5 September 2014
Professor Claire Jackson
After Hours Primary Health Care Review
Primary and Mental health Care Division
Department of Health
GPO Box 9848
Canberra ACT 2601
Via email to: afterhoursreview@health.gov.au
Dear Professor Jackson
Re: After Hours Primary Health Review
Leading Age Services Australia (LASA) welcomes the opportunity to provide input to the
After Hours Primary Health Review.
LASA is the peak body for age service providers with around 70% of providers covering all
service types (retirement living, home care, and residential care) in all settings (private, notfor-profit and mission based). LASA is committed to improved standards, equality and
efficiency throughout the industry. We advocate for the health, community and
accommodation needs of older Australians, working with government and other
stakeholders to advance the interests of all age services providers, and through them, the
interests of older Australians.
As providers of aged care services LASA’s core constituency has a high level of intersection
with the activities of after-hours primary health services. This specifically relates to access to
General Practitioners and specialist services such as mental health. There is widespread
concern geographically on accessing these services and exacerbated for rural and remote
locations.
The key principals for after-hours primary health service:
Regardless of where a person resides they should have equal access to primary health care,
including out of hours services. However many people who are in receipt of Commonwealth
funded residential care are often not eligible, or are not considered for after-hours services.
This is often seen when palliative care or mental health services are required.
In some locations it is difficult to access primary health services within hours, let alone out
of hours. Age should not be a deterrent to access, however many aged care service
recipients, are not the target audience for such services.
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Primary health care often sees its interaction with public health and the secondary and
tertiary health care sectors and not with the aged care industry. With a focus now on
consumer directed care many recipients of aged care services, especially in the retirement
living and home care environment are precluded from or are not attracted to primary
health services. There is little interaction with allied health services, including
pharmaceutical services especially in after-hour timeframes.
The role of General Practitioners and general practice in delivering after-hours services
and Delivery challenges of after-hours primary health care services in rural and remote
regions:
For the delivery of primary health services the General Practitioner is often the key link to
the aged care recipient. However, for residential services many, and particularly in rural,
remote and very remote services, accessing a General Practitioner to visit the residential
setting is for the most part very difficult. This is also the case for those areas that focus on
services for the indigenous population. Education for the care recipient, especially in
focussing on a wellness, reablement framework is often lacking and the lack of knowledge is
often exacerbated when the caregiver is also not well educated from a primary health
perspective.
Experience/views on the Practice Incentive Program after hours incentive:
Several aspects of the PIP are not well seen within aged care, for example a practice nurse
would rarely be involved with the delivery of GP services to recipients of aged care services,
unless the care recipient visited the GP practice.
There are limited but not well known or widely disseminated activities that are conducted
through the Aged Care Access Initiative and the Quality Prescribing Incentive. The quality
use of medicines is obviously a focus for age services and links closely with quality reporting
and accreditation processes for home and residential care providers.
Experience/views with Medicare Locals being responsible for funding and incentivising
after hours primary health care services;
Some Medicare Local initiatives have provided significant input into age service delivery,
where other Medicare Local services have not seen this as a core business activity. It is the
variability of service delivery that affects the system as a whole.
Experience/views on after hours GP helpline:
This line has obviously not been set up to support those people in receipt of aged care
services, however those residing in their own home would presumably have access to the
service. However, Providers of home care services, as part of their contract with the
Department of Social Services are required to provide out of hours emergency services for
some care recipients. This responsibility may not always be supported by the GP helpline.
Experience/views on using video conferencing for after-hours primary health care
services:
Video conferencing and tele-health more generally are becoming more popular within the
age service sector, primarily for specialist services. This is one area that could be improved
to be able to provide a more direct primary health focus for recipients of aged care services.
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Any other comments:
LASA is involved in a range of activities that have a link to primary health services including:


A consortium member of the Decision Assist Program which is designed to deliver a
number of training programs, other web based resources and, importantly,
telephone advisory services for specialist palliative care and advance care planning
support.
A consortium member to the RedUSe Project. The Reducing Use of Sedatives
(RedUSe) Project aims to promote the quality use of antipsychotic and
benzodiazepine medication in residential aged care facilities.
Thank you for the opportunity to comment, should you have any questions please do not
hesitate to contact Ms Kay Richards, LASA National Policy Manager on 02 6230 1676.
Yours sincerely
Patrick Reid
CEO
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