Coronavirus (COVID-19) information for GPs

The Department of Health and Aged Care has released the National COVID-19 Health Management Plan for 2023. The plan sees several changes including implementing the requirement for a referral for PCR testing and scaling back of GP-led respiratory clinics. 
 

Access to PCR Testing

From 1 January 2023 PCR testing is only available by referral by a GP or nurse practitioner, or at a state testing site or GP-led respiratory clinic for priority populations.

The approach to testing is outlined in this explainer from the Department of Health and Aged Care and as per below.  

Low-risk population
Low risk people are encouraged to stay home when feeling sick. They should take a RAT if they have respiratory and/or other COVID-19 symptoms. If a positive COVID19 result is received, stay home where possible and if you must leave, wear a mask and avoid highrisk settings. Continue to monitor symptoms, and engage early with your primary care provider if symptoms worsen.

Low risk, with close contact to high-risk population
Low-risk people who live or work with people who are high risk, particularly for COVID-19, are encouraged to take a RAT if they have respiratory and/or other COVID-19 symptoms and stay home when feeling sick. If symptoms persist following a negative RAT, these people should get a PCR through a GP or normal referral pathway. People entering high-risk settings will be encouraged to continue to use RATs for screening and diagnosis to prevent further transmission.

High-risk population
People in high-risk populations who are at risk of severe COVID-19 and would benefit from antiviral treatments will be prioritised for PCR testing and engagement with primary care services. If you are at risk of severe COVID-19, you should consult with your primary care provider about your eligibility for antiviral treatments and create a plan to ensure fast access to treatment. Those at higher risk of severe COVID-19 include: older Australians, First Nations people, people with disability, people from culturally and linguistically diverse communities, people living in remote communities, people with complex underlying health conditions and the immunocompromised.

 

Exemption to the 12-month ‘Existing relationship’ telehealth rule for COVID-positive patients

Patients who test positive to COVID-19 on a PCR test or rapid antigen test (RAT) within the last seven days can access general telehealth consultations from any GP under normal MBS telehealth eligibility requirements. This means they do not need to have seen the GP providing the service or another health professional at the same practice in-person at least once in the last 12 months to access telehealth.

The Department of Health and Aged Care have confirmed that this exemption will be temporarily extended until 31 December 2023.

Exemption to the 12-month ‘Existing relationship’ telehealth rule for high risk people who suspect they have COVID-19 and who meet the PBS criteria for COVID-19 antiviral therapy

A temporary exemption from the established clinical relationship requirement for telehealth consultations is now place until 31 Marc 2023, for high risk people who suspect they have COVID-19 and who meet the PBS criteria for COVID-19 antiviral therapy to seek a request to a private pathologist for PCR test in relation to COVID-19.
 
The rule is defined as having had at least one face-to-face consultation with the GP, or another practitioner at the same practice, within the 12 months preceding the telehealth service.
 
Under these new arrangements, any GP or other medical practitioner (OMP) can provide a telehealth consultation to patients who meet all of the following criteria:

• Do not meet the established clinical relationship requirement
• Are eligible for PBS criteria for antiviral therapy
• Are experiencing acute respiratory symptoms
• Are seeking a request to a private pathologist for Polymerase Chain Reaction (PCR) testing in relation to COVID-19

These changes will enable high-risk patients to continue to have timely access to PCR testing over the summer period. 

GPs claiming the exemption are expected to record their justification in the context of their requirement to keep adequate and contemporaneous patient records.
 
Visit MBS Online for more information.
 

Change to notification advice for COVID antiviral treatment pathways in QLD, NSW, VIC and SA

Since mid-2022, Healthdirect Australia has assisted COVID-positive people in Queensland, New South Wales, Victoria and South Australia connect to their GP for antiviral treatment assessment and prescription.

Healthdirect notifies the consumer via text message to call their GP if they may be potentially eligible for antivirals, and to date has also notified their GP or GP-led respiratory clinic (GPRC) by secure messaging of the patient status. This secure message to GPs and GPRCs was followed up with a phone call.

From 1 January 2023, the follow up call will no longer be made. The secure messaging of the patient status will continue.  
 

Changes to GP-led respiratory clinics

While there has already been a scaling back of GP-led respiratory clinics (GPRCs) 78 GPRCs will continue to be funded until 28 February 2023. From March 2023 the GPRC model will move to a panel model for activation during emergencies.
 
The Department of Health and Aged Care (the Department) has advised that existing accredited general practices will be selected for the GPRC Panel (GPRCP) through an approach to market that has now been listed on the AusTender website. The below information has been provided by the Department in relation to the new GPRCP and lodging an application via AusTender. 
 

