Unclear health assessment items advice undermines team-based primary health care
AMA President, A/Prof Brian Owler, said today that recent advice from the Department of Human Services (DHS) that practice nurse time does not count in Medicare Benefits Schedule (MBS) Health Assessment items undermines team-based primary health care arrangements.
DHS has advised that MBS Health Assessment items would no longer cover the time spent by practice nurses contributing to the health assessment. The items will now only cover the time spent by the supervising medical practitioner with the patient.
A/Prof Owler said that the advice is at odds with the Government’s stated objective of making the best use of the health workforce.
“This unclear advice will have a devastating impact on the practice nurse workforce,” A/Prof Owler said.
“The existing arrangements are based on advice given by the Department of Health and Ageing that the time spent by nurses could be added to the time taken by the doctor. These arrangements allow a cooperative approach between doctors and supervised practice nurses.
“When the Practice Nurse Incentive Program replaced the Practice Nurse items in the MBS, there was no advice that the Health Assessment items would be affected.
“The system has been working very well for patients and the stretched resources of medical practices.
“The people in greatest need of regular health assessments are the elderly, children, and the disabled – patients who need more medical care.
“Practice nurses provide important work conducting visits to residential aged care facilities and visits to elderly still living at home, and they are key to assessments for four-year age checks.
“This vital service delivery model is now under threat.
“Not only will it make it more difficult for busy general practitioners to look after their most needy patients, it will potentially threaten the job security of practice nurses in general practice.
“Many general practices have hired practice nurses specifically to assist with health assessments.
“The use of practice nurses to complete elements of the health assessment, under the supervision of the doctor, and with the doctor attending the patient for part of the service, is efficient and acceptable practice.
“These constant changes to advice - and poor communication with practices - are making it difficult to navigate the unclear MBS requirements.
“The AMA urges the Government and DHS to urgently reinstate the former arrangements,” A/Prof Owler said.
1 July 2014
CONTACT: John Flannery 02 6270 5477 / 0419 494 761
Odette Visser 02 6270 5464 / 0427 209 753