The Challenge

General practitioner interest in providing primary health care services to residential aged care facilities (RACF) has been steadily declining [1] due to a range of factors including:

1. inadequate renumeration under Medicare reflecting the complexity of patient needs;

2. inconsistent standards between RACF in the management of GP time when attending to resident needs impacting on the availability of the GP in their usual practice;

3. inconsistent standards of training of RACF staff eg knowing when to call a GP and when other options may be more appropriate; 

4. fragmentation of care managed by the RACF and GP leading to inconsistencies in the quality of care and decision making increasing risks or error.

The decline in the number of GPs prepared to visit RACF raises a number of issues for residents and providers including:

1. inability to admit a new resident to care without a referring GP leading to vacant beds at a time when demand for elder care is growing;

2. lack of access to appropriate care for patients with complex health needs at a vulnerable time in their life course;

3. overburdening of RACF personal care and nursing staff trying to manage the complex care needs of ageing people;

4. lack of confidence among elderly resdents, and their families, about the quality of care;

5. residents forced to relocate away from their home town for care.