29 September 2022
WA Primary Health Alliance acknowledges and pays respect to the Traditional Owners and Elders of this country and recognises the significant importance of their cultural heritage, values and beliefs and how these contribute to the positive health and well being of the whole community. Throughout this newsletter, the term 'Aboriginal' is used to refer to Aboriginal and/or Torres Strait Islander people, unless stated otherwise.
Feature Topic - Chronic Disease Management
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Chronic disease is one of the leading causes of illness, disability, and death in Australia. Chronic medical conditions are those that have been, or are likely to be, present for at least 6 months. This includes asthma, cancer, cardiovascular disease, diabetes, kidney disease, musculoskeletal conditions, and stroke. Chronic Disease Management is essential to both improving health outcomes of individuals and containing costs in the health care system. The introduction of a Chronic Disease Management Plan by the practice, can provide an organised approach of care that can assist patients with chronic medical conditions. Chronic Disease Management Plan and Team Care Arrangements are the process of developing a structured approach to a care plan for a patient with complex health needs that require ongoing care. This is achieved by setting patient-centred goals agreed upon by the Health Care Provider and their patient. The aim and focus of a Chronic Disease Management Plan is:
Our practice Primary Care Navigators and Quality Improvement Coaches can assist practices to use their practice data to identify patients in these target groups as well as assistance with developing strategies. For further information and resources to support Chronic Disease Management, please contact us via Practice Assist.
“International primary care responses to the coronavirus disease 2019 (COVID‐19) pandemic have seen the prioritisation of acute and urgent services for people with COVID‐19 as well as seeing many practitioners involved in COVID‐19 vaccination counselling and delivery. This prioritisation has often resulted in partial or complete disruption to chronic disease management (CDM)” (Cited in Medical Journey Australia) General practice is now challenged with re-establishing the coordinated care of patients with chronic conditions and complex care needs. This is a great opportunity to undertake QI activities within your practice. Quality data within the clinical software is paramount to data driven improvement.
If there is a high number of non-active patients it could mean that archiving is not occurring on a regular basis. Archiving non-active patients, allows for the understanding of the practice population including chronic disease “groups”. Resources and information to support archiving activities are available in the Practice Assist Quality Improvement (QI) Toolkit.
Coded diagnoses can maximise visibility of the chronic disease sub-groups within the practice population. Patients with uncoded/free text diagnoses will not be identified in practice data or data searches, as clinical software and 3rd party data analytic tools are unable to “read” free text. Practice software also supports the bulk clean-up of uncoded diagnoses
Plan-Do-Study-Act (PDSAs) is a tool to assist with documenting Quality Improvement activities. The Practice Assist Quality Improvement (QI) Toolkit can assist you in understanding and developing QI activities within your practice. For 1:1 support with Quality Improvement (QI) activities or the development of your practice Quality Improvement Strategy, please contact Practice Assist and one of our QI coaches will be in touch with you.
A new suite of online training modules, Conversations About Weight, is empowering health professionals to play a more central role in supporting their patients to improve health and wellbeing outcomes, including guiding sensitive conversations around weight. Conversations about weight can be challenging for both health professionals and patients alike. Hesitancy among health professionals to discuss weight, along with stigma, shame and other psychological factors often act as barriers to people seeking or getting the support they need. This training focuses on the various aspects of weight management, including causes and support strategies taking the perspective of both patient and health professional. Each module provides insight into the complexity of this topic, to empower health professionals to support patients and guide these sensitive, yet important conversations. Conversations About Weight will support you to:
Developed by Diabetes WA and CPD accredited by the Royal Australian College of General Practitioners, Conversations About Weight includes six modules, approximately one hour per module, with two RACGP CPD points allocated per module. Visit SHAPE get started.
HealthPathways WA has a Telehealth, Guide to MBS Items and a Chronic Disease Management Items pathway, which cover Medicare items for GPs to manage chronic or terminal medical conditions. These pathways can assist GPs in consultation with patients and act as a reference for other health care professionals, if needed. A GP or health professional seeking to refer a patient should see the Chronic Disease Support Services request page for relevant service information. To gain access, you can request a login via the HealthPathways WA Project Site and complete the ‘Request a login’ form, or email the team at health.pathways@wapha.org.au. You can use the search bar, located at the top of the webpage, or the left-hand navigation panel to search for information. To provide feedback email the HealthPathways team at health.pathways@wapha.org.au, or use the “Send Feedback” button at the bottom of each page on the site.
