Guess what’s next? Primary care report cards

GENERAL practice will soon be asked to measure up to a new set of clinical safety and quality standards as part of the Federal Government’s National Health and Hospitals Network (NHHN) plan.

Under the plan, which was thrashed out with the states at last week’s prolonged Council of Australian Governments (COAG) meeting, the Federal Government will establish a permanent Australian Commission on Safety and Quality in Health Care that will set standards for hospitals and primary care.

An independent National Performance Authority will be established and charged with drawing up hospital performance reports and healthy community reports. 

The Government is yet to reveal the detail of how the new reporting system will work, including what reporting requirements will fall on individual practices and whether the performance reports will be made public. Health Minister Nicola Roxon is yet to rule out the possibility of using the data to create practice or regional league tables, similar to those available on the Government’s contentious My Schools website, which compares the performance of schools nationwide.

A spokesperson for Ms Roxon said the previously unannounced element of the NHHN plan demonstrated the Government’s intention to “move to increase the link between health and hospital performance and funding”. The spokesperson added that the standards, reporting arrangements and other details of the plan would be developed in consultation with clinicians. 

AGPN chair Dr Emil Djakic suggested performance reporting could take placeat the level of the newly announ-ced Primary Health Care Organisations, which will replace divisions of general practice. He did not anticipate individual practice performance data would be made public in league tables.

Professor of general practice at the University of Sydney Tim Usherwood suggested performance indicators could include patient satisfaction and practice level activity data “like some of the things that the college measures as part of its accreditation standards”.

While supporting the need for performance benchmarking in primary care, RACGP president Dr Chris Mitchell warned the Government against using meaningless indicators, such as HbA1c levels for diabetes cases. 

“So long as what we are measuring is what general practice does best – which is whole patient, coordinated care over time – then I think that will be a good thing,” he said.

Bob Wells, director of the Menzies Centre for Health Policy, warned that if the performance reporting was not handled correctly, it was likely to create an additional burden on  practices. “It is time and dollars and resources that might otherwise go into practice nurses [for example],” he said.