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Medicare Specialist Outreach Assistance Program Maternity Services Guidelines

Requirements, guidelines and support for medical specialists working in the MSOAP Maternity Sevices program.

PDF printable version of the Medical Specialist Outreach Assistance Program Maternity Services Guidelines (PDF 66 KB)

Table of Contents
Background to the MSOAP- Maternity Service (MSOAP-MS)
MSOAP-MS Service
Participants
What can MSOAP-MS support?
Program Operation
MSOAP-MS Department of Health and Ageing Contacts
Glossary of Terms - MSOAP-MS

Background to the MSOAP- Maternity Service (MSOAP-MS)

The Medical Specialist Outreach Assistance Program (MSOAP) Maternity Services Expansion is one of a number of MSOAP expansions. This expansion will provide $10.6 million dollars in funding over the next three years to 30 June 2013, to build on the core MSOAP service delivery model by incorporating multi-disciplinary teams of health professionals in addition to medical specialists in the delivery of maternity care up until the infant is six months of age.

Aims and Objectives of the MSOAP-MS

The aim of the MSOAP–MS measure is to increase and improve access to high quality, safe, evidence-based maternity care for women and their families in rural and remote communities primarily for, but not limited to, the antenatal and postnatal stage of pregnancy.
The objectives of the MSOAP-MS measure are to:

• support health professionals to provide outreach maternity services to rural and remote communities;
• increase the range of maternity services offered by visiting health professionals to effectively support women and families through the antenatal and postnatal stage;
• improve ongoing management and continuity of care; and
• increase and maintain the skills of health professionals in rural and remote areas in accordance with local need.

Medical Specialist Outreach Assistance Program

The Medical Specialist Outreach Assistance Program (MSOAP) was established in 2000 to improve the access of rural and remote communities to medical specialist services by complementing outreach medical specialist services provided by state and Northern Territory governments.

The objectives of MSOAP are to:

• increase visiting medical specialist services in areas of identified need;
• support medical specialists to provide outreach services in rural and remote communities;
• facilitate communication between visiting medical specialists and local health professionals about on-going patient care; and
• increase and maintain the skills of health professionals in regional, rural and remote areas in accordance with local need.

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MSOAP-MS Service

Eligibility

Top of pageServices delivered to communities in Australian Standard Geographical Classification (ASGC) – Remoteness Areas (RA) 2 (Inner Regional) to 5 (Very Remote) are eligible to be supported under this measure. However, where possible the MSOAP-MS measure will focus the delivery of outreach services in communities situated in remote (RA 4) and very remote (RA 5) locations.

Further information on the ASGC can be found at www.abs.gov.au or by accessing the Remoteness Area Locator at www.doctorconnect.gov.au

Target Communities

The primary focus of the MSOAP- MS measure will be to deliver services to rural and remote locations where there is an identified need for antenatal and maternal services.
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The Advisory Forum in each state and the Northern Territory will consider suitable locations and their relative needs in recommending services under the MSOAP-MS to the Department.

Services to be provided

The MSOAP-MS measure will build on existing services and establish new services. Services are to provide more choice and greater access to antenatal and postnatal services in their local communities.

Services funded under this measure should complement services provided by state and Northern Territory governments or other providers/ funders.

Preventative health services provided by allied health professionals are eligible for support under the MSOAP-MS following referral by a medical specialist or primary health care service provider. For example, physiotherapists, psychiatrist, exercise physiologists and health educators could engage with, and provide ante-natal and postnatal education and support to women in rural and remote locations.

Under the MSOAP-MS, a Service is defined as a health professional (i.e. any individual medical specialist, GP midwife, nurse and/or allied health worker), visiting and providing a consultation at an approved location.

A Service may be approved for one or more financial years up to a maximum term of the Funding Agreement period and will be reviewed annually.

Models of Care

These Guidelines note that pregnancy is for a defined period and therefore any ante-natal or postnatal care should be offered flexibly to maximise services for women and provide value for money. Due to the unpredictable nature of birth the program will focus of the antenatal and postnatal stages of pregnancy in the delivery of services. A range of flexible service delivery models may be used under this measure to meet the aim and objectives of the MSOAP-MS program. Co-ordination is paramount to ensure a united approach to care. There is no preferred service delivery model under the MSOAP-MS measure.