In collaboration with, Armadale Kalamunda Group and WA Primary Health Alliance, East Metropolitan Health Service is developing and piloting a Multimorbidity Management Framework which aims to improve the management of patients with complex chronic medical conditions when transitioning from hospital to primary care. To truly develop patient centred care, the Healthcare To Community team will be facilitating case conferencing from an outpatient setting. This aims to improve the communication between Armadale Health Service and local General practice by providing a multidisciplinary clinical handover of the patient when transitioning from hospital to primary care “Our vision is to provide excellent care by promoting self-management and linkage to the community” This service will be provided through The Healthcare To Community (HC2C) team that provides inpatient and outpatient care coordination. The service is focused on delivering Patient centred, personalised & individualised care to support patients to manage their complex conditions. The benefits to general practice include:
For more information on how your practice can be involved please contact: EMHS, Planning Innovation & Commissioning EMHS.PlanningInnovationCommissioning@health.wa.gov.au
COVID-19 Updates
All sites currently participating in the COVID-19 Vaccine Program will be onboarded for Moderna bivalent 18+ blue/green in three tranches.
WA Primary Health Alliance have now advised you which tranche you will be onboarded in. Please contact Practice Assist if you have not been notified which tranche you are in.
Under the COVID-19 Vaccination Program, the Australian Government Department of Health and Aged Care Taskforce monitors the ordering and distribution of COVID-19 vaccines and consumables across the country. It has come to their attention that some sites consumable orders are disproportionately high compared to the number of vaccine doses ordered. The Taskforce understands that there are many reasons why this may have happened, and no immediate action is required by your practice. However, to ensure your practice isn’t flagged as part of this monitoring program in future, the Taskforce suggests that you:
You are also able to review your ordering history in CVAS under the Orders Tab and review by Order Number for further details. If you have any questions or need assistance in this regard, please contact Practice Assist or the Vaccine Operations Centre on 1800 318 208 or COVID19VaccineOperationsCentre@Health.gov.au
Did you know that WA Primary Health Alliance has access to funding from the Australian Government Department of Health and Aged Care to support COVID-19 vaccination of Vulnerable Populations? This funding is available until 31 December 2022.
We can provide general practices reimbursement to the value of the relevant MBS item number to support non-Medicare patients being vaccinated against COVID-19. Historical vaccination claims will be accepted post 1 September 2021, however initially we would welcome a discussion with any general practice looking to submit a historical reimbursement claim to ensure the remaining applicable doses are administered.
The invoicing process and requirements for reports from practices will be minimal (reports would include: numbers vaccinated, dose interval and any good news stories).
Please contact the Practice Assist team for further information.
General practices can access two COVID booster videos to share on in practice screens and social media channels. Topics covered are who should have a COVID booster, what happens if you don’t get a booster and other commonly asked questions. Produced by WA Primary Health Alliance in collaboration with Tonic Media Network, the videos are narrated by Dr Norman Swan. Download the videos here.
The Australian Government has extended the supply of PPE, treatments, rapid antigen tests and other supplies from the National Medical Stockpile to 31 December 2022.
The PPE ordering process will remain the same, PPE order form available here for all requests for:
COVID-19 PCR testing through the MBS for tests requested by a medical practitioner or nurse practitioner for the clinical management of patients has also been extended through to 31 December 2022.
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GPs and Practice Managers are reminded that from 1 October, patients will need a referral from a GP or other medical practitioner to access PCR testing by private pathology providers.
Public COVID clinics will continue to offer PCR testing without a referral for people who have COVID-like symptoms or are close contacts. COVID clinics are at Joondalup Hospital, PathWest Murdoch drive-through, Rockingham Hospital drive-through and Royal Perth Hospital.
Learn more at www.healthywa.wa.gov.au/COVIDtesting
The Australian Government Department of Health and Australian Technical Advisory Group on Immunisation (ATAGI) have released guidance on myocarditis and pericarditis after COVID-19 vaccines. Learn more.
Immunisation & Cancer Screening Updates
Nationally we have seen a promising level of self-collection uptake amongst eligible patients since it was made available to all women and people with a cervix eligible for cervical screening. To help maintain the continued uptake, please see below some key messages to support you in offering self-collection, including through telehealth consultations in your practices.
Anyone eligible for a Cervical Screening Test under the National Cervical Screening Program (i.e., women and people with a cervix aged 25-74 years who have ever had any sexual contact) can choose to screen either through self-collection of a vaginal sample using a simple swab (unless a co-test is indicated), or clinician-collection of a sample from the cervix using a speculum. The NCSP Clinical Guidelines recommend that all women due for cervical screening in pregnancy may be offered the option to self-collect a vaginal sample for HPV testing. A Cervical Screening Test using a self-collected vaginal sample is as accurate as a clinician-collected sample taken from the cervix during a speculum examination.
