Document 3
Engagement Plan- ADHD Implementation
PROGRAMME NAME:
ADHD Implementation
Customer / SME (s)
Clinical Team
Date
14/11/2025
1982
APPROVALS
ACT
If applicable, provide a summary of approvals. These may differ for each programme.
Role
Name
Organisation
Date
Senior Engagement Advisor
Paul Cleary
Ministry of Health
1/10/2025
Mariana
Principal Engagement Advisor
Ministry of Health
10/11/2025
Pobornikova
INFORMATION
Engagement Manager
Ruth Cook
Ministry of Health
11/11/2025
Group Manager Clinical, Quality Rosie Moore
Ministry of Health
12/11/2025
and Safety
OFFICIAL Ministry of Health
Group Manager
Annie Coughlan
25/11/2025
THE
CONSULTATION
UNDER
Chief Clinical Advisor Child and Jin Russel
Ministry of Health
17/11/2025
Youth
Alice Chisnal -
Principal Advisor
Ministry of Health
21/10/2025
Kalouniviti
Clinical Chief Advisor Primary
RELEASED
Ministry of Health
Care
Anna Skinner
5/11/2025
Document 3
CONTENTS
Purpose of this plan ......................................................................................................................................................................... 3
Context ...................................................................................................................................................................................................... 3
Engagement objectives ................................................................................................................................................................ 3
Engagement approach ................................................................................................................................................................ 3
Key messages ......................................................................................................................................................................................
1982 4
Engagement and communications activities .............................................................................................................. 5
ACT
Appendix 1: Stakeholder analysis ........................................................................................................................................... 7
Appendix 2: Communication products to be developed .................................................................................... 12
Appendix 3: Ministry of Health email to stakeholders prior to 1 February 2026 ................................... 13
INFORMATION
OFFICIAL
THE
UNDER
RELEASED
2 | P a g e
Document 3
PURPOSE OF THIS PLAN
This plan sets out an engagement approach to communicating to the health sector the
changes on Attention-Deficit/Hyperactivity Disorder (ADHD) medicine prescription powers.
The changes come into effect on 1 February 2026.
CONTEXT
Regulatory and funding changes take effect on 1 February 2026 to allow a wider range of
1982
health professionals to initiate and manage stimulant medicines for ADHD:
• Adults (18 years and over): General practitioners (GPs) (vocational y registered
ACT
specialist) and nurse practitioners (NPs) working within their area of practice wil be
able to initiate these medicines.
• Children and young people (17 years and under): NPs working in paediatric services
or child and adolescent mental health services wil be able to initiate these
medicines.
• Psychiatrists and paediatricians wil continue to prescribe as they do now.
INFORMATION
• Other prescribers may prescribe only on the written recommendation of an
authorised practitioner.
Feedback from consultation on the proposed changes suggested strong support for
improved access, alongside concerns about training, equity, and supply.
ENGAGEMENT OBJECTIVES
OFFICIAL
Prepare the health sector for the regulatory and funding changes coming into effect on 1
THE
February 2026 to enable a broader range of health professionals to initiate ADHD treatment.
ENGAGEMENT APPROACH
This engagement plan focuses on working closely with the health sector to support the
UNDER
upcoming changes. Communications regarding the regulatory and funding changes in
February 2026 have been identified and the relevant communications products wil be
attached as appendices.
Engagement will enable the health sector to
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• Understand what they are expected to deliver in their respective professions.
• Stay connected and reduce duplication, by having clarity on roles and timelines.
• Understand the training and products that wil be offered for new prescribers.
3 | P a g e
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Proposed engagement and communication activities
• An Implementation Working Group wil support this engagement. The group meets
weekly and includes representatives from the Ministry of Health including Medsafe,
and Pharmac. This group wil :
o Engage with stakeholders impacted by the changes. Refer Appendix One.
o Design and deliver online sector sessions.
1982
• Develop a point in time frequently asked questions (FAQs)document.
