KEY STRATEGIC DIRECTIONS FOR 2004-05
Reduced Red Tape and Streamlined Communications for General Practitioners
During 2004-05, the Department worked with the medical profession to progress and implement changes for simplifying and improving the Practice Incentives Program (PIP) and Enhanced Primary Care (EPC) items based on the recommendations of the Red Tape Review Taskforce. The changes to EPC have been completed with the commencement of new Chronic Disease Management (CDM) items on 1 July 2005. The Department has implemented a number of the identified changes to PIP and will progress other changes during 2005-06.
The introduction of new CDM items will make it easier for general practitioners (GPs) to manage the health care of patients with chronic medical conditions, including patients needing multidisciplinary care. These items have been developed by the Department in close consultation with GP organisations. They significantly increase care planning options for GPs, as well as expanding patient eligibility and increasing the assistance that practice nurses and others can provide.
The Department’s contribution to the National Broadband Strategy includes the Broadband for Health initiative, which provides $35 million over three years, to encourage health services to adopt business-grade broadband connectivity. The Department has made substantial progress in encouraging the adoption of business-grade and advanced broadband connectivity in the health sector. At least 35 per cent of eligible primary care providers accessed subsidised business-grade broadband services, with 76 per cent of these connecting to a high speed internet connection for the first time. The remainder of participants upgraded from a domestic-grade to a businessgrade broadband service with strengthened security requirements. Barriers to participation included the infancy of the broadband industry in Australia resulting in slow supply and demand, complex administrative procedures, and security concerns by health providers. The review of program guidelines and implementation of a continuous assessment process to qualify services increased the participation of eligible organisations in the Broadband for Health program at least six-fold since the changes were implemented, with a noticeable improvement in uptake in regional, rural and remote areas.
Strengthened Funding Arrangements for the Divisions of General Practice Network
During 2004-05, the Department strengthened funding arrangements for the Divisions of General Practice (Divisions) network through the development of the national performance framework within the new Multi Program funding Agreements (MPAs). The framework includes performance indicators and streamlined planning and reporting.
The new MPAs reflect the key recommendations of the Government’s response: Divisions of General Practice: Future Directions
, concerning the roles, structures and funding arrangements of the Division’s network. They set out clear expectations of Divisions and improve accountability arrangements. The inclusion of national performance indicators are used to monitor progress towards the achievement of program objectives in national priority areas for primary health care. These new agreements allow for streamlined reporting and payment cycles, and funding for multiple programs within the one agreement.
In addition to performance indicators and streamlined planning and reporting, the National Quality and Performance System (NQPS) provides a strong foundation for the future growth of the network. The NQPS comprises several elements to promote quality and achievement:
- a quality system leading to accreditation; and
- a framework for recognising and improving performance.
The Department, through the NQPS, works with the Division’s network to build on existing strengths and achievements in order to advance primary care in Australia.
Development of New National Public Hospital Data Collections
The Department worked with the States and Territories under the 2003-08 Australian Health Care Agreements to expand public hospital emergency department data collection by developing datasets on patients’ presenting with problems and their related diagnoses. The Department has also established a new national minimum dataset on patients’ use of outpatient services at public hospitals. These data collections are designed to allow reporting to the community to increase its understanding of the performance of the public hospital sector, including areas of variation between the States and Territories. It will also be used by the Australian Government to inform policy development on improving performance and funding arrangements for public hospitals.
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Improved Rates of Organ Donation
The Department continues to work to increase the rate of organ and tissue donation with the aim of reducing waiting lists and improving the quality of life for many Australians. At any one time there are approximately 2,000 Australians on transplantation waiting lists. Australia has one of the lowest organ donation rates in the Organisation for Economic Cooperation and Development and a major strategy to improve the rate in Australia is to increase community awareness of the Australian Organ Donor Register (the Register).
These children are all transplant recipients competing at the Australian Transplant Games.