Overview of the GPRCP

• To ensure sufficient surge capacity is in place to respond to subsequent COVID-19 waves or any other future respiratory health emergencies, the GPRCP will be implemented from March 2023.
• Under this new panel arrangement, up to 150 existing, accredited primary care practices, which may include former GPRCs if they meet the standard criteria to participate, would be held in reserve to be activated as needed in response to the emergence of another COVID-19 wave or other major heath respiratory emergency.
• During periods of activation, GPRCP participants will be provided access to a new MBS Item (bulk-billed) for each respiratory consultation. Upon activation, they will also be eligible to claim a Practice Incentive Payment (PIP) equivalent to their PIP QI payment per 3-month period.
• Participating clinics will be able to provide their usual services through standard MBS Items while activated, they will not be constrained to only providing services under the GPRCP.

Key dates

AusTender Registration

1. Register on AusTender at  New User Registration: AusTender (tenders.gov.au)  -  AusTender is the Australian Government’s procurement information system.

2. Any queries or requests for technical or operational support can be directed to:

• AusTender Help Desk
• Telephone:  1300 651 698
• International:  +61 2 6215 1558
• Email:  tenders@finance.gov.au

3. The AusTender Help Desk is available between 9am and 5pm AEDT, Monday to Friday (excluding ACT and national public holidays).
    

Lodging a response

1. Once registered, navigate to Current ATM View - Health/23/325151: AusTender (tenders.gov.au) – here you will find a link to the ‘ATM Documents’ and ‘Lodgement Page’
2. Tenders must be lodged electronically via AusTender before the Closing Time (AEDT)
3. If Tenderers need to lodge material that cannot be submitted via AusTender, Tenderers should contact the Contact Officer at email GPRC@health.gov.au prior to Closing Time to make arrangements for its submission. 
4. Where a Tender lodgement consists of multiple uploads, due to the number and/or size of the files, Tenderers must ensure that transmission of all files is completed and receipted before the Closing Time and clause 9.4 will only apply to the final upload.
5. The Department will accept Tenders lodged in Microsoft Word 2003 (or above), or PDF format
6. The Tender file name/s should:

• incorporate the Tenderer’s company name; and
• reflect the various parts of the bid they represent, where the Tender comprises multiple files.
• Tender response files should not exceed a combined file size of 5 megabytes per upload.
• Tenders must be completely self-contained.  No hyperlinked or other material may be incorporated by reference. 

RACGP resources to support care of COVID-19 positive patients

National COVID-19 Clinical Evidence Taskforce resources

The National COVID-19 Clinical Evidence Taskforce, of which the RACGP is a collaborating partner, has living guidelines, FAQs, and clinical flowcharts and decision tools to support the management of people with COVID-19.
 

Prescribing Paxlovid and Lagevrio via the PBS

The RACGP has developed resources to support GPs safely prescribe these treatments including a prescribing workflow that aims to support GPs and practices to carry out patient suitability assessments for COVID-19 oral treatments in advance of a patient testing positive to COVID-19, to expedite access to these treatments in the event the patient contracts COVID-19.
 

Eligibility criteria

Adults who have mild to moderate COVID-19 (confirmed by a PCR or medically verified RAT) and who can start treatment within five days of symptom onset, are eligible to be prescribed oral antiviral treatments if:

• they are 70 years of age or older*
• they are 50 years of age or older with two other risk factors for severe disease
• they identify as Aboriginal or Torres Strait Islander origin, and are 30 years of age or older with one other risk factor for severe disease; or
• they are 18 years of age or older and moderately to severely immunocompromised.

National Clinical Evidence Taskforce recommendations

Evusheld

Evusheld (tixagevimab and cilgavimab) has been provisionally approved by the TGA  for the prevention of COVID-19 in people who are at risk of infection but have not been exposed to the virus (pre-exposure prevention of COVID-19).

Provisional approval has been granted for pre-exposure prophylaxis of COVID-19 in people aged 12 years and older weighing at least 40 kg:

• who have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments that make it likely that they will not mount an adequate immune response to COVID-19 vaccination; or
• for whom vaccination is not recommended due to a history of severe adverse reaction to a COVID‐19 vaccine or COVID‐19 vaccine component.

Evusheld is not currently listed on the Pharmaceutical Benefits Scheme (PBS). Evusheld is distributed via the National Medical Stockpile to state and territory governments. Information on access to this medicine can be found via each state/territory health department website.

The Department of Health has published guidance on the use of Evusheld.

Mandatory isolation requirements for COVID-19 positive people has now ceased, with each jurisdiction implementing the change via relevant public health legislation. Exceptions apply for workers in aged care, disability care, aboriginal healthcare and hospital care sectors.

