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GPs take a stand on after-hours services

GPs take a stand against after-hours services - Featured Image

The Royal Australian College of General Practitioners believes after-hours doctor services shouldn’t advertise to the general public and should only be accessed through their general practice.

The recommendation is one of many in the college’s recently released position statement about after-hours services.

RACGP President Dr Frank R Jones wrote in the college’s ‘In Practice’ newsletter: “Many issues of concern were identified by practicing GPs, especially around quality clinical assessment and continuity of care, as the patients’ normal treating doctor often receives variable and limited information about their patients’ after-hours visit.”

After-hours visiting services have become increasingly popular in recent years, which the college says coincides with an increase in the use of after-hours MBS item numbers.

Related: General practice after-hours incentive funding: a rationale for change

“The increase in the use of after-hours related MBS item numbers could be attributed to the emergence of new business models offering dedicated after-hours home visiting services,” the college wrote in its statement.

After-hours visits classified as ‘urgent’ receives a rebate of $130-$150 compared to a non-urgent visit of $55 and $36 for a standard visit in the GP surgery.

The RACGP’s position is:

  • Only vocationally registered GPs, non-VR GPs, doctors on a pathway to Fellowship or GP registers with appropriate supervision should provide after-hours doctor services that attract an MBS rebate.
  • Patients should only be able to access after-hours services through their GP practice
  • Practices should provide information about access after-hours services to patients.
  • After-hours visiting services should have a formal connection with the patient’s usual GP.
  • There should be a summary document detailing clinical management forwarded to the patient’s usual GP by the next morning.
  • After-hours services should only take appointments during after-hours periods.
  • There should be appropriate triage processes from GP, nurse or other properly trained professional to minimise the amount of home visits required.
  • After-hours services are more expensive to the tax payer and should be subject to specific regulation and accreditation.
  • After-hours services should avoid advertising directly to the public.

Related: Round-the-clock GP care needs right incentives

The National Association for Medical Deputising (NAMDS) says it agrees in principle with the RACGP’s statement.

President of NAMDS, Ben Keneally, said: “We strongly support the view that Medical Deputising Services should work in support of General Practice.”

However they believe deputising services should be able to raise their own awareness. NAMDS said until recently, many patients weren’t aware of after-hours services and would inappropriately present at emergency departments instead.

“It is true that there has been growth in both after-hours clinic consultation and after-hours home visits. Indeed, in terms of volume, the growth in after-hours clinic visits has been much greater. This growth reflects the success of deliberate government policy to improve availability of primary healthcare in the after-hours period.”

The NAMDS recently released their Definition of a Medical Deputising Service: Interpretation and Guidance document to provide clarity on the role of Medical Deputising Services in after-hours primary care.

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