Annual Report - Performance Information

PART 2: PERFORMANCE INFORMATION

Performance Information for Administered Items

Administered Funding - Primary Care Programs, including:

Primary Care Education and Training;
Primary Care Financing, Quality and Access;
Primary Care Policy, Innovation and Research; and
Primary Care Practice Incentives.

Target:	Quantity: Four high quality primary health care research projects/program grants funded.
Result:	Target met.	9 research grants worth $3.8 million were awarded under the Primary Health Care Research Evaluation and Development (PHCRED) Strategy for priority-driven research to help build the evidence in chronic disease prevention and management through general practice. A further 3 investigator-driven grants were funded under PHCRED totalling $1.5 million.
Target:	Quality: Innovative models of general practice and primary care service delivery trialled or implemented.
Result:	Target met.	23 services are being funded through the After Hours Primary Medical Care Program and 58 services through Round the Clock Medicare: Investing in After Hours GP Services. Recognising the need to develop high quality and safe services, a time lag before service commencement will occur in some cases. 8 Sharing Health Care Initiative demonstration projects were evaluated over a 2 year period by an external consultant. Evaluation outcomes underpinned the National Chronic Disease Strategy Self Management element. 4 Coordinated Care Trials were completed by 1 July 2005. The fifth trial was completed by 1 October 2005. The National Evaluation of the Trials is being undertaken and will be finalised in 2006-07.
Target:	Quantity: Training places available for GP registrars in rural and urban areas are filled.
Result:	Target not met.	Training is conducted on a calendar year basis. In 2006, 326 of the 350 General Pathway places were filled and 232 of 250 Rural Pathway places were filled. This represents 93% for both Pathways.
Target:	Quantity: An estimated 70% of prevocational general practice placements are undertaken.
Result:	Target not met.	The Prevocational General Practice Placements Program aims to make up to 280 placements available per annum for junior doctors, with the aim of encouraging them to take up general practice as a career. While 270 placements have now been approved, around 117 placements, or 42%, were taken up in 2005-06. A major factor reducing uptake has been the refusal of New South Wales to accept the program’s arrangements, which have been accepted by all other State and Territory governments. As a result, only 6 placements were undertaken in New South Wales in 2005-06. Across the country, some hospitals have also been unable to release junior doctors for placements owing to workforce pressures.
Target:	Quantity: Increased number of non-vocationally recognised medical practitioners undertaking continuing professional development through general practice incentive programs.
Result:	Target met.	At 30 June 2005, there were a total of 438 participants on the After Hours Other Medical Practitioners Program and the MedicarePlus for Other Medical Practitioners Program. This had increased to 554 participants as at 30 June 2006. In order to maintain eligibility, participants on both programs are required to undertake continuing professional development activities.
Target:	Quantity: : Initiatives lead to an increase in primary care services in areas of need.
Result:	Target met.	262 GP registrars undertook placements in outer metropolitan areas of workforce shortage during the 2005 training year. This is an increase of 30% over 2004 where 201 registrars undertook placements. In 2005-06, the Rural Retention Program, the Rural and Remote GP Program and the Training for Rural and Remote Procedural GPs Program have resulted in an increase in the number of primary care GP services in rural and remote locations. This represents a growth of 3.2% from the previous year. In 2005-06, the Rural Women's GP Service increased its number of general practice consultations by female GPs in rural and remote areas. There were 15,819 consultations in 2004-05 and 15,926 consultations in 2005-2006.
Target:	Quality: Divisions of General Practice address key priority areas such as access, chronic disease management, prevention and integration.
Result:	Target met.	Under the newly implemented National Quality and Performance System, all Divisions of General Practice address National Performance Indicators in the key priority areas of governance, access, chronic disease management, prevention and integration. Through this process, the activities and progress of the Divisions in each priority area are recorded.
Target:	Quality: Increase in practices qualifying for incentives through the Practice Incentives Program.
Result:	Target met	The majority of general practices in Australia participate in the Practice Incentives Program. At May 2006, there were 4,745 practices (4,681 practices at May 2005) participating in the program, providing 80% of GP care provided to patients nationally.
Target:	Quantity: Increased up-take of general practice MBS financing initiatives. (footnote)
Result:	Target met.	Following their introduction on 1 July 2005, 1.135 million new chronic disease management items were claimed in 2005-06, substantially increasing the amount of structured care being provided to patients with chronic conditions. In June 2006, the overall level of care planning, including for GP managed care, was more than 3 times higher than in June 2005. The level of team-based care planning in June 2006 was 22% higher than the level of Enhanced Primary Care multidisciplinary care planning in June 2005. Other examples of uptake include: increase in the GP bulk billing rate. This was 75.6% at the end of 2005-06 compared to 73.2% at the end of 2004-05; increased uptake of GP bulk billing incentives. There were 55.8 million claims in 2005-06 compared to 52.7 million claims in 2004-05; increased uptake of practice nurse items. There were 3.2 million claims in 2005-06 compared to 2.7 million claims in 2004-05; and increased uptake of allied health and dental care items on referral from GPs. There were 536,327 claims in 2005-06 compared to 251,203 claims in 2004-05.
Target:	Quality: A range of MBS benefits are maintained or introduced that improve access to primary care for Aboriginal and Torres Strait Islander people. (footnote)
Result:	Target met.	The Aboriginal and Torres Strait Islander child health check Medical Benefits Schedule item was introduced on 1 May 2006. MBS items for immunisation and wound management services provided by registered Aboriginal Health Workers on behalf of GPs were introduced on 1 May 2006. Uptake of the Aboriginal and Torres Strait Islander Adult Health Check item increased in 2005-06 (8,747 services), compared to 2004-05 (7,801 services).

