be subjected to appropriate statistical analysis.
and their carer/s are appropriately addressed, and to increase the knowledge and skills of GPs in mental heath care. Six months following the initial quality of life assessment for the control group; for the study group, six months following the combined medication review, the quality of life assessment will be repeated and the patients medical
Dissemination of information on IM/IT issues (eg. problem prevention  measures). Barriers to the program have been accessibility, reliability, and slowness of communications infrastructure in rural areas, as well as the limited sources of local suppliers for computer support and training for GPs in rural areas. Most events for assisting Division IM/IT staff are held in Sydney. care for people with a mental health related problem and their carers. The Division also aims to support GPs to utilise tools for case conferencing, increase GP participation in the management of their clients by utilising the
The Division has also developed a Website, and established a Helpdesk, as well as furthered collaboration with Organising demonstrations of software, equipment, and methods.
CME points. All General Practitioners registered with the Division benefit from the CME activities. Specific programs are also targeted at the needs of practice staff in supporting GPs and also Area Health staff in facilitating collaborative partnerships in the provision of primary health care services. Distance, workload and on-call The Information Management/Information Technology (IM/IT) Program provides services to General Practice doctor's and staff. The program is also involved with the maintenance of the Divisions computer network and library. The IM/IT program provides independent help and advice on information management and technology to GPs and sectors. It also assists GPs use information systems and technology effectively in their transition to becoming the focus for health care in an integrated health system and their move towards more evidenced-based medicine. prescribing, and information for patients on the doctor's desktop. Provision of training and workshops for General better communication through the increased take-up and use of email and electronic data transfer of health information.
Division Numberresponsibilities prevent some GPs attending CME activities. 202Information Management and Information Technology
Classification Urbantheir staff, Division staff, and other organisations working towards integrating GP services with those in other health
Number of Member GPsThe program has increased computerisation of General Practice, for example, electronic clinical records, 435Practice and Division staff has greatly increased the effectiveness of computerisation. As a result, there has been
other health services. Services provided by the Division include: recommendations). Training/Coaching (eg. on-site individual tuition email and internet). First level support. Immediate resolution of simple problems. Referrals to appropriate support for specialised areas not covered internally. Information regarding internet resources. Advice on appropriate suppliers and training courses.
State New South WalesIndependent advice on the selection and acquisition of equipment and software (eg. proposals, suggestions,
Year Established 1993
Number of Member Practices 180
Providing contacts using software/equipment of interest.
Installation of software and upgrades. Help with network issues and integration with other systems. Assistance in organisation of Continuing Medical Education.
Enhanced Mental Health Care Program care. The program provides an opportunity for GPs to participate in clinical attachments with the psychiatric days in these areas. In addition, GPs can elect two of three elective clinical attachments depending on their special interests. The three electives are Child and Adolescent Psychiatry, Psychogeriatrics and Forensic Psychiatry. GPs spend the equivalent of one day at each elective. Aims of the program are to identify specific areas of need in relation to mental health care for General Practitioners, between GPs, mental health staff and allied health staff. Over the past 12 months, a total of 12 GPs have commenced their clinical attachments. The clinical attachments have been awarded 75 RACGP QA and CE CME points. The Division also arranges a two-day annual Mental Health Conference for GPs, Area Health Service staff and Dementia and Depression in the elderly, Adolescent Mental Health and ADD. Services provided by the Division are an annual needs analysis for GP mental health care requirements, coordination of clinical attachments, and an annual Mental Health Conference. A shortage of GPs in Wagga Wagga has influenced the number of GPs The mental health shared care program aims to get key care providers, including the GP, communicating together
Postcodes CoveredThe program seeks to enhance the involvement and contribution made by General Practitioners in mental health 2000, 2008, 2010, 2011, 2012, 2021, 2022, 2023, 2025, 2056, 2027, 2028, 2029, 2030inpatient facility, the community mental health services and the visiting psychiatrist spending the equivalent of three

Population 173,371 (2001 Census)to improve the knowledge and skills of GPs in the management of mental illness, and to improve communication

Area Covered Sydney City, Chippendale, Surry Hills, Darlinghurst, Woolloomooloo, Potts Point, Elizabeth Bay, Kings Cross, Rushcutters Bay, Paddington, Centennial Park, Bondi, Junction, Queens Park, Bellevue Hill, Woollahra, North Bondi, Bondi, Tamarama, Darling Point, Edgecliff, Double Bay, Rose Bay, Dover Heights, and Vaucluse.other interested parties. This year there were over 90 participants at the conference. The major themes were

