For most of us working in chronic pain the barriers to quality, community-based care are all too familiar. The shortage of health professionals with chronic pain training, the wait times at specialist pain services, the distances faced by those in regional and rural areas – it all spells bad news. Have you ever wondered when something will be done? Well, our primary health care system is under review RIGHT NOW – and the good news is, we can all be part of the conversation.
OK, so what are these reviews all about?
There are actually two important Commonwealth reviews happening currently, with a third pending:
- Review of Primary Health Care to support patients with complex and chronic illness and the treatment of mental health conditions,
- Medicare Benefits Schedule Review, and
- Review of Private Health Insurance Funding.
These reviews have enormous potential for some really big changes to our health care system. Just imagine a world where people with chronic pain and associated mental health concerns were managed well; where they’re identified early (around three months post-injury) and linked with a local health care provider via an established local treatment pathway.
Ideally, this would be a GP with the appropriate training, who could take responsibility for managing the patient’s care; starting with a Treatment Plan developed in conjunction with local allied health providers (who also had appropriate training) to identify and address the barriers impacting on recovery.
Imagine those treatment goals being communicated via an online e-health system, using standardised outcome measures and being managed by a dedicated Care Coordinator – such as a Practice Nurse – who could promote self-management by engaging the patient as a partner.
Sound incredible? Well, these are some of the ideas being thrown around in the Primary Health Care Advisory Group (PHCAG) discussion paper released earlier this month.
It all depends on funding though, which is why the concurrent review of Medicare and private health insurance funding is also important. There are currently over 5,500 Medicare codes – and not all of them reflect current best practice. In fact, most were designed for acute conditions, which explains why those at the chronic end often fall through the cracks.
What if there was a Medicare code for chronic pain? What if the providers using it were required to undergo specific training? Could there be a Medicare code for case conferencing? Any one of these ideas would be potentially game changing.
The private health insurance industry also has a stake in these reforms because they have interest in reducing unnecessary hospital admissions. So there is room for innovation in coordinating funding systems, as well as developing new service models to suit different areas.
The PHCAG will be reviewing the literature, identifying innovative service models and holding public information briefings in capital cities around the country. But sometimes the best ideas come from patients and service providers who already know their way around the system – and have a good understanding of the small things that would make a really big difference. This is where you come in.
Don’t miss the online survey (open until Thursday 3 September): http://survey.orcinternational.com/orc/j10262/surveylinkn.asp?job=Au3000136&id=RANDOM)
Want to know more?
Download the discussion paper here: http://www.health.gov.au/internet/main/publishing.nsf/Content/primary-phcag-discussion
A Fact Sheet for service users can be downloaded here: http://www.health.gov.au/internet/main/publishing.nsf/Content/primary-phcag-consumer
Download the National webcast (from the public information briefings) here: http://livestream.ssc.gov.au/health/august2015/
You can hear more from the Innovative Rehab team about these and other service provision issues at our upcoming workshop, Working with Chronic Pain: Laying a Foundation for Rehab and Recovery, 14 & 15 November, 2015. Sign up now!