Division Management
This Program is about the Division's commitment to policies and procedures for the effective and efficient management of the Division. The aim of the program is to provide efficient and effective management and support to all Division activities. Other aims include ongoing communication and support to management and staff, implementation of a human resource plan, policies and procedures.

The Division is aiming at optimal employment practices. It is also aiming at executive members with sound and efficient management skills. Other aims for the Division are sound and efficient financial management, promotion of the Division to GP members, the local community and health stakeholders, communication and liaison between the Division, its GP members and regional, area and community health services and significant others.

Achievements of the program include the Business Plan 2000 - 2001 that continues the systems and procedures established in the previous year's plan. The Division's Public Relations Plan is ongoing. There has been increased liaison with neighbouring Divisions and the development of a new logo and image for the Division.

The Division has also launched their own website. Other services provided by the Division include Monthly Management Committee Meetings and Regular meetings between Division Management and Management Committee. The Division also provides Strategic and Business Planning, General Meetings and Annual General Meetings, Financial Reporting, Review of Division policy and constitutional issues, and access to resources. A Monthly Newsletter is published and distributed to GP members. A new challenge for the Division is the pursuit of Corporate Governance practice and training.

Local Health
The Local Health program encompasses several projects, each with the ultimate goal of improving the health of our local community.

Ambulatory Care
The Ambulatory Care Project has been divided into two parts. GPs from Program 1 graduate to Program 2.

Ambulatory Care (Program 1)
Ambulatory Care Program 1 is the established program of upskilling of our GPs by the Director of Ambulatory Care. GPs on the Program are rostered in the Ambulatory Care Ward, Bankstown Lidcombe Hospital to review patients for discharge with the Director of Ambulatory Care, learning about the management of acute conditions presenting in Ambulatory Care. GPs also notify patient's own GP of their discharge. The Division provides seminars and workshops support the program. The aim of the program is to upskill GPs in acute conditions and to redefine a role for GPs in Ambulatory Care. As a result of Program 1; a total of 33 GPs graduated from Program 1 to Program 2.

These GPs have been upskilled in conditions of cellulitis, DVT and UTI. Services provided by the Division include GPs reviewing patients for discharge including follow-up with patients own GP. The challenge for the Division now is to recruit new GP members to Program 1 so there are increased numbers graduating to Program 2.

Shared Care in Medicine (Program 2).
Program 2 is innovative and is about upskilled GPs managing the care of patients with acute conditions such as cellulitis, deep vein thrombosis (DVT) and Urinary Tract Infection (UTI) through their practice in the surgery or at home.

Patients eligible for Program 2 will not need to be admitted to the Ambulatory Care Ward, saving of Health Service resources and giving patients new care options. The Division provided seminars and workshops support the program. The aim of the program is for GPs and the Health Service to establish new treatment options for patients with Cellulitis, DVT and UTI, to keep the GP in the forefront of treatment design and implementation, and increased treatment options established for patients with specific acute conditions.

The Division is also aiming for GP's to treat at home patients with specific acute conditions. As a result of the program 13 GPs will take part in a six week trial on the management of cellulitis. This trial will assist the Division in ensuring any teething problems are corrected before full program launch. Other achievements include a Joint Management Plan between GP and Director of Ambulatory Care which has been developed for the Program, and a protocol for Cellulitis which is now developed.

Services provided by the Division include that those Patients eligible for Program 2 have the option to be cared at home by their GP under a Joint Management Plan with the GP and Director of Ambulatory Care. This program helps patients, and those GP members who have graduated from Program 1, it allows them to use their skills in their everyday practice.

Antenatal Shared Care (Program 1)
This project is about increasing care options to low risk expectant mothers who access the public health systems in the Bankstown local government area. Women attending the Antenatal Clinic at the Bankstown Health Service who are eligible for Program 1 have the option of Shared ante-natal Care with their General Practitioner. The program also means that Women can attend their local GP for many of their ante-natal visits and also for their post-natal visit. The Division provides seminars and workshops support GPs on the Program.

