Post on 23-Mar-2016
description
Joshua Cringle headspace Central Sydney Youth Reference Group
Josh with Human Rights Commisioner Graham Innes among others
Internet and Privacy workshop
3-14 PROJECT BRIEFS 16 CPD UPDATE 3 UPDATES 15 GP ADVERTISEMENTS
NEWSLETTER FOR THE CENTRAL SYDNEY GP NETWORK Ltd July edition 2009
FOR THE LATEST NEWS AND UPDATES PLEASE VISIT OUR WEBSITE http://www.csgpn.com.au
Looking for staff phone numbers! see page 2MERRY MONTH
OF JULY EDITION
NEW IN STROKEPREVENTION
continued on page 3
Rights here, rights now! forum see page 8
Antiplatelet and anticoagulant therapy in stroke prevention: new NPS program
CSGPN will be participating in a new National Prescrib-
ing Service Limited (NPS) therapeutic education program,
“Antiplatelet and anticoagulant therapy in stroke preven-
tion”.
Stroke is the second leading cause of death in Australia
and often results in significant long-term disability. Al-
though the incidence has declined in recent decades about
40,000 to 48,000 strokes still occur each year, with 70%
of these being first-time events (AIHW 2008). One in five
people having a first-ever stroke die within one month and
one in three die within a year (National Stroke Foundation
2008).
Antiplatelet and anticoagulant therapies have an impor-
tant role in primary and secondary prevention.
Despite evidence that antithrombotics are effective in re-
ducing the risk of stroke in atrial fibrillation (AF), they re-
main widely underused in clinical practice. It is well docu-
mented that warfarin is underutilized in atrial fibrillation,
yet it reduces the relative risk of stroke in patients with
atrial fibrillation by 64%, while aspirin reduces the relative
risk by 22%.
There is also uncertainty for prescribers over the use of
clopidogrel and alternative antiplatelets in secondary pre-
vention of stroke. Our program aims to reiterate the role of
aspirin as first line therapy in stroke prevention, and dispel
some of the myths surrounding the prevalence of aspirin
intolerance, as well as the perceived advantage of clopidog-
rel over aspirin in secondary prevention.
This latest program focuses on:
Assessing absolute cardiovascular risk ( New Australian •absolute cardiovascular risk assessment guidelines) to
establish which patients would benefit from aspirin in
primary prevention of cardiovascular events
Deciphering the evidence behind aspirin, aspirin plus •dipyridamole and clopidogrel to choose the appropri-
ate antiplatelet to prevent recurrent stroke and TIA
Using scoring of risk factors in patients with atrial •fibrillation to stratify stroke risk and decide between
warfarin and aspirin
2
Central Sydney GP Network Ltd
July 2009
StaffMichael MooreCEOPh 8752 4921 Email mmoore@csgpn.com.au
Peter WoodDeputy CEOPh: 8752 4903 Email pwood@csgpn.com.au
Lee Sheppard (Newsletter Editor)Communications OfficerPh 8752 4927 Email lsheppard@csgpn.com.au
Project OfficersMano ArumanayagamCervical ScreeningPh 8752 4926 Email marumanayagam@csgpn.com.au
Jerry BacichMental Health / D&APh 8752 4907 Email jbacich@csgpn.com.au
Christopher Daniel Preventive Health / CollaborativesPh 8752 4918 Email cdaniel@csgpn.com.au
Dianne DeschampsAntenatal Shared Care / Aged CarePh 8752 4923 Email ddeschamps@csgpn.com.au
Alex DolezalIT/IMPh 8752 4912 Email adolezal@csgpn.com.au
Melissa FranklinDiabetes Prevention: Live Life WellPh 8752 4914 Email mfranklin@csgpn.com.au
Karen FrostMental Health - ATAPSPh 8752 4910 Email kfrost@csgpn.com.au
Michelle Lampis Headspace Youth CoordinatorPh 8752 4931 Email mlampis@csgpn.com.au
FROM THE CHAIR . . .CSGPN, like all Divisions of General Practice, has been asked to take a leading
role in relation to the H1NI Influenza (Swine Flu). Specifically CSGPN has been
requested to conduct Pandemic Planning and Pandemic control-related matters
training sessions for a senior staff member (GP, Practice Nurse or Practice
Manager) at each practice before 15 July 2009. The training will cover issues
such as: practice pandemic preparedness and response, infection control and
effective use and safe disposal of personal protective equipment. The training
is focused on correctly using personal protective equipment to make sure
that GPs and their staff who we rely on to diagnose and treat swine flu don’t
contract the virus themselves and can continue to do the great job in keeping
the community well.
The training will be conducted in one of three ways: a session at all upcoming
CSGPN CPD events until mid-July; 5 specific workshops in June and July
(details of these were included in a recent fax to all practices) and personal
visits by CSGPN Project Officers. Should you require any further information
please contact Beba Ostrugnaj or any CSGPN Project Officer.