The MSOAP-MS measure focuses on a team approach to care. It may not be necessary or possible for team members to deliver an outreach service at the same time. Therefore, issues relating to the coordination and continuity of care, managing the impact on the community and costs related to travel should be considered when planning services to these communities.

The multidisciplinary approach of this measure requires a case management and coordination function.

Health Professionals supported by measure

The multidisciplinary teams to be funded under this measure may include midwives, medical specialists, GPs including Procedural GPs, Aboriginal health workers and allied health professionals. A definition of medical specialists, GPs, midwives, nurses and allied health professionals is included in the glossary (see Section 7).

The composition of multidisciplinary teams will vary depending on the health and treatment/ support needs of individual women and communities. In some instances the team may include a medical specialist who is accompanied by relevant health professionals (e.g. an obstetrician with a physiotherapist). On other occasions it may be a combination of a midwife
and/or allied health professionals, or a medical specialist, GP and/or allied health professionals, or it may be a midwife with an arrangement in place with the family’s General Practitioner, or a midwife and an obstetrician working as a team.

In negotiating with health professionals the fundholder must ensure that those professionals who will be relying on Medicare billing have the appropriate registration to enable them to access Medicare benefits.

Who can be supported?

Any health professional or appropriate support and/or supplementary staff relevant to the provision of antenatal and postnatal care will be eligible for support under the MSOAP-MS measure.Top of page

The following criteria would need to be met by health professionals through the MSOAP-MS

• have appropriate skills and a clearly defined role relevant to the treatment and management of the individuals needs identified for this measure;
• are appropriately qualified, registered and/or licensed and adequately insured to practice in their profession both individually and in their area of speciality if appropriate;
• be sensitive to the needs of the community where the intended service is to be provided ( ie culturally appropriate midwifery services);
• have undertaken cultural awareness and safety training as necessary; and
• provide services that are directly related to patient management and not for research or other purposes.

All services must be delivered by appropriately trained, qualified, registered and insured health professionals.

• Allied health professionals supported under the MSOAP-MS measure must hold recognised educational and/or vocational qualifications specific to the position for, or jurisdiction, in which they are employed.
• General practitioners supported under the MSOAP-MS measure must be a person registered or licensed as a medical practitioner under State or Territory law.
• Medical specialists supported under the MSOAP-MS measure must be a person registered as a specialist under State or Territory law.
• Midwives who hold appropriate qualifications, registration and insurance to provide midwifery services in Australia.
• Registered nurses supported under the MSOAP-MS measure must be registered under a law of a State or Territory (other than South Australia) as a general nurse or registered under a law in South Australia as a nurse.
• A registered nurse with a specialist role is defined as a nurse who holds appropriate tertiary or vocational qualifications or is employed in that specialist area.
• Enrolled nurses supported under the MSOAP-MS measure must be registered by the nursing/midwifery registration Board of Australia.
• Aboriginal and Torres Strait Islander Health Workers participating in the MSOAP-MS measure must have qualifications recognised in their state and territory jurisdictions.

Cultural Awareness and Safety Training

All health professionals providing services through the MSOAP-MS to Indigenous communities must demonstrate that they have undertaken appropriate Cultural Awareness and Safety Training prior to commencing service delivery.

The fundholder will be responsible for verifying and/ or arranging this training. Should a member of a MSOAP-MS team need to undertake Cultural Awareness and Safety Training, the MSOAP-MS will support training costs. Non-salaried private outreach service providers may claim MSOAP-MS absence from practice allowance benefits for the time they attend Cultural Awareness and Safety training.

Any attending health students will need to demonstrate they have undertaken or participated in Cultural Awareness and Safety training prior to participating in outreach visits to Indigenous women and /or communities.

Orientation to the outreach location

Top of pageTravel and absence from practice payment (see Section 3) will be available for up to four hours orientation for appropriate service providers. Orientation visits to each new location for each new health provider (excluding students) can be supported under the MSOAP–MS and would include a briefing on specific Cultural Awareness and Safety training issues specific to the community as required. Top of page

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Participants

The participants in the MSOAP-MS measure are:

• The Department of Health and Ageing – central and state/territory offices;
• The Fundholders;
• The MSOAP Advisory Forums;
• Health professionals delivering the services; and
• Host locations for outreach service provision.

