Keep scrolling to read more articles
FSH Virtual Immunology Clinic now accepting referrals for patients in SMHS catchment
The Virtual Immunology Clinic – GP (VIC-GP) at Fiona Stanley Hospital bypasses the standard referral pathway and associated wait times and enables general practitioners to refer patients to an immunologist in real time via an online portal.
Via a secure telehealth consultation, an immunology specialist can discuss appropriate management advice with the patient and their GP in real time. This allows review and an ongoing management plan to be formulated by the consultant and GP in the presence of the patient and supports the GP to manage their patient’s care.
Referring GPs must first register and sign in to the SMHS Online Services Portal before they can directly refer patients to VIC-GP.
More information is available here
Diversion of NMHS Gastroenterology Elective Surgery Wait List cases to EMHS
To manage the increased demand for diagnostic endoscopy within the North Metropolitan Health Service (NMHS), an agreement has been made between East Metropolitan Health Service (EMHS) and NMHS for redirection of referrals for specific endoscopy procedures.
This will include all referrals for flexible sigmoidoscopy, diagnostic gastroscopy, diagnostic colonoscopy, and both diagnostic gastroscopy and colonoscopy to be redirected to either Kalamunda or Armadale Hospital. This will concern the following NMHS postcodes 6005, 6006, 6007, 6008, 6016, 6017, 6050, 6059, 6060, 6061, 6062, 6066, and 6090.
The diversion commenced 6 February 2023 and is currently scheduled to conclude on 30 June 2023. Referrals should continue to be sent via the Central Referral Service, using the Referring to Direct Access Endoscopy Services referral form.
TGA medicine shortages
There are ongoing medication shortages in Australia, including of some commonly prescribed antibiotics. TGA advice is that prescribers should continue to follow best-practice prescribing guidelines and not switch to second-line antibiotics without strong clinical indications to do so.
There are Serious Scarcity Substitution Instrument (SSSIs) in place for both amoxicillin and cefalexin that allow pharmacists to supply alternative amoxicillin or cefalexin medicines (including different brands, strengths, or formulations) according to the established substitution protocol in the instrument.
Further information for prescribers and patients can be found on the TGA Medicine Shortage Alerts page
TGA advice on avoiding pregabalin in pregnancy
The TGA is advising prescribers to avoid prescribing pregabalin in pregnancy if possible.
This advice is based on a recent study showing an increased risk of major congenital malformations among babies exposed to pregabalin in utero. The pregnancy category for pregabalin has been changed from B3 to D in Australia. The TGA advice is that women should use effective contraception if using pregabalin, and that it ought not be prescribed in pregnancy unless the benefits clearly outweigh the risks.
Local information about prescribing in pregnancy can be accessed through the KEMH Obstetric Medicines Information Service (details on the Drug Information and Advice HealthPathway).
Sign up to receive TGA Health Professional Updates here.
New AJGP paper presents practical approach for engaging patients with AOD related issues
n the March Australian Journal of General Practice (AJGP), Alcohol and Other Drugs (AOD) GP medical education team Dr Shani Macaulay, Dr Paul Grinzi and Dr Simon Slota-Kan, published a clinical peer-reviewed article, ‘Engaging patients who use alcohol and other drugs: A practical approach’.
The paper builds on the RACGP’s AOD GP Education Program, delivered between 2020–22 and funded by the Department of Health and Aged Care. A library of legacy resources are still available on the RACGP website
Palliative care resources for health professionals working in primary care
CareSearch has now released printable reference guides to direct GPs to actionable, relevant, evidence-based CareSearch resources that assist in providing palliative care, including to specific populations. Visit the CareSearch website for more information and to download.
2023 seasonal flu vaccine advice now available
Advice on seasonal influenza vaccination under the National Immunisation Program in 2023 is now available.
ATAGI has released seasonal influenza vaccines advice, including eligibility for vaccination, timing of vaccination and vaccination in pregnancy.
They have also included a reminder that it is safe to administer the influenza vaccination with any COVID-19 vaccination.
The Australian Government Department of Health and Aged Care have released Program advice for Vaccination Providers outlining Federal eligibility, vaccination timing, NIP vaccines by age group and reporting influenza to the Australian Immunisation Register (AIR).
