Disability

Project Officer: Lisa Maude
Phone: 8752 4902

This page offers useful websites for GPs and the community.

Annual Health Aassessment for People with an Intellectual Disability

Special Care Dentistry Services

 

For GPs

Specialist Clinics and Services

Respite and Day Centres in the Inner West

Associations

Useful links for families and carers

Service Directories for Local Councils

Mental Health Nursing

Project Officer: Karen Frost
Phone: 8752 4910

The Mental Health Nurse Incentive Program

The Mental Health Nurse Incentive Program (MHNIP) provides a non-MBS incentive payments to community based general practices, private psychiatry services and other appropriate organisations (including divisions of general practice) who engage mental health nurses to assist in the provision of coordinated clinical care for people with severe mental disorders in the community.

Mental health nurses work in collaboration with psychiatrists and general practitioners to provide services such as monitoring a patient’s mental state, medication management and improving links to other health professionals and clinical service providers.

For more information including brochures and fact sheets and advice on recruiting mental health nurses please call Karen Frost on 8752 4910 or visit www.acmhn.org.

Resources

  • Medicare Australia has a variety of resources available for the MHNIP, including:
    • Program overview
    • Eligibility
    • Payments
    • Application details
    • MHNIP documents

  • The Australian College of Mental Health Nurses website has information regarding:

Aboriginal Health

Project Officer: Kim Toole
Phone: 8752 4924

Care Coordination and Supplementary Services Officer: Mary Kearns
Phone: 8752 4926
Mobile: 0459 826 880

Aboriginal Outreach Worker: Dorothy Bamblett
Phone: 8752 4928
Mobile: 0420 365 454

Closing the Gap - Improving Indigenous Access to Mainstream Primary Care Program

Central Sydney GP Network acknowledges the traditional custodians of the land that we work on - the Gadigal and Wangal people of the Eora Nation and we pay our respects to the Elders, both past and present.

The Central Sydney GP Network (CSGPN) Aboriginal Health webpage refers only to Aboriginal people, in recognition that Aboriginal people are the original inhabitants of NSW. The use of “Torres Strait Islander” and “Indigenous” is only made when quoting the Commonwealth Government, which has a charter of providing services to both Aboriginal and Torres Strait Islander peoples.

Background

In 2008 the Council of Australian Governments (COAG) agreed to a $1.6 billion National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes to fund a broad package of initiatives addressing the target of closing the life expectancy gap within a generation.

One element of the package has involved engaging GP Networks to deliver the Closing the Gap – Improving Indigenous Access to Mainstream Primary Care Program. The aim of this program is to contribute to closing the gap in life expectancy by improving access to culturally sensitive primary care services for Aboriginal Australians.

Primary care services have been identified as generally being a first point of contact for health services in Australia. However, cultural barriers have historically limited access by Aboriginal people. According to 2006 Census figures the area serviced by CSGPN is home to approximately 4,800 Aboriginal Australians, which represents 3.3% of the NSW Aboriginal population. Within the network there are several Aboriginal specific health services, however as part of improving the options for Aboriginal Australians and ultimately their health it is important that all Central Sydney mainstream primary care services commit to playing their part.

The Closing the Gap – Improving Indigenous Access to Mainstream Primary Care Program is funded by the Department of Health and Ageing (DoHA).

Program Objectives

(source: DoHA Version 1.1 March 2010)

  • increase access to mainstream primary care services by Aboriginal and Torres Strait Islander peoples;
  • improve the capacity of general practice to deliver culturally sensitive primary care services;
  • increase the uptake of Indigenous specific Medical Benefits Schedule (MBS) items including Indigenous health checks and follow up items;
  • support mainstream primary care services to encourage Indigenous Australians to self-identify
  • increase the awareness and understanding of Closing the Gap measures relevant to mainstream primary care; and
  • foster collaboration and support between the mainstream primary care and the Indigenous health sectors.

Activities

CSGPN has several activities planned to meet the above objectives, which will be tailored to meet local needs. These involve:

  • promotion of the Program to community organisations through a range of methods.
  • collaborating with Aboriginal health organisations to identify and address barriers to Aboriginal Australians accessing primary care services.
  • promoting general practice as a valid, trustworthy and accessible first point of contact for Aboriginal health needs.
  • assisting general practice to manage specific Aboriginal health needs and issues at the local level.
  • providing support to general practices on methods to encourage Aboriginal Australians to self-identify when accessing primary care services.
  • coordinating education events for general practitioners and Division staff, including cultural awareness training and quality improvement activities.
  • developing and disseminating information resources for Aboriginal Australians.

Aboriginal Outreach Workers

Our aim is to contribute to closing the gap in life expectancy by improving access to culturally sensitive primary care services by the local Aboriginal community.

As part of the Closing the Gap program the Aboriginal Outreach Worker is available to support Aboriginal and Torres Strait Islander people to access local health services including GPs, specialists and allied health providers.

    The Aboriginal Outreach Worker can provide the following:
  • Information & resources about locally available health services
  • Referrals to culturally appropriate health care providers & services
  • Information & assistance with travel options to & from health appointments
  • Support when attending health appointments, including GPs, specialists, allied health providers & diagnostic tests
  • Assistance with effective communication between yourself & the health care provider
  • Information about local community services & activities

All services by the Aboriginal Outreach Worker are STRICTLY CONFIDENTIAL and FREE

If you are a GP with an Aboriginal patient who requires any of the above assistance please complete the Closing the Gap Referral Form and send via secure fax to: 9009 0690.

Care Coordination and Supplementary Services

The Care Coordination and Supplementary Services (CCSS) program is one of the measures under the Closing the Gap scheme aimed at improving chronic disease management in Aboriginal patients. This program has recently commenced at CSGPN. The program has two main components:

  1. Care Coordination provided by qualified healthcare workers to Aboriginal patients with a chronic disease. Patients will be referred by GP’s in general practices participating in the Practice Incentives Program (PIP) Indigenous Health Incentive; and
  2. Supplementary Services: A flexible pool of funds that can be used to assist patients receiving care coordination under the CCSS program. The funds can be used to access medical specialist and allied health services that are in accordance with the patient’s care plan. Care coordination can:
    • assist people in understanding their chronic health condition and managing it on a daily basis;
    • advise on the importance of following their care plan; and
    • provide support in identifying signs that their condition may require further assistance from a health professional.