Roles and Responsibilities of Participants

Department of Health and Ageing

Departmental officers have responsibility for the oversight and management of the MSOAPMS measure. The Department through the Rural Health Services and Policy Branch (RHSPB) will:

• develop and revise, as necessary, guidelines for the program;
• chair and provide secretariat services to the Advisory Forum in each jurisdiction;
• prepare funding agreements with fundholders;
• approve strategic service plans, annual plans and progress reports, approval will be granted by the Assistant Secretary of the RHSPB.
• approve services recommended by Advisory Forum; and
• distribute funds to fundholders as agreed in the schedule of the funding agreement.

Officers in the Department’s state and territory offices will be the primary program contact for fundholders.

Levels of funding provided to fundholders will be published on the Departments website within seven days of the execution of the Funding Agreement.

Fundholders

Fundholder(s) in each state and the Northern Territory have responsibility to auspice on behalf of the Department the MSOAP–MS to ensure the provision of clinical outreach services by a range of health professionals to deliver improved antenatal and postnatal services in rural and remote communities.

The fundholder will ensure that full time personnel are available to provide and maintain the administrative requirements of the Program to fulfil and be responsible for the operation of the MSOAP-MS. Responsibilities to be managed will include, but not be limited to:

• Undertaking needs analysis at the commencement of this measure, in consultation with the MSOAP Advisory Forums and local health professionals;
• development and implementation of a MSOAP-MS business plan;
• communication with health professionals and the public to inform them about the MSOAP-MS;
• development and application of strategies to recruit and retain health professionals services;
• monitoring, management and fulfilment of all program obligations;
• accurate collection, collation and appropriate analysis of data and reporting this data to the Department;
• administration of payments to participating health professionals in accordance with services provided;
• development and implementation of strategies to market and educate the public and the health care sector about the MSOAP-MS;
• assistance with the provision of upskilling sessions to health care professionals as required; and
• provide other activities necessary for the effective and efficient operation of the project.

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Fundholders are required to ensure that the MSOAP-MS is coordinated with local health services to facilitate, where possible, continuity of care to patients and coordination and integration with local health services.

Fundholders are required to send a representative to relevant meetings held by the Department, unless otherwise negotiated with the Department.

The Fundholders in each state and the Northern Territory are:

New South Wales - NSW Rural Doctors Network:      02 8337 8100
New South Wales - NSW Health:                               02 9391 9000
Northern Territory - NT Department of Health:           08 8999 2400
Queensland - General Practice Queensland:              07 3105 8300
Queensland - Queensland Health:                             07 3234 0111
South Australia - Rural Doctors Workforce Agency:    08 8234 8277
Tasmania - Tasmanian Department of
Health and Human Services:                                       03 6336 4373
Victoria - Rural Workforce Agency Victoria:                  03 9349 7800
Western Australia - Rural Health West -                     08 6389 4518

Advisory Forum

The Advisory Forum is a state/ territory based forum comprising a broad range of stakeholders, with relevant knowledge and expertise, who provide advice on the suitability of services under consideration by the MSOAP-MS.

Recommendations regarding service priorities will be made by the Advisory Forum in each state and the Northern Territory. Fundholders will report on this aspect of service planning. The following information may act as a guide to the role and responsibilities of an Advisory Forum.

The Advisory Forum should work as an effective consultative mechanism that informs the fundholder about how to best deploy resources and determine priorities in project plans. The fundholder is to ensure that the selection of services or any changes in the Strategic Services Plan meet the priority health needs of the relevant community and are decided in conjunction
with the advisory forum.

The principal role for the Advisory Forum is to evaluate all proposals for MSOAP-MS funding as they are presented to:

• identify whether the selected region has the need and the capacity to sustain support for a new service;
• determine gaps in services;
• advise on the appropriate types of services to be delivered; and
• link (when appropriate) with the planning mechanisms of other programs to explore possibilities for integrated program implementation.

It is expected that under the MSOAP-MS measure the membership of the Advisory Forum will include Aboriginal and Torres Strait Islander health representatives and representatives from allied health and midwife organisations to ensure proper consideration of issues. The Advisory Forum will ensure appropriate consultations are undertaken should a specific
discipline/ profession not have a role in the Advisory Forum.

