1. Preamble

The growing interest in call centres is of concern to the AMA. While telephone triage can be part of an integrated GP out-of-hours service model, it is not a total solution to the issue of access to out-of-hours GP services.

AMA concerns relate to the unproven, and often disproved, objectives for the establishment of call centres. Evidence demonstrates that while telephone triage services gain high consumer satisfaction they have no demonstrable impact on relieving pressure on Emergency Departments.

The recent focus on call centres is politically rather than need driven at all levels of Government. Government data indicates that there has been no significant increase in presentation of GP patients at Emergency Departments over the period 1998/99 to 2002/03 (increase of Category 4 of 5% and decrease in Category 5 of 11%). The pattern of emergency presentations at a national level does not support the myth that GP patients are imposing significant pressure on hospitals (in fact Category 2 has increased by 45% over the same period). There is acknowledgement that in some specific areas this may be the case but the overall picture is vastly different.

Consumer health information services require high levels of quality control that need to become part of an accreditation process to ensure they provide high quality information. They must operate on the basis of general practitioner endorsed protocols that are adhered to and quality assurance regularly undertaken. They must be consistent with a GP focus to allow the patient access to a diagnosis and an explanation of their presentation in the context of their personal setting and environment.

Locally and internationally, call centres are used increasingly by various industries to provide a single gateway to their service. Call centre triage can be used to serve economic imperatives rather than the best intervention for patients for quality health outcomes.

Call centres must only be used as a tool to access genuine triage and not as a substitute for general practice care or pre-existing hospital and community services (eg crisis teams) to restrict access to services or to introduce managed care.

2. Call Centre Triage and Advice Services Resolution

2.1 That Executive Council adopt the AMA Position Statement on Call Centre Triage and Advice Services (dated 27 July 2004).

2.2 That Executive Council adopt the following criteria for call centres:

2.2.1 Essential: Any call centre model must:

• comply with national standards and protocols;
• meet a proven need;
• have clearly defined and transparent objectives;
• demonstrate that its establishment is based on credible evidence that it is best able to fulfil the proven need and stated objectives;
• incorporate transparent evaluation processes linked to its objectives;
• be able to provide patients with meaningful local knowledge;
• be demonstrated to be cost efficient and effective; and
• meet all other criteria deemed as essential by the AMA for out-of-hours primary care services.

2.2.2 Unacceptable: A call centre is unacceptable to the AMA if it incorporates any of the following elements:

• it incorporates costs containment as it primary aim;
• it redirects essential resources from other health services;
• it compromises other GP in hours or out-of-hours services;
• it is established at the expense of other essential GP services;
• the call centre is located off shore; and
• it contains any other criteria identified as unacceptable to the AMA for out-of-hours primary care services.