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| Program | MANAGEMENT | | Goal | A high standard of excellence for the Board and individual directors | | Strategy | Review the Division Constitution |
| Outcomes | Activities | Indicators | Results&Commentary |
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| A Constitution that meets all legal requirements and provides the Company with the structure to meet its objectives. |
Working party formed to review current constitution |
Regular reports to Board |
The Constitution committee met three times to review and draft a new constitution. Reports on progress and a final draft were presented to the Board of Directors.
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| Draft constitution tabled for voting at Division AGM |
Tabled Constitution adopted by Division GP members |
A new Constitution for the Barwon Division was adopted by over 75% of the Membership on the 22.9.04.
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| Program | MANAGEMENT | | Goal | A high standard of excellence for the Board and individual directors | | Strategy | Develop the Director's awareness of their roles and responsibilities |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Board of excellence |
Ensure remaining Board member is trained in Governance Level 1 |
All Board members trained in Governance Level 1. |
New Board of Directors elected on the 15.11.04. All Board Directors have been previously trained in governance level 1.
Further governance training will be offered early in the 2005-2006 year and a method of Board performance evaluation developed |
| Bi monthly reporting against Business Plan for staff and Board. |
Outcomes of Business Plan met by June 2005 |
Progress against the business plan reported every second Board of Directors meeting. All areas of the business plan have been met within the capacity of the division budget and staffing.
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| Financial education for Board and management |
Division financial control meets audit and ATO requirements |
Financial education provided to Board members and CEO by Division Auditor in April 2005.
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| Annual review of Risk Management Plan |
Division risk minimised |
Risk Management plan currently being reviewed to bring it in line with Insurance providers requirements that it meet Standard AS/NZS 4360:2004. Due to the introduction of Accreditation and KPI's this process will now be extended to ensure all standards and KPI's are met in the review process.
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| Program | MANAGEMENT | | Goal | Management accountability | | Strategy | All Division policies and procedures practiced.
Appropriate human resource management.
Increased financial accountability.
Occupational health and safety and risk management plans continually reviewed and updated. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Efficient and ethical management of the Division financial, physical and human resources resulting in minimal risk. |
Policy and procedure reviewed annually or as required, and adhered to by all Division staff. |
No incidents reported. |
Policy and procedure continue to be reviewed and updated as required.
2 incidents reported to Board and appropriate action taken to prevent their reoccurrence.
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| Annual staff appraisals and 6 monthly reviews for new positions. |
Number of staff appraised.
Staff efficiencies maximised. |
All staff appraisals performed in line with employment dates. New staff appraised 6 months after employment. 1 resignation during the 12 month period however renegotiation of the job description resulted in a withdrawal of the resignation. 2.4 FTE staff employed to assist with current and new programs.
Although the introduction of a more vertical staffing structure failed the employment of additional staff has assisted with the workload issues. |
| OH&S training |
Number of staff attending training.
Number of incident reports. |
All new staff and those previously not trained received OH&S training in February.
1 incident reported.
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| All permanent and contracted staff have appropriate contracts. |
Contracts in place for all staff and contractors. |
All staff contracts renewed and current.
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| All contract staff have appropriate insurance and registration |
Copies of insurance and registration sighted. |
All contract staff insurance and registration details updated annually and kept on file.
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| Staff education/development |
Professional development attended. |
Staff training requirements reviewed at annual performance reviews. Agreed training provided. Staff attended various SBO workshops:
Orientation education - 3
Aged Care - 2 staff 1 GP
Accreditation training - 2
Financial template training - 1
Immunisation update -1
Alliance State Forum - 3
RACGP training - 4
Clinical Risk Management - 3
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| Appropriate communication and demarcation of CEO and Chairman's role. |
Meetings held (CEO & Chair, DEN)
Appropriate management of Division |
Chair regularly attends staff meetings. Regular meetings between Chair and CEO did not ocurr however communication via other means was frequent and satisfactory
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| Program | MANAGEMENT | | Goal | GP participation in health planning at all levels is maximised | | Strategy | Ensure GP representation and communication with key stakeholders at all levels |
| Outcomes | Activities | Indicators | Results&Commentary |
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| High level communication between Division and stakeholders is maintained at a local, state and national levels. |
Support GPs and Division representatives on relevant committees e.g Warialda Primary Care Committee, NEAHS RHS Primary Care Project, NEAHS Broadband Working Party. |
Meetings attended and outcomes. |
The majority of Area Health Service meetings were placed on hold while the AHS amalgamations occured. Division representation continued at the Warialda Primary Care meetings. 2 GPs and the CEO attended 6 meetings. Results from this project are finally beginning to be realised with an increase in care planning, case conferencing and resource sharing.
