RACGP: Walk in centres could compromise patient care

The Royal Australian College of General Practitioners (RACGP) is seeking clarification on the ACT’s new “walk-in” centres due to fears they could lead to fragmented care.

It has been reported that Canberra’s GPs have “thrown their support” behind the Government’s plan for five new walk-in centres.

However, RACGP President Dr Karen Price warned that the walk-in centres could well prove problematic for GPs and patients.

“The RACGP does not support clinics that lead to increased fragmentation of care,” she said.

“We are keen to talk to ACT Health and clarify what these new centres will actually look like. That includes details on whether the new walk-in clinics will be integrated with the usual care that GPs provide.

“Walk-in clinics to date have had a specific cohort focus on mothers and babies, which is not in keeping with the whole person care approach that GPs take.

“In addition to that, there is insufficient data demonstrating that this model of providing primary care is effective or cost-efficient.

“There is no clear proof that they save money or reduce the workload on GPs. Similarly, there is no evidence that they enhance quality of care, including for the management of multiple chronic diseases.

“Walk-in centres increase the likelihood of patients doubling up, by presenting to a walk-in centre and subsequently a general practice with the same health concern. It is also clear that these centres do not reduce emergency department attendances and their convenience creates artificial demand from people who would otherwise manage their health concern themselves.

“Further, because many patients do not completely understand what their function is you do see greater fragmentation of care.

“There is a reason why this model has not been adopted in Australia’s other jurisdictions – it simply does not stack up. This is not isolated to Australia either – in the United Kingdom nurse-led walk-in centres were closed between 2010 and 2013 and replaced by GP-led clinics.”

Dr Price urged policymakers to have continuity of care front of mind when considering models of primary care.

“If a person builds a relationship with their local GP, they will benefit from regular screening and prevention to proactively manage risks as well as complications from chronic conditions and enjoy better health outcomes,” she said.

“We must do everything possible to encourage people to have an ongoing relationship with a trusted GP who can monitor their conditions and pick up where they left off every time a consultation is needed. You will avoid the potential pitfalls of fragmented care and missing records and most of all, over time, you will develop a greater sense of trust and rapport with your GP.

“All patients benefit from having a regular GP; however, older patients and those with chronic conditions definitely have more to lose from having poorly coordinated care. So, the older you get and the more complicated your medical history becomes the more important it is to have ongoing access to the same GP.

“I recommend to all patients that they find a GP to whom they can relate to and feel comfortable with and then keep going back to the same place. The introduction of telehealth means that this much easier for patients and makes a real difference in the long run.”

The RACGP’s position statement on nurse-led clinics in primary care is available here

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