Additional funding for emergent presentation in GP

Current GP funding significantly limits the ability to provide emergency care for lower acuity presentations.  Most practices only leave a couple of appointments per day/session unbooked to allow for emergencies.  If these slots are not filled the practice and doctors do not generate any income.  As a result often people cannot get in to their regular doctor on the day (leading to fragmented care).  If someone presents requiring more involved treatment e.g. assessment, urgent blood tests, urgent imaging and then second review there is often inadequate time and very little funding to allow this.  Transport/monitoring is often also difficult.  As a result people are diverted to Ed or choose to attend Ed as it is free and all required investigations/treatment can be done in one location.  If funding models were improved and private general practices were provided funding to divert people away from emergency departments, treating within the community would be more feasible.  If additional funding were available, larger practices could have a dedicated GP available (without prebooked appointments) to manage more acute presentations.  E.g. Person presents with clinical pneumonia, currently may be referred to Ed due to time pressures, lack of funding and lack of appointment availability.  Alternatively, if GP practice is provided block funding to have one dedicated doctor available for urgent presentations, person receives on the day appointment, urgent bloods and imaging done nearby (or in conjunction with local hospital), second review with GP and treatment instigated.  A specific item number would need to be billed to reflect the additional time/cost required and to cover the sessional costs for the clinic/GP (to allow emergent access/dedicated GP for acute on the day appointments). 

Why the contribution is important

Care within the community leads to less fragmentation and improved continuity.  Increased funding of general practice will allow GPs to manage lower acuity presentations.  Currently funding is the main barrier.  

by ALE on August 20, 2019 at 01:18PM

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Average rating: 5.0
Based on: 1 vote

Comments

  • Posted by mcrice August 22, 2019 at 05:28

    What gets funded, gets done.
    Presently the funding streams are designed to achieve...exactly what happens now.
    Significant redesign of State and Commonwealth funding will be needed to achieve different outcomes

    Block funding as proposed may be one solution.

    Would you put this "dedicated doctor" on a hospital style salary at consultant rates with paid sick leave, professional development, superannuation and WorkCover?

    How to arrange for patients to see their regular GP for chronic care (similar to hospital outpatients) rather than just presenting "as needed" to the dedicated "urgent care" doc? Expecting the GP clinic to solve patient behaviour hospitals can't might be expecting too much
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