Keeping Gps Informed in the Changing Primary Health Landscape
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Welcome to the Keeping GPs informed in the July 2016 edition of GP Connect changing primary health landscape In the lead up to the Federal election, there have been significant announcements made by the major parties in the primary health care space. INSIDE: Clearly, the issue of the Federal In this sixth edition of GP Connect, Government’s extended freeze on we continue to provide important • Perth Childrens Hospital Medicare rebates has been top-of-mind public hospital clinical updates that are • Hospital Liaison within general practice, as is primary of direct concern to general practice – healthcare research and GP training. and to your patients. • Digital Health • Aboriginal Health WAPHA and the WA Primary Health The work of the PHNs’ Hospital Liaison Networks (PHNs) view general practice GPs is valuable in connecting what • Clinical Update as the foundation of Australia’s is happening in our major hospitals • HealthPathways WA healthcare system and we are to general practice and the care of committed to continuing our ongoing your patients. • Rural Round-up consultation and engagement with the The WA PHNs have a key role in RACGP, WAGPET and individual GPs. If you wish to receive this supporting general practice during The three major political parties have the complex transition phase of the newsletter electronically, each made significant announcements My Health Record (MyHR). Please ‘subscribe’ by in areas that impact on primary health signing up via our website MyHR is rapidly becoming firmly care including health system reform, at www.wapha.org.au established within the Australian health funding, medical research, primary system, and it is important that GPs, prevention, mental health, Aboriginal your practice staff and patients are health and chronic disease. enabled to achieve optimal value from It is clear that the important role of a shared patient health record. Australia’s GPs has been considered The WA PHNs have employed a Digital in health policy development within Health Team, who will facilitate the all major parties. We now await the support general practices will need election outcome and the subsequent to navigate MyHR, e-health practice policy announcements that will further incentives, data management and develop the role of the PHNs and our the changes we will see in relation to ongoing interaction with GPs. technology requirements associated WAPHA and the WA PHNs are currently with the Health Care Home and in the process of commencing management of patients with communication with GPs around the complex and chronic disease within value that PHNs can add to general general practice. practice. At this stage of our evolution, I hope you enjoy reading the current it is critical that we seek your views on edition of GP Connect, and we welcome the most valuable types of GP practice your comments and suggestions to support services that can be provided by Contact us assist us in developing content for WAPHA and the PHNs. I hope that GPs future editions. [email protected] across the State engage with us in this (08) 6272 4900 process to ensure that WAPHA and the Learne Durrington, www.wapha.org.au PHNs provide the most effective and CEO WA Primary Health Alliance 1 useful set of GP support services. PERTH CHILDRENS HOSPITAL Perth Children’s Hospital (PCH) will replace Princess Margaret Hospital as the specialist paediatric hospital at the end of this year. Located adjacent to Sir Charles This opening schedule has been Gairdner Hospital on the QEII Medical designed to ensure that patient safety Centre grounds, the hospital is is prioritised, and that the highest a modern facility that uses the standards of clinical care continue best design features to provide a to be delivered during the transition light bright and positive healing period and beyond. environment for young WA patients. To stay up to date as we progress towards opening you can sign up to Opening schedule the newsletter via eepurl.com/b5uNdX The building is now reaching or visit newchildrenshospitalproject. completion and on the 8 June health.wa.gov.au the Premier of WA, Colin Barnett announced that PCH will commence taking its first outpatients on 24 October 2016. PCH will open over the following three stages: Stage Activity Date Stage 1 Some outpatient clinics commence 24 October Stage 2 Same day surgery commences 7 November Stage 3 Final Move Day: 20 November • All inpatients moved • PCH ED opens • PMH closes 2 HOSPITAL LIAISON If a woman is found to have a Fax number for referrals: King Edward shortened cervix measuring between • 9340 1031 (Outpatient clinic) 10-20mm in mid-pregnancy, it is Memorial Hospital recommended that she uses natural • 9340 1060 (Maternal Fetal Medicine) vaginal progesterone 200mg daily GPs who require further information or Cervical length and the until 36 weeks as this will halve the advice should contact the Preterm Birth role of