- 23 June 2017
Medicare Benefits Schedule (MBS) Review Taskforce – Reports from clinical committees and working groups – June 2017
The MBS Review Taskforce released six reports for public consultation – recommendations in the reports may affect you, your practice and your patients.
The reports released for public consultation included:
To inform the RACGP’s Submission to the MBS Review Taskforce on each of these reports, we called for member feedback on the recommendations, focussing on:
Diagnostic Imaging – knee imaging
Urgent after-hours primary care services funded by the MBS
Dermatology, Allergy and Immunology
- Recommendations 5.2, 5.3, 5.4, 5.5, 5.8, 5.10
In April 2015, the Department of Health announced the formation of the Medicare Benefits Schedule (MBS) Review Taskforce as part of the Government’s Healthier Medicare initiative. The 2017-18 Federal Budget allocated funding for the MBS Review Taskforce to continue for another three years until 2020.
- 27 April 2017
2017 update of the RACGP’s MBS fee summary
The Medicare Benefits Schedule (MBS) currently contains more than 5700 items, is 903 pages long and outlines all Medicare item numbers for GPs, other medical specialists and other health practitioners.
Our MBS fee summary provides members with a quick and easy guide to the item numbers relevant to general practice. We update this widely used resource annually to reflect changes to the MBS.
To produce an updated MBS fee summary that meets your needs, we are calling for feedback and suggestions for the 2017 edition. We invite you to comment on the following areas:
- additions, removals or amendments to the items listed in the 2016 MBS fee summary
- additional content not previously included in the MBS fee summary (eg DVA rebates)
- format of the 2017 version (hard copy, electronic, etc)
- additional MBS resources (eg poster versions, one page reference sheet, etc)
- general feedback on the MBS fee summary (order, layout, etc)
Changes made to the MBS since the release of the 2016 version will be incorporated into this update, including updates to skin service and wrist and finger fracture items. Medicare’s 1 May 2017 updates will also be incorporated into this version before it is finalised if relevant to general practice.
- 8 February 2017
In 2016, a Senate inquiry was conducted into the medical complaints process in Australia, focused on the prevalence, reporting and processing of bullying and harassment complaints in the medical profession. During the consultation a number of concerns were raised regarding administration and implementation of the complaints process. The Senate Committee recommended that a new inquiry be established to focus on the process itself, rather than the ways in which the process can be used and misused.
The focus of the current inquiry:
The Senate Community Affairs References Committee (the Committee) have announced a new inquiry looking into the complaints mechanism administered under the Health Practitioner Regulation National Law. The inquiry will address the following matters:
the implementation of the current complaints system under the National Law, including the role of the Australian Health Practitioner Regulation Authority (AHPRA) and the National Boards;
whether the existing regulatory framework, established by the National Law, contains adequate provision for addressing medical complaints;
the roles of AHPRA, the National Boards and professional organisations, such as the various Colleges, in addressing concerns within the medical profession with the complaints process;
the adequacy of the relationships between those bodies responsible for handling complaints;
whether amendments to the National Law, in relation to the complaints handling process, are required; and
other improvements that could assist in a fairer, quicker and more effective medical complaints process.
The new inquiry focusses on the complaints mechanism more broadly - including how patient complaints are managed.
The RACGP sought feedback from members with experience surrounding the complaints mechanism and processes, particularly regarding the matters identified by the Committee above. The feedback and suggestions will help to inform the RACGP submission to the Committee’s inquiry.
- 11 January 2017
National Digital Health Strategy Consultation
The Australian Digital Health Agency (the Agency) has recently released the National Digital Health Strategy Consultation. The findings from this consultation will be used by the Agency to identify new ways to deliver more effective and efficient health and care, and guide the development of a national digital health strategy for delivery to Government in 2017.
The RACGP is seeking your feedback on the discussion paper Your health. Your say. Shaping the future of health and care together to inform our response to the consultation.
