Medicare Locals: the way forward?
Aged care providers, doctors and Government are all looking to Medicare Locals as the forum to facilitate better access to healthcare for aged care recipients.www.acqi.org.au/
Above: GP Partners Director, Dr Trish Baker, left, promoting the GPpartners Team Care Coordination program, with Coordinator, Sue King and (now Qld Health Minister) Geoff Wilson MP [Nov 2009]
By Stephen Easton
Aged Care Queensland (ACQ) and Blue Care, the state’s largest non-profit aged care provider, have both been welcomed as members of Metro North Medicare Local in Brisbane by GPpartners, the Division of General Practice that has the lead postion in the new Medicare Local consortium which commences operation tomorrow.
ACQ’s manager of community care, Paul Johnson, has been involved with the partnership and said ACQ has been actively encouraging its members to join the Medicare Local in their area, and that the peak body itself had also joined the West Moreton-Oxley Medicare Local in Brisbane’s south, as well as Metro North.
“We’ve welcomed the transition from Divisions of General Practice to Medicare Locals because these new company structures allow for a broader focus in primary care provision,” Mr Johnson said. “And the Department [of Health and Ageing] has specifically named the aged care sector as one area they should be focusing on.”
“I guess at the heart of this whole approach by the Commonwealth, decision-making, population health priorities and planning are devolved down to a regional level, so it’s crucial that providers in remote parts of QLD, or any part of QLD, are advocating and have effective links to get their message heard in the primary care system that operates in their regional area.”
“What the actual direct benefits to aged care providers will be is still a bit nebulous, but it’s all under the broad assumption that these regional Medicare Locals will really be that conduit between primary care delivery and the Commonwealth Government.”
“It’s certainly a step in the right direction, but it is still early days.”
A forum for new ideas
In a speech at the HammondCare Conference last week, HammondCare CEO Stephen Judd threw his support behind Medicare Locals, which he said could provide the framework for combined efforts to develop new models for interaction between health professionals and the aged care sector, such as providers locating medical clinics on-site at larger facilities, or employing salaried doctors in job-sharing arrangements.
GPpartners have previously addressed the same issues, in partnership with the Brisbane South Division of General Practice, through the Aged Care Access Initiative (ACAI), in which they focused on improving access to dentists and psychologists.
The purpose of ACAI was to “explore innovative workforce models” to address the problem by chanelling funding to any clinical care services that were helpful to aged care residents, but did not attract any other form of government subsidy.
GPpartners director, Dr Trish Baker, said that unfortunately, funding for the “very successful” project had not been continued, although it had “given them a bit of a head start” on finding solutions to the problems of aged care residents.
She stressed that Medicare Locals were not service providers, but partnerships between different service providers that would work together to provide better primary health care in their areas.
“We’re very keen to listen to all suggestions from members [of the Medicare Local] or any other organisations in the community,” Dr Baker said. “We’re really happy to discuss ideas and explore ways that we can work with aged care providers”
“We’re looking to form partnerships that will improve the patient journey, including the people in residential aged care facilities and people who are ageing in the community.”
“One of things we can do is bring different parties together. We can talk and have a situation where various health providers are talking – community nurses with other allied health professionals, pharmacists and doctors – we can look for better ways of supporting people in the community.”
Looking for the ideal situation
Dr Baker said that she had heard of some large aged care providers who were looking into different arrangements for having doctors available on-site, but stopped short of favouring a particular funding model.
“One very large campus in Brisbane has an excellent setup,” she said. “They have a doctor there most days, and they also have a geriatrician and a psycho geriatrician. That’s a very well set-up clinic where the patients are identified by the nursing staff and the various care planning elements are all done, there’s a lovely consulting room set up for the doctors, and that makes it more attractive, for them to work in a situation like that.”
“They do need to look at these models, so there will be more doctors working in aged care, but I don’t know whether it matters if it’s a salaried or fee-for-service model. All I can say is we’re ready, willing and keen to work on finding solutions and we do have a bit of a head start from our own work on aged care, which unfortunately did not have the funding continued.”
Dr Baker added that she believed nurse practitioners would play a role in improving the situation, by acting as a “bridge” between nursing staff and doctors.
