Table of Contents

 

1. Executive summary

2. Overview for consumers

3. About the MBS Review and the process for reviewing the after-hours items

4. Concerns raised by stakeholders about urgent after-hours items

5. Principles for after-hours services provision

6. Background - MBS items for after-hours services

7. Analysis of Medicare and other data

8. Options considered

9. Taskforce findings

10. Conclusions and implications of changes to the urgent after-hours items

11. Additional data

12. Glossary

Attachment A – MBS Review Taskforce membership and Terms of Reference

Attachment B – Membership of the After-hours Working Group

Attachment C – Pathways for seeking care in the after-hours period

Attachment D – MBS after-hours items—Complete list

Attachment E – Current urgent after-hours item descriptors and explanatory notes

Attachment F – Summary for consumers

5.           Principles for after-hours services provision

The Taskforce recommends that the following principles should underpin MBS funding of after-hours services generally and urgent after-hours services in particular:

1. After-hours GP services are essential services, highly valued by consumers, and no measures should be introduced which would impact adversely on their responsible provision by appropriately qualified health professionals.
2. Urgent after-hours GP services should only be provided in genuinely urgent situations.
3. The MBS fees for urgent after-hours services should reflect the complexity of the service and the lifestyle disruption and other imposts incurred by GPs who provide urgent after-hours services in addition to their normal in-hours workload.
4. Ideally, after-hours services should be provided by GPs who have a relationship with the patient’s usual general practice, facilitating quality and continuity of care.
5. After-hours services provided by medical deputising services have an important role in ensuring patients have access to necessary after-hours services, recognising that it is not feasible for all general practices to offer comprehensive after-hours care.
6. Providers of MBS-funded urgent after-hours services should not market these services by prioritising convenience and low (or no) cost over clinical need.
7. The rebate structure for after-hours services should not provide perverse incentives to divert services from in-hours to out-of-hours or to drive utilisation that is not commensurate with clinical need.