Health Professionals

Health professionals funded under the MSOAP-MS measure will work in a multidisciplinary team environment to provide management of antenatal and postnatal care for women. Health professionals will:

• deliver services as agreed in their contract with the fundholder;
• liaise as necessary with other members of the team to ensure effective coordinated patient care;
• share patient records as appropriate with other members of the team;
• undertake cultural safety and awareness training as required by the program;
• advise fundholders and other team members of changes to scheduling arrangements to ensure these changes are managed by multidisciplinary team members and by the host outreach location;
• maintain appropriate records and submit tax invoices as required by the fundholder within two months of completion of an outreach visit; and
• ensure the timely provision of deliverables as detailed in the contract with the fundholder.

MSOAP-MS Outreach Service Host

Outreach Service Hosts are funded through the MSOAP-MS to host an outreach service. The host service will:

• ensure adequate and appropriate access to facilities as required for health professionals delivering health services as members of the MSOAP-MS team;
• ensure adequate and appropriate facilities and support required for patients receiving health services by members of the MSOAP-MS team;
• liaise as necessary with the fundholder and other members of the team to ensure effective coordinated patient care;
• share patient records as agreed and as appropriate with other members of the multidisciplinary team;
• demonstrate awareness of cultural safety and training as required by the program;
• advise fundholders and other team members of changes to scheduling arrangements to ensure these changes are managed by multidisciplinary team members and by the host outreach location;
• maintain appropriate records and submit tax invoices as required by the fundholder within two months of completion of an outreach visit; and
• ensure the timely provision of deliverables as detailed in the contract with the fundholder. Top of page

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What can MSOAP-MS support?

Allowable use of funding

The MSOAP-MS measure is able to assist with funding to support new and established services or expand established outreach medical specialist services. The MSOAP-MS measure will cover the following costs:

Remuneration for MSOAP-MS team members

The MSOAP-MS measure provides funding to address the financial costs to health practitioners (listed in Section 3) of delivering outreach services.

Where ever possible health providers should claim against the Medicare Benefits Schedule (i.e. direct (bulk) bill or patient bill) for their service where direct or patient billing is used it is not appropriate to claim workforce support payments.

Consultation rates for services by other health professionals who cannot claim against Medicare will be paid at an hourly rate appropriate for the professional’s qualifications in the state or territory where the service is provided.

Registrars and students

Costs can be supported (i.e. travel, meals, and accommodation) for registrars and associated health students who accompany members of multidisciplinary teams in order to gain exposure to rural practice. Salaries for registrars and students will not be paid under the MSOAP-MS measure.

The supervising health professional must ensure that adequate/ appropriate insurance is available for health students accompanying them to outreach locations.

Workforce support

Financial support (at sessional rates) may be available to private specialists and allied health professionals who provide services under this measure. A workforce support payment may be paid in circumstances where:

• MBS payments cannot be claimed or are not assured; and/ or
• Patient compliance with appointments is uncertain.

Members of the visiting team who receive a workforce payment will be precluded from claiming any MBS payments for services at outreach locations.

They are also eligible to receive MSOAP-MS payments such as the Absence from Practice Allowance to cover reasonable financial disadvantage incurred by leaving their normal place of work to provide the outreach service.

Workforce support may occur only if other payment options have been exhausted.

Administrative Support for MSOAP-MS team members

The MSOAP-MS may pay for one administrative support person associated with the delivery of outreach services, such as the organisation of appointments, processing of correspondence and follow up with patients, at the outreach location.

Only one administrative support person will be funded daily for each team at the service location. MSOAP-MS can cover the cost of administrative support for up to the same working hours (consultations/ treatment time) as those hours undertaken by the visiting health professionals.

A sessional coordination payment may be made to either a member of the multidisciplinary team (eg GP) or an administrative officer to ensure that team members have access to up to date information on each patient’s records on arrival at each outreach location.

It is expected that administrative support staff will be engaged locally and will be paid at a casual, hourly rate. It is recommended that the rate payable for administrative assistance is equivalent to the hourly rate for a medical receptionist with three years experience. Locally engaged administrative support staff may require training in the first instance on a time
limited basis and only in exceptional circumstances.

The MSOAP–MS will not pay travel meals or accommodation for administrative support staff. Administrative support staff will not be funded under the MSOAP-MS during the time the visiting specialist, allied health professional and/or GP provide upskilling.

