Online version of the 2012-13 Department of Health and Ageing Annual Report

Outcome 5: Primary Care

Access to comprehensive, community-based health care, including through first point of call services for prevention, diagnosis and treatment of ill-health, and for ongoing management of chronic disease

Page last updated: 29 October 2013

Major Achievements

  • Strengthened primary health care through the completion of 284 Primary Care Infrastructure Grant projects which are delivering expanded health care services and additional training for health professionals.
  • Improved access to integrated, multidisciplinary, team-based primary health care services through GP Super Clinics. Thirty-one fully operational Clinics are better meeting local community health needs.
  • Delivered improved primary health care to patients by helping the network of 61 Medicare Locals better respond to identified priorities and by working closely with the representative peak body – the Australian Medicare Local Alliance.
  • Developed the first National Primary Health Care Strategic Framework which identifies initiatives that can lead to better integrated care across the health system.
  • Provided access for consumers and health practitioners to accurate and current health provider service information through the new National Health Services Directory.

Challenges

  • Implementing the National Primary Health Care Strategic Framework requires developing state and territory-specific bilateral agreements. A key challenge of these agreements is to work in partnership to integrate care across settings and implement programs that will lead to improved health outcomes.

Performance

This is a doughnut chart and a table that summarises the results for all deliverables and key performance indicators in outcome 5 during 2012-13. The results show that 72.7% were met compared with 83.9% in 2011-12, 18.2% were substantially met compared with 6.4% in 2011-12 and 9.1% were not met compared with 9.7% in 2011-12.

72.7% MET

18.2% SUBSTANTIALLY MET

9.1% NOT MET

Period Met Substantially met Not met
2012-13 72.7% 18.2% 9.1%
2011-12 83.9% 6.4% 9.7%

Programs contributing to Outcome 5

Outcome Strategy

Outcome 5 aims to provide cost-effective, community-based primary health care. In 2012-13, the Department worked to achieve this Outcome by managing initiatives under the programs outlined below.

Program 5.1: Primary Care Education and Training

As a result of a review of departmental administered arrangements, the activities funded through Program 5.1 are discussed in Outcome 11 – Mental Health.

Program 5.2: Primary care financing, quality and access

Program 5.2 aims to improve the infrastructure, coordination and integration of primary health care services across the health system.

Establish Medicare Locals

Medicare Locals are a national network of primary health care organisations established to coordinate primary health care delivery, identify local health care needs and seek to address service gaps. They are driving improvements in primary health care and ensuring that services are better tailored to meet the needs of local communities.

On 1 July 2012, the Department completed the establishment of 61 Medicare Locals. Each Medicare Local is an independent, locally run organisation responsible for responding to the primary health care needs of their local communities. The national map overleaf provides the location of each Medicare Local.

Medicare Locals are working to make it easier for patients to navigate the health system by coordinating and integrating primary health care services at the local level with other sectors including acute care, aged care and Aboriginal and Torres Strait Islander health providers. Building upon a comprehensive analysis of local health needs, Medicare Locals are planning and coordinating services to improve health outcomes.

Medicare Locals are expanding existing primary health care services, establishing new services where none have previously been available and engaging frontline staff to work with their local communities. Medicare Locals are funded to respond to existing and emerging health priorities and provide tailored health services that make a difference to the lives of Australians.

The Department is responsible for supporting the network of 61 Medicare Locals in achieving their objectives and building their capacity as regional primary health care coordinators.

In 2012-13, the Department established the Australian Medicare Local (AML) Alliance to act as a peak representative body for the 61 Medicare Locals. The AML Alliance promotes and supports Medicare Locals as high performing regional health system planners with responsibility for assessing service needs and improving patient care.