The care coordinator may assist the patient in a number of ways, e.g. assisting them to access specialist services, ensuring patients can get to appointments, assisting them to participate in regular reviews with their GP, develop chronic condition self management skills and connect with community based services as needed. The care coordinator will work collaboratively with the GP and in accordance with the care plan.

All services provided by the Care Coordinator are free.

If you are a GP with an Aboriginal patient who requires the above service, please complete the CCSS referral form and send it via secure fax to 9009 0690.

The role of mainstream general practice

“While Aboriginal community controlled health services (ACCHSs) play a vital role in Aboriginal health, it is estimated that 60% of Aboriginal people and Torres Strait Islanders access health care elsewhere. Mainstream general practice therefore has an important role in ensuring better service provision, including improved HA (health assessment) uptake” (Kehoe, H., Lovett, R. W. (2008). Aboriginal and Torres Strait Islander health assessments - barriers to improving uptake. Australian Family Physician, 37(12), p. 1033).

Identifying Patients of Aboriginal Descent

This is important to know because the health of Aboriginal Australians is still significantly poorer than that of non-Aboriginal Australians. Identifying patients as Aboriginal ensures health services are matched to their needs. Practice staff and GPs can actively encourage Aboriginal patients to self-identify, which is the essential first step in providing specific health services.

A patient is considered to be of Aboriginal descent if they identify as being so. Appearance is not a reliable way of determining cultural identity. Routine identification can be assisted through:

  • staff cultural awareness training
  • improved understanding of the need for and the benefits of the health assessments
  • culturally appropriate resources in the waiting room
  • being confident when asking patients the question. An appropriate way to ask is:

    “Are you of Aboriginal and/or Torres Strait Islander descent?”

A RACGP fact sheet on identification of Aboriginal and Torres Strait Islander patients can be viewed at:
https://www.racgp.org.au/Content/NavigationMenu/PracticeSupport/StandardsforGeneralPractices3/RACGPStandards3rdEdFactSheets/200608Identificationofpatients.pdf

DoHA Practice support: How to Identify Aboriginal and/or Torres Strait Islander Patients

Health Assessments

Early indications are that the Medicare Aboriginal and Torres Strait Islander health assessments have the potential to considerably reduce morbidity and mortality. Early detection, diagnosis and intervention of common, treatable conditions needs to start happening to reduce the disproportionately high rate of late presentation, diagnosis and hospitalisation amongst Aboriginal Australians.

NACCHO National guide to a Preventative Health Assessment in Aboriginal and Torres Strait Islander peoples

Proformas:

PIP Indigenous Health Incentive

The Practice Incentive Program (PIP) Indigenous Health Incentive is aimed at supporting general practice, as well as Aboriginal health services to provide a comprehensive range of health services to Aboriginal people with chronic health problems. Financial incentives are arranged into 3 components that are based upon the level of care provided. Practices participating in the incentive will also have increased access to supporting health services for their patients.

More information on the PIP Indigenous Health Incentive can be accessed at:

Practices registered for the Indigenous Health Practice Incentive Program

current as of 27 July 2011

Practice Address Phone
Aboriginal Medical Service Cooperative (AMS) 36 Turner Street, Redfern 9319 5823
Albert Road Medical Centre 60 Albert Rd, Strathfield 9746 9440
Alice St General Practice 6 Alice St, Newtown 9550 6201
Burleigh Street Surgery 4 Burleigh Street, Burwood 9745 6560
Burwood Medical Practice 179 Burwood Rd, Burwood 9747 6327
Campsie Family Medical Centre 248 Beamish Street, Campsie 9718 0633
Church Street Medical Practice 280 Church Street, Newtown 9516 2944
The Clocktower Medical Centre Shop 2, 266-274 Burwood Road, Burwood 9747 4005
DMC Medical Centre 159 Victoria Rd, Drummoyne 9819 6666
Dr Doong’s Surgery 8 Burwood Road, Burwood 9745 2755
Dr Hamdy Boulis Surgery 14 Evaline Street, Campsie 9787 4986
Dr James Shao Surgery Marrickville 221a Marrickville Road, Marrickville 9550 9292
Dr A. Jones Surgery 79 Pitt St, Redfern 9699 8327
Dr Ramrakha Surgery 77 Elliott Street, Balmain 9810 1523
Dr Tan Surgery 672 Elizabeth Street, Waterloo 9699 8593
General Medical Practice 102 Marion Street, Leichhardt 9569 6051
Glebe Family Medical Practice 114 Glebe Point Road, Glebe 9660 8399
Homebush Medical and Dental Centre 17 The Crescent, Homebush 9746 7789
Krishnan Services Redfern 429 Cleveland Street, Redfern 9319 7600
Leichhardt General Practice 112 Balmain Road, Leichhardt 9560 2511
Newtown Medical Practice 327 King StNewtown 9557 5254
Dr Papadakis & Dr Ralec Surgery 18 Clarke St, Earlwood 9558 0171
Dr Patricia Mohr-Bell Surgery 342 Stanmore Rd, Petersham 9560 5610
Poet’s Corner Medical Centre Shop 5, 45 Morehead Street, Redfern 9698 3060
Rozelle Total Health 579 Darling Street, Rozelle 9087 4600
Surry Hills Village Medical Centre Shop 13, Surry Hills Village Centre, Redfern 9319 0656
Sydney Inner West Medical Centre 188-190 Burwood Road, Burwood 9745 3381
The Village Medical Practice 130 Smith St, Summer Hill 9798 3100
Waterloo Medical Centre 134 Raglan Street, Waterloo 9319 5823
Your Doctors Leichhardt 93-95 Balmain Rd, Leichhardt 9550 0288
Your Doctors Summer Hill 3 Lackey St, Summer Hill 9797 3900

PBS Co-payment Measure

The Government has introduced assistance to eliminate or lower the cost of Pharmaceutical Benefits Scheme (PBS) medicines for Aboriginal patients living with, or at risk of, chronic disease. The PBS Co-payment Measure is a response to identifying that cost is a significant barrier to accessing medicines for Aboriginal people.

