“Our vision is for a sustainable system that delivers quality health outcomes for all Australians, including indigenous Australians whose health and well-being are a key priority for this government.”
Assistant Minister for Health, Senator Fiona Nash pictured above
THE largest rural medicine conference ever held in Australia has been told the federal government has a reform program in place to ensure better access to health services for people living in regional, rural and remote communities.
Assistant Minister for Health, Senator Fiona Nash (pictured) told 650 delegates in Cairns today that there would be more time and effort put into consulting local professionals and communities about their needs.
The centrepiece of Senator Nash’s address was a commitment to provide $40 million over the forward estimates to support up to 100 additional intern places each year in private hospitals and non-traditional settings, with priority given to positions and rotations in rural and regional areas.
She said the government would provide $13.4 million for an additional 500 scholarships for nurses and allied health professionals, and allow more rural allied health workers to take leave, on top of the 100 allied health locum placements provided each year.
“Further, the government will invest $119 million to double the Practice Incentive Program (PIP) Teaching Payment for GPs who provide teaching opportunities with an additional benefit paid to those in rural and remote areas,” Senator Nash said.
“GP practices can also apply for expansion grants for teaching infrastructure based on an equal financial commitment, starting next July.
“Training for existing doctors and nurses in rural areas is also vital to keep up their skill levels and allow them to develop as professionals.
“Our vision is for a sustainable system that delivers quality health outcomes for all Australians, including indigenous Australians whose health and well-being are a key priority for this government.”
Rural Doctors Association of Australia president Dr Sheilagh Cronin, Cloncurry, said more support for training students was one of the best ways of increasing doctor numbers in the bush.
“We know that students who spend time in rural communities to get their training and have a positive experience there are more likely to return as registrars before moving to become qualified general practitioners,” she said.
“The Northern Territory is the only place on track to Close the Gap by 2031 and for this to continue we need to continue to grow our General Practice workforce,”
Approximately 1,000 medical professionals from across Australia will be in Darwin for the Royal Australian College of General Practitioners (RACGP) Annual Conference are set to make a difference to health outcomes for Aboriginal and Torres Strait Islander people , GP13, on 17–19 October.
Aboriginal and Torres Strait Islander health is a primary focus of the GP13 program with the aim of ensuring all general practitioners and their practice staff provide culturally and clinically appropriate healthcare to all Aboriginal and Torres Strait Islander patients.
“Aboriginal and Torres Strait Islander people have the same right as non-Indigenous Australians to enjoy a high quality of health, including not just the physical wellbeing of the individual, but also the social, emotional and cultural wellbeing of the entire community,” A/Prof Murphy said.
A highlight of the GP13 program is key note speaker, Dr Theresa Maresca (Mohawk Tribe, Kahnawake Band) presenting AKWE:KON (all of us, together): What American Indian communities can teach general practitioners plenary session.
A/Prof Murphy said, “The importance of learning from other cultures success and failures in incorporating Indigenous culture into general practice is critical if Australia is to move closer to removing health disparities between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.”
The RACGP’s National Faculty of Aboriginal and Torres Strait Islander Health, working closely with the Larrakia Nation, is hosting this year’s GP13 conference and offers delegates a wide range of Aboriginal and Torres Strait Islander health related presentations and workshops*, including:
Wednesday 16 October (College Day)
• National Faculty of Aboriginal and Torres Strait Islander Health annual meeting and the Standing Strong Together Forum
• Announcements of the RACGP Standing Strong Together Award, recognising partnerships between GPs and Aboriginal and Torres Strait Islander people in improving Aboriginal and Torres Strait Islander health
Thursday 17 October
• Plenary – Health is a state of mind, Dr Jeff McMullen AM
• Working successfully in an Aboriginal medical service – building an introductory workshop, Dr Tamsin Cockayne and Ms Leeanne Pena
Friday 18 October
• Plenary – AKWE:KON (all of us, together): What American Indian communities can teach general practitioners, Dr Theresa Maresca
• The experience of working in Indigenous medicine on the Tiwi Islands, Dr Rodney Omond
• Addressing awareness and practice gaps of polycystic ovary syndrome (PCOS) in Aboriginal and Torres Strait Islander women – a comprehensive approach to knowledge creation and translation, Mrs Rhonda Garad
• Quality training in Aboriginal and Torres Strait Islander health, Dr Tim Senior
• Islander medicine, A/Prof Bruce Harris
Saturday 19 October
• The role and responsibilities of the Aboriginal and/or Torres Strait Islander health worker, Ms Jenny Poelina and Mr Clarke Scott
• Increasing the number of Indigenous medical specialists, Dr Tammy Kimpton
The RACGP is pleased to host two Aboriginal medical students at GP13, who have been given the opportunity to attend through student bursaries offered by the RACGP.
