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Medicare Local After Hours Program. After Hours Primary Care Reform Aim to provide all Australians regardless of where they live, with accessible and effective after hours primary care services Objectives access to after hours GP telephone advice when needed
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After Hours Primary Care Reform Aim • to provide all Australians regardless of where they live, with accessible and effective after hours primary care services Objectives • access to after hours GP telephone advice when needed • local service delivery is well planned, well coordinated and appropriate to community needs • accessible services in both the sociable and unsociable hours • accessible services for disadvantaged groups such as residents of aged-care facilities, home bound, palliative care, etc • patients directed to most appropriate point of care for their condition • better support for health professionals in arranging care for patients
After Hours Primary Care Reform Components • after hours GP helpline • Medicare Local After Hours Program
after hours GP helpline Commenced 1 July 2011 • 105,545 calls • 62.9% were provided with self-care advice • 19.8% advised to see a GP immediately • 15.9% referred by GP to 000 or emergency • 8.6% were referred to a hospital emergency department because no after hour GP services were available in their area. Note: data is from 6pm 1 July 2011 to midnight 27 February 2012
after hours GP helpline • 60% of callers are female • 30% about children 0-5 years of age • top three symptoms - paediatric cough, abdominal pain, paediatric fever • 47.7% NSW; 28.6% WA; 16.8% SA
after hours GP helpline Enhancements • National Health Services Directory • Fast Track Support for Health Professionals • Improved continuity of care with PCEHR • Video-conferencing capabilities from July 2012 • Integration with Local Service Delivery
Medicare Local After Hours Program Overview: • Stage 1, pre 1 July 2013: planning and gap filling • Stage 2, post 1 July 2013: comprehensive whole of region planned approach
Medicare Local After Hours Program Tranche 1 Stage 1 – 1 July 2011 to 30 June 2013 • Known gap filling • Whole of region needs assessment • Whole of region plan
Medicare Local After Hours Program Tranche 2 Stage 1 – 1 January 2012 to 30 June 2013 • Whole of region needs assessment • Whole of region plan
Medicare Local After Hours Program Tranche 3 Stage 1 – 1 July 2012 to 30 June 2013 • Sub-region needs assessment • Sub-region plan
Medicare Local After Hours Program Funding • Program administration • Service delivery support funding • stage 1 gap filling funding, 2011-13 • funding based on core ML funding formula • indicative amount provided • stage 2 comprehensive funding, July 2013- • includes funding previously provided through GPAH, PIP after hours incentives, as well as additional funding
Medicare Local After Hours Program Resources • Stage 1 Guidelines • Supporting resources and templates for needs assessments and plans • Data • Medical Benefits Schedule • Practice Incentive Program After Hours Incentive • General Practice After Hours Program • after hours GP helpline call usage statistics (yet to be provided) • Stage 2 Guidelines
Medicare Local After Hours Program Stage 2 - 1 July 2013 onwardsImplementation of comprehensive stage two plan
After Hours Reform Evaluation Evaluation • Focuses on all of the components of the after hours reform initiative • To be conducted in two stages: • Stage 1 – expected to start mid-2012 • Stage 2 – mid-2013
Medicare Local After Hours Program Roles and Responsibilities • DoHA – Central Office • DoHA – State and Territory Offices • Australian General Practice Network (until 30 June 2012)
Thank you Queries can be sent to: afterhoursreform@health.gov.au