RACGP President’s Update: August

24/08/2021 Written by Dr Karen Price

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RACGP President’s Update: August

The vaccine rollout has certainly had its challenges, but general practice has persevered and done a remarkable job. We’ve delivered more than nine million COVID-19 vaccines – more than half of the total administered in Australia.
 
Even if your practice is not directly involved in administering vaccines, every GP has played a part in keeping the rollout moving, from counselling hesitant patients to working with culturally and linguistically diverse communities to get the word out. I’d like to thank you for the outstanding work you've all done. GPs’ efforts are regularly acknowledged in the RACGP’s ongoing meetings with government, and I’m proud to represent such a dedicated group of professionals. Despite the difficult circumstances, GPs have has stood up for their communities again and again. Well done.
 
There's still a long road ahead of us, so remember to take care of yourselves, your practice teams and your loved ones as you carry this extra load. As you know, pandemic fatigue is a very real entity in areas currently in lockdown. It’s very tough and I encourage you to review the support resources within your RACGP and to take moments out of the madness to relax and recharge.  I’m sure we’re all feeling the strain at this point.
 
Vaccine distribution of through pharmacies
Our overarching position is that general practices are best equipped to deliver all COVID-19 vaccines. Cold-chain storage is no longer a barrier to administering mRNA vaccines, so patients should be able to get their vaccine of choice from their usual GP when supply allows. We’ve made our view known to the Department of Health.
 
However, at this critical juncture in Australia’s pandemic response, we believe the greater good will be best served by having as many Australians vaccinated as possible, as soon as possible. Although allocating Moderna vaccines to pharmacies certainly doesn’t align with the RACGP’s standard position on primary care services being provided by pharmacists, we appreciate the intention is to speed up the vaccine rollout. We remain patient-focused in the middle of this pandemic.
 
Our key concerns at this crucial stage of the rollout are ensuring vaccine safety and getting needles in arms as quickly as possible. Australia has one of the lowest vaccination rates among the world’s developed countries, so drastic action is needed if we’re to get on top of the virus.
 
We’ll get increasing Pfizer supply to GPs later in 2021 and this will be in order of magnitude above the supply of Moderna this year. General practices will receive increasing supply of the Pfizer vaccine in the coming weeks, and we expect to see more practices joining the Pfizer rollout as supply increases ahead of the Moderna rollout to pharmacies.
 
In 2022, it's envisaged a greater range of vaccines, including Moderna, will be available to all GPs.
 
COVID vaccination during pregnancy
In line with advice from the Australian Technical Advisory Group on Immunisation (ATAGI) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), I’d like to remind all GPs that the Pfizer vaccine is safe to offer patients at any stage of pregnancy.
 
The increased risk of COVID-19 complications for pregnant patients and the increased risk of complications for newborns when COVID-19 strikes during pregnancy mean we should encourage our expectant patients to get vaccinated as soon as possible.
 
Department of Health guidelines and ATAGI advice, along with accumulated real-world evidence, tell us that mRNA vaccines are safe during pregnancy.
 
Please encourage your pregnant patients to discuss getting vaccinated.
 
RANZCOG has also updated its advice for vaccinating breastfeeding women, confirming AstraZeneca is safe for these patients, along with Pfizer and Moderna.
 
‘The mRNA in Pfizer or Moderna is rapidly broken down in the body and does not appear to pass into breastmilk. The viral vector in AstraZeneca cannot cause infection,’ RANZCOG said in its advice.
 
RACGP profession-led training model
We've had excellent collaborative meetings with important stakeholders for the good of the future of general practice training.
 
ACRRM President Dr Sarah Chalmers and I are committed to a new collaborative model of respectful leadership between our two colleges – we both appreciate how important this process is for our collective futures.
 
Further productive meetings have occurred with GPSA, GPRA, RTOs and the Department of Health. Most recently, both colleges were able to brief the Health Minister on the significant progress of the profession-led community-based model. We’re all committed to delivering on programs of excellence for general practice healthcare delivery to every part of Australia.
 
I’d like to thank all who have contributed to the stability of the sector while we manage the operational transition and essential reforms required. The RACGP has been very ably partnered by a KPMG transition team with the complex and important work of managing business as usual with a transition.
 
We’ll keep you updated as the model progresses.
 
Data governance
Data governance has been on the RACGP’s radar this month as we aim to future-proof the college and general practice. We’ve been consulting with experts including Dr Edwin Kruys, Chair of the RACGP’s Data Governance Advisory Group, and Dr Rob Hosking, Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM), as well as the Australian Digital Health Agency and the medical software industry on how to make the most of Australian general practice data.
 
I also note the purchase of practice management software firm MedicalDirector by Telstra Heath. Telstra intends to link the software with Telstra’s existing network of digital health services for hospitals, pharmacies and the aged care sector.
 
It’s my firm view that we need to be involved and watch this sector very closely. It seems many people are involved in wanting general practice-generated data, and I’m well aware of the challenges within that for our patients and the future of our profession. The governance of new technology is closely watched by myself, as well as the college’s Data Governance Advisory Group and REC–PTM, who are frequent contributors to policy requests and review in this space.
 