2 Representatives from the Division attended 4 Combined Senior Executive meetings with Area Health Service Executive.
In April 2005 a General Practice Advisory Committee was formed by the Hunter/New England Area Health Service which saw the Area health Service, 5 Divisions, Regional Training Services, NSW Rural Doctors Network, Rural Training Unit and Newcastle University meet to discuss common issues. From this meeting a number of working parties were developed to address priority issues. The Workforce working party has since met and developed a paper addressing short, medium and long term GP workforce issues and recommendations. The GPAC will continue to meet on a quarterly basis.
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| Consumer feedback sought through Community Advisory group |
Consumer Advisory Group developed. No. of meetings attended and outcomes. |
A casual staff member was recruited to research, develop and implement the Consumer Advisory Committee. A proposal was developed and accepted by the Board. Positions on the Consumer Advisory Committee have been advertised and participants will be recruited in August 2005.
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| Annual GP member visits by CEO and Program Development Manager to discuss Division activity and future role. |
No. of GPs interviewed. Activities reviewed against GP recommendations. |
.........GP visits have been conducted by Program Managers
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| Support GP's and Division representatives on relevant committees. |
Meetings attended
Financial support provided
Outcomes from meetings |
GPs supported to represent the Division at relevant meetings, e.g. Warialda Primary Care, Aged Care, Better Outcomes in Mental Health Allied Health Initiative. Area Health Service committee representation has been low due to amalgamation. The Division is represented on some Area Health Service Committees by neighbouring Divisions of General Practice.
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Quarterly meetings of Executive from Barwon, New England and North west Slopes Divisions of General Practice with the Executive from Area Health Service.
Regular liaison and activities with the New England Area training Service (NEATS), the Aboriginal Medical Service, Universities, Councils and Rural Workforce Agency. |
Improved relationship between medical services and Area Health Service.
Improved efficiencies through the sharing of information and activities with neighbouring Divisions, communication with NEATS, universities, COuncils and workforce agencies. |
Quarterly meetings of the Combined Senior Executive have continued throughout the Area Health Service restructure with representation from Area Health Service. Relationships with the new Executive of the amalgamated area health services are yet to be established. As reported earlier the General Practice advisory Committee was established in April 2005 with representation by the Division CEO and Board Director.
Sound relationship established with the Aboriginal Medical Service due to assistance provided with accreditation. Regular meetings with NEATS CEO yet to be established. The Division CEO has assisted with staff recruitment and Area of Needs.
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| Program | MANAGEMENT | | Goal | GP participation in health planning at all levels is maximised | | Strategy | Ensure local issues are taken to the appropriate local, state and national levels |
| Outcomes | Activities | Indicators | Results&Commentary |
| - no details provided - |
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| Program | MANAGEMENT | | Goal | Division profile as a major stakeholder in health planning and Primary Care is maximised | | Strategy | Develop appropriate marketing strategies |
| Outcomes | Activities | Indicators | Results&Commentary |
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| The Division is a recognised stakeholder in local health planning and primary care |
Attend marketable opportunities and forums relevant to GP practice and health planning. |
Forums attended. Outcomes from attendance. |
Division attended Ag Quip at Gunnedah once again to market the lifestyle program. The population was provided with blood pressure, blood sugar and skin spot checks as well as dietetic information on lifestyle. 3 GPs, 3 Division nurses and the Division dietitian provided the checks and advice.
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| Program | MANAGEMENT | | Goal | The quality of Division activities is continually assessed | | Strategy | Develop key performance indicators to evaluate Division performance |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Division activity is of a high standard and meets assessed needs |
Develop appropriate key performance indicators against which the standard of Division activity can be evaluated. |
Division meets all Key Performance Indicators. |
The Division registered for Accreditation with ACHS EQUIP in June 2005 and work is underway to prepare for for survey.
The Division has signed the multi program agreement and is working towards meeting the KPI's within this agreement.
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| Program | POPULATION HEALTH | | Goal | To decrease the incidence of infectious disease | | Strategy | Maintain and increase the current immunisation rate through activity such as data cleansing, cold chain monitoring, partnerships with appropriate stakeholders and community advertising. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Current immunisation rate of 93.5% maintained and increased. |
Increase Division immunisation nurse activity of data cleansing, liaison with ACIR and Public Health Unit. |
Number of practice visits by Division Immunisation nurses
Current Division immunisation rate of 93.5% is maintained and increased. |
Quarterly practice visits continue to assist with data cleansing and recall. Visits occurred in each quarter following arrival of notification by ACIR that the practice report was available.