Travel costs

MSOAP-MS will cover the cost of travel by the most efficient and cost effective means to and from the outreach service location. This may include commercial air, bus or train fares, charter flights, which could include private commercial charter arrangements, and/or expenses associated with the use of a private vehicle (see Table 1 below for rates). Top of page

Private vehicles

Table 1: Kilometre rates for private vehicle use

Engine capacity (standard)	Rate cents per km (ex GST)	GST	Rate cents per km (inc GST)
1,600cc and under	$0.62	$0.06	$0.68
1,601 to 2,600cc	$0.75	$0.08	$0.83
Above 2,600cc	$0.76	$0.08	$0.84

(Current at October 2009). Rates for Rotary engine vehicles are available on request.

Hire car

If road travel is the most cost effective option, the visiting health professional may elect to travel to/ from the outreach location by a self-drive hire car. The Fundholder will arrange the booking and payment of the hire car. Fuel allowances payable for a hire car are as follows:

Table 2: Kilometre fuel rates for hire cars

Engine capacity (standard)	Rate cents per km (ex GST)	GST	Rate cents per km (inc GST)
1,600cc and under	$0.13	$0.01	$0.14
1,601 to 2,600cc	$0.12	$0.01	$0.13
Above 2,600cc	$0.12	$0.01	$0.13
4WD (for remote locations only where travel is undertaken on nonsealed roads)	$0.13	$0.01	$0.84

(Current at October 2009). Rates for Rotary/ Gas engine vehicles are available on request.

Parking and taxi fares are paid on a cost recovery basis only.

Accommodation costs

Accommodation costs will be paid in accordance with Australian Public Service rates. The suggested range for accommodation rates is between $77.00 and $150.00 per night (GST exclusive). However, as accommodation in some locations may be more expensive due to seasonal variations, consideration will be given to paying higher rates on a case by case basis.

Meal and Incidental costs

Meals and incidentals for visiting health professionals will be paid at the following rates.

Table 3: Meal and incidental allowances

Meal / Incidentals	Allowance payable (ex GST)	GST	Allowance payable (inc GST)
Breakfast	$19.95	$2.00	$21.95
Lunch	$22.80	$2.28	$25.08
Dinner	$39.30	$3.93	$43.23
*Incidentals	$16.50	$1.65	$18.15

(Current at October 2009) * Incidental allowance payments are only payable for the second and any subsequent days of a visit at the outreach location. Breakfast on the first day and dinner on the last day of outreach services are not payable for any team member.

Equipment lease and transport

Under MSOAP-MS, consideration will be given to assisting with clinical / medical equipment lease arrangements. Any financial assistance for the lease of equipment for these purposes must be with the approval of the Department. All lease quotes must include budget for replacement parts and maintenance to ensure equipment meets required standards.

The MSOAP-MS will not cover the purchase of equipment for use by medical specialists, allied health professionals and GPs on outreach visits nor the lease of portable attractive and/or information technology equipment.
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MSOAP-MS may assist with the cost of transportation of equipment (on commercial transport) for use by health professionals to an approved MSOAP-MS outreach service.

Outreach service host location

Fundholders will negotiate the roles and responsibilities of outreach service host locations to ensure appropriate arrangements are in place for outreach visits.

Fees incurred in hiring appropriate venues or facilities to support either outreach service provision or upskilling activities will be paid as appropriate. The suggested maximum facility fee payable for any venue is $200 per day (GST exclusive).

Absence from Practice Allowance

An Absence from Practice Allowance is payable to non-salaried private outreach service providers to compensate for “loss of business opportunity” due to the time spent travelling to and from a location where they are delivering an outreach service and/or upskilling.

The hourly rate payable for the absence from practice is consistent with the fee-for-service hourly rates paid by the relevant state/Northern Territory government, area health service or local hospital (depending on the organisational level at which these payments are established in the state/ Northern Territory).

Backfilling

The MSOAP-MS measure will fund backfilling at the nominated sessional rate for that health profession, for rostered hours absent from their employer for salaried health professionals who provide approved MSOAP-MS services. Neither backfilling costs, nor an hourly rate, will be paid to registrars and health students who participate in the MSOAP-MS measure.

Upskilling

Visiting and/or host health professionals/organisations may wish to provide incidental or informal educational and upskilling activities, of either a theoretical or clinical nature, to local medical practitioners, health professionals and community members such as carers which are aimed at:

• developing or enhancing specific skills;
• sharing of knowledge; and/ or
• enhancing on-going patient care.

