From DHS communication to divisions of general practice in December 2002.

In the 2000-2001 year GPs in Victoria provided 53,736,303 services . Of these 26.8 percent were services to people over 65 years of age. The average number of Medicare services used per person per year is 11 in Victoria, but for those over 65 years the number is 23 services per year. This level of health service usage may be taken as a measure of need in this older age group. Older people are more likely to have a range of chronic and degenerative conditions some of which would benefit from the range of allied health services provided through the primary care system. GPs� access of these services has been highly variable and very dependent on local arrangements and relationships, often leading to dissatisfaction and criticism on both sides. While some community members may be able to navigate the health system themselves, this is less certain for those who are elderly, frail and disadvantaged by chronic illness.

Service coordination was a major initiative in primary care reform introduced in Victoria this year and its basic aim was to improve the experience of people using the primary care system. The reform was to be achieved through the following means:

• Patient centred and planned approach to care (not tied to service boundaries)
• Improved quality of referral
• Shared awareness of patient service needs and use of services
• Standardised quality of recording information
• Reduced duplication of data collection

The aim is not to reduce the amount of contact an individual has with a health professional for it is this contact that often improves the sense of wellbeing and security in those who are frail and elderly. Patients regularly report the importance of a trusting relationship with their GP who has time to show concern and explain what is happening to them .

Community based services, through Primary Care Partnerships, are currently implementing the reform at the local level. A generic set of tools has been developed for collecting and sharing patient information. The tools most useful in General Practice are:

• Summary and referral (This is a uniform referral tool and is now preferred by all community service providers ie Community Health Centres, Aged Care Assessment Services, Local Councils and other HACC providers)
• Consumer consent form (Meets both Commonwealth & State regulations)
• Consumer Information brochure

In order to support GP participation in local service coordination the Summary & Referral and the Consumer Consent forms have been installed as templates in �Letter Writer� within Medical Director software and we would hope other medical software would follow soon. The advantage of a structured format for referral and reply forms that make use of headings is that it makes it easier for the reader to quickly identify the required information.

Click here to find out more about the generic tool templates and guidelines for their use.

Click here to view the latest version of the Medical Director template as an Rich Text Format (RTF) document.  This template will be available in the August 2003 update of Medical Director.