East Melbourne Medicare Local (EMML) GP Primary Health Networks (PHN) Survey 2015 Interim Results Apr 2015

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Summary Methodology  To provide Eastern Melbourne Medicare Local (EMML) with the opinions of General Practitioners (GP) as they relate to the new Primary Healthcare Networks (PHN) with a view to informing their approach to supporting them in this change.  A nationwide on-line survey was conducted 16 th – 24 th April 2015: A sample of n=400 current GPs (and their practices) nationwide. Total sample accurate to +/-4.9% margin of error (at the 95% confidence level). Survey used a research panel of medical professionals. Minimum quotas and data weighting by area to ensure adequate representation.  Questionnaire tool used to investigate and quantify the following topics: How informed GPs feel about the change to PHNs. Their current level of support for PHNs, and the reasons for this prejudice. Priorities for the new PHNs to address for GPs, their practices and their patients. The need for new services from PHNs, and areas in which they should not be involved. Views of the new geographical areas covered by the PHNs. Views on purchasing of services by PHNs. Preferred methods of contact and engagement with PHNs.  Results broken down by region throughout, noting some limited sample sizes.

Summary Findings  GPs do not consider themselves well informed about the change to PHNs as yet, with 36% stating they feel informed (just 5% very well informed) and 64% uninformed.  Support for and opposition to the change to PHNs, i.e. acceptance of the virtue of change, is currently split and weak in intensity. This suggests that GPs are not yet fully decided on their attitude to PHNs, with some suggestion of the ‘fear of the unknown’: 34% support the change to PHNs (just 4% strongly supportive). 39% opposed the changes (11% strongly opposing them). But amongst those considering themselves informed, 48% support and 43% oppose.  Those supporting the changes do so because they hope and expect the PHNs to be an improvement on Medicare Locals, whereas those opposed show a wider variety of hesitations and concerns (again, indicative of ‘the unknown’): 34% of those supporting the change to PHNs reported dissatisfied with Medicare locals, with 5-10% each citing improvement in service, delivery, support, cost, efficiency and outcomes. 15% of those opposing thought the change a waste of money, 13% did not believe that change was needed, 10% thought that there were too many changes, with a series of other minor concerns around perceived bureaucracy, the geographical areas, consultation, etc.  This dissatisfaction with Medicare Locals is highlighted in the areas that GPs do not want repeated by PHNs. Commonly, they want; more consultation (13%), reduced bureaucracy (8%), less waste (7%) and better communication (5%).

Summary Findings  When asked what they and their practice consider priorities for the PHNs to address, there were varied suggestions, but with support, information and access key themes: More than 20% stated that education, training and general support for GPs were priorities. And more than 10% cited improved communications (generally and between GPs and hospitals), better access to services and mental health and priorities.  GPs were less sure about what PHNs should be doing as priorities for their patients: 14% suggested that educating and informing the community about the changes. 11% nominated access to services generally, and a further 10% mental health specifically.  These responses tally strongly with their nominated areas of most value for PHNs: 36% mentioned education and training as a necessary or valuable service to be provided. 20% nominated mental health; with diabetes, psychology and immunisation also common. 9% cited general support here, but also for after hours, IT, accreditation and nursing (6-11%).  On the other side of the equation, GPs felt that the PHNs should not have involvement in several areas of operation. Notably: 10% do not want to see involvement in the daily running of their own practices or their finances, 9% in providing patient care, and 6% in any health services. A further 8% hoped that the PHNs would not be involved in politics, 7% in funding decisions and 5% in unnecessary bureaucracy.

Summary Findings  Whilst some GPs agree that the larger PHN areas will mean economies of scale in purchasing for their practices, more agree that there might be a lack of flexibility: 61% agree that larger networks will produce economies of scale, but only 14% strongly agree. 74% agree that this will mean a ‘one size fits all’ approach, including 26% strongly agreeing.  In terms of purchasing, there is very strong want amongst these GPs that they are involved in both decisions that affect their practice and their local area: 92% agreed that they want a say in how money is spent for their practice, 59% strongly. 90% also agreed that they want a say at a local level too, including 52% strongly agreeing.  Given this want to be involved, and the lack of information more generally, it is a significant finding that (67%), personal visits (60%) and central meetings (41%) are by far the preferred methods of contact and engagement.

GP Knowledge & Opinions of PHNs

GPs Informed on PHNs: Summary Q1) The Federal Government has announced that the existing Medicare Locals will be replaced by Primary Health Networks, or PHNs. How informed would you say you are about this change and the new system?

GPs Informed on PHNs: Area Q1) The Federal Government has announced that the existing Medicare Locals will be replaced by Primary Health Networks, or PHNs. How informed would you say you are about this change and the new system?

