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What has the RACGP been advocating for at the end of 2020?


Michael Wright


18/12/2020 1:16:17 PM

December has been a big month in advocacy, from economic modelling to long-term plans to mental health in aged care.

2020 sign
What doors will open next year?

This month has seen advocacy on many fronts.
 
Developing the Primary Health Care 10-Year Plan
Throughout 2019 and 2020, RACGP representatives have been involved in Department of Health (DoH) consultations over the shape of the Primary Health Care 10-Year Plan, with GP, Aboriginal and Torres Strait Islander, and future focus roundtables held in November this year.
 
After I co-chaired the consultation for GPs, our president subsequently wrote to the DoH’s First Assistant Secretary Simon Cotterell to outline the merits of implementing our Vision for general practice and a sustainable healthcare system (the Vision)
 
Some of the key issues being discussed in the 10-Year Plan consultations include:

  • shifting the culture of healthcare from illness to wellness, treatment to prevention, and patient management to patient activation
  • increasing the attractiveness of general practice as a profession and improving GPs’ job satisfaction
  • continuation of telehealth beyond COVID-19, the potential introduction of voluntary patient enrolment and supporting quality improvement in general practice
  • lessons from COVID-19 and ensuring the primary healthcare system is future-focused
  • establishing multidisciplinary teams and the inclusion of non-GP primary health providers without compromising the role of GPs.
Economic benefits of the RACGP’s Vision
In related news, our president recently met with Federal Health Minister Greg Hunt, Federal Minister for Regional Health Mark Coulton and Shadow Health Minister Chris Bowen to discuss our recently commissioned economic benefit analysis of the Vision.
 
Undertaken by PwC, this analysis conservatively estimates the direct benefits of implementing our Vision would be $5.6 billion over the next five years.
 
How was this figure determined? The direct benefits would emerge from an estimated annual saving of $773 million savings in preventable hospitalisation, hospital readmission and emergency department presentations, and $250 million annually in improved workforce productivity.
 
Beyond the direct benefits, there would be 98,000 quality-adjusted life years (QALYs) gained in 2021, and 520,000 QALYs gained over the next five years – representing billions of additional dollars in value to individuals and Australia.
 
Other benefits to society would come through improving health equity for the groups that disproportionately rely on secondary care, including treatment in hospitals, improved patient satisfaction with care and improved health provider satisfaction.
 
In short, if our government allocated an extra $1 billion to general practice ­– compared to the $79 billion spent on hospitals in 2018–19 – we would see a much greater range of combined benefits than any resulting loss due to reduced expenditure on hospitals.
 
Recognition of the GP role in NDIS planning
The Joint Standing Committee on the National Disability Scheme (NDIS) released its final report this month.
 
We were pleased it recognised the concerns raised in our submissions, particularly that there is no process to ensure GPs are involved in the development of their patients’ NDIS plans and no process to ensure we are provided with notifications once a plan has been implemented and/or revised.
 
Recommendation 14 of the final report proposes that the National Disability Insurance Agency (NDIA) investigate ways in which GPs, with participant consent, can be sent plans either via post, through My Health Record, or other appropriate means.
 
newsGP wrote about this earlier this month.
 
Medicare funding for mental health care in RACFs
Over the past year, we have mounted a consistent campaign through submissions, witness statements and direct advocacy on the need to recognise the vital role GPs have in supporting the mental health of residents in aged care facilities.
 
That has been recognised, with Minister Hunt announcing $132 million funding for aged care in response to the aged care royal commission’s recommendations on COVID-19.
 
This funding includes a range of new MBS items to support mental health for residents of aged care facilities (RACFs) , including 17 new GP items supporting the development and review of Mental Health Treatment Plans (available face-to-face, or via video/phone) and two new GP items for chronic disease management in RACFs.
 
As of 10 December, eligibility requirements for the Better Access to General Practitioners, Psychiatrists and Psychologists and through the MBS will be expanded to residents of aged care facilities.
 
The RACGP will continue to campaign for the continuation of Medicare subsidised mental health care in residential aged care facilities beyond the current 30 June 2022 sunset timeframe.
 
More information on the new MBS items is available on the RACGP website.
 
Looking ahead to 2021
Next year will be another big one for funding and health system reform advocacy.
 
With the Federal Budget to be handed down in May, a possible federal election and several final reports from inquiries due in early 2021, the RACGP will continue to argue for a sustainable healthcare system and appropriate support for general practitioners and their patients.
 
We can also expect major policy announcements and responses from these inquiries and plans: 
 
  • Productivity Commission Inquiry into Mental Health
  • Final report of the Royal Commission into Aged Care Quality and Safety
  • Federal Government’s Primary Health Care 10-Year Plan
  • Long-term telehealth arrangements
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Dr Leah Curtis   7/01/2021 8:42:27 PM

Is there any advocacy going on to support GPs working in aged care facilities? The bombardment (and threats) to fill in and sign paperwork is getting out of hand. Chemical restraint forms are a huge challenge - no standard form, no agreement even on what medications are considered a restraint, and being asked to re-do it every 1-3 months is just not possible. Other health directives are also thrust at GPs without consultation. Medical diagnosis forms (ACFI funding tools) are completed by staff rather than using the GPs more reliable and comprehensive health summary or CMA. None of them (or their clinical software) are compatible with GP software either. Will the RACGP support and help create realistic and clinically useful systems and guidelines around such things?