Channels to be updated:
ACT
• Pharmac wil update medicines pages for Special Authority, supply updates.
• HealthPathways, NZ Formulary, Best Practice Advocacy Centre New Zealand
(bpacnz), Goodfellow - for prescriber guidance.
• ADHD NZ and Healthify websites – for consumers.
Agency roles
INFORMATION
Ministry of
Leads and convenes cross-agency sessions (Clinical, Quality and Safety
Health
team, Medsafe, PHA and Strategy & Policy, Engagement team)
Pharmac
Support session planning and administration. Contribute to consumer
and prescriber resources
OFFICIAL
THE
KEY MESSAGES
• From 1 February 2026, more prescribers can apply for funded ADHD medicines to
initiate ADHD treatment:
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• GPs and NPs working in their area of practice can initiate ADHD stimulant treatment
for adults.
• Nurse practitioners in paediatric or mental health services can initiate treatment for
children and adolescents aged under 18 years.
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• Only specialist GPs and nurse practitioners who have developed the requisite
competence in ADHD care should initiate treatment. Others may refer patients to
trained colleagues or specialists.
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• Specialist GPs cannot initiate ADHD treatment for under-18s but can continue
prescriptions started by specialist psychiatrists, paediatricians or nurse practitioners
working in specialist child or mental health teams.
• A clinical principles framework has been developed to guide safe, evidence-based
ADHD diagnosis and treatment.
• As a specialised service is not available in standard primary care, consultations are
1982
expected to take longer and cost more than general appointments.
• These changes aim to reduce wait times and improve equity by enabling more
ACT
trained health professionals to assess, diagnose, and treat ADHD.
• Up to 7,000 more people may access treatment in the first year, growing to 50,000 by
year five.
ENGAGEMENT AND COMMUNICATIONS ACTIVITIES
INFORMATION
Date
Activity / channel
Engagement objectives
Stakeholder groups
29 October Session 1: Technical
Implementation leads
Prescribers, pharmacy sector,
and operational
Information-Sharing and
selected training providers
readiness
Insights.
OFFICIAL
24
Session 2: Practical
Training providers depend on
Session 1 attendees
November implementation
what comes out of session 1.
Quality, safety and rights
THE
agencies, PHOs
1
Session 3: Consumer
Build awareness of changes.
ADHD NZ, Aroreretini Aotearoa,
December groups
Provide clear, accessible
Young Neurodiversity
information. Gather feedback
Champions, Healthify, Māori
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and concerns.
and Pacific groups, Pharmac,
Medsafe
December Internal Ministry
Build awareness of the
Ministry of Health staff
channels, e.g. Te
changes.
Whare, weekly internal
DG pānui
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End of
Publication of FAQs on
All stakeholder groups
December the Ministry’s website
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Document 3
Date
Activity / channel
Engagement objectives
Stakeholder groups
1 February Ministerial press
External communication of
General public
2026
release (tbc)
legislation coming into force
(legislation Provide link to FAQs
comes into and reactive lines to
force)
the Minister’s Office
Website update
External communication of
All prescribers
1982
External DG pānui
legislation coming into force
Email Clinical
Refer Appendix 2 f
ACT or a full list
stakeholders
of communication products
Te Whare article
Internal Ministry
Ministry staff
Weekly DG pānui
communications
INFORMATION
OFFICIAL
THE
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APPENDIX 1: STAKEHOLDER ANALYSIS
Stakeholder
What we want from them
What they may want from us
Why
Who
Activities
group
1982
Consumer
•
Understand the
•
Know what changes on 1
•
Directly impacted by
ADHD NZ,
Session
Groups
changes and the
February 2026, what does
the change, especial y
Aroreretini
Three
ACT
impact on
not change, what to
people who have been Aotearoa,
stakeholders
expect from assessments,
waiting or had access
Healthify, Māori
•
If advocacy
likely costs, and where to
issues for a long time.
and Pacific
organisations are
find trusted information
consumer groups
developing any
and support.
