Nurse practitioners, midwives and allied health professionals are calling for primary health care reform to allow them to work to their full scope of practice.
But the RACGP has called for better collaboration between health professional and increased funding for general practice, instead of arguing over who should do what.
Nine organisations, including the Australian Primary Health Care Nurses Association (APNA), Australian Nursing and Midwifery Federation and Australian College of Nurse Practitioners, have joined forces campaign for reform in line with reviews under the Strengthening Medicare banner.
This includes the recent Unleashing the Potential of our Health Workforce – Scope of Practice Review which recommended the removal of unnecessary barriers to supervision in primary care education and training and the implementation of new direct referral pathways for access to specified non-GP specialists.
Nurses, nurse practitioners, and midwives make up 54% of Australia’s health workforce, but one-third rarely work to their full scope, according to the alliance.
It said patients and communities, especially those in rural and regional areas, will benefit when they can work to their full scope.
APNA president Karen Booth said nurse practitioners should be able to provide more care, which would free up GP time and benefit patients.
“You’ve got a highly skilled health professional; they should be seeing patients. That would help improve access, support the GP better and it actually helps the business bottom line because you can see more people,” she told Medical Forum.
“The things they could be doing and want to do more of are preventative health activities like health checks, screening and other population health activities.
“We need to make sure we can run a system where people with complex illness can be managed by the healthcare team and the short, sharp, acute cases can all be seen by the GP.”
She said the way general practice is funded also needs reform, suggesting it moves towards a model of funding for patient activity instead of doctor activity, meaning a GP would not have to be present in some circumstances for the patient to be able to claim it back on Medicare.
Part of this could include direct referrals, a recommendation in the Scope of Practice review. Ms Booth said a pregnant woman who needs a physiotherapist referral, for example, could be referred by their nurse practitioner who will already be responsible for managing that patient.
“It’s not one-size-fits-all and it’s not about who is the boss either, it’s about how you coordinate care in a team approach.”
The RACGP and AMA have both cautioned against the introduction of direct referral pathways and said reform needs to address GP shortages to improve access to care.
RACGP President Dr Michael Wright said patients get the best outcomes when GPs and other health professionals work together.
“We can and should build relationships and look for opportunities to engage and support each other,” he said.
“We should be collaborating, not arguing, over who can do what. A shortage of health professionals across the board means there is plenty of the work for everybody.
“GPs have the broadest training and the highest qualifications in primary care. Over 10 years training gives us the understanding of the broad scope of issues that patients face in general practice.”
Instead, the college is calling on the Government to increase funding to GP-led multidisciplinary care teams.
“Removing restrictions to some referral pathways will result in increased referrals, which can and should, be managed by a GP,” it said.
When the Scope of Practice review was published, the AMA said it supported enhancing multidisciplinary care to allow all health professionals to work to their full scope, but that this required better funding models for general practice.