Resources including fact sheets, brochures and posters are now also available to download and print here
TGA statement: Limited Ozempic supplies to commence distribution in Australia
Limited supplies of Ozempic (semaglutide) have now commenced distribution in Australia, at some (but not all) community pharmacies. Initial supplies of Ozempic will not be enough to meet demand from all patients with current valid prescriptions for type 2 diabetes nor for those taking it off-label for other conditions.
The TGA advises prescribers to avoid initiating new patients until supply stabilises and should continue to prioritise supply of Ozempic for people with type 2 diabetes who are current or previous users and for whom other medicines are not suitable.
Where feasible, prescribers are encouraged to liaise with community pharmacies to obtain updates on stock availability to help inform their prescribing decisions.
Read the full statement from the TGA or visit the Ozempic shortage webpage on the TGA website.
The TGA is also aware of several scams targeting consumers seeking Ozempic during the current medicines shortage and is urging consumers to only obtain these products from an Australian pharmacy and when dispensed on a valid doctor’s prescription. More information is available here
New exemption for GPs practicing at regional and remote headspace services
From 1 February 2023, GPs at eligible headspace services, who currently receive salaries or other payments from lead agencies, are exempt from subsection 19(2) of the Health Insurance Act 1973 and able to bill against 28 eligible MBS items.
Subsection 19(2) prohibits the payment of Medicare benefits where other government funding is provided for that service. This initiative has been designed to provide headspace services the opportunity to enhance GP remuneration using headspace grants or other funding streams to supplement eligible MBS billings.
Eligible headspace services are those located within Modified Monash (MM) regions MM2-MM7 (rural and remote). headspace services located in MM1 regions will be ineligible for this exemption.
If you have any questions about this exemption, please contact the Youth Mental Health Section at YMHInputs@health.gov.au.
Removal of requirement for GP endorsement for Patient Assisted Travel Scheme applications.
The WA Country Health Service (WACHS) Patient Assisted Travel Scheme (PATS) Program has recently streamlined the application process and no longer requires a GP endorsement of PATS applications forms. It is hoped this will result in:
- Simpler, more streamlined process for patients accessing PATS.
- Fewer steps and stakeholders involved in the PATS application process.
- A single point of endorsement (WACHS) for PATS applications.
To streamline the patient journey, any request that falls outside of the current guidelines will be reviewed internally by WACHS.
The patient’s GP may be contacted for additional information, as required to support the decision. The new process will be implemented throughout WACHS regions in the first half of 2023.
To obtain a date for when this process will be effective in your region please contact your local PATS office or contact Renee Whyatt, PATS Senior Project Officer on (08) 9781 2016 or email renee.whyatt@health.wa.gov.au.
For more information about PATS please visit the PATS website.
Free online education on helping to prevent suicide in seniors
If you work with older people and would like gatekeeper training in how to help prevent suicide, Anglicare have recently developed an online education package. Suicide Prevention for Seniors is funded by the Australian Government under the National Suicide Prevention Leadership and Support Program.
The three-hour online education package is free and suitable for aged care workers, retirement living staff, pharmacists, geriatricians, GP practice staff (clinical and non-clinical) and anyone who works closely with older people.
he program includes one hour of self-paced online gatekeeper training followed by a two-hour Zoom workshop to contextualise the training for seniors. Anglicare can take group or individual bookings for the training package through the Anglicare website.
New eLearning – supporting alcohol-free pregnancy and safe breastfeeding
The Foundation for Alcohol Research and Education (FARE) has launched free training for health professionals, Supporting alcohol-free pregnancy and safe breastfeeding. The course aims to give healthcare professionals the tools, information and confidence to discuss alcohol use in a non-judgemental way with patients who are planning a pregnancy, are already pregnant or are breastfeeding.
Accredited by the Royal Australian College of General Practitioners (RACGP), the Australian College of Midwives (ACM), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Australian College of Rural and Remote Medicine (ACRRM).
To find out more, visit everymomentmatters.org.au
November 2022
Infection prevention and control guidelines
To protect against COVID-19, the Department of Health WA suggests GPs and practice managers may wish to adapt WA Health’s updated COVID-19 Infection Prevention and Control guidelines for Western Australian Healthcare Facilities for their own clinic needs as appropriate.
Practices requiring support with transition to business as usual are encouraged to contact Practice Assist, call 1800 2 ASSIST or email practiceassist@wapha.org.au. Visit the WA Health website for up to date COVID-19 information for health professional.