Find more information and resources about the National Cervical Screening Program and self-collection at health.gov.au/NCSP
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The PneumoSmart Vaccination Tool has been created using the pneumococcal disease vaccination recommendations in the online Australian Immunisation Handbook, and has been developed to assist GPs, medical specialists and other immunisation providers to comply with them. As pneumococcal disease vaccination recommendations change, the tool will be updated by clinical experts at the Immunisation Coalition. Catch-up pneumococcal immunisations for children less than 5 years of age are complex. Appropriate catch-up vaccines should be offered as recommended:
The tool and further information can be accessed via here
The Commonwealth Department of Health have shared information regarding a backlog of Adult Overdue reminder letters that will begin distribution next week. The volumes include 50+ Indigenous and 70+ Non-Indigenous individuals eligible to receive a letter.
It is expected that these letters will commence being sent on Monday, 19 September 2022.
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Shoulder Injury Related to Vaccine Administration (SIRVA) is a rare complication of suspected incorrect vaccine administration into the shoulder and not into the correct site of the deltoid muscle. Damage to local structures within the shoulder joint can occur, including to ligaments and tendons, as well as a local inflammatory response to the vaccine components. This results in shoulder pain and limited range of movement of the affected limb. Diagnoses include bursitis, tendinitis and rotator cuff tears. Bursitis is the most commonly reported diagnosis on ultrasound. Symptoms are usually immediate and can last for days, months or as long as years. More information on SIVA can be found in the Immunisation Handbook and on the MVEC website
Returning by popular demand, the Department of Health and Aged Care, GPEx and the Jodi Lee Foundation invite GPs, Practice Nurses and their clinics to attend a free 30-minute webinar focusing on the skills and knowledge needed to support patient participation in the National Bowel Cancer Screening Program (NBCSP). Topics covered in the webinar include:
If you missed last week’s webinar on Pertussis, presented by Angela Newbound for the Immunisation Coalition, it is now available to watch on YouTube. Click this link to watch. This webinar provided viewers with an update regarding pertussis epidemiology and current trends in vaccination rates. Low pertussis booster rates in Australian adults impact the epidemiology of the disease. This webinar explores what current literature indicates are the barriers and potential enablers to improving pertussis vaccination rates in Australia, and therefore reducing disease burden and complications.
Important Practice Updates
In preparation for the launch of the WA Department of Health ‘This is Palliative Care’ campaign, health professionals and those involved in end of life and palliative care are encouraged to refresh their skills and knowledge in anticipation of increased discussions with patients. The End of Life and Palliative Care Education and Training Framework has a range of training resources to support health professionals across care settings. Patients can also be referred to healthywa.wa.gov.au/palliativecare or the Palliative Care Helpline 1800 573 299 for more information.
Registrations are open for the 5 October 2022 free webinar “Think Rare, Think Care, Think Together”, a rare disease webinar increasing awareness of health care linked to rare disease in paediatric palliative care. Register to further your understanding about the resources to support patients and their families living with rare disease. This event is run by Palliative Care Australia in collaboration with the Paediatric Palliative Care National Action Plan Project.
A dementia diagnosis can be a complex and challenging time, but Dementia Australia can support GPs and healthcare professionals to support their patients. Just like with other chronic diseases such as heart disease or diabetes, there is information and support that can be provided to people living with dementia, their families and carers, to help them live as well as possible and to navigate challenges and changes. Dementia Australia can help GPs and healthcare professionals support patients by providing access to dementia-specific and evidence-based information and resources. Dementia Australia is a core part of the pathway to services that empower people living with dementia, their families and carers, and can connect patients with life-changing information, support and services. This includes the popular Post Diagnostic Support Program which is for people of all ages, living with all forms of dementia or mild cognitive impairment. To learn more about Dementia Australia, please call the National Dementia Helpline on 1800 100 500. Dementia Australia bridges the gap between diagnosis and early supports, ensuring no one falls between the cracks. The National Dementia Helpline is a free service available 24 hours a day, seven days a week, 365 days a year.
Pride in Health + Wellbeing is excited to offer general practices the opportunity to apply for one of 12 memberships in Pride in Health + Wellbeing, intended to help smaller organisations and general practices provide more LGBTQ inclusive care. These memberships will allow organisations to not only review and upskill on their care for gender and sexuality diverse patients/service users, but also to measure this change through the free annual Health + Wellbeing Equality Index (HWEI) benchmark and surveys. For further information and application form please click here. Closing date for applications is 1 October 2022.
Diabetes WA is partnering with WA Primary Health Alliance, HealthPathways WA and South Metro Health Service to offer their multidisciplinary team of credentialled diabetes educators (CDEs) to support the upcoming ARMED (Annual Review of Metabolism, Endocrinology and Diabetes) education event at Fiona Stanley Hospital on 15 October, 2022.