Recently I participated in a Panel Discussion on Diabetes hosted by CSGPN
for GPs and other health providers about the incidence of diabetes in the area
and what this means for health services and families. Experts are quoted as
saying that more than 34,000 people in Sydney’s inner west and south west
have diabetes and 17,500 of those don’t even know it. The Forum heard
about the AUSDRISK (Australian Type 2 Diabetes Risk Assessment) tool, a
simple questionnaire which helps individuals assess their risk of developing
Lara Leibbrandt Aged CarePh 8752 4911 Email lleibbrandt@csgpn.com.au
Danielle Maloney Headspace Clinical Services ManagerPh 8752 4924 Email dmaloney@csgpn.com.au
Lisa MaudeEnhanced Primary CarePh 8752 4902 Email lmaude@csgpn.com.au
Julie McLean-MurrayNPS Facilitator / CPD Ph 8752 4905 Email jmclean-murray@csgpn.com.au
John MulleyDiabetes Prevention: Live Life Well Project CoordinatorPh 8752 4916 Email jmulley@csgpn.com.au
Beba Ostrugnaj NPS / Home Medicine ReviewPh 8752 4909 Email bostrugnaj@csgpn.com.au
Vijay RamanathanNPS / Home Medicine ReviewPh 8752 4915 Email vramanathan@csgpn.com.au
Julia ThompsonDiabetes Prevention: Live Life WellPh 8752 4928 Email jthompson@csgpn.com.au
Helene WalshPractice Management Ph 8752 4906 Email hwalsh@csgpn.com.au
Kerstin WaltherChronic Disease Management / Preventive HealthPh 8752 4904 Email kwalther@csgpn.com.au
Jo WildImmunisation / Preventive HealthPh 8752 4919 Email jwild@csgpn.com.au
Fan YangDiabetes Prevention: Live Life WellPh 8752 4941 Email fyang@csgpn.com.au
Sarah YorkDiabetes Prevention: Live Life WellPh 8752 4940 Email syork@csgpn.com.au
AdministrationFrank Calcagno Administration AssistantPh 8752 4901 Email office@csgpn.com.au
Gabrielle CallaghanFinance OfficerPh 9799 0933 Email gcallaghan@csgpn.com.au
Ian Hunter Administration OfficerPh 8752 4922 Email ihunter@csgpn.com.au
Donna LesterAccounts Co-ordinatorPh 8752 4944 Email dlester@csgpn.com.au
Sue Moxon Administration Officer / MembershipPh 8752 4920 Email smoxon@csgpn.com.au
Dr Janice Colagiuri Dr George Nema
Dr Jeremy Bunker
Dr Linda Mann Jennie Burrows
Dr Anne Sutherland Dr Aline Smith
2009 Board of Directors
CSGPN is an ISO certified system
ISO 9000 is a family of standards
for quality management systems.
ISO 9000 is maintained by ISO,
the International Organisation for
Standardisation and is adminis-
tered by accreditation and certifi-
cation bodies. CSGPN is managed
by SAI Global.
diabetes in the next five years. As part of the Federal Government’s AUSDRISK
program, GPs can refer 40-49 year old high risk patients to a subsidised six
month lifestyle modification program that CSGPN is running in conjunction with
Diabetes Australia-NSW Branch. For further information on this initiative please
contact Jo Wild, CSGPN’s Project Officer.
Of course the other CSGPN Diabetes project is the Prevent Diabetes - Live
Life Well program (PDLLW). This is a pilot program funded by NSW Health and
run in conjunction with Sydney University, SSWAHS and two other divisions
of General Practice (Macarthur and Southern Highlands). The PDLLW program
targets people aged 50-65 years of age and a GP needs to be enrolled in the
program to refer people. For further information contact John Mulley CSGPN’s
Project Coordinator.
Dr Janice Colagiuri, CSGPN Chair.
3
Central Sydney GP Network Ltd
July 2009continued from page 1
The Medical Benevolent Association of NSW
provides assistance for doctors, their families
and other members of the medical family.
It offers a free professional counselling service
through its Social Worker and financial assist-
ance to those in need.
Doctors and their families would find the use
of a sympathetic but confidential ear of much
benefit in times of personal or professional cri-
sis and/or financial distress.
Please contact: Meredith McVey
MBA Social Worker
(02) 9987 0504
www.mbansw.org.au
Donations to the MBA NSW are tax deductible
Prizes for best photograph - GP
Prizes for best photograph - Practice staff
Gift voucher prizes:
$500 (1st prize), $300 (2nd prize), $200 (3rd prize)
More detailed information in the next newsletter.
What are you waiting for? Get clicking!
COMPETITION2009
Assessing risk factors for bleeding in patients with •atrial fibrillation before commencing warfarin therapy
Strategies that will help increase patient concordance •with warfarin and educate patients on the safe use of
warfarin
The importance of maintaining INR within therapeutic •range.
The program includes one-on-one educational visits from
NPS facilitators and small-group, case based peer meet-
ings for GPs and pharmacists. If you wish to participate in
an educational visit or divisional case study at your prac-
tice please contact Beba or Vijay, QUM Facilitators on 9799
0933.
AGED CARE“Round One” of the Aged Care Access
Initiative (ACAI) is now underway.
CSGPN approved forty seven submis-
sions from fourteen Residential Aged
Care Facilities (RACFs) with funding of
$63,000 provided in the first round. The initiatives are var-
ied and fall in the following Allied Health areas:
Physiotherapy/Exercise Physiology (Falls Prevention)•Speech Pathology (Communication and swallowing as-•sessments)
Diversional Therapy/Occupational Therapy (improving •independence and ability to participate in activities,
development of tailored activities)
Dietician (Nutrition: menu reviews, individual assess-•ments staff education)
Specialist Nursing services (pain management, pallia-•tive care)
Psychology (Behaviour and challenging behaviour •management)
In the area of Speech Pathology, CSGPN received ten sub-
missions. The submissions either related to staff educa-
tion or to individual resident assessments in RACFs. Bar-
bara Braithwaite from Braithwaite Speech and Learning
Clinic explains that a common scenario is:
“The resident returns from a hospital admission on thick-
ened fluids and a pureed diet. But how long should they
stay on this regime? Who assesses when and if they are
able to return to a more normal diet, or if they remain safe
For more information contact:Beba Ostrugnajp. 8752 4909 e. bostrugnaj@csgpn.com.au
4
Central Sydney GP Network Ltd
July 2009
For more information contact:Lara Leibbrandtp. 8752 4911e. lleibbrandt@csgpn.com.au
on their current regime? RACF staff are reluctant to make
this change themselves.”
This occurred at one RACF recently. The resident was dis-
tressed asking for other food and water, the family was
particularly keen to give them sips of water and did so
resulting in the resident aspirating and ending up back in
hospital. Under the ACAI, a speech pathologist was able
to assess this resident. In this particular case the speech
pathology assessment found the resident was not able to
return to a more normal diet (soft and small cut up piec-
es). However, at least staff could now reassure the family
who will be more willing to accept the decision to stay on
thickened fluids due to professional advice.
Barbara says: “sometimes these residents are fine to re-
turn to a more normal diet, RACF staff are likely to put/or
keep residents on puree diets and thickened fluids (if they
are unsure or the person is coughing/choking) and this is
not always necessary”
Puree and thickened fluid diets look visually unappealing
and can make the resident uncomfortable due to consti-
pation. A formal assessment from speech pathologist will
ensure the right and safest decision is made.
