Rebates, PPE and oxygen monitors for primary care

General practice will be expected to keep mild covid cases in the community, but one GP says more RAT support is crucial.

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GPs will help keep covid patients out of hospital with new Medicare funding for additional face-to-face care in the community, says Minister for Health and Aged Care Greg Hunt.

In an effort to prepare the Australian health system for an increase in covid cases in the coming months, Mr Hunt announced on Friday an $180 million plan to ensure there were clear management pathways available for mild patients through primary care, as well as access to pulse oximetry and PPE through the National Medical Stockpile.

Under the scheme, patients with a covid diagnosis who were being managed by their GP could access an additional $25 rebate through Medicare. The rebate is able to be added to existing general consults.

“The government is rapidly updating covid care pathways in every region of Australia through collaboration between the 31 Primary Health Networks and their corresponding local hospital networks,” Mr Hunt said in a media statement.

“The care pathways will connect covid patients with the right level of care, whether that is self-monitoring, care from a general practice or general practice respiratory clinic, or for higher-risk patients, care in a hospital or a hospital-in-the-home arrangement.”

The announcement was celebrated by RACGP president Dr Karen Price, who said cases were likely to spike across Australia.

“GPs stand ready to help, we have the right skills and expertise to continue caring for covid patients in the community,” she said.

The announcement follows calls from Victorian GP Dr Nathan Pinskier for the government to limit covid exposure in primary care settings by funding routine implementation and interpretation of rapid antigen tests (RATs).

“What we’re suggesting is to minimise the risk to the community and to the practice itself, so people don’t just turn up unannounced [with covid],” he told TMR.

A study published earlier this month suggesting GPs may still be fearful of being exposed to the virus at work, which also throws into doubt how many primary care clinics would actually put their hand up to manage infectious individuals face to face.

But in the Commonwealth’s effort to bolster covid management in general practice, GPs would be able to access the National Medical Stockpile for pulse oximeters to encourage patients to monitor their condition at home and enable their doctor to monitor for potential deterioration. Additional PPE would also be made available to practices through their PHN.

Other measures include harnessing GP respiratory clinics as a primary point of care for patients struggling to access care through a general practice.

This would hopefully deter additional presentations to emergency departments in non-urgent circumstances, Mr Hunt said.

And enabling home visits by practice nurses, nurse practitioners and medical deputising services would also be crucial for the community management of covid patients, particularly in rural areas.

“This will mobilise additional workforce to respond to any spikes in local cases and help ensure patients can be safely and effectively cared for at home,” Mr Hunt said.

The plan also finally responds to some of the concerns raised by the AMA in September, which claimed a national approach that integrated primary and tertiary care pathways would be vital for coordinating the care of covid patients.

However, diagnosis pathways in the community still remain murky, with home testing RAT kits set to be available for public purchase from supermarkets next week.

Dr Pinskier said he was interested in the utility of RATs as a mechanism to thwart potential covid exposures in general practice.

“A number of Melbourne practices have been forced to temporarily close as a result of exposures,” Dr Pinskier said.

And he also had some concerns over the ability for the public to interpret the results of these recently TGA approved tests.

“General practice needs support to be able to guide patients through the testing process, give them advice, ensure that they stay at home and not just turn up and have the test on the premises – which immediately creates a risk for everybody,” Dr Pinskier said.

Adding to the government funding wishlist this week, the AMA also issued a statement calling for a funding review into GP remuneration for administering covid booster doses.

“It will be important GPs are properly funded to administer booster vaccines,” said AMA president Dr Omar Khorshid.

“The current funding model is not fit for purpose, having been designed to support the administration of two primary doses – not a booster program.”

On Wednesday, following TGA approval of Pfizer as a booster vaccination for Australian adults, Mr Hunt announced that a general population program would commence by 8 November.

It follows similar programs in the UK, US and Israel which encourage a third dose of a covid vaccine to bolster population immunity against the virus.