In December 2019, EMPHN sought feedback from general practice staff and allied health providers on how they engage with EMPHN, experiences in the healthcare sector and opportunities for development.
Thank you to the 380 general practice staff (GPs, practice managers and practice nurses) and 90 allied health providers who responded to our third survey. Your feedback has been valuable in shaping our future engagement activities and has helped to define our areas of focus to improve support for primary care.
Findings are benchmarked against EMPHN’s 2017 and 2018 surveys, and seven other PHNs Australia-wide.
EMPHNs Overall performance
Other than a slight decrease in GP ratings for practice support, all stakeholder group ratings are higher in all areas (practice support, education performance and website performance) for 2019 compared to 2018.
Improvements were experienced in education for practice managers and allied health providers, and practice support and website for practice nurses.
Practice nurses showed the most improvement (13% improvement since 2018), reflecting a conscious effort by EMPHN to provide focussed training and education opportunities for these professionals during the past two years.
1. We heard the uptake of digital technology has almost reached saturation point in most areas except for some financial transactions and pharmacy transfers.
There has been a 15% increase in general practices using SMS with patients since 2017 and a 9% increase in patients receiving electronic discharge summaries. My Health Record uptake is 83% for general practice and 17% for allied health, above the benchmarks of 56% and 4% respectively.
What does this mean?
Digital prescribing is anticipated to develop rapidly as electronic prescribing is implemented in by the Australian Digital Health Agency with help from Primary Health Networks.
Despite the uptake in digital technology there remains a reluctance of general practices to stop using fax, with between 94%-98% using the fax to send and receive referrals and reports. EMPHN’s ambition to ‘axe the fax’ is outlined in our Strategic Plan.
2. We heard NDIS is difficult to understand.
Allied health professionals are less confident assisting patients with disabilities with their healthcare needs than in 2018, possibly related to NDIS introduction challenges.
What does this mean?
While GPs have improved their understanding of the NDIS system there is still a need for both GPs and allied health professionals to better understand the system and how to support patients to access the care they need.
EMPHN is working with the NDIS Local Area Coordinators to provide access to more tailored information for GPs and health professionals through our website and to support these services in reaching out to local practices.
The Yumarrala Ngarrdji NDIS Project, funded by EMPHN, builds capacity for community controlled and mainstream organisations to support Aboriginal and Torres Strait Islander people to access the NDIS. The project, which involves Oonah, Wellways, VAHS and EACH, provide direct support for community members, resolve issues in the NDIS with NDIS participants, and focuses on NDIS pathways and resources for this cohort.
3. We heard we’re getting even better at how we support healthcare providers.
- 69% of GP staff rated EMPHN’s support very high or high (compared to 49% in 2017 and 50% in 2018).
- 46% AHPs rated EMPHN’s practice support very high or high (compared to 36% in 2017 and 39% in 2018).
What does this mean?
Our skilled practice facilitators continue to develop productive relationships with general practice teams. EMPHN’s work with providers during the introduction of My Health Record, PIP QI and changes in delivery of mental health services over the past two years has been received positively. However changes to the way we deliver mental health services in particular has meant less direct contact with allied health providers. Our engagement with allied health providers is predominantly through service co-design, commissioning and contract management.
4. We heard around 60% of respondents are unaware of EMPHN’s commissioning role.
This is reflected by only 5% of general practice respondents applying successfully or unsuccessfully for commissioning opportunities with EMPHN. The engagement is much higher among allied health providers completing the survey with 11% participating in commissioning opportunities. Successful commissioning applicants rated EMPHN highly on the commissioning process (75%+ rated high or very high). The small sample size is noted and EMPHN falls short on user friendliness of the commissioning process and meeting local needs.
What does this mean?
We have been working to simplify our commissioning activities to make them more accessible and appropriate, given the diverse range of providers in our catchment. This includes an updated Commissioning Framework, which provides EMPHN employees and consumers, providers and other stakeholders with a shared and transparent approach to decision making in an environment of collaboration and co-design. We could do better at communicating identified priorities in our Needs Assessment and decision-making regarding delivering services to address identified needs.
5. We heard a misalignment between GP and AHP expectations in interaction continues, with an unquantified, but potentially significant, impact on consumer health journeys.
Allied health professionals rated their provision of reports and information when a GP has referred a patient significantly higher than GP’s say they receive them.
What does this mean?
Shared care among a person’s care team, keeping the GP at the centre of their care remains a challenge. The rapid uptake in digital technology experienced in the healthcare system during the COVID-19 pandemic could help fill gaps in secure messaging and delays in referrals. Allied health providers and GPs may consider using telehealth to support collaborative care planning with the consumer.
Conclusion
COVID-19 will change the way many of our general practices and allied health providers will work into the future, particularly around digital health.
We predict a significant number of providers will be more interested in engaging with our digital health support and initiatives in the future, which has the potential to improve patient experiences, timeliness of information and shared care arrangements.
EMPN has moved its learning and development activities to an online and video enabled environment and the uptake has been great. We will be providing more online learning opportunities for primary care as we implement our new Learning Management System (LMS).
What next?
EMPHN now has a solid baseline from three consecutive years’ survey results. The new General Practice Engagement Plan will come into effect from late 2020, a new approach to engage with general practice in the region that recognises practices have different interests and capacity, driven by the unique needs of their patients.
Given this and the impact of COVID-19 on the healthcare sector in 2020, our next survey is planned to be undertaken late 2021.