Figure 5.1: Location of the 61 Medicare Locals

The figure is a map of Australia that shows the location of the 61 Medicare Locals distributed across each state and territory (listed in a table on page 110).
New South Wales
1. Eastern Sydney 2. Inner West Sydney 3. South Eastern Sydney
4. South Western Sydney 5. Western Sydney 6. Nepean – Blue Mountains
7. Northern Sydney 8. Sydney North Shore and Beaches 9. Central Coast NSW
10. Illawarra – Shoalhaven 11. Hunter 12. North Coast NSW
13. New England 14. Western NSW 15. Murrumbidgee
16. Southern NSW 17. Far West NSW
Victoria
18. Inner North West Melbourne 19. Bayside 20. South Western Melbourne
21. Macedon Ranges and North Western Melbourne 22. Northern Melbourne 23. Inner East Melbourne
24. Eastern Melbourne 25. South Eastern Melbourne 26. Frankston – Mornington Peninsula
27. Barwon 28. Grampians 29. Great South Coast
30. Lower Murray 31. Loddon – Mallee – Murray 32. Hume
33. Goulburn Valley 34. Gippsland
Queensland
35. Metro North Brisbane 36. Greater Metro South Brisbane 37. Gold Coast
38. Sunshine Coast 39. West Moreton – Oxley 40. Darling Downs – South West Queensland
41. Wide Bay 42. Central Queensland 43. Central and North West Queensland
44. Townsville – Mackay 45. Far North Queensland
South Australia
46. Northern Adelaide 47. Central Adelaide and Hills 48. Southern Adelaide – Fleurieu – Kangaroo Island
49. Country South SA 50. Country North SA
Western Australia
51. Perth Central and East Metro 52. Perth North Metro 53. Fremantle
54. Bentley – Armadale 55. Perth South Coastal 56. South West WA
57. Goldfields – Midwest 58. Kimberley – Pilbara
Tasmania
59. Tasmania
Northern Territory
60. Northern Territory
Australian Capital Territory
61. ACT
Medicare Locals Accreditation Standards

In 2012-13, the Medicare Locals Accreditation (MLA) Standards and Guidelines were completed to support Medicare Locals and put in place the best possible processes to ensure high quality service delivery and organisational management. In developing the Standards, the Department consulted with key stakeholders including selected Medicare Locals, the Australian Medicare Local Alliance, the Australian Commission on Safety and Quality in Health Care (the Commission) and accrediting agencies.

By 31 May 2013, all 61 Medicare Locals had registered for accreditation with one of the six accreditation agencies awarded full approval by the Commission and the Department to administer the accreditation process. Medicare Locals have from 3 June 2013 to 30 June 2014 to achieve accreditation.

Tasmanian Health Assistance Package

In June 2012, the Australian Government announced an assistance package for Tasmania’s health system, outlining a number of significant investments to ease pressures and equip Tasmania’s health system to meet future challenges. The Department engaged the Tasmanian Medicare Local to implement initiatives to improve primary health care services to improve health outcomes for Tasmanians.

Progress has been made in planning services to address social determinants of health and health risk factors. Care coordination for people with chronic diseases and assistance for aged care clients is improving. Initiatives to better meet the post hospital care needs of patients are also being developed. In addition, the Tasmanian Medicare Local is evaluating implementation progress and effectiveness of the initiatives.

Improve the coordination and integration of primary health care services across the health system

In 2012-13, the Department worked with the states and territories to develop the National Primary Health Care Strategic Framework. The framework was submitted to the National Standing Council on Health in December 2012, and was agreed in April 2013. The framework sets out agreed future policy directions and priority areas for primary health care including the following strategic outcomes:

  • build a consumer-focused integrated primary health care system;
  • improve access and reduce inequity;
  • increase the focus on health promotion, prevention, screening and early intervention; and
  • improve quality, safety, performance and accountability.

These strategic outcomes are the focus of the ongoing work of the Department with each of the states and territories in developing bilateral plans that will support implementation of the framework.

Improve access to health and information services

In 2012-13, the National Health Services Directory (NHSD) was established to provide consumers and health practitioners with access to accurate current service information including, but not limited to, general practices, pharmacies and hospital emergency departments. The NHSD is available online66 and as free smartphone applications on Apple and Android. In 2013-14, the NHSD will expand to include additional primary care and allied health information, greater service detail, an endpoint location service to help with secure clinical messaging and the personally controlled electronic health record adoption strategy, and the inclusion of telehealth information.

Improve primary health care infrastructure

Improved infrastructure is pivotal to increasing the capacity of primary health care to adapt to and meet current and future challenges, such as the growing burden of chronic disease.

GP Super Clinics

The GP Super Clinic Program is establishing more than 60 clinics across Australia. GP Super Clinics bring together GPs, nurses, allied health professionals, visiting medical specialists and other health providers to deliver primary health care that is tailored to the needs and priorities of the local community.

In 2012-13, the Department worked in collaboration with state, territory and local governments and funding recipients to establish the remaining GP Super Clinics. A total of 50 GP Super Clinics have either started operations, provided early services or were under construction by 30 June 2013, including 31 which are fully operational.

During 2012-13, the Department awarded three grants to expand or establish new primary health care services in Bridgewater, Sorell and Brighton in Tasmania. These three grants were awarded in lieu of funding for the Sorell GP Super Clinic not proceeding.

