Doctors have had their say on a proposal to extend the validity of referrals.
The Department of Health, Disability and Ageing is considering whether to make changes to the current referrals system to extend the period, or even make them indefinite.
The current default period for a referral from a GP is 12 months and referrals between non-GP specialists-to-non-GP specialists expire after three months.
However, a consultation on modernising the Medicare referrals process has looked at the effectiveness of the current system and suggested extending the duration of referrals as a way to better support patient access to specialist care and reduce repeat consultations.
It made clear current validity periods had been criticised for not aligning with contemporary healthcare needs, especially in the case of those with chronic conditions who may require ongoing non-GP specialist care.
However doctors have said that they still see a need for time limits on referrals as a safe guard.
The AMA and RACGP both provided submissions as part of the consultation process, which closed earlier this month.
The AMA strongly opposed the idea of extending the default 12-month GP referral validity period, or moving to a system of default indefinite referrals, highlighting the need for patients to regularly reconnect with their GP.
“Broad extension of default referral validity periods or removal of GP reconnection points would fragment care and place patient safety and quality of care at risk,” it’s submission said.
It noted that referral frameworks must support coordinated GP oversight of patient care.
“Coordinated GP oversight remains essential, particularly for patients with multi-morbidity or complex chronic diseases, who may be on multiple medications requiring regular adjustment, and often have multiple non-GP specialists involved in their care.
“Referrals are a way of communicating a wide range of information, including changes in a patient’s health and medications, and who is currently (or has been) involved in their care.”
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The RACGP cautioned against reforms that “prioritise access, convenience, or cost at the expense of quality and safety”.
“General practice plays a central role in guiding patients through the health system, avoiding unnecessary tests and treatment, and directing them to appropriate care,” the College said in its submission.
“GPs are key to reducing inappropriate referrals, limiting low value care and alleviating pressure on non-GP specialist waitlists.”
The RACGP noted that in most cases a 12-month validity period for referrals from GP to non-GP specialists provided an “appropriate balance between continuity, oversight and flexibility in GP to non-GP specialist referrals”.
While it acknowledged indefinite referrals had the potential to enhance convenience and reduce administrative burden, it warned it would also risk private non-GP specialists over-servicing patients, placing additional burden on non-GP specialist availability and increasing costs to the Medicare Benefits Schedule.
“Regular patient checkpoints provide the GP with oversight of their condition, reducing the risk of fragmentation of care and maintains the GP-patient relationship for routine care,” the submission stated.
The College said it could support longer referrals in the future if there were additional safeguards in place, such as structured and timely information exchange and improved digital interoperability.
However in the current situation, without prompted summary exchanges, extending referral periods would risk weakening communication pathways that are vital for safe, integrated care.
The AMA also supported measures to improve transparency and patient information sharing, including standardising referral content and ensuring patients are routinely offered copies of their referrals and specialist reports.
Its submission highlighted that ensuring referrals from public hospital emergency departments were recognised as valid for private specialist Medicare billing could also reduce unnecessary repeat GP visits, speed up access to care, and remove an inequity that currently disadvantages patients.
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