The RACGP is also seeking feedback on the questions in the Agency’s survey:
- What aspects of healthcare currently work well from your perspective?
- What aspects of healthcare need improvement?
- For the aspects of healthcare that you consider need improvement, what do you think are the barriers to improving performance in this area?
- What does 'being in control of your healthcare' mean to you?
- To what extent do you agree with the following statement:
Digital technology will transform and improve healthcare outcomes for Australia
- Strongly Agree
- Strongly Disagree
- How would you like to see digital technologies change peoples’ experiences of managing their health, and the way they interact with the healthcare system?
- What gets in the way of health professionals being able to connect, communicate and coordinate with the right people?
- What do health professionals need to be able to effectively connect, communicate and coordinate with the right people?
- How could data and technology be better used to improve health and wellbeing?
- What are the barriers or obstacles to innovation in health and care?
- What opportunities would you prioritise in respect to innovation in health and care?
- What should be the immediate priority initiative for the My Health Record to ensure it delivers real value for clinicians and the public?
Please provide your feedback to firstname.lastname@example.org
The RACGP consultation period closes 12 pm AEDT Wednesday 11 January 2017.
- 16 December 2016
Use of secure electronic communications
Patients are required to interact with multiple healthcare professionals or organisations in different physical locations. In order to provide high quality, effective and safe healthcare, there has to be efficient communication between general practitioners and other healthcare providers involved in a patient’s care. Secure electronic communication is currently one of the most efficient methods of communication.
The RACGP would like to see the elimination of paper forms in general practice within three years. There are however a range of concerns that members may have with the increased use of electronic forms. In September 2016, the RACGP released a position statement: The use of secure electronic communication within the health care system. This outlines support for the following principles for electronic communication between general practice and other healthcare agencies:
- all electronic communications templates and systems should use existing data and information from general practice clinical information systems to pre-populate documents and forms
- all communications should be
- created and sent from within the general practice’s electronic clinical software system and
- automatically received into the local patient electronic health record via the clinical software system inbox
- all electronic communications to external healthcare providers and agencies should be sent securely using secure messaging to align with best practice data privacy handling principles to protect patient privacy and confidentiality.
The RACGP sought feedback on what challenges you face in increased use of two-way secure electronic communication; completing forms for corporate and government agencies, as well as your reasons for using electronic forms.
Results from this consultation were published in In Practice on 16 December 2016.
- 9 November 2016
Redesigning the Practice Incentives Program
In the 2016-17 Federal Budget, the Australian Government announced a review of the Practice Incentives Program (PIP). The Department of Health has released a consultation paper on Redesigning the Practice Incentives Program and is seeking stakeholder feedback on the redesign.
The stated intention of the redesign is to reduce the administrative burden associated with multiple PIP payments and move towards a streamlined and simplified system. The redesign will introduce a Quality Improvement Incentive to replace 7 of the 11 incentives in the current PIP. It is anticipated that funds available through the redesigned PIP will remain unchanged from current levels. The After-hours, eHealth, Rural Loading and Teaching incentives will not be affected by the PIP redesign.
The RACGP is seeking your feedback on a number of key questions raised in the consultation paper. In addition to the questions raised in the paper, the RACGP is also seeking your feedback on the two preliminary redesign options outlined on page 15 – 16 of the consultation paper.
The RACGP consultation period closes on Wednesday 9 November 2016.
The Consultation paper raises the following key questions:
What are the strengths of the current PIP?
How has the PIP influenced your quality improvement work to date?
What elements of the current PIP should be kept and which should change?
What aspects of the current PIP can be improved through better use of technology?
What is the best way to ensure the PIP funds meet the principle for efficient, effective and economical and ethical use of public money?
How would we ensure that the needs of Aboriginal and Torres Strait Islander people are considered and continue to be met under a redesigned PIP?
Would you participate in a patient focussed quality improvement PIP incentive?
What are the key aspects of quality improvement that should be captured in a redesign of the PIP?
