Refresh of the RACGP’s ‘Vision for general practice and a sustainable healthcare system’

The Vision for general practice and a sustainable healthcare system (the Vision) was released in 2015 at the RACGP’s annual conference for general practice.
 
The RACGP is now planning to ‘refresh’ the document in an effort to ensure it is up-to-date with current evidence.
 
The Vision was created by the RACGP to address the pressures and concerns of GPs working in everyday general practice in Australia as they faced the challenges of an ageing population and increases in the prevalence of chronic disease, combined with rising medical costs and uncertainty in funding distribution across the healthcare sector.
 
‘We wanted to reorient [healthcare] funding towards the primary care model, and for it to be less hospital-based,’ immediate past-RACGP President Dr Frank R Jones told newsGP.
 
The Vision proposed a new model of primary healthcare, along with a funding overhaul to better support GPs working within the pressures of the existing Australian healthcare system. The Vision was informed by the principals of the medical home model, which is patient-centred, GP-led and supports an ongoing relationship between patients and an extended healthcare team.
 
‘The medical home means the patient identifies a particular GP and practice that commit to overseeing all of their care,’ Dr Jones said when the Vision was launched in 2015.
 
‘It’s coordinated, continuous, compassionate and very much contextualised to who the patients are.’
 
It seemed the Federal Government had taken the Vision on board in 2016 when it announced a pilot of Health Care Homes, a patient care concept that initially appeared to be based on the medical home model. However, as more detail emerged, it became clear that the government version had strayed from the RACGP’s original vision.
 
‘The [Federal] Government set up its own separate task-force and didn’t implement our ideas,’ Dr Jones explained.
 
As the trial launched, it became clear it was based around simply altering the payment model of general practice without proper investment into the necessary supports for coordinated, comprehensive primary care.
 
‘The current trial is not of a Health Care Home, rather it’s a trial of a capitated funding model for chronic disease, using a risk allocation software that has never been tested,’ Dr Evan Ackermann, GP and Chair of the RACGP Expert Committee – Quality Care, told newsGP last year.
 
‘It does nothing to solve service problems of identifying those at greatest need for health services and ensuring evidence-based systems of care are supported.’
 
With only 171 practices signed up and fewer than 2000 patient enrolments – far short of its intended targets of up to 200 medical practices and 65,000 patients – the future of Health Care Homes remains unclear.
 
The RACGP believes the Vision still presents a viable solution to challenges to the healthcare system, and is taking steps to ensure it is up-to-date with best available evidence.
 
The development of the original Vision included wide ranging consultation, with feedback received from more than 1000 GPs, stakeholders and consumer groups. The college is again seeking input from members based on their needs and experience of working within the Australian healthcare system, with consultation open from Friday 6 July.

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