Practices, partnerships and population health: report on the annual survey of general practice departments 2000–2001. Adelaide: Primary Health Care Research & Information Service, Discipline of General Practice, Flinders University, and Australian Government Department of Health and Ageing. ATAPS Access to Allied Psychological Services ATSI Aboriginal and Torres Strait Islander ASD Annual Survey of Divisions.
INTRODUCTION
METHOD
It should be noted that due to a series of unforeseen circumstances, the current report on summary data from the 2008-09 ASD has been delayed. One hundred and eleven departments out of 113 (98%) submitted their survey by the deadline – the highest completion rate ever. As in 2007–08, the Remote Rural Metropolitan Area (RRMA) classification system was used in 2008–09 to allocate divisions according to rurality.
DIVISION CONTEXT
There has been a consistent downward trend over time in the number of general practices across Australia (as shown in Figure 3.2). In most states, this trend reflects an overall decline in the number of solo GP practices (the exceptions were South Australia and the ACT, where the number of solo practices increased by 19 and 4 respectively). Note: In 2007–08, the number of non-GP members was not available for the two NSW disbanded divisions (formerly Liverpool Division and Sydney South-West GP Network).
GOVERNANCE
Data for the two NSW disbanded divisions (formerly Liverpool Division and Sydney South-West GP Network) was not available in 2007–08. Funding and reporting arrangements for the Divisions of General Practice program were streamlined with the introduction of the Multi-Program Funding Agreement (MPA) in 2005. Data for the two NSW disbanded divisions (formerly Liverpool Division and Sydney South-West GP Network) were not available in 2007-08.
PREVENTION AND EARLY INTERVENTION
Note, proportions are calculated using the number of sections with the specified program or activity as the denominator. Divisions were asked to report on programs with a focus on prevention and early intervention carried out in 2008-09. More than half of all departments ran Lifescripts (56%) and 'other programmes' (57%) with a focus on prevention and early intervention.
The approaches used and target population groups by department, specific to programs with an emphasis on prevention and early intervention, are shown in Table 5.3 and Table 5.4. The Men’s Sheds and Pit stop programmes, which were supported by a small proportion of departments (10% and 19% respectively), were aimed at men and promoted mainly through community outreach and collaboration with other organisations. Of the 26 departments implementing the Healthy for Life program, half reported focusing on Indigenous Australians, with GP education and engagement being the preferred approaches (81% and 77% respectively).
ACCESS
Please note that questions about access to aged care were not asked for reporting in 2007-2008 and therefore no data was available for that period. Sixty-four divisions reported providing 140,416 more Allied Health Services (MAHS)-funded services in 2008-2009 and 86 divisions reported providing 249,234 services through other programs in 2008-2009. In terms of FTE, psychologists (202.0 FTE) receive the most funding from MAHS and other program funding (see Table 6.1). The previously reported funding components Allied Psychological Services (ATAPS) and Better Outcomes in Mental Health Care Initiative (BOiMHCI) are now non-operational and therefore were not reported for the 2008-2009 period.
Number of divisions reporting specified FTEs or number of services for AHPs (number of divisions reporting AHP engagement where the amount was 'unknown'). Nearly all divisions (94%) carried out at least one activity to improve access to primary health care for Aboriginal and Torres Strait Islander people. Of the seven divisions that had no programs, six divisions were from Victoria and one from New South Wales.
Other Recruitment and retention of Indigenous staff Recruitment and retention of staff for Indigenous services Supporting ACCHOs in PIP accreditation related activities Assisting with grant applications and project proposals Cultural awareness training Introducing Indigenous services into existing clinic/practice Professional development for Indigenous staff Support of ACCHOs in immunization-related activities Assisting ACCHOs to make optimal use of the MBS. Support the development of indigenous clinics. Involvement in indigenous organizations. Participation in community projects. Promoting Indigenous health issues. Please note that the wording of the question changed from 2007-08 to 2008-09, from improving access to key ATSI health services to ATSI basic health care services. One hundred and eleven divisions (98%) also supported activities to help GPs accurately record the Indigenous status of all patients.
All activities increased over the previous year, and the most common activity carried out by divisions was to incorporate this topic into other briefings (see Figure 6.4).
COLLABORATION AND INTEGRATION
Note, programs or activities addressing CDM or EPC items, and shared care are not included prior to 2005-06.
CHRONIC DISEASE MANAGEMENT
All divisions used at least one chronic disease management program or activity (see Table 8.1). Consistent with previous years, GP education and practical support remained the most used approaches overall (99%, 112 of 113 Divisions for each). As well as a strong commitment to GP education (94%) and practice support (91%), divisions with mental health programs or activities were generally more likely to report using a patient services approach ( 87%), collaboration with other organizations (93%), and a community awareness approach (69%), signaling an emphasis on multi-strategy approaches in this context.