Additional information on the Measure is available at:
Medicare - closing the gap

Forms for the PIP Indigenous Health Incentive and PBS Co-Payment Measure:

Resources and Useful Links

Aboriginal organisations

National Indigenous newspapers

Additional Information

Health Checks and Assessment

Project Officer: Vijay Ramanathan
Phone: 8752 4915

Overview Health Checks and Health Assessments



Health assessments overview

Health assessments are used to assess the over health of a patient taking into consideration their social, physical, physiological health, family history and environmental risk factors. They are useful tools to establish a baseline for the patient to consider, monitor or focus on self management to maintain or address their potential future health predicament.

They can provide the impetus needed to address a potential health problem such as CVD or diabetes. They can be valuable to patients and carers to help direct interventions before problems arise such as hearing problems in small children or dental issues in intellectually delayed patients.

They are also there to show parents the positives about their health. That their children are doing really well, they have reached the appropriate milestones and everything is on track.

We encourage all practices to take a whole of practice approach and utilise health assessments as a best practice frontline approach to health promotion, encouraging patient wellness and self management of care.

Guidelines to Health Assessments

  • The patient must give consent and the consent must be recorded. If the patient can’t give it or is too young. It will need to be given by a responsible person who has the authority to do so i.e. a parent, carers or guardian.
  • The patient’s usual doctor is best placed to carry out the assessment. Usual means having seen the patient on previous occasions over the past 12 months.
  • Both Practice Nurse and registered Aboriginal Health Workers are able to assist with history taking and provide health promotion interventions. All clinical diagnosis of the health assessment must be conducted under the care of the GP.
  • The patient should receive a copy of their health assessment.
  • Follow up and review where appropriate particularly with lifestyle interventions and goal setting.

Claiming rules

  • Always check with Medicare on 131231 to ensure the patient is eligible for the health assessment.
  • Health Assessments should not be claimed with other consolation unless it is clinical significant. The exception to this is with a Healthy kids check or a Comprehensive Medical Assessment. When they are often provided in conjunction with another consultation.
  • Bulk billing incentives can be claimed with health assessments.
  • Practice nurse item numbers and health assessments can also be claimed together.
  • The GP and the practice nurses total time combined equates to the item number claimed.

New rules for claiming and assessing (Question and Answers)
From 1 May 2010 new rules apply to health assessments this cheat sheet should help explain the process.

1.  Healthy Kids Check

Claiming rules

Only claim once

  • Claimed with practice nurse immunisation item number
  • Claimed with bulk billing incentive

Can be completed by

  • GP
  • GP and practice nurse
  • Practice nurse or Aboriginal Health Worker (item 10986)

Eligible children must:

  1. Be aged between 3 and 5 years of age
  2. Have received or be going to received their 4 year old vaccinations (NSW health Schedule)
  3. Have consent from parent or carers
  4. Be provided with a copy of “Get set 4 Life”

2.  45-49 year old Health Check for patients

Claiming rules

Patients is eligible for ONE health check between the age of 45-49 years Claimed with bulk billing incentive can be completed by

  • GP
  • GP with the assistance of a practice nurse

The patient

  • Aged between 45-49 years of age
  • At risk of developing a chronic disease

Risk factors include

  • Smoking
  • Poor nutrition and Physical inactivity
  • Alcohol intake

Biomedical Risk Factors

  • Blood pressure
  • High cholesterol
  • Weight issues
  • Impaired glucose metabolism
  • Family history

Tools to assist

3.  Type Two Diabetes Risk Evaluation – people 40-49

Target

people aged 40-49 at risk of developing Type 2 diabetes

Claiming rules

  • Once every three years
  • Claimed with bulk billing incentive

Can be completed by the

  • GP
  • GP and practice nurse

The patient

  • aged between 40 - 49 years of age Complete AUSDrisk assessment tool (link)
  • Have consent from parent or carers
  • Be provided with a copy of Get set for Life
  • Clinical risk factors
  • Lifestyle factors
  • Smoking
  • Poor nutrition
  • inactivity

Biomedical risk factors

  • blood pressure
  • weight
  • impaired glucose metabolism
  • recent diagnostic test results
  • family history of chronic illness

The health assessment will include

  • evaluation of patients risk using AusDRISK completed at least 3months before the health assesment
  • physcial examination and update of patients history and clincial investigation
  • make the assessment of patients risk
  • initiate patients readiness to change interventions
  • recommend Lifestyle Modification Program (LMP)
  • Contact CSGPN for referral number and provider
  • Implement motivalion interviewing and lifestyle coaching

Other services to support newly diagnosed diabetics

4.  75+ Health Assessment

5.  CMA

6.  People with an Intellectual Disability

7.  Refugee and Humanitarian Check

8.  Health Checks for Aboriginal and Torres Strait Islander patients

Children aged 0-5 information and form
Adults aged 16-54 information and form
Older patients aged above 55 information and form

Links

Further Resources

Modified Otago Falls Prevention Program

Overview

Falls are a common and potentially devastating cause of morbidity in older people living in the community. Falls result not only in physical injury, but can potentially reduce independence and impair quality of life. However, falls can be prevented.

CSGPN in collaboration with SSWAHS is now conducting a Modified Otago Falls Prevention Pilot Program. This project will assess the effect of an exercise program, developed specifically for each individual, to reduce their risk of falling and to improve their balance and strength.

The Modified Otago Program will work with participants to implement a home-based, individual exercise plan with the addition of three group based Otago exercise sessions at weeks 2, 4 and 8. These group sessions are intended to increase motivation, improve compliance, and monitor individual progress.

The original Otago Exercise Program has been shown to be highly effective in reducing the risk of falling in older people through individual exercise plans. This program was shown to be most effective in 80+ year olds and reduced falls risk by 35%.

Exercise programs for falls prevention have been shown to be most effective if targeted at older people who have had a recent fall or are at high risk of falling. However, current strategies for recruiting people into community-based exercise programs cannot screen participants for risk. The modified Otago program has been able to identify an effective screening tool to help identify those at risk of suffering a fall by examining the risk factors associated with this.

