First released in 2015 and now revised, The Royal Australian College of General Practitioners’ (RACGP’s) Vision for general practice and a sustainable healthcare system (the Vision) outlines a model of care that aims to address many of Australia’s longstanding healthcare challenges. The Vision has been developed by specialist general practitioners (GPs) – the health professionals with the unique dual roles of providing whole-person care over time, and acting as facilitators for healthcare in the rest of the health system. Given these dual roles, GPs are ideally placed to understand where the current health system is failing to meet the health needs of all Australians and how it can be improved.
Australia’s population is ageing and complex, and chronic conditions, such as diabetes and mental health conditions, are becoming more prevalent. These conditions are long term, and require early identification and care that can be provided appropriately in the community. However, our current health system focuses on acute treatments and costly hospital care, rather than on chronic disease management or preventive care.
Healthcare costs for patients, providers and funders are increasing at above the rate of inflation. This is partly due to the misalignment between how the current healthcare system is structured and the type of care needed.
The Vision looks to ensure the sustainability of the healthcare system in the long term. General practice is the most efficient part of the healthcare system. The Vision therefore sees that a well-resourced general practice sector is essential to addressing the existing and future challenges facing patients, funders and providers.
The Vision places the patient at the centre of care, supported in the first instance by their regular GP and broader general practice team. GPs and their teams then connect their patients to, and guide them through, the often complex wider healthcare system.
The Vision is underpinned by six core features of high-performing general practice:
Patient centered
Continuous
Comprehensive
Coordinated
High-quality
Accessible
As well as identifying the features that underpin a high-performing system, the Vision identifies how these features can be better supported. It also demonstrates how existing financial support for general practice can be restructured to ensure that care is aligned to support high-performing general practice.
Existing general practice services must be better supported through:
- maintaining and modernising the fee-for-service system
- setting rebates that accurately reflect the cost of service provision by GPs and ensuring appropriate and regular indexation of rebates
- appropriately supporting the delivery of comprehensive general practice care
- increasing payments to practices to facilitate team-based general practice care
- facilitating genuine high-quality improvement activities in general practice
- increasing funding for GPs and practices to undertake teaching of medical students and general practice registrars, and introducing new funding to support teaching for all other members of the general practice team.
General practice can be further strengthened by:
- encouraging continuity of care for patients within their preferred practice via voluntary patient enrolment
- supporting the role of GPs and their teams in coordinating care with hospitals and other health and social services
- recognising increasing patient complexity by introducing a complexity loading payment to GPs and practices
- supporting general practice–based research
- supporting the collection and appropriate use of general practice data to strengthen the evidence about the effectiveness of primary care, and to provide better population planning
- supporting better use of health resources through improved information-sharing and regional coordination.
The Vision identifies how better use and support of general practice will bring about significant savings for the wider system by reducing the need for expensive secondary care. Enhanced support for general practice will also boost the overall productivity of the nation by ensuring Australians stay healthy and are able to fully participate in society and the workforce.
The Vision outlines the urgent need to restructure the healthcare system into one that provides the right care for patients at the right time and in the right place, and that is sustainably funded into the future.