•
They wil have
resources
•
Access practical
expectations,
•
Understand any key
guidance on how to
questions and
risks or issues for them
navigate common
concerns about the
from a public health
chal enges with ADHD
change.
INFORMATION
system perspective.
treatment, especial y
regarding supply of
medicines and switching
brands.
•
Where information wil be
located
OFFICIAL
•
What services wil look like
•
What they should expect
THE
from services.
Govt agencies,
•
Understand any key
•
Continued system level
•
These are the system
Ministry of Health, Session
funders and
risks or issues for them
alignment (i.e.
stewards who provider Medsafe,
One
regulators
from a public health
implementation working
regulatory, funding and Pharmac
system perspective.
group
UNDER )
national materials to
support ADHD policies.
Of note, there is no
national coordinated
ADHD clinical pathway
from a system level.
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Document 3
Stakeholder
What we want from them
What they may want from us
Why
Who
Activities
group
Professional
•
Understand which
•
Access practical
•
Involved in the
RNZCGP, RANZCP,
Session
and prescriber
training they’re
guidance on clinical
implementation phase. Paediatric
1982
One (Oct
bodies
endorsing
frameworks, regulatory
•
They wil :
Society, NPNZ, NZ
29)
•
Understand what their
rules, Special Authority
•
Endorse training
College of Mental *Pharmace
ACT
messaging to their
and funded access,
provider/s
Health Nurses,
utical
members are to
supply considerations,
•
Share communications Pharmacy Guild*, bodies wil
receive
and responsible and
with their members
PSNZ*, NZHPA*
be invited
•
Understand any key
optimal use of medicines
•
Advocate resources
to Session
risks or issues for them
to share with their
and support
Two as
members
there is not
•
Input into local,
•
Clarify understanding of
regional and national
as direct of
the changes from a
clinical resources
a change
funding, regulatory and
to their
INFORMATION
operational perspective.
practice.
•
Understand what the
costs are for members to
do CPD and who wil pay
for that
•
What the expectations are
OFFICIAL
of them (We expect it wil
take time for general
practitioners and nurse
THE
practitioners to develop
competence and
confidence in ADHD care
and treatment. Not al
UNDER general practitioners and
nurse practitioners wil
develop an interest in
ADHD and uptake across
the country wil be
variable)
•
How to manage public
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and patient expectations
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Stakeholder
What we want from them
What they may want from us
Why
Who
Activities
group
Clinical
•
Understand any key
•
What needs to be
•
The organisations and
Health NZ Ops
Session
systems and
risks or issues for them
updated in their systems
teams within the public (electronic
1982
One
operational
from a public health
and platforms
system that provide
special Authority),
enablers
system perspective
•
Are they getting any more
operational tools to
Health NZ
ACT
•
Timelines and
money
help clinicians
Pharmacy
alignment with policy
•
What do they need to
understand referral
Commissioning
change (i.e. wil the
share and to who
pathways, write and
(write guidance
systems and guidance
send prescriptions,
for pharmacists)
be ready)
apply for funded
NZePS team,
medicines and access
NZ Formulary,
clinical treatment
HealthPathways
advice.
Training
•
Understand what they
•
Funding and
•
Responsibility for
Goodfel ow Unit
Session
INFORMATION
providers
are developing
commissioning
producing education
Best Practice
One
•
What wil the training
opportunities
and training resources. Advocacy Centre
cover
•
How to access
New Zealand
•
How long wil the
professional networks
(bpacnz)
training take
•
Specific clinical pathways
Australasian
•
How much wil the
in New Zealand / details of
ADHD
OFFICIAL
training cost
New Zealand system
Professionals
•
Is the training
Association
THE
endorsed by
(AADPA)
professional body?