Would you like to provide an example of a quality Practice improvement incentive payment as outlined?
Do you support the use of collated regional data for population health and planning purposes?
Do you have any suggestions to improve the proposed Quality Improvement Incentive payment?
- 30 October 2016
5th edition Standards: Patient Feedback Guide
The RACGP is currently developing the 5th edition of the Standards for general practices (the Standards), to be released in October 2017.
Feedback from stakeholders and practices on patient feedback in 4th edition Standards indicates that the requirements are too prescriptive and focus on the process for collecting the feedback rather than the outcome.
As a result of the feedback received and the move to more outcomes focused Indicators in the 5th edition Standards, the requirements relating to patient feedback have been modified to provide increased flexibility for practices in how they undertake patient feedback.
Criterion QI1.2 – Patient Feedback in the draft 5th edition Standards contains the following three mandatory Indicators:
► A. Our practice seeks feedback from patients, carers and other relevant parties in accordance with the RACGP Patient Feedback Guide: learning from our patients (the Patient Feedback Guide).
► B. Our practice can demonstrate how we have analysed and responded to feedback and considered feedback for quality improvement
► C. Our practice promotes how we have responded to feedback and used feedback for quality improvements.
The above Indicators focus on the importance of:
- collecting the feedback
- analysing the feedback
- using the feedback for quality improvement purposes.
In order to reflect the requirements of the Indicators in the 5th edition Standards, the Patient Feedback Guide has been revised and updated.
The RACGP will consider all feedback received to inform the next draft of the Patient Feedback Guide. The Patient Feedback Guide will be released with the 5th edition Standards in October 2017. For more information on the development of the 5th edition Standards visit the Standards development page.
- 31 October 2016
Responding to financial pressures with new business models and billing practices
As highlighted in September’s Good Practice, GPs and their practices are looking at their financial bottom line to determine how they can remain viable in response to the Medicare freeze. Many practices are adapting to the landscape by shifting billing models, and introducing copayments and other fees so that they can combat financial pressures and continue to provide quality general practice services to their patients.
The RACGP is looking to prepare case studies of GPs and practices adapting to inform members of what their peers are doing. We invited members to answer our poll below and provide information regarding any models or approaches their practice has implemented (successful or otherwise).
Respondents were asked to comment on:
- the triggers that made you contemplate change
- the obstacles you faced, and whether/how these were overcome
- patient reactions to change
- how you assessed success
- what made your plan effective, or otherwise.
- 7 October 2016
Putting prevention into practice: guidelines for the implementation of prevention in the general practice setting (the Green book).
The RACGP is developing a new edition of the Green book. The Green book is the companion to the RACGP Guidelines for preventive activities in general practice (the Red book), and is designed to be a practice resource to strengthen prevention activities in general practice.
To ensure the Green book is useful and relevant to the profession, we invited members to provide feedback and suggestions on the 2nd edition available from the RACGP website: http://www.racgp.org.au/your-practice/guidelines/greenbook/
- 30 September 2016
Development of the RACGP Standards for general practices (5th edition)
The 4th edition of the RACGP Standards for general practices (the Standards) was released in October 2010. The RACGP is now developing the 5th edition Standards which will be launched in October 2017.
The second draft of the 5th edition Standards is now available for review. The second draft has been developed by the RACGP Expert Committee - Standards for General Practices and has been informed by:
- stakeholder feedback from two consultation phases
- results of the small scale pilot
- available evidence
- comparable national and international primary care standards.
- 7 October 2016
Patient referrals to other medical specialists
The RACGP is exploring a number of matters in relation to patient referrals to other medical specialists.
Previously, the RACGP developed Referring to other medical specialists: A guide for ensuring good referral outcomes for your patientsfor members. This guide addresses referrals from GPs to other medical specialists and covers:
- types of referrals and suggested wording
- the use of indefinite referrals
- good practice for referral content.
