The COVID-19 pandemic had an obvious impact on shifting our work into practicable action. In May this year we were able to pivot our focus back into stakeholder engagement and hearing the voices of the General Practice (GP) community via our EMPHN GP Needs and Engagement Survey. This survey, conducted between April and May 2023, marks a key moment for us as it is the first post-COVID survey related to General Practice since 2019.
What did you tell us?
We can do better by:
- Renewing our focus and commitment to improving satisfaction levels with our account management of GP.
- Addressing concerns of respondents whose perception of us had not improved in the survey period.
- Acknowledging and responding to the different needs and capacities among GP practices, moving away from a "one size fits most" approach.
- Communicating our role as an innovator at a system level and how that translates into enabling and supporting individual practices.
- Making our communication less bulky and lengthy.
We are pleased by respondents’ positivity regarding:
- Our responsiveness to requests and the telephone and email support provided.
- Useful communications for practice managers and nurses.
- The usability and usefulness of our website.
- Feedback for our COVID Vaccination Program.
- The currency and accessibility of HealthPathways Melbourne.
What respondents told us about service integration:
- Effectiveness barriers between general practice and hospital services exist, including challenges related to system functionality and the quality, delay, and inconsistencies in communication.
- GPs feel underutilised in their role of providing integrated care.
- The role of the General Practice Liaison Officer (GPLO) is valued.
- GPs often face significant demands and expectations from both the government and hospitals, sometimes without adequate consideration for their role or the reciprocity of the professional courtesy.
What will we do now?
- The insights from the survey have already been digested and discussed by our Board and members of the Clinical Council.
- Meetings are in progress with each LHN to discuss the findings and proposed way forward.
- Our communications to external stakeholders including newsletters are in review to align with best practice.
- Further engagement to determine the way forward including opportunities for you to be involved – we will be in touch with more details.
Why survey GP?
These survey data insights, from one of our key stakeholder groups, contributes to measuring the success of EMPHN's 2020-2025 Strategic Plan. One of our focus areas has been enhancing primary care and improving GP satisfaction with us. Survey data will help us make informed decisions and take targeted actions to enhance our services and achieve the desired outcomes outlined in our Strategic Plan. The survey results present an assessment of GP demographics, needs, and the various touchpoints between EMPHN and GPs. By collecting this information, we have created an opportunity to drive stakeholder engagement activities and meet strategic goals across multiple areas.
The process
We were pleased by the sound response rate to survey completion, with a participation rate of 19%. This rate is comparable to the previous 2019 survey, which sat at 20%.
Notably, we observed an uplift in responses from individual GPs, with 160 respondents in 2023 compared to 116 in 2019.
The survey, for the third time, was undertaken by consultants Outcome Services.
Their analysis and assessment of qualitative and quantitative data has been explored for thematic insights. Over 1,000 individual comments have been mined. To gain a deeper understanding of the survey responses, we conducted 12 in-depth stakeholder interviews. These interviews provided us with additional qualitative information from respondents who volunteered to be contacted.
Key findings
We can do better by:
- Renewing our focus and commitment to improving satisfaction levels with our account management of GP.
- Addressing concerns of respondents whose perception of us had not improved in the survey period.
- Acknowledging and responding to the different needs and capacities among GP practices, moving away from a "one size fits most" approach.
- Communicating our role as an innovator at a system level and how that translates into enabling and supporting individual practices.
We are pleased by respondents’ positivity regarding:
- Our responsiveness to requests and the telephone and email support provided.
- Useful communications for practice managers and nurses.
- The usability and usefulness of our website.
- Feedback for our COVID Vaccination Program
- The currency and accessibility of HealthPathways Melbourne.
What respondents told us about service integration:
- Effectiveness barriers between general practice and hospital services exist, including challenges related to system functionality and the quality, delay, and inconsistencies in communication.
- GPs feel underutilised in their role of providing integrated care.
