August 2001

CONTENTS

Workforce
After Hours Program
State priorities for rural health
Privacy
Reminder to GPs
Commonwealth Budget and the Chronic Illness Initiatives
Diabetes
Changes to the outcomes payment for General Practice Immunisation Incentives (GPII)
National Information Conference for Regionalised Vocational Training
Better Medication Management System (BMMS)
Accreditation

Workforce
The final report of the Workforce Project conducted in the first half of this year by Susanne White and Geraldine Marsh of The Resolutions Group has been presented to GPDV board.

The board gave priority for the immediate future to working with other stakeholders on the development of more adequate data about the GP workforce and the development of a more effective index of needs. The board's next priority is the enhancement of the role of the practice nurse and after-hours issues, which will be taken-up by GPDV's After-Hours Program Officer who will shortly be appointed.

Your division has a copy of this report.

After Hours Program
GPDV will shortly appoint an After-Hours Program Officer. The one-year senior position is part of DH&AC's National After Hours Primary Medical Care Initiative to develop proposals for the greater involvement of divisions of general practice and GPs in the provision of more effective after-hours medical services. Similar appointments are being made in all SBOs.

The Program Officer will work with divisions, existing after-hours services and other stakeholders to investigate successful models for after hours care in Victoria, determine the models that divisions of general practice in Victoria may most effectively use, promote initiatives and opportunities for collaborative arrangements with existing after-hours services and hospitals, and identify opportunities for and barriers to integration with existing and planned services.

We are advertising the position now and expect to make an appointment in early September.

State priorities for rural health
Rural representatives from all parts of the health sector, as well as local government rural departments of universities and community organisations met on 17 August with Andrejs Zamurs, Chief of Staff in the Office of Health Minister John Thwaites. At the meeting which was called by RWAV, Andrejs said that, by creating senior positions of Director and Assistant Director, Rural Health, the current restructure of DHS will provide the structural support for action in key areas in rural health, which are

• Working with communities to find models of health service provision that are sustainable in rural Victoria
• Planning to retain and support an integrated health workforce
• Developing networking and partnership arrangements that will make the full range of services accessible to all rural communities, however small.

A feature of the discussion was the critical importance of joint work across all three levels of government and the need for organisations on the ground with the capacity to manage and integrate services whose funding comes from many small Commonwealth and State programs. Divisions of general practice are in a good position to take up this challenge.

Privacy
As reported in last month's newsletter, there are two sets of new privacy legislation (Commonwealth and State) which will affect GPs, divisions, other health service providers, as well as private sector organisations which do not handle health information. (This includes divisions of general practice).

ADGP is providing information for divisions on the Commonwealth legislation. GPDV is working on clarifying how the two sets of legislation relate. This is particularly important because of the information sharing between GPs and other health providers (through Primary Care Partnerships, communication with hospitals etc.). It seems that divisions and GPs will be covered by both the Commonwealth and State legislation, and will need to be aware that the state-funded agencies they work with will be working to comply with the State legislation. Similarly, other agencies (including the PCPs) will need to remember that it is generally the Commonwealth legislation that will apply to general practices and divisions.

In working to clarify how the two sets of legislation relate, and identifying the differences between them, GPDV will produce some overview information (2-3 pages) for GPs and divisions to set out who is covered by what legislation. This overview information will be circulated to divisions, and posted on our web site shortly.

GPDV is also arranging for speakers to address privacy issues at a workshop for divisions. This is planned for October, depending on speakers' availability. More details will be circulated to divisions as soon as they are confirmed.

Reminder to GPs
If your contact details change, or if someone joins or leaves your practice, please advise your division(s) who will forward your new details to us in order to amend the General Practitioner Register (GPR).

Commonwealth Budget and the Chronic Illness Initiatives
John McEncroe, GPDV Chair, and Bill Newton, CEO, attended the SBO/ADGP National Workshop on 27-8 July. The main topic was the implementation of the five new initiatives in the Commonwealth Budget - Diabetes, Asthma, Mental Health, Cervical Screening and Practice Nurses - and the maintenance of other ongoing components of the Divisions program, such as IMIT.