ANSCIt is recognised that any GP may see
women early in pregnancy not just
GPs accredited as part of the Antena-
tal Shared Care Program.
Often there can be lengthy waits be-
fore women can make their booking at one of the Sydney
South West Area Health Service (SSWAHS) Hospitals.
If you see a woman who you consider to be at risk of com-
plications, please refer her for a review early in her preg-
nancy. Do not wait until she is booked into hospital.
Conditions that may require review early in pregnancy in-
clude:
Diabetes•Hypertension•Renal Disease•Thyroid Disease •Haematological disorders•Known uterine anomalies•Previous pregnancy complications•Possible multiple pregnancy.•
It is also important to organise all the necessary blood
tests DO NOT FORGET:
IMPORTANT MESSAGE FOR ALL GENERAL PRACTITION-
ERS WHO SEE WOMEN IN EARLY PREGNANCY.
Many women consult General Practitioners who are part
of the antenatal share care program. However it is recog-
nised that women may also attend a general practitioner
in the area of Royal Prince Alfred Hospital who may not be
involved in the share care program.
You will be aware that women who make their bookings
in at Royal Prince Alfred Hospital may not have their first
visit to the hospital until they are well into the second tri-
mester.
It is important that if you see a woman in the first trimes-
ter who you may consider high risk of a complication of
pregnancy that she be referred for early review and not to
wait for her booking visit. This is called a “consultation in
pregnancy” and these consultations are seen in the various
high risk pregnancy clinics at Royal Prince Alfred Hospital.
The high risk pregnancy clinics have different emphases
depending on the consultant involved and the expertise in
that clinic.
CENTRAL VIEWPOINTUPCOMING SUBMISSION DEADLINES:August Edition - Monday 6 July 2009September Edition - Monday 3 August 2009October Edition - Monday 7 September 2009November Edition - Monday 5 October 2009
JULY CPD EVENTSUpcoming events in July:
Wed 8 CPD Large Group Event: Diabetes•Tue 14 EPC Health Assessments ALM I•Mon 20 CPD Small Group Event: Lymphoedema•Tue 21 EPC Health Assessments ALM II•Thu 23 Practice Staff Event: LabTests Online•
Please refer to the back page for a full listing.
5
Central Sydney GP Network Ltd
July 2009
For more information contact:Dianne Deschampsp. 8752 4923e. ddeschamps@csgpn.com.au
The high risk clinics that you should be aware of at the
Royal Prince Alfred Hospital are:
Clinic Women seen Consultant/s
Tue AM Women who have known renal •
disease/renal transplant
Pre existing hypertension•
Previous severe pre eclampsia•
Recurrent urinary tract infection •
in pregnancy
Dr Robert Ogle
Dr Jon Hyett
Tue PM Multiple pregnancies•
Drug and alcohol problems/•
psychiatric disorders
Women who are referred from •
Aboriginal Medical Service
Pregnancies with placenta •
praevia or uterine fibroids
Dr Joanne Ludlow
Dr Sue Jacobs
Thu AM Type I or type II diabetes •
Current gestational diabetes•
Graves disease•
Other endocrine disorders•
Dr Brad de Vries
Dr Warwick Birrell
Dr David Kowalski
Thu PM Women with previous caesarean •
section requesting a trial of
vaginal delivery
Women with known uterine •
fibroids
Women with known placenta •
praevia
Dr Brad de Vries
Fri AM Any medical or genetic disorder •
in pregnancy
Previous stillbirth•
Previous preterm delivery/wom-•
en with uterine anomalies
Previous cervical surgery (eg •
LLETZ or cone biopsy)
Dr Robert Ogle
Dr Jon Hyett
Following this consultation a pregnancy plan will be made
which will involve either follow up in one of the high risk
pregnancy clinics or a joint care with the share care Gener-
al Practitioner. It is ideal that when referring these women
for consultation that the appointment be prior to 12 weeks
so that the necessary early investigations can be done. We
would be happy to organise nuchal translucency screening
and her morphology scan and appropriate other interval
scans depending on the nature of the high risk complica-
tion being assessed.
To arrange for a consultation in early pregnancy in high
risk patients please ring the Royal Prince Alfred Hospital
Women and Babies Ambulatory Care on 9515 7101 or
9515 7102 and specify which high risk clinic you would
like the consultation.
If you are asking your patient to make a phone call for this
consultation please indicate to your patient that it is for
a consultation and that it would be desirable if she could
specify which clinic she is to attend. If there are any diffi-
culties with accessing consultations please feel free to ring
Dr Robert Ogle, Director, RPA Women and Babies through
the Royal Prince Alfred Hospital switchboard or contact
Audrey Lee the SSWAHS GP Liaison Midwife on 0425 230
662.
Also consider the need for Nuchal Translucency Screening
and Genetic Counselling.
For an early clinical review for your patient do not hesitate
to ring Royal Prince Alfred Hospital Women and Babies
Ambulatory Care (Antenatal Clinic) on 9515 7101 or 9515
7102.
Women when phoning must indicate that their GP has
asked for her to be reviewed, or you or your staff can ring
on her behalf.
If you require any further advice or clarification you can
contact Audrey Lee the SSWAHS GP Liaison Midwife on
0425 230 662.
ATAPSATAPS Self Harm
Referrals
Referrals into the ATAPS Self Harm
Prevention and Early Intervention
project were slow to take off in the
2008/09 Financial Year. Following
recent promotional activities, some GP training, and some
further liaison with the Emergency Department at RPA, I
am confident that referrals in the 2009/10 Financial Year
will be much higher.
The ATAPS Self Harm project provides immediate access
to fee-free focussed psychological strategies for individu-
als at risk of or currently undertaking self harming behav-
iours. To be part of this, GPs must first be registered on
the ATAPS GP listing – ring me to organise this – it’s easy.
Under the self harm project self harming behaviours in-
clude self-mutilation and co-occurring self-poisoning, reck-
6
Central Sydney GP Network Ltd
July 2009
For more information contact:Karen Frostp. 8752 4910e. kfrost@csgpn.com.au
less use of alcohol and/or other substances, high risk
sexual behaviours and behaviours which may be consid-
ered as eating disorders such as bulimia or self starvation.
Prior to activating a referral, the GP MUST ensure their
patient is ready for immediate services, and is willing to be
contacted by the Service Provider to commence treatment.
