Nurse practitioner or GP?

New Commonwealth legislation, made effective yesterday, will encourage GPs and nurse practitioners to work together to deliver a collaborative approach to patient care.

Family doctors and nurse practitioners working in autonomous settings are being encouraged to work with each other to deliver a high quality of collaborative patient care, following the implementation of new Medicare funding legislation yesterday.

In a long-awaited move by the federal government, new regulations have been introduced which require nurse practitioners to collaborate with general practitioners (GPs) to provide Medicare-funded services to patients or to prescribe them medications listed on the Pharmaceutical Benefits Scheme (PBS).

The Australian Medical Association (AMA) has officially welcomed the legislation, which enshrines in law the requirement for nurse practitioners and midwives to work with medical practitioners. The AMA encouraged GPs to accept the new regulations in a new guide released to its members last week.

“Some doctors will be challenged by the Government’s reforms, which will fund new models of patient care,” the guide said.

“However, the requirement for a collaborative arrangement with a medical practitioner puts in place an overarching quality framework to preserve patient safety and ensure that medical practitioners are not left out of the loop.

“…If we do not embrace these changes, then pressure will mount on the government to relax the requirement for collaborative arrangements to be in place. This would risk fragmentation of care to the detriment of patients.”

AMA vice president, Dr Steve Hambelton, stressed how well nurses and doctors have worked together in the past.

“The measure of how well [this new model] will work will be the quality of the collaboration between family doctors and nurse practitioners,” said Dr Hambelton.

“Our main concern is the fragmentation of health care, which is a risk…We don’t need two health care systems, just one.”

He said that the most difficult and risky model of care is the stand alone nurse practitioner clinic.

“…If there is no sharing of patient information between doctors and nurses, there will be a risk. If there is no close consultation, there will be a risk. If there is no proper handover of care from one health professional to another, there will also be a risk.”

“The fact is that there are 400 nurse practitioners in the country, with a few in primary care and a few in aged care. [The legislation] is not the solution to the aged care or rural crisis. Anyone suggesting that it will relieve the pressure off the [aged care system] is stretching the point a lot.

“It should strengthen cooperation between nurses and doctors, not put them at odds with each other…We have to learn where we fit and learn to work together.”

The Australian Nursing Federation (ANF) said that it was very pleased that nurse practitioners will be able to offer their patients access to MBS and PBS rebates.

“I think the legislation is very clear,” said ANF assistant secretary, Yvonne Chaperon.

“It’s a collaborative model and there will be no fragmentation at all…It’s about enhancing the health services that are being provided now, not fragmenting it.”

While some details are still being debated, Ms Chaperon said this legislation has the potential to greatly increase affordable access to health professionals for all patients.

“The way the legislation is set up, a patient can potentially walk in off the street, access the services of a nurse practitioner and receive benefits.

“Nurse practitioners have master’s degrees, extensive clinical practice expertise and many, many years of experience. This is great news for consumers who want affordable, quality care without long waiting times.”

The ANF looks forward to working with the federal government to address any issue that may arise during the roll out of this legislation.
 

Tags: aged-care, australian-medical-association, australian-nursing-federation, gp, nurse-practitioner,

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