Upskilling activities should take place at the location where an outreach service is being delivered and should aim to complement existing training arrangements within the area. Funding support may be provided for MSOAP-MS supported procedural and non-procedural upskilling.

Resident medical specialists, general practitioners, local nursing and allied health professionals and, where appropriate, other members of the community may attend upskilling sessions provided by the visiting health professional. MSOAP-MS does not cover any costs associated with the attendance of local resident medical and health professionals, or other
community members, at the upskilling sessions.

Arrangements for formal upskilling activities must be developed in consultation with local medical and health professionals and the health professions providing the service and, therefore, may vary from region to region. MSOAP-MS funds must not be used for the administration and allocation of points for Continuing Professional Development.

Where visiting health professions provide upskilling to local medical and health professionals and, where appropriate, other members of the public (such as carers), MSOAP-MS may cover the cost of the venue/ facility/ room hire.

In addition, non-salaried private outreach service providers may claim an hourly rate which is consistent with the applicable MSOAP-MS fee-for-service rates for the time required to present the upskilling activity. Top of page

Administrative support staff will not be funded under the MSOAP-MS to assist with preparation of upskilling materials or during the time the visiting health professional provides upskilling.

Upskilling is not a requirement of health professionals providing MSOAP-MS supported outreach services.

Professional support

For the purposes of the MSOAP-MS, professional support means the informal support provided by the visiting health professionals to local medical and health professionals through telephone/ email support once the health professional has returned to their principal practice.

Non-salaried private health professionals may claim an hourly rate for providing professional support which is consistent with the fee-for-service rates paid by the relevant state/Northern Territory government, area health service or local hospital (depending on the organisational level at which these payments are established in the state/ Northern Territory).

Any professional support claim must include evidence that professional support occurred.

Professional support is not a requirement of MSOAP-MS supported outreach services.

Services to public hospital patients

The provision of hospital services to public patients is the responsibility of state and territory governments under the National Healthcare Agreement. Therefore the cost of patient care in hospital, if needed, will not be met under the MSOAP-MS measure.

Telemedicine

MSOAP-MS supports the use of telemedicine services as a supplement, and not as a substitute, to usual face-to-face consultation between patients and health professionals. MSOAP-MS does not support the capital costs associated with the establishment of telemedicine services but may cover costs, such as hire of venue and equipment, associated with consultations using this medium.

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Program Operation

Service proposals

Fundholders, health professionals or organisations can suggest or develop outreach services for consideration by the Advisory Forum in each state. Health professionals or organisations should seek assistance from fundholders in the relevant jurisdiction in the preparation of the proposed MSOAP-MS service/s proposal.

The fundholder will submit appropriate proposals to the Advisory Forum for consideration on the Service Proposal Form. The fundholder will notify the nominee of the proposal in writing of the outcome of their application.

Delivery of services

It is anticipated that services will be delivered at appropriate, agreed locations in a community. Host facilities will be responsible for supporting the coordination of visits.

Review of services

All services supported under the MSOAP-MS should be reviewed regularly by the fundholder and the Advisory Forum to ensure there is a flexible approach to service locations that enable women to access safe and quality maternity services.

The outcomes of the annual review of services and any proposed changes should be submitted to the Department as part of the annual plan for the upcoming year.

A service no longer meeting the needs of the program will be reconsidered and funds may be allocated to an alternative location.

A proposal for a new service endorsed by the Advisory Forum can be submitted to the Department for approval at any time.

Variations to services

Top of pageA variation to a service is a planned change that affects the costs associated with and/ or the delivery of the outreach service in the medium to long term. The variation may include the increase or decrease of services provided to one or more outreach locations.

Should a change to an approved service be required, the Department must be notified prior to the change. A change which amends the budget must be documented on the MSOAP-MS Service Proposal Form (include a revised budget) and be submitted to the Department. A change to service frequency or provider does not require Advisory Forum approval. It should be noted for advice for the next Advisory Forum meeting. A change of location (unless previously approved) must be agreed by the Advisory Forum prior to being submitted to the Department for approval.

Fundholders should seek approval from the Department with respect to any changes to intended or operational services. A formal variation to the Multi Project Agreement between the Department and the fundholder may be required in some circumstances.

