Update: GP Visit Delays, Autonomous Pharmacist Prescribing and Mammography Services

November 18, 2019 0 Comments

We highlight statistics about the frequency of GP Visit Delays, proposals for Autonomous Pharmacist Prescribing and awareness for women’s Mammography Services.

GP Visit Delays

Autonomous Pharmacist Prescribing

Mammography Services

 

GP Visit Delays

The Australian Bureau of Statistics revealed that of the amount of people who needed to see a GP, 22.8% delayed seeing or did not see a GP over the past 12 months. This has been a 6.5% decrease from the previous year.

A decrease in GP visits delay

In the new release, the Australian Bureau of Statistics (ABS) revealed that of the people who needed to see a GP, 22.8% delayed or did not see a GP over the past 12 months, a decrease of 6.5% since the last year’s period.

The result are from the Patient Experience Survey which collected information from people aged 15 years and over about their experiences with health services in the last 12 months.

The report also highlights that General Practitioners were the most common health service people visited. Around 8 in 10 people (82.8%) saw a GP, followed by dental professionals (49.0%) and medical specialists (35.5%).

However, there has been a general decrease in health service use compared to the previous year:

  • 1.8% decrease for GPs (from 84.3% last year to 82.8% this year).
  • 2.2% decrease for dental professionals (from 50.1% last year to 49.0% this year).
  • 5.1% decrease for medical specialists (from 37.4% last year to 35.5% this year).

Doctor seeing a patient

In an interview to newsGP, RACGP President Dr Harry Nespolon said that the statistics emphasise the crucial role of Primary Care from general practices in Australia’s healthcare system. They also highlight the needs for better government support.

Of the survey respondents, only 3.4% reported that cost was a factor for them to delay a visit to the GP. Cost was also considered a more serious factor for younger people (aged 15–24) than for those aged 65 and over. For people living in areas of socioeconomic disadvantage, cost was also a more predominant factor.

For people living outside of the cities, RACGP points to issues like longer waiting times, fewer after-hours appointments and higher out-of-pocket expenses. but highlights that better distribution could help tackle some of these issues.

Attractive female doctor working on her laptop in her office

Earlier this year, RACGP has announced the Rural Generalist Pathway (Rural Generalist Fellowship), the new program to ensure suitably trained GPs are available to provide services in rural and remote Australia.

RACGP will continue to work in collaboration with the Australian College of Rural and Remote Medicine and other specialist medical colleges to ensure future rural doctors are well supported and adequately skilled to address the health needs of Australia’s rural and remote communities.

However, Dr Harry Nespolon added that serious investment is still required in those remote regions to ensure all Australians receive the same high-quality healthcare, regardless of where they are.

Private insurers’ push to fund GP visits

A recent KPMG report suggested that community-based Preventive and Primary Care are preferred by the general public over hospital visits. This is due to fewer complications, lower mortality rates, cost savings and better patient outcomes in a lot of cases.

Private health insurers have asked to cover services outside hospitals that currently attract a Medicare benefit, such as GP visits. Australians are not always able to cover medical expenses incurred outside of the hospital system with their current private health insurance policies.

However, RACGP worries that any proposed reform should avoid risking disruption to universal patient access, and it could create a two-tiered system that excludes the most vulnerable patients. Health Minister Greg Hunt also indicated they are open to considering new options for providing care in different settings that would benefit those patients.

However, Australian Private Hospitals Association’s Chief Executive raised a safety concern as having an insurer determining care options instead of a medical professional could lead to dangerous business.

As a better option, the Chief Executive considered this as a base for health insurers to diversify their business models and move into the delivery of health services themselves. Any further reform should be in the consumers’ best interests, she said.

Cardiogram with love

Questions?

What do you think about the funding proposal? Please contact one of our friendly team of consultants Today.

 

Autonomous Pharmacist Prescribing

Under Autonomous Prescribing, pharmacists could prescribe within the scope of their practice without the supervision or approval of another health professional. And the Pharmacy Board recently released its Statement.

The Proposal

Earlier this year, the Pharmacy Board released a discussion paper – Pharmacist Prescribing – and suggested three structures under which pharmacists could prescribe:

  1. Autonomous prescribing
  2. Prescribing under supervision
  3. Structured prescribing arrangement

The Pharmacy Guild has responded to this discussion that autonomous pharmacist prescribing would be able to satisfy public needs.

The Guild believed that it would improve access to treatment options for simple conditions that can be managed by a pharmacist, including after hours and weekends when access to other health care professionals can be limited depending on a patient’s location.

The Guild also suggested prescribing under a structured prescribing arrangement or under supervision creates a dependence on other health care professionals. Therefore, the method would not be flexible enough to meet the needs of all Australians from remote areas where there is severely limited access to a medical doctor or nurse practitioner.

Other examples of services a Pharmacist prescriber could provide the necessary care include after hours, palliative care, aged care or addiction medicine.