As of May quarter 2005-: All but 3 practices have immunisation rate >90%
8/16 (50%) have an immunisation rate > 95%
Current Division rate 92.1%
The May Quarter 2005 rates have shown a 1.4% decrease in the Division's overall immunisation rate |
| Cold chain audits |
100% Audit compliance by GP practices
100% Practice participation |
Annual cold chain audits conducted in February 2005. 100% participation by practices. All practices maintaining cold chain according to NH&MRC guidelines
Practices are kept informed of any changes to the guidelines |
| Public education advertising campaign targeting immunisation initiatives and difficult to immunise groups. e.g. Flu vax, new schedule, 4 year olds. |
Number of media advertising campaigns.
Increase in immunisation rate of difficult to immunise groups |
Petussis community service article developed and placed in all local media. February 2005 annual "Flu Vac" advertising conducted in the Division area however, a few practices elected not to participate this year due to the vaccine shortage.
Investigation of media campaign developed by Central Coast Division "I'm 4 and Immunised" to increase the rate of 4 years old being immunised at 4 not 5 years. Campaign to be implemented later in 2005. |
| Hold regular quarterly practice nurse education meetings to update and review immunisation procedures. |
Number of meetings held.
Number of nurses attending meetings. |
Immunisation nurses meeting held on the 26.7.04 and the 31.05.05. 3 of the 4 nurses attended. Education and peer support provided at these meetings.
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| Provide GP practices and Practice nurses with up to date information regarding all immunisation initiatives. |
GPs and practice nurses aware of new immunisation initiatives. |
Regular updates provided to nurses and practices via the quarterly Newsletter "The Grapevine". Distributed September, December, March and June. More immediate information is supplied by weekly fax outs and other means where appropriate
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| Program | POPULATION HEALTH | | Goal | Improve the management of chronic disease. | | Strategy | Provide general practice with appropriate support to manage chronic disease. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Increased uptake of the Chronic Disease Initiatives. |
Provide GPs and Practice staff with education relevant to CDM initiatives as required, particularly in the area of mental health. |
%GP uptake of SIP and PIP
Currently:
Diabetes - 100%
Asthma - 93%
Cervical Screening - 100%
Mental Health - 0%
Increase Mental Health uptake to 30%
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The GP uptake of the PIP remains at previous levels.
Data available to date shows that less than 10 practices had participated in asthma 3+ plans, ......% of practices were
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| Program | POPULATION HEALTH | | Goal | Improve the management of chronic disease. | | Strategy | Continue to develop partnerships with other stakeholder organisations to promote the coordinated management of chronic disease. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Coordinated management of Chronic disease |
Electronic and movie theatre advertising developed for Cervical Screening, Asthma and Diabetes and screened throughout the year. |
Increased community awareness of CDM initiatives. Increased uptake of CDM initiatives. |
3 ads developed - cervical screening, asthma and diabetes. Rolled every 3 months in local movie theatres in Moree, Gunnedah and Narrabri over the 12 months period. Over 74866 people in Narrabri, Gunnedah and Moree viewed the Division ads.
Current uptake of CDM initiatives: data unavailable at this time
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In partnership with the University of New England provide Psychology service to Warialda and Bingara through the Better Mental Health Initiative - Allied Health.
Provide training for GPs so they can access the Better Mental Health Outcomes Initiative item number. |
Number of GPs trained % uptake of BoMHI from 0% to 30%. Patient statistics. |
Clinical Psychology services commenced in December after a lengthy delay due to contract negotiation with the University of New England. Services are being provided to patients in Bingara and Warialda by the Clinical Psychologist from the UNE. Services will be provided to both towns by Intern Clinical Psychologists from the UNE as of February 2005. The Division has been unsuccessful in recruiting a Clinical Psychologist for the town of Moree.
13 GPs and GP Registrars were trained in the BOiMHI Level 1. 6 GPs have registered for the BOiMHI.
Steps are being taken to investigate other avenues for the provision of Clinical Psychology services to the remaining Division area. |
Continue Diabetes Integrated Care program.
GP/Practice staff evaluation of program |
Number of diabetes registrations (Dec 2003 - 1339)
Number of diabetes care plans.
GP uptake of EPC MBS items - current rate 63.75% |
1383 registrations on the Division diabetes recall reminder database. The 6 month decrease is due to 303 deletions of patients who have died, moved or no longer wish to be on the register.
1383 diabetes care plans performed during the reporting period.
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| Meet the needs of cultural groups through GP practices, liaison with Aboriginal Medical Services, Community health and Diabetes clinics. |
Number of clinics held.
Number of ATSI registrations on diabetes database (Dec 2003 - 151) to be increased by 100% |
No clinics held at Aboriginal Medical Service due to loss of Podiatry service in Moree.