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Performance Information for Departmental Outputs

Output Group 1. Policy Advice, including:

Primary Care Education and Training;
Primary Care Financing, Quality and Access;
Primary Care Policy, Innovation and Research;
Primary Care Practice Incentives; and
2005-06 Budget measures.

Target:	Quality: Ministers' satisfaction with the quality, relevance and timeliness of our advice for Australian Government decision making.
Result:	Target met.	Ministers were satisfied with the quality, relevance and timeliness of advice provided for Australian Government decision making.
Target:	Quality: Production of timely evidence-based policy research.
Result:	Target met.	The Department funded evidence examining the sustainability of primary health care innovations, commissioned through the Australian Primary Health Care Research Institute. This was published in November 2005 as a Medical Journal of Australia supplement. Research was commissioned by the Australian Primary Health Care Research Institute to synthesise the evidence in a range of policy-relevant primary care areas, with research reports due in September 2006.

Output Group 2. Program Management, including:

financial management and reporting;
development and management of grants and contracts; and
administration and revision of legislation as required.

Target:	Quality: Administered budget predictions are met and actual expenses vary less than 0.5% from budgeted expenses.
Result:	Target not met.	Expenditure was not within 0.5% of budget predictions.
Target:	Quality: Opportunity for stakeholders to participate in program development.
Result:	Target met.	Development work for the Round the Clock Medicare infrastructure support grants application pack was undertaken in consultation with major GP stakeholder groups, including the Australian Medical Association, Royal Australian College of General Practice and the Australian Divisions of General Practice. New Medicare chronic disease management items were developed by the Department in conjunction with the major GP organisations. The new items provide a more streamlined approach to care planning and review services for patients with chronic or terminal conditions, including patients with complex care needs.

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Performance Assessment: Evaluations and Reviews

Evaluation/Review:	Review of the Rural, Remote and Metropolitan Areas classification system
TimeFrame:	Commencement date: 1 November 2004 End date: Not complete.

Footnote

Funding for these Medicare Benefits Schedule-related activities is provided under the Medical Benefits special appropriation, under the Health Insurance Act 1973, under Outcome 2.

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