Practice Connect #123

23 July 2021

Welcome to Practice Connect, a fortnightly update for practice managers, nurses and practice administration staff on relevant issues, upcoming events and education.
 

Due to limited uptake of the downloadable PDF, Practice Connect will now be provided in a streamlined online format only.

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COVID-19 Vaccine Rollout: Ways your practice can assist

If your practice is not taking part in the COVID-19 Vaccine Rollout

There is still an opportunity for general practices to join the Commonwealth COVID-19 Vaccine Rollout.

All general practices not currently taking part in the COVID-19 Vaccine Rollout that would like to join are asked to email practiceassist@wapha.org.au

If your practice is taking part in the COVID-19 Vaccine Rollout and is waiting to be given an allocation of the Pfizer (Comirnaty) vaccine there are a number of things to do to get ready:

1. Read the Pfizer (Comirnaty) Information pack – this is in addition to the Onboarding Pack and contains vital information about administering the Pfizer (Comirnaty) vaccine.
2. Complete the Pfizer training module
3. Engage with your booking system provider to ensure that patients can book the appropriate vaccine for their eligibility.

Provider Bulletin from the Department of Health - 22 July 2021

The Australian Department of Health has issued its latest Provider Bulletin (22 July) for COVID-19 vaccination providers. The Bulletin includes information on groups prioritised for vaccination including residential aged care staff, people aged over 70 and pregnant women.


 

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COVID-19 Vaccine Pfizer (Comirnaty) for pregnant women

Pregnant women 16 years and older are eligible and should be prioritised to receive the Pfizer (Comirnaty) COVID-19 vaccine.

The Commonwealth has advised that the Vaccine Eligibility Checker will be updated to reflect this change.

Providers can take appointments through their preferred booking method.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has more information on this cohort in relation to COVID-19 vaccines.

 

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MBS support for people affected by COVID-19

From 16 July 2021, the Government is implementing longer general practice telephone services to provide an increased Medicare benefit for patients who are located in an area declared as a COVID-19 hotspot by the Commonwealth Chief Medical Officer or are subject to a public health order that requires the person to be in isolation or quarantine. The list of hotspots declared by the Chief Medical Officer is currently available here.
 
Two new items numbers 92746 for GP’s and 92747 for other medical practitioners allow for longer telephone consultations for people who are:

• in a COVID-19 Commonwealth declared hotspot; or
• in COVID-19 isolation because of a State or Territory public health order; or
• in COVID-19 quarantine because of a State or Territory public health order

 
For more information see the MBS factsheet.

MBS XML files.

The updated July 2021 Medicare Benefits Schedule (MBS) files, including an updated XML file, are available here.


 

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Aboriginal and Torres Strait Islanders are eligible for the Pfizer (Comirnaty) vaccine from 16 years of age

Aboriginal and Torres Strait Islander people are eligible for the Pfizer (Comirnaty) vaccine once they turn 16.

The Commonwealth guidance advises that self-identification as an Aboriginal and/or Torres Strait Islander person (remember to ask the question) is the only proof needed for this cohort.

The Australian Department of Health has a number of Aboriginal and Torres Strait Islander resources available for vaccine providers to use in their clinics.
 

 

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Electronic prescriptions making telehealth easier

Patients facing COVID-19 social distancing requirements or other barriers to attending face-to face GP appointments can be provided with easier access to their essential medicines through an electronic prescription.
 
The Australian Digital Health Agency reports more than 12 million electronic prescriptions have already been issued in Australia and at least 98% of all community pharmacies around the country are dispensing them.
 
In addition to the standard paper based prescription forms, changes to the National Health (Pharmaceutical Benefits) Regulations 2017 allow prescribers to provide electronic prescriptions in one of two ways:

1. Write prescriptions electronically – prescribers will need to update clinical information system to do this and check that the patient’s pharmacy is ready. Read about setting up electronic prescribing, or you can contact your software provider directly.  
2. Send an image (photo or scan) of a paper prescription (until 30 September 2021). This does not apply to medicines in Schedule 8 and Schedule 4 Appendix D in the Poisons Standard. These are to be supplied under normal prescribing and dispensing rules, unless specifically permitted under state or territory arrangements. 

 
Electronic prescriptions can be sent straight to a patient’s mobile phone or email. Patients can then conveniently on-send to their local pharmacy or consumer medication management app.
 
Find more information in the ‘Electronic Prescribing HealthPathway, digitalhealth.gov.au or contact the WA Primary Health Alliance Digital Health Team

 

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COVID-19 Vaccination Training Modules Updated

Updates have occurred in the COVID-19 vaccination training program on Friday 23 July. Module progress and completion have not been affected.

You are expected to login and view the new information. A summary of the updates can be found in the announcement forum. All changes within the modules are identified by 'NEW' in red.

You can log-in to the training modules here.