The ARMED event aims to provide GPs with current, evidence-based information and interactive, practical demonstrations on clinical topics related to diabetes and endocrine disorders. The opportunity for forum discussion will be held on topical aspects of endocrine care with a panel of expert speakers from medical, allied health and scientific fields. This event is pending approval of 40 CPD Accredited Activity points through RACGP, applicable for in-person attendance.
Diabetes WA’s contribution to the ARMED event will also encompass enhanced awareness and education on how the National Diabetes Services Scheme (NDSS) in WA provides allied health professionals and patients living with diabetes with free or subsidised access to a multitude of evidence-based, self-management education programs and support services.
Phone 1300 001 880 (Monday-Friday 8:30am - 4:30pm) to speak to a Diabetes WA credential diabetes educator CDEs or email info@diabeteswa.com.au
Reference: Government of Western Australia; South Metropolitan Health Services. (2022). ARMED 2022 Annual Review of Metabolism, Endocrinology & Diabetes. Dr Greg Ong, Fiona Stanley Hospital.
Researchers from Macquarie University are interested in understanding what people believe causes psychological disorders. They are asking practices to help them with this research by completing their online survey. In this survey, you will be asked some simple questions about yourself and invited to share your opinions about the causes of psychological disorders. If you would like to participate, please click this link If you would like to know more at any point during the study, you are welcome to contact Dr Amelia Scott (amelia.scott@mq.edu.au, 02 9850 8602).
Do you want to have a voice in how South Metropolitan Health Service (SMHS) delivers healthcare? In October, they will launch an online platform that will make it easier to capture the views and thoughts of the community, and you are invited to join.
View the flyer here for more information.
Practice Assist Tool Kit
These resources are a compilation of fact sheets, user guides, checklists, business plans and posters. They can be found in the Tool Kit pages on our website. In addition to this there are a small number of resources available in our Resource Library.
If you have an idea for a new resource or feedback on our current resources, please email practiceassist@wapha.org.au with ideas and comments.
Education & Events
An estimated 2 million Australians live with a rare or undiagnosed disease. In WA, it is estimated that 63, 000 children are affected by a rare disease and every full time GP has at least 70 patients with a rare disease on their books. Rare diseases, like many other chronic diseases, are often serious and progressive. However, due to the individual rarity of their disease, people living with rare disease worldwide face distinct challenges related to diagnostic delay, lack of care coordination, stigmatisation. Topics covered include:
The ARMED series is a multi-format educational event held annually providing general practice with updates and reviews in clinical topics related to endocrine disorders, including diabetes. Join us for an interactive day featuring practical demonstrations and a forum for discussion and debate on topical aspects of endocrine care. For the 2022 event, we will focus on Assessment and Interpretation: Order from Chaos in Endocrine and Diabetes Care.
Topics include:
View the flyer here Register here
Registrations are essential as participant numbers will be capped. This activity is pending approval of 40 CPD Accredited Activity (formerly Category 1 QI&CPD) points through RACGP.
The WA Department of Health has released a new and improved Advance Health Directive (AHD) for use in WA.
The Royal Australian College of General Practitioners (RACGP) is hosting a number of free webinars throughout September and October 2022. These webinars are part of the Improving the sustainability of your practice series, which is proudly supported by CommBank Health. The following webinars are being held as part of the series:
Registrations for all webinars are now open and CPD points are available.
Imagined Futures Alliance Against Depression (IFAAD) is preparing to host their second GP Dinner Workshop for 2022. Building upon the success of the first event, this one will be held in a larger venue, to accommodate the increased number of GP’s anticipated to attend. Guest speaker Dr Mat Coleman (Psychiatrist) will aim to improve GP’s knowledge of recommended approaches to treating depression in young people. The event will also provide an opportunity for GPs to connect with local mental health service providers and learn about referral options. The event is limited to GPs and mental health professionals servicing the Local Government areas of Cockburn, Fremantle and Melville. This event is just one of IFAAD’s community-based activities that align to the Alliance Against Depression framework, informed by the evidence-based European Alliance Against Depression. To reserve a place at this workshop, please contact Imagined Futures Alliance Against Depression by email at Ifaad@stpats.com.au
Complexities in working with co-occurring mental health and alcohol and other drug presentations Presented by Mental Health Professionals Netowrk (MHPN) 4 October
Advanced Training in Suicide Prevention - Online Workshop Presented by Black Dog Institute Multiple dates
Hepatitis B in Primary Care Presented by ASHM 24 November
Ear Wax Removal (Irrigation) Presented by The Benchmarque Group Pty Limited 29 November
Course in Ear Wax Removal (Microsuction) Presented by The Benchmarque Group Pty Limited 30 November