Service termination

It can be expected that over the life of the MSOAP-MS measure:

• the need in the community for an identified service may change;
• the services provided by state/territory planning governments may change;
• a service may become self-sustaining from a commercial perspective and will no longer require MSOAP-MS support;
• a service provider may not wish to continue providing outreach services; and
• the priorities of the Department may vary.

The Department retains the right to terminate any service.

In the event that a service is terminated the fundholder should ensure that:

• all patients are advised and informed of the location of their medical records; and
• any agreements/lease arrangements for the provision of consultations, treatments or equipment are terminated within the nominated period.

New resident health professionals

In the event a health professional establishes a practice in a location where the MSOAP-MS is supporting an equivalent outreach service, the fundholder should:

• initiate, or facilitate negotiations with the new “resident” health professional for a three month grace period to wind down the MSOAP-MS service. This could include patients being notified of the location of their health records or for agreements and lease arrangements to be appropriately terminated ; and
• source a suitable location for the services of the “displaced” health professional/s if they wish to provide an outreach service in another location.

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MSOAP-MS Department of Health and Ageing Contacts

Address: GPO Box 9848 in your capital city.

Central Office (Canberra, ACT):    02 6289 7291
New South Wales:                        02 9263 3574
Northern Territory:                        08 8919 3435
Queensland:                                 07 3360 2597
South Australia:                            08 8237 8107
Tasmania:                                     03 6221 1540
Victoria:                                         03 9665 8220
Western Australia:                        08 9346 5463 Top of page

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Glossary of Terms - MSOAP-MS

Aboriginal Medical Service

A health service funded principally to provide services to Aboriginal and Torres Strait Islander individuals¹.

Absence From Practice Allowance

An MSOAP-MS payment made to a non-salaried private health professional for the time spent travelling to and from a location where they are providing approved MSOAP-MS outreach services and/or upskilling.

Allied Health Professional

Health professionals who:

• are involved in health care/health related care such as direct treatment, assessment, primary health care, community care, heath promotion in ether the public or private sector;
• are tertiary trained at a recognised university course and required to obtain specific qualifications to either be registered or to join a professional association2; and
• are registered or licensed as an allied health professional under a law of a State or Territory that provides for the registration or licensing of allied health professionals.

ASGC-RA

Australian Standard Geographic Classification System (ASGC) –
Remoteness Areas (RA) system developed by the Australian
Bureau of Statistics using 2006 Census data. It uses six categories of remoteness which are:

• ASGC-RA1 – Major Cities;
• ASGC-RA2 – Inner Regional;
• ASGC-RA3 – Outer Regional;
• ASGC-RA4 – Remote;
• ASGC-RA5 – Very Remote; and
• ASGC-RA6 – Migratory (Areas composed of off-shore, shipping and migratory Census Districts).

Administration costs

An MSOAP-MS payment made to cover the costs of administration directly related to the provision of patient services including reception duties, organising appointments, processing of correspondence, typing of referral letters and making hospital bookings etc.

Backfilling

An MSOAP-MS payment made for financial relief for a position vacated by a salaried public health professional who is providing approved MSOAP-MS outreach services.

General Practice

General practice is the provision of primary continuing comprehensive whole-patient medical care to individuals, families and their communities⁴.

General/ Medical Practitioner

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• Vocationally recognised General Practitioners under Section 3F of the Health Insurance Act 1973 ⁵;
• A person registered or licensed as a medical practitioner under a law of a State or Territory that provides for the registration or licensing of medical practitioners;
• A holder of the Fellowship of the Australian College of Rural and Remote Medicine as an eligible general practice training program and an eligible Fellowship for continuing professional development, or
• A holder of the Fellowship of the Royal Australian College of General Practitioners who participates in, and meets the requirements for, quality assurance and continuing medical education as defined in the RACGP Quality Assurance and Continuing Medical Education Program; or
• Undertaking an approved placement in a general practice as part of a training program for general practice leading to the award of the Fellowship of the RACGP, or undertaking an approved placement in general practice as part of some other training program recognised by the RACGP as being of equivalent standard.

Health professional

A general term for a person with tertiary qualifications in a health related field, eg. doctor, dietician, nurse, midwife, pharmacist, physiotherapist, psychologist.