 

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Upcoming Webinar: Mandatory COVID-19 vaccination

Vaccination against COVID-19 is the main tool for bringing the world out of the COVID-19 pandemic. Mandatory vaccination has been debated as a strategy to get high vaccination coverage and protect individuals in certain settings. Collaboration on Social Science and Immunisation (COSSI) Group will be presenting a webinar on this topic. This webinar will consider the policy, behavioural, ethical and epidemiological aspects of mandating COVID-19 vaccination.
 
Date: Monday 26 July 2021
Time: 12:00 pm – 2:00 pm WST

In this webinar: 

• find out what vaccination mandates are, who they may be used for and how they could be delivered
• hear about the governance and political aspects of vaccination mandates
• hear about epidemiological, behavioural and social considerations of mandates, including effectiveness
• hear about ethical considerations of vaccine mandates for adults
• contribute to the discussion about the ethics, politics, and practicalities of mandating vaccination

Register here

 

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Allocation of surgical masks from the National Medical Stockpile

WA Primary Health Alliance has been advised by the Australian Department of Health that the National Medical Stockpile is a strategic reserve and not a general supplier of personal protective equipment (PPE). The Stockpile is only intended to provide PPE where commercial supply is unavailable and there is a demonstrated need or clinical advice for its use.
 
We appreciate that some providers have been accessing the Stockpile regularly until now.

Due to the widespread commercial availability of PPE supply, as per Government advice, WA Primary Health Alliance will request a declaration from your organisation as proof it has been unable to source a commercial supply.
 
WA Primary Health Alliance can only provide PPE where commercial supply is unavailable and requests meet the following criteria:
 

• There is no local supply available commercially.
• The people coming to your practice are more likely to have been exposed to COVID-19.
• Your practice has an unusual number of patients who have respiratory symptoms.

 
WA Primary Health Alliance will provide surgical masks to community pharmacies if they meet both of the criteria below:

• There is no local supply available commercially.
• Staff have significant contact with people who have fever and respiratory symptoms.

 
If you are experiencing difficulties obtaining PPE from a commercial supplier, please email WA Primary Health Alliance via practiceassist@wapha.org.au addressing the above points.

 

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Department of Veterans and their families during COVID-19

The Department of Veterans’ Affairs Provider News has published the following articles: 

• GP Care Coordination Payment expanded - From July 1 2021, GP’s providing care coordination for White Card Holders with accepted mental health conditions will now be able to claim the Coordinated Veterans Care (CVC) payments. The expansion of the  CVC program aims to ensure long term health improvements for this cohort. Read more here.
  • ​ Treating veterans and their families during the Coronavirus pandemic -  information on treating veterans during the COVID-19 pandemic amid new lockdown and restriction measures across the country. Read more here.
• Extension of COVID-19 telehealth arrangements  - Telehealth services and other temporary COVID-19 arrangements for Department of Veterans’ Affairs (DVA) clients have been extended until 31 December 2021. Providers are able to continue delivering telehealth services for general practitioner (GP), allied health, specialist and community nursing services; and hospital-based mental health and rehabilitation day programs until the end of this year. Read more here.
  • ​Extension to Provisional Access to Medical Treatment (PAMT) for veterans  - As part of the commitment to improve veterans’ access to health services, the Government has announced an extension to the Provisional Access to Medical Treatment (PAMT) program. This program enables eligible veterans who are waiting for their claims to be considered by DVA, to receive medical and allied health treatment on a provisional basis for one or more of the 20 most commonly accepted conditions for ex-serving members of the Australian Defence Force. Read more here.

 

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Reminder: National Immunisation Program (NIP) funded zoster vaccination catch-up ends soon

People aged 70- 79 years of age can receive a funded Zostavax® as part of a catch-up program until 31 October 2021. After this date, only 70-year-olds will be eligible for a free Zostavax®. 

The National Immunisation Program schedule lists advice regarding the catch up program.


 

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New ATAGI advice on zoster vaccines in older adults

The Australian Technical Advisory Group on Immunisation (ATAGI) has released a Clinical Statement on the use of Zostavax vaccine and Shingrix vaccine for prevention of herpes zoster, please click here to read about the recommendations.  The Australian Immunisation Handbook is being updated to reflect this information and this advice should be used for clinical guidance in the interim.

Shingrix is registered in Australia but not available on the National Immunisation Program (NIP) at this stage. It will need to be privately prescribed.  

Zostavax is available and funded under the NIP for individuals aged 70 years. A catch-up program for individuals aged 71-79 years of age is available until October 2021.  

 

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Supporting general practice with the implementation of voluntary assisted dying in WA

Voluntary assisted dying is now a choice for eligible Western Australians at the end of their life, and general practice is forefront of supporting patients with end of life care.
 
The Voluntary Assisted Dying Act 2019 (the Act) allows GPs, nurse practitioners and other medical practitioners who meet the eligibility requirements, and who have successfully completed the approved training, to participate in the voluntary assisted dying process. The Act also provides protection from criminal liability for eligible medical practitioners who assist patient access to voluntary assisted dying.
 