178 Aboriginal Diabetics registered with Division diabetes recall/reminder database. 13% of total registrations. 331 registrations remain unidentified so the total number of Aboriginal registrations could be higher than recorded.
An education session will be held for GPs at the Division AGM in November to discuss the importance of completing all sections of the data entry forms when registering a patient for the Diabetes database. |
| Provide GPs with clinical audit and quality assurance activities through Diabetes program. |
25 Clinical audit points awarded.
% patients managed according to diabetes guidelines.
% patients with HbA1C<7% |
GPs surveyed, low interest in Clinical Audit points so audit not offered.
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Continue National Diabetes Improvement program: Compiling patient resource. Piloting the resource.
Marketing the finished resource. |
Patient satisfaction with resource.
GP evaluation |
Resource developed and evaluated by committee and sent to consumers for comment. The project was completed at the end of December. Work in the development of the resource was extremely thorough and professional and the final resource is an extremely worthwhile product.
Printing of the resource was completed in January and the resources were disseminated to GP practices within the division area. Due to printing costs the original number of resources was not able to be printed so distribution was confined to the Division area.
A major problem was encountered when receiving quotes for printing of the resources. When the project application was submitted it was envisaged that we would produce a simple Diabetes diary. The outcome from the focus groups with consumers was for far more than this hence the development of a 2 part resource with comprehensive information regarding self management of the disease. Consequently printing costs were far beyond the scope of the budget. |
| Investigate opportunity to develop other specific chronic disease care plans. |
Care plans developed |
Investigation of other opportunities for the development of care plans did not proceed due to time constraints. With the HIC changes to care planning the Division will not be allocating resources to develop additional care plans but rather to adapt the Diabetes care plan to meet the new requirements for a management plan.
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| Program | POPULATION HEALTH | | Goal | Improve the management of chronic disease. | | Strategy | Utilise the MAHS program to maintain and increase Allied health services. Facilitate the appropriate use of Allied Health Services. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Assessed needs met through Allied Health Program. |
Continue to provide MAHS services to meet assessed needs of the community and enhance the uptake of EPC MBS items of care planning and case conferencing:
ø Dietetics - areas of need in Division.
ø Podiatry - Mungindi, Gunnedah, Narrabri, Moree
ø Physiotherapy - Narrabri, Warialda, Bingara, Gunnedah
ø Psychology - Gunnedah
ø Occupational Therapy - Moree
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Number GP referrals.
Occasions of service.
Uptake of EPC MBS item numbers for care planning.
Current uptake 63.75%.
Number of registrations on Diabetes database. Current 1339. Increase by 50%. |
EPC uptake at June 2004 (more current data was unavailable from the Department) = 78%
1383 registrations on Diabetes Database.
Occasions of Service by MAHS services:
Physiotherapy - 165 patients, 512 OOS
Podiatry - 415 patients, 1095 OOS
Psychology - 51 patients, 191 OOS
Dietetics - 270 Patients, 331 OOS plus 101 OOS for Lifestyle Program.
255 Care plans and 45 health assessments utilising division services.
Referrals from Division Diabetes Database:
47 to renal specialists
253 to Diabetes Educators
322 to Podiatry services (all MAHS funded services)
382 to Dietitians (AHS and MAHS)
431 to Ophthalmology services
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| Regular review of services needs. |
Services provided to areas of indicated need.
Consumer/community satisfaction.
Decreased waiting lists. |
Services are being provided to all towns within the Division area based on the Needs Assessment conducted in January 2004. A consumer satisfaction survey will form part of the Needs Assessment next reporting period.
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| Program | POPULATION HEALTH | | Goal | Improve the management of chronic disease. | | Strategy | Continue implementation of Lifestyle Program throughout the Division area |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Community awareness of lifestyle related disease. |
Continuation of Lifestyle Program throughout the Division area.
Promotion through community advertising of healthy lifestyle. |
Number of Lifestyle programs run.
Occasions of Service.
Patient outcomes. |
The Ready Set Live program was offered twice during the reporting period - Mungindi and Wee Waa. 77 occasions of service Mungingi, 7 registrations in Wee Waa but attendance low resulting in 18 occasions of service.
