Resourcing, not medication restrictions, needed in aged care

Thanks to Dr Michael Clements and NewsGP from the RACGP for highlighting the needs for aged care 👍🏼

Dr Michael Clements


9/12/2019 3:14:11 PM

The Government’s recent funding injection has to be specifically targeted to address the problems GPs, staff and patients face within residential aged care facilities, Dr Michael Clements writes.

Aged care
Dr Michael Clements believes that while aged care requires a significant funding boost, it will only be helpful if it is specifically targeted to the sector’s needs.

‘Mrs X was found wandering at night in the carpark, can you please prescribe medication?’
 
This was how one recent residential aged care facility (RACF) interaction began for me.
 
After meeting with the staff and ruling out delirium or biochemical causes, and noting a worsening in the behavioural aspects of dementia, I suggested the patient move to the restricted ward or have extra supervision.
 
But my request was declined due to lack of beds and I was specifically asked, once again, to commence a medication to prevent the patient from wandering.
 
The situation was clear: under-staffing in this facility led to pressure to prescribe sedative medications that would keep the patient compliant and allow staff to attend to other residents.
 
Provision of care within RACFs has become more complex and time-consuming as the population ages and rates of dementia rise. Unfortunately, funding models have not kept pace, even as clinical governance requirements in RACFs have increased and nurse autonomy reduced.
 
This has led to a situation for many GPs who work within RACFs in which countless night-time phone calls, form-signing, box-ticking and compliance measures now form the largest part of their care. It has also led to an overreliance on anti-psychotic medications for the behavioural aspects of dementia, as understaffed facilities come under pressure to medicate their problems away.
 
GPs have been looking forward to the Royal Commission into Aged Care, Quality and Safety because they, along with RACF staff, have seen cost-cutting measures applied in facilities, with reductions in numbers of trained staff, greater reliance on lower-skilled assistants, and decreased activities and programs.
 
Staff across the aged care sector want to see better diversionary activities and care services, nursing numbers, and funding to allow GPs to spend more time with patients and their families. This is felt most acutely in rural and regional areas, which are already experiencing aged care staff and GP workforce shortages.
 
The Federal Government has suggested high prescriptions of anti-psychotic medications in RACFs is a source of the problem, rather than an indicator of a system that is under-resourced to deal with the complex issues of dementia care.
 
However, the latest promise of extra funding from the Federal Government does nothing to address the reasons behind the increased use of anti-psychotic medications for the behavioural aspects of dementia; it is simply ‘shooting the canary’ and will have no impact on the gas leak in the coalmine the canary has been screaming about for the last five years.
 
What RACFs need instead is funding targeted towards sufficient numbers of appropriately trained nursing staff, for GPs to provide comprehensive team-based care, and for tertiary services to get out of hospital grounds and into RACFs to work with GPs.
 
Novel solutions are required to the problems faced in residential aged care, and each facility will need to find one that reflects their community workforce and need.
 
But some general steps that will be helpful across the board include:

  • additional money injected into the system from federal and state health budgets
  • patients getting used to private fees for GP services
  • nurses and nurse practitioners being allowed to practice at their full scope
  • GP-led rather than GP-delivered care being utilised where possible.

The message should be clear: fund RACFs and GPs in order to enable them to provide the care that is so desperately needed.

Do not shoot the canary.

© 2018 The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807

PartridgeGP and Dr Nick Tellis are doing our best for better aged care in many of our local aged care facilities. We will do more in 2020! Watch this space 👍🏼

Emergency thoughts from PartridgeGP

 

Thoughts on our Emergency Departments

 

Introduction by Croakey: Emergency departments are often thought of as the canary in the coalmine, but what do we do when the canary is clearly in distress?

Dr Simon Judkins, President of the Australasian College for Emergency Medicine (ACEM), started a much-needed conversation about Australia’s overburdened emergency departments back in September with a post to coincide with national RUOK Day.

In response, an anonymous emergency clinician penned this searing, heartfelt account of the very real pressures ED workers face every day. If you haven’t yet read it, we’d very much encourage you to do so.

While only one person’s story, it resonated with and captured the experience of many, reflecting a system underresourced and overwhelmed, according to Judkins, who wrote an open letter in reply — below — calling for courageous reform.


Simon Judkins writes:

Dear Anonymous,

You are not anonymous to me; I know you.

 

Read on…

 

Meet
Treat
Street

 

You don’t need to meet them if they are being dealt with in primary care and have better access to non GP specialist outpatients

 

You treat them better with specialist oversight and so FACEMS 24/7 should be funded to provide that

 

You can’t street them unless you have access to inpatient beds (better use of inpatient beds – yes, care awaiting placement and inappropriate admissions are still things) and better clinical handover to primary care GPs will reduce bounce back and improve patient care

 

The funding model needs to reflect this
Because hospital EDs are a volume model at the moment for funding so there really isn’t the institutional drive to reduce demand

 

A recurring thought at GP19 was the embedding of GPwSI in non GP specialist hospital areas to improve these areas – works in Queensland but I think SA have spent all the $ on bricks and mortar.

