HealthCert Blog

Important coronavirus (COVID-19) update for GPs from Professor Michael Kidd, Deputy Chief Medical Officer, Department of Health

We have seen a reduction in the daily number of reports of new COVID-19 infections and, while this is encouraging news, we all realise there are no grounds for complacency. Please urge all your patients to remain vigilant and continue to practise the recommended hygiene practices and social distancing measures, especially over the Easter weekend.

I also take this opportunity to encourage you to reach out to your vulnerable patients with chronic illness and mental health concerns, many of whom may have stopped receiving their regular checkups with you. This is not the time for our patients to neglect their general health conditions. The expansion of telehealth items is an important way to ensure our patients continue to receive consultations and treatment via phone or video consultation and, when this is not appropriate, we encourage face-to-face consultations to continue with the appropriate precautionary measures.

My sincere thanks to you all for everything you are doing in these challenging times, and please – look after yourselves and each other as well.

Professor Michael Kidd AM
Deputy Chief Medical Officer & Principal Medical Advisor

1. Update on bulk billing

From 6 April 2020, it is a legislative requirement that the new telehealth services be bulk billed for Commonwealth concession card holders, children under 16 years old and patients who are more vulnerable to COVID-19 – that is, a person who:

• is required to self-isolate or self-quarantine in accordance with guidance issued by the Australian Health Protection Principal Committee in relation to COVID-19; or
• is at least 70 years old; or
• if the person identifies as being of Aboriginal or Torres Strait Islander descent – is at least 50 years old; or
• is pregnant; or
• is the parent of a child aged under 12 months; or
• is being treated for a chronic health condition; or
• is immune compromised; or
• meets the current national triage protocol criteria for suspected COVID-19 infection.

Health providers may apply their usual billing practices to the telehealth items for patients who do not fit the above criteria. We do encourage you to continue to show discretion to patients who are financially impacted during this challenging time, as we know you will.

Doctors, nurses and mental health professionals can deliver bulk billed services via telehealth until 30 September 2020 via phone or video conferencing.

Key information links for GPs:

• All new MBS Items (tables on the MBS Online news page)
• COVID-19 Temporary Telehealth Services – all fact sheets
• Regulations for the BBI fee increase on the Federal Register of Legislation

2. Point-of-care serology testing (antibody strips)

There has been a lot of recent interest in the point-of-care serology tests. It is important to note that as with all serology tests, the results are not useful in the acute phase of infection.

A positive serology test after a week of symptoms could indicate either COVID-19 OR previous exposure to another coronavirus that causes the common cold. A negative test after a week of respiratory symptoms may be reassuring that the illness is not COVID-19, but the patient may require further investigation.

While research is being done to validate the performance of serology tests and to provide clear guidance on interpretation of results and use, we advise against the general use of these tests in primary care.

Download infographic here

3. Free NBN upgrade for GP clinics

In response to the rapid expansion of telehealth services, NBN Co announced this week it is upgrading Australian GP clinics to 50Mbps download and 20Mbps upload connections at no extra cost for a period of six months. The provision of high speed broadband will allow practices around the country to deliver multiple telehealth consultations simultaneously and ensure your patients receive the care and treatment they need at this crucial time. To access the upgrade, contact your internet provider. Read more

4. Australian Clinical Evidence Resources announced 

The Australian Government is investing $1.5 million to support guidance for clinicians to ensure they are given the best possible advice on managing COVID-19 patients.

The National COVID-19 Clinical Evidence taskforce includes a large coalition of peak health professional bodies. The taskforce will analyse emerging national and international research and data on COVID-19 to provide frontline health care workers with the most up-to-date information and advice on the disease. Read more

5. Electronic prescribing

As part of the National Health Plan, electronic prescribing has been fast tracked. Work to upgrade healthcare providers’ clinical software is under way and is expected to be ready by May 2020. Read more

In the meantime here are some useful resources to share with your networks, providing information on issues such as PBS claiming arrangements, supply of medicine to patients, signing for receipts of a prescription, repeats and existing prescriptions.

