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General practice accreditation in Australia: Data from 2010–2021
The main aims of accreditation are to protect patients from harm and support quality improvement efforts.1 The accreditation processes are therefore designed to measure compliance and improve the quality and safety of care. Accreditation against standards such as those set by the RACGP has been shown to promote leadership, enhance corporate culture and improve clinical performance.2
The RACGP has a 30-year history in the development of standards for primary healthcare settings. The Standards are profession led and form a foundational benchmark for quality and safety in Australian general practice. The Standards meet international best practice benchmarks and have been awarded accreditation by the International Society for Quality in Health Care (ISQua). ISQua’s international accreditation program for healthcare facilities assesses the standards of organisations that set benchmarks in healthcare safety and quality.
In Australia, a general practice can demonstrate its commitment to safety, quality and continuous improvement through achieving independent accreditation against the Standards. Accreditation against the Standards is voluntary; however, accreditation is a requirement for a general practice to access Services Australia’s Practice Incentives Program (PIP).3 The PIP is administered by Services Australia on behalf of the Australian Department of Health. It includes payments for eHealth, quality improvement, teaching, Indigenous health, after-hours care, procedural activities, aged care access and loadings for rural locations.4
The ACSQHC, in collaboration with the RACGP, developed the National General Practice Accreditation (NGPA) Scheme in response to recommendations made by the Australian National Audit Office5. The NGPA Scheme commenced on 1 January 2017 to oversee the consistent assessment of Australian general practices against the Standards.
Under the terms of the NGPA Scheme, the RACGP develops the Standards and general practices obtain formal accreditation through independent, third party accreditation agencies. Historically, accreditation services were provided by two agencies: Australian General Practice Accreditation Limited (AGPAL) and Quality Practice Accreditation (QPA).
The introduction of the Standards fifth edition in 2017 brought significant changes for general practices undergoing accreditation. The indicators in the fifth edition were written, where appropriate, with a focus on outcomes and patients instead of prescribed processes. By focusing on outcomes, a general practice can develop systems and processes that reflect its preferred ways of working and choose how to demonstrate that it meets the intent of each indicator.
Using the RoGS, we are able to assess the state of general practice accreditation using national data between two time points, 10 years apart (2010 and 2019). We can see how general practice accreditation has fared over that 10-year period having continued through the introduction of the NGPA Scheme and changing editions of the Standards. The RoGS also provides us some insights on accreditation in 2020 and 2021; however, the Department of Health was unable to provide the number of general practices (denominator) for the last two years, meaning a proportion of general practices could not be calculated.
The linked aims of this paper are twofold:
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