Here’s an update on a few of the issues AMA Victoria is working on for members, including:
AMA Victoria responds to proposed ADHD prescribing reforms
Urgent care services: AMA Victoria seeks clarity and member feedback.
AMA Victoria responds to proposed ADHD prescribing reforms
AMA Victoria has supported, in principle, proposed reforms that would allow approved GPs to diagnose and treat ADHD, including initiating psychostimulant prescribing, for adults and children aged six years and over. We also support reducing unnecessary permit requirements for prescribing psychostimulants to non-drug-dependent patients.
Victoria has a clear access problem, with many patients facing long waits, high out-of-pocket costs and limited access to appropriate care, particularly in regional and rural communities. Appropriately trained and supported GPs can play a greater role. However, changing the regulations will not, by itself, improve access.
Our submission calls for robust training, timely access to psychiatrists and paediatricians, clear referral and escalation pathways, and sustainable funding that reflects the clinical and administrative work involved. The reforms should strengthen comprehensive general practice and the relationship between patients and their usual GP, rather than encourage fragmented or single-condition models of care.
We have also called for clear safeguards around the proposed use of treatment instructions. A treatment instruction should not automatically transfer prescribing responsibility: the receiving practitioner must agree, have access to current clinical information and retain independent clinical judgement.
The Government should also be realistic about the scale and timing of the reforms. Training 150 GPs from September will not create immediate or universal access to GP-led ADHD care. The changes should be carefully evaluated, including their effects on access, patient outcomes, continuity of care, practice workload, and viability.
Urgent care services: AMA Victoria seeks clarity and member feedback
AMA Victoria has raised member concerns with the Department of Health about nurse practitioner-led urgent care services treating patients with undifferentiated illness or injury with limited or no embedded medical oversight.
Members raised the potential for serious conditions to be missed, increased investigation and onward referral, and uncertainty about the clinical governance, medical oversight and escalation arrangements in place.
These concerns relate to the model of care, not to nurse practitioners themselves, who are valued colleagues. The question is whether these services provide sufficient medical support for patients presenting with undifferentiated conditions.
Our discussions with the Department also highlighted that "urgent care" encompasses several quite different service models. These include GP-led Medicare Urgent Care Clinics, the remaining state-funded urgent care clinics that will transition to Commonwealth funding, rural and regional Urgent Care Centres, and urgent care services provided through community hospitals or community health services. These models vary in their staffing, capability, funding arrangements and integration with the broader health system.
The Department has undertaken to respond to the concerns raised and provide further information about the urgent care models operating across Victoria. AMA Victoria has also called for a clear public explanation of the different services available, the types of presentations they are intended to manage, and the clinical governance, medical oversight and escalation arrangements that support them.
We would welcome hearing from members who have encountered similar issues with nurse practitioner-led urgent care services, particularly where medical oversight or escalation pathways appear limited or unclear. Please contact Principal Policy Adviser Lewis Horton at [email protected].