CEOparticipating in the program. Mr Kevin ReidShared Mental Health Care Program
to provide coordinated shared care for their clients with mental illness and to improve the level and continuity of
existing services, facilitate effective communication between service providers to ensure that the needs of the client
Over the past 12 months, 26 people have been referred to the Shared Mental Health Care program. Sixteen shared care meetings have been arranged with individual management plans completed, and seven additional meetings have been arranged where management reviews were completed. A partnership between the Greater Murray Area Health Service (GMAHS) and Wagga Wagga & District Division of General Practice (WWDDGP). The WWDDGP have been running a Mental Health Shared Care Project since 1997; the form of evening education sessions, along with the Annual Mental Health Conference having one day devoted with informed consent obtained. Participants from the two groups have had standardised SF-36 quality of life assessments performed. The study group are having combined pharmacist/GP review of medications.
Services provided by the Division include case conferencing and care planning for mental health clients, CME presentations for GPs, allied health workers and practice staff in care planning and case conferencing, development and distribution of policies and guidelines for the Health Integration Program
Dementia Shared Care Project -Health Integration Program
funding was granted for the trial of a Dementia Shared Care Project to be run along similar lines. and produce 'generic' guidelines, therefore making a useful tool which could be used across all health care settings Care Plan, Case Conference and Health Assessments. The Protocols and Guidelines have incorporated these Aged Care (DHAC). The Division aims to promote the role of the General Practitioner in the primary care of people with dementia. WWDDGP have received copies of the HIP, with copies also distributed to Practice Managers, ACAS, Community both in terms of being beneficial to the person with dementia, their carer, GPs and service providers. Services provided by the Division include coordination of all Community Health and Community Service Providers
Physical Address:Rather than have two separate sets of protocols for mental health and dementia, it was decided to combine these
Suite 103, Level 1, 35 Spring Streetwhere shared care is appropriate. As of 1 November 1999, GPs are able to claim for new MBS items, including
BONDI JUNCTION NSW 2022new items and have been accepted for use by the RACGP and representatives of the Department of Health and
Australia
Postal Address:Achievements of the program include the completion of the Protocols and Guidelines, MBS compliant. GPs in the
Suite 103, Level 1, 35 Spring StreetHealth and Community Service Providers.
BONDI JUNCTION NSW 2022The Care Plan/Case Conference is underway approximately two days a week. Outcomes have been very positive,
Australia
with the GP in the management of people with dementia. The project has provided education and support to GPs in 		to Dementia and Psychogeriatric issues for both GPs and health professionals. The objectives of the project are to have patients participating in the project who are 65 years and over, living in following; a) > twelve doses per day b) > six active medical diagnoses c) low body weight (bmi < 22) or d) on one of Patients 65 years and over who are ambulatory living independently have been selected from the General Practices
Email:Initially, the Division found it was difficult to coordinate suitable timeframes for both GPs and service providers. One ceo@esdgp.org.auvery large barrier is the lack of available time for most participants (ie. GPs, service providers).
Phone:Aged Care- Quality Use of Medicines02 9389 0874
Fax:Wagga Wagga and immediate area, be ambulant living in their own home, andno regular assistance with activities 02 9387 4175of daily living. These patients must be on five or more prescribed regular medications and at least one of the
Website:the following medications; anticholinergics, anticonvulsants, antipsychotics, narcotics, benzodiazepine, drugs with http://www.esdgp.org.aunarrow therapeutic index, eg. warfarin/lithium/theophylline.
based in Wagga Wagga and three rural communities. Patients were allocated to either the study or control group
records will be reviewed for hospital admissions attributable to adverse reaction to medication. This data will then
The aims are to determine if the patient's quality of life is improved due to having their medications reviewed, to

determine if a medication review decreases hospital admission rates in the same population and to raise GP

The Eastern Sydney Division of General Practice (ESDGP) has been operating since 1993 with funding from the awareness of the interaction and suitability of medications in the elderly.Department of Health and Aged Care. ESDGP has encouraged and developed a close working alliance with St Vincent's and Prince of Wales Hospitals and two university campuses, Sydney University and the University of The GPs are becoming more aware of the interactions and suitability of medications in the older patients following NSW, as well as a multitude of other health care agencies.the medication review by the pharmacist, who meets with the GP to discuss the interactions and suitability of their

patients medications. Services provided include a pharmacist review of medications with GPs re drug interactions

The Division's extensive activities include the development and running of community-based projects and liaison and suitability of drugs.and policy development input with Commonwealth, State and Local health authorities via representation on relevant committees and groups.National Prescribing Service

In July 1999, ESDGP entered its next phase of evolution with an increased focus on "GP Support". This includes National Prescribing Service (NPS) programs systematically target specific areas where evidence has show that help with Practice Management, Practice Accreditation, the Practice Incentives Program and Peer Support. The GP education and information can lead to quality prescribing that improves the health of patients and represents value Support Program also incorporates IM/IT Education and Support to provide members with expert advice on for money. Quality prescribing does not always mean less prescribing, in fact some of the programs will lead to computer problems. The program provides 'hands-on' workshops and oversees the improvement of 'Electronic increased prescribing of medicines that have been shown to be effective.Links' between GPs, hospitals, Pathology Laboratories and other providers.