Patients referred into this project will be contacted by the
ATAPS provider within 24 hours of referral, and seen within
72 hours of referral.
To obtain a unique referral number for their patient, GPs
contact the CSGPN Admin team on 9799 0933. The GP and
patient need to have selected a Service Provider, from the
Self Harm Prevention provider listing (also see below). The
Admin team will provide the GP with the unique patient ID
code, which must be recorded on the ATAPS documenta-
tion for this patient. We recommend the GP also contacts
the Service Provider with the referral details and to engage
a shared care approach for the patient.
Each patient referred under this project is entitled to unlim-
ited access to psychological services (within a two month
period). Each referral will cover twelve sessions to allow
us to monitor the project, and to ensure regular contact is
made between the GP and the Service Provider.
Providers
The providers listed below have all undertaken the man-
datory training to provide services under the ATAPS Self
Harm Prevention project. Their details are included on the
ATAPS provider directory which is available on our website
www.csgpn.org.au
John Carmody – Mental Health Nurse•Stephanie Hurst – Psychologist /Occupational Therapist•Janine Peckham – Clinical Psychologist•Alison Smith – Psychologist •Janina Szyndler – Clinical Psychologist•
The following providers have been recruited to provide
ATAPS Self Harm Prevention services to youth aged 12
– 25 years who are presenting with Self Harming Behav-
iours, as outlined above:
headspace• – South Sydney Youth Services - Juliet Don-
ald & Jessica Swinbourne
The following providers have been recruited to provide
services specifically within the Canterbury area of CSG-
PN’s catchment:
Canterbur• y – Christina Moscovis & Noris Ma
CENTRAL VIEWPOINTUPCOMING SUBMISSION DEADLINES:August Edition - Monday 6 July 2009
CERVICAL SCREENING
BARRIERS IN CERVICAL SCREENING
How can you encourage your patients to
have regular Pap Tests?
Take the initiative and raise the issue of Pap Tests. •One of the easiest ways to introduce the subject is
simply to ask: “while you are here, can we check when
you last had a Pap test?”
Ensure clients are physically and psychologically com-•fortable when taking a Pap Smear
A recall and reminder system is useful for keeping •track of women who are due for a Pap test.
Which patients should I target?
Women who are more likely than the general population to
be significantly unscreened include:
women of lower socioeconomic status•women from culturally and linguistically diverse back-•grounds
indigenous women, and •older women•
Can the NSW Pap Test Register (PTR) give me a list of my pa-
tients who are due for a Pap Test?
Yes, the PTR will gladly issue you with a list on a CD of your
overdue patients – simply go to www.csgpn.com.au, click
on services, and click on cervical screening to download
the form. Complete the form with your provider number
and those who work in your practice and fax it to the NSW
PTR (fax number shown on the form) and a CD will be sent
you.
Just remember the PTR list of patients includes only those
who have had a Pap test under your care (provider no). If
the client has gone elsewhere for a Pap test, then she will
not appear on your list.
7
Central Sydney GP Network Ltd
July 2009
CT Lung Nodule Analysis
CT Nodule analysis involves advanced software where the •volume of the nodule is calculated.
On a 12 week follow-up study the volumetric doubling •time (VDT) can be calculated
Nodules with a >25% increase in volume & a doubling •time of <400 days are suspicious for malignancy
The negative predictive value is around 98%. •If the the VDT is > 400 days at 3 months then a 1 year •follow-up could be performed.
QUIZ
50 year old female presents with weight loss. CT Colonography
- Where is the cancer?
Answer in the next issue of Central Viewpoint. Previously -
How should this nodule be followed up? There is a lung nodule which
may represent an early lung cancer, granuloma or hamartoma.
For further information please contact:
Five Dock Medical Imaging (Five Dock) 8705 8300 www.fivedockmedicalimaging.com.au
Alfred Medical Imaging (Camperdown) 8228 9000www.AlfredMedicalImaging.com.au
Inner West Imaging (Nth Strathfield) 8282 8100 www.InnerWestImaging.com.au
Advertisement
For more information contact:Mano Arumanayagamp. 8752 4926e. marumanayagam@csgpn.com.au
The PTR list of your overdue patients could include a •number of women who are no longer attending your
practice
Not all your eligible patients are listed with PTR. You •will still need to check your own database to find the
ones who are not listed with PTR, and follow-up with
them to have their Pap test.
If you need assistance with any aspect of managing and
increasing your practice’s cervical screening rates, please
call Mano Arumanayagam, Project Officer, Cervical Screen-
ing on 8752 4926 or email marumanayagam@cspgn.com.
au
EPC
Bay Run - 2 August
As CSGPN is a corporate sponsor
for the Bay Run, it would be great to
see our local GPs and practice staff
out there living the dream! If your
practice would like to participate or you would like to join
the CSGPN team why not register on our website www.
csgpn.com.au
The Bay Run website has a direct link to the AUSDRISK as-
sessment tool that can be completed online. This is a great
opportunity for people to check their status. If people be-
tween the age of 40-49 years have scored =>15 remember
the steps:
1. Do the AUSDRISK assessment
2. Do a fasting glucose test to eliminate diabetes if their
score is =>15
3. Offer them the opportunity of joining the Diabetes
NSW LMP program
4. Fill out the LMP referral form
5. Call us for a referral number
6. Fax the form to Diabetes NSW
7. MBS Item 713 is the item to bill for the consultation
Australian Cardiovascular RISK CHART
The Heart Foundation (2009) has produced a useful re-
source that was presented at our recent Stroke CPD. All
GPs present thought it was a useful tool hence I have in-
cluded it as a flyer in this newsletter. It could be useful as
a visual indicator to patients, both with and without diabe-
50 year old female with wt loss
CT Colonography - Where is the cancer?
8
Central Sydney GP Network Ltd
July 2009
For more information contact:Lisa Maudep. 8752 4902 e. lmaude@csgpn.com.au
tes, to identify what their risk of a cardiovascular episode
could be.
