We don’t even know for sure how many unaccredited general practices there are.
GP practices that have a smaller number of doctors, limited support staff, an alternative practice model or are located in a lower socio-economic or non-metro are all more likely to be unaccredited, a new analysis has found.
According to the report, which was published by the Department of Health, Disability and Ageing last week but is dated 2024, there is “significant potential” for further action by the government and Primary Health Networks to increase motivation and incentives for clinics to get accredited.
One of the key findings was that the government does not actually know much about Australia’s unaccredited GP clinics.
There is no single dataset that captures the details of unaccredited practices; the report even conceded that there remains uncertainty about the precise number of unaccredited practices operating at any given time.
What it did find, though, was that doctors at smaller or solo-GP clinics often felt they did not have the time or resources to manage accreditation and felt that the available incentives (i.e. the WIP and PIP programs) were inadequate to warrant the time and expense.
The doctors at these clinics tended to skew older, with some still operating paper-based filing systems which would likely make it difficult to meet some standards.
One case study included in the report told the story of a solo practitioner in a previously accredited practice who had decided not to seek reaccreditation because his last experience with an accreditor had left him “angry and disillusioned”.
“[The GP] indicated that the assessors’ style was too rigid, and they were preoccupied with trying to justify their role by ‘telling us all the things we’re doing wrong’, rather than being helpful and providing practical advice,” the report said.
The report, which was produced by Allen + Clarke Consulting, also identified geographic and demographic considerations as influencing the ability of clinics to become accredited.
“Levels of accreditation are lower in some rural and remote areas, despite the fact that accreditation would enable access to rural incentives,” it said.
“Rates of accreditation are also lower in some socioeconomically disadvantaged outer suburban areas.
“The Gap Analysis found that areas with large overseas-born populations, or where English is not the primary language spoken, tend to have lower levels of practice accreditation.”
The RACGP’s complex accreditation standards and narrow definition of general practice – both of which have since been revised – were continually cited as reasons why practices remained unaccredited.
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Accreditation requirements were so onerous, the report contended, that a cottage industry sprang up to assist practices with meeting them.
“One consequence of the complexity of the Standards and the large amount of effort required to establish practice policies and procedures has been that some general practices feel they need to use the services of lawyers and consultants to support the accreditation processes,” the report read.
“One PHN described that the industry is ‘leveraging fear’ and ‘taking advantage of GPs out of fear – this is going against the intent of accreditation’.
“Another PHN advised of instances where consultancy firms had approached them for advice and resources about accreditation which they could then pass onto a general practice they were providing accreditation services to, indicating that there should not be an expectation that PHNs would provide support to consultancy firms, and that they needed to develop a clear process for managing such requests.”
In total, the report gave 12 recommendations.
Some have already been addressed in the intervening two years since the report was completed.
Others include communicating the benefits of MyMedicare more clearly, making accreditation material available in languages other than English and tailoring support and incentives to the needs of practice cohorts with low levels of accreditation.
