DIVISIONS DIVISIONS ——AGENTSAGENTS

OF CHANGEOF CHANGE

SUMMARYSUMMARY

The Context & Role of General PracticeThe Context & Role of General PracticeThe Need for ChangeThe Need for ChangeThe Role of DivisionsThe Role of DivisionsDivisions at Centre of Primary HealthDivisions at Centre of Primary HealthDivisions as ManagersDivisions as ManagersDivisions as Change AgentsDivisions as Change Agents

PILLARS OF GENERAL PILLARS OF GENERAL PRACTICEPRACTICE

••ContinuousContinuous

••Comprehensive Comprehensive CareCare

••CoordinatedCoordinated

Fundamentals of Fundamentals of Australia’s HealthAustralia’s Health

•• DRIVERSDRIVERS–– Increased AgingIncreased Aging–– Increased chronic care needs Increased chronic care needs –– Increased private outlayIncreased private outlay–– Increased Federal Funding %Increased Federal Funding %–– Increased preventative Increased preventative activitiesactivities

Australia’s Health Australia’s Health ExpenditureExpenditure

••PBS PBS –– 90%90%••MBS MBS –– 74% of attendances are GP74% of attendances are GP

–– 26% of attendances are Specialist26% of attendances are Specialist

••Private (insurances, out of pocket)Private (insurances, out of pocket)••Aged CareAged Care

All largely GP influencedAll largely GP influenced

Drivers for ChangeDrivers for Change

••AgreementAgreement••Incentives Incentives ••InfrastructureInfrastructure••ResourcesResources

Barriers to ChangeBarriers to Change

••TimeTime••Trust Trust ••TerritoryTerritory••TraditionTradition

Catalysts for Catalysts for General PracticeGeneral Practice

ChangesChanges••Infrastructure and supportInfrastructure and support••IM/ITIM/IT••Quality agendaQuality agenda••Personnel Personnel –– Practice Nurses, Practice Nurses, ManagersManagers

Riverina Division of Riverina Division of General Practice and General Practice and Primary Health LtdPrimary Health Ltd

VisionVision‘‘A leading Division providing General Practice A leading Division providing General Practice

with quality innovative services that improve with quality innovative services that improve health outcomes for individuals and the health outcomes for individuals and the community’community’

MissionMissionThe Riverina Division of General Practice & Primary The Riverina Division of General Practice & Primary Health ensures the central role of general practice in Health ensures the central role of general practice in

health care.health care.

The Division will empower General Practice to The Division will empower General Practice to improve the health of the community by assisting improve the health of the community by assisting with:with:•• Effective advocacy, support, communication and Effective advocacy, support, communication and

representation representation •• Enhancing quality general practice and provision of primary Enhancing quality general practice and provision of primary

health care serviceshealth care services•• Collaborating with the broader health system, the Collaborating with the broader health system, the

community and other key stakeholderscommunity and other key stakeholders

DIVISIONS DELIVERDIVISIONS DELIVERLOCAL HEALTH LOCAL HEALTH

SOLUTIONSSOLUTIONSTHROUGHTHROUGH

GENERAL PRACTICEGENERAL PRACTICE

Division RolesDivision Roles

••Implement Implement -- policy and programspolicy and programs••Influence Influence –– representationsrepresentations••Integrate Integrate –– across primary health across primary health

including communicationincluding communication••InnovateInnovate

National Divisions Network StructureNational Divisions Network Structure

Division AreaDivision Area

Allied Health Centered InitiativesAllied Health Centered Initiatives•• More Allied Health Services (MAHS)More Allied Health Services (MAHS)

–– Diabetes EducatorDiabetes Educator–– PodiatristPodiatrist–– DietitianDietitian–– Occupational TherapistOccupational Therapist–– Asthma EducatorAsthma Educator

•• Access to Applied Psychological Services (ATAPS) Access to Applied Psychological Services (ATAPS) –– PsychologistsPsychologists–– Social WorkerSocial Worker

•• PrePre--diabetesdiabetes–– Exercise physiologistExercise physiologist–– Diabetes Educator/DietitianDiabetes Educator/Dietitian

Pharmacy Centered InitiativesPharmacy Centered Initiatives

••Residential Medication Management Residential Medication Management Review (RMMR)Review (RMMR)

••National Pharmacy Service (NPS)National Pharmacy Service (NPS)••Quality Use of Medicine (QUM)Quality Use of Medicine (QUM)••Enhanced Divisional Quality Use of Enhanced Divisional Quality Use of Medicine (EDQUM)Medicine (EDQUM)

••Home Medicine Review (HMR)Home Medicine Review (HMR)

Practice Centered InitiativesPractice Centered Initiatives

••ManagersManagers••Practice NursesPractice Nurses••ImmunisationImmunisation••IM/ITIM/IT••AccreditationAccreditation

GP Centered InitiativesGP Centered Initiatives

••AccreditationAccreditation••RecruitmentRecruitment••RetentionRetention••CPDCPD••CollegialityCollegiality

DIVISIONS WILL DIVISIONS WILL BE THE PROVIDERBE THE PROVIDER

OF CHOICEOF CHOICE

Building on our Strengths to Building on our Strengths to advance Primary Health Careadvance Primary Health Care

•• Changes to constitution to address the Division’s Changes to constitution to address the Division’s Primary Health Care focus, role, membership, Primary Health Care focus, role, membership, accountability and governanceaccountability and governance

