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‘Clearly not practical’: Practices overwhelmed following PM’s direction to call GPs
Scott Morrison has directed people with a positive rapid antigen test result to contact their general practice – but GPs say no suitable system has been established.
GPs say they have no way of capturing positive rapid antigen test result in the system so people can access COVID-19-positive pathways.
Already-stretched general practice staff were left blindsided on Wednesday evening after Australians who return a positive rapid antigen test were directed to contact their GP to have their case registered with the health system.
Speaking to newsGP on Thursday, RACGP President Dr Karen Price said GPs have been left feeling ‘overwhelmed’ and practice phone lines are likely ‘in meltdown’ given exploding infection rates, particularly in New South Wales and Victoria.
‘It’s clearly not practical for every single patient who’s got COVID to call their GP, and we won’t be able to drop everything and do a telehealth consultation right away,’ Dr Price said.
‘We are flat out delivering booster doses and from Monday we will be delivering vaccines to children – a difficult task – all while managing and treating patients who have delayed or avoided care during the pandemic, including those with mental health concerns.
‘While the timing is not ideal – which it undoubtedly never is in a pandemic – the last thing we need is another new announcement without detail.’
The announcement, made by Prime Minister Scott Morrison late on Wednesday following a national cabinet meeting, revealed significant changes to testing requirements that mean people who test positive on a rapid antigen test will no longer need to have their result confirmed by a PCR test, in a bid to take pressure off testing resources.
‘They should let [their GP] know because that is the principal point of care under the primary health network. They are in a position to provide further advice and telehealth is put in place to support that,’ Prime Minister Morrison said.
‘And your GP would be able to assist you through telehealth if you need to go and get further treatment in hospital.’
Prominent Melbourne GP Professor Kerryn Phelps was among those who took to Twitter to express their frustration, indicating the announcement was an example of general practice being informed of a policy change alongside the public.
While the changes to testing requirements suggest that COVID-positive patients will be able to gain access to care pathways with a rapid antigen test result, GPs have been left navigating how to record patients’ results in the absence of a suitable system.
A GP, going by the name of ‘KB’ on Twitter, said they have no access to a system that can ensure patients have access to the clinical care they need.
Despite COVID-positive patients being directed to contact their GP, when questioned further about the process during Wednesday’s press conference, Prime Minister Morrison said the Government is ‘working on a system through our GPs and other processes for people to report whether they’ve got a positive test’.
Dr Price said there is an urgent need for state and federal governments to find a suitable system, adding that GPs ‘certainly can’t manage this process on our own’ given their existing workload.
The RACGP President did say, however, that the college has since been in contact with the Federal Health Minister’s office to discuss possible options, including QR codes on rapid antigen tests that can be recorded through Services Australia.
‘I know in
the UK there are sites where patients can manually upload the results themselves either using photographs or just a manual entry of barcodes into the system,’ Dr Price said.
‘But at the moment, I’m not sure which system we need to upload it into and that’s something that has to come from the Government.’
In addition to concerns about patients being able to access timely care, it has also been noted that without a system in place to record positive rapid antigen results there is no way for the health system to know the true number of positive cases in the community in order to prepare accordingly.
In the meantime, for patients with asymptomatic or mild COVID-19 that could be safely managed at home, Dr Price said she is advising that people hold on to their positive test with a record of the date and that they have the result recorded in their file the next time they see their GP.
‘We’re in disaster mode,’ she said. ‘We can’t manage uploading people retrospectively for mild or asymptomatic disease.
‘It’s important but, at the moment, it’s really important to look after those who are most severely affected.’
What also remains unclear, according to Dr Price, is whether GPs seeing COVID-positive patients in person based on a rapid antigen test result would be eligible for
the $25 fee through Medicare.
‘That needs to be clarified and we’re working with the Government on that,’ she said.
‘We’re also working on whether that bonus should just apply for face-to-face care, or whether it should be for over the phone care, too. What I’m hearing from many GPs is that the telehealth involved in managing COVID-positive patients is significantly long and detailed, as you would expect.
‘So we have also asked for an emergency Level C telephone item number for telehealth because we have to manage as many of these people from home as we can.’
Thanks in large part to high vaccination rates, the majority of the
more than 220,000 positive cases recorded in Australia so far this week are expected to be mild and self-managed at home.
Dr Price said the latest development again highlights the importance of the Federal Government having clear lines of communication with general practice.
‘We know at the moment that GPs are under enormous pressure and that they are responding as best as they can,’ she said.
‘In many instances, there are general practices who have enacted their disaster plans and so we need to state very clearly to the Government, to the public and to our patients that this is not business as usual.
‘This is a wildfire of infectious disease, and we need to respond at that level.’
To support GPs and their patients, the RACGP has updated its Home-care guidelines for patients with COVID-19, as well as a guide, action plan and symptom diary that doctors can share with their patients.
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