The aims of this program are to:

  • Test whether a modified Otago program can achieve greater participant compliance
  • Evaluate a modified Otago program for decreasing falls in a high risk population
  • Develop and evaluate referral pathways from primary care providers onto a modified Otago program
  • Increase the capacity within SSWAHS and the local community for providing Otago style programs
  • Recruit 100 community dwelling people aged 75 years and older with falls risk factors into the project
  • To engage selected local fitness providers and train exercise physiologists to deliver a modified Otago program in a group-based setting.

Screening

Screening will involve completing the 75+ Health Assessment for eligible patients. As part of this assessment GPs will be required to also complete the QuickScreen© Falls Risk Assessment (developed by the Prince of Wales Medical Research Institute.)

GPs role

  • Screen patients over the age of 75, using the MBS 75+ Health Assessment
  • During the assessment screen your patients for falls risk using the QuickScreen Falls Risk Assessment
  • Generate management plan (or GPMP if chronic conditions exist)
  • Refer eligible patients (with their consent) to the program coordinator.

GP benefits

  • 40 RACGP points for referring a minimum of 5 patients and performing a simple audit
  • Feedback on your patient’s progress in the program and health outcomes
  • Financial reimbursement for your time via the Medicare rebate for the 75+ Health Assessment (MBS item no. 700, 702)
  • A free QuickScreen© Falls Risk Assessment package (valued at $300) to assist in the screening process.

Patient benefits

  • A comprehensive assessment of their falls risk that provides a risk factor score that correlates with their probability of falling in the next 12 months
  • A visit from an exercise physiologist who will assess their abilities and tailor an exercise program to suit their needs
  • Three, free group exercise classes in their local community instructed by an exercise physiologist
  • Additionally, it is hoped that at the end of the six-month program they will have improved strength, balance and confidence in avoiding falls, as well as a decreased risk of falls.

Target areas

    At present, this study is targeting practices in the following areas:
  • Belmore
  • Campsie
  • Lakemba
  • Hurlstone Park
  • Kingsgrove
  • Ashfield
  • Croydon
  • Summer Hill
  • Lewisham
  • Petersham

Advance Care Planning

Project Officer: Vijay Ramanathan
Phone: 8752 4915

What is Advance Care Planning?

Advance Care Planning involves a patient thinking about and communicating to others how they would like to be treated in the future if they have a condition where they can no longer speak for themself. This may happen, for example, because of a stroke, progressive dementia, or becoming unconscious from some form of accident or illness. For more information, please visit SSWAHS or download the ACP Information Sheet for GPs.

Advance Care Planning used to be called Advance Care Directives and many web sites still utilise this terminology. Another term is Respecting Patient Choices.

Why Advance Care Planning is important?

Undertaking ACP means that future decisions about a person’s care are more likely to reflect their wishes. It helps them raise sensitive issues about the future with those close to them that they might otherwise avoid. It will mean that other people will not have to make decisions on the person’s behalf without knowing what that person’s real feelings and wishes would be. It reduces the chance of confusion and conflict when others are making decisions about a person’s care. It means that the patient and the people close to them can feel comfortable and reassured that there will be a common and calm approach to their care toward the end-of-life.

What does ACP involve for GPs?

The role of GPs in advance care planning may include:

  1. discussing the idea of advance care planning with patients/residents
  2. providing patients/residents with information regarding their current health status, prognosis and future treatment options
  3. witnessing or completing instructional directives where appropriate
  4. applying patients’/residents’ wishes to medical management.

What are the steps involved?

Step 1: Incorporate advance care planning as part of routine care of patients/residents
Step 2: Assess capacity of patient/resident to appoint a representative and complete an advance care plan
Step 3: Support discussion and documentation of advance care plan
Step 4: Apply the patient’s/resident’s wishes to medical care
Step 5: Review plan regularly or when health status changes significantly

SUGGESTION: Discuss ACP with the patients or residents during an ordinary consultation (opportunistic) or as part of health assessments.

Templates to complete ACP

  1. Statement of Values and Wishes (completed by the patient) Statement of Values and Wishes (Patient)
  2. Statement of Values and Wishes (completed for the patient) Statement of Values and Wishes (completed for the patient)
  3. Record of ACP discussion (for RACFs to complete) Record of ACP discussions

Links

  • Sydney South West Area Health Service: My Wishes SSWAHS My Wishes
  • The Royal Australian College of General Practitioners has guidelines on Advance Care Planning
  • New South Wales Government- Attorney General’s Department Capacity Toolkit - Information for government and community workers, professionals, families and carers in NSW. This has a section on Health including using their terminology Advanced Care Directives. Phone 02 8688 7507 or email diversity_services@agd.nsw.gov.au
  • The Advance Care Directives Association also has its own website and a book ‘My Health, My Future, My Choice’ can be purchased
  • The Benevolent Society developed a booklet that is no longer in print but can be downloaded titled ‘Your Future Starts Now - Guide for the over 50s’ -  (search for Advance Care Planning on their website)
  • Aged care assessment care planning framework 2009

Directory of Medical Specialists

This page provides a directory of services developed by CSGPN and other affiliated services. If you have any updates or would like to contribute a link to this directory, please contact Lee Sheppard on 8752 4927.

Medical Specialists

Surgical Specialists

Specialists Colleges

Others

Diabetes Prevention

Diabetes Prevention

Project Officer: Vijay Ramanathan
Phone: 8752 4915

Diabetes mellitus was endorsed as a National Health Priority Area at the Australian Health Ministers’ Conference in 1996 in recognition of the high prevalence of the disease in Australia, its impact on morbidity and mortality, and its potential for health improvements through prevention and treatment programs.

Type Two Diabetes Risk Evaluation

The Australian Type 2 Diabetes Risk Assessment Tool was developed by the Baker IDI Heart and Diabetes Institute on behalf of the Australian, state and territory governments as part of the COAG initiative to reduce the risk of type 2 diabetes.

Target people aged 40-49 at risk of developing Type 2 diabetes

To know more about and/or complete AUSDRISK, visit AUSDRISK Tool.

LIFESCRIPTS

The Lifescripts initiative provides general practice with evidence-based tools and skills to help patients address the main lifestyle risk factors for chronic disease: smoking; poor nutrition; alcohol misuse; physical inactivity; and unhealthy weight. The initiative assists with the provision of tailored advice to patients on modifying their lifestyle.