The project is also about improving communication between GPs and Hospital staff. As a result of the project a total of 93 GPs are registered on the GP Ante-natal Shared Care Program, 258 women were enrolled in Program 1 between July and December 1999, and overall a total of 1000 women have chosen GP shared care since July 1997.

A challenge for the Division has been to increase the number of women who choose this option. As a recent innovation a part-time GP Antenatal Shared Care Coordinator is being recruited at the time of writing. The Coordinator will be a midwife based in the Antenatal Shared Care Clinic. The coordinators primary aim is recruit more eligible women to Programs 1 & 2 and improve services to GPs and women on the program.

Post partum visit review (Program 2)
This program is aimed at encouraging women on Ante-natal Shared Care to visit their GP for their Post-partum visit review. Services provided by the Division include a Post-partum visit with GP, Continuity of care including advice on immunisation.

Cardiac
This is an ongoing project to support GPs in the care and monitoring of their cardiac patients. It is a joint program with the Department of General Practice to research recall of patients with Unstable Angina Pectoris (UAP). The aim of the program is to have a patient recall system in place, for GPs promote cardiac rehabilitation at the Bankstown Health Service, and for GPs to implement systems for monitoring cardiac patients. The Division ultimately wants to see the local community have an increased awareness of the benefits of a health lifestyle and modifiable risk factors.

As a result of the program a total of 40 GPs are currently enrolled in program and 12 GPs are on the Clinical Audit. Services provided by the Division include a recall of GP patients with cardiac conditions to GPs on a three monthly basis, the development of a patient record to assist GPs in the monitoring of their cardiac patient, and a Clinical Audit available to GP members on the program. At present there are 10 cardiac patients to be monitored, and a speaking program aimed at increasing awareness of the benefits of a healthy lifestyle.

The only barrier to the program has been that there are multiple research projects at the Bankstown Health Service competing for patient on each program.

Diabetes Shared Care
The Diabetes Shared Care program is aimed at improving management of diabetes in general practice. To increase GPs skills and knowledge through seminars and workshops, and for improved patient access to education through GP practices. Diabetes Nurse Educator reviews patients of GP members on the program in "mini clinics" held in GP member surgeries.

As a result of the program 763 patients of GP members have been through a mini clinic since March 1998 to June 2000. Also there has been a total of 74 patients referred to a Podiatrist, 93 % of patients had HbA1c tested, and a total of 46 GPs currently on the program.

The Division provides Mini clinics in GP member practices conducted by the Diabetes Nurse Educator, a Patient recall system based on NDOW data is under development, and a Clinical Audit is available to GP members using NDOW data. Mini clinics provide patient complications screening with follow-up education and support. The challenges for the Division have been in implementing new directions for the program and in increasing its application and its cost effectiveness.

Mental Health Shared Care
The program involves the development of a five-part CME program with Liverpool Division, which will assist GPs with the management, treatment and referral of patients with Schizophrenia, Mood Disorders, Anxiety and Personality Disorders, Drug and Alcohol problems. The Division is aiming for improved management of patients with mental health problems/disorders and for GPs to use the best options for treatment and interventions. The Division also aims to acquire closer links with community services for improved patient care, and an active working party to manage ongoing education and links between GPs and community mental health Services.

One of the achievements of the program has been a joint Division survey of GP members in Bankstown, Liverpool and Fairfield Divisions, which identified the areas to be developed in the education program.

Services provided by the Division include a five-part CME program, and support materials to assist GPs in the ongoing care of patients with mental illness including flipchart on identifying patients with suicidal tendencies.

A new initiative, which will assist the development of closer links between GPs and Community Mental Health Services, is the appointment of a GP liaison Officer at the Area Health Service level. The Liaison Officer will take up the position in the next few months.

Hepatitis C
A program designed to provide an upskilling program on Hepatitis C to GP members. As a result of the program GPs have been upskilled and supported in the management of patients with Hepatitis C. There has also been an increase in services to patients with Hepatitis C attending Bankstown Health Service.

Asthma
A GP practice based program for the improvement of Asthma control in adolescents. The program is designed to upskill GPs in the diagnosis and management of adolescents presenting with asthma in General Practice. Barriers have been finding funding to support future training programs.

