GPs in CHS Strategy 2006-2008

1. GPs in CHS Strategy2006-2008 Colac Area Health Damian Melican

3. Title of Proposal • Supporting GP Practices in Managing Clients with Chronic and Complex Needs and Enhancing Integration with the Primary Care Team of Colac Area Health

4. Key Partners COLAC AREA HEALTH • Acute • Aged Care • Primary Care GENERAL PRACTICE • Corangamite Clinic • Otway Clinic • Sole Practitioner CLIENTS • Chronic, Complex, Socioeconomic Difficulty

5. MBS Chronic Disease Item Numbers • MBS Item 721 - preparation of a GP Management Plan (GPMP) • MBS Item 723 - coordination of Team Care Arrangements (TCA) • MBS Item 725 - review of a GP Management Plan • MBS Item 727 - coordination of a review of Team Care Arrangements • MBS Item 729 - contribution to a multidisciplinary care plan being prepared or reviewed by another health or care provider • MBS Item 731 - contribution to a multidisciplinary care plan being prepared or reviewed by another health or care provider for residents of aged care facilities

6. MBS Chronic Disease Item Numbers continued • Further 13 Item numbers for Allied Health services requested by GP. - i.e. GP Referral to specific private allied health practitioners.

7. Aims, Objectives, Outcomes • Service Coordination and Integration • Access – Card holders to GPs +CHS • MBS Item Numbers - increase number of - assist admin of • Completions and Outcomes • Sustainability

8. Developmental Issues • History of Program • Development of Role • Relationship between CAH + Practices and Practitioners • Engaging with Key Partners • I.T. Incompatibilities • Relationship Building

9. Day to Day • Enthusiastic response from GPs • Current work practice – recruit, refer, recall • Capacity of CHS • Lack of awareness of Primary Care by GPs • Broad parameters of Project

10. Better Connection – Better Care • Clinic Data Access • Narrow Focus • IT Communication Issues • Relationship Development • Client Focus • Review and Reporting • Sustainability