During 2004-05, the Department worked with the Health Insurance Commission to raise the donation rate by strengthening the Register. The Government, together with the Pharmacy Guild and supported by the Australian Divisions of General Practice, undertook an organ donor registration drive through a mail-out to all Australian households. From April 2005, the Register commenced recording a person’s legally valid consent to donate organs. This is a clear legal statement of the donor’s wishes and, with other related strategies, should translate to improved donor rates.
Management of Blood Services across Australia
In 2004-05, the Department provided 63 per cent of the funding for the Australian blood sector under the National Blood Agreement, with the States and Territories contributing the remaining 37 per cent of the funding.
The Department also provided advice for the Government’s response to the Senate Community Affairs References Committee Inquiry into hepatitis C and the blood supply in Australia, which reported in June 2004. During 2004-05, the Department implemented the recommendation to increase access to recombinant clotting factors for haemophilia patients and all haemophilia patients are now able to elect to be treated with recombinant blood clotting factors VIII and IX.
A new five-year agreement providing for a range of plasma products was signed between the National Blood Authority, being an Australian Government agency acting on behalf of all jurisdictions under the national blood arrangements, and CSL Limited, coming into effect on 1 January 2005.
The Department continued the advisory service it provides to the Minister on blood matters. Through chairing the Jurisdictional Blood Committee, the Department contributed to managing a shortage of Australian intravenous immunoglobulin products via an overseas contingency supply and securing savings via new supply arrangements for diagnostic reagents to take effect on 1 July 2005.
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Improved Quality of Life for Terminally Ill People and their Carers
In 2004-05, the Department worked with a number of agencies such as Palliative Care Australia, service providers, universities and Divisions of General Practice to improve the quality of life for terminally ill people and their carers.
The Department funded the Program of Experience in the Palliative Approach (PEPA), which assists health care professionals, including nurses, residential aged care workers and allied health professionals, to improve their skills in caring for people with a terminal illness. In 2004-05, over 200 health care professionals completed a PEPA placement, with participants learning more about palliative care and forming strong links between their own service and the specialist palliative care service.
To support residential aged care staff to provide better care to residents with a terminal illness, the Department provided Guidelines for a Palliative Approach in Residential Aged Care
to all Australian Government funded residential aged care facilities as well as training institutions in Australia and overseas. Over 8,000 copies have been distributed since July 2004. These are the first evidence-based guidelines of their type in the world. The Department also provided funds for an online Palliative Care in Aged Care postgraduate course which provides students with the knowledge and skills necessary for improved palliative care practice in aged care settings. During 2004-05, there were 61 enrolments and 11 scholarships awarded under this program.
Palliative Care Services
During 2004-05, the Department supported a number of key initiatives to help palliative care services improve the quality of the care they provide. For example, the Department engaged a consortium of four universities to form an Australian Palliative Care Outcomes Collaboration. This collaboration will support services to compare and measure the service they provide, and through this, ensure continued quality improvement.
To improve access to respite care for families of palliative care patients, the Department provided $3 million in 2004-05 to Commonwealth Carer Respite Centres (CCRCs). Preliminary evaluation results indicate an increase in the number of carers of people with a terminal illness accessing CCRCs in 2004-05 and improved referral links between palliative care services and the CCRCs.
In 2004-05, the Department continued to fund the Rural Palliative Care Program, which links services and offers education and training to improve the quality of care in a number of regions across Australia. Some services have established a 24 hour 1800 number to assist patients and their carers receive support and advice from their health professional over the phone, without the need to travel to their local service or hospital. Care teams which may include the patient’s GP, community nurse, palliative care specialist and pastoral carer, are using case conferences and care plans to help coordinate and improve care.
Mental Health Care
The Department led the development of a whole-of-government submission to the Senate Inquiry on mental health, synthesising the broad range of current government activity to support people with a mental illness and their families. The Department continued to strengthen its leadership role to create improvements to this area of the health system by working with other departments, governments and the non-government sector. The Department also continued development of the Better Outcomes in Mental Health Care Program. This program supports GPs in the care and management of their patients with a mental illness by funding support from allied health professionals and psychiatrists. This initiative has delivered allied health services to about 20,000 consumers since its inception.