Breast screening
Revised protocol for GP breast screening program with Area and private breast screening services. It is designed as a seminar and workshop program. The aim is for GPs to be better able to determine signs of breast abnormalities. Barriers have been finding funding to support future training programs.

Services to GPs
This program includes a GP needs assessment to allow the Division to be responsive to current issues facing General Practice and to provide services to, advocacy for and representation of GPs that will enhance their roles as primary health care providers.

GP Needs assessment
An annual survey of GP members, a challenge for the Division is to increase number of GP responses to the Survey, and to increase access to the use of resources.

GP Education
This is an annual program, which holds monthly clinical education sessions. In recent years there has been an increase in professional development sessions complementing the clinical sessions. The aim of the program is for GPs to be better able to meet the needs of patients with varying cultural backgrounds and to keep GPs updated on current issues.

Achievements of the program have included an increase in the average number of GPs attending CME sessions, and a new calendar of events, registration and RSVP response sheets.

Barriers have been the challenge of increasing GP numbers at CME sessions, the development of interactive CME and the introduction of more professional and business topics in the program.

Advocacy and Relationships
A program that provides support services, advocacy and representation for GPs. The aim of the program is for the Division to be viewed as an advocate for GPs. The Division also plans for GPs to have input into the planning and management of local health Services, to keep GPs informed on current issues in general practice, and for GP services to meet the needs of the community.

Achievements of the program have been that GPs are represented on Local, Regional and Area health Service Committees, an Advocacy Committee was formed to support GPs members in Medicare Australia reviews, and the CME program supports facilitation of discussion on accreditation and amalgamation. Other achievements include the Division carrying out mock surveyor visits to assist GPs enrolled for accreditation, also the Division and Health Service have a joint agreement to improve the status of GPs within the Health Service and to improve the health of the local community.

The challenge for the Division is to find new opportunities for GP representation in the development of health services.

Enhanced Primary Care Education
The aim of the program is to establish links and resources with the Bankstown Health Service to support GP members uptake of the new Enhanced Primary Care (EPC) items, and to include education sessions about the new items in project CME to assist GP members.

Services being planned include an introductory workshop called "getting to know EPC" and EPC education sessions incorporated in Project Workshops. The Division is also developing new communication pathways with Bankstown Health Service, an EPC referral form developed to assist GP members with care planning and case conferencing, and a Best practice health assessment form.

Barriers have been the limited health service resources, GP time constraints, and the challenge of reaching all GPs.

Information Management and Technology
The Division has established a full computer training and support program. The aim of the program is to train GPs in basic computer skills and also practice software. The Division also aims to facilitate the use of electronic communication including email, Internet and the World Wide Web. The Division has also set up and maintained a Web-site that facilitates GP networking and access to Division resources. The program has resulted to date in a total of 45 GPs completing a basic introduction to computers and over 90 GPs have completed introductory or advanced sessions in medical software.

The Division provides seminar sessions on computers getting started, World Wide Web, and Internet. They also provide other services including hands-on sessions in the introduction to computers and medical software, provision of support materials including Manuals. The Division has also conducted introduction to typing sessions to enhance computer keyboard skills. Development of further support skills, and individual support for GPs with special needs.

Immunisation
The program is designed to achieve the development of a no-cost immunisation service to children under five years of age, as well as a promotional campaign to promote the role of GPs in immunisation. Other activities involve a comparison of the ACIR form and Division designed GP friendly reporting form.

The Division is looking to increase the number of GPs on the Trial to ensure that there is a true comparison of reporting forms and results.

Aims of the program are to have GPs as the key provider of immunisation in the Bankstown Local Government Area, increased immunisation rates, and an improved immunisation service for both GP and patients. Over 30 GPs are on the Immunisation Clinical Audit, and 62 GPs are on the trial of the GP friendly reporting form. The Division has also developed a stickers for Blue Health Books given to new mothers promoting the role of GPs in immunisation and continuity of care.

Services provided by the Division include a six months trial of GP friendly reporting form, there is a Clinical Audit available, data collection and analysis, and Bankstown Health Service notification of unimmunised children presenting in Emergency and Paediatric Ward.