SSWAHS = SWSLHD + SLHD and the Medicare Locals - 72

Loss of divisions' support will hit rural GPs - ■ Michael Woodhead - 6Minutes

Rural areas may see an exodus of GPs if Medicare Locals do not maintain the support services to GP practices that have been provided by divisions, a Senate inquiry has heard.
 

Chris Mitchell, CEO of Health Workforce Queensland, says GPs are becoming “disenfranchised” in the transition to Medicare Locals as GP divisions have their funding terminated.

Speaking at a Senate rural health hearing in Townsville, Mr Mitchell said GP practices had relied heavily on divisions for areas such as IT support.
 

“The divisions did a lot of boutique work for practices and I do not think that stuff is going to continue [with Medicare Locals].
 

The IT support in some of these divisions has been sensational and it has kept those GP businesses going ... But I am not sure that that is going to continue,” he told the hearing. Mr Mitchell said the town of Weipa was likely to lose its GP practice because the GP division in Cairns that had supported the practice had lost its funding and been replaced by a Medicare Local.
 
He said Medicare Locals were preoccupied with setting up and focusing on developing after hours care and population planning programs rather than on support for local practices.

SWSLHD and Bowral's Health - 41

Mental health nurses improve access

• By Gemma Collins on  24 October 2011 - 6Minutes

Incorporating mental health nurses into general practice can lead to better outcomes for patients and GPs, but a shortage of these specialist nurses could make it difficult to expand the program, a pilot scheme has found.

A four-year program, which involved mental health nurses working with GPs and private psychiatrists in five states, was found to have “significantly improved” access to appropriate mental health services, a report has revealed (link).

More than 40,500 people received a service through the $191.6m Mental Health Nurse Incentive Program (MHNIP) from 2007-2011, in a range of areas which ranged from one nurse supporting one practice to seven nurses supporting 29 practices, according to the recently released report.

The authors say the program led to earlier intervention, shorter admissions and better follow-up with patients receiving mental health services in “convenient and non-stigmatising settings”.

GPs said they felt better supported in their work with mentally ill patients and said their knowledge and confidence had improved. 

Out of the 57 patients who were surveyed, 80% reported improvements in their mental health and almost half reported improvements in their social relationships. 

The government has since announced it will allocate a further $13m over two years to employ an additional 136 mental health nurses.     

But the limited availability of ‘credentialed’ nurses, particularly in rural areas, could make it difficult for the program to expand, the authors say.  

The funding which was based around a fixed payment per half day session was also found to be a deterrent, as it did not allow for any additional costs including computers or professional development and for the extra time needed to get around rural areas.

Now here is an interesting tale! I'm told that the Southern Highlands still has only one Credentialed Mental Health Nurse who provides this service. Other's have tried to enter the SH area to also provide the service but have not been supported by .... you guessed it !... the CEO of the Southern Highlands Division of General Practice..... who suggests it may be due instead to the others not being able to market themselves to the GPs. I guess it does not help if the CEO informs the GPs who are interested that they would be more open to being audited and other bits of misinformation guaranteed to turn off even the most ardent advocate for the program. The fact remains that since the failure of their own staff member in achieving credentialed mental health nurse status, the Southern Highlands Division of General Practice has taken their bat and ball and left the MHNIP field of play.

SWSLHD and Bowral's Health - 40

GPs to prepare for mental health cuts

• By Gemma Collins on  21 October 2011 - 6Minutes

Many bulk-billing GP practices will have to start charging patients for Better Access services, the RACGP says.

With the final report into the Senate inquiry on mental health cuts being delayed, the College has said that the changes to the Better Access general practice mental health item numbers announced in the May budget, are likely to come into effect from November 1. 

Ina  series of likely scenarios (link) the College says it will continue to lobby the government but “practices may require revised practice systems and billings in order to continue delivering high quality patient care”.

College members have come up with a list of different practice scenarios to provide GPs with alternatives models of care for mental health services.

It has given the scenarios of a large practice in the northern suburbs of Melbourne and a small busy private practice in the western suburbs of Sydney that will both no longer be able to afford to continue bulk-billing mental health services through the Better Access program.

They will instead charge a patient co-payment for all the mental health services or refer their patient to public state-based services.

Meanwhile a medium sized private rural general practice in Queensland that employs a practice nurse with mental health skills is planning to use General Practice Management Plans (GPMP) and Team Care Arrangements (TCAs) which will involve the GP and the practice nurse who will coordinate mental health screening and assessment. 

Meanwhile a fourth scenario for a bulk-billing practice that is unable to charge a patient co-payment due to its service charter, is to use the new MBS item 2715 in combination with other appropriate MBS items.

GPs are being told to contact the RACGP Policy & Practice Support Unit for advice (advocacy@racgp.org.au)

Comments

We drew up our new fees at the beginning of October and published them at the practice for patient’s information. Mostly our Gap is $30, but the gap for <40minutes plan is higher. I only realised this week when I received a mailing from Psychologist Association the if a patient has already used 10 sessions this year, they are ineligible for any more session after November 1st.

Milton Doctor | 22 October 2011 at 20:56