RACGP seeks member feedback on Standards

Morgan Liotta

16/02/2021 4:54:18 PM

Does the current definition of a general practice reflect all contemporary general practices? The college is asking GPs to have their say.

GP on the phone while using a tablet
If a change to the current definition of general practice results from the consultation, it could be an opportunity to ‘open accreditation to new, innovative models of care’.

The RACGP Expert Committee – Standards for General Practices (REC–SGP) is consulting with the profession on whether it needs to update its definition of a general practice for the purpose of accreditation.
From now until 1 April, the REC–SGP is seeking clarity on whether the definition is reflective of all contemporary general practices, and if its current form is ‘fit for purpose’ or requires an update to better reflect how general practice services are currently delivered in the community.
Associate Professor Carl de Wet, Deputy Chair of the REC–SGP, told newsGP this is a significant consultation, given the outcomes could lead to a change in the definition, broaden the availability of accreditation to different models of general practice, and potentially have implications on Services Australia’s Practice Incentives Program (PIP) for general practice.
‘Accreditation is directly tied to the PIP – a practice has to be accredited against our Standards for general practices [the Standards] in order to access PIP,’ he said.
‘Having a definition is the only way to reliably and consistently identify if a healthcare organisation is a general practice eligible for accreditation against the Standards.
‘Without a definition, specialist services that do not typically provide predominantly general practice services could have access to PIP, which should be reserved for general practice.’
For healthcare services identified as general practices eligible for accreditation against the Standards, there are three key considerations:

  1. Can the service demonstrate each of the characteristics that define the speciality of general practice?
  2. Are the services provided predominantly of a general practice nature?
  3. Does the service operate within a safety and quality model that meets peer expectations, ie is it capable of meeting all mandatory Indicators in the Standards?
 Reliable identification of these three points forms the purpose of the consultation, as the Standards set out the current definition that all primary healthcare organisations must meet in full before they are considered eligible for general practice accreditation.
The REC–SGP also receives feedback from members whose services are excluded from accreditation because the business model does not meet the current definition. These include outreach general practice services, residential aged care facilities, telehealth-only services and specialised clinics.
Although they may provide general practice services, these services are often unable to meet all the existing mandatory indicators within the Standards, as per the current third requirement of the definition.
‘For instance, a service that operates entirely remotely doesn’t have physical premises and so is unable to meet several mandatory Indicators surrounding practice facilities,’ Associate Professor de Wet said.
‘In other cases, we have GPs questioning whether their model that services a specific patient demographic – such as aged care service only – should have access to accreditation.’
The REC–SGP also outlines that most specialised services have a limited ability to provide whole-of-person care, meaning they do not predominantly provide general practice services, as per the current second requirement of the definition.
These health services are therefore unable to currently seek accreditation or access additional supports and payments via PIP.
Issues such as these prompted the rollout of the consultation, Associate Professor de Wet said.
‘We want to take a closer look at these services, and learn what other barriers the definition puts in front of contemporary general practice models,’ he said.
‘The consultation is a way for us to explore the extent of such barriers and to collect ideas on how the definition might be updated so accreditation is more accessible to those offering safe and quality services in the community.’
Associate Professor de Wet said the REC–SGP is exploring to what extent there are health services who want to be accredited, but are excluded by the Standards’ definition – and the consultation will inform whether or not the RACGP will consider a change to the definition.
‘If a change happens, we hope it’s an opportunity to open accreditation to new, innovative models of care that are still general practice for all intents and purposes,’ he said.

‘The consultation paper acknowledges that any changes made to the definition may have implications on PIP; however, the full extent of such implications is something we will explore further with the Department of Health.
‘We really encourage all members or practice staff involved in accreditation, or those who want to be, to respond to this consultation and provide their thoughts.
‘From a community perspective, it is as much about highlighting the providers of safe and quality general practice services who should be recognised for their work.’
This consultation is only about the definition of a general practice as it applied to accreditation – it does not include the definition of the specialty of general practice.
The REC–SGP consultation is open for members from 16 February – 1 April via the RACGP website.
The consultation paper is available for review on the RACGP website.
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