• Fact sheet for prescribers
• Fact sheet for pharmacists
• Fact sheet for patients 

6. Looking after yourselves and one another

As the days since the pandemic was declared stretch on, and as our case load increases, as our isolation and physical distancing requirements ramp up – we know that there is another aspect of this virus that will start to take its toll; and that is on our mental wellbeing.

I know the challenges we are facing each day are complex; in addition to the COVID-19 illness itself, we are needing to adapt our treatment methods, we have our practices and staff to keep running, we have families to support – and I know there are many of you who have had to isolate away from your families to keep them safe from infection. I implore you all to, please, look after yourselves.

Find a moment in every day to do something that helps you to be you – connecting with friends or family, getting out for a run or a walk, reading a book, even just switching off from the emails and the relentless news cycles. Support is available if you feel like you may not be doing ok.

The Australian Government is working to establish a dedicated mental wellbeing platform for health care workers and I will keep you updated on that. In the meantime, a great place to start is the Government’s Head to Health website – headtohealth.gov.au – you can find a range of resources, some great tips and ways to connect if you feel like you might want to chat to someone.

And please do keep speaking with one another, checking in on each other and remember that it’s ok to not be doing ok. We are in this together and we are here for one another.

Here are some resources you and those around you may find helpful:

• Beyond Blue has launched its dedicated Coronavirus mental wellbeing support service, which includes a range of resources and a dedicated phone counselling service
• As the economic impacts of Coronavirus and physical distancing requirements start to become more widespread, this Heads Up page about mental health at work is a valuable resource, and is something many of us may find helpful in navigating the challenges we’re experiencing as small business owners, managers and employees.
• Phoenix Australia has released a range of Coronavirus resources, for health practitioners, workplaces and members of the community.

If you need to talk, these free support lines are here to listen 24/7:

Lifeline: 13 11 14
Beyond Blue: 1300 22 4636
Kids Helpline: 1800 55 1800

7. Addressing institutional racism early

The Department has been made aware of concerning information around racist comments and attitudes towards Aboriginal and Torres Strait Islander peoples as they seek COVID-19 related health care. It is disappointing to have to remind some of our colleagues that racism is never okay, let alone in a time when we do not want anyone to be dis-incentivised from seeking health care.

Aboriginal and Torres Strait Islander Australians over the age of 50 and those with chronic conditions are considered to be among the group of Australians most at risk of serious illness from COVID-19. Asking a patient if they identify as Aboriginal and/or Torres Strait Islander is an appropriate question and important to record as you are testing and treating patients for COVID-19. It is not appropriate however, to question an individual’s answer.

As this pandemic evolves, a person’s usual place of health care may be at capacity and not able to provide COVID-19 related care. It will become everyone in the health system’s responsibility to ensure Aboriginal and Torres Strait Islander patients feel comfortable, supported and able to access care. This responsibility lies with everyone, from health reception staff to doctors, nurses and allied health workers. Together we can contribute to the cultural safety of the health system.

The Royal Australian College of General Practitioners has resources available to ensure cultural safety for Aboriginal and Torres Strait Islander people, available here.

8. Journal articles and resources of interest

The University of Oxford’s COVID-19 resource continues to provide evidence-based answers to common questions which arise in general practice. Here are three questions around the ways patients might present in primary care.

1. In patients with COVID-19, what are the symptoms and clinical features of mild and moderate cases? Answer here.
2. What is the evidence for anosmia (loss of smell) as a clinical feature of COVID-19? Answer here.
3. What signs and symptoms are most commonly reported? Check out the COVID-19 Signs and Symptoms Tracker here.

Original source: https://mailchi.mp/health.gov.au/covid-19-update-for-gps-from-the-chief-medical-officer-xxxxxx-4389555?e=83862cc2c1

See last week’s update from Professor Michael Kidd here.

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