Health NZ
•
Understand any key
•
Understand the changes,
•
Specifical y – their
Health NZ
Session
primary care &
risks or issues for them
expectations of what’l
mental health teams
national functions One
mental health
from a public health
ha
UNDER ppen etc
wil have an increase in
Commissiong
system perspective
referrals and
•
To see regional teams
escalations and cases
front footing
in MH teams. Those
preparation for
psychiatrists are more
changes (i.e. local
established
clinical networks,
prescribers. Like with
formal or informal
RELEASED )
anything in primary
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Stakeholder
What we want from them
What they may want from us
Why
Who
Activities
group
•
Understand the
care, they must
changes, expectations
escalate to specialist
1982
of what wil happen.
(part of competence)
•
At the commissioning
ACT
level (primary care)
•
Monitoring risks and
changes over time
Care delivery
•
Who is developing
•
Understand scope
•
Existing and those
PHOs
Session
organisations
services, and what are
boundaries, clinical
potential y developing
Private ADHD
Two
they
information sources, and
services. They wil
providers
•
Cost of services to
commissioning pathways,
mainly be engaged via
patients
so that service
professional bodies
•
Any specific services
development is aligned
and local structures.
INFORMATION
for Māori, Pasifika and
and safe
•
This might include
other high need groups • Reassurance to GPs about
groups of GPs with a
•
Understand any key
expectations from the
special interest, or
risks or issues for them
system
specifical y
from a public health
•
Gaining a line of sight of
representing a sub-
system perspective
implementation activities
type of GPs (e.g. Rural)
OFFICIAL
across the health system.
(Understand who is
THE
developing services / lay
of the land and what is
happening in the sector)
•
Understand how they wil
be regulated and
UNDER governed
Quality, safety
•
Understand any key
•
Be informed and prepared Safety and regulatory role.
Medical Council,
Session
and rights
risks or issues for them
for the key changes
Nursing Council,
Two
agencies
from a public health
Pharmacy
system perspective
Council, HQSC,
HDC, Privacy
RELEASED
Commissioner
10 | P a g e
Document 3
Stakeholder
What we want from them
What they may want from us
Why
Who
Activities
group
Government
•
Have the same
•
Be confident that sector
n/a
Minister of Mental Updated
and Policy
messaging as the
readiness is being
Health, Assoc
1982 iate via existing
sector (i.e. managing
coordinated, risks are
Minister of Health channels
expectations)
visible with mitigations,
for Pharmac
ACT
•
Be aware of the risks
and that public messages
(i.e. lack of additional
are consistent and careful
funding and capacity)
about expectations and
safety.
•
Ensure we have clear
understanding of different
connections occurring
•
Supply of medicines
•
Be confident that sector
INFORMATION
readiness is being
coordinated, risks are
visible with mitigations,
and that public messages
are consistent and careful
about expectations and
OFFICIAL
safety.
•
Ensure we have clear
understand
THE ing of different
connections occurring
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ACT
INFORMATION
OFFICIAL
THE
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Document 3
APPENDIX 3: MINISTRY OF HEALTH EMAIL TO STAKEHOLDERS PRIOR TO 1 FEBRUARY 2026
Subject: Upcoming changes to ADHD treatment initiation – effective 1 February 2026
1982
Kia ora,
ACT
From 1 February 2026, specialist general practitioners and nurse practitioners working within their area of practice wil
be able to initiate stimulant treatment for adults with ADHD. Nurse practitioners in paediatric or mental health services
wil also be able to initiate treatment for children and adolescents. Psychiatrists and paediatricians wil continue to
prescribe stimulant treatments as they do now.
These updates are designed to meet the needs of people living with ADHD across New Zealand by improving access,
and timeliness of care.
INFORMATION
Prescribing wil continue to follow existing regulatory and clinical guidelines to ensure quality care and prevent
misuse. Pharmac is actively managing supply and exploring alternative brands and treatments to support increased
demand.
