CURRENT PROGRAMS AND PROJECTS

Mental Health

The aim of the Mental Health program is to maintain and strengthen networks developed among GPs, other providers of mental health care, as well as mental health consumers and carers, in order to improve patient outcomes. To achieve this, the Division organises activities to enhance communication among GPs and other stakeholders, and provides education for GPs to improve their assessment and management of mental health problems.

The program has had a very high involvement (almost 80%) of local GPs in project activities, and has demonstrated an increase in communication among GPs and members of the Mental Health Team. There has also been good feedback from GPs and Mental Health Team members on educational and case discussion activities, and strong support from Mental Health Service.

The program provides education for GPs, opportunities for networking and working together on problems and issues, and small group case discussions for GPs with a psychiatrist and a Mental Health Team member.

A major achievement of this program has been the six monthly networking forums which have moved from "putting faces to names" to drawing upon the experience of a range of participants (including health care providers, government and non-government staff, consumers and carers) to develop and initiate strategies.

The Division has now started to work together with the mental health project officer in Wentworth Area Health Service to address some of the barriers to integrated care, such as limited access to psychiatric services in the Mountains.

Diabetes

The aim of this program is to improve the outcomes for diabetes patients through good quality GP management that meets clinical management guidelines.

GPs register their diabetic patients with the program and provide the Division with the results of complications screening tests as they are conducted. The project comprises a computerised database (Cardiab), a reminder system for GPs if no data is received for six months, an audit system enabling GPs to compare their screening rates to Division aggregated results, a free clinical audit and a diabetes educator to see patients at their GP's surgery.

The achievements of the program to date have included 87% of Division members with patients enrolled with over one third of the estimated diabetic population in the Mountains involved.

The program has helped GPs (and, in turn, their patients) via the reminder and audit systems and education, also the patients via local, accessible diabetes education. A recent diabetes patient survey indicated strong support for the latter.

The Division is still encountering some problems with GPs not sending their screening data to the Division. They are hoping to address this in the longer term by enabling reporting via computer.

Information Management / Information Technology

The aim of the Information Management/Information Technology (IM/IT) program is to facilitate the computerisation of GP surgeries to meet GP needs, and to provide support for Practices to meet Practice Incentive Program (PIP) Computerisation requirements. The Division provides assistance to members with analysis of requirements, evaluation and purchase, setup, training and ongoing support of Practice systems, including hardware, clinical and administrative software, and networks.

Since December 1999, when the Program commenced, new systems have been implemented in three Practices (10% of population), and the Division has provided IT advice and Help Desk assistance to a further 12 Practices (40% of population). The Division has also implemented a 24hrs 7 days a week Help Desk service, developed a Help Desk Manual, implemented centralised email and intranet/extranet server, implemented CD Archive service, organised a Software Expo, and has had ongoing discussions with Area Health Service re integration.

Barriers on the program have been the need to extend resources and funds to provide a comprehensive service. In general, there has been a lack of GP/Practice staff exposure to computers, much of this because of prior bad experiences, anecdotal information with/about computerisation. Also small practices have been resisting the expense of computerisation for what they see as minimal benefits.

The Division intends to develop firm and ongoing integration with Area Health Service (AHS) Systems to provide better information for GPs, to provide relevant training to those who require it in a timely fashion, and enhance and maximise the computer skills of all members and their staff.

Immunisation

The Immunisation program aims to increase childhood immunisation rates in the Blue Mountains, and to provide support and education for GPs and their practice staff in issues relating to immunisation, including reporting to the Australian Childhood Immunisation Register (ACIR) and cold chain maintenance.

The program helps practices manage ACIR paperwork and website, and ensures that practices are trained and equipped to maintain the cold chain for vaccine storage. It also keeps practices informed of any changes and development in immunisation; for example change of Schedule.

Achievements of the program have been an increase in the childhood Immunisation Rate by 12.1% from the August 98 quarter (66.6%) to the May 2000 quarter (78.7%), and two successful education nights for GPs and their staff.

The Division has also produced a series of documents for practice use, a promotional campaign in the local newspaper, and information to all primary schools in the Blue Mountains re the Free Hepatitis B vaccine for ten year olds.

Services provided by the Division include practice visits to train staff and GPs in ACIR reporting and cold chain maintenance, responding to enquiries, supplying resources, and lobbying through the Alliance and other channels for a simpler ACIR website, encounter forms, and ACIR reports.

The program has been faced with some challenges. The Division believes the ACIR still frightens some GPs who have not yet enrolled their practices with the Incentives Scheme, although some actually send data to the ACIR.

Also, conscientious objection is an issue in the area.

The Division is developing a Cold Chain Awareness campaign for practice staff, and plans to continue educating all stakeholders about the new Schedule. They are currently developing a clinical audit, and a stronger connection with the IM/IT Project, as well as addressing issues such as the possibility of recycling vaccine delivery polystyrene boxes.

Liaison and Communication

This program feeds into all the other programs, and specifically aims to enhance networking and liaison opportunities. The aim of the program is to ensure GPs have input into local health services planning, to enhance opportunities for integrated care for improved patient outcomes and to provide opportunities for good communication among GPs and other stakeholders, including consumers.

The program has achieved a broad-based representation on project committees, the establishment of liaison committees for community health and Blue Mountains Hospital, signed Memorandum of Understanding with Wentworth Area Health Services (WAHS), and has a regular consumer newsletter that is well received.

The Division sees enormous potential in pursuing this program as it allows for better integration of GPs into the greater health care system and ultimately directly benefits health care consumers.

GP/Practice Support

The aim of this program is to provide surgeries with information and resources that help them in their daily work.

The Division does this by providing support and advice for surgeries regarding accreditation, PIP, the new Medicare items, human resource management and other practice management issues. There has been a very high uptake of these services by practices.

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