COVID-19 testing reminder
Murdoch drive-through remains the only metropolitan public COVID-19 testing clinic. PCR testing is also available via private providers. A GP referral is required for testing at private clinics. Learn more at HealthyWA: COVID-19 testing Where local testing clinics are no longer available, patients can be directed to private pathology or GP Respiratory clinics.
Post COVID-19 Clinic for patients in the EMHS catchment now accepting referrals
The East Metropolitan Health Service (EMHS) has commenced a Post COVID-19 Clinic, based at Bentley Health Service for patients in the EMHS catchment, over 16 years of age who are:
- Still experiencing non-urgent significant symptoms at least twelve weeks from the date of positive SARS-CoV-2 diagnosis; and
- GP screen does not detect conditions more suitable for direct referral for sub-specialty medical review or Community Rehabilitation.
More information and referral criteria is available here.
Reminder to general practice – It’s time to register for training support payments
As part of the transition of the Australian General Practice Training program, training support payments will now be paid through the Services Australia payment system.
The new support payments will commence from semester 1 2023.
The new support payments will be available to accredited training practices, supervisors and registrars. More information is available here
Register to provide access to voluntary assisted dying to regional patients
The Regional Access Support Scheme (RASS) provides funds to support regional patients to access voluntary assisted dying when a local provider is not readily available in the necessary timeframe.
Recent changes to the RASS now allow eligible medical practitioners and nurse practitioners who care for regional patients to receive a payment of $1500 upon completion of the mandatory online training required to become a VAD provider.
If you meet the eligibility requirements to access the WA VAD Approved Training you may also be eligible for this payment. Further information is available from the WA VAD Statewide Care Navigator Service which manages the RASS. For more information, phone 9431 2755 or email VADcarenavigator@health.wa.gov.au
Triple P – Positive Parenting Program now free to access
The Australian Government is providing free, online parenting education and mental health support to Australian parents and carers of children under 12.
The free Triple P Parenting Program offers a suite of parenting resources to enable parents and carers to develop the confidence, skills, and strategies required to better support child mental health and wellbeing as infants and children progress through the key development milestones and help them identify potential problem behaviours early.
The current program offering includes Triple P online under 12, Fear-less Triple P online and the new Triple P online for Babies. Patients can be directed to find out more here
Providing younger people in the residential aged care system with greater choice
The Younger People in Residential Aged Care (YPIRAC) System Coordinator Program aims to give people under 65 years living in residential aged care (as well as those in hospital or in the community who are at risk of entering permanent residential aged care) greater choice and control in understanding their options where they would like to live and what age appropriate supports they need.
With the consent of the younger person and/or their guardian, the team works
collaboratively with government, local community and welfare organisations and service providers to help explore alternate home and support options.
Download an information sheet or contact WA/SA Regional Manager Isabelle Currie on 0407 241 187 or email Isabelle.Currie@abilityfirstypirac.org.au
YPIRAC is a national initiative funded by the Commonwealth Government and operated by Ability First Australia.
Free infant and child mental health resources for parents, families and practitioners
Emerging Minds has recently launched Emerging Minds Families – a brand new range of resources for parents and families looking for information and support about infant and child mental health.
The free videos, factsheets, animations and podcasts have been developed in collaboration with families, practitioners and researchers. They are designed for practitioners to share and use with the parents and families they work with, or for parents and families to access directly.
Topics include:
- Supporting parents and families living with mental illness
- Responding to and managing the impact of natural disasters including floods, bushfire and drought
- Understanding and managing anxiety in children and young people, and
- Infant mental health and wellbeing.
Visit the Emerging Minds website to access the resources and subscribe to the Emerging Minds Families newsletter for the latest updates and releases.
Watch on demand: EMHS Virtual Forum on Improving Aboriginal Cultural Security during virtual appointments
A recording of the EMHS Virtual Forum on Improving Aboriginal Cultural Security during virtual appointments (19 October 2022) is now available on Youtube to view and share
Watch the virtual forum here
October 2022
Updated Perth Children’s Hospital Enuresis Pre-Referral Guidelines
Enuresis (nocturnal enuresis) or bedwetting is the most common type of urinary incontinence in children. It is multifaceted and can cause significant psychological effects on both the child and the family.
Monosymptomatic enuresis is treatable in the primary healthcare setting.