- The role of the General Practice Liaison Officer (GPLO) is valued.
- GPs often face significant demands and expectations from both the government and hospitals, sometimes without adequate consideration for their role or the reciprocity of the professional courtesy.
Themes - what have we learned?
| General Practitioner workforce/demographics | - Part-time employment in general practice is becoming increasingly common, especially amongst female GPs. 37% of survey respondents are working less than 30 hours per week. - 18% of GPs surveyed intend to retire from general practice within three years. - GPs are the least likely (49%) to rate their enjoyment of work highly, a decline compared to 2019 results (when 63% of GPs expressed a high/very high level of work enjoyment.) |
| Digital enhancement | - Approximately 1 in 4 practices have data analysis tools in place that are under-utilised – this is a valuable contact and service opportunity. - Telehealth consultations via telephone only are more likely to be problem-free. - Internet connectivity and technical barriers (both patient and GP) are common and can reduce video telehealth consultation success rates. - Although 1 in 3 use My Health Record (MHR) frequently, routinised, policy-driven use is very uncommon as MHR continues to generate negative experience amongst users. - 1 in 3 responses refer to a manually managed system for recalling patients. - Review of practice data may not be occurring consistently – alternatively, this may not be visible and / or communicated across all practice staff roles – around 1 in 4 staff seem to be unsure about data review. - Usage ratings by GPs for HealthPathways Melbourne are strong and indicate a continued growth as a central source of clinical/localised guidelines – especially during COVID-19 workload changes. |
| Quality Improvement (QI) | - Respondents noted limited opportunities to participate in EMPHN-led intensive QI programs. 65% of those who did engage in intensive QI rate their resulting practice changes as being very/moderately sustainable. - 14% are unaware of EMPHN QI offerings. - 13% suggested more face-to-face contact to offer practice-specific QI support. |
| Cultural Awareness and Cultural Safety | - Although most practices have a cultural awareness / cultural safety policy in place, the implementation of this is likely to be informally managed in around half of practices.
- Only 1 in 3 practices are currently using MBS Item No: 715. |
| Aged and Palliative Care | - GPs continue to face challenges in delivering care to their aged care facility patients. - Even though GPs may initiate most palliation and/or advance care planning discussions, practice managers and practice nurses are also actively involved and should be supported in providing related Continuing Professional Development (CPD) and resources. |
| Practice Support | - Digital enablement and QI support is the most common reason for follow up requests in the survey. - GPs, Practice Managers (PMgrs) and Practice Nurses (PN) have a varied rating of practice support service areas. PMs=highest, GP= lowest. - Ratings of specific EMPHN practice improvement services are generally very positive, suggesting what is offered is valued. However, there are unmet needs. - PHN engagement with/and support of PMgrs and PNs may not be recognised by GPs. - Overall satisfaction ratings for GPs are significantly lower and may require offering more customised support approaches. Although lower, GP feedback in this survey indicate a strong interest in building enduring relationships with EMPHN. |
| COVID-19 | - COVID-19-focused support has been rated as higher than general practice support. - GPs, PMgrs and PNs are consistent in their [pandemic] communication preferences, with GPs rating HealthPathways Melbourne as their most preferred channel. |
| Education | - Education ratings for GPs are significantly lower. - GPs express an ongoing interest in practice based face-to-face education support. |
| Mental Health (MH) | - Access to MH support services varies by patient category, with between 30% to 59% of responses indicating that severe access difficulties are being experienced. - Sources of MH support for patients are fragmented, with very limited visibility of centralised hubs in use. - Private MH services were mentioned most frequently (41% of comments) – many via employed/on-site private psychologists/counsellors/MH nurses. - Around 1 in 4 (24%) responses indicated that a MH service solution seemed “too hard.” |
| Local health system integration | - Only 1 in 3 provide a positive overall rating for their most used hospital. - Discharge summary delay is the most mentioned complaint by GPs, PMgrs and PNs. |