For a more comprehensive look at the Quick reference
guide for health professionals absolute cardiovascular dis-
ease risk assessment go to the Stroke Foundation website
which has an interactive Cardiovascular risk calculator tool
that can be downloaded to both windows and mac:
http://www.strokefoundation.com.au/health-professionals
HEADSPACE
Rights Here Rights Now Youth Forum
headspace in partnership with Marrick-
ville Legal Centre
Currently, the Australian Government
wants to hear what all people in Australian think about
human rights and how our rights should be protected in
Australia. Part of this process includes making sure young
people’s views are being heard. As part of the National
Human Rights Consultation, a Youth Forum was held on
Thursday 21 May 2009 at Marrickville Town Hall.
The forum, entitled “Rights Here, Right Now”, provided an
opportunity for young people to be involved in expressing
their views on their rights and providing feedback on how
to protect their rights and address gaps in current laws/
policies. The forum was a huge success and involved the
participation of 100 young people from a variety of differ-
ent schools and youth services from the inner West, Bank-
stown/Canterbury area and the St George region.
The “Rights Here, Rights Now” forum consisted of five
workshops targeting high school aged children in the In-
ner West area. The workshop was facilitated by a young
person and a professional with topics including: police and
young people, debt and fines, public space, education and
Internet privacy.
Josh, a member of the heads together Youth Reference
Group, reports on the success of this event:
My name is Josh Cringle, I am 21 years old and a member
of the headspace youth reference group ‘headstogether’. I co
-facilitated the police and young people workshop with Katrina
For more information contact:Michelle Lampisp. 8752 4931e. mlampis@csgpn.com.au
Wong a children solicitor from Marrickville legal centre.
I have a background of being in trouble with the law, living on
the streets and drug and alcohol problems. A few years ago I
would have found the information at a forum like this invalu-
able. In the work shop we asked the young people what kind
of interactions they have had with the police, what was nega-
tive in their interactions and what could be improved. Also we
discussed what their obligations are when dealing with the
police.
There was about 90-100 young people at this event. The Hu-
man Rights Commissioner Graeme Innes spoke and had a
photo taken with organisers and young people. I met him and
thought it was an awesome experience. Graeme spoke strong,
generous and kind words. I think it was good of him coming to
an event and speaking where all young people can listen and
be inspired.
It was also good to see young people from all different ages
and all different cultures all having their say. It takes a lot of
courage to stand up and speak about their rights as young peo-
ple. They said they found the forum helpful and good as they
now know the correct procedure and can come up with a lot of
other ideas and are all willing to make a change for all youth
in the future.
Some of the participants commented on how it was good to
have a young person talking about their experiences, someone
that has been where they have and understand them.
I as a young person found it helpful and also learnt a lot from
the forum and was happy to hear that it is going places to help
other youth.
Joshua Cringle headspace Central Sydney Youth Reference Group
Josh with Human Rights Commisioner Graham Innes among others
Internet and Privacy workshop
Josh (2nd from Right) with Human Rights Commissioner Graham Innes (middle).
9
Central Sydney GP Network Ltd
July 2009
HMR
ONLINE EDUCATION
Medicare and You – eLearning for
health care professionals
Medicare now has on online edu-
cation tool (free to anyone) that promotes HMR as part
of Enhanced Primary Care. The tool is aimed at GPs and
practice managers/staff/nurses.
This is a self-paced eLearning program for all (new) health
care professionals that:
make it easier for health professionals to access Medi-•care education
improve confidence in using the Medicare Benefits •Schedule, and
increase awareness of associated rules and regula-•tions.
The program is easy to use, interactive and case based.
There are seven modules – each with multiple topics that
will take between 5 and 20 minutes to complete. To get the
most out of this training you will need to actively partici-
pate in the e-Learning activities.
Go to:
http://medicare.gov.au/provider/business/education
then click on Medicare and You – eLearning for new health
care professional which takes you to the education tool:
http://www.medicareaust.com/medicareandyou/
Follow the prompts by clicking on Begin. Eventually you
will get to a screen that lists all the modules. Module Four
is called Enhanced Primary Care.
This module will provide an overview of the enhanced pri-
mary care program and the range of allied health services
available for patients with chronic conditions and complex
care needs. The first part of this module is Medication
Management Reviews.
In Quarter 1, 2009 (Jan - Mar), 189 HMR services were
completed by 57 GPs. This is a significant increase when
compared to the same quarter last year (142 services by
46 GPs). We, the HMR Facilitators, would like to thank
those GPs who undertake HMRs and request others to con-
sider the benefits of HMR.
HMR Self-evaluation quiz
Please tick the correct response and check with the answers
below:
1. Which of the following is the mandatory criterion to
do HMR?
a. Patient should be taking more than 5 medicines
b. Patient should be aged over 60 years
c. Patient should be residing in the community
d. None of the above
2. Which is/are the risk factor(s) for medication misad-
venture?
a. Taking more than 12 doses a day
b. Confusion or worry about their medicines
c. Seeing more than one GP or specialist
d. All of the above
3. HMR can only be done annually unless there is a
major change to patient’s medication or had a recent
discharge from hospital.
TRUE / FALSE
4. What is the approximate income per year for the
practice for doing 5 HMR/week?
a. $ 5,000
b. $ 10,000
c. $ 20,000
d. $ 35,000
5. Who benefits from a HMR?
a. the patient
b. the patients’ GP
c. the patients’ pharmacy
d. all
Please check your responses with the correct answers. Do
you want to know more about HMR, please contact the
QUM Facilitators (Vijay Ramanathan or Beba Ostrugnaj) at
CSGPN or visit www.csgpn.org.au
Answers: 1 c; 2 d; 3 TRUE; 4 d; 5 d.
For more information contact:Vijay Ramanathanp. 8752 4915e. vramanathan@csgpn.com.au
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Central Sydney GP Network Ltd
July 2009
IT/IM
Benefits of HL7 pathology format
Downloaded electronic investigations
are convenient and most GPs who
are computerised are now receiving
their pathology electronically. Some
radiology providers also offer their radiology in electronic
format, however this is still less common than with pathol-
ogy providers.
Electronic pathology results are available in two formats.
The default format is called Pathology Information Trans-
fer (PIT) and it is a text file, which after processing goes
into your results. This format now has been superseded by
a more user friendly format called Health Level 7 (HL7).
