Online version of the 2012-13 Department of Health and Ageing Annual Report
- 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.
- 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.
18.2% SUBSTANTIALLY MET
9.1% NOT MET
|Period||Met||Substantially met||Not met|
Programs contributing to Outcome 5
- Program 5.1: Primary care education and training
- Program 5.2: Primary care financing, quality and access
- Program 5.3: Primary care practice incentives
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
|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|
|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|
|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|
|46. Northern Adelaide||47. Central Adelaide and Hills||48. Southern Adelaide – Fleurieu – Kangaroo Island|
|49. Country South SA||50. Country North SA|
|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|
|60. Northern Territory|
|Australian Capital Territory|
Deliverable: Establish a Medicare Local national body
2012-13 Reference Point: The AML Alliance will be established in July 2012
- On 1 July 2012, the Department established the AML Alliance to act as a lead change agent for the Medicare Local network. During 2012-13, the AML Alliance provided support to Medicare Locals to achieve their strategic objectives and work cohesively as a network capable of responding to evolving Government priorities. In 2013-14, the Department will continue to work with the AML Alliance to promote best practice and outcome focused activities across the network.
KPI: Percentage of Medicare Locals meeting performance reporting requirements
2012-13 Target: 100%
2012-13 Actual: 100%
- In 2012-13, the network of 61 Medicare Locals met all the Department’s reporting requirements including needs assessments, strategic plans, annual plans, budget and bi-annual progress reports. These deliverables outline ongoing and planned activities and progress against key reporting areas consistent with the strategic objectives of the program. In 2013-14, the Department will continue to monitor performance reporting with an increasing focus on outcomes.
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.
Medicare Locals improving health on the Central Coast
An innovative mobile x-ray service is enabling elderly people living in aged care facilities on the NSW Central Coast to obtain x-rays when needed, without leaving their home.
For a frail older person, a visit to the hospital for an x-ray can be a mentally and physically stressful experience. It can also be expensive, as an ambulance or taxi is usually needed to get the patients to and from the hospital.
Recognising this problem, the Central Coast NSW Medicare Local (ML) worked with a local mobile x-ray provider to devise a solution.
The resulting mobile x-ray service visits aged care facilities whenever residents need x-rays, to allow their doctors to obtain the images they need for a correct diagnosis with minimal disruption to the patient.
The mobile service, which began in April 2013, is funded by the Central Coast NSW ML from its 2012-13 flexible funding pool. In its first three months of operation, the service attended to up to 5 residents of aged care facilities each day.
An additional benefit is a reduced burden on both the Central Coast ambulance service and local hospital emergency departments, allowing these services to concentrate on other patients requiring urgent attention.
The ML hopes to be able to expand the mobile x-ray service in the future to include older patients living in the community.
The flexible funding to MLs is intended to be used to fill gaps in local health services. Central Coast ML has also used its funding to establish a Community Health Grants Program.
The program has provided up to $5,000 each to 15 local groups to promote healthy lifestyles and nutrition. Their diverse initiatives funded through the grants include a healthy breakfast program for disadvantaged young people and a menopause lifestyle and exercise program for women.
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.
Deliverable: Develop a national strategic framework to set out agreed future policy directions and priority areas for primary health care
2012-13 Reference Point: Framework developed by December 2012
- The National Primary Health Care Strategic Framework was developed by December 2013 and agreed in April 2013.
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.
Deliverable: Number of grants awarded to establish GP Super Clinics
2012-13 Target: 8
2012-13 Actual: 667
Result: Substantially met
- The Emerald GP Super Clinic grant was one of the eight grants expected to be awarded in 2012-13, however this occurred earlier than expected, in June 2012. In 2012-13, grants were awarded to establish GP Super Clinics in Liverpool, Lower Hunter (NSW), Caboolture, Wynnum (QLD), and Mount Barker (SA). The awarding of grants for Darwin and Deeragun/Northern Beaches of Townsville (Deeragun) GP Super Clinics were delayed. Grants to the preferred applicants for both sites were awarded in July 2013.
KPI: Number of GP Super Clinics that commence delivery of services, including early services
2012-13 Target: 9
2012-13 Actual: 5
Result: Not met
- As published in the 2013-14 Portfolio Budget Statements, the target was revised to six during the year to factor in additional time for extended council development application processes, land acquisition, state government approvals and associated processes outside the Commonwealth’s control. This revised target is considered to have been substantially met. In 2012-13, the ACT, Coffs Harbour, Sunshine Coast, Tweed Heads and South Morang GP Super Clinics all began delivering services, including early services. As at 30 June 2013, a total of 40 GP Super Clinics were delivering services.