Inaugural Dr Harry Nespolon Grant
The RACGP was thrilled to award the inaugural RACGP Foundation Dr Harry Nespolon Grant to Assoc Prof Jill Benson. Jill has been a GP for more than 40 years, with a focus on Aboriginal and migrant health and the mental health of GPs.
 
The grant honours our late President Dr Harry Nespolon, who left us far too soon in July last year. The grant supports research into the wellbeing of GPs and/or GPs in training, including factors that support wellbeing, self-care and peer support.
 
Harry was a passionate advocate for the health and wellbeing of his GP colleagues, and the awarding of the grant will appropriately honour that legacy. Jill told newsGP that her research will focus on how career diversity within general practice can benefit GPs, help avoid burnout and support sustainable careers.
 
I’m sure the research outcomes will help improve our understanding of what successful work–life balance means for GPs and ensure general practice remains an attractive career for the next generation.
 
Congratulations, Jill.
 
Aboriginal and Torres Strait Islander health
The Close the Gap health campaign, the Uluru Statement from the Heart, the Raise the Age campaign to raise the age of criminal responsibility and other Aboriginal and Torres Strait Islander health issues are a high priority for the RACGP. These campaigns remain ongoing.
 
Australia has one of the highest indigenous incarceration rates in the world. In particular, we remain concerned at the age for youth detention, which has potential long-term effects on Aboriginal and Torres Strait Islander health outcomes and for the children involved.
 
The recent pandemic spread into Aboriginal and Torres Strait Islander communities in western NSW has highlighted how fragile healthcare can be and that it’s not universally delivered for some of our most vulnerable people. We've continued to campaign for bespoke outreach programs that address these issues and support peer mentors in this vital component of healthcare.
 
I'd like to thank those GPs who’ve become involved as a matter of urgency for the western NSW Delta outbreaks.
 
Taking action on climate change
We’re certainly facing many national and international health challenges at the moment, and climate health continues to alarm.
 
Given the data in the Intergovernmental Panel on Climate Change’s (IPCC) latest report, it’s time we started viewing climate change as a public health emergency in the same vein as global pandemics.
 
Dr Jessica Kneebone, Chair of RACGP Specific Interests Environmental Impacts in General Practice, is calling for ‘strong, ambitious climate action to minimise the risk of warming as rapidly as we can.’ GPs are already seeing the impacts of climate change firsthand, particularly during the horrific 2019–20 summer bushfires.
 
‘There are health risks from air pollution, heat, direct fire impacts, loss of housing, mental health effects from the fallout – and I’m just talking about fires,’ Jessica told newsGP. ‘This is something that’s directly and indirectly going to increasingly impact human health, and we’ll be seeing these issues more and more as GPs.’
 
We need our governments to heed lessons learnt during the COVID-19 pandemic, such as acting on the science and making evidence-based decisions – now.
 
I encourage GPs interested in taking action to join the RACGP’s Environmental Impacts in General Practice Specific Interests group.
 
Subsidised Focussed Psychological Strategies Skills Training
I’m sure we’ve all seen a sharp uptick in patients seeking help with mental health issues over the last 18 months. So I highly recommend you take advantage of the training subsidy an offer from the General Practice Mental Health Standards Collaboration to upskill in mental health care.
 
For a limited time, you can apply for a training subsidy that covers part of the cost of completing accredited Focussed Psychological Strategies Skills Training (FPS ST). You’ll need to complete the training and register as GP provider of FPS with Services Australia between 1 August 2021 and 30 June 2022.
 
I encourage all GPs, especially GPs in training and those practising in rural and remote MMM 3–7 areas, to take advantage of this subsidy. The funding covers up to 190 GPs, so apply now.
 
Find our more.
 
Your RACGP in the media
In August, the RACGP urged Australians to consider the risk of ‘long COVID’ when deciding whether to get vaccinated, rather than focusing on the very rare risk of blood clots, with appearances on Sunrise, 7News and WIN TV. Stay tuned for plenty more action on this front.
 
We had a great response on social media to GPs recently passing the seven-million-vaccines milestone – even former Federal Deputy Chief Medical Officer Dr Nick Coatsworth tweeted his congratulations to GPs and general practice staff. (As I mentioned above, we’ve since passed the nine-million mark)
 
I represented general practice on 10 News First and other TV and radio networks to continue the RACGP’s push to encourage pregnant patients across Australia to get the Pfizer jab as soon as possible.
 
The RACGP spoke out against advice from the Queensland Government for patients to get their first vaccine with their GP and their second at a pharmacy. RACGP Vice-President Dr Bruce Willett told The Courier Mail that this mix-and-match model could compromise continuity of care. Bruce also featured on ABC’s PM program urging Australians to step up and get their jab as soon as they’re eligible.
 
Finally, the last 18 months have been tough – on you, on me, on everyone. I’m noticing fatigue and distress in many people at the moment, so take good care of you and yours. These are such complex times. Your RACGP continues to serve in its mission to support and enable GPs, GPs in training and medical students to deliver quality healthcare throughout Australia.
 
Thanks to our members for all your supportive feedback and messages – it means a lot. We’re committed to supporting our members in all that they do and bringing your college through this challenging and transformative time.
 
Until next month, stay safe and vigilant.

Paving the way for research excellence
Chair’s report August 2021

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