HL7 format allows the result to auto-populate other sec-
tions of your clinical software, namely diabetes record,
diabetes register and INR calculator. If you receive your re-
sults in HL7 format you do not have to double enter HbA1c,
cholesterol, microalbumin or triglyceride values into your
diabetes record, these values come across automatically.
Same applies for the INR results that go into International
Normalised Ratio Record. If you use the PIT format you
need to re key this data into your diabetes record or your
INR record, which in my experience rarely happens.
Additional benefit is that HL7 pathology format allows cu-
mulative result graphing, which can be used for fast trend
analysis and also as a patient education tool.
Unfortunately your pathology provider will send you the
pathology in PIT format unless you request otherwise. To
receive pathology in HL7 format contact your provider and
request this change. It is usually only a matter of minutes
to enable your pathology to come in HL7 format and there
is hardly any difference in the appearance of the results.
HL7 pathology format is especially useful to those GPs
who wish to concentrate on management of patients with
diabetes. I have worked closely with practices which start-
ed receiving their pathology in HL7 format and within six
to twelve months they can extract meaningful data show-
ing levels of HbA1c and cholesterol for these patients. For
more information about the benefits of HL7 pathology for-
mat please contact me on 9799 0933.
For more information contact:Alex Dolezalp. 8752 4912 e. adolezal@csgpn.com.au
LIVE LIFE WELL
Field Agent Report 5 to CSGPN-HQ
Codename: Prevent Diabetes – Live
Life Well
The CALD stream…..
The mainstream project is up and running and the team is
now gearing up for the CALD (Culturally and Linguistically
Diverse) stream of the Prevent Diabetes – Live Life Well
program. Diabetes is a growing problem in people from
many different cultures living in Australia, but the same
lifestyle changes can prevent diabetes across the board.
The CALD stream of the Program is targeting Chinese and
Arabic speaking people. Diabetes is very prevalent in these
communities living in Australia and both of these groups
have significant numbers living within CSGPN’s area. There
are definitely other cultural groups that also have a high
prevalence of diabetes within CSGPN’s area and the im-
portant thing to note is that the aim of CALD stream is to
see if the program can be effective across cultures, not
just in the specific cultural groups chosen.
CSGPN aims to see 100 Arabic speaking and 100 Chinese
speaking people through the Program.
The Chinese speaking stream will be conducted in Manda-
rin. One of our current agents, Fan Yang, speaks Mandarin
and will be running this stream of the Program. Thanks
Fan!
CSGPN recently interviewed for an Arabic speaking agent
to run the Arabic stream and we should have someone on
board very soon – we will bring you more on this as it de-
velops.
All the materials used for the program are being translated
into the appropriate language, including the screening tool,
referral form and all the educational material. If anyone
has been involved in translating material before you will
know that this is not necessarily a straight forward process
and may take a little time (the manual has 175 pages).
As soon as we have the materials and the staff on board we
will be starting CALD stream of the Prevent Diabetes – Live
Life Well program. Prior to this we will be signing up GPs
who are interested in being involved.
If you are interested in being part of the Prevent Diabetes
11
Central Sydney GP Network Ltd
July 2009
For more information contact:John Mulleyp. 8752 4916 e. jmulley@csgpn.com.au
– Live Life Well program, either in the CALD stream or the
mainstream, please contact John Mulley on 8752 4916.
MENTAL HEALTH
CARE for Families is looking for re-
ferrals from GPs and allied mental
health professionals
CARE for Families is an Australian
Government initiative funded by the
Department of Families, Housing, Community Services
and Indigenous Affairs
CARE for Families Clients
CARE for Families provides case management and psycho-
education for people with a mental illness and their family
members and friends for nine months.
8 Weeks Option
If only one family member is able to attend then one per-
son may attend the CARE for Families program for up to 8
weeks on their own.
CARE for Families Program Outcomes:
Enhance well-being and family stability•Improve knowledge and understanding of mental illness•Improve communication and problem solving skills•Increase awareness of knowledge of services.•
The CARE for Families program is offered at the following
Break Thru sites:
Enfield•Rockdale •Bankstown•Blacktown•Liverpool •Maroubra•Parramatta•Penrith•St Marys•
Support Group
Support Group – a fortnightly support group is run at En-
field and Rockdale. The aim of the support group is to
reduce social isolation and offer an opportunity to share
and learn from other people’s experiences.
Enfield - Every 2nd Tuesday from 5:30pm - 7:00pm•Rockdale - Every 2nd Wednesday from 6:00pm - 7:30pm•
If you have any questions about the CARE for Families pro-
gram please see the attached CARE for Families brochure
(Is this a flyer?) or contact the CARE for Families Manager
Hoda Kobeissi on ph 9745 1529.
The Woolcock Insomnia Clinic
Insomnia is a distressing difficulty with going to sleep,
staying asleep or waking too early where the unwanted
wakefulness is greater than 30 minutes; occurs more than
three times per week and has been present for more than
a month.
The Woolcock Insomnia Clinic is part of the Woolcock Insti-
tute of Medical Research and is located at 431 Glebe Point
Road, Sydney. People with insomnia can make appoint-
ments to see psychologists who have specialist training in
behavioural sleep medicine. They have also had additional
training of working in a sleep laboratory, attending sleep
training courses and sleep conferences and can read sleep
studies to diagnose possible ‘other’ sleep disorders.
The patient’s initial consultation is to assess applicabil-
ity for the insomnia program and identify any other sleep
disorders. The Woolcock clinic offers a cognitive behav-
ioural therapy (CBT) program based on international re-
search. CBT “works as well or better than hypnotic medi-
cations to alleviate chronic insomnia and its benefits also
continue after active treatment ends” (Lamberg. JAMA,
2008;300:2474).
A group CBT program was introduced at Royal Prince Al-
fred Hospital in 2002 to reduce the waiting list for insomnia
consultations which at that time extended to five months.
Questionnaire data on sleep quality, fatigue, sleepiness,
depression, anxiety, stress and beliefs and attitudes at the
initial visit, after the four group sessions and at six months
was collected. The data showed that individuals who at-
tended at least three out of the four sessions had signifi-
cantly improved sleep outcomes (increased total sleep
time, reduced sleep onset times, reduced wake times and
increased sleep efficiency) and these were maintained at
six months with mood outcomes further improving. These
positive outcomes were in an unselected population (RPAH
sleep clinic) which had considerable co-morbidity. The
data is presently being evaluated for publication.
