GPs to staff 50 ‘urgent care services’ in NSW and Victoria

Matt Woodley

30/08/2022 6:14:12 PM

The bulk-billing clinics will be established near existing hospitals with the aim of easing pressure on overburdened emergency departments.

Daniel Andrews and Dominic Perrottet.
Victorian and NSW Premiers Daniel Andrews and Dominic Perrottet announced the new clinics at the Olivia Newton-John Cancer Wellness and Research Centre. (Image: AAP)

The Victorian and New South Wales Governments will each establish 25 urgent care services in partnership with GPs in an effort to ease record demand on the states’ emergency departments.
According to an announcement made by Premiers Daniel Andrews and Dominic Perrottet, the services will operate for extended hours and be well equipped to handle conditions such as mild infections, fractures and burns. Patients, including non-Medicare card holders, will not be charged for services provided at the clinics.
‘Trying to find an after-hours GP who bulk bills has never been harder,’ Premier Andrews told reporters at a joint press event at the Olivia Newton-John Cancer Wellness and Research Centre.
‘Because people can’t find a free bulk-billing doctor, the only free place to go for many is to go to the hospital, or perhaps wait [for care] longer than they would prefer to wait and their condition gets worse and worse.
‘Instead of complaining about it, we’re doing something about it.’
The RACGP has responded positively to the news, with President Adjunct Professor Karen Price saying it is beyond time that state and federal governments work together to create one health system.
‘There is a great deal of patient suffering when health is used as a political football and this plan signals an end to that,’ she said.  
‘This initiative begins implementing one of the aims of the primary health care 10-year plan.
‘It makes sense for state governments to recognise the critical role general practice plays and the ability to work in the acute care and after-hours space, which is traditional territory for GPs working at full scope.
‘The RACGP looks forward to the evaluation of these clinics and to work on the concept of the “one health system” to create a seamless care journey for patients in need.’
Professor Price also called for the establishment of similar schemes to be make provision of this type of care available to every general practice in Australia.
‘This level of care should never have been defunded in the first place,’ she said. 
‘Further, a nationwide investment would enhance the evidence-based continuity-of-care model as we know most patients prefer to see their usual trusted GP.
‘The lost decades of insufficient investment in general practice care have never been more evident than during a pandemic.’
Meanwhile, RACGP Victoria Chair Dr Anita Muñoz said it is encouraging that state governments are becoming more involved in primary care, but cautioned that general practice still needs greater support.
‘We have been clear that practices must not be made financially vulnerable through their participation in these programs, and that urgent care clinics are not for delivering usual care that is best delivered by a patient’s own GP,’ she said.
‘States [funding] general practice activities indicates an understanding that innovative solutions to problems affecting our health system, including flexible funding arrangements, will be the way to provide the right health services to patients in the right place at the right time.’
The new services will be commissioned in partnership with Primary Health Networks, with locations determined following consideration of population, community needs and emergency department demand.
As part of the package in Victoria, 10 centres will partner with hospitals in Frankston, Bendigo, Casey, Albury–Wodonga, Dandenong, Latrobe, Werribee and Box Hill, as well as at Austin Hospital and Alfred Hospital. These are in addition to five other sites revealed last week, while a further 10 Victorian locations will be announced ‘soon’.
Meanwhile, NSW has recently established partnerships with GPs and Primary Health Networks in Western Sydney, the Murrumbidgee, Northern Sydney and Western NSW.
A joint release issued by the NSW and Victorian governments said the locations of future urgent care services in NSW will be delivered where there is ‘greatest need’, based on the demands experienced by hospital emergency departments, including where services can be scaled up quickly.
While the new partnerships are limited to NSW and Victoria, Premier Perrottet said states and territories across Australia have been under similar pressure to find long-term solutions to the ‘emergency care crisis’.
‘We’ve seen in [NSW] over the last 10 years a 30% increase in presentations at our emergency departments and that is not a unique experience, that is happening around the nation,’ he said.
‘Here is an opportunity for two state governments, the largest states in the country, to work together in a space that’s not traditionally ours.’
At the beginning of her term, RACGP President Dr Karen Price called for reforms to address what she identified as dysfunction in Australia’s healthcare system between state/territory and federal governments, while she also recently called for ‘integrated systems’ to help bridge the divide.
However, the college has also expressed wariness in the past regarding urgent care clinics, due to the potential for them to duplicate and fragment care, and advocated for any new services to be built on existing infrastructure.
A model established in 2019 by the West Australian Government involving more than 130 existing general practices was hailed at the time by RACGP WA as an ‘excellent solution’, while Tasmania has also drawn praise for a system that sees select clinics receive $150 from the state government for each patient it treats and keeps out of the hospital system.
These developments are in addition to priority care clinics backed by the South Australian Government, while an extension for state-funding for after-hours clinics in Tasmania has recently been confirmed.
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Dr Anthony Cletus McCarthy   31/08/2022 7:17:20 AM

Just the normal pre election electioneering.

When you have made your existing services dysfunctional, hey , look over here at this wondrous new service. Should be working sometime just after the election. Very little mention of funding, or who is going to run them, or staff them.
Shades of the superclinics.

Dr Greg Saville   31/08/2022 9:36:15 AM

I’d be more than happy to help out and relieve the burden on our ED colleagues. They really have had a tough time of it lately.
I could see Cat 4 and Cat 5 patients allowing our FACEM friends to deal with more pressing emergencies.
However, I’d like to be paid commensurate with that of a FACEM. In other words, an hourly rate equal to that of a junior ED consultant, superannuation, sick leave, annual leave, salary packaging, and the generous CPD allowance they receive.
Any GP accepting less than this needs to take a long, hard look at themselves.