The WA Health Voluntary Assisted Dying Implementation Leadership Team has worked hard during the 18-month implementation period to ensure general practice and other care related  sectors are well informed and prepared for implementation. This has involved guiding the development of each of the elements needed to deliver voluntary assisted dying in line with the Act, including:

• Voluntary Assisted Dying Statewide Care Navigator Service
• Voluntary Assisted Dying Statewide Pharmacy Service
• WA Voluntary Assisted Dying Approved Training
• The Voluntary Assisted Dying Board

 
As of 1 July, patients in WA who meet the following eligibility criteria are now able to begin the process to request legal access to medication that will cause their death:

•  Aged 18 years or over
• Australian citizen or permanent resident
• Ordinarily resident in WA for at least 12 months
• Diagnosed with at least one disease, illness or medical condition that:

        - is advanced, progressive and will cause death
        - will, on the balance of probabilities, cause death within a period of six months (or 12 months for neurodegenerative)
        - is causing suffering that cannot be relieved in a manner that the patient considers tolerable
        - has decision-making capacity in relation to voluntary assisted dying (as set out in the Act)
        - is acting voluntarily and without coercion; and
        - has an enduring request for access to voluntary assisted dying.
 
Under the Act, anyone involved in the care of a patient can respond to questions about voluntary assisted dying (if they are comfortable doing so), but only GPs, nurse practitioners and other medical practitioners can initiate a conversation about voluntary assisted dying with the patient. However, they must also at the same time, discuss:

•  Palliative care and treatment options
• The likely outcome of that care and treatment.

 
This differs to the Victorian legislation that prohibits a doctor raising voluntary assisted dying with a patient.
 
Talking about voluntary assisted dying does not begin the process and a formal request for access to voluntary assisted dying must be made (First Request). The First Request must be:

• Clear and unambiguous
• Made to a registered medical practitioner
• Made during a medical consultation
• Made either in person or, where this is not practicable, using audiovisual communication.

 
All GPs, nurse practitioners and other medical practitioners may receive a First Request from a patient but can only accept a First Request from a patient if they:

• Hold specialist registration, have practiced the medical profession for at least one year as the holder of specialist registration, and meet the requirements approved by the Director General of Health (as the CEO); or
• Hold general registration, have practiced the medical profession for at least 10 years as the holder of general registration, and meet the requirements approved by the CEO; or
• Are an overseas-trained specialist who holds limited registration or provisional registration and meets the requirements approved by the CEO.

 
Director General of Health requirements relate to recency and hours of practice, lack of AHPRA notifications and provision of two professional referees.
 
GPs, nurse practitioners and other medical practitioners may refuse to participate for any reason (e.g. holding a conscientious objection to voluntary assisted dying, being ineligible, unwilling or unable). However, all medical practitioners who receive a First Request from a patient must:
 

1. Give the patient the Approved information for a person making a First Request for voluntary assisted dying booklet
2. Decide if they are going to accept or refuse the First Request
3. Inform the patient of their decision
4. Complete and submit the First Request Form to the Voluntary Assisted Dying Board
5. Document key information in the patient’s medical record

 
Participation in the voluntary assisted dying process must, at all times, comply with the Act. The Western Australian Voluntary Assisted Dying Guidelines have been developed by WA Health to support compliance with the Act by assisting health professionals to understand the Act and their roles and responsibilities in the voluntary assisted dying process.
 
A suite of further information is available for general practice and patients on the WA Health website, and there is a “Voluntary Assisted Dying (VAD)” HealthPathway.
 
WA Primary Health Alliance will continue to work with general practice and other professionals across the health industry and related care sectors, to make sure we all understand our obligations and responsibilities under the WA Voluntary Assisted Dying legislation.

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New Guides to support people to manage their diabetes in hospital

The Diabetes Health Network’s Integrated Care Working Group and Lived Experience Working Group have collaborated on the development of two new guides that support people to manage their own insulin while in hospital.

• For hospitals – Self-management of diabetes in WA hospitals: A suggested approach – you can find it on the Diabetes Health Network website under “Models of care and resources”
• For consumers – Consumer information guide: Managing your diabetes needs while in hospital – you can find it on Diabetes page on the HealthyWA website under “How can diabetes be managed?”

The guides support a collaborative partnership between people with diabetes and their hospital care team that focusses on joint decision making and establishing a formal agreement which all parties can follow. They have been developed in consultation with the WA Medical Safety Collaborative and are dedicated to Nancy McKenna and her lifelong advocacy of people’s rights to safely manage their own diabetes in hospital.

 

Services Australia website for more information on how to register patients for the CTG PBS Co-payment.
 
The Australian Government Department of Health has also developed factsheets for health professionals or Aboriginal patients.