Grafton GP Super Clinic brings more doctors and new services to local patients
The Grafton GP Super Clinic in Clarence Valley, New South Wales has made a big difference to the health of local patients since it opened in October 2011.
With four additional GPs, the Clinic has made it easier for local people to see a doctor quickly. Attracted by the clinic’s commitment to becoming a centre of primary health care research, and supporting clinical education and training, the extra doctors have also made it possible to offer increased after hours services in Grafton.
Patients with Type 2 Diabetes have particularly benefited. They have received integrated care to manage their condition, with health professionals at the Super Clinic working as a team to meet their needs.
Other patients with chronic diseases are also showing improved health outcomes as a result of the clinic’s team-based approach.
Grafton GP Super Clinic has broadened the services on offer in the area. As well as GP services it has a GP specialising in paediatrics, nursing services including mental health nursing, and allied health services including dietetics, podiatry, speech pathology, occupational therapy, and exercise physiology.
GP Super Clinics are a key element of the National Health Reforms aimed at building a stronger national primary health care system, including a greater focus on management of chronic disease and illness prevention.
GP Super Clinic services are tailored to meet the needs of the local community. They are coordinated between privately provided GP services, allied health providers, community health and other state or territory government services.
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.
Deliverable: Number of grants to upgrade or extend existing general practices, primary and community care services or Aboriginal Medical Services
2012-13 Target: 70
2012-13 Actual: 85
- In 2012-13, the Department awarded 85 grants from the first and second round of the Primary Care Infrastructure Grants Program. As of 30 June 2013, 417 grants have been awarded. Of these, 284 have been completed and are delivering expanded primary health care services and additional training for health professionals.
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.
KPI: Number of calls to the after hours GP helpline
2012-13 Target: 195,000
2012-13 Actual: 169,218
Result: Substantially met
- The after hours GP helpline is a demand driven service with forecasts, rather than targets. healthdirect Australia, 13HEALTH and NURSE-ON-CALL transferred 169,218 calls to the after hours GP helpline in 2012-13. Residents in Queensland were referred to the after hours GP helpline at a significantly lower rate than forecast. Residents in Tasmania continued to access after hours GP services through the GP Assist service.
healthdirect Australia and the after hours GP helpline are available nationally on 1800 022 222
Residents of Queensland can contact 13HEALTH on 13 43 25 84
Residents of Victoria can contact NURSE-ON-CALL on 1300 60 60 24
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.
KPI: Percentage of GP patient care provided by PIP practices
2012-13 Target: 83.4%
2012-13 Actual: 84.4%
- As at May 2013, 84.4% of GP patient care was provided by PIP practices. This compares to 84.0% in 2011-12 and 82.8% in 2010-11.
KPI: Number of general practices receiving Indigenous health incentives
2012-13 Target: 2,800
2012-13 Actual: 3,333
- Participation in the Practice Incentives Program Indigenous Health Incentive continued to increase in 2012-13 with 3,333 practices registered for the incentive by May 2013. This compares to 2,900 in 2011-12 and 2,100 in 2010-11.
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.
Deliverable: Implementation of new eligibility requirements for the PIP eHealth Incentive
2012-13 Reference Point: New eligibility requirements are introduced from 1 February 2013
- The new eligibility requirements came into effect from 1 February 2013, with further requirements effective from 1 May and 1 August 2013.
KPI: Percentage of PIP practices receiving the eHealth incentive under new eligibility requirements
2012-13 Target: 78%
2012-13 Actual: 80%
- 3,712 practices were eligible from 1 February 2013, and 4,176 eligible from 1 May 2013. Participation in the PIP eHealth Incentive under the new eligibility requirements was 80% of PIP practices at 1 May 2013.
Outcome 5 – Financial Resource Summary
(A) Budget Estimate 2012-13
(B) Actual 2012-13
Variation (Column B minus Column A)
|Program 5.1: Primary Care Education and Training|
|Ordinary Annual Services (Annual Appropriation Bill 1)||6,852||6,654||( 198)|
|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|
|Ordinary Annual Services (Annual Appropriation Bill 1)||546,167||545,053||( 1,114)|
|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|
|Ordinary Annual Services (Annual Appropriation Bill 1)||280,507||299,842||19,335|
|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|
|Ordinary Annual Services (Annual Appropriation Bill 1)||833,526||851,549||18,023|
|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)|
- Departmental appropriation combines 'Ordinary annual services (Appropriation Bill 1)' and 'Revenue from independent sources (s31)'.
- '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.