The guide is intended to improve professional relationships between GPs and other medical specialists. While it provides advice on referrals by GPs to specialists, it does not address how other medical specialists manage GP referrals.
Some of the issues currently being considered by the RACGP and identified in recent commentary include other medical specialists:
- asking for a new referral for a patient with the same ongoing problem every 12 months
- at times not acknowledging or responding to referrals from GPs
- at times not accepting indefinite or timed referrals from GPs other than 12 months
- inconsistently communicating with the referring GP about any referrals to other specialists.
In this consultation, the RACGP sought member feedback on these issues and any additional experiences relating to how other medical specialists’ have handled your referrals. Feedback will inform our advocacy on behalf of GPs on these issues.
- 22 September 2016
The Medicare Benefits Schedule (MBS) Review Taskforce: Reports by Clinical Committees
In April 2015, the Department of Health announced the formation of the Medicare Benefits Schedule (MBS) Review Taskforce as part of the Government’s Healthier Medicare initiative. The Taskforce is reviewing the MBS in its entirety, considering individual items as well as the rules and legislation governing their application.
The first review from the MBS Review Taskforce was released at the end of 2015, with 23 items removed from the MBS.
An Interim Report to the Minister for Health was released on 6 September 2016.
The MBS Review Taskforce’s Clinical Committees released six Clinical Committee reports and the First Report of the MBS Principles and Rules Committee for public consultation.
The reports released for public consultation include:
- First report of the MBS Principles and Rules Committee
- Report from the Gastroenterology Clinical Committee
- Report from the Obstetrics Clinical Committee
- First report from the Diagnostic Imaging Clinical Committee – Low Back Pain
- Second report from the Diagnostic Imaging Clinical Committee – Bone Densitometry
- Report from the Thoracic Medicine Clinical Committee
- First report of the Ear, Nose and Throat Surgery Clinical Committee on Tonsillectomy, Adenoidectomy & Insertion of Grommets
The MBS Review Taskforce called on health professionals to have their say about the recommendations proposed by the Clinical Committees, prior to consideration by the MBS Taskforce and subsequent recommendations being made to Government.
In order to inform the RACGP’s Submission to the MBS Review Taskforce on each of these reports, we called on member feedback on the recommendations made within each.
- 27 May 2016
Extension of freeze on MBS patient rebates - tell us how it will affect you and your practice
On 3 May 2016, as part of its 2016–17 Federal Budget, the federal government announced an extension of the freeze on the Medicare Benefits Schedule (MBS) for a further two years until 30 June 2020.
The extension of the MBS freeze will have significant implications on the affordability of vital health services and the overall sustainability of general practice. There is now an even greater likelihood of reduced access for patients and higher out of pocket costs, as GPs strive to maintain viable practices.
In 2015, the RACGP surveyed members on how the freeze was affecting patient services, with the majority of respondents saying they would be forced to pass increased out-of-pocket expenses onto patients.
The continued freeze and its extension until 2020 demonstrates the federal government’s sustained efforts to ignore and devalue GPs and the crucial services provided by general practices.
The RACGP will increase advocacy efforts to have the indexation freeze lifted. To assist us with our efforts, we asked to hear your stories and examples of how the freeze is impacting you, your patients and your community and how you and your practice will adapt.
The RACGP thanks all respondents for their feedback. We will use this information in continued advocacy efforts for appropriate indexation of Medicare rebates.
The RACGP’s You’ve been targeted campaign includes further information for both GPs and patients on how the freeze will affect them, including fact sheets, posters and letters to send to local candidates.
- 6 April 2016
Medical complaints processing in Australia
The RACGP is preparing a submission to the Senate Community Affairs References Committee, who are conducting an inquiry into medical complaints processing in Australia .