Ways in which to increase attendance at Lifestyle sessions is currently being investigated. |
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| Program | POPULATION HEALTH | | Goal | Improve the management of chronic disease. | | Strategy | Implementation of a Childhood Obesity Program in partnership with the Department of Education |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Effective partnership with the Department of Education in the treatment of childhood obesity. |
Develop and pilot school based program targeting childhood obesity. |
Program developed
Number of sessions
Occasions of Service
Program evaluation |
The initial draft of the Obesity program has been developed and is currently being reviewed
It was hoped that the Childhood Obesity Program would have been completed and trailed within the reporting period however this has not occurred. The trial is scheduled for October 2005. |
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| Program | POPULATION HEALTH | | Goal | Aged Care Initiative | | Strategy | Provide local liaison, development and administrative support to GPs, GP panels and Aged Care homes in the introduction of the Aged Care Panels Initiative |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Residents of Aged Care Homes have improved access to Primary medical care. |
Implement needs assessment with Aged Care facilities, GPs and consumers to determine current partnership arrangements between GPs and Aged CAre facilities to determine if an access problem exists. |
Aged Care Homes advice that access to GP services has improved.
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Facility visits conducted in May 2005 indicated an overall improvement in access to GP services. 3 of 14 facilities continued to state that they had no issues, 12 facilities registered an improvement in issues identified as concerns in the initial needs assessment, 3 facilities registered an increase in CMAs. However HIC data indicates a -2% increase in services to Aged Care facilities.
GP panels were developed. Applications received and approved by Aged Care facilities. A GP Coordinator for the program was recruited. An initial meeting of all panel members was held on the 14th November with Division staff and the GP Program Coordinator to ensure all panel members were informed as to their role as a panel member and the desired outcomes. Site visits commenced in December 2004 with the initial panel meetings being held. Issues for each facility were prioritised and action agreed upon. A follow up panel meeting for each site occurred in the second reporting period with all sites reporting there had been an improvement in at least one of the identified issues at each centre. Overall it was agreed that the initiative had brought to the attention of the GPs the care of the aged and how this could be improved.
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Aged Care Needs Assessment.
Establish baseline data for Medicare Residential Item Numbers.
Provide GPs with information regarding Medicare residential item numbers.
Establish GP panels to review processes that enable the uptake of Residential Medicare item numbers.
Repeat Aged Care Needs Assessment every 12 months. |
Maintain and increase (where an access problem is identified) the number of GP services provided to residents of Aged Care homes.
Maintain and increase (where an access problem is identified) the number of GP services provided as a proportion of aged care beds.
Maintain and increase (where an access problem is identified) the number of residential aged care services as a ratio to FTE GPs.
The age and gender of GPs providing residential aged care services in the region is comparable with the national rural average. (average age of a rural GP is |
The Division experienced a -2% increase in aged care service for the 2004-2005 period. This was a decrease by 90 actual services. GP workforce issues may have effected this percentage as Moree lost two long standing GPs during the reporting period. 1 has not been replaced.
The Division had a 8.1% increase in the number of residential aged care GP services as a ratio of FTEs for the Jan - June 05 Period compared with the state average of -0.7% and the national average of 1.9%. The annual data showed a -4.1% increase (a decrease from 166 in 2003-2004 to 160 in 2004-2005)
The division experienced a -15.1% increase in the proportion of female GPs providing services to residents of aged care homes. This icould be due to the fact that one female GP left the Division area and another took up a position with the AMS.
The proportion of GPs providing services to residents of aged care homes that are aged 55 or more has increased by 16.7% in the last year, while the state and national levels have seen increases (3.4% and 5.5% respectively).
In real terms this is an increase by 3.
CMA item number information packages were distributed to all Division GPs at the commencement of the program with a further follow up letter encouraging all GPs to use this item number. Facility visits commenced in December 2004 where the GP Coordinator promoted the use of CMAs with both the Aged Care Facilities and the Local GP town representative. The forms were located in Medical Director. A computer link was developed between the practices and the Aged Care facility in Moree.
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| General Practitioners have increased involvement in aged care homes' quality activities. |
Quality improvement activities a set agenda item for each GP panel meeting.
GP panel involved in quality improvement activities, medication advisory committees.
Protocols and strategies implemented where necessary. |
Increase in the proportion of aged care homes that have general practitioner involvement in their quality improvement activities. |
With December 2004 town visits, local GPs and facility representatives prioritised their most urgent problems. These differed in each town and the GP panels worked towards implementing protocols.
The follow up panel meetings showed some increases in a number of towns, but further improvement and involvement is necessary.
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Baseline of satisfaction with quality improvement activities set with Division Needs Assessment.
GP panel activities address quality improvement activities.
Needs Assessment conducted every 12 months to monitor improvement. |
Increase in Aged Care Homes satisfaction with the outcomes of general practitioner involvement in their quality improvement activities. |
A needs assessment was conducted at the commencement of the program with surveys sent to all Division GPs and the Aged Care Facilities. From this needs assessment identified problems were prioritised and the most pressing issues that were within the guidelines of the program were presented at the initial panel meetings.
Followup meetings indicated an improvement in all facilities of at least one priority.
