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Putting prevention into practice (Green Book)

Improving access to services

3.20 Coordination

3.20.1 Improving access to services

Evidence suggests that socioeconomically disadvantaged patients can make effective use of preventive services if barriers to their participation are addressed. Consideration should be given to issues such as transport to and from services, carer responsibilities of participants, financial barriers, and language and cultural barriers. It may be easier to reach disadvantaged populations by working with community groups, a regional community or an indigenous health service that has already established effective communication and service. You could ask your division of general practice if they are already involved in such partnerships, or ask them to facilitate this development. You could review the flexibility of your appointment or billing systems. Does it allow for someone arriving late, being accomodated at the last minute or for an unplanned bulk-billed consultation?

Team Health Care II

Team Health Care II is a 3 year coordinated care trial investigating different ways of managing the health needs of people over 50 years of age, and over 30 years of age for indigenous people, with chronic and complex conditions. Focusing on intervention and prevention, the trial aims to improve the health and wellbeing for patients with chronic and complex conditions, improve communication and information exchange between general practice, hospitals and health service providers, reduce duplication of service provision, and prevent hospital admissions where appropriate.

Brisbane North Division of General Practice, Queensland

There are specific groups other than the socioeconomically disadvantaged that may experience barriers to accessing general practice services. It is well documented that youths between 15–24 years of age do not access services as often as other groups. People with physical, intellectual and mental disabilities also face barriers to accessing preventive services. Transport may not be easily accessible. People with communication difficulties may need longer to communicate their needs. GPs may have difficulties performing physical examinations and procedures with patients with certain disabilities.

Aboriginal and Torres Strait Islander peoples are a specific group whose morbidity and risk is significantly above the national average for certain diseases (see the National guide to a preventive health assessment in Aboriginal and Torres Strait Islander peoples).

Improving access and service delivery to disadvantaged groups

A 'street doctor' program. In December 2003, a division of general practice commenced a mobile, street based health service. The service is provided for people at risk such as young people, indigenous people, homeless people, people with diagnosed and undiagnosed mental illness, and injecting drug users. The mobile medical service aims to increase access to health care to meet the physical, mental and social needs of people in the area. The service operates in a local park and its success may be attributed to overwhelming public support, sponsorships, donations, and divisional commitment to the project. The mobile medical service is a free, visible, easily accessible, culturally appropriate and nonjudgmental mobile service for members of street based populations in the area. The mobile medical service provides flexible and local service at predetermined sites. Where possible, people are referred to certain GPs and other providers rather than being offered long term management of health issues. At last analysis, a total of 663 people had accessed the service and of those, 251 have gone on to consult a GP. A number of media outlets have printed newspaper and journal articles about the service, and the division is greatly appreciative of the widespread support it receives from the community.

Fremantle Regional GP Network, Western Australia



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