GP clinic in the A&E department

By having a GP clinic in the A&E department it can

1. Reduce waiting times for patients who really needs treatment

2 Reduce impatient people waiting

3.  The GP clinic can be also used as a teaching tool for Residents and Student nurses. A separate section to be dedicated in the A&E department -after the Triage RN has assess the patient and patient are  identify to attend the A&E department or for GP clinic.

The GP clinic should be opened from 8am to 11pm  7days a week...to capture the high traffice times especially over the weekend. The Resident assigned to the clinic can also be utilized in A&E when ther is no patients.

At the GP clinic,  education should be  given to the patient about  as to other resources in the community such as afterhour doctor service which is a  bulk  billing service or a list of bulk billing GP's in the area for further referrence.

Hopefully after enought time... 12months each hospital can assess the attendance of the GP clinic... if the demand is deminishing then the hospital can make a decision to reduce opening times depending on the statistic.

 

Why the contribution is important

It important to have the A&E department only for emergency's. So people have no idea that they should not be there if they could see a GP but either:

1. can't afford the out of pocket expence to see a GP

2. have no idea where the bulk billing GP are in there area especially over Sunday as some bulk billing medical centers are only open 6days a week.

3. Some people believe that the hospital should have a GP clinic.

by ClarkLy1900 on August 13, 2019 at 12:32PM

Current Rating

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Average score : 3.3
Based on : 6 votes

Comments

  • Posted by kathyk August 13, 2019 at 15:43

    Good idea, but a significant issue with people attending ED are that GPs are not available "out of office hours"and that there just AREN'T many bulk-billed practices anymore (I can only think of one in my area, I live in Fairfield, the closest is Buranda).

    It would make more sense (in my opinion) to have the co-located service available during the times when ED is usually busiest, otherwise people will choose to come to the ED-based (free) GP service instead of their usual practice.

    This idea could be combined with the 24 hr A&E idea, as co-located with ED but offering a slightly different service. In this way the blockage at/in ED could be reduced/streamlined (in addition to choosing other ideas that would assist in reducing the blockage prior to ED, such as the home visiting service described elsewhere).

    I think the whole "accessing appropriate medical care" is a complexity issue, so needs to be managed at each "pressure point" not just at the hospital. There is a major pressure point issue in the community/GP sector which is not being properly addressed - perhaps hospital funding could be used to provide out-of-hours free GP services in the community? GPs don't want to provide these services because they want to earn more (they are small business owners after all), and the AMA supports their earning. The only way to get around that "blockage" is to offer something different. If ED is overwhelmed, perhaps using the funding outside of the hospital site will also 'move' the problem away from the hospital campus?
  • Posted by Bowds22 August 16, 2019 at 06:06

    there is plenty of information available in a digital format for availability - to have these options made available in the ED waiting rooms would be beneficial to presenting patients - the days of a Hospital based GP service I feel are a step backwards - to make best use of Hospital equipment and space is imperative - to ensure patients have the available information of GP services and other health professionals - location, opening hours and online booking system in the digital arena is assisting with making best use of time and space.
  • Posted by ClarkLy1900 August 19, 2019 at 12:17

    I agree that there is plenty of information available in a digital format but people are not using it and are still presenting in A&E with minor conditions. So the current system is not working and I doubt that A&E staff will be given the authority to turn away minor cases. I also doubt that being given information about bulking billing doctors in the area will give the person incentive to leave A&E once they arrive.
  • Posted by BrettW August 22, 2019 at 15:36

    An important part of getting patients to implement an action plan during an exacerbation of a chronic disease is seeing their GP early.
    This is often a futile component though, because patients report not being able to get an appointment for up to a week. This is a regular occurrence.
    Anecdotally, negotiation from a clinician to the clinic doesn't usually elicit an appointment for the patient.

    Perhaps Metro South does need to revisit the idea having a primary care/GP clinic where chronic disease staff could refer patients with exacerbations to see a medical officer that day.

    Exacerbations of chronic disease or any acute illness not requiring ED, are difficult to treat in the community where the required business model necessitates appointment slots in GP clinics be kept full in advance.
    A service delivery model where there is responsible spending of funds (Public health model with Medicare item claims where allowed) rather than a business model requiring the generation of revenue to cover all costs, will help provide timely access to GPs.

    With respect to partnering with other organisations, would partnering to the UQ and RACGP and provide GP training be feasible? Possibly generate revenue?
    A service where 13 health and chronic disease staff etc could refer people if they can't see there own GP.

    From a chronic disease perspective, to help keep people out of ED, when a patient either self identifies or is told by a clinician that they need a medical assessment, they need to be able to see a GP in the next several hours and not be told that the next appointment is in a week.
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