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Improving COVID vaccine rollout top of RACGP advocacy list


Michael Wright


15/04/2021 11:04:55 AM

Dr Michael Wright details the college’s recent behind-the-scenes advocacy work.

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The college is providing ongoing feedback about the vaccine rollout at the highest levels of the Australian Government.

Phase 1b of the coronavirus vaccine rollout began last month. There have been some well documented logistical issues (thanks to the many members who have shared their experiences with RACGP), and significant challenges for GPs following Australian Technical Advisory Group on Immunisation’s (ATAGI) recent recommendation regarding Pfizer being the preferred vaccine in adults aged under 50.
 
The RACGP is providing ongoing feedback at the highest levels, including Federal Health Minister Greg Hunt and the Department of Health (DoH) regarding these challenges and the impact they are having on GPs. Issues raised include:

  • unpredictable supply, including delayed delivery, reduced quantity of vaccine delivery, or missing product (such as syringes), which has forced practices to cancel and reschedule entire clinic sessions
  • the fact that vaccine supply is not based on Standardised Whole Patient Equivalent (SWPE), leaving some practices with a significant undersupply compared to others
  • the inability for provisionally accredited practices, such as those who have had their accreditation survey delayed due to COVID-19 restrictions, or non-accredited practices like immunising travel clinics, to participate in this phase
    • the DoH has noted that travel clinics will be considered in a future phase of the rollout
  • practices being invited to make online orders with extremely short notice, which has resulted in them missing deadlines and being left without an order arriving in time for clinics
  • some GPs having difficulty in getting vaccinated, including their second dose, as part of phases 1a and 1b of the vaccination rollout
  • the need for further clarity regarding adults under 50 receiving AstraZeneca vaccinations
  • given recent developments regarding vaccine recommendations, the need for additional funding to support GPs providing vaccine counselling to their patients.
The college has also been working hard to provide GPs and patients with clarity around Medicare-funded access to telehealth, which was originally due to end last month. However, successful RACGP advocacy has seen the temporary Medicare Benefits Schedule (MBS) items that support telehealth extended until at least 30 June while the DoH develops a long-term model.
 
While the RACGP continues to advocate for a permanent telehealth scheme, the college is calling for the current model to be extended until December to enable a better understanding of ongoing telehealth usage by general practice in a non-lockdown environment, and patient need.
 
The RACGP has also been advocating for increased funding for aged care, in both residential aged care facilities (RACFs) and older people in the community through coordination payments and increased incentives to GPs providing aged care services.
 
Elsewhere, a review of last year’s changes to MBS items for electrocardiograms (ECGs) is now underway, which will look at how the decision to remove support for GP ECG interpretation has impacted GPs and patients.
 
The RACGP is contributing to the review through member representation and a formal submission, which highlights the patient and economic benefits of community-based ECG interpretation, especially in areas where access to specialists is limited, and for Aboriginal and Torres Strait Islander patients.
 
Finally, the RACGP recently convened a roundtable in response to increasing member concerns about the impact of Medicare compliance activities, particularly where they discourage GPs from providing necessary care, and where they impact on GP wellbeing.
 
Attendees raised a number of common issues, including the growing complexity of MBS item descriptors which is making compliance more difficult and increasing the administrative burdens for GPs, as well as reports of conflicting advice from AskMBS.
 
Concerns were also raised about the procedural fairness and an apparent assumption of guilt within some of Medicare’s compliance processes, and a worrying trend of GPs being increasingly identified in Professional Services Review (PSR) determinations, including Section 92 decisions.
 
The Australian Medical Association (AMA), Australian College of Rural and Remote Medicine (ACRRM), Rural Doctors Association of Australia (RDAA), Australian Association of Practice Management (AAPM) and Medical Defence Organisations were all in attendance.
 
The RACGP will also work with roundtable participants to ensure these issues are raised with relevant areas of the Government, including the DoH’s Benefits Integrity and Digital Health Unit (responsible for Medicare compliance) and the PSR.
 
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Dr Oliver Frank   16/04/2021 7:53:05 AM

I would like to comment on the report: "Attendees raised a number of common issues, including the growing complexity of MBS item descriptors which is making compliance more difficult and increasing the administrative burdens for GPs, as well as reports of conflicting advice from AskMBS."

Item number madness is a real thing. GPs and their staff spend more and more time trying to work out the appropriate MBS item number(s) for a consultation or other service, with the conflicting advice from Medicare itself testifying to that complexity. The time and energy spent on working out the item number(s) to use could have been better spent in providing better care for the patient.

We need to seriously consider alternatives, and to revisit the RACGP's much-ignored Vision for General Practice.