Definition of a general practice for the purpose of accreditation
For a practice or health service to seek accreditation:
- it needs to provide comprehensive, person-centred, whole-person and continuous care; and
- its services are predominantly* of a general practice nature.
(* More than 50% of the practice’s general practitioners’ clinical time (ie collectively), and more than 50% of services for which Medicare benefits are claimed or could be claimed (from that practice) are in general practice.)
The above definition exists solely to identify services eligible to be assessed as a general practice against the RACGP’s Standards for general practices (the Standards) by an accrediting agency approved under the NGPA Scheme. This definition is for the assessment of the environment and systems of quality and safety. There will be some services that are eligible to be accredited against the Standards but that may not be appropriate as training practice locations or eligible for entry into a training program.
The general practice, once acknowledged as meeting the definition, needs to then meet all required criteria in the Standards to be accredited.
GP-led care
Accredited practices need to be General Practitioner (GP) led. GP-led care refers to primary healthcare services:
- that are clinically governed primarily by one or more GPs
- have GPs who are physically present and provide patient consultations in person on a regular and ongoing basis.
To be considered GP-led, GPs need to be involved in the clinical governance of the practice.
It is recognised that in certain practice models or contexts, such as in remote or multi-site services, physical presence may not be feasible at all times. GP-led practices maintain continuous shared care with GPs during times the GPs are not physically present.
Comprehensive care
Comprehensive care is the coordinated delivery and/or facilitation of the total healthcare required or requested by a patient. The scope of clinical practice is challenging, spanning prevention, health promotion, early intervention for those at risk, and the management of acute, chronic and complex conditions within the practice population. Comprehensiveness means services are not limited by body system, disease process or service site.
This use of ‘comprehensiveness’ in the definition of a general practice for the purpose of accreditation is not intended to change the requirements for general practice as a speciality or for training purposes. This definition is to be used for practice accreditation. For training and achieving Fellowship the definition of Comprehensive Australian general practice is used.
Person-centredness
Person-centredness places the patient's needs, values and preferences at the forefront of medical decision-making, empowering patients to take an active role in their own healthcare. Patients are provided the information and health literacy to help them generate well-informed needs and preferences that are likely to improve health outcomes. Person-centredness is reflected in a general practice team’s understanding that health, illness and disease are ultimately personal experiences, and that the role of the team is to collaborate with patients to support their healthcare.
Whole-person care
Whole-person care is reflected in the interplay between bio-psycho-social contributors to health, and which leads to a deep understanding of the whole person, and the ability to manage complex conditions and circumstances. A GP functions as a physician, counsellor, advocate and agent of change for individuals, families and their communities.
Continuous care
Continuity of care is when a patient experiences a series of discrete healthcare events and/or services that are coherent, connected and consistent with their medical needs and personal circumstances. Continuity of care is distinguished from other attributes of care because of two key characteristics: it refers to care that takes place over time and focuses on individual patients.
When patients visit the same GP over time, they develop a patient–practitioner relationship, which has been shown to reduce visits to emergency departments and preventable hospital admissions(4).
Patients who have continuity of care with a regular GP:
- report high levels of satisfaction with their experience of care(5)
- have lower rates of hospitalisation and emergency department attendances(6)
- have lower mortality rates(7)
- are more likely to receive appropriate and person-centred care.