Paul   31/08/2022 9:51:14 AM

Great. Wait till all the druggies get wind of this!

Dr Daniel Petrus Jacobus Bothma   31/08/2022 10:01:23 AM

Such a great photo. After drumming into the health profession for over 2 years NOT to shake hands, to socially distance, wear masks, etc.... the premier of Victoria just cannot help himself. Very amusing.

Dr Harsh Aggarwal   31/08/2022 10:08:56 AM

Great to see that in a cloud somewhere the state and federal governments coming together…until after it rains after elections and the cloud dissipates…so I guess Drs will be junior AGPT registrars? Nurses? Or am I guessing, and there is a secret plan to have hundreds and hundreds of GPs and nurses suddenly fall out of that cloud?

Dr Peter Lewis   31/08/2022 10:40:31 AM

So where are the GPs who would staff these urgent care services going to come from?!

Dr Bradley Arthur Olsen   31/08/2022 11:36:19 AM

I doubt it would happen in QLD as Queensland health would expect the GPs to work for nothing

Dr John Maxwell Power   31/08/2022 3:58:10 PM

Will 80/20 apply?

Dr Christopher Francis Boyle   31/08/2022 6:03:48 PM

Is it to run 24/7 or only in the after hours period? Significant funding is needed to fund this sort of system either way. The staff have to be paid at an after hours rate from 6pm but Medicare does not pay after hours rates for consultations till 8pm. We all know that in hours medicare funding is woefully inadequate which is why the bulk billing rate is crashing. If you do a phone consulation after hours there is no loading at all on it.
I am with Dr Saville on the idea of an hourly rate based on a staff specialist award as we are specialists just as much as a FACEM, FRACP or FRACS is. They could not do what we do just as we could not do what they do. It certainly cannot be done without significant resourcing.

Dr Bradley Arthur Olsen   31/08/2022 10:39:53 PM

I also agree with DR Saville , but I doubt any state govt would do it, they will just expect us to bulk bill ,with the after 8pm loading , having nearly 15 yrs of rural and remote GP experience at 7 yr of ED experience I would love to do it BUT i do expect to be treated as an equal to other specialists

Dr Karin Hage   1/09/2022 12:01:45 PM

I worked in Fast Track clinics for a while. Same idea. Lots of inappropriate presentations. Asking for scripts, presentations needing follow up but patients don't have a GP, cant / won't pay to see one. Certificate for work, drivers license, you get the picture. More fragmentation and undermines our push for Private Billing. I cant understand why the college supports that.

Dr Benjamin Weiss   3/09/2022 7:40:15 AM

Where are we going to get the GPs to run these centres?Wouldn't it be cheaper to increase the bulk billing rebate and encourage doctors to work full time as most of my colleges now only work part time.At least 5 GPS i know are retiring this year.Will all the new GPS to run these clinics come from overseas and will they need to do the GP training courses or will they act as administrative nurses telling patients where to go to obtain appropriate treatment.Train more doctors and make it more attractive for them to consider general practice rather than highly overpaid paid specialists.More trained GPs could be added to existing clinics and and there would would be no need too waste more funding for theses super clinics.

SD   3/09/2022 9:42:35 AM

The future clinics could advise patients that these clinics are not for:
- continuation scripts
- med certificates
- driving medicals
- referrals
- STI checks
- Chronic disease management plans
-Mental health plans
- Pain management
- Routine bloods
- skin checks or biopsies
- etc etc
Otherwise it will not ease of ED burden but share GP workload only
The other issue is that most presentations to urgent clinics will likely be 36, 44 or longer which risks falling out of Bell’s curve and Medicare audit.

Dr Susan Margaret McDonald   4/09/2022 6:44:41 PM

Good Luck getting doctors. They will need to be paid at ED rates at least double what they get now with benefits like superannuation.
I am 73 and will not work in this rotten system any longer. I feel nauseous every time I go to work. Lousy pay, no succession plan possible, no practice manager and rotating reception. Not to mention the ridiculous time waster of Q script and now the onerous CPD being forced on GP's who are learning everyday. I have a full list of patients and nowhere for them to go. It's a sad end to a 50 year career!
It's NO LONGER MY PROBLEM GOVERNMENT WILL NOT LISTEN and I am retiring at the end of the year an our practice could well close.

Dr Bilal Ali Khan   15/09/2022 8:50:37 PM

Goodluck getting quality doctors to staff these unless they are paid a good hourly rate or a rate on top of medicare billing.

Dr Paul   19/01/2023 12:56:42 AM

The government and general public need to understand and recognise GPs for what they are - qualified medical specialists who work in a community setting providing a critical medical service to the general public. The government keeps coming up with new strategies to replace GPs and/or ignore their importance (eg. getting more overseas doctors, nurses, nurse practitioners, physiotherapists or podiatrists etc) but fact of the matter is the patients who simply can’t afford the gap fee just want to access a regular doctor. Their last resort is attending ED. The governments solution at current - run your small business like a charity and go out of business. GPs save the health system an incredible amount of money through early diagnosis/treatment/early referral. Just because the health system is haemorrhaging money through the hospital system (the great sinkhole), this doesn’t mean that other cost-saving facets of the medical system (such as general practice) should be ignored.