Australian researchers find that primary care needs reform

28 July, 2009

Australia’s primary health care workforce is under strain but the problem could be addressed by better funding models and training for GPs and practice nurses on how to work together, according to researchers from the Australian Primary Health Care Research Institute (APHCRI) based at ANU.

In an article in the latest General Practice edition of the Medical Journal of Australia, APHCRI Research Fellow Associate Professor Kirsty Douglas and her co-authors argue that a strong primary health care system would improve patients’ experience and reduce costs.

Professor Kirsty Douglas said the primary health care workforce would need to be “adequate, sustainable and effective” to achieve these goals. “Currently, however, Australia’s primary health care workforce is facing significant challenges in supply, distribution, changing demands and role delineation,” she said.

In the article, the authors discussed policy options based on research commissioned by APHCRI and the Primary Health Care Workforce Roundtable held in Canberra. Key recommendations were:

  •  simplifying the Medicare Benefits Schedule, which is unnecessarily complex and inflexible;
  • effectively funding undergraduate and prevocational medical and nursing education and training in primary health care;
  • developing career structure and training pathways for general practitioners and primary health care nurses;
  •  developing of functional primary health care teams; an
  •  using a blended funding model, comprising fee-for-service as well as capitation for patients with chronic or complex needs.

In another article from the same issue of the Medical Journal of Australia, ANU researcher Dr Christine Phillips and her co-authors identified six roles for nurses in general practice: patient carer, organiser, quality controller, problem solver, educator and agent of connectivity.

“Many of the nurses in our study were highly accomplished clinicians who expressed frustration at the limited clinical care they were able to provide in general practice,” Dr Phillips said. “To realise the full potential of nurses’ skills, they need to be supported to expand their roles, not just because of workforce shortages, but because of the contribution they make to improving patient care.”

The article was informed by the Australian General Practice Nursing Study, which was funded by APHCRI.

APHCRI was established in 2003 to provide national leadership in improving the quality and effectiveness of primary health care through the conduct of high-quality, priority-driven research, and in supporting and promoting best practice. General Practice Week runs from July 20-26.