‘Fantastic’ partnership leads to state government-funded GP respiratory clinics

‘A huge leap forward.’
 
That’s how RACGP Victoria Chair Dr Anita Muñoz views a collaboration between the state government and general practice, with 20 new GP respiratory clinics planned to help health services cope with the pandemic.
 
Announced by the state’s Minister for Health Martin Foley on Tuesday, the clinics are earmarked for areas with high case numbers in Melbourne. Expressions of interest are now being invited for funding from a $23.8m state government initiative, with clinics due to open within 3–6 weeks.
 
Dr Muñoz has been at the heart of discussions. She said the clinics are just one of a number of ideas put forward to the health department suggesting an expanded role for general practice in the face of the COVID-19 outbreak challenges – and is the result of an increasingly collegiate relationship.
 
‘It’s absolutely been a case of where there’s a will there’s a way,’ Dr Muñoz told newsGP.
 
She said her predecessor as RACGP Victoria Chair, Dr Cameron Loy, had paved the way with increasing cooperation with state officials, who she said have been ‘very open to hearing what general practice is capable of’.
 
‘There’s a determination to reduce the separation between what has traditionally been federal versus state funding streams in the design of health system solutions,’ Dr Muñoz said.
 
The announcement came with the backdrop of an increasing COVID-19 burden on healthcare professionals in Victoria.
 
The latest figures show 784 people in hospital with COVID-19 across Victoria, a sharp rise in the past few days. Of them, 149 are in intensive care and 100 are using a ventilator.
 
While the current case numbers are expected to peak shortly, a subsequent climb is also expected once the state begins to lift restrictions. In public hospitals, non-urgent elective surgery has been paused, and doctors have also voiced concerns that more urgent category one and category two procedures are being delayed due to the demand for intensive care beds.
 
‘I think the Victorian Department of Health have really come to recognise that going into this pandemic without deploying general practices is like going to war without the army,’ Dr Muñoz said.
 
‘The idea [is] that we need to keep respiratory patients out of [hospital] unless they truly [require] emergency department presentation.
 
‘Similarly, we have to protect general practice from being contaminated or infected with COVID because their environments are not designed to cope with this kind of airborne infectious disease transmission.’
 
The new clinics are designed to be strategically placed to receive GP referrals when other clinics are unable to receive patients prior to a negative COVID test. They are particularly designed for families with young children who are likely to be more prone to catching coughs and colds.
 
Dr Muñoz described them as like ‘a step in between’ hospital and general practice.
 
‘It’s [allowing] patients who can stay out of hospital to do so because what they need is a test as soon as they become symptomatic, and they need to have their respiratory health assessed and treated while they’re waiting for the test to come back,’ she said.
 
The announcement follows another recent collaboration between the Victorian State Government and GPs, with grants offered to general practices in under-vaccinated postcodes to facilitate out-of-hours vaccinations.
 
RACGP President Dr Karen Price has long advocated for fewer barriers between general practice and state health systems – and described the news as ‘fantastic’.
 
‘I’m so pleased that out of the pandemic, we’ve had increasing communication with our state governments,’ Dr Price told newsGP.
 
‘Hats off to Dr Anita Muñoz, who’s has been working really hard and collaboratively with the state.
 
‘We’ve been talking about increasing the integration of primary care into the health system for a long time. It’s starting to break down those barriers about what primary care can actually do.’

Dr Price hopes other states will consider a similar model of state government-funded respiratory clinics, with care in the community likely to be an increasing part of the COVID-19 health response. She is also optimistic that it will help set the course for future collaborations.
 
‘Hospitals really need help. They need general practice to be resourced enough to manage everything that is coming at us in the next few months,’ she said.
 
‘General practice is an enormous contributor to the healthcare system, and it’s where people want to be looked after.’
 
Dr Muñoz also hopes the clinics will both provide some immediate relief to health-workers in the hospital system as well as pave the way for more cooperation.
 
‘My hope is that this will set a new standard for collaboration between state governments and general practice,’ Dr Muñoz said.
 
‘I have an optimistic feeling that this is only just the beginning.
 
‘These collaborations can transform the way we deliver public health around our country and make great use of community medicine, which we know improves outcomes and creates a more sustainable health system.’
 
The GP respiratory clinics are earmarked for local government areas within metropolitan Melbourne.
 
Expressions of interest are being administered through three Primary Health Networks: South Eastern Melbourne, North Western Melbourne, and Eastern Melbourne.
 
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