OFFICIAL
We appreciate your ongoing commitment to providing high-quality care. If you have any questions, please see
[Ministry of Health weblink with FAQ publication]
THE
Ngā mihi nui,
[Name]
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ACT
INFORMATION
OFFICIAL
THE
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ACT
INFORMATION
OFFICIAL
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Document 6
Kia hora te marino1982
Kia whakapapa po
ACT unamu te
moana
Karakia
Hei huarahi mō tātou i te rangi nei
whakatuwhera
Haumi ē, hui ē, t
INFORMATION āiki ē!
Opening karakia
OFFICIAL
May peace be widespread
THE
May the seas be as flat as pounamu
To provide a path for us today
J
UNDER oin, group, and affirm
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Document 6
Agenda overview
1982
Chair: Dr Anna Skinner
ACT
Hosts: Ministry of Health, supported by Medsafe and Pharmac
Attendees: Organisations and professionals involved in implementing the changes. This includes
prescriber leadership bodies, clinical education providers, and related system partners.
1. Intro and System Update – ADHD NZ, Ministry of Health, Medsafe
INFORMATION , Pharmac (~2:00-2:30pm)
2. Sector Readiness Round Robin (~2:30-3:20)
1. Professional bodies (RNZCGP, NPNZ, RANZCP, PSNZ)
2. Clinical education providers (AADPA, Goodfel ow, Bpacnz)
3. Operational enablers and sector partners (Pharmac, Hea
OFFICIAL lthPathways, Health NZ)
4. Each share: readiness activities, next steps, communication plans, support needs
THE
3. Shared Discussion (~3:25-3:40)
1. Gaps, risks, and equity considerations
2. Feedback on key messages
3. Visibility of sector priorities
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4. Wrap-up & Next Steps
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Document 6
Housekeeping
1982
1. This is a safe space for open discussion. Please respect th
ACT at comments shared
here are for sector col aboration and not for wider distribution.
2. Introduce yourself in the chat
3. Keep microphones muted unless speaking
4. Use the “Raise Hand” function
INFORMATION
5. Introduce yourself before speaking
6. This session wil be recorded and transcribe
OFFICIAL d
7. Slides and a summary of key points w
THE il be shared afterwards
8. Parking lot: We’ll note items for fol ow-up if they can’t be addressed today. Please
put comments in the chat (if they
UNDER 're outside discussion time)
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ACT
INFORMATION
OFFICIAL
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Hearing from Sarah Hogan, ADHD NZ – lived experience perspective
from the ADHD community
1982
ACT
INFORMATION
OFFICIAL
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INFORMATION
OFFICIAL
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INFORMATION
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Prescribing changes shifting to include GPs and nurse
practitioners
1982
• From 1 February 2026:
ACT
• vocational y registered general practitioners (GPs) and nurse practitioners wil
be able to initiate stimulant medicines for ADHD to adults (18 years and older)
• nurse practitioners working in paediatric or mental h
INFORMATION ealth services wil be able
to initiate and prescribe stimulant medicines for ADHD to children and
teenagers (17 years and younger)
OFFICIAL
• This means that people diagnosed with ADHD wil find it easier to start ADHD
THE
stimulant treatments, as they wil be able to see a wider range of medical and
nurse practitioners.
UNDER
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Document 6
Creating the health system environment for safe and effective
implementation of the changes
1982
• The safe and effective implementation of the prescribing c
ACT hanges relies on the
actions of several key stakeholders.
• Key stakeholders have a role to play in
creating the health system environment
for the policy to be taken up.
• The Ministry of Health, Pharmac, and Medsafe are conve
INFORMATION ning a short series of
meetings with stakeholders:
• 29 October: Key stakeholders – coordination of actions, increase visibility including of risks
• TBC November: Health system stakeholder updates
OFFICIAL – share information and col ate queries
THE
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Creating the health system environment for implementation:
Ministry of Health activities
1982
• Maintaining high quality and clinical y safe practice
• NZ
ACT Clinical Principles Framework
• Clinical guidance, educational opportunities, escalation and
for ADHD
referral
• Confidence and competence among new prescribers
• Endorsement of a single set of
clinical guidelines for ADHD
• Clear communication to the public and providers
(AADPA, 2022)
INFORMATION
• Including clear information about what to expect
• Liaison with key stakeholders for
• Monitoring impacts
coordination
• Managing ministerial and cross-agency
OFFICIAL
communication
• Development of
THE
communications and
engagement approach
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• Briefings for Ministers
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Document 6
What we expect will happen when the changes take effect
1982
• It wil take time for general practitioners and nurse practitioners to develop
competence and confidence in ADHD care and treatment.
