Nine nursing peaks have renewed calls for dedicated multidisciplinary team meeting funding, warning that nurse- and midwife-led initiatives need financial viability.
A coalition of nine nursing peak bodies are calling on the Commonwealth to act on recommendations from the 2024 scope of practice review – but on an issue which, potentially, all segments of the health sector could agree on.
The Joint position statement on multidisciplinary teams in health care “builds on the vision for workforce reform” outlined in the scope of practice review by recommending that the government fund more of the work not spent directly in front of a patient.
“Funding should appropriately remunerate practitioners for time and resources required for care coordination, collaboration across settings, and referral activities, in acknowledgement of the complexities of team-based care,” Australian College of Nursing CEO Adjunct Professor Kathryn Zeitz said.
“This includes establishing dedicated funding streams for multidisciplinary team support functions such as case conferences, shared care planning, and discharge/transition management, to ensure nurse and midwife-led initiatives are financially viable.”
While one may be hard-pressed to find a GP who agreed with the general vision of the future laid out in the scope of practice review, funding for the work that happens outside of a face-to-face consultation is something which GPs have argued for since time immemorial.
“We know that multidisciplinary teams work really well on the ground every day,” Professor Zeitz told The Medical Republic.
“We know that GPs, physiotherapists and nurses work really closely together every single day in all sorts of settings in the primary care space … we know that operates.
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“It sometimes becomes tricky at a higher level when that everyday practice gets translated into policy and funding decision making.
“We would have all been sitting in a practice where the nurse has done all of your chronic disease plan or provided your immunisation, and you have this visit by the GP to just come in so that it is eligible for Medicare.
“For me, that’s just not good use of any of the multidisciplinary team’s time.”
In other areas, Professor Zeitz’ views may diverge from that of mainstream general practice.
“We genuinely believe that there are different ways to fund care, where funding follows the patient and not necessarily the profession,” she said.
“A lot of primary care funding is tied to MyMedicare, and MyMedicare requires practices to be accredited by the Royal Australian College of General Practice, and for that there has to be a GP involved in that practice.”
Any funding reform, she said, needed to recognise new models of care that may not necessarily wrap around a traditional GP clinic.
The statement was endorsed by the Australian College of Mental Health Nurses, the Australian College of Midwives, the Australian College of Nurse Practitioners, the Australian College of Nursing, the Australian Nursing and Midwifery Federation, the Australian Primary Health Care Nurses Association, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, the Council of Deans of Nursing and Midwifery, and CRANAplus.
It called on the federal government to act on five “enablers” of multidisciplinary care: modernising funding models to value coordination and complexity, establishing person-centred governance frameworks, investing in advanced practice pathways for nurse practitioners and endorsed midwives, enabling flexible solutions, and connecting digital health systems.