Lifescripts resources have been developed specifically for use with Aboriginal and Torres Strait Islander patients. The resources can be used by Aboriginal health workers, general practitioners and practice nurses within general practice or in Aboriginal and Torres Strait Islander health care settings.

Lifescripts resources are available in hard copy and as electronic template (Medical Director, Best Practice) from the Department of Health and Ageing website. The Lifescripts resoruces are available in English, Arabic, Chinese, Greek, Italian and Vietnamese.

Mental Health - Medicare

Project Officer: Karen Frost
Phone: 8752 4910

Overview

The ‘Better Access to Psychiatrists, Psychologists and GPs through the MBS’ initiative (Better Access) introduced new Medicare items in 2006 to provide better and more affordable mental health care.  The Better Access MBS Item Numbers are designed to promote a team approach to mental health care, with GPs better supported to continue working with psychiatrists, clinical psychologists, and other allied mental health professionals to increase the availability of care.

If you need any help with medicare item numbers and billings procedures please call Karen Frost on 8752 4910. Alternatively you can search the Medicare Benefits Schedule online Medicare Benefits Schedule - Search

For futher information on the Better Access project please visit the AGPN Primary Mental Health Care Network website.

Resources

  • CSGPNs Mental Health Treatment Plan and Review template
  • The Australian General Practice Network has a range of resources for GPs to assist with the implementation of the GP component of the Better Access to Mental Health Care Initiative, including:
    • The Better Access to Mental Health Care: Orientation Manual
    • The Better Access - General Practice Briefing - Powerpoint Presentation
    • Patient Pathways Flowchart
    • Outcome measurement tools
      • To access these resources please visit the AGPN Primary Mental Health Care Network Resources page on the AGPN website.
  • The Department of Health and Ageing website contains information on initiatives to build the capacity of the mental health care system

Urgent advice from pychiatrists

Mental Health Skills Training for GPs

  • CSGPN regularly runs Mental Health CPD events (including MHST), please refer to the CPD Events page on our website for further details.
  • A number of external education providers (including the Black Dog Institute and The NSW Institute of Psychiatry) offer mental health activities. For details on external education providers refer to the External Education page of our website.

Sexual Health

Project Officers:

Vijay Ramanathan Phone: 8752 4915
Julie McLean Phone: 8752 4905

Sexual health is a major aspect of health worldwide and an integral component of reproductive health. The World Health Organisation (WHO) defines it as:

‘a state of physical, emotional, mental and social wellbeing related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled’.

Sexually transmissible infections (STIs) is an important SH problem in Australia where 20.2% of males and 16.9% of females had reported that they had been diagnosed with an STI at some stage of their life.

General Practitioners are the most common source of treatment for sexually transmissible infections. Also, GPs are normally considered as the first medical contact for men with sexual dysfunction.

Key organisations

CSGPN distributes information on STIs and other sexual health issues and provides education on a range of sexual health topics through continuing professional development. Some useful information and vital resources:

Men’s Sexual Health

Women’s Sexual and Reproductive Health

Sexual health - Education and Training

ThinkGP Education

  • Interactive case studies on men’s health, women’s health and sexual health
  • Activities for practicing sexual history taking and managing specific sexual health issues
  • Activities can be found at www.thinkgp.com.au/education

Vital contacts

RPA Sexual Health Clinic
Ground Floor, Page Building (Building 14) RPA Hospital
119-143 Missenden Road, Camperdown
Phone: 02 9515 3131

Sexual Health Infoline: 1800 451 624

NPS - better choices, better health

NPS Facilitators:
Beba Ostrugnaj Phone: 8752 4909
Cameron Stewart Phone: 8752 4939

NPS Administration:
Julie McLean Phone: 8752 4905
Mary Eurlings Phone: 8752 4948

About NPS

NPS is an independent, not-for-profit and evidence based organisation that enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing. To find more about NPS, go to About NPS.

Therapeutic Topics 2010-2011

Topic Availability Topic flyer
CVD Risk: Guiding Lipid Management July 2011 - Dec 2011 Lipids_flyer.pdf
Balancing benefits & risks of antipsychotics Feb 2012 – June 2012

For further information on this program or to book a practice visit please contact the NPS Facilitators on 9799 0933

CSGPN educational visiting program includes

  • One-to-one practice visits to discuss objective up-to-date information on drug therapies and guidelines are offered on two therapeutic topics per year.
  • Small group case study discussions on select therapeutic area involving up to 12 GPs.
  • Interactive workshops on select therapeutic area, involving GPs, practice nurses and pharmacists.
  • Workshops that encourage further development of critical appraisal skills
  • Education and resources for consumers about QUM.

What is Quality Use of Medicines?

Quality Use of Medicines (QUM) is one of the central objectives of Australia’s National Medicines Policy. QUM means:

  • Selecting management options wisely
  • Choosing suitable medicines if a medicine is considered necessary
  • Using medicines safely and effectively to get best possible results

CSGPN and NPS

CSGPN works in partnership with the NPS to provide independent evidence based information and support to health professionals and consumers on the quality use of medicines through education and quality assurance activities, local programs, training and skills development.

Quality Prescribing Initiative (QPI)

GP participation in practice visits and nationally co-ordinated NPS clinical audits & case studies will qualify accredited practices for the Quality Prescribing Initiative (QPI) of Practice Incentives Program (PIP). NPS activities attract QA & CPD RACGP points.

