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‘Important to get our voice heard’: RACGP scope of practice survey

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Improved rebates for longer consultations, MBS reform, and wider task delegation would allow GPs to maximise their potential within Australia’s healthcare system, according to the early results of an ongoing RACGP survey.
 
The college’s survey into an independent Scope of Practice review is now live and members are being asked to have their say on what the future of general practice care should look like.
 
The request for feedback has come in response to the Department of Health and Aged Care’s ‘Unleashing the Potential of our Health Workforce Review’, which is aimed at ensuring that Australia is optimising the skills and training of its healthcare professionals.
 
Dozens of GPs have so far completed the survey, who have raised wide range of issues with the status quo, as well as ideas for change.
 
Improving rebates for longer consultations so GPs are not financially disadvantaged when spending 30-minutes with a patient, compared to two, 15-minute consultations, is a key theme to have emerged so far, as is Medicare remuneration for iron infusions and joint injections .
 
Respondents have also called for GPs to have the option to play a bigger role in the diagnosis and management of ADHD and neurodiversity, as well as changing the current restrictions on patient reimbursements for certain diagnostic tests, prescriptions and procedures which could be organised or provided in general practice.
 
Dr Edwin Kruys, a member of RACGP Expert Committee – Funding and Health System Reform, told newsGP the survey is about uncovering what GPs need to work to their full capacity.
 
‘There are moments when it is important to get our voice heard and this may be one of those,’ he said.
 
‘The review will look at how health practitioners can better work to the full extent of their skills and training … many GPs feel that they are also unable to maximise their potential due to various restrictions, such as the MBS and the Pharmaceutical Benefits Scheme [PBS].
 
‘Extending the scope of general practice team members could enable GPs to delegate where appropriate and required, and work to the top of their scope of practice.’
 
Respondents have also called for:

• the removal of restrictions on imaging, particularly MRIs
• clearance to provide advanced palliative care management
• the ability to prescribe oral retinoids (tretinoin)
• more appropriate resourcing to take part in shared care, such as antenatal or chronic health.

One person also brought up the idea of being able to consult on paediatric patients without the child needing to be present when this will cause trauma or poor self-esteem.
 
Dr Kruys said allowing GPs to work at their full potential is important as it would benefit patients, improve efficiency, and increase job satisfaction, among other positives.
 
‘Imagine the benefit to our patients and the wider health system if GPs could diagnose ADHD and safely prescribe stimulants, without having to wait 6–12 months for the patient to see one of our busy psychiatrist colleagues,’ he said.
 
‘Furthermore, the responses so far indicate that GPs want to delegate more tasks to practice nurses, including chronic disease management, social prescribing, child health checks, cervical screening, vaccination clinics, wound clinics, venepuncture, cannulation, and iron infusions.
 
‘Respondents see roles for pharmacists, nurse practitioners and other allied health providers within the general practice team.’
 
Members have until 9.00 am (AEST) on 28 September to complete the online survey and can submit any supporting evidence or case examples, including literature, examples of community need and expanded scope within multidisciplinary teams, via email to the RACGP.
 
Alternatively, feedback can be provided directly by completing the independent review’s online survey, which will remain open until 16 October.
 
 Dr Kruys encourages all GPs to get involved in the survey as that deadline grows closer.
 
‘Extending scope comes with responsibilities with regards to training, agreed escalation pathways and communication and clinical handover,’ he said.
 
‘Many GPs have chosen the profession because they enjoy providing holistic care, be it complex or less complex.
 
‘Scope expansion should support continuity of care so that patients don’t have to go elsewhere, but can receive more care through their preferred practice, when they need it.’
 
An interim Scope of Practice report is due by the end of the year, with a final report due by September 2024.
 
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general practice scope of practice

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