 

GPs can help!

 

For patients – book in here to see Your GP at PartridgeGP

 

 

 

 

And for other doctors – including our great colleagues in hospitals and their Emergency Departments…we can help too! Clinical Handover is awesome – we can all do better!

 

gpdu clinical handover

 

GPDU Clinical Handover infographic – final for dissemination

 

 

Secrets Healthy Men know with PartridgeGP and Coles

Tim Ferriss asked a question in his book Tribe of Mentors.

 

 

‘If you could put a message on a billboard, to be seen by millions (or billions) of people, what would you say?’

 

 

I was lucky enough to have an opportunity to answer this in real life when a journalist from Coles contacted me. They wanted to know a GPs views on Men’s Health. The article we produced is here (and reproduced below). This is in the Coles Health and Beauty magazine – they have printed 500,000 copies of this! What was that one message I wanted to get across?

 

 

dr nick tellis coles health and beauty the money quote
The Message!

 

 

 

 

Our practice, PartridgeGP, our GPs, and the rest of our team are here for you. No billboards needed – just book in for an appointment 😎

 

 

 

 

 

 

 

 

 

 

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The Road to being a GP with PartridgeGP

Just check out this picture of what someone goes through to become a GP. Wow!

(thanks to Dr Jared Dart for finding this)

 

 

How do doctors get to be doctors.jpg

 

 

 

 

 

 

PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

 

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Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

 

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Some of our recent GP registrars

Dr Katherine Astill

Dr Clare Mackillop

 

 

 

 

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Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Katherine Astill back to PartridgeGP

Dr Katherine Astill Partridge Street General Practice new female registrar

 

 

Dr Katherine Astill commenced her specialist General Practice training with PartridgeGP in August 2017 and has returned to work with us at our new site in August 2019! She graduated with a Bachelor of Physiotherapy from the University of South Australia in 2009 and furthered her education with a Bachelor of Medicine and Surgery from Deakin University in 2013. After holding positions with the Muscular Dystrophy Association and the Women’s and Children’s Hospital, she decided to specialise in General Practice, with a special interest in Women’s and Children’s Health completing her Diploma of Child Health in 2016.

Dr Katherine has a passion for holistic care and preventative health.

 

 

 

She loves the local Glenelg area and is keen to hit the ground running with the rest of our Great Team here at PartridgeGP!

 

 

 

 

 

 

 

 

PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

 

img_1954
Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Dr Katherine Astill is a valuable member of our growing Clinical Team!

 

 

 

 

IMG_20190404_191100

 

 

 

 

Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Nici Williams to PartridgeGP

PartridgeGP is proud to welcome Dr Nici Williams to our team!

 

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Born in South Africa, Dr Nici graduated from the University of New South Wales in 2010. She has worked in Indigenous Communities in Cairns, and spent two years on Thursday Island in the Torres Straits where she obtained her Fellowship of the RACGP as well as Fellowship in Advanced Rural General Practice. Following a further year practicing medicine in rural NSW, she and her family relocated permanently to Adelaide in 2018.

Dr Nici also works at the Refugee Health Service, and other interests include dermatology, contraception (including Implanon) and optimising health. She is accredited for Obstetric Shared Care in SA.

 

 

We welcome Dr Nici to Our Team here at PartridgeGP to be Your GP!

 

 

She is available to help you with all of your General Practice needs from mid April 2019 and you can book your appointment with her conveniently online right here – or call our friendly reception team on 0882953200.

 

 

Dr Nici Williams - your gp

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

 

 

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

IMG_20190321_202633

 

DR PENNY MASSY-WESTROPP

dr penny massy westropp - your gp

DR MONIKA MOY

dr monika moy- your gp

DR JEN BECKER

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DR DAVID HOOPER

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Casual Receptionist Position at PartridgeGP

Professional

 

Comprehensive

 

Empowering

 

Great General Practice Care

 

Better for our patients, our staff and GPs, and our practice – that’s the PartridgeGP way 👍🏼

 

Find out more here

http://ow.ly/w3uf50uLZ6w

#glenelggp #glenelgsouth #glenelgriver #glenelgnorth #jettyrdglenelg #glenelgbeach #glenelgcountry #glenelgsa #glenelgjetty #glenelgin #glenelg #PartridgeGP #MedicalPractice #Glenelg #AdelaideGP #justagp #generalpractice #medicalcentre #health #wellness #primarycare #better #medical #amazingopportunity #receptionist #joinourteam

What the Medicare Freeze Lift Actually Means For Medical Centres and GPs – HotDoc

PartridgeGP provides comprehensive, professional, and empowering General Practice care. It’s great…and it’s not free.

 

 

 

 

Please feel free to contact your MP if you think Your Medicare Rebate should increase 👍🏼

 

https://www.hotdoc.com.au/practices/blog/medicare-freeze-lift-2019/

 

More reading: http://bit.ly/2SHA5BB

 

You can book and experience PartridgeGP for yourself here: http://bit.ly/2XmM0n5