The program aims to improve the health of residents within the area of Wagga Wagga and District Division of

The Divisional area is home to substantial wealth and pockets of great poverty, including the largest concentration General Practice through appropriate and cost-effective prescribing of medicines.of homeless people, sex workers and people living with HIV/AIDS.

Since December 1998, successful programs have been run on peptic ulcer management, non-steroid antiinflammatory

Stakeholders include Commonwealth Department of Health and Aged Care, NSW Health, Alliance of NSW drugs for treating osteoarthritis, antibiotics for treating upper respiratory food infections, Divisions, National Prescribing Service, South Eastern Sydney Area Health Service (SESAHS), St. Vincent's Benzodiazepines, anti-hypertensive drugs, heart failure etc.. Services provided by the Division include the Hospital Campus, Prince of Wales Hospital Campus, Royal Hospital for Women, Sydney Children's Hospital, War distribution of a bi-monthly newsletter (NPS News), case studies and clinical audits for doctors and pharmacists, Memorial Hospital, St. Luke's Hospital Complex, SESAHS Community Health Services and Programs, SESAHS direct mailing to all GPs - describing practice reviews, NPS facilitator training, surgery visits and one-on-one Public Health Unit, LGOs: Waverley and Woollahra Municipal Councils, local community organisations and education. The availability of unbiased information presented through this service is unique and extremely valuable.consumer groups and the University of NSW.

Immunisation

The project is aimed at improving the quality of data provided by GPs to the Australian Childhood Immunisation

Register (ACIR), the vaccine cold chain and GPs knowledge about immunisation, the Australian Standard

MAJOR ACHIEVEMENTSVaccination Schedule (ASVS), the ACIR and the General Practice Incentives Scheme (GPII). The aim is to improve immunisation rates in the Wagga Wagga & District Division and provide education on all aspects of the ACIR and

ASVS.
  • Developed an ever growing and strengthening network of the region's GPs.The Division also aims to improve the quality of vaccine cold chain data in General Practice, support the implementation of changes to the NHMRC 7th Edition Australian Standard Immunisation Schedule, and provide
  • Providing 'the contact point' for interfacing and communicating between GPs and local health providers.interim and final reporting to the Executive Director of Wagga Wagga & District Division of General Practice including recommendations for further action.
  • Significant contribution to development of the area health policies. As a result of the program, the immunisation rate has increased to 86% and WWDDGP has moved from 37th to
  • Collaboration with SESAHS Public Health Unit.12th position nationally for aged-appropriate fully immunised children according to the ACIR within one reference period. Services provided by the Division include education on all aspects of the ACIR and GPII, academic detailing
  • Improving the quality and expertise of local GPs through a relevant and valued quality CME Program.of the ACIR 020A report, monitoring of General Practice vaccine fridges, and information via monthly newsletter and weekly fax.
  • Empowering GPs to value the work they do. Accreditation
  • Successful shared models of care in Antenatal and Mental Health programs. The Accreditation program involves visiting all the practices within the WWDDGP area to encourage and provide
  • GP focused/friendly Discharge Protocol from local public hospital.assistance with the accreditation process of General Practices, and to provide information and material to assist GP practices complete accreditation. As a result of the program a total of 34 surgeries were visited and provided with
  • Beginnings of improved communication by local hospitals with GPs.advice and support. Nine surgeries have been accredited and a further seven surgeries have registered for
accreditation.

CHALLENGES FOR THE FUTURE

Services provided by the Division include the provision of advice on registration and the accreditation process, the
The Division has developed and distributed a 'GP Orientated Cardiac Rehabilitation Manual' a 'Cardiac Patient Handbook' which covers diet diary and exercise diary for the cardiac patient, and a 'GP Cardiac Education Folder' Discussion Forums

The aim of the program is to provide services to support GPs in cardiac rehabilitation and to enhance their ability to prevent and treat cardiovascular disease, and to increase access to rehabilitation services for rural people in the


Handbook' which covers diet diary and exercise diary for the cardiac patient, and a 'GP Cardiac Education Folder' Site Map  |  containing best practice guidelines, policy standards and the latest journal articles of interest. The Division has also Helpdistributed a 'heart health resource folder' that contains the National Heart Foundation resources for the GP to  |  distribute to patients. The only barrier the Division has encountered is the difficulty in identifying the number of Hot Issuespatients attending and completing the program.establishing mechanisms to promote and sustain secondary
prevention. The major strength of this model is that it is designed and delivered for rural people taking into account
distance and access to services. The General Practitioner is in a favourable position to take on the task of Annual Forum

© Copyright 2007 rehabilitation, as often patients have one or more other chronic conditions eg. diabetes, and the General Eastern Sydney Division of General PracticePractitioner is in the best position to manage these complex patients.

Division.