A number of traditional Aboriginal artwork will be available for purchase for the duration of the GP13 conference.
The RACGP is proud to support efforts to tackle health disparities between Aboriginal and Torres Strait Islander people and non-Indigenous Australians and acknowledges the daily work of many of its members to improve health outcomes for their Aboriginal and Torres Strait Islander patients.
Follow GP13 on Twitter @RACGPConference for real-time GP13 conference updates or visit the website for an up-to-date program.
This year’s theme is ‘Individual. Family. Community.’ and e-health will be a focus across the streams of Dermatology, Clinical skills across general practice, Musculoskeletal medicine, Pain management and chronic conditions, Education and training and Business in practice.
Officially launched at GP13, the revised Computer and information security standards (CISS) (2nd edition) provides general practices with information and recommendations that will raise awareness of contemporary security issues and help protect against potential loss of sensitive data.
The CISS is being released in an interactive HTML version making compliance to the standards easier for general practices.
Dr Liz Marles, RACGP President, said the conference program has been designed to reflect the current issues and subjects relevant to the general practice environment, none more topical than e-health.
“E-health is the future of healthcare. It has tremendous promise to improve the efficiency, cost-effectiveness, and quality of healthcare delivery,” said Dr Marles.
The RACGP is hosting a high-speed broadband booth to highlight how the National Broadband Network (NBN) can better support both the business of healthcare and the use of technology in clinical care.
Dr Liz Marles said, “The booth offers the opportunity for general practitioners (GPs) to speak with other GPs who have embraced technology in healthcare, and how the national eHealth record system is being implemented into clinical practice.”
GP13 will offer delegates the opportunity to build upon current knowledge and understanding of the benefits of e-health in a series of presentations and workshops*, including:
Thursday 17 October
• Tweet and blog your way to a medical education – Dr Justin Coleman and Dr Tim Senior
• Using the eHealth record system to add value to clinical consultations – Dr Rob Hosking
• Online communication for education – risks, responsibilities and rewards – Prof Hugh Taylor and Mr Mitchell Anjou
• Mastering e-health in Best Practice Software – Mr William Durnford
Friday 18 October
• Electronic prescribing to reduce medication error – Dr Trina Gregory
• The GP guide to social media: an introduction to professional life on the web – Mr David Townsend, Mr Aaron Sparshott and Dr Edwin Kruys
Saturday 19 October
• Guidelines for quality health records in Australian primary healthcare – Dr Michael Civil
• When should I share my practice data? – Dr Patricia Williams
• Test the software: computer clinical support for osteoporosis – Dr Yvonne Selecki
Northern Territory General Practitioners will be promoting the Northern Territory this week to interstate medical professionals by wearing cheekydog shirts designed by local Indigenous artist Dion Beasley.
CHEEKY DOGS AND DOCS
“The Northern Territory is the only place on track to Close the Gap by 2031 and for this to continue we need to continue to grow our General Practice workforce,” Dr Cockayne who practices part‐time on the Tiwi Islands says.
Interstate doctors will be encouraged to strike up a conversation and share these and photos via social media with any doctors wearing the cheekydog shirts, specifically conversations about the Northern Territory lifestyle.
The initiative has been developed by Northern Territory General Practice Education (NTGPE) together with Dion Beasley to promote working and training as a General Practitioner in the Northern Territory and to create a sense of community for Northern Territory doctors.
“Being a General Practitioner in the Northern Territory is uniquely different to other parts of Australia, this initiative not only promotes working in the Territory but has the added benefit of creating a sense of community for NorthernTerritory GP’s, many of whom work in very remote areas,” Dr Tamsin Cockayne said.
A medical cheekydog band, ten musically talented GP’s who have worked all over the Northern Territory, has also been added to the mix calling themselves ‘Medical cheekydocs’.
The ‘cheekydocs’ will be playing at the Adelaide River Pub Tuesday 15 November and at Crocosaurus Cove Friday 18 November to enable interstate GP’s experience to the territory outside the Conference.
