November 2021


Chair report


A message from the Chair – Dr Louise Acland

In September this year, the RACGP made a submission to the Department of Health’s consultation into the National General Practice Accreditation Arrangements Review. The submission outlined our support for recommendations that enable appropriate efficiencies between the various accreditation schemes practices may be required to meet based on the function of their businesses. We believe now is the right time to consider changes to the governance, streamlining of data, and consistency of surveyor training and application of non-conformance.

I recently spoke with Australian Doctor about our submission, providing further detail on the RACGP’s exploration of an alternative process of accreditation. While there has been some attention in the media regarding short-notice accreditation checks, this is only one aspect of the model we’re investigating. Our intention is to promote a continuous approach to improvement and to leverage technology and data to reduce the effort involved in accreditation. I encourage you to read our full submission on the RACGP website. The review is being independently run by mpconsulting on behalf of the Department of Health.

Regarding our ongoing review of the college’s definition of a general practice for the purpose of accreditation (the definition), I’m pleased to let you know that with the support of the RACGP Board, the RACGP Expert Committee – Standards for General Practices (REC–SGP) is now working on an update to the definition. We made this decision following consultation with the profession and are now seeking a definition that encompasses all models of quality general practice. We’ll be consulting on a draft definition shortly.

As we approach the end of the year, I’d like to thank members of the REC–SGP for their ongoing work across our Standards projects. I hope the final weeks of 2021 are safe and productive for you, and I’d like to again thank you for your ongoing engagement with the RACGP Standards. 


Point-of-care testing Medicare item


As of 1 November 2021, you can now claim a Medicare item for point-of-care glycated haemoglobin (HbA1c) tests.

The item for HbA1c tests is only available to practitioners working in a practice accredited against the RACGP Standards for point-of-care testing (5th edition). These standards are accredited by the International Society for Quality in Health Care and were developed to improve the quality and safety of point-of-care testing (PoCT) performed by health services.

The service may be claimed in respect of a patient a maximum of three times in a 12-month period and may not be claimed by a patient if a total of four other HbA1c testing items (laboratory or PoCT) have already been provided to the patient in the last 12 months. This is in accordance with the recommendation from the Medical Services Advisory Committee (MSAC) that PoCT HbA1c testing should be used for the ongoing management of patients with established diabetes on an as needed basis every 3–6 months to assess blood glucose control. MSAC considered that the test provides a clinically meaningful indication of diabetes status over the previous three to four months. Therefore, it is not of value to repeat the test within this timeframe.

The relevant item numbers and descriptors are provided below.


Item 73812
Fee: $11.80
Descriptor:

Quantitation of glycated haemoglobin (HbA1c) performed in the management of established diabetes when performed:

(a) as a point‑of‑care test; and

(b) by or on behalf of a medical practitioner who works in a general practice that is accredited against the point of care testing accreditation module under the National General Practice Accreditation Scheme; and

(c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%)

Applicable not more than 3 times per 12 months per patient.


Item 73826
Fee: $11.80
Descriptor:

Quantitation of glycated haemoglobin (HbA1c) performed by a participating nurse practitioner in the management of established diabetes when performed:

(a) as a point‑of‑care test;

(b) by a nurse practitioner who works in a general practice that is accredited against the point of care testing accreditation module under the National General Practice Accreditation Scheme; and

(c) using a method and instrument certified by the National Glycohemoglobin Standardization Program (NGSP), if the instrument has a total coefficient variation less than 3.0% at 48 mmol/mol (6.5%)

Applicable not more than 3 times per 12 months per patient.


Telehealth updates in the Standards for general practices


We’ve reviewed the Standards to include suggestions, explanatory materials, and resources for practices offering telehealth. These changes are proposed in response to provision of Medicare Benefits Schedule (MBS) item numbers for telehealth consultations during the COVID-19 pandemic and anticipation that telehealth consultations will be further normalised as a consultation type in a post-pandemic environment.

Changes relate to how telehealth is defined in the Standards, as well as additional supporting explanatory materials across areas of the Standards, including:

In addition to new explanatory materials, the Standards refer practices to the RACGP’s Guide to providing telephone and video consultations in general practice, which helps practices to provide safe and effective telehealth consultations to patients.

These changes have recently been approved by the REC–SGP and will be updated in the Standards mid-November. 


Sex and gender updates in the Standards for general practices


We’ve reviewed the Standards to reflect contemporary and accurate collection and recording of information about sex, gender and variations of sex characteristics. This will enable general practice to be responsive to patient needs and deliver better patient outcomes. 

While the RACGP recognises that a practice’s clinical software may not support recording of both sex and gender (independent of one another), practices still must consider how to collect and record this information, which will help them to be more accurate with data collection and responsive to patient needs.

Changes include:

These have recently been approved by the REC–SGP and we will advise you when the document has been updated.


Standards for health services in Australian prisons


We’ll soon be commencing our pilot of the Standards for health services in Australian prisons (Prison Standards), which will be accompanied by the next round of stakeholder consultation. The draft being piloted has been updated to incorporate feedback from earlier consultation, as well as new recommendations by the REC–SGP. Upcoming stakeholder consultation will provide you with an opportunity to review this draft and provide feedback to us.

When launched, the draft will be hosted on our consultations page and communicated via RACGP channels.


Consultation on a new definition of a general practice for the purpose of accreditation


The REC–SGP is undertaking an ongoing review of the RACGP’s definition of a general practice for the purpose of accreditation (the definition).

Diverse feedback was received during our consultation on the current definition earlier this year. The REC–SGP has reviewed the outcomes of the consultation, considering the qualities of general practice that members regard as defining of the profession – holistic, patient-centred and continuous care. Taking all feedback into account, the REC–SGP decided, with RACGP Board approval, to update to the definition to better encompass all models of quality general practice.

We’ll soon provide a draft definition and strongly encourage you to review the recommendation and provide feedback on its strengths and limitations. This will help the REC–SGP to refine a new definition to best suit the profession and address any barriers that emerge in doing so.


RACGP response to review of general practice accreditation arrangements consultation


We recently provided a response to the Department of Health’s National General Practice Accreditation Arrangements Review consultation. We provided our support for recommendations that enable appropriate efficiencies between the various accreditation schemes practices may be required to meet based on the function of their businesses. The review is being independently run by mpconsulting on behalf of the Department of Health.

Our submission explored various strengths and limitations of:

  • the current accreditation model
  • the National General Practice Accreditation Scheme
  • the Standards for general practices
  • arrangements and requirements for accreditation agencies
  • accreditation data and transparency.
You can read about how the RACGP perceives each of these aspects of accreditation in our full submission.

Fact sheet: Collecting and recording information about patient sex, gender, variations of sex characteristics and sexual orientation


Our new fact sheet, Collecting and recording information about patient sex, gender, variations of sex characteristics and sexual orientation (the fact sheet), is a supplement to the Standards that supports the updates proposed regarding sex and gender. It contains additional explanatory material to support general practices collecting, recording and using information about a patient appropriately.

The fact sheet:

  • describes why your practice needs to collect information about sex, gender, variations of sex characteristics and sexual orientation
  • provides question and answer formats for collecting information about sex, gender, variations of sex characteristics and pronouns
  • reinforces patient privacy when collecting sensitive information
  • suggests ways a practice can enhance gender sensitivity when collecting patient information
  • describes considerations for using pronouns in practice forms and templates
  • outlines how to manage requests by patients to confirm their gender with Services Australia.

This resource is available with all Standards fact sheets on our website.


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