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| Effective partnerships and collaboration are established and maintained between GPs, Divisions and Aged Care homes. |
Survey Aged Care facilities to identify gaps and pressures to primary care.
Identify possible solutions to gaps and pressures.
develop a priority list for actions. |
Communication and partnerships are established and maintained between general practitioners and aged care homes. |
Communication between GPs and Aged Care facilities differed in each town. The implementation of the GP panels is in its infancy but it is hoped that communication and partnerships will improve.
The follow up panel meetings showed an increase in GP service provision and an improvement in at least one of the two priorities set for the year.
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Baseline survey to determine level of satisfaction with GP/Aged care home partnerships.
Priority list developed for each GP panel and Aged Care facility and solutions devised.
Panel members and Division promote improvements to all GPs and Aged Care facilities.
Needs Assessment repeated every 12 months. |
Aged care homes and general practitioners are working effectively together to improve access to medical care for residents of aged care homes. |
Minutes are taken at each GP panel meeting which show the position between the GPs and Aged Care Facilities. The GP Program Coordinator has written a general conclusion to the overall situation.
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Key areas of concern identified through needs assessment and an action plan developed for each GP panel.
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Aged Care homes advise that Aged Care GP Panel is undertaking work to address key concerns.
Key priorities to address needs within the Division boundaries have been identified. |
All identified problems have been prioritised to be investigated and where appropriate, local GP panel members discuss these with their peers.
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Seek expressions of interest for panel membership from Division GPs as per page 19 of the Aged Care Guidelines.
Panel members engaged in consultation with the Division of General practice and Aged Care homes.
Regular panel meetings held.
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Aged Care GP Panel is operational.
Transparent and accountable processes for Aged Care GP Panel Member selection and appointment is established and maintained. |
Selection of GP panel members was carried out according to the Aged Care guidelines.
Initial and follow up meeting of each GP panel has occured. The GP Panel Coordinator is regularly in touch with Division staff and GP panel members.
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| Review panel arrangements at regular intervals to ensure that they meet the objectives of the initiative. |
The Aged Care GP Panel model is built on and amended in light of the initiative's development. |
A follow up panel meeting highlighted further priority areas, initial priority areas that had not been addressed and issues with GP panel members.
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| Program | POPULATION HEALTH | | Goal | Increase consumer involvement in all levels of health program planning | | Strategy | Consumer Advisory Committee developed to provide advice regarding Division programs |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Division programs better meet the needs of the Consumer |
Develop a Consumer Advisory Committee to provide input into all Division programs. |
Consumer Advisory Committee developed and active. Outcomes of committee |
Casual staff member was recruited to research, develop and implement a Consumer Advisory Committee. A plan was developed and passed by the Board. Recruitment for members of the Advisory Committee has commenced with nominations closing on the 1st August 2005.
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| Program | POPULATION HEALTH | | Goal | Increase the Division involvement in Aboriginal Health | | Strategy | Liaise with local Aboriginal organisations to access the health needs of the local Aboriginal populations to determine an area for program development. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Development of an Aboriginal Health program |
Liaise with local Aboriginal organisations to assess the health needs of the local Aboriginal populations to determine an area for program development |
Health needs assessed and a program outline developed. |
The memorandum of understanding was developed and signed by the Board of the Aboriginal Medical Service and The Board of the Barwon Division of General Practice. Initial discussions have commenced with the AMS regarding the development of an Aboriginal program. A needs assessment and further discussions are necessary before commencement.
Since the signing of the MOU the Division has assisted with recruitment of staff and area of needs.
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| Program | GP SUPPORT | | Goal | Increase the number of GPs in areas of need within the Barwon Division of General Practice | | Strategy | Network with key stakeholders.
Liaise with GP training bodies. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| GP assisted with the recruitment process. |
Liaise with workforce stakeholders, Councils, Area health Service, Rural Doctors Network, New England Area Training Service, universities to increase capacity to support GP Registrars, Medical Students and current and prospective GPs. |
New initiatives.
GP numbers remain stable or increase. Currently 32.5FTE GPs and 11 GP Registrars. |
The Division, in partnership with the Area Health Service, the Newcastle University, the Regional Training Services (NEATS), the Rural Training Unit, the NSW Rural Doctors Network and North west Slopes, New England and Hunter Rural Divisions of General Practice have developed a workforce plan to address short term, medium term and long term GP workforce issues of recruitment and retention.
In partnership with the New England Area Training Service the Division held 2 meet and greets for new GPs and GP Registrars as well as potential GP Registrars. 17 GPs, GP Registrars, partners and Division staff attended the meet and Greet held in Narrabri for new GPs and 5 GP Registrars attended the Meet and Greet in Moree for potential GPs. Moree has since enjoyed the services of 5 GP Registrars (an increase from 2 the year before), and expect 7 GP Registrars come July 2005.