The General Paediatrics Department together with the Continence Service at PCH have updated the Enuresis Pre-referral guidelines (PRG) and can be found here
This PRG provides updated information on:
- Management of enuresis in conjunction with the HealthPathways Enuresis in Children Pathway
- A Bladder and Bowel Diary resource for use by families and GP’s to track urine output and bowel function
- Available clinics dedicated to enuresis and their eligibility criteria
- Having discussed advance care planning with anyone (including a clinician), made a person 3 times more likely to document an advance care(health) directive.
End to mandatory COVID isolation
The WA Department of Health reminds GPs that mandatory COVID isolation ended last Friday 14 October. Western Australians are still recommended to take steps to reduce the spread of COVID-19 and protect others.
People with COVID-19 are recommended to:
- Stay at home for at least 5 days until their symptoms clear
- Avoid large gatherings and crowded indoor places
- Don’t visit people at high risk of severe illness, aged or disability care facilities or healthcare facilities, such as GP, physio and dentists for 7 days
- Wear a mask when indoors and on public transport
- Notify their employer and discuss when to return to work.
People should still register their positive RAT online.
People working in high-risk settings, such as hospitals or public healthcare services or facilities, cannot attend work until 7 days after testing positive for COVID-19.
Asymptomatic close contacts who work in high-risk settings can attend work with the agreement of their employer, provided they:
- Wear a face mask
- Return a negative RAT prior to each work shift and;
- Actively monitor for symptoms.
Supporting patients with cervical screening self-collection
Anyone eligible for a Cervical Screening Test (CST) under the National Cervical Screening Program (NCSP), i.e., women and people with a cervix aged 25-74 years who have ever had any sexual contact, can now choose to screen either through self-collection of a vaginal sample (unless a co-test is indicated), or clinician-collection of a sample from the cervix using a speculum.
A CST using a self-collected vaginal sample is as accurate as a clinician-collected sample taken from the cervix during a speculum examination.In some cases, including where patients require a co-test (HPV and LBC), self-collection is not appropriate.
The program has 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 resources to support GPs in offering self-collection:
- The NSCP has produced a quick reference guide to self-collected vaginal samples for healthcare providers.
- The HealthPathways Cervical Screening Pathway contains information to support clinicians in the assessment, management, and referral of patients presenting for cervical screening.
State-run COVID-19 vaccination clinics close
Participating GPs continue to play a key role in administering COVID-19 vaccinations, with all WA’s State-run COVID vaccination clinics set to close by early November.
The State-run clinics at Claremont Showgrounds, Armadale, Maddington and Wanneroo have already closed while Joondalup (27 October), Midland (29 October), Mirrabooka (6 November) and Kwinana (6 November) clinics will close in a phased approach.
New day hospice in Kalamunda Hospital
The East Metropolitan Health Service has recently opened a new public day hospice for palliative care patients in the catchment.
Offering a 12-week social and therapeutic programme of care, the day hospice can help to address symptom control and support your patients physical, emotional and spiritual needs.
It can also provide an environment where patients can relax and meet others living at home with a life-limiting illness. See the patient brochure for more information or download a copy of the GP referral form. Send completed referrals to akg.referrals@health.wa.gov.au
Shoulder injury related to vaccine administration (SIRVA)
Shoulder Injury Related to Vaccine Administration (SIRVA) is a rare complication of suspected incorrect vaccine administration into the shoulder. 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 Melbourne Vaccine Education Centre website.
Health of the Nation 2022 report out now
The RACGP’s General Practice: Health of the Nation report provides annual insights and draws on specifically commissioned research spanning six years to highlight point-in-time and longer-term trends in Australian general practice.
This year’s report focuses on the sustainability of general practice, highlighting concerning issues that have arisen after years of chronic underfunding.
New report: Youth depression in Australia
Each year, at the beginning of Mental Health Month, the Black Dog Institute publishes a research report on a key topic to stimulate discussion about how we can better prevent and manage mental health issues in our society.
This year’s report, Turning the tide on depression: A vision that starts with Australia’s youth, focuses on depression in children, adolescents, and young adults.
Black Dog has used the latest research data to document how rates of depression and self-harm have risen amongst Australia’s adolescents and young adults over the last decade and some of the worrying changes in symptoms amongst Australian children since the COVID-19 pandemic.
They have also explored the challenges of poor social and emotional wellbeing for young First Nations peoples.