‘Devastating’ impact on practice nurse workforce
Recent advice from the Department of Human Services (DHS) that practice nurse time does not count in Medicare Benefits Schedule (MBS) Health Assessment items undermines team-based primary health care arrangements.
The claim comes from Associate Professor Brain Owler, associate president of the Australian Medical Association (AMA).
DHS has advised that MBS Health Assessment items will no longer cover the time spent by practice nurses contributing to the health assessment. The items will now only cover the time spent by the supervising medical practitioner with the patient.
Associate Professor Owler says the advice is at odds with the government’s stated objective of making the best use of the health workforce.
“This unclear advice will have a devastating impact on the practice nurse workforce,” he said.
“The existing arrangements are based on advice given by the Department of Social Services that the time spent by nurses could be added to the time taken by the doctor. These arrangements allow a cooperative approach between doctors and supervised practice nurses.”
When the Practice Nurse Incentive Program replaced the Practice Nurse items in the MBS, there was no advice that the Health Assessment items would be affected, claims Associate Professor Owler.
“The system has been working very well for patients and the stretched resources of medical practices.”
The people in greatest need of regular health assessments are the elderly, children, and the disabled – patients who need more medical care, according to Associate Professor Owler.
“Practice nurses provide important work conducting visits to residential aged care facilities and visits to elderly still living at home, and they are key to assessments for four-year age checks. This vital service delivery model is now under threat.
“Not only will it make it more difficult for busy general practitioners to look after their most needy patients, it will potentially threaten the job security of practice nurses in general practice.
“Many general practices have hired practice nurses specifically to assist with health assessments.”
According to Associate Professor Owler, the use of practice nurses to complete elements of the health assessment, under the supervision of the doctor, and with the doctor attending the patient for part of the service, is efficient and acceptable practice.
“These constant changes to advice – and poor communication with practices – are making it difficult to navigate the unclear MBS requirements.”
AMA now urges the government and DHS to urgently reinstate the former arrangements.