SBOs and divisions will have the task of integrating the separate packets of funding for each of these initiatives into programs at the service level. SBOs and ADGP are negotiating with GP Branch to obtain from the budget initiatives the resources needed for divisions to do this effectively. GPDV will work at state level with DHS and Victorian branches of national organisations such as Diabetes Australia, as well as with RACGP, other Medical Specialist Colleges and university departments of general practice.

At the GPDV Forum on 19 August Julie Thompson, Chair of ADGP, reported that information about the role of divisions in the Cervical Screening Program and the Asthma Program will be available next week. Planning for the Diabetes Program is also well advanced.

A national workshop on the Practice Nurse Program, at which ADGP and SBOs were represented, was held on July 28-29 from which a report will be available shortly.

Diabetes
The Commonwealth Budget provided $49.8 million over four years for diabetes treatment and care, including $43.4 million over four years to improve prevention, provide earlier diagnosis and improve management of people with diabetes through general practice. The package will:

• provide incentives for GPs for earlier diagnosis and effective management for people with diabetes;
• provide support for Divisions of General Practice to work with GPs and other health professionals to improve access to better care for people with diabetes;
• encourage consumers with diabetes to support appropriate self care and partnerships with health professionals; and
• support changes in the practices of health professionals to provide better care for those affected by diabetes.

The details of this program, and the place of divisions in it, are being worked out in negotiations with DH&AC. A key role for divisions will be support for GPs and practices to encourage them to make the structural changes to enable the effective use of registers and recall systems at the practice level.

GPDV will work at state level with DHS and with the Victorian branch of Diabetes Australia, as well as with RACGP, diabetes specialists and the National Association of Diabetes Centres.

Changes to the outcomes payment for General Practice Immunisation Incentives (GPII)
Due to the success of the General Practice Immunisation Incentives (GPII) scheme the Government recently announced an extension of the scheme to 30 June 2003. The scheme will continue unchanged until 31 December 2001, with some changes to apply after 1 January 2002.

The Scheme will continue to consist of the three components:

An Outcomes Payment. The current payment tiers reward practices that achieve immunisation rates of 80% to less than 90% and 90% and over. From 1 January 2002 the payment tiers will be changed to 85% to less than 90% and, 90% and over. From 1 January 2003 payments will be made to practices that achieve 90% and over

A Service Incentive Payment (SIP). A payment of $18.50 will continue to be paid to GPs and Other Medical Practitioners (OMPs), who notify the Australian Childhood Immunisation Register (ACIR) of a vaccination that completes an age-appropriate immunisation schedule; and

Divisional funding. Divisions of General Practice will continue to be funded at current levels to June 2002 to assist them in improving the proportion of children who are immunised. As well, support for State-Based Organisations and national co-ordination activity will continue at current levels until June 2002.

No changes will be made to SIP or divisional funding until at least June 2002.

National Information Conference for Regionalised Vocational Training
In Sydney on 26 July, General Practice Education and Training (GPET), the Commonwealth's recently created GP training body convened a national information conference for consortia intending to bid for the conduct of GP vocational training under the new regionalised program arrangements due for commencement next January.

The meeting was convened to give consortia information about the policy reasons behind the Commonwealth decision to restructure GP vocational registration training along regional lines. As future training will be delivered by regional consortia who have been funded on a competitive tendering basis, the conference also provided essential information for tender preparation, including: clarification of the training objectives involved, special points to be included in bids, and selection criteria for assessing successful proposals.

A full coverage of this important information event dealing the implementation of radical changes to the delivery structures for GP vocational training and the implications for divisions is presented in the GPDV Education Project Update No 1 available through all Victorian divisions and the GPDV web site www.gpdv.com.au

Better Medication Management System (BMMS)
As divisions may have noticed in the media (including last week's Medical Observer) the BMMS Development Group have decided not to introduce the BMMS legislation at this stage. The BMMS Development Group have decided to consult more fully before proceeding with the proposal, as support from each of the 3 main stakeholder groups (doctors, pharmacists and consumers) is essential for successful implementation of the BMMS.

The BMMS Implementation Taskforce say that more information should be available in a few weeks. (Their website is at http://www.health.gov.au/hfs/bmms/index.htm where there is currently no information about the changed plans).

Accreditation
AGPAL reported that 80% of Australian general practices have registered for accreditation with AGPAL. The percentage take up by state is