ACT
• Not al general practitioners and nurse practitioners wil develop an interest in ADHD.
• Uptake wil vary.
• Training and educational opportunities for new prescribers wil be self-funded.
• There is no mandatory requirement for training or micro-credential ing system.
• Health professionals are expected to practice within their scope and refer
INFORMATION when appropriate.
• ADHD assessment and diagnosis is not a core general practice service and is not
included in capitation funding.
OFFICIAL
• The policy change is not linked to any additional funding.
THE
• These services cannot be undertaken in a standard consultation.
• Providers wil charge service users. Fees are likely to vary between providers.
• The fee-for-service model has implications
UNDER for the accessibility of ADHD care.
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Document 6
What we expect will happen when the changes take effect
1982
• Local ways of working wil emerge, and wil vary
ACT
• Primary care providers wil seek to discuss or refer complex cases to specialists at the local level.
• Multidisciplinary clinical models of care may be established that include practitioners working in private.
• Clear communication to the public and prescribers about what to expect wil be
important during this time.
INFORMATION
• The Ministry wil monitor the impacts of the policy, including analysis of
geographic and between-group variation.
• Over time, we expect that the changes wil re
OFFICIAL duce costs and improve access to
ADHD treatment.
THE
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1982
ACT
INFORMATION
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THE
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Document 6
Consultation on changes to the regulatory restrictions for
stimulant medicines
1982
ACT
• The proposed setting developed through engagement with a multi-
disciplinary group of experts
• Public joint consultation with Pharmac – Dec 2024 to Feb 2025
• Approximately 900 responses received to the con
INFORMATION sultation
Broad support for the proposal
▪ Improved access to ADHD stimulant medicin
OFFICIAL es
▪ Potential reduction to waitlists and costs
THE
Some concerns
▪ Risk of misdiagnosis and over prescribing
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▪ Need for clear scope and targeted training
▪ Preference for specialist oversight in complex cases
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Document 6
Current prescribing settings
1982
ACT
PRESCRIBING SETTINGS
PATIENT AGE
INITIATION OF PRESCRIBING
ONGOING PRESCRIBING
Any
Medical practitioners with a vocational
Any medica
INFORMATION l practitioner or nurse practitioner
scope of practice of paediatrics or
may prescribe when acting on the written
psychiatry may initiate prescribing.
recommendation of one of the practitioners who
have initiated prescribing.
OFFICIAL
THE
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Approved prescribing settings from 1 February 2026
1982
PRESCRIBING SETTINGS
ACT
PATIENT AGE
INITIATION OF PRESCRIBING
ONGOING PRESCRIBING
17 years and under
Medical practitioners with a vocational
Any medical practitioner or nurse practitioner
scope of practice of paediatrics or
may prescribe when acting on the written
psychiatry.
recommendation of one of the practitioners who
have initiated prescribing.
Nurse practitioners practising within their
INFORMATION
area of practice of paediatric services or
child and adolescent mental health
services.
OFFICIAL
18 years and above
Medical practitioners with a vocational
scope of practice of paediatric
THE s,
psychiatry, or general practice.
Nurse practitioners work
UNDER ing within their
area of practice.
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INFORMATION
OFFICIAL
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Sharing Implementation activities from key organisations
1982
• RNZCGPs
ACT
• NPNZ
• RANZCP
• Paediatric Society NZ
INFORMATION
• AADPA
• Goodfellow
OFFICIAL
• Bpacnz
THE
• Pharmac
• HealthPathways
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• Health NZ
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