See current requirements and advice in each state and territory below:
 

Most people who test positive for COVID-19 will likely only experience mild symptoms and recover without requiring special treatment or hospitalisation, especially if fully vaccinated. Patients can use the most relevant information in the RACGP’s COVID-19 patient guide to self-manage their illness at home. An online version is now accessible from the same page.

Healthdirect has launched an online tool (based on our COVID-19 patient guide) to help COVID-19-positive patients know what they should do while isolating at home and when to seek medical help. People with COVID-19 are advised that if they are worried about their symptoms, but it is not an emergency, they should use the COVID-19 Symptom Checker or call the National Coronavirus Helpline on 1800 020 080 for free information and advice.

The Department of Health (DoH) has also published information for people who test positive for COVID-19 or are close contacts in 63 languages.

People can also access state specific guidance via their state or territory health department website:

• Australian Capital Territory
• New South Wales
• Northern Territory
• Queensland
• South Australia
• Tasmania
• Victoria
• Western Australia

You may consider linking these resources from your practice website and sharing them via your practice’s social media accounts.

Caring for yourself

During events such as the current coronavirus situation, additional pressure may be placed on GPs and practice staff as frontline workers through increased patient attendance to the practice, responding to fear and anxiety amidst the community and staying up to date as the situation evolves.

It is important during such times that GPs and practice staff take time to care for themselves and take the opportunity to debrief with colleagues. If you require additional support, services are available, specifically developed for doctors.
 

The Essential Network (TEN) for frontline workers

DRS4DRS

You can also access support via the DRS4DRS website and state/territory based helplines. DRS4DRS is an independent program providing confidential support and resources to doctors and medical students across Australia, by doctors. Confidential phone advice is available 24/7 for any doctor or medical student in Australia via each state/territory helpline and referral service.

Hand-n-Hand Peer Support

Helping Australian & New Zealand Nurses and Doctors (Hand-n-Hand) was founded as a response to the COVID-19 pandemic and the growing emotional burden that came with it.

Hundreds of people across the healthcare sector have now signed up to be a part of the growing peer support movement. Visit their website to find out more and get involved.
 

RACGP GP Support Program

Should you need support, don't hesitate to contact the RACGP GP Support Program. This is a free and confidential psychological support service available to all members, delivered by LifeWorks Access the service by calling 1300 361 008 (24 hours/7 days).
 

Immediate 24/7 supports

Providing mental health and wellbeing support to your patients

The General Practice Mental Health Standards Collaboration (GPMHSC) has collated important information to help you support and care for the mental health and wellbeing of your patients during the COVID-19 pandemic.

This includes:

• Mental health resources - resources, factsheets and guides
• Telehealth consultations - information on MBS item numbers for the provision of telehealth (videoconferencing and phone) consultations by GPs with and without mental health training.

Aged Care COVID-19 Grief and Bereavement Service

Do you or your practice provide care in residential aged care or for home care recipients?

Aged care residents, home care recipients, their families, loved ones and staff affected by loss or trauma as a result of COVID-19 can now access free grief, loss and bereavement support services.

Tailored, easy-to-access support is available via the Australian Centre for Grief and Bereavement, including in-person help when possible.

Call 1800 222 220 or visit the Aged Care COVID-19 Grief and Bereavement Service website for help, or to download the MyGrief app. All services are inclusive, confidential, and eligible for the Translating and Interpreting Service and Auslan.
 

As COVID-19 transmission prevention measures are removed, use of face masks in general practice is no longer nationally mandated. In the event jurisdictions remove mask mandates in general practice, the RACGP strongly encourages practices to continue mask use for the practice team, patients, and visitors. Practices can make it a condition of entry to the practice to wear a mask.  

You can display RACGP developed posters to inform patients of mask requirements, as well as noting this on your practice website, online booking system and phone holding message. It is suggested that this requirement is also outlined in your practice’s infection prevention and control policy and COVID Safety Plan (a COVID Safety Plan template is available here).

Processes must be in place to facilitate access to care for patients who are not able to wear a mask or who are deaf or hard of hearing and who cannot communicate with clinicians who are wearing a mask. These processes will depend on capacity within the practice and may include use of telehealth (telephone or video), temporary removal of mask during face-to-face consultations with those who are hard of hearing (in the absence of respiratory symptoms, with social distancing in place and noting the clinicians own risk factors and comfort), use of written notes to communicate or, if no other approach is workable, assisting the patient in seeking healthcare via another GP.
 

Current mask requirements/recommendations in each state/territory are: 

• Australian Capital Territory 
• New South Wales
• Northern Territory
• Queensland ​
• South Australia 
• Tasmania 
• Victoria 
• Western Australia 

Ordering PPE and pulse oximeters