The body that represents over 90% of Australia’s GPs and advocates on behalf of their patients, has provided a formal submission for the Australian Government’s review of urgent after-hours home visit services.
Royal Australian College of General Practitioners President Dr Bastian Seidel has welcomed the intent of the Medicare Benefits Schedule Review Taskforce preliminary consultation report for urgent after-hours primary care
The report aims to secure high-quality services and better use of Medicare rebates.
“However, there are a couple of recommendations in the report that may have unintended consequences for GPs and their patients – and we have identified these in our submission to the review,” Dr Seidel said.
“One recommendation is that the higher-priced urgent after-hours Medicare rebates should be restricted to GPs who predominantly work regular hours and also provide after-hours services to their patients.
“While the intent of this recommendation is to promote continuity of care for patients, a large proportion of after-hours care is currently being, and should rightly continue to be, provided by Medical Deputising Services and after-hours home visiting services who have a formal relationship with the patient’s usual GP or practice.
“This recommendation doesn’t take account of common situations where a qualified GP employed by an after-hours service might assess a patient referred by the patient’s regular GP.
“Another recommendation is that businesses that mainly provide medical services after-hours, including Medical Deputising Services, shouldn’t be able to claim the high-priced urgent after-hours Medicare rebates.
“However, many general practices have a formal contract with a Medical Deputising Service to provide coverage for the practice’s patients after hours. Continuity of care, communication and safety are supported through these arrangements.
As an alternative way of supporting continuity of care for patients the RACGP is suggesting providers of urgent after-hours services should be required to:
- enter into formal agreements with local general practices in the areas where they intend to provide services
- provide a summary detailing the clinical management of the patient to the patient’s regular GP as soon as possible.
The RACGP also recommends that a patient’s eligibility for urgent after-hours services be linked to their usual GP or practice. This would mean:
- after‑hours service providers could only access urgent after-hours item numbers when a patient is referred by their usual
GP or practice
- the after‑hours service provider would need a formal agreement with the GP or practice, and
- the service would need to be provided by a qualified GP, or a doctor in a recognised general practice Fellowship pathway.
Dr Seidel said, “these moves would help guarantee patients continued to have access to premium, high-quality, urgent after‑hours services. The moves would also ensure continuity of care through urgent after hours GP led services.
“Stronger links between after-hours services and in-house general practices would help stop the fragmentation of patient care and ensure the effective use of the funding available for Medicare rebates.
“We’ll continue to work closely and collaboratively with GPs and their patients, other professional medical organisations and the Australian Government to ensure we get the best possible health outcomes for patients across Australia from the MBS Review.”