NPS Resources

  • NPS Nurse Update is a digest of evidence-based information to help you improve your knowledge of medicines use and prescribing practices. NPS actively engages with nurses to encourage a greater understanding of medicines by providing information and activities on various therapeutic programs
  • NPS News is distributed bimonthly with Australian Prescriber and contains summaries of specific therapeutic areas and updates on complementary medicines.
  • Case studies are provided as inserts to NPS News and may be completed and returned to the NPS. GPs who participate receive a report on the aggregated responses
  • Clinical audits developed or approved by the NPS are free to GPs and recognised by the RACGP Quality Assurance and Continuing Professional Development Program
  • Prescribing Practice Reviews mailed to all GPs provide evidence-based information and prescribing data to enable doctors to review their own prescribing practices
  • RADAR (Rational Assessment of Drugs and Research) provides information on new drugs, PBS listings and commentaries of new research relevant to primary practice. Access quarterly RADAR releases at RADAR or look in your prescribing software.
  • Therapeutic Advice and Information Service (TAIS) phone 1300138 677 provides information to health professionals on newly available drugs, drug interactions, adverse drug reactions, use of drugs in unapproved indications.
  • Patient leaflets and action plans are designed to help health professionals communicate essential treatment messages to their patients and are best used in conjunction with verbal communication during patient consultation
  • NPS tools for health professionals practical help for health professionals in prescribing and achieving Quality Use of Medicines in practice.
  • Medicines Line phone 1300 888 763 provides consumers with independent information on prescription, over-the-counter and complementary medicines.

Useful links

Practice Support and Accreditation

Project Officer: Gabrielle Pilgrim
Phone: 8752 4937

Quick Reference Link
Practice Accreditation
4th Edition RACGP Standard
Accreditation Links and Resources
Practice Incentive Program
Practice Management Information

 

Program Overview

The Central Sydney GP Network (CSGPN) Practice Management Project provides support and information to GPs and practice staff through the following:

  • Practice Visits
  • On-site presentations to GPs and Practice Staff
  • Helpdesk (telephone and email)
  • Workshops
  • Communication tools such as newsletters, fax-outs and emails.

Assistance is available to practices in the following areas:

  • Accreditation: accreditation advice and assistance, collation of patient survey results, mock accreditation
  • Practice Incentives Program (PIP) & Service Incentives Payments (SIP)
  • Starting a new practice - assistance with all aspects of starting a practice
  • Business Process Review: review current processes and provide recommendations and advice on the flow of procedures including procedure manuals
  • Change Management and Human Resources
  • Workshops for GPs and Practice Staff
  • Risk Management and Occupational Health & Safety
  • Privacy and Confidentiality including record retention guidelines
  • Infection Control
  • Other practice management enquiries as required

What is Accreditation?

Accreditation is the assessment of a general practice against the requirements outlined in the Standards of General Practice written and published by the Royal Australian College of General Practitioners (RACGP). The Standards of General Practice are considered the benchmark for Australian practices. The accreditation process is completed by either AGPAL or GPA Plus and covers the following areas:

  • Practice Administration: appointment systems, triage processes, communication tools, interpreter services, after hours services, home visits, security, signage and health promotion
  • Practice Management: human resources, training, occupational health and safety, quality improvement
  • Consultation Room: facilities including design layout of the rooms and what to include in the doctor’s bag
  • Management of Health Information: confidentiality, privacy, transfer of health information, retention and destruction of records, electronic information security and access, content of patient records
  • Patient Management: practice costs, health promotion, continuity and co-ordination of care, recall systems, engaging other services, collaborating with patients
  • Treatment Room: practice equipment, Schedule 8 medicines, vaccine potency, perishable materials, perishable materials, infection control
  • Interviews: doctor interview, clinical staff (if applicable), staff interview
  • Document Review: practice information sheet, policies and procedures; patient feedback surveys

What benefits do I get from being an Accredited practice?

  • Guidance for best practice using benchmarks with other accredited practices
  • Access to the Commonwealth’s financial incentives programs - Practice Incentives Program (PIP) and Service Incentives Program (SIP)
  • RACGP QI & CPD points (Category 2)
  • Increased recognition from insurance providers
  • Reduced risks in service delivery
  • Improved practice efficiency
  • Improved patient outcomes

What does it involve?

Most practices prepare up to 8 months ahead of their accreditation date to gradually address the tasks needed. Practices must complete a Policy and Procedures manual, Patient Feedback survey and a formal Survey visit. Most requirements are already in place within practices however this process is a formal documentation and recognition of practices. For new registrations, the accreditation cycle lasts 12 months. The normal accreditation cycle lasts for 3 years. CSGPN is available to assist practices register and prepare for their accreditation.

New Changes in the 4th Edition Standards

From 1st of July until 31st of October 2011, any practice which registers for accreditation will be able to choose between the 3rd or 4th Edition RACGP Standards for General Practice for their practice assessment. Practices who are currently accredited and whose expiry dates fall between 1st of April 2012 and 31st of July 2012 will also have a choice of which edition they would like to be re-accredited against.The 4th Edition Standards will be used for all practices who register for accreditation from the 1st of November 2011 and whose current accreditation expires after the 1st of August 2012.

To help familiarise practices with the changes in the new edition of the Standards, the RACGP have produced a presentation and summary fact sheet which outlines the key changes between the 3rd and 4th editions.  The RACGP will also be running education sessions scheduled to resume in early September. Visit the RACGP Standards website for more information and timetables.

New Criterion- 1.5.2 Clinical Handover- Our practice has an effective clinical handover system that ensures safe and continuing healthcare delivery for patients
Clinical handover has been defined by the AMA as ‘the transfer of professional responsbility and accountability for some or all aspects of a patient’s or group of patient’s care to another person or professional group on a temporary or permanent basis’. Practices must be able to demonstrate that an effective clinical handover system is in place to deal with situations of clinician illness, annual leave or patient referral to other health services. This procedure should be supported by a documented policy to ensure that it is standardised across all clinicians within the practice and so all practice support staff are aware of it. Attention should be paid to patient health summaries and referral letters as these will assist in the safe handover of patients to other clinicians both internally and externally. Useful resources to assist practices include the ACSQHC OSSIE Guide to Clinical Handover or the AMA’s Safe handover: Safe patients guide.

New Criterion- 3.1.3 Clinical Governance- Our practice has clear lines of accountability and responsibility for encouraging improvement in safety and quality of clinical care.
The RACGP define clinical governance as ‘the framework through which clinicians and health service managers are jointly accountable for patient safety and quality care. This criterion is made up of two flagged indicators:

  • Our practice has leaders who have designated responsbility for safety and quality improvement systems
  • Our practice shares information about quality improvement and patient safety within the practice team

The Australian Commission on Safety and Quality in Health Care proposes that an effective clinical governance model should include recognisably high standards of care, transparent responsbility and accountability for maintaining those standards, and a constant dynamic of quality improvement. Practices must nominate clinical leaders in areas of quality improvement and patient safety who are responsbile for the implementation and monitoring of safety and quality systems. It may be beneficial for practices to consider other activities currently undertaken by the practice or other criterion within the Standards, as many activities may intersect. For example, regular practice meetings and the use of clinical audits, can satisfy more than one criterion and lend itself to elements of a clinical governance system.