–– Effective 1 December 2004Effective 1 December 2004–– Provides for Provides for Primary and Associate MembersPrimary and Associate Members–– Board from 9 GP Directors to 7 Primary Members and Board from 9 GP Directors to 7 Primary Members and

2 Associate Members2 Associate Members

Building on our Strengths to Building on our Strengths to advance Primary Health Care advance Primary Health Care

Name change from Name change from Riverina Division of General Practice IncRiverina Division of General Practice Inc

to to

Riverina Division of General Riverina Division of General Practice and Primary Health LtdPractice and Primary Health Ltd

Committee StructureCommittee Structure

Organisational StructureOrganisational Structure

Funding SourcesFunding SourcesRIVERINA DIVISION OF GENERAL PRACTICE & PRIMARY HEALTH -

Application of Funds to 31st January, 2007

Falls Prevention0%

MSOAP3%

Other Projects17%

GP After Hours15%

Dementia Community Grant1%

Managed Health Network1%

Primary Care Nurses9%

BOMHC11%

EDQUM- Primary Health1%

WSRGP Workforce Support1%

MAHS8%

Immunisation1%

Aged Care2%

Palliative Care3%

OBF Consolidated27%

Funding SourcesFunding SourcesRIVERINA DIVISION OF GENERAL PRACTICE & PRIMARY HEALTH LTD

Source of Funds to 31st January, 2007

DoHA Funding71%

Other Revenue Earned2%

Admin. Support for Programs

5%

Other Project Funding20%

Division Funds0%

Interest Earned2%

Meeting the Challenges inMeeting the Challenges ina Changing Environmenta Changing Environment

For the Big pictureFor the Big picture••ChairChair--Australian General Practice Australian General Practice NetworkNetwork

••BoardBoard--Alliance Of NSW DivisionsAlliance Of NSW Divisions••BoardBoard--RACGP RACGP -- NSW FacultyNSW Faculty••ChairChair--NSW Division Executive NSW Division Executive NetworkNetwork

Meeting the Challenges in a Meeting the Challenges in a Changing EnvironmentChanging Environment

•• Staff Qualifications Staff Qualifications and expertiseand expertise–– Health administrationHealth administration–– Business ManagementBusiness Management–– AccountancyAccountancy–– HR ManagementHR Management–– Computer ScienceComputer Science–– Practice Management Practice Management –– Research Research –– Health Promotion Health Promotion –– NursingNursing

–– Clinical PsychologyClinical Psychology–– Clinical Pharmacy Clinical Pharmacy –– Social WelfareSocial Welfare–– Occupational TherapyOccupational Therapy–– DieteticsDietetics–– Diabetes Education and Diabetes Education and

Management Management –– Asthma EducationAsthma Education–– Podiatry Podiatry –– Human MovementHuman Movement

Meeting the Challenges in a Meeting the Challenges in a Changing EnvironmentChanging Environment

–– Drug & AlcoholDrug & Alcohol--GP GP Education (AHS) Education (AHS)

–– Practice Nursing Practice Nursing –– Medical Specialist Outreach Medical Specialist Outreach

Program (MSOAP)Program (MSOAP)•• PsychiatristPsychiatrist•• Rheumatologist Rheumatologist •• Paediatric Haematology Paediatric Haematology

and Neurology.and Neurology.–– HR/IR Support HR/IR Support --

Consortium of DivisionsConsortium of Divisions–– Zest MagazineZest Magazine–– Palliative CarePalliative Care–– Dementia CareDementia Care

--Falls PreventionFalls Prevention–– Men's HealthMen's Health--PitPit--stop stop –– Youth HealthYouth Health–– AsthmaAsthma-- HarvestHarvest–– GP Registrar/OTD Support GP Registrar/OTD Support

( CCC)( CCC)–– IPHCSIPHCS--CootamundraCootamundra–– Accommodation Accommodation

•• Cootamundra Cootamundra –– Medical Medical students & GP students & GP Registrars (RACGP)Registrars (RACGP)

Meeting the Challenges in a Meeting the Challenges in a Changing EnvironmentChanging Environment

–– Primary Care Nurses Primary Care Nurses –– Better Outcomes in Mental Health Care Better Outcomes in Mental Health Care –– National Primary Care Collaboratives National Primary Care Collaboratives –– Quality Use of MedicinesQuality Use of Medicines

•• NPSNPS•• HMRHMR•• EDQUM (Pre Diabetes)EDQUM (Pre Diabetes)•• ERMERM

–– Allied Health Services (MAHS, ATAPS, Allied Health Services (MAHS, ATAPS, Pre Diabetes)Pre Diabetes)

Meeting the Challenges in a Meeting the Challenges in a Changing Environment Changing Environment

Program DeliveryProgram Delivery

Core Programs Core Programs + Innovation + Innovation + Diversity + Diversity

= = Improved Primary HealthImproved Primary Health

SUMMARYSUMMARY

The Context & Role of General PracticeThe Context & Role of General PracticeThe Need for ChangeThe Need for ChangeThe Role of DivisionsThe Role of DivisionsDivisions at Centre of Primary HealthDivisions at Centre of Primary HealthDivisions as ManagersDivisions as ManagersDivisions as Change AgentsDivisions as Change Agents

And the Future???And the Future???

MORE CHANGEMORE CHANGE&&

Expansion of theExpansion of thePrimary Health rolePrimary Health role