Medical cheekydog band at Adelaide River Pub on Tuesday 15 October
Doctors wearing Medical cheekydog shirts – Tuesday 15 October
GP13 Conference at Darwin Convention Centre Wednesday 15 – Saturday 19 October
Cheekydoc band at Crocosaurus Cove Friday 18 October
Dr Tamsin Cockayne is the Director of Cultural and Medical Education for NTGPE, a part‐time General Practitioner on the Tiwi Islands and a singer of the Medical cheekydog band.
The community gets to keep their doctor and the doctor receives the support they need to achieve Fellowship .The community is the real winner.
Doctors working in Aboriginal Community Controlled Health Services (ACCHS’s) will now be eligible to undertake vocational training towards fellowship of the RACGP & ACRRM via an extension to the Remote Vocational Training Scheme (RVTS).
There will be ten training positions available nationally for commencement in February 2014.
The RVTS extension is an Australian Government initiative designed to deliver structured distance education and supervision to doctors already providing medical services within ACCHS’s.
The program is supported by the National Aboriginal Community Controlled Health Organisation (NACCHO).
Doctors will receive training over a 3 to 4 year period, while they continue to work in their health service.
Training will be delivered by distance education and remote supervision and will be specifically tailored to doctors working in indigenous communities.
The extension will deliver support to ACCHS’s doctors so that they don’t have to move to another community to access mainstream general practice training. “The community gets to keep their doctor and the doctor receives the support they need to achieve Fellowship” says RVTS Chief Executive Officer, Dr Pat Giddings. “The community is the real winner”.
For further information please contact Dr Pat Giddings 0408 573 933 or Denise Burnett (NACCHO) 0417 983 581
The daughter of a prominent WA Aboriginal family is the pride of her generation, becoming the first Yawuru Karajarri doctor in Broome.
Kim Isaacs finished 12 years of hard toil on Friday when she passed the Royal Australian College of General Practitioners Fellowship exams.
The 34-year-old will work at the Broome Regional Aboriginal Medical Service, where she completed her GP training. Dr Isaacs said her family had a strong history in medicine. “I am the first western medicine doctor but my grandfather was a traditional healer,” she said.
Dr Isaacs started her medical degree at the University of WA at a time when there were few indigenous doctors nationally.
“Whether to do medical school was a hard decision to make as I had just finished my bachelor of commerce degree, I was broke and I had a job lined up,” she said.
“The poor health statistics of our mob and the small workforce of indigenous health professionals was enough to convince me I wanted to help make a difference, so I signed up.”
Dr Isaacs said she was passionate about child health.
“Our mob trust us, we work at a grassroots level and know what the health issues are facing our community,” she said.
Pictured Sarah Paterson (left) and Aislinn Martin (right) presenting the first copy of RACGP Standards to NACCHO CEO Lisa Briggs here in Canberra
The Royal Australian College of General Practitioners (RACGP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) are proud to launch the
New Interpretive guide to the RACGP Standards set to assist Aboriginal community controlled health services Interpretive guide to the RACGP Standards for general practice (4th edition) for Aboriginal community controlled health services (‘Interpretive guide’).
A companion document to the RACGP’s current Standards for General Practices (4th edition) (‘the Standards’), the Interpretive guide aims to assist Aboriginal community controlled health services to meet the requirements for accreditation against the RACGP standards and to apply quality measures to their everyday practice.
The RACGP and NACCHO acknowledge the efforts made by the Aboriginal Community Controlled Health Services (ACCHS), across Australia, to obtain RACGP accreditation, an important step towards achieving the best possible health outcomes for patients.
The Interpretive guide explains the Standards in a meaningful way for Aboriginal community controlled health services by taking into account their context, culture and service delivery models.
Associate Professor Brad Murphy, Chair of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health, acknowledges that Aboriginal community controlled health services are committed to achieving RACGP and other forms of accreditation, and this new resource aims to assist in identifying the relevance of the Standards to their own health services and communities.
“Thanks to the highly effective collaboration that took place between the RACGP and NACCHO, as well as its state and territory affiliates, we are proud to jointly launch a significant piece of work that will contribute to ongoing quality and safety improvements in the health services delivered to Aboriginal and Torres Strait Islander communities,” A/Prof Murphy said.
By applying the Standards to individual practices, GPs, Aboriginal Health Workers and their practice teams ensure the provision of high quality, safe and contemporary primary healthcare is delivered to all Australians.