GPs’ Current Support for PHNs: Summary Q2) Do you support or oppose the change from Medicare Locals to Primary Health Networks? That is, are you optimistic about this change and agree with it, or are you concerned about this change and tend to disagree with it?

GPs’ Current Support for PHNs: Informed

Q2) Do you support or oppose the change from Medicare Locals to Primary Health Networks? That is, are you optimistic about this change and agree with it, or are you concerned about this change and tend to disagree with it? GPs’ Current Support for PHNs: Area

Reasons for Supporting PHNs Q3a) What is the main reason that you support the change to Primary Health Networks? Please explain your thinking in just a few words below. Base: Those supporting PHNs

Reasons for Opposing PHNs Q3b) What is the main reason that you oppose the change to Primary Health Networks? Please explain your thinking in just a few words below. Base: Those opposing PHNs

PHN Priorities, Needs & Wants

GP Priorities for PHNs: Summary Q4) Regardless of your overall opinion, as a GP what do you think should be the immediate priorities for the new Primary Health Networks to address…?

GP Priorities for PHNs: Area (1) Q4) Regardless of your overall opinion, as a GP what do you think should be the immediate priorities for the new Primary Health Networks to address…?

GP Priorities for PHNs: Area (2) Q4) Regardless of your overall opinion, as a GP what do you think should be the immediate priorities for the new Primary Health Networks to address…?

Patient Priorities for PHNs: Summary Q5) And thinking about the needs of your patients, their satisfaction and well-being, what is the one most valuable thing that the Primary Health Networks could do as a priority for action?

Patient Priorities for PHNs: Area Q5) And thinking about the needs of your patients, their satisfaction and well-being, what is the one most valuable thing that the Primary Health Networks could do as a priority for action?

Valuable PHN Services: Summary Q6) Are there any services that could be provided to your practice by the new Primary Health Networks that you believe would be necessary or valuable? These could be existing services that should be maintained or taken over by them, or new services that should be introduced.

Valuable PHN Services: Area Q6) Are there any services that could be provided to your practice by the new Primary Health Networks that you believe would be necessary or valuable? These could be existing services that should be maintained or taken over by them, or new services that should be introduced.

Areas of PHN Non-Involvement: Summary Q7) Are there any things that you feel the new Primary Health Networks should not have involvement in?

Areas of PHN Non-Involvement: Area Q7) Are there any things that you feel the new Primary Health Networks should not have involvement in?

PHNs & Medicare Locals

Q8) Most of the new Primary Health Networks will cover larger geographical areas than the Medicare Locals they will replace. In terms of understanding and meeting the needs of general practice do you think they will be better or worse? PHN Geographical Areas Compared to Medicare Locals: Summary

Q8) Most of the new Primary Health Networks will cover larger geographical areas than the Medicare Locals they will replace. In terms of understanding and meeting the needs of general practice do you think they will be better or worse? PHN Geographical Areas Compared to Medicare Locals: Informed

Q8) Most of the new Primary Health Networks will cover larger geographical areas than the Medicare Locals they will replace. In terms of understanding and meeting the needs of general practice do you think they will be better or worse? PHN Geographical Areas Compared to Medicare Locals: Area

Medicare Local Mistakes to be Avoided: Summary Q9) Thinking about Medicare Locals, is there anything they did or anything about the way they worked that should not be repeated in these Primary Health Networks?

Medicare Local Mistakes to be Avoided: Area Q9) Thinking about Medicare Locals, is there anything they did or anything about the way they worked that should not be repeated in these Primary Health Networks?

PHN & Purchasing

Q11) One of the roles of the new Primary Health Networks will be to help purchase services for GPs and others. Below are a series of statements about this role, and for each please tell us whether you agree or disagree with what’s being said. PHN & Purchasing: Summary

Q11) One of the roles of the new Primary Health Networks will be to help purchase services for GPs and others. Below are a series of statements about this role, and for each please tell us whether you agree or disagree with what’s being said. % Total Agree PHN & Purchasing: Area

PHN Consultation & Engagement

Q10) As a GP, how would you prefer that you (and your practice) are consulted and engaged by the new Primary Health Network in your area? Please tick all that apply. PHN Consultation & Engagement Preferences: Summary

Q10) As a GP, how would you prefer that you (and your practice) are consulted and engaged by the new Primary Health Network in your area? Please tick all that apply. PHN Consultation & Engagement Preferences: Area

East Melbourne Medicare Local (EMML) GP Primary Health Networks (PHN) Survey 2015 [Month & Year] Interim Results Apr 2015