The RACP says Australias current health and aged care system is ill-equipped to cope with the increasing demands of an ageing population, and reform is urgently needed. According to RACP President, Professor John Kolbe, theAustralian Government must ensure that aged care reforms are integrated with national health reforms to deliver more seamless and coordinated health and aged care services to older Australians Almost all Australians aged over 65 years have at least one chronic condition, and 80 per cent report having three or more chronic conditions. Specialist physicians, including geriatricians, rehabilitation physicians and palliative medicine specialists, are experts in multidisciplinary care and complex disease prevention, assessment, management and treatment for older Australians, Professor Kolbe said. Older people, particularly those living in residential aged care facilities, often have difficulty accessing timely specialist medical care, resulting in unnecessary hospitalisation. Improved integration of the health and aged care systems is needed to ensure older people can access the right care, in the right place, at the right time and by the right team. The implementation of National Health Reforms , including Medicare Locals, Local Hospital Networks, Lead Clinicians Groups and eHealth and telehealth initiatives, provides opportunities to better coordinate health and aged care, and deliver more specialist medical care to older people outside of hospital. Working with Medicare Locals and Local Hospital Networks can allow for specialist medical care to be delivered locally to older people in primary and community settings, in particular residential aged care facilities, where current gaps have been identified, Professor Kolbe said. This will allow for early assessment, prevention and management of chronic disease and complex health conditions in the elderly to improve health outcomes and reduce emergency department admissions. Specialist physicians should be integrated within multidisciplinary teams to improve continuity of and satisfaction with care and to reduce duplication. Now is the time to align health and aged care reform to ensure older people can access timely, high quality care when they need it. The RACP supports the Productivity Commissions recommendation for the expanded use of in-reach services to residential aged care facilities and the development of regionally or locally-based visiting multi-disciplinary health care teams. Add your own comment
Health Workforce Australia report gives the nod to physician assistants
They worked in Queensland in Cooktown, Mount Isa and Brisbane to see if patient care improved. A report into the trial says there was some positive feedback from doctors and nurses, but “infrastructure, staffing and financial limitations” restricted the physicians assistants in some cases. The report says it was clear that clinical staff “felt more evidence is needed” before the position is rolled out. The AMAQ says the trial wrapped up months ago and Queensland Health still had not confirmed if the positions will be rolled out across the state. AMAQ president-elect Dr Richard Kidd says the Queensland Government should abandon the idea of physicians assistants, because it takes training places and jobs from junior doctors and nurses. “Why on Earth start looking at another part of the workforce that they’re not going to employ properly either?” he said. He says there is no room for physicians assistants in a health system already crowded with medical graduates. “The need for physicians assistants – if there ever was truly a need – is going to be eclipsed by the number of young doctors that are going to be out there,” he said. “Why have a physicians assistant when you’re actually producing enough physicians?” Dr Kidd says doctor assistants are not covered under the new national registration system. The AMAQ also says the report into the trial should be made public. Plan ‘on hold’ But Health Minister Paul Lucas has rejected the trial was a waste of time and money and it was a worthwhile exercise.
Scrap plan for physicians assistants: AMAQ
Rural and remote doctors are the strongest advocates for an urgent and positive consideration of the roles of PAs, it says. Interestingly, NSW is the only jurisdiction not to back PAs: all other states and territories were willing to consider PAs as part of their health workforce. (NSW representatives instead wanted more generalist medical positions such as hospitalists). The report notes that those with direct experience of PAs or PA students are confident about the safety and acceptability of PAs for the Australian health system. They also say that PAs would improve the productivity of other health professions, and would be unlikely to threaten the training of medical graduates or the advanced practice roles in other professions. Despite a decade of discussion and two successful pilot programs, says the report, there remains a high level of misunderstanding about the clinical role and professional attributes of PAs and how they might complement and add value to existing team structures. On a related note, the report says: Those who openly declared their opposition to introducing PAs in Australia were likely to advocate for the interests of existing professions, either nursing or medicine. (Croakey wonders if this gives any hint of the reason for the NSW resistance: are the medical and nursing lobbies more influential in NSW?) The report also notes the potential of PAs to reduce health care costs by providing a new workforce group to provide safe and effective services at lower cost. The report, considered by the Australian Health Ministers Advisory Council (AHMAC) in February, has been keenly awaited by PAs and their supporters, including one of the first PAs to graduate in Australia,Ben Stock, who writes below that action is now needed. *** Report represents overwhelming support for PAs Ben Stock writes: In 2011, Health Workforce Australia commissioned a report into the Physician Assistant and their potential role in the Australian health workforce. This report was completed in November 2011 and earlier this year was tabled to the Australian Health Ministers Advisory Council for consideration and it has now just been formally released. This comprehensive report conducted an extensive literature review of supporting documentation regarding Physician Assistants from overseas evidence and considered the impact of the two Australian Physician Assistant trials, which were conducted in Queensland and in South Australia. In addition the report also considered submissions from various key stakeholders such as personnel from the rule and remote health sector, Physician Assistant graduates and students from the Australian PA programs conducted by University of Queensland and other professional bodies representing nurses and doctors.