the GP risk of early preterm birth. Prevention Clinic Midwives by phone Research now suggests that many • GPs will need to write a private 0466 329 638 (Mon-Fri 8am-4pm) or cases of preterm birth may be prescription for progesterone fax 08 9340 2469. preventable and GPs play an important pessaries as they are not For further information about role in prevention of preterm birth. currently covered by the PBS prevention of preterm birth including The WA Preterm Birth Prevention for this indication. The script patient handouts on vaginal Initiative recommends that ultrasound will need to be taken to a progesterone and cervical cerclage visit measurement of the length of the compounding pharmacy. Cost is thewholeninemonths.com.au cervix is routinely performed at 18-20 approximately $65-$75 for one box weeks during the anatomy scan which of 15 pessaries ($140/month) Dr Vicki Westoby Hospital Liaison GP, KEMH is ordered by the GP prior to the • Vaginal progesterone is generally hospital booking visit. free of side effects. [email protected] Available: Monday and Tuesday The presence of a shortened If the cervical length is less than (08) 9340 1561 cervix between 10-20mm at 16-24 10mm, cervical cerclage is usually weeks gestation is a risk factor for recommended. preterm birth. The KEMH Preterm Birth Prevention • If the cervix is 35mm or more on Clinic welcomes GP referrals that meet transabdominal scan, no further the following criteria: assessment is required. 1. Previous preterm birth at 24 to 34 • If the cervix is less than 35mm, a weeks’ gestation transvaginal scan is recommended. 2. Two or more previous preterm The transvaginal scan may need births between 24 and 36+6 weeks’ to be performed at a follow-up gestation appointment and usually the cost of the second ultrasound will be 3. A pregnancy loss between 16+0 bulk-billed. and 23+6 weeks’ gestation 4. Significant uterine anomaly 5. History of cone biopsy of the cervix or more than one LLETZ procedure 6. Cervical length less than 10mm 7. Specific concern of referring clinician 4 3 When discussing referral with your Fiona Stanley/ patients, you might be interested to Central Referral know that there are useful health Fremantle information fact sheets available Service on the GESA website (gesa.org.au), Hospital update including gastroscopy, colonoscopy and Inpatient Discharge Summary GP Delivery Gastro procedures bowel preparation information. Methods – metro and As many referrers have discovered, Including radiology results there is a mandated dedicated referral country form for open access gastro procedures in referrals Many General Practices have (gastroscopy and/or colonoscopy). Referrals for patients who have had requested that hospitals no longer radiology procedures in the community mail inpatient discharge summaries if This form allows accurate and (e.g. orthopaedic or respiratory) are sent by secure electronic messaging timely triaging of patients and safer expedited by the inclusion of reports or faxed. procedures. detailing the name of the radiology Princess Margaret Hospital and Great There is a single process of referral as service and date of procedure. Southern are now only mailing detailed on both fsh.health.wa.gov.au This allows the images to be imported discharge summaries where delivery and fhhs.health.wa.gov.au websites into the hospital imaging system has not been requested by secure where a link to the form is also for clinician access during triage and electronic messaging or fax, and other available (under the health clinic visits. sites may follow suit. professionals tab). Most private radiology services are set The recipient practice’s preferred This form includes information about up to allow image sharing. delivery method now displays along relevant past history and current with other details at the end of symptoms/indications, weight Should these be unavailable, there inpatient discharge summaries from and BMI, medications (especially may be the need to repeat imaging Fiona Stanley Hospital, King Edward anticoagulation/antiplatelet agents), with possible increased radiation Memorial Hospital, Princess Margaret allergies and co-morbidities. exposure, patient inconvenience Hospital, Royal Perth Hospital, the and waste of resources through This information is required by the Great Southern and the South-West duplication. hospital at the time of referral. (currently being rolled out). Patients are contacted to confirm any Dr Monica Lacey To change your practice’s preference changes to management and current Hospital Liaison GP, FS/FHG or update any other details in the GP health status close to the time of [email protected] database used by many sites, please the procedure. email [email protected] or phone 9224 7066 with: Procedure specific information forms are provided to patients by the 4 hospital with their bookings. Joondalup Health Campus Discharge summaries We are currently compiling our priority list for educational events Electronic Discharge Summary for the 2017-2019 triennium.