Here’s an update on a few of the issues AMA Victoria is working on for members, including:

• Meeting with Minister for Mental Health
• Advocacy on Medical Certificates of Cause of Death
• Expansion of Safewards model - Webinar featuring AMA Victoria President Dr Simon Judkins.
   

Meeting with Minister for Mental Health

This week, AMA Victoria President Dr Simon Judkins met with Victorian Minister for Mental Health Ingrid Stitt, in his first engagement with her since taking on the presidency.

The discussion centred on priorities for the sector, including implementation of the Royal Commission into Victoria’s Mental Health System, the rollout of Mental Health and Wellbeing Locals, and the need for robust clinical governance frameworks and clear referral pathways within the Locals to ensure patients receive the right care at the right time.

Dr Judkins raised ongoing workforce shortages, pressures in emergency departments, and the need for better integration with primary care to improve continuity of care. He also highlighted the unique challenges facing rural and regional services, where workforce constraints, service gaps, and travel distances compound existing system pressures. Discussion also addressed the “missing middle”-  those patients whose needs are too complex for primary care alone, but who do not meet the threshold for specialist mental health services- the “revolving door” experienced by many chronically unwell patients who cycle repeatedly through the system without sustained improvement, and the significant role of social determinants of health in shaping outcomes for this cohort.

AMA Victoria will continue to work with the Minister and her office to progress these priorities, ensuring that policy design and service delivery more meaningfully reflect the experience and expertise of the medical profession.
 

Advocacy on Medical Certificates of Cause of Death

AMA Victoria has written to the Registry of Births, Deaths and Marriages (the Registry) in support of modifying the mandatory duration fields currently required on the electronic Medical Certificates of Cause of Death (MCCDs).

Medical practitioners have raised longstanding concerns about the accuracy of MCCDs due to the requirement that the duration between onset and death of the direct cause of death, antecedent causes, and other significant conditions must be completed with both a numeric value and a unit of time (e.g. 6 months). While establishing the duration for the direct cause of death is generally straightforward, clinicians frequently find it difficult or impossible to accurately determine durations for antecedent or other significant conditions.

This requirement leads to two problems. Firstly, conditions of significant public health and statistical interest, such as hypertension or diabetes, are often omitted entirely due to uncertainty regarding the exact duration. Secondly, inaccurate durations are entered based on guesswork or assumptions, diminishing the integrity of the certificate as a legal and statistical record.

Members report MCCDs excluding contributing conditions such as ischaemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease, peripheral vascular disease, diabetic foot ulcers, and hypercholesterolaemia because precise timeframes were unavailable. Inaccurate durations have also been recorded for conditions such as dementia and renal failure despite no supporting evidence from hospital, primary care, or community palliative care records. These inaccuracies have ramifications beyond public health, including potential implications for probate and legal decisions regarding capacity.

Such omissions and inaccuracies undermine Victoria’s mortality data quality, reducing its reliability for epidemiological research, public health surveillance, and resource allocation.

AMA Victoria supports reform to remove the mandatory requirement for duration fields and to explicitly allow clinicians to enter approximate durations where possible- such as “years” or “months”- without being required to provide a precise numeric value. Where no reasonable estimate can be made, it is preferable that the field be left blank, rather than compel a clinician to record a guess or omit the diagnosis entirely. This reflects longstanding paper-based practice and clinical reality, and is consistent with Australian Bureau of Statistics guidance, which permits approximations, accepts units alone, and allows “unknown” to be entered where duration cannot be ascertained.

We are aware that discussions regarding this issue have taken place between relevant stakeholders, including the ABS and the Registry, and support efforts to resolve the concerns raised.

We have also followed up on our previous advocacy seeking clarification from the Registry on its website wording regarding fees for completing MCCDs.
 

Expansion of Safewards model- Webinar featuring AMA Victoria President Dr Simon Judkins

On Wednesday 20 August, 1-2pm, Safer Care Victoria will host a webinar on expanding the successful Safewards model across the Victorian health system.

Topics include stakeholder engagement and executive buy-in, OVA data and how Safewards can reduce occupational violence and aggression, key considerations for implementation, and what worked well (and what didn’t) in previous rollouts.

The expert panel- which will take audience questions-  features AMA Victoria’s President, Dr Simon Judkins- also Director of Emergency Medicine at Echuca Regional Health- alongside Karrie Long, SCV Chief Nursing and Midwifery Officer; Sirini Griffiths, Director of Education at Austin Health; and Nonie Rickard, Director of Nursing at Austin Health.

Register here: Safewards Expansion Webinar – 20 August