Health Student

A person enrolled (or with multiple enrolments) in a higher education program or programs related to the health disciplines supported through the MSOAP-MS.

Medical Specialist

A medical practitioner who:

• is registered as a specialist under State or Territory law; or
• holds a fellowship of a recognised specialist college; or
• is considered eligible for recognition as a specialist or consultant physician by a specialist recognition advisory committee.

Models of Care

Cluster service provision to multiple communities from a variety of service providers located in different communities within the cluster. Coordination is paramount in this model to ensure a united approach to care.

Hub and spoke service provision provided both in a central town and the service provider(s) travelling to remote communities.

Outreach: service provision provided to remote communities by service providers travelling to these locations from a larger town. This is the preferred model under the current MSOAP-MS measure.

Multi-disciplinary Care

For the purposes of the MSOAP-MS measure, multi-disciplinary care refers to specific services provided by identified and approved medical specialists, GPs including Procedural GPs, allied health professionals, Aboriginal health workers and appropriate support staff to increase and improve access to high quality, safe, evidence-based maternity care for women and their families in rural and remote communities.

Midwife

Under National Law, midwifery is recognised as a separate profession. To register and practise as a midwife, a person must have appropriate qualifications in midwifery. There are two paths to these qualifications

• qualify as a registered nurse and then undertake additional education and training in midwifery.
• direct entry midwifery (DEMs), who are restricted to practising midwifery only,(whereas other midwives are also able to practise general nursing). Top of page

Need

Need would include consideration of issues such as the burden of disease, level of disadvantage, services currently available locally, linkages and integration with other services and effect on local planning and initiatives.

Nurse

Enrolled nurse - a nurse who is on the roll maintained by the nursing/midwifery registration board in each state and territory. Enrolled nurses include mothercraft and dental nurses where the educational course requirements are less than a 3-year degree course or equivalent. Enrolled nurses usually work with registered nurses to provide patients with basic nursing care, undertaking less complex procedures than registered nurses⁶.

Nurse Practitioner – a registered nurse educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role. Their role includes referral of patients to other health care professionals, prescribing medications and ordering diagnostic investigations⁷.

Practice Nurse - a qualified registered or enrolled nurse who delivers primary health care in a general practice setting⁸.

Registered Nurse

• a) a person registered under a law of a State or Territory (other than the State of South Australia) as a general nurse; or
• (b) a person registered under a law of the State of South Australia as a nurse.

Outreach service

Where a health professional provides medical services in a location that is not the location of their principal practice.

Professional support

An MSOAP-MS payment made for informal support provided by the visiting health professional to the general practitioner and/ or other local health professionals through meetings and/ or telephone/ email support once the health professional has returned to their main practice.

Registrar

A person training in a recognised training placement to become a medical specialist. A person in this stream must possess qualifications admitting him/ her to registration as a medical practitioner under the laws of one of the States or Territories of the Commonwealth of Australia.

Service

A single health professional (whether medical specialist, general practitioner or allied health) visiting a single town or community (e.g. Endocrinologist, Podiatrist, Nurse Practitioner etc.).

Telemedicine

A patient health professional interaction using technology that focuses on clinical care or connecting the patient and health professional for the delivery of clinical care. The key criterion being, however, that the interaction via technology is between a physician (or health professional) for the purposes of delivering clinical care. Regardless of the type of technology used, say telephone, video or e-mail, health professional to patient consultations fall into this category. Under this term, however, can be grouped specific types of telemedicine, for example, telepsychiatry, tele-dermatology.

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References

1. Ann O’Kane & Rob Curry (2003) Unveiling the secrets of the allied health workforce. Presentation to the 7^th National
Rural Health Conference.

2. National Chronic Disease Strategy, AHMC (2005).

3. The Royal Australian College of General Practitioners (http://www.racgp.org.au/whatisgeneralpractice).

4. Health Insurance Act 1973

5. Nursing and Midwifery Labour Force 2005 (AIHW) - http://www.aihw.gov.au/publications/hwl/nmlf05/nmlf05.pdf

6. Australian Nursing Federation - http://www.anf.org.au/pdf/Fact_Sheet_Snap_Shot_Nurse_Practitioners.pdf

7. Australian Nursing Federation - http://www.anf.org.au/pdf/Fact_Sheet_Snap_Shot_General_Practice_Nurses.pdf Top of page