GPs should be paid for NDIS paperwork: RACGP

Michelle Wisbey

10/01/2024 1:46:32 PM

Current Medicare requirements make it difficult for GPs to receive compensation for the time-consuming task, the college has said.

Medical professional at desk speaking on phone.
GPs are not remunerated for completing NDIS forms without the patient being present.

GPs must be better connected to service providers and adequately compensated for their work with National Disability Insurance Scheme (NDIS) patients, according to a new RACGP position statement.
Aside from providing medical treatment for NDIS patients, the college points out that GPs are also often tasked with providing evidence of disability, advocating for access, helping patients understand letters and emails, and working with families.
However, current Medicare rebates do not allow GPs to complete NDIS forms without the patient being present, making it difficult for them to receive compensation for what is often a time-consuming process.
‘There is no other avenue for GPs to be remunerated for their time and expertise unless they charge the patient a fee,’ the RACGP said.
‘GPs should be remunerated for time spent preparing reports and other relevant documentation to support NDIS applications when patients are not present.’
The position statement says a change could be funded through MyMedicare, which would see GPs and practices receive multiple, targeted payments to support the delivery of additional services.
It also contains other recommendations aimed at improving the disability sector and GPs’ ability to provide best-practice care to patients, including that:

  • the National Disability Insurance Agency (NDIA) provides clear, up-to-date information on the NDIS to people with disability and GPs
  • GPs have appropriate input into the NDIS planning process 
  • patients should be encouraged to have the NDIA forward a copy of their NDIS plan to their GP
  • NDIS funding be allocated appropriately and fairly
  • cultural safety be at the forefront of disability services provided to Aboriginal and Torres Strait Islander people 
  • improved communication occur between GPs, healthcare professionals, and the disability sector.
RACGP President Dr Nicole Higgins told newsGP overall, the NDIS needs to be ‘transparent and accountable’.
‘GPs haven’t been involved in the process and that has been a design flaw in the NDIS,’ she said.
Around 18% of Australians are living with disability, with general practice playing a significant role in their care, management, and support.
Additionally, 92% of people with disability see a GP, and 20% saw a GP for urgent medical care in the past 12 months.

Despite this, GPs are often left out of the conversation, both at a government level and among service providers, with the RACGP calling for general practice to be better integrated with disability service providers.
‘New lines of communication need to be developed to prioritise capacity for ongoing cooperation between the health and disability sectors,’ its position statement said.
It is also calling for GPs to view and discuss a draft of a patient’s NDIS plan and provide feedback, as well as that they automatically receive a copy of a patient’s plan and are kept updated with any changes.
More consideration should likewise be given to Australia’s rural and remote patients, the statement suggests, with the college recommending that they be involved in NDIS design and implementation processes.
Dr Higgins said for patients with disability, GPs are more than just doctors, as they also help with emotional health, carers, family, and support teams in often complex consultations.
‘There are multiple health providers involved in someone’s care that you actually have to coordinate with and it’s important that we continue to support GPs to provide this care,’ she said.
‘That needs to be reflected in the remuneration, consultation, and the support for ongoing education.
‘My greatest bugbear is providers forgetting that there is a GP that walks alongside the person with a disability who’s often been there for a long time, knows the person well, and knows their families and their carers.
‘It’s important to provide holistic care and if other providers are not providing that communication, it makes it really challenging and frustrating.’
The statement was released just months after the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability handed down its landmark report, laying bare the hardships faced by those living with disability.
The report made for sobering reading and included 222 recommendations to ‘improve laws, policies, structures and practices to ensure a more inclusive and just society’.
Dr Higgins said GPs can play a key role in implementing these recommendations and ensuring all Australians can access high-quality healthcare.
‘We’re often the ones who will pick up misuse or abuse of the system or the person,’ she said.
‘It’s important that GPs are included in all loops to provide the best healthcare for everyone.’
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Dr James McLeod   11/01/2024 10:51:36 AM

A major flaw of NDIS is not having a GP as either a triage tool or gatekeeper to services. Too often we have severely disabled patients stuck in hospital for 6 months or more awaiting home care packages and there is no way of advocating to speed up the delivery of services. Meanwhile big corporate paediatric clinics are diagnosing every kid that walks through the doors with autism or ADHD, getting them tens of thousands of dollars of NDIS funding then referring them to their in-house allied health providers and charging top dollar. How ICAC hasn't already reviewed the NDIS baffles me. And don't get me started on the NDIS funding expensive holidays or "equine therapy" meanwhile the Medicare rebates are so low only 1 in 5 GP practices bulk bill anymore.

Dr Maureen Anne Fitzsimon   11/01/2024 4:48:25 PM

Having just spent 3 hours on one report, and two hours on another, I think it would be rather lovely if I could be paid a little for 5 hours work, Too much to ask?