Opportunities for General Practice Liaison Officers (GPLO) in Outpatient Departments

1. Opportunities for General Practice Liaison Officers (GPLO) in Outpatient Departments Ms Ann Maree Liddy CEO

2. Current Situation in Queensland • General Practice Liaison Officers or Units have existed in most Australian states sine the 1990s • Most roles have been developed ad hoc • GPLO program strengthened over the years, but varying investment across the nation • Approximately 95 GPLOs across Australia, with a number of units across Australia (Tasmania, NT, ACT, WA, Victoria) • Currently 11 GPLOs in QLD

3. Current GPQ Work • QLD Health engaged GPQ to undertake a project to assist the Queensland Clinical Senate in developing a policy position on GP Liaison roles. • Purpose: • To review the roles and skill requirements of the current GPLO workforce to improve the GP – Hospital interface • Develop a statewide policy framework and implementation plan for ‘GP Liaison’ • Steering Committee established

4. Using an Evidence-Based Approach • Literature review: • The use and impact of GPLOs working to improve the interface • Barriers • Enablers • Practice skills of current GLO workforce • Semi-structured interviews (35 participants)

5. Evidence from the Literature GPLO roles have been shown to: • Reduce patient hospital usage; • Improve communication between primary and hospital sectors; • Increase the skills of primary care team; • Improve treatment compliance; • Reduce unnecessary referrals hospital sector.

6. What was developed? • GPLO model and scope of practice includes: • Principles of the role • Standards for integration • How the model would integrate with national health reform • Role descriptions and scope of practice • KPIs • Sustainability • GPLO implementation plan for Queensland

7. Opportunities for Outpatient Departments • The Australian Government has asserted that: “LHHNs and MLs will need to work together…ensuring that there are appropriate clinical pathways between settings, such as clinical handover or on discharge from hospital; better integration of services; and identifying and addressing service gaps especially at the interface between primary and acute care”

8. Opportunities Cont. GPLOs could assist in reaching four hour access target for EDs by coordinating ML/LHHN activity through: • Providing GPs with information on ED and access to ED physician hotlines to assist in patient management • Improving referral and communication processes to reduce re-presentations • Developing local social marketing strategies to encourage appropriate use of ED services and access to PHC • Developing models of care such as collocated clinics and building linkages with after hours services

9. Opportunities Cont. GPLOs could also contribute to meeting elective surgery access targets through facilitating ML/LHHN activity in: • Ensuring GPs have access to info on Specialist Clinics (E.g. wait times) so GPs can provide patients with options around care • Assisting GPs to have access to pre-referral guidelines and specialist support to manage non-urgent patients in the community • Improving discharge communication • Ensuring GPs are provided with guidance on management of condition in preparation for surgery

10. Examples of Outcomes Townsville based ‘Strategy for Managing Aged Referrals’ • Purpose of the project was to implement a process for reducing the number of ‘long wait’ patients awaiting specialist outpatient appointments – particularly orthopaedic specialty area • Changes to the referral system were made, along with comprehensive change management process and education program • Significant reductions in orthopaedic SOPD wait times • Key success factor was utilisation of the Townsville GPLO

11. Examples of Outcomes Cont. Gold Coast model to reduce SOPD wait lists: • Development of SOPD resource directory so that GPs are aware of eligibility criteria for clinics, services offered, contact details, doctors within each and the pre-requisite tests to be completed prior to first appointment • Development of a suite of referral templates for GPs • Loading templates onto GPs desktop software so they can be populated from patient files • Establishment of electronic messaging systems in the SOPD bookings and referral centre to be able to receive secure electronic referrals from GPs.

12. Finally… • The opportunities for utlising GPLOs in Outpatient Departments presented today are by no means an exhaustive list • Implementing new (and building on existing) local General Practice Liaison programs would be timely, achievable and practical to improving the hospital / primary health care interface • The GPLO workforce can drive improvements in cross sector relationships and cultural change • More information on the GPLO Model and Scope of Practice developed by GPQ is available.

13. Thank you