Voluntary patient enrolment, a bigger role for pharmacists and nurses and a shot in the arm for after-hours care were among the unexpected funding announcements this morning.
Prime Minister Anthony Albanese has pre-empted the upcoming budget with a surprise spate of announcements following National Cabinet this morning.
Chief among them was that a voluntary patient enrolment scheme, to be called “My Medicare”, will be introduced.
According to Mr Albanese, the scheme will start with a focus on patients who are regularly presenting at emergency departments with complications from chronic health issues like mental illness and drug or alcohol addiction.
Practices that register patients will be eligible to receive block funding along with regular fee-for-service.
RACGP president Dr Nicole Higgins said the college was cautiously welcoming the measure.
“This is targeted at ‘frequent flyer’ high-risk patients who are often in and out of hospital with poorly managed conditions,” she said.
“The devil is in the detail, and we will work with government on a suitable model.”
Introducing a blended payment model tied to patient registration was the first recommendation included in the Strengthening Medicare Taskforce report, a combined effort between the government and peak primary care bodies.
The @RACGP warmly welcomes the Albanese Government committing $2.2 billion to strengthen Medicare.
— Royal Australian College of GPs (RACGP) President (@RACGPPresident) April 28, 2023
Greater support for general practice including after-hours care is the key to relieving the strain on our entire health system. No patients should be left behind. #NationalCabinet
It was initially backed by a promised $750 million in funding, but at the post-National Cabinet press conference this morning Mr Albanese indicated that there was now some $2.2 billion available to back the taskforce’s recommendations. Other taskforce recommendations that were announced today broadly cover four areas: allied health and nursing, team-based care, digital health and after-hours care.
Allied health and nursing
Health Minister Mark Butler confirmed that the Department of Health will launch a national scope-of-practice review, which will examine the barriers and incentives to health professionals working to their “full scope”.
Pharmacists and nurses appear to be the big winners out of the allied health fields.
From July this year, the PBS-funded opioid dependence treatment program will broaden to community pharmacies, as will the National Immunisation Program beginning January next year.
For nurses, there will be an incentive – it’s unclear yet what this will be – to attract them back to primary care, as well as 6000 new primary care nursing placements.
Multidisciplinary team care
PHNs will be given more power to commission allied health and nursing services to improve access to affordable multidisciplinary health care teams, beginning this year.
The DoH has also committed to increasing and indexing all Workforce Incentive Program – Practice Stream payments to make multidisciplinary team care more affordable to general practice.
After-hours care
A new funding scheme to support after hours care will kick into gear later this year, with the DoH purporting to fund collaboration across primary care providers, to be supported by PHNs.
GPs will also be eligible for a new incentive payment for attending residential aged care facilities – this will eventually replace the extended GP Aged Care Access Incentive. It will be tied to “My Medicare”.
Digital health
The announcement for digital health is something of a non-item – the DoH just notes that it will continue to support the operation of the Australian Digital Health Agency and My Health Record past June 30.
Reactions
The RACGP reacted positively to the announcements on after-hours care and the WIP but expressed caution on the announcements regarding pharmacy.
“We also welcome substantial increases to the Workforce Incentive Program, which will enable general practice to grow existing multidisciplinary care teams within general practice,” Dr Higgins said.
“This is essential in GPs delivering complex chronic disease care and this boost, in addition to the general practice infrastructure grants announced last week, really highlights the vital role GPs and practice teams play in communities nationwide.
“The college also supports greater investment in digital health to improve health outcomes, we have made massive inroads on this front in recent years and the sky is the limit.”
Dr Higgins also reiterated that, while she held reservations about the expanding scope of pharmacists, it was “not about us versus them”.
“Moves such as expanding the role of pharmacists delivering vaccines must be approached warily,” she said.
“Let me be 100% clear – GPs and practice teams absolutely value the vital role that pharmacists perform in communities across Australia.
“The RACGP is right behind GPs working hand in glove with a range of allied health professionals including pharmacists.”
To every Pharmacist, especially those in non-corporate run chemists,
— Dr Marian Dover (@DoverMarian) April 27, 2023
We value you.
We appreciate you.
We want to work closely with you in Primary Care.
You are an important part of the Healthcare Team.
Please keep talking to us, to let us know how you’re going. @Mark_Butler_MP
AMA president Professor Steve Robson said he hopes that reforms to GP services will help ease pressures on hospitals.
“We welcome projects that are going to help the people who most commonly go to emergency departments be able to set up and work with people with primary care and general practices around the country,” he said.
“These are great first steps and we really welcome them and we hope that it will lead to long term reform for out-of-hours care.”
He also expressed hopes that any changes in the scope of allied health professionals will occur within an integrated general practice setting.