Questions about these subcategories for COPD were not requested for reporting in 2008-09 and therefore no data available for that period. As in previous years, many of the reported chronic disease programs in 2008-09 had a generic focus rather than targeting specific population groups (see Table 8.2). However, where programs specified target populations, they were most likely to be women, men and children/youth, with approximately half of all departments targeting these groups in at least one chronic disease program or activity.
Targeting of these population groups was most common for mental health activities (approximately 42% of divisions), although men and women were similarly targeted for diabetes (41% in both cases). Indigenous Australians were targeted for mental health (37%) and diabetes (33%) activities, and older people for diabetes (35%) and arthritis (33%) activities.
GENERAL PRACTICE SUPPORT
Note: when comparing over the years, 'patient surveys for accreditation' replaced 'support for accreditation' in 2008-2009. No questions were asked about the type of support for reporting in 2007-2008 and therefore no data are available for that period. The IM/IT Division's training and support activities in relation to general practice were first assessed in 2007-2008, both in terms of practice applications and the Division's offering.
As shown in Table 9.2, in 2008-2009 the share of divisions receiving training requests increased for all types of training except basic computer literacy (a decrease of 1%). The share of divisions offering training has increased for all types of training, except for website development (a decrease of 5%). The greatest disparity was in the use of practice management systems, with 78 divisions providing training out of 86 that received a request.
Along the same lines, the share of divisions receiving requests for IM/IT support has increased for all types of support except new application development (a decrease of 4%; see Table 9.3). This equates to 4% fewer Divisions offering the same type of support, compared to increases for all other types. Sixty-five of the 76 divisions that received requests for computer support and technical assistance actually provided this form of support.
CONSUMER FOCUS
Note, questions about consumer involvement in Division activities were not requested for reporting in 2007-08 and therefore no data available for that period. In terms of specific activities, departments were most likely to involve consumers in the evaluation of program activities (65%), then strategic planning (62%) and needs assessment (60%) (see Table 10.1). The proportion of sections that engage consumers in all three activities is at its highest, or equal highest level since 2004-05.
Questions relating to evaluation, needs assessment and strategic planning were not asked for reporting in 2007-2008 and therefore no data are available for that period.
WORKFORCE
Almost all divisions (99%) reported offering at least one activity to support GP staffing needs and wellbeing in 2008-2009. Compared to the previous year, all activities in 2008-2009 were carried out by a greater proportion of divisions, with the exception of locum support, which decreased slightly (see Figure 11.3). Encouraging GPs to have their own GP remained the most common activity, as illustrated in Figure 11.4.
All 113 departments delivered at least one medical practice development and training activity for the year 2008-09, compared with 99% of departments in 2007-08. The number of medical staff receiving WSRGP support has increased over the past three reporting periods as the number of departments reporting 'unknown' has decreased, therefore the number of beneficiaries has increased. As shown in Figure 11.6, there was an increase in most activities, and departments funded by the WSRGP program most often carried out general medical support activities.
Divisions reported relatively stable WSRGP funding for all GP health activities from year to year (see Figure 11.7). The proportion of reporting Divisions receiving WSRGP support for recruitment and retention programs increased steadily from 2006-07 to 2008-09 (see Figure 11.8), while funding for other activities varied across reporting periods. Note, proportions calculated using number of Divisions receiving WSRGP funding as denominator (N) These activities were not addressed in this way prior to 2005-06.
Please note that the ratios calculated using the number of divisions receiving WSRGP funding as the denominator (N) Needs assessment/data collection were not treated in this way prior to 2005-2006.
THE DIVISIONS NETWORK (AND RWA)
How many GPs do you estimate were working in your ward area on 30 June 2009? How many other primary care doctors (eg Royal Flying Doctor Service doctors) were in your ward area on 30 June 2009. How many Aboriginal communities under the supervision of Health Services were in your department's area on 30 June 2009.
How was your Division involved in activities aimed at improving access to GP services in 2008-09. How was your Division involved in carrying out any programs or activities to improve access to primary health care services for Aboriginal and Torres Strait Islander patients. What programs or activities aimed at improving GP collaboration with hospitals and/or specialists was your Division involved in carrying out in 2008-09.
What programs or activities to improve the collaboration of general practitioners with other primary care providers was your department involved in implementing in 2008-2009? How did your department provide support to practices (via GPs or practice staff) in 2008-2009? What formal mechanisms did your division use to engage Indigenous health organizations or Indigenous consumers in 2008-2009.
How was your department involved in carrying out activities or programs to improve GP care for the elderly in 2008-2009? How was your department involved in activities aimed at supporting practice nurses in general practice in 2008-2009? Did your division use the AGPN National Resource Library (formerly known as the Clearing House) in 2008-2009?