New Criterion- 3.1.4- Patient Identification- Our patients are correctly identified at each encounter with our practice team.
Incorrect patient identification can result in medication errors, diagnostic test errors or failure to receive appropriate medical treatment. Studies have shown that using three identifiers decreases the risk of incorrect identification from 1 in 3 to 1 in 3500. The RACGP has introduced one new flagged indicator to meet this criterion: Our practice has a patient identification process using three approved patient identifiers and the practice team can describe how it is applied. The approved identifiers include:

  • Patient name, including given and surname/family name
  • Date of birth
  • Gender (self identified by the patient)
  • Address
  • Patient record number (where one exists)

When asking patient’s for identifying information, it is important that practice staff not volunteer the information for confirmation as errors may occur and that patient’s state their own information. All staff in the practice must be aware of the process for identifying patients and patients should be identified on occasions when attending the practice, over the telephone or when documents are requested/collected. Three approved identifiers must also be used when preparing referral letters.

New Criterion 5.3.1- Safe and Quality Use of Medicines- Our clinical team prescribes, dispenses and administers appropriate medicines safely to informed patients.
The 4th Edition Standards expands on medicine safety outside the previous focus on Schedule 8 medications. The medicines safety framework consists of 4 flagged indicators:

  • Our clinical team can demonstrate how patients are informed about the purpose, importance, benefits and risks of their medicines and how patients are made aware of their own responsbility to comply with the recommended treatment plan
  • Our clinical team can demonstrate how we access current information on medicines and review our prescribing patterns in accordance with best available evidence
  • Our clinical team can demonstrate how we ensure patients and other health providers to whom we refer receive an accurate and current medicines list
  • Our clinical team can demonstrate how we ensure that medicines are acquired, stored, administered, supplied and disposed of in accordance with manufacturers’ directions and jurisdictional requirements

Clinical team members must be able to demonstrate how patients are informed about their medications, how staff access current prescribing information and the medicines management within the practice. Patient medical records and consultation notes are of crucial importance in satisfying this criterion as well as the availability and use of promotional patient information. Clinical desktop systems and prescribing software allow for consumer information to be produced and, in some cases, self-recorded within the patient file. The Therapeutic Goods Administration Safety website has medicine safety information for both consumers and health professionals which may be used.

New Flagged Indicator- 1.7.1B Where our practice has an active hybrid medica record system, for each consultation/interaction, our practice can demonstrate that there is a record made in each system indicating where the clinical notes are recorded
Hybrid record systems pose a significant risk to patient management particularly in situations where patients are unable to see their regular GP. Where hyrbid record systems exist, practices need to ensure that all information is accessible when needed and it is recommended that practices work toward creating wholly electronic systems.

New Flagged Indicator- 5.1.1G The practice must have one or more height-adjustable beds
The RACGP has released a fact sheet on Height-Adjustable Beds outlining the rationale for the change and factors for consideration by practices. To assist practices with the cost of purchasing a new height-adjustable bed, your practice may be eligible for a rebate from Workcover NSW. Visit the Workcover NSW Safety Solutions Rebate page for more information.

New Flagged Indicator- 2.1.2C At least once every 3 years, the practice actively seeks feedback about patient experiences by using a validated patient experience questionnaire approved by the RACGP or their own uniquely developed method
The RACGP has acted on research evidence which suggests that the most meaningful changes to a practice can occur from collecting and using patient experience feedback. Tha RACGP have recently published a detailed guide Learning from our Patients which describes the methods practice can use to gather patient feedback along with their advantages and disadvantages. The RACGP has approved the following survey tools:

  • Patient Accreditation Improvement Survey- developed by Client-Focused Evaluation Programs. Two versions have been approved for use, a whole-of-practice survey and practitioner-specific feedback. Download the CFEP information sheet for more information about fees and processes.
  • PSI v4 of a Patient Satisfaction Instrument- developed by Ultrafeedback. For more information, download the PSI Flyer.

Human Resource System- Designated Responsibility amongst the ‘Practice Team’
The 4th Edition Standards has introduced the term ‘Practice Team’ to reflect the changing dynamics of medical practices and recognises the multi-disciplinary roles amongst practice staff, acknowledging to both clinical and non-clinical staff. Practice must now designate a team member responsbility in the following areas:

  • Cleaning
  • Complaints Management
  • Infection Control
  • Information technology
  • Quality Improvement
  • Risk Management Systems
  • Sterilisation
  • Vaccine Management

Under the 4th Edition Standards, position descriptions are now mandatory for all staff and if a team member has a deligated responsbility in the above areas, it must be documented as part of this document. It is expected that all other members of the practice team can identify the designated leaders in each area and that a process is implemented to monitor team member performance against their position descriptions. The CSGPN Practice Recruitment Guide may be able to assist you with the require documentation and implementing an effective performance management system.

Accreditation Links and Resources

How can CSGPN Practice Support help practices with Accreditation?

Full assistance is provided by CSGPN to plan for the accreditation visit including the provision of resources, checklists, collating patient survey results, mock interviews and training with staff, and conducting a mock accreditation visit. For assistance with your practice accreditation, contact Gabby or phone 8752 4937.

Practice Incentive Program

The Practice Incentive Program (PIP) provides financial incentives to general practices aimed to encourage improvements in quality of care, access and outcomes of all patients. Practices must either be accredited or become accredited within 12 months to be eligible for the PIP. The PIP is administered by Medicare Australia on behalf of the Department of Health and Ageing. There are 13 individual incentives which make up the PIP each with their own payment structures. Payments are made to both the practice and the individual practitioner, and are generally calculated based on practice size.

For more information about the PIP and the individual incentives, visit Medicare Australia: Practice Incentive Program website.