At the Woolcock Insomnia Clinic patients attend two edu-
cational or group sessions and two individual consultations
which are after the initial individual consultation. This for-
12
Central Sydney GP Network Ltd
July 2009
mat has been found to be the most useful and will be ex-
amined as a pilot study for future research.
All patients are given a number of booklets relating to
healthy sleep habits (including sleep hygiene), relaxa-
tion, reducing anxiety and worry, monitoring sleep and the
strategies involved in changing behaviours, and increas-
ing awareness about unhelpful thoughts linked with poor
sleep. Patients are expected to complete sleep diaries and
sleep homework scheduling.
The Woolcock Clinic is considered unique because there
are a number of specialists covering a number of medical
areas, all in the one building, which enables the doctors to
treat a range of conditions comprehensively without the
patient having to travel to see various specialists.
Many of the Woolcock doctors are leading edge research-
ers. A range of diagnostic services including overnight
sleep studies, comprehensive respiratory, stress and pul-
monary tests, ECG and EEG tests and a number of at
home portable diagnostics for measuring sleep patterns
are available.
Patients can make appointments for the following special-
ty areas:
Sleep specialists for the treatment of sleep disorders •such as sleep apnea, Restless Legs Syndrome, insom-
nia;
Respiratory physicians for the treatment of diseases •such as asthma, COPD, emphysema and allergies
Ear, Nose and Throat surgeon•Psychiatrist•Endocrinologist and andrologist for the testosterone •deficiency, male infertility and internal referrals diabe-
tes mellitus and metabolic disorders.
Delwyn Bartlett PhD MAPS
Co-ordinator Medical Psychology; Sleep & Circadian Re-
search Group
The Woolcock Clinic,
431 Glebe Point Road, Glebe
Ph: 9114 0000
PRACTICE MANAGEMENT
Provider percentile charts available
on Medicare Australia website
Medicare Australia has launched a
website that enables GPs to com-
pare their billing data with their
peers. The provider percentile charts show the number of
services billed by peer groups for selected MBS items. GPs
can obtain information on their own billing from their prac-
tice management software or by requesting a rendered
items report from Medicare Australia. Find out more here
http://www.medicare.gov.au/about/stats/provider-per-
centile-charts.jsp#N1008F
AGPAL/QIP ACCREDITATION
Earn RACGP QA&CPD points
GPs can now earn RACGP QA&CPD points for participating
in accreditation. However practices must ensure that their
GP(s) have recorded their QA&CPD number(s) in Accredi-
tionPro prior to their accreditation visit.
Medicare and You - enhancing your learning journey
Medicare Australia has recently launched its latest online
eLearning initiative, Medicare and You.
Medicare and You is a series of interactive eLearning mod-
ules and covers topics you need to know when you begin
Medicare billing.
They have designed this new educational tool to help you
better understand the Medicare program and your obliga-
tions when working with the MBS.
Successfully piloted since July, Medicare and You is aimed
at new health professionals, as well as anyone who may
want a refresher.
QIP/AGPAL: ONLINE EDUCATION COMING SOON
QIP/AGPAL has partnered with “ThinkGP”, Australia’s
leading provider of online education solutions for health
care professionals including general practice teams. The
partnership will result in a series of six by one hour online
educational modules on quality improvement and accredi-
tation.
The topics that will be covered are:
quality improvement and accreditation•sterilisation, •infection control, •health information management, •
For more information contact:Jerry Bacichp. 8752 4907 e. jbacich@csgpn.com.au
13
Central Sydney GP Network Ltd
July 2009
For more information contact:Helene Walshp. 8752 4906 e. hwalsh@csgpn.com.au
practice management, and •practice services.•
For more information visit the ThinkGP website.
Face Masks P2 (N95 equivalent) in stock and ready for
immediate delivery
The US Centre for Disease Control (CDC) recommends N95
NIOSH approved masks to prevent the spread of swine flu.
The P2 mask is the Australian Standards equivalent of the
US N95. Easidirect provide immediate dispatch on respi-
rators via Australian Air Express (AAE). Stock is available
from various locations. Please call CSGPN for further infor-
mation on 9799 0933.
Certificate III in Business Administration
(Ideal for healthcare staff involved in office reception of admin-
istrative tasks)
This workplace program is assed within the workplace, en-
suring that new skills are directly applied to the context of
the practice. Assessors are representatives from the AMA
(NSW).
Traineeships may provide financial funding for eligible em-
ployers and employees gain a nationally accredited quali-
fication. Commonwealth Incentives of up to $4,000 (sub-
ject to eligibility) may be available in NSW. Please contact
Helene for further information.
Medicare health checks reveal hidden suffering
Jim Simpson, NSW Council for Intellectual Disability
GPs around Australia are reporting very positive results
from using the annual health assessments of people with
intellectual disability that are now covered by Medicare.
From July 2007 to December 2008 there were 8,700 peo-
ple with intellectual disability assessed.
Hobart GP Nick Cooling reports often finding up to three
previously untreated conditions when doing the assess-
ment. These include reflux, tooth decay, skin cancers, side
effects from medication interactions, excess ear wax and
various visual problems. Dr Cooling suspects that the as-
sessments will be of greatest use for detecting the less
acute conditions which may have long term consequences
if not treated early.
Dr Bob Davis is Director of the Centre for Developmental
Disability Health in Melbourne. He also works in a general
practice. Even with his expertise in intellectual disability,
Dr Davis is finding that the new assessments are helping
him to pick up important health problems. For example, he
recently found that a patient had an inflamed oesophagus
– the assessment had revealed that the patient often wakes
up quite distressed and then settles with a glass of milk.
An Adelaide woman who was thought to be “uncoopera-
tive” was found to have significant hearing loss. She now
has hearing aids and her first word after they were fitted
was “Birdies!” – it was a long time since she had heard
birds cheeping.
A Canberra woman was found to have a serious malignant
cancer which is now being treated.
It is a promising start that 8,700 assessments occurred in
the first 18 months. However that is only a small propor-
tion of the population of people with intellectual disabil-
ity. Hopefully, the take-up on the assessments will steadily
grow as word spreads about the practical benefits they are
bringing.