The Division has lost 2 GPs in the last 12 months, one to retirement, one due to difficulties with the Area Health Service. The current FTE is 30.2 with 11.5 FTE GP Registrars. A further 5 GPs have indicated that they will be leaving in December 2005
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Implement GP support initiatives eg. "GP Well being" program, locum support, GP accommodation, GP registrar and medical student support, upskilling. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Reduced attrition of current GPs. |
Liaise with other workforce support stakeholders and provide support to GP Registrars and GP members:
ø Social/community activities to welcome new GPs and registrars.
ø GP Registrars Accommodation
ø Assist GP members to take Medical Students
ø GP involvement in undergraduate education at Universities. |
Occupancy rate of GP Registrar accommodation.
Uptake of financial support.
Number of education sessions
Number of GPs leaving Division. Number recruited to the Division. |
The Division currently has vacancies at Collarenebri, Wee Waa, Gunnedah and Moree. The Division held two networking events early in the year to encourage GP Registrars to consider settling in Division area. The Meet and Greet held in Moree was held in partnership with the New England Area Training Service and the Chamber of Commerce. A second meet and greet was held in Narrabri to welcome new GPs and Registrars to the Division area and introduce them to other GP members.
The Division continues to be associated with the provision of housing for GP registrars in the towns of Moree, Warialda, Gunnedah and Wee Waa.
Uptake of Medical Student support:- 20 weeks support provided
Uptake of Locum Support:- 13 weeks support provided
5 hours of GP community education supported
3 GPs supported in taking care of their own health
1 GP supported through crisis intervention
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| provide GP members with travel and accommodation support to attend GP procedural education. |
Number of GPs accessing support. |
1 GP has accessed procedural training support.
As NSW Rural Doctors Network introduced support to rural GPs to attend procedural training the Division requested a change in business plan which was accepted by the Department. Money allocated to procedural training support was redirected to locum support for those Gps not eligible for support through the NSW RDN locum grants.
13 weeks of locum support was provided by the Division.
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| Revise GP orientation package for new and prospective GPs. |
Orientation package updated and disseminated. |
The package was updated and disseminated to GP Registrars in the area.
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| Continue GP health program providing support to GP members to attend to own health problems. |
Number of GPs supported |
GP health program has been revised and currently being disseminated.
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Deliver effective, appropriate and accessible Continuing Professional Development. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| GP CPD requirements met. |
Based on Division education Needs Assessment, provide GP education in all Division towns ensuring equal access and high quality |
GP satisfaction greater than 90% |
GP and Practice Nurse Education needs assessment completed. Topics prioritised. Calendar compiled. 12 education sessions held during the reporting period. Topics covered were: BOiMH training, Managing Traumatic Brain Injury in the Community, Neurology, Chest Physician, Breast surgery, Women's Heath, Arthritis, Drink Less, Critical Evaluation of Articles, Drug & Alcohol, Neonatal Outreach. 75 GPs have attended the CPD sessions. Two events each attracted attendance of over 60% of the Division GPs. Two practice staff training days have been held covering OH&S and other topics identified by practice staff on the needs assessment.
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| Ensure all education attracts RACGP and ACRRM CPD points |
Number of RACGP and ACRRM points awarded to Division CPD |
ACRRM and RACGP points applied for for every education event. A total of 71.5 ACRRM and 82 RACGP points allocated for Division education during 2004-2005
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Develop appropriate marketing strategies. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| GP member and community awareness of Division objectives and activities increased. |
Media articles promoting Division activities and topical health issues. |
Number of media articles/release/opportunities |
4 media articles have been placed in all local newspaper concerning the following topics:
Organ Donation
Johne's Disease
Pnuemoccal Vaccination
Division AGM and Education
Media releases-:
1. January 2005 "National Childhood Pneumoccal Proram Launch"
2. March 2005 "Dr William Hunter Scholarship Launch"
Compiling articles such as these are very time consuming as GP consent is required from all towns before publishing. The Division has decided to cease the monthly newspaper article and produce media releases regarding topical issues and Division programs.
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| Develop a series of electronic media advertisements promoting Division activities and topical health issues. |
Electronic media campaign developed and aired |
Advertising slides developed on Diabetes, Asthma and cervical screening and aired in cinemas in Moree, Narrabri and Gunnedah over the past 12 months.
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| Evaluate media campaign |
Evaluation report |
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| Division website maintained and updated |
Informative up to date website |
Website up to date and containing information regarding Division programs, education events, information for prospective doctors and Allied Health workers, and current Division publications.