Primary Care Infrastructure Grants

Primary Care Infrastructure Grants aim to improve the quality and accessibility of primary health care services in Australia and increase capacity to train the future health workforce.

Projects are providing expanded and improved facilities for GPs and other health professionals, leading to better integrated primary health care services, more clinical training and expanded opening hours. Local communities are benefiting from improved access to a broader range of integrated health services coordinated through general practice, that meet local community health needs with a focus on preventive health activities and better chronic disease management.

Improve access to after hours primary health care

Medicare Locals After Hours Program

Through Medicare Locals, the Department aims to improve the coordination and integration of face-to-face after hours primary health care services. This seeks to ensure all Australians, regardless of where they live, have access to effective after hours primary health care services.

In 2012-13, Medicare Locals developed locally tailored solutions to address priority gaps in after hours primary health care services in their areas. Initiatives include funding for new and extended opening hours predominantly via general practice, increased after hours support for residential aged care facilities and awareness campaigns about after hours services availability.

In 2013-14, the Department and the AML Alliance will continue to work with Medicare Locals to promote improved after hours access and integration with national services such as the after hours GP helpline.

after hours GP helpline

In 2012-13, the Department continued to support improved community access to primary care through the 24 hour nurse-based triage telephone service, healthdirect Australia, and the after hours GP helpline. From July to December 2012, a pilot video consultation service was introduced in selected residential aged care facilities to improve the ability of the after hours service to effectively assess a caller’s medical condition. In 2013-14, the after hours GP helpline and the Pregnancy, Birth and Baby service will both become video-enabled which will provide these benefits to a broader audience, and provide data for further evaluation of the technology.

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Program 5.3: Primary care practice incentives

Program 5.3 aims to provide incentive payments to general practices and GPs to support activities that encourage continuing improvements, increase quality of care, enhance capacity, and improve access and health outcomes for patients.

Provide general practice incentive payments

In 2012-13, the Department worked with the Department of Human Services to make around 20,000 Practice Incentives Program (PIP) payments to general practices and 55,000 payments to GPs for services such as:

  • cervical cancer screening;
  • diabetes management;
  • asthma management;
  • procedures in rural and remote areas;
  • appropriate and timely access for older people to primary health care services in residential aged care facilities; and
  • comprehensive and consistent care for Aboriginal and Torres Strait Islander patients with chronic disease.
Practice Incentives Program eHealth Incentive

In 2012-13, the Department implemented new eligibility requirements for the Practice Incentives Program (PIP) eHealth Incentive to encourage general practices to keep up to date with the latest developments in eHealth and to promote uptake of the personally controlled electronic health record. The Department will continue to consult closely with the National eHealth Transition Authority, the PIP Advisory Group, medical software developers and the Department of Human Services in implementing the new requirements.

Outcome 5 – Financial Resource Summary

Program (A) Budget Estimate 2012-13
$’000
(B) Actual 2012-13
$’000
Variation (Column B minus Column A)
$’000
Program 5.1: Primary Care Education and Training
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 6,852 6,654 ( 198)
Departmental Expenses
Departmental Appropriation 1 1,054 1,085 31
Expenses not requiring appropriation in the current year 2 33 56 23
Total for Program 5.1 7,939 7,795 ( 144)
Program 5.2: Primary Care Financing, Quality and Access
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 546,167 545,053 ( 1,114)
Departmental Expenses
Departmental Appropriation 1 29,057 28,003 ( 1,054)
Expenses not requiring appropriation in the current year 2 914 1,428 514
Total for Program 5.2 576,138 574,484 ( 1,654)
Program 5.3: Primary Care Practices Incentives
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 280,507 299,842 19,335
Departmental Expenses
Departmental Appropriation 1 1,455 1,394 ( 61)
Expenses not requiring appropriation in the current year 2 46 71 25
Total for Program 5.3 282,008 301,307 19,299
Outcome 5 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 833,526 851,549 18,023
Departmental Expenses
Departmental Appropriation 1 31,566 30,482 ( 1,084)
Expenses not requiring appropriation in the current year 2 993 1,555 562
Total expenses for Outcome 5 866,085 883,586 17,501
Average Staffing Level (Number) 215 213 ( 2)
  1. Departmental appropriation combines 'Ordinary annual services (Appropriation Bill 1)' and 'Revenue from independent sources (s31)'.
  2. 'Expenses not requiring appropriation in the budget year' is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses - please refer to the departmental financial statements for further information.

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