❓ This detailed parliamentary question scrutinizes WA Country Health Service policies and practices regarding communication between regional nursing staff and local GPs, particularly concerning the use of Emergency Telehealth Services and potential impacts on patient care, practitioner engagement, and rural workforce sustainability.
⏳ Awaiting AnswerQoN 2667Legislative Assembly
QuestionView source ↗
I refer to Regional GP communication and Emergency Telehealth Services (ETS) and I ask:
(a) Has the Minister for Health or WA Country Health Service been made aware of any formal or informal directions, practices or operational instructions restricting nursing staff at regional facilities from directly contacting locally based general practitioners regarding patient care;
(b) If yes:
(i) at which facilities or regions do such directions or practices apply;
(ii) who authorised them; and
(iii) what was the rationale for their implementation;
(c) Is it current WA Country Health Service policy or operational practice at any site that nursing staff are to preferentially contact Emergency Telehealth Service clinicians instead of locally available treating practitioners or contracted local general practitioners;
(d) If yes:
(i) what clinical, operational or financial rationale underpins this approach;
(ii) what consultation occurred with local practitioners prior to implementation; and
(iii) what assessment has been undertaken regarding impacts on continuity of care, duplication of consultations, patient wait times and system costs;
(e) Has WA Country Health Service received complaints, concerns or feedback from clinicians, nursing staff, local practitioners or patients regarding:
(i) reduced access between nursing staff and local doctors;
(ii) duplication of care involving ETS and local practitioner;
(iii) delays in treatment or review; and
(iv) fragmentation of care arising from communication restrictions or altered escalation pathways;
(f) If yes, please provide details excluding any identifying personal information;
(g) Are nursing staff at regional WA Country Health Service facilities currently permitted to seek telephone orders, clinical advice or patient management guidance directly from locally based practitioners where that practitioner is clinically available and familiar with the patient;
(h) If not:
(i) under what policy or directive are such restrictions imposed; and
(ii) how does WA Country Health Service assess the impact of this approach on continuity of care and rural workforce retention;
(i) Has the Minister or WA Country Health Service undertaken any review or assessment into whether reduced involvement of local rural practitioners in hospital and emergency care contributes to:
(i) declining rural GP workforce participation;
(ii) reduced procedural capability in regional towns;
(iii) increased reliance on locum services;
(iv) increased Emergency Telehealth Service utilisation; and
(v) increased health system costs;
(j) Will the Minister undertake a review into communication and escalation protocols between WA Country Health Service facilities, Emergency Telehealth Service clinicians and locally based rural practitioners to ensure continuity of care and rural workforce sustainability are not adversely impacted;
(k) What is the current WA Country Health Service policy regarding documentation requirements for telephone orders provided by locally based practitioners to regional nursing staff;
(l) Is nursing documentation of the interaction and resulting orders considered sufficient under current WA Country Health Service policy, or are practitioners additionally required to generate separate clinical notes within their own medical record systems;
(m) If separate practitioner documentation is required:
(i) under what policy, directive or medico-legal advice is this requirement based;
(ii) does this requirement apply uniformly across all WA Country Health Service sites; and
(iii) when was this requirement introduced;
(n) Has WA Country Health Service undertaken any assessment regarding whether duplicate documentation requirements for telephone orders
:
(i) create unnecessary administrative burden;
(ii) reduce practitioner willingness to provide timely telephone advice;
(iii) delay patient care;
(iv) duplicate existing nursing documentation; and
(v) adversely impact rural practitioner engagement with local hospitals;
(o) Has WA Country Health Service received feedback or concerns from rural practitioners regarding duplication of documentation associated with telephone orders or after-hours advice;
(p) For the purposes of documentation requirements and practitioner obligations, does WA Country Health Service distinguish between:
(i) formal clinical consultations;
(ii) emergency department reviews; and
(iii) brief telephone advice or medication/order clarification requests; and
(q) Will the Minister undertake a review into whether current documentation and communication processes relating to telephone orders in regional facilities are proportionate, efficient and supportive of rural workforce retention and continuity of care?
