- 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 .