Clinical Taskforce targeting urgent after-hours primary care services

The clinician-led Taskforce that is reviewing more than 5,700 items covered by the Medicare Benefits Schedule (MBS) including after-hours GP home visits.

 

Today the Taskforce released its third round of recommendations for public consultation.

 

Professor Bruce Robinson, chair of the MBS Review Taskforce commissioned by the Federal Government, said the MBS review is aimed at ensuring that subsidised procedures covered by the MBS are up-to-date, clinically effective, provide value for the healthcare system and support the best quality care for patients.

 

The consultation also includes a preliminary MBS Review Taskforce report on Urgent After-Hours Primary Care Services funded through the MBS.

 

“It was the strong view of the Urgent After-hours Working Group and the Taskforce that the current use of urgent after-hours services does not reflect clinical need in Australia.

 

“The growth in use of urgent after-hours GP services does not seem to reflect patients’ clinical needs.”

 

“After-hours services are important, but we must ensure that patients get the right test or treatment first time, every time and not be subjected to unnecessary and inappropriate care,” Professor Robinson said.

 

The Taskforce reported that “there are a range of Medicare Benefits Schedule (MBS) items available for urgent and non-urgent services provided after-hours including those that take place in consultation rooms, at a patient’s home and services provided to patients in residential aged care facilities. The MBS pays for two kinds of after-hours care; standard care and clinically urgent care, which is a higher payment.

 

“The Taskforce is recommending changes that will ensure appropriate use of ‘urgent’ after-hours primary care services by appropriate providers that will achieve good patient outcomes.

 

“In reviewing the ‘urgent’ after-hours items, the Taskforce considered the perspectives of consumers in a wide range of life circumstances and recognised there is a need for people to access appropriate home visits in the after-hours period.”

 

The Taskforce areas of concern with after-hours primary care were:

  • Routine use of 'urgent” MBS items for services which may not be urgent

  • Not all urgent care can be provided at home

  • Urgent after-hours services are growing because of new business models, not clinical needs

  • Urgent after-hours home visits are often provided by clinicians less qualified than a patient's regular GP.

The Taskforce is recommending that:

  • MBS funding should continue to be available for appropriate after-hours home visits

  • The highest rebate should be for GPs who normally work during the day and are called out to see their patients to make an assessment

  • Businesses established to provide care after-hours, staffed by doctors who mainly work after-hours, should be using the lower general after-hours MBS items

  • Urgent after-hours care should not be able to booked prior to the start of the after-hours period 6:00pm.

The recommendations are said not to impact after hours services related to:

  • Non-urgent after-hours home visits

  • After-hours clinics (after 6:00pm)

  • Visits to residential aged care facilities

  • Access to after-hours care in rural communities.

The latest round of public consultation also includes over 40 recommendations effecting over 170 items, from the Spinal Surgery, Renal Medicine, Dermatology, Allergy & Immunology, Diagnostic Imaging- Knee Imaging, and Diagnostic Imaging – PE/DVT Imaging clinical committees.

 

A new item is proposed to provide funding for the delivery of dialysis by appropriately trained nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal Health Workers in very remote areas of Australia.

 

“This will have significant health, social and economic impacts, for the patient and their families,” Professor Robinson said.

“Consultation with clinicians, consumer representatives, and the Australian public on committee recommendations is a critical step prior to the Taskforce delivering final recommendations to the Government,” Professor Robinson said.

 

For information and to complete a consultation questionnaire see www.mbsreview.com.au.

 

The Taskforce’s work is continuing and further draft recommendations will be released for public consultation throughout the year.

 

7 June 2017.