The New Practice Nurse Incentive Program

Medicare Australia and the Commonwealth Government released in early June the guidelines for the new Practice Nurse Incentive Program (PNIP). The PNIP is designed to streamline current financial payments made to practices through the PIP Nurse Incentive and MBS nurse items into one single payment. Under these new arrangements, eligible practices will be supported with payments of up to $12,500 per annum for an Enrolled nurse or Aboriginal Health Worker and up to $25,000 for a Registered nurse. Payments are calculate based on practice SWPE and contracted hours of the employed nurse or Aboriginal health worker.

The program also offers a one-off $5,000 incentive payment to eligible non-accredited practices to become accredited. Applications for the program open 1st of October 2011. For more information on the PNIP, click on the program guidelines below. To calculate how much your practice may be eligible for, use the Ready Reckoner link below.

PIP Links and Resources

 

Practice Management

Practice management is a growing area of need for Australian general practices and is now being recognised by professional bodies as a key element in the delivery of high quality healthcare services. The RACGP in it’s review and development of the new 4th Edition Standards for General Practice, has acknowledged the evolution in the general practice environment and the growth of the general practice team by acknowledging the contribution they can make in areas of risk management and service coordination. In the RACGP’s Draft Definition of General Practice published in March 2011, there is further acknowledgement of the need for coordination and teamwork in delivering high quality patient care including compliance with national standards and guidelines, in the general practice setting. Practice management encompasses a number of issues which affect the day-to-day running of a practice including human resources, information technology and information management, facility and equipment maintenance, accreditation and compliance, administration and finance.

Practice Management Training Providers

  • The Australian Association of Practice Managers (AAPM) is a non-profit, national organisation which exists to provide professional support, advocacy and education to Practice Managers to assist them with the performance of their practice.
  • UNE Partnerships is the education and training company of the University of New England and in association with the AAPM, have developed a number of professional qualifications for Practice Managers.
  • Indigo Medical and Dental Consulting are a nationally Registered Training Organisation (RTO) who have several courses available in Healthcare Business Administration, Medical Reception, Dental Assisting and Practice Management. I
  • Medical Administration Training is a natioanlly Registered Training Organisation (RTO) who has been delivering medical administration courses since 2004.
  • Some courses are available for completion as Traineeships in conjunction with some RTO’s so employees can learn whilst ‘on-the-job’. The NSW State Government supports the employment of Trainees and there may be financial incentives available for employers to establish Traineeships. Download the NSW State Government Guide to Apprenticeships and Traineeships in NSW for more information or contact CSGPN for a list of Australian Apprenticeship Centres in your area.

How CSGPN supports Practice Managers

CSGPN helps support the education and professional development of Practice Managers with monthly practice staff events with a range of topics to address practice management issues. Download our CPD Calendar to check what events are coming up or visit our CPD Page to access presentations from previous events. 

We strongly encourage Practice Managers to provide feedback and comments on what topics or information should be featured both at events and on our website. Use the feedback tool on the website to send us your comments or you can contact Gabby via email.

CSGPN also offers Practice Managers, Practice Nurses and Aboriginal Health Workers, working in practices within the CSGPN area to apply for full Ordinary membership. If you are interested in a Member, please visit the Membership page for more information or to download an application form.

Diabetes Prevention: Live Life Well for 50-65 year olds

Project Officer: Vijay Ramanathan
Phone: 8752 4915

The Prevent Diabetes Live Life Well program is being run in collaboration with Sydney University, SLHD, Diabetes Australia NSW and funded by NSW Health. This program is available to patients of participating GPs, aged 50 - 65 years at risk of developing type 2 diabetes. Participants receive an initial 90-minute consultation followed by 3 two-hour group sessions where they learn about eating better, moving more and behavioural change skills. Follow-up support is provided for 1 year after referral to the program. The consultation and sessions are run by trained Lifestyle Officers and will be held across three locations in the Central Sydney GP Network area. For more information including a copy of our fact sheets, please visit www.livelifewell.nsw.gov.au.

We are no longer accepting new referrals into this Program. Please contact Vijay Ramanathan on 8752 4915 if you have any questions.

Domestic Violence

Project Officer: Lisa Maude
Phone: 8752 4902

DOMESTIC VIOLENCE HOTLINE 1800 656 463
Domestic Violence is a very challenging issue for general practice. It is a problem that does not discriminate between social status, race or religion. One in four women will experience Domestic Violence in their lifetime. Often their GP is the person the patient will turn to seeking support and guidance.

This page offers useful tools, links and contacts that can help better resource GPs to support their patients living in Domestic Violence situations.

White Ribbon Campaign

Disclosure is the first step to helping patients who are victims of Domestic Violence deal with their situation. Providing a safe environment for the patient to do so is vital.

One way to create a safe environment for the patient is to demonstrate your stance against Domestic Violence. Signage, posters and brochures can express your position and help the patient feel validated and safe.

The White Ribbon is internationally recognised as a symbol that represents The National Day of Remembrance and Action on Violence against Women. Displaying the symbol and supporting the cause is just one way to share your concern with patients. If not already, have you and your practice considered joining the campaign and signing the national pledge to stop violence against women? To do so go to: www.whiteribbonday.org.au

Useful tools for general practice

  • Power and control wheel (a useful tool in helping to understanding the patterns of abusive and violent behaviours that can be used to establish and control and power over others)
  • SOFFT method of recording file notes. In order to discharge your professional responsibilities to patients, meet all legal requirements and provide a record of your treatment and the decisions you have made in relation to treatment. The SOFFT method of recording file notes is recommended. SOFFT stands for SAID OBSERVED FELT FORMULATION THEN

Child safety

Sunday, February 5th 2012

Office hours are weekdays 9am - 5pm
The current time is now 1:17am

Upcoming events

  1. CPD event : February 7, Tuesday
    Workplace Health and Safety for General Practice

  2. CPD event : February 8, Wednesday
    Men’s Health

  3. CPD event : February 9, Thursday
    Advanced Medical Director ALM

  4. CPD event : February 13, Monday
    Aboriginal Cultural Awareness

  5. CPD event : February 16, Thursday
    Sexuality & People with a Disability

    6. Click here for more...
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