The Terms of Reference of the Committee are as follows:
- the prevalence of bullying and harassment in Australia’s medical profession;
- any barriers, whether real or perceived, to medical practitioners reporting bullying and harassment;
- the roles of the Medical Board of Australia, the Australian Health Practitioners Regulation Agency and other relevant organisations in managing investigations into the professional conduct (including allegations of bullying and harassment), performance or health of a registered medical practitioner or student;
- the operation of the Health Practitioners Regulation National Law Act 2009 (the National Law), particularly as it relates to the complaints handling process;
- whether the National Registration and Accreditation Scheme, established under the National Law, results in better health outcomes for patients, and supports a world-class standard of medical care in Australia;
- the benefits of ‘benchmarking’ complaints about complication rates of particular medical practitioners against complication rates for the same procedure against other similarly qualified and experienced medical practitioners when assessing complaints;
- the desirability of requiring complainants to sign a declaration that their complaint is being made in good faith; and
- any related matters.
The RACGP is seeking your feedback regarding the medical complaints handling process in Australia, including any further information you feel is relevant to this inquiry.
All comments and feedback received will be treated confidentially.
Further information regarding this inquiry can be accessed from: http://www.aph.gov.au/ Parliamentary_Business/ Committees/ Senate/ Community_Affairs/ Medical_Complaints
- 21 March 2016
New MBS Proposal – Fibroscan for the diagnosis of liver fibrosis in patients with hepatitis B or C
The Medical Services Advisory Committee (MSAC) are considering an application for a new MBS item using Transient Elastography (TE, known by its trade name, Fibroscan) for the diagnosis of liver fibrosis in patients with chronic hepatitis B or hepatitis C.
The RACGP are seeking member views and feedback to assist us in developing a response. Specifically, MSAC are seeking feedback on:
- The clinical utility of Fibroscan for patients with hepatitis C or hepatitis B
- The diagnostic information offered by Fibroscan compared to the information provided through other currently available tests. For example, what benefits does Fibroscan offer over other existing diagnostic services? Does the use of Fibroscan change treatment options/regimes for patients?
- Dissemination of the service into gastroenterology and GP practices. Is this service currently offered? And if so, in what type of practices? Would an MBS rebate affect uptake for this service?
The Final Protocol to guide the assessment of transient elastography at 50Hz for the diagnosis of liver fibrosis in patients with hepatitis B or C can be viewed below:
- 1 Apr 2016
Development of the 5th edition Standards for general practices
The Royal Australian College of General Practitioners (RACGP) develops the RACGP Standards for general practices (the Standards). The Standards are designed as a template for quality care and risk management in Australian general practice as well as a framework for good practice in the ongoing operation of a general practice.
The RACGP has now concluded its Second Consultation Phase for the 5th edition Standards for general practices . In this Phase, the RACGP sought the views of stakeholders regarding the first draft of the Standards.
It is important to note that this first draft of the 5th edition Standards is a working draft. There will be further revisions to successive drafts of the Standards based on feedback received which will be released for stakeholder feedback prior to the release of the 5th edition Standards in October 2017.
Updates and information on the development of the 5th edition Standards are available on the Standards Development page .
- 18 March 2016
Emerging after-hours services in Australia
The number of Medical Deputising Services (MDS) and dedicated after-hours services operating across Australia have increased significantly in recent years. It appears that the increase in the number of MDS and after-hours services has been driven by a number of factors:
- Medicare Locals administering after-hours funding in 2012 and subsequent changes to the RACGP Standards, allowing GPs to opt out of providing and/or organising 24/7 patient care
- difficulties in attracting GPs to work unsociable hours and difficulties in securing appropriate support and financial incentives
- other factors impacting the sustainability and viability of general practice (rebate freeze, inadequate support).
General practice has a long history of working with after-hours services. However, there have recently been concerns raised by RACGP Members regarding some after-hours services currently operating across Australia.
To date, particular concerns raised by RACGP Members include:
- fragmentation of care when there is no link to an established GP or practice
- the lack of infrastructure within some of these services which does not support the provision of quality care
- the aggressive approach to advertising that some services undertake, highlighting an entrepreneurial type of business model (making these services more appealing to patients)
- the increase in the use of after-hours patient rebates, and urgent after-hours items.
