RACGP position
The Royal Australian College of General Practitioners (RACGP) develops the RACGP Standards for general practices (the Standards). The Standards are developed by the profession, for the profession and facilitate safe and quality practices to promote high quality care and support patient health outcomes - an appropriate accreditation model should seek to build on this.
The RACGP:
- considers that the peer surveyor model is paramount to continue to foster genuine collaboration and sharing of expertise amongst peers
- believes that accreditation must be voluntary
The RACGP recommends that any new model must ensure that accreditation surveyors have:
- the necessary understanding of, and recent experience in, general practice to effectively assess practices against the Standards
- completed the appropriate training and maintain their competence demonstrating their knowledge of the Standards
- demonstrated that they participate in and meet the requirements for quality assurance and continuous quality improvement.
Background
The Australian Commission on Safety and Quality in Health Care (ACSQHC) released a consultation paper - General Practice Accreditation Scheme – June 2015 1 (the Paper) outlining a proposed model for general practice accreditation to support national coordination of the processes for accreditation of general practices.
This document defines the RACGP Guiding Principles and Surveyor Team Requirements for a profession led model of accreditation for general practice. The RACGP recognises that there were a number of concerns identified with the current model in the Australian National Audit Office’s Report2 (the ANAO Report). The ANAO report identified a number of recommendations including a review of the accreditation governance arrangements and the quality of general practice accreditation more broadly.
The RACGP is committed to ensuring that the ANAO recommendations are addressed with minimal imposition placed on general practices. The RACGP is concerned that the current model described in the Paper may overstep those recommendations through introducing the potential for greater Government control in the accreditation space. In addition, the Paper suggests that accrediting agencies will ‘provide data on general practice accreditation outcomes,’ and ‘comply with agreed reporting timeframes and processes.’ The Paper also states that ‘general practice demographic data, accreditation status and safety and quality information (if collected)’ will be able to be accessed by the Department of Health and the ACSQHC.
The RACGP is concerned that these requirements, seeking greater Government control and the provision of data to the Department of Health, will reduce support from the profession for the Standards and accreditation overall. There are also concerns that greater Government oversight will lead to increasing the burden on practices undertaking accreditation through introducing additional reporting requirements.
The RACGP would seek to ensure that any new accreditation model would reduce costs, or at least be cost neutral for practices. This is because general practices frequently cite accreditation costs as a barrier to undertaking accreditation.
In recognition of the RACGP’s position as the peak professional body for general practice, the RACGP has developed a number of Guiding Principles and Surveyor Team Requirements in order to inform the appropriate development of a future general practice accreditation model.
Guiding Principles
The RACGP recommends that Guiding Principles must be demonstrated by accrediting agencies seeking to accredit general practices against the RACGP Standards for general practices. These Guiding Principles require accrediting bodies to demonstrate:
- an in depth understanding of:
- the Standards
- the nature of general practice in Australia
- requirements for training and vocational registration of GPs
- the capacity to efficiently accredit general practices across Australia
- a governance and advisory structure that includes GPs with considerable experience in general practice, and
- that applications from any practice that meets the RACGP definition of a general practice (regardless of location or size) will not be financially or otherwise discriminated against, or refused accreditation because of size or remoteness.
Surveyor Team Requirements
In addition to the Guiding Principles, the RACGP requires that:
- surveyor teams include at least two surveyors, of which one must be an appropriately qualified, trained and approved GP surveyor
- all surveyors must demonstrate a good understanding of confidentiality issues relating to general practice and personal health information and patient privacy
- GP and non-GP surveyors meet previous and recent experience requirements prior to being permitted to conduct survey visits
- GP surveyors shall be a vocationally registered GP and from 1 January 2016 all new surveyors will hold general practice Fellowship
- GP surveyors have at least five years full time or equivalent part time experience as a vocationally registered GP or Fellow, working as a GP in a practice (defined as a general practice for the purposes of accreditation by the RACGP), including recent experience in active general practice within the last two years. Active general practice is defined as working for at least two session a week in face-to-face patient contact in an accredited general practice
- GP surveyors participate in, and meet College requirements for quality assurance and continuing medical education
- all surveyors complete appropriate training and maintain their competence demonstrating their knowledge of the Standards.
Conclusion
RACGP considers that any future accreditation model must retain the GP peer surveyor model as this is paramount to fostering genuine collaboration and sharing of experience amongst peers. Adoption of the Guiding Principles and Surveyor Team Requirements, it would support increased rigour and accountability of the general practice accreditation model now and into the future.