In these instances a pharmacist would be similar to a nurse practitioner, where pharmacists would provide care within their individual scope of practice, and in collaboration with other team members.

Pharmacy store medicine display

The Board’s Response

The Pharmacy Board has recently released its Position Statement on Pharmacist Prescribing and elaborated it should not seek to chase a model whereby pharmacists could prescribe medications without medical supervision.

Autonomous prescribing by pharmacists would require additional regulation, changes to legislation, and an application to the Ministerial Council following the development of a registration standard.

As for the restricted models, no barriers will apply for pharmacists. As highlighted in their statement, there are no obstacles to collaborative prescribing alongside medical professionals, and structured prescribing whereby pharmacists have limited authorisation under guidelines.

Medication in patient hand

The Pharmacy Board highlighted that significant issues remain with any model of pharmacist prescribing. These may include conflicts of interest and the importance of separating the prescribing and supply of medicines.

The Pharmacy Board’s Position Statement was published shortly after the AMA released its 10 Minimum Standards for Prescribing document. It was developed by the AMA Council of General Practice and approved by the AMA Federal Council and it seeks to ensure patient safety and high-quality health care.

The Board concluded there are no regulatory barriers in place for pharmacists to be able to prescribe in two of those models of care within a collaborative healthcare environment, both with a structured prescribing arrangement or under supervision.

For autonomous prescribing by pharmacists, the Board recommends additional regulation is required via an endorsement for scheduled medicines. The Board hopes stakeholders will further explore the potential role of pharmacists in prescribing that may contribute to the healthcare needs of the public.

Questions?

What do you think about the proposal result? Let us know by scheduling a call Today with our friendly consultants Sean Kelly and Alyssa Bonfa.

Heart shape animated

 

Mammography Services

A review of Australia’s BreastScreen program from 2014 found that it had reduced mortality rates in Australia by approximately 21–28%. The services are important but may be impacted with workforce shortages.

Mammography Services in Battle with Breast Cancer

A mammogram is an X-ray of breast tissue that can find changes that a physical examination could not detect. There are two types of mammograms: screening and diagnostic.

A screening mammogram is used to check for breast cancer without any previous signs or symptoms while a diagnostic mammogram is used to check for breast cancer after a potential symptom has been found.

BreastScreen Australia is widely available and accessible to many women in Australia. Particularly, women aged 40-49 and those aged over 74 may also be screened free of charge. While not all women will get a specific invitation for a screening, all women are encouraged to know the risks and benefits of screening and where they can get it done.

Smiling women organising event for breast cancer awareness on a sunny day

A review of Australia’s BreastScreen program published in 2014 found that the program had reduced breast cancer mortality rates in Australia by up to 28% with a participation rate of 56% in the targeted age group of women aged 50 to 69.

Evidence indicates that mammography screening for women aged 50–69 years impacts and reduces the mortality from breast cancer, and supports the continued screening of women at population risk in the similar age group.

Early detection can significantly improve treatment outcomes and the goal with any screening program is to minimise the potential harms. However, there are potential risks with the screening including over-diagnosis, some inaccuracies as well as radiation exposure.

The Cost of Mammography Services

Screening mammograms under the BreastScreen Australia program are freely available every two years to all Australian women over 40 and without any signs or symptoms of breast disease.

Women who have been referred for a mammogram by their doctor may have to pay a fee though. While there is a Medicare rebate for mammograms, some private imaging clinics may charge more than the Medicare Schedule Fee. In this case there may be an outstanding out-of-pocket expense.

Claims have been made previously that mammography reimbursed through the Medicare Benefits Schedule (MBS) impacts the Program participation rate.

Survey results showed that due to the modelling of the Program, the demand and capacity in the future for the Program will continue to exceed capacity if nothing is currently done to prevent it.

Implementation of digital mammography could improve capacity, but its introduction alone will not provide sufficient capacity to address the gap between demand and capacity for services. Shortages in the Radiography workforce are the greatest constraint to capacity while demand for mammography services is growing.

Breast Cancer ribbon awareness

Grants Available for Mammography Students

Mammography students will receive grants from BreastScreen Victoria to support their future career.

Students who enrolled in the Graduate Diploma of Mammography at Charles Sturt University are eligible to apply for the Dr Marjorie Dalgarno Grant. There are six grants of $10,000 and two $20,000 grants for Aboriginal and Torres Strait Islander students.

The Graduate Diploma of Mammography is designed to provide alternative ways for training mammography practitioners and hopefully to minimise the recruitment shortages in the industry. Charles Sturt University together with BreastScreen Australia, the Australian Institute of Radiography and the federal Department of Health and Ageing co-developed the postgraduate course.

The course is delivered online and clinical placements through BreastScreen Australia will be mandatory. The grant also includes opportunities for employment after graduation.

Medical student studying

Questions?

What are your thoughts on the findings of the study? Schedule a call Today with our friendly consultant Judith Butcher.

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