The RACGP Expert Committee – General Practice Advocacy and Funding (REC-GPAF) is currently considering the impacts of after-hours services on the provision of quality primary healthcare after-hours services in Australia.
To progress this work the REC-GPAF is seeking feedback regarding these types of services from the broader RACGP Membership.
All comments and feedback received will be used to ensure the RACGP is best placed to represent the views of the profession in its future advocacy work.
* Citations available upon request
- 9 March 2016
Draft Clinical Management Guidelines for the Prevention of Cervical Cancer – seeking member feedback
The RACGP is seeking feedback on Cancer Council Australia’s Draft clinical management guidelines for the prevention of cervical cancer . These guidelines will supersede the NHMRC approved 2005 Guidelines Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen-detected abnormalities .
The draft Guidelines can be accessed at wiki.cancer.org.au/australia/Guidelines:Cervical_cancer/Prevention
With the change to primary HPV testing it was necessary and timely to review the 2005 Guidelines and to consider recent evidence to formulate guidelines that are relevant to primary HPV testing and triage using liquid-based cytology. The guidelines aim to assist women and health professionals to achieve best outcomes in clinical management of women with screen-detected cervical abnormalities.
The Guidelines were commissioned by the Department of Health to support the renewed National Cervical Screening Program coming into effect on 1 May 2017. Larissa Roeske is on the Guidelines committee and Amanda McBride is the RACGP Rep on the steering committee for the National Cervical Screening Program.
- 2 Mar 2016
Senate Community Affairs References Committee Inquiry into the aged care sector workforce - Seeking member feedback
The RACGP is preparing a submission to the Senate Community Affairs References Committee , who are conducting an inquiry into the future of Australia’s aged care sector workforce.
The submission will draw on previous RACGP work on this topic, including a submission to the Select Committee on Health .
The RACGP has sought feedback on the Committee’s terms of reference (below) and the challenges for GPs of working in residential aged care facilities or in aged care more generally.
Inquiry into the future of Australia’s aged care sector workforce
Terms of reference:
- the current composition of the aged care workforce;
- future aged care workforce requirements, including the impacts of sector growth, changes in how care is delivered, and increasing competition for workers;
- the interaction of aged care workforce needs with employment by the broader community services sector, including workforce needs in disability, health and other areas, and increased employment as the National Disability Insurance Scheme rolls out;
- challenges in attracting and retaining aged care workers;
- factors impacting aged care workers, including remuneration, working environment, staffing ratios, education and training, skills development and career paths;
- the role and regulation of registered training organisations, including work placements, and the quality and consistency of qualifications awarded;
- government policies at the state, territory and Commonwealth level which have a significant impact on the aged care workforce;
- relevant parallels or strategies in an international context;
- the role of government in providing a coordinated strategic approach for the sector;
- challenges of creating a culturally competent and inclusive aged care workforce to cater for the different care needs of Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups and lesbian, gay, bisexual, transgender and intersex people;
- the particular aged care workforce challenges in regional towns and remote communities;
- impact of the Government’s cuts to the Aged Care Workforce Fund; and
- any other related matters.
Note: The findings from RACGP Rural survey of National Rural Faculty members in February 2016 will be included in the RACGP’s submission to this inquiry.
- 22 Jan 2016
Medicare Benefits Schedule (MBS) Review Taskforce on obsolete Medicare items (Tranche #1)
The RACGP provided comment on the first round of recommendations from MBS Review Taskforce Clinical Committees on items that they considered obsolete and should be removed from the MBS. The RACGP broadly supported the Clinical Committee recommendations and welcomed the inclusion of GPs on the committees. However, the RACGP is concerned that savings found from removing items from the MBS will not be reinvested into healthcare.
The submission can be viewed here .