The Royal Australian College of General Practitioners (RACGP) is warning that general practice is at breaking point and that more support is urgently needed on the frontline of the pandemic.
It comes following comments from the Prime Minister on Wednesday evening strongly encouraging people who have tested positive to COVID-19, including those who took a rapid antigen test, to contact their GP.
The Victorian Government has since announced that from midnight Thursday, people who have tested positive on a rapid antigen test can report the result to the Department of Health via an online form or by phone so that they can access care, information, and financial support during isolation. South Australia is launching a system enabling close contacts to be sent a QR code which can be shown to staff at collection points to receive two rapid antigen tests.
RACGP President Dr Karen Price said that soaring COVID-19 case numbers meant new reporting systems were sorely needed.
“Right across Australia, there needs to be a system in place for recording positive rapid antigen tests and, like the current PCR testing, this needs to be managed by the state and territory or federal governments,” she said.
“The Victorian model of patient reporting does have some merit; however, we will have to see whether the reliance on self-reporting, even when mandatory, captures all results. Phone conversations and online forms can be challenging for some people, including those from a culturally and linguistically diverse background.
“As things currently stand, positive rapid antigen test results are not being recorded or counted as part of the official case numbers as there is no formal notification process. Patients contacting their GP with a positive rapid antigen test result does not equate to the health system having an aggregate view of the number of positive cases in the community.
“General practices simply do not have the administrative capacity to officially lodge all COVID-19 cases, so we need governments to step up and set up a system so that all cases are recorded and everyone has access to COVID-19-positive care pathways.
“There needs to be a triage system designed to assist many thousands of people across Australia because GPs can only shoulder the burden of so much responsibility and we certainly can’t manage this process on our own. We are ready to work with government as needed to resolve this issue and ensure there is a system that works for general practice and their patients.”
The RACGP President said that communication with general practice was essential.
“I think this latest announcement once again highlights the importance of the Government having clear lines of communication with general practice,” she said.
“General practice teams are exhausted, and we need to ensure that any Government-initiated changes to managing patients in the pandemic have undergone careful planning so that general practice teams can immediately adapt. When general practice teams learn information via a press conference or, even worse, from their patients - it does make our vital role in the vaccine rollout much more difficult.”
Dr Price warned that GPs and general practice teams are working under enormous pressure.
“My message to patients across Australia is simple - please be patient with GPs, practice managers, nurses, receptionists and admin staff who are doing their best,” she said.
“I know that receiving a positive test result can make people feel anxious and uncertain, but I don’t want to hear reports emerging of general practice staff being subject to abusive or threatening behaviour. The last two years have been a trying time and the call for patients to contact their GP to advise them that they are COVID-19-positive does pose many challenges for GPs and their practice teams.
“I suspect that given the escalating numbers of cases, particularly in New South Wales and Victoria, reception phone lines will be in meltdown.
“Practices are flat out delivering booster doses and from Monday we will be delivering vaccines to children, which is a more complex task compared to vaccinating adults. Remember too we are busy with our usual day to day patient load and treating patients who have delayed or avoided care during the pandemic, including those with mental health concerns. We must not have more administrative work come our way without support and consideration of the burden this places on a system already stretched to capacity.
“The health and wellbeing of our patients is always our number one priority but please be mindful of the workload we are managing. If someone tests positive for COVID-19 and reports this to their GP we won’t necessarily be able to drop everything and do a telehealth consultation right away, it will depend on the severity of illness and how high-risk they are.
“It is unclear whether GPs seeing COVID-19-positive patients face-to-face based on a rapid antigen test would be eligible for the $25 bonus through Medicare. That needs to be clarified and we’re working with the Government on that.
“We’re also working on whether that bonus should just apply for face-to-face care, or whether it should apply to telehealth consultations. What I’m hearing from many GPs is that the telehealth consultations for COVID-positive patients are long and detailed, as you would expect. So, we have also asked for an emergency Level C telephone item number for telehealth because we have to manage as many of these people from home as we can.”
Dr Price reassured the community that most COVID-19-positive people could safely manage their symptoms at home.
“I know that receiving a positive test is daunting but please remember that people who test positive for COVID-19 are most likely to only experience mild symptoms and recover without requiring special treatment or hospitalisation, especially if fully vaccinated,” she said.
“Most patients will be able to self-manage their illness at home, as they would a cold a flu, and they won’t need to speak to a GP. For those patients at higher risk of severe illness from COVID-19 including those aged 65 and over or with other chronic medical conditions - please make a telehealth appointment to speak with your GP about your positive results.
“The Royal Australian College of GPs will be providing guidance to practices to help them manage the influx of calls. Once again, my message to GPs and general practice teams is keep up the great work. Your communities have never needed you more than ever before and in time the critical role of general practice during the COVID-19 pandemic will be properly recognised.”