Answered on
(a) Has the Minister for Health or WA Country Health Service been made aware of any formal or informal directions, practices or operational instructions restricting nursing staff at regional facilities from directly contacting locally based general practitioners regarding patient care;
(b) If yes:
(i) at which facilities or regions do such directions or practices apply;
(ii) who authorised them; and
(iii) what was the rationale for their implementation;
(c) Is it current WA Country Health Service policy or operational practice at any site that nursing staff are to preferentially contact Emergency Telehealth Service clinicians instead of locally available treating practitioners or contracted local general practitioners;
(d) If yes:
(i) what clinical, operational or financial rationale underpins this approach;
(ii) what consultation occurred with local practitioners prior to implementation; and
(iii) what assessment has been undertaken regarding impacts on continuity of care, duplication of consultations, patient wait times and system costs;
(e) Has WA Country Health Service received complaints, concerns or feedback from clinicians, nursing staff, local practitioners or patients regarding:
(i) reduced access between nursing staff and local doctors;
(ii) duplication of care involving ETS and local practitioner;
(iii) delays in treatment or review; and
(iv) fragmentation of care arising from communication restrictions or altered escalation pathways;
(f) If yes, please provide details excluding any identifying personal information;
(g) Are nursing staff at regional WA Country Health Service facilities currently permitted to seek telephone orders, clinical advice or patient management guidance directly from locally based practitioners where that practitioner is clinically available and familiar with the patient;
(h) If not:
(i) under what policy or directive are such restrictions imposed; and
(ii) how does WA Country Health Service assess the impact of this approach on continuity of care and rural workforce retention;
(i) Has the Minister or WA Country Health Service undertaken any review or assessment into whether reduced involvement of local rural practitioners in hospital and emergency care contributes to:
(i) declining rural GP workforce participation;
(ii) reduced procedural capability in regional towns;
(iii) increased reliance on locum services;
(iv) increased Emergency Telehealth Service utilisation; and
(v) increased health system costs;
(j) Will the Minister undertake a review into communication and escalation protocols between WA Country Health Service facilities, Emergency Telehealth Service clinicians and locally based rural practitioners to ensure continuity of care and rural workforce sustainability are not adversely impacted;
(k) What is the current WA Country Health Service policy regarding documentation requirements for telephone orders provided by locally based practitioners to regional nursing staff;
(l) Is nursing documentation of the interaction and resulting orders considered sufficient under current WA Country Health Service policy, or are practitioners additionally required to generate separate clinical notes within their own medical record systems;
(m) If separate practitioner documentation is required:
(i) under what policy, directive or medico-legal advice is this requirement based;
(ii) does this requirement apply uniformly across all WA Country Health Service sites; and
(iii) when was this requirement introduced;
(n) Has WA Country Health Service undertaken any assessment regarding whether duplicate documentation requirements for telephone orders
:
(i) create unnecessary administrative burden;
(ii) reduce practitioner willingness to provide timely telephone advice;
(iii) delay patient care;
(iv) duplicate existing nursing documentation; and
(v) adversely impact rural practitioner engagement with local hospitals;
(o) Has WA Country Health Service received feedback or concerns from rural practitioners regarding duplication of documentation associated with telephone orders or after-hours advice;
(p) For the purposes of documentation requirements and practitioner obligations, does WA Country Health Service distinguish between:
(i) formal clinical consultations;
(ii) emergency department reviews; and
(iii) brief telephone advice or medication/order clarification requests; and
(q) Will the Minister undertake a review into whether current documentation and communication processes relating to telephone orders in regional facilities are proportionate, efficient and supportive of rural workforce retention and continuity of care?
Answered on
AnswerView source ↗
⏳
This question is awaiting a response from the Minister.
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