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New in-home aged care program could lead to worse health outcomes, RACGP says

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The Royal Australian College of General Practitioners (RACGP) has raised concerns that the government’s proposal for a new in-home aged care program does not include GPs and could lead to worse health outcomes for older people.

In a submission to the Department of Health and Aged Care on the indicative model for in-home aged care, the RACGP said the proposed model was “a missed opportunity to support better integrated GP-led care for older people”.

RACGP President Dr Nicole Higgins said the central role of GPs in aged care was too often overlooked.

“The fact that neither general practice nor GPs are mentioned once in the discussion paper on the proposed model is a significant oversight – GPs are key to improving the health and wellbeing of older people,” she said.

“Older people have much greater need for care, they require GP services at a significantly higher rate than other age groups and are more likely to go to hospital. In 2019–20, there were 43 million Medicare claims for unreferred GP attendances for people aged 65 and over – 30% of the total 141 million claims for unreferred GP attendances. *

“GP-led multidisciplinary care is vital to keeping older people well and in their homes. GPs provide critical services to older patients, including ongoing management of complex and chronic disease, health risk assessments, and preventative care including screening and immunisations.

“The research also shows that, for optimal health outcomes, people should see the same GP for most of their care needs. Those who do see the same GP or practice have high continuity of care, better health outcomes and satisfaction, and fewer trips to hospital than those who don’t.

“And we know that older Australians are far more likely to report that they have a preferred GP, and their right to see their preferred GP for their care needs to recognised.

“The Department of Health and Aged Care Discussion Paper on the indicative model for in-home aged care doesn’t account for the central role GPs have in supporting older people to stay healthier in their homes. Nor does it discuss the importance of engagement and information exchange between other health professionals and a patient’s usual GP to ensure integrated care.

“This is a significant concern given the importance of ensuring older people can access their GP, and the broader issues around fragmentation of care highlighted throughout the Royal Commission into Aged Care Quality and Safety.”

The RACGP President called for the in-home aged care policy to be updated to include the role of GPs.

“The RACGP strongly recommends that the Department of Health and Aged Care update the policy for the new in-home aged care program to address the crucial role of GPs in supporting older people to be healthier at home for longer.

“More broadly, we need to see government take action to address the significant barriers GPs face in providing coordinated care to older people, both in the community and residential aged care, due to the current models of care and funding arrangements.

“We are continuing to call for changes to funding for GP-led care for older people that simplify the approach and increase investment in care for older people. Funding arrangements should acknowledge the importance of GPs liaising with their patient’s family and carers and provide appropriate support for after-hours care.

“Re-introducing patient rebates for phone consultations longer than 20 minutes is also a key measure that would help improve access to care for older people, particularly those who have mobility concerns.

“I also urge the government to make sure that GPs are actively involved in this and other aged care reforms moving forward – GPs play a central role in the health and wellbeing of older people, we must have a seat at the table.”

Media release from the Royal Australian College of General Practitioners (RACGP)Note: Content has been edited for style and length.

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