... hits over the 12 month period
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| Quarterly newsletter and weekly fax out |
High quality resourceful newsletter |
Quarterly newsletters distributed September, December 2004, March and June 2005
Weekly fax distributed every Friday.
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| Consumer involvement in the planning and audit process of Division programs |
Consumer involvement and outcomes |
Consumer involvement in Aged Care, Better Outcomes in Mental Health Allied Health Initiative and National Diabetes Improvement Programs via program committees and surveys. All division evaluation and needs assessments involve consumer input. The Division has researched and developed a Consumer Advisory Committee and nominations are currently being advertised.
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Improve practice efficiency through provision of assistance with practice management, accreditation, Information management, EPC, SIP and PIP education |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Assistance with practice management provided resulting in improved practice efficiencies. |
Investigate options for employment/contracting of a practice manager to provide assistance to GP practices in the Division area |
Division practice manager employed/contracted. GP feedback and utilisation |
GP Practice survey conducted in October with 8 practices interested in the Division providing Practice Management services. A Consultant was engaged in May 2005 to conduct a trial initial consultation of one practice within the Division area. A favourable outcome was reported by the Warialda practice and the consultant will now be introduced to the other interested practices.
Although the Division envisaged contracting the consultant out to GP practices, it is more likely that the practices will contract the consultant should they wish to continue an alliance following the initial visit. |
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Facilitate the uptake of the Commonwealth Practice Nurse Initiatives. |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Increased access to and utilisation of practice nurses. |
Provide GPs with education regarding the role of practice nurses. Provide practice nurses with the opportunity for upskilling and networking. |
Number of education sessions provided. Uptake of EPC, SIP and PIP items. |
The Division "Grapevine" newsletter for Practice Nurses has been distributed quarterly. Practice Managers are notified quarterly of workshops via mailouts. EPC training provided to PIUS X Aboriginal Medical Service as part of Accreditation preparation. 1 Practice Nurse commenced at Boggabri part time.
No SIP and PIP data available.
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| Program | GP SUPPORT | | Goal | Provide workforce support to Division members. | | Strategy | Continue to support the provision of specialist services to the Barwon area through the Medical Specialist Outreach Assistance program |
| Outcomes | Activities | Indicators | Results&Commentary |
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| Increased access to specialist services locally |
Continue to provide financial support to medical specialists to increase access to local communities. |
Number of specialist services provided. Number of occasions of service. |
Support was provided by the Division to the following services under MSOAP :
GP Surgeons to Mungindi, Bingara and Warialda.
Haematologist to Moree
Ophthalmology upskilling to Moree
Gynaecology to Narrabri
General Physician to Barraba
Paediatrician to Gunnedah
554 OOS with 24.5 hrs of upskilling provided
Patient referrals to specialist services remain constant. Services to Mungindi were ceased due to lack of patient referrals.
Currently 6 specialist provide services under MSOAP funding |
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| Program | GP SUPPORT | | Goal | Support GPs and Pharmacists in the quality use and management of medicines | | Strategy | Facilitate the Quality Use of Medicines program and Medications Management Review Program |
| Outcomes | Activities | Indicators | Results&Commentary |
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| GPs and Pharmacists supported to provide appropriate medication management |
Through the Queensland Rural Medical Support Agency, provide education to GPs and Pharmacists in prescribing and MMR. Extend to Aged Care facilities |
Number of education sessions held. Number of community forums |
Quality Use of Medicines education and Home Medications Review visits conducted with GPs and Pharmacists in October 2004 and February 2005. 20 GPs received 1-1 education on Pronton pump Inhibitors and 22 GPs received 1-1 education in February NPS round. The Division continues to enjoy >50% GP participation in NPS vists.
Joint information session for HMR held in Narrabri with 2 GPs and 3 Pharmacists attending. GPs notified of relevant information via fax outs and newsletters. Whilst the QUM program under NPS funding continues to be well received by GPs the HMR program under the Pharmacy Guild continues to be poorly received due to the difficulties implementing this program in a rural area where Pharmacists operate from sole practices and cannot access locums to allow them to attend training or leave their practice during the day to undertake home visits. Various options have been investigated with little success.
3 HMR plans were completed during the reporting period. 2 GPs have been conducting HMRs and 4 GPs have indicated that they have no interest in referring patients for a HMR.
Currently the Division has 3 accredited Pharmacists.
Focus group teleconference held. All Pharmacists invited. 1 Pharmacist from Barwon participated - <10% participation rate.
A Quality Use of Medicines Advisory Group (QUMAG) was formed to address effective management of the quality use of medicine program. Barwon is represented by 2 Gps and 1 pharmacist.
It has been decided that 1-1 education may be a more effective way of informing both GPs and Pharmacists of HMR rather than continuing with the joint information sessions.
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