“Achieving accreditation demonstrates that a practice has been assessed as having reached defined standards of excellence in safety and quality in primary healthcare. This should be a matter of great pride to the practice itself, its patients and the community,” said A/Prof Murphy.
Justin Mohamed the Chair of NACCHO on behalf of all the 150 members throughout Australia thanked the RACGP for the highly effective collaboration that has taken place between the two peak bodies to produce such an important resource
Both the Interpretive guide and Standards are available to all College stakeholders
The Royal Australian College of General Practitioners (RACGP) is Australia’s largest professional general practice organisation and represents urban and rural general practitioners. We represent over 21,500 members working in or towards a career in general practice and are proud that over 19,300 Australian-registered general practitioners have chosen to be a member of the College. There are over 125 million general practice consultations taking place annually in Australia. Visit
http://www.racgp.org.au. The RACGP recognises the traditional custodians of land and sea, on whose lands we work and live. We wish to pay our respects to all Traditional Owners and Elders past, present and future.
To promote the benefits of working and training in an Aboriginal Medical Service (AMS), Pius X AMS in Moree, Armajun AMS in Inverell and local general practice training provider, GP Synergy, have come together to develop a video showcasing the AMS training experience to GP registrars.
Across the country, many AMS facilities are involved in the education and training of GP registrars, who are qualified doctors undertaking specialist training in the field of general practice.
The general practice training program requires GP registrars to undertake training in a variety of hospital and community based settings, and this can include training in accredited AMS facilities.
To encourage more GP registrars to consider undertaking part of their training in a rural AMS facility, GP Synergy approached Armajun AMS and Pius X AMS to develop a promotional video showcasing the benefits of working and training in an AMS.
The video features interviews with GP registrars who have undertaken their training in the facilities, as well as interviews with GPs and AMS staff about their AMS experience.
“We wanted to be able to explain to GP registrars the benefits of training in a rural AMS and felt the best way to do this was for the registrars and staff to share their own personal AMS experiences,” said GP Synergy CEO John Oldfield.
Both AMS facilities were happy to take part in the initiative.
“Our involvement in the training program has shown that GP registrars training in AMS facilities can contribute enormously to the primary care health provision for local Aboriginal communities,” Said Armajun AMS CEO Debbie McCowen.
“We are happy to support any initiative that seeks to increase the numbers of GP registrars training in AMS facilities,” she said.
Acting CEO Ray Dennison from Pius X AMS agrees.
“We have found being involved in training GP registrars invaluable,” Ray Dennison.
“Our local community has benefited from improved access to primary health care and it has been a positive two way learning experience. We have learnt as much from the registrar as they have from working with us,” she said.
CEO John Oldfield said the video provides a positive and realistic account of what registrars could expect working in an AMS.
“We hope the video encourages more GP registrars to undertake part of their GP training in an AMS, not just in New England/Northwest NSW, but anywhere in Australia,” he said.
All services are invited to register to participate in the QUMAX Program. The QUMAX (Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander Peoples) Program provides services with funding to assist with improving the way medicines are used to maximise the benefits to the client.
A range of initiatives may be eligible for funding under all or some of seven categories.
Possible initiatives may include;-
the supply of delivery devices such as spacers for asthma medications,
transport to collect medicines,
dose administration aids to help with compliance,
education tools such as Ibera software licences and medicines reference texts,
medication education for staff,
cultural training for pharmacists and pharmacy staff and
facilitation of medication reviews for clients.
The QUMAX program has been running since 2008 and has guaranteed funding to 30th June, 2015 under the Fifth Community Pharmacy Agreement. Administration of the program is shared between NACCHO, The Pharmacy Guild of Australia and the Department of Health and Ageing.
Participation in QUMAX requires an annual registration process. This is done online using the NCN a custom built program for the administration of QUMAX. Patient numbers and the number of services registered are used to allocate the annual QUMAX budget.
Services will be notified of their budget and be asked to complete a workplan shortly after the close of registrations.
You may access the NCN through NACCHO’s website. Most services will already have staff that have been provided with usernames and passwords that enable them to logon and complete the registration form.
If you are new to the NCN or QUMAX please contact the QUMAX Program Manager at NACCHO to arrange access to the NCN. See contact details below
The access of Aboriginal and Torres Strait Islander patients to medications is improving, but more could be done to identify Aboriginal (Indigenous ) patients in general practice, says Jill Dixon, a project manager working in Indigenous health.
