Hundreds of patients, some children with anaphylaxis, are understood to have been cut from the Canberra Health Services allergy outpatients waitlists.
The RACGP says it was not consulted on Canberra Health Services’ plan to review the criteria for its specialist outpatient appointments, a decision which has now affected hundreds of patients.
Earlier this week, Canberra based demographer Dr Liz Allen posted a photo of a letter from CHS informing her that her young daughter’s referral to the paediatric allergy clinic – for which she had already been on a waitlist for three years – had been cancelled.
“To deliver an effective service, the criteria we use to decide which patients can be seen at the Clinic has recently been reviewed and updated by out clinicians,” the letter read.
“Our team has reviewed the information your doctor sent us against the new criteria, and your referral no longer meets the criteria for a specialist appointment with CHS, and your referral has been closed.”
The letter noted that there were more than 65,000 people on outpatient waitlists across CHS, and that the waiting list for the allergy clinic alone now stretched to six years.
Canberra Health Services told The Medical Republic that approximately 1000 of these letters had been sent to patients on the paediatric allergy clinic waitlist.
RACGP NSW and ACT chair Dr Rebekah Hoffman told TMR that the college met with CHS regularly, but that this was “not something which had come up in any … conversations”.
ACT health minister Dr Marisa Paterson, meanwhile, told TMR that CHS had sent correspondence informing key stakeholders of the review of outpatient services on 7 October.
Recipients included the Chief GP & Primary Care Advisor, ACT Health; the AMA; the RACGP; and all practising ACT GPs.
“GPs will continue to be supported through referral guidance, specialist advice and escalation pathways where required,” Dr Paterson said.
“These changes are intended to ensure specialist allergy services remain available for children with the highest clinical need, while providing greater transparency for families and clinicians about care options and expected wait times.”
Dr Paterson also said CHS would also develop an evidence-based outpatient clinical services plan over the next 12 months. This will explore opportunities to expand care through virtual care and community-based service delivery, supported by high-level workforce, digital and infrastructure planning and a phased implementation roadmap.
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In May of this year, the ACT government published the final report from the inquiry into ACT health system data, demand and processes, chaired by former Queensland director-general of health Mike Walsh.
“We’re trying to workshop what some potential solutions to this would be – obviously there’s a workforce issue at Canberra Hospital, which means they’re unable to maintain their outpatient clinics,” Dr Hoffman said.
“There’s a few things that we’ve been talking to them about, and they were all identified in the Walsh report that was commissioned by the ACT government.
“The first one is GPs with special interests. So, using GPs in the outpatient clinic to be able to manage those [patients] that can be managed by GPs.”
Recommendation 24 from the Walsh report specifically called for GPs with special interests to be employed in a multi-disciplinary care model to undertake initial patient assessments.
“By enabling a broader set of health professionals to serve as the first point of contact in the public hospital system for new patients, the clinical capacity of consultants is increased,” the report said.
“This model of care provides the opportunity to ensure that the most clinically complex and urgent cases are seen by the most highly trained clinical professions, whilst ensuring all staff are working to the top of their licence.”
Dr Hoffman suggested that these GPs could be drawn from the college’s existing specific interests groups.
The RACGP’s specific interest group on allergy, for instance, has 3339 GP members across the country.
An upcoming roundtable hosted by the ACT Greens will address the issue of long specialist waitlists.
This story was updated with comment from ACT health minister Dr Marisa Paterson.