Access to primary health care outside the community controlled primary health care services requires patients to be identified and recorded as being of Aboriginal and/or Torres Strait Islander heritage by the general practice to receive access to the closing the gap prescription co-payment relief measure.
General practice also needs to be registered for the Indigenous Health Incentive, Practice Incentive Payment, to be eligible to provide co-payment relief prescriptions
Improving identification of Aboriginal patients in general practice
Our thanks to Jill Dixon for permission to republish:
A recent issue of Australian Doctor (8 November 2012) reported that a significant number of GPs did not know about a scheme that enables eligible Aboriginal and Torres Strait Islander patients to receive free or cheaper PBS medications.
The cost of medications has been identified as a key factor that prevents many Aboriginal and Torres Strait Islander people from obtaining optimum healthcare.
The PBS co-payment measure was introduced in 2010 to address this financial barrier and is a key measure to help close the inequity gap between Aboriginal and Torres Strait Islander people and non-Indigenous people.
The scheme has been successful beyond all projections in providing Indigenous access to vitally needed medications, especially for people with chronic conditions who previously could not afford to fill their prescriptions.
Ninety-six per cent of pharmacies participated in the scheme, dispensing 2.7 million prescriptions during that time.
This translates to a significant increase in the number of Aboriginal and Torres Strait Islander people being better treated for the prevention or management of chronic disease.
However, the report also claims that, while the gap is closing, there is still more to be done in ensuring access to medicines through the PBS Co-payment scheme for all Aboriginal and Torres Strait Islander people.
The most recent data (2008-2009) shows that benefits paid through the PBS scheme were about 74% of the level of expenditures for non-Indigenous people, and total expenditure was only 44% of that for non-Indigenous people.
Surprisingly, the gaps between expenditures for Aboriginal and Torres Strait Islander people and non-Indigenous people are greatest in non-remote areas, because of special provisions for pharmaceutical services for those living in remote and very remote areas.
In addition to cost, another barrier is the extent to which Aboriginal and Torres Strait Islander people access – or are known to access – primary and specialist health care services in the first place.
Mentioned in the above report is the importance of the identification of Aboriginal and Torres Strait Islander patients in those services. After all, how can a GP provide prescriptions under the PBS Co-payment measure if they don’t know that their patient is of Aboriginal and/or Torres Strait Islander origin?
Another recently released report provides some useful information here. The Bettering the Evaluation and Care of Health (BEACH) Report states that Aboriginal and Torres Strait Islander people, who constitute about 2.5% of the total population, were identified at only 1.6% of total GP encounters.
This is only marginally better than findings from 10 years ago, in the 2002-3 BEACH report, which found identification occurring at 1.2% of encounters. See the comparisons here.
We now know that the vast majority of pharmacists actively support the PBS Co-payment Measure.
However, we have no equivalent information on the percentage of general practices that identify the Indigenous status of their patients, thereby helping to start their Aboriginal and Torres Strait Islander patients on the pathway to better health outcomes.
The BEACH data suggest that routine identification in general practices is low, and this would then lead to the generally low uptake of Aboriginal and Torres Strait Islander specific health interventions.
There are many reasons for the low rates of Indigenous identification in general practice.
One is that many GPs and practice staff believe that they don’t have any Aboriginal and/or Torres Strait Islander people amongst their patient group. This is often an assumption based on the location of the practice, or that their patients ‘don’t look Aboriginal’.
Some practice staff believe that Aboriginal and Torres Strait Islander people should be treated just the same as non-Indigenous patients, and so should not receive any special services earmarked for them.
The gap between the health outcomes and life expectancy rates of Aboriginal and Torres Strait Islander people is now well known, and the government Closing the Gap health initiatives are intended to address this shameful discrepancy.
All GPs and practice staff are strongly urged to participate in these measures, starting with routinely identifying the Indigenous status of their patients.
The RACGP Standards for General Practices (4th edition) require general practices seeking accreditation to demonstrate that they ‘routinely record Aboriginal and Torres Strait Islander status in (their) active patient health records’. See the RACGP position statement.
The PBS Co-payment Measure is intended for Aboriginal and Torres Strait Islander people of any age who present with an existing chronic disease or are at risk of chronic disease and in the opinion of the prescriber would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine and are unlikely to adhere to their medicines regimen without assistance through the Measure. For more information, see here.