GPs can claim on item 718 for an assessment in their
practice ($208.70) and item 719 ($232.15) if the assess-
ment needs to be done at the patient’s home. Someone
who knows the patient well should attend the appointment
to help provide the information the doctor needs.
They should bring the person’s medical records and cur-
rent medications.
In NSW, the Department of Ageing, Disability and Home
Care requires supported accommodation services to en-
sure that each resident has an annual health assessment.
The Department provides the Comprehensive Health As-
sessment Program (CHAP) tool to be used in the Medicare
assessment. The CHAP has a section to be completed by
the person, family and support worker to give the doctor
information about the person’s health situation. The CHAP
is also used by the disability departments in Victoria,
Queensland and Western Australia.
For further information phone NSW Council for Intellectual
Disability on 6296 4400 or email ncid@ncid.org.au
14
Central Sydney GP Network Ltd
July 2009
CONCORD NEUROLOGISTDr PENNY SPRING (MBBS Hons 1, FRACP, PhD)
Has recently returned from leave to:
Suite 100, Ground Floor
Concord Hospital Medical Centre
Hospital Rd, Concord 2139
Ph: 9767 8380 for appointments
All general neurology referrals including migraine
Special interests - peripheral nerve and muscle
disorders, burning feet & restless legs syndrome.
Do you have an interest in Mental Health?
Northside West Clinic in Wentworthville is part of The Northside Group, owned by Ramsay Health Care, Australia’s premier provider of private mental health services.
We are looking for a doctor to join our ECT
(Electroconvulsive Therapy) treatment team, led by Dr
Bill Lyndon, Consultant Psychiatrist, Director of ECT Services, The Northside Group; and Clinical Lecturer
in Dept of Psychological Medicine University of
Sydney.
We have a vacancy on Wednesdays with option of holiday relief cover.
You will participate in an ECT training course, run by Dr Lyndon, which is offered to psychiatrists from all over Australia and New Zealand. You will also have access to ongoing support and consultation.
Attractive remuneration offered.
For further enquiries, please contact Di Hollings, ECT Coordinator on 02 9433 3555 or email hollingsd@ramsayhealth.com.au.
www.northsidegroup.com.au
Dr Brindha Shivalingam
Neurosurgeon
MBBS (Syd), FRACS Provider No : 214282CB Practice address : RPAH Medical Centre Suite 208 100 Carillon Avenue Newtown 2042. Phone : 02 9519 4214 Fax : 02 9519 4302 Email : contact@brain‐surgeon.com.au Webste : www.brain‐surgeon.com.au
Hospital Appointments Royal Prince Alfred Hospital Camperdown
Prince Of Wales Private Hospital Randwick
The Mater North Sydney
A physician is obligated to consider more than a
diseased organ, more even than the whole man
– he must view this man in his world
Rene J Dubois
CENTRAL VIEWPOINTUPCOMING SUBMISSION DEADLINES:
August Edition - Monday 6 July 2009September Edition - Monday 3 August 2009October Edition - Monday 7 September 2009November Edition - Monday 5 October 2009December/January Edition - Monday 2 November 2009
15
Central Sydney GP Network Ltd
July 2009
Doctor:Full Time / Part Time
Flexible hours for friendly, accredited group practice in Ashfield. Excellent facilities. Great Conditions.
Phone: 9798 6999Multicare Family Medical Centre
Strathfield, Sydney
VR GP required to join established, busy family friendly practice
in Strathfield. Mentorships available with support from FRACGP
GPs, mentoring since 1992. AGPAL accredited, well-equipped and
fully computerised surgery with good support from reception staff,
experienced colleagues, pathology sister, psychologist, podiatrist and
audiologist. Located next to Strathfield station (parking provided) and
within walking distance to Sydney’s top private, Catholic and selective
schools. No Sunday work or house calls are required. For more
information contact:
Tracy Alexakis 0418 865 013 or email tracyalex111@yahoo.com
Dr Brian Harrisberg MB BCh FRACS FRANZCO
• Cataract Surgery • Refractive Surgery• Diabetic Eye Disease • General Ophthalmology
Dr Gayatri Banerjee MB BS (Hons) UNSW FRCOphth (London) FRANZCO
• Medical Retina • Uveitis• Diabetic Eye Disease • General Ophthalmology
Dr Valerie Saw MBBS (Hons) PhD (Lond) FRANZCO
• Corneal Surgery • Cataract Surgery• External Eye Disease • General Ophthalmology
Suite 1155 Missenden Road
Newtown
Ph: 9519 3882
Fax: 9550 2839
enquiries@centralsydneyeye.com.au
www.centralsydneyeye.com.au
DISCLAIMER: The views expressed in this newsletter are those of the contributor and do not necessarily reflect those of the Directors or Staff. All
advertisements including employment related articles are paid for. Enquiries can be made by contacting CSGPN.
CSGPN CPD EVENTS JULY ‘09Wed 1 Practice Nurse Event: Legal and Professional issuesVenue: CSGPN, ASHFIELD @ 7:00 pm Thu 2 Personal Protective Equipment workshopVenue: CSGPN, ASHFIELD @ 6:30 pmMon 6 Personal Protective Equipment workshopVenue: CSGPN, ASHFIELD @ 6:30 pmTue 7 Personal Protective Equipment workshopVenue: CSGPN, ASHFIELD @ 6:30 pmWed 8 CPD Large Group Event: DiabetesVenue: Burwood Function Centre, BURWOOD @ 6:30pmThu 9 Personal Protective Equipment workshopVenue: CSGPN, ASHFIELD @ 6:30 pmTue 14 ALM: EPC Health Assessments ALM IVenue: CSGPN, ASHFIELD @ 6:30 pmMon 20 CPD Small Group Event: LymphoedemaVenue: CSGPN, ASHFIELD @ 7:00 pmTue 21 ALM: EPC Health Assessments ALM IIVenue: CSGPN, ASHFIELD @ 6:30 pmThu 23 Practice Staff Event: LabTests OnlineVenue: CSGPN, ASHFIELD @ 6:30 pmThu 30 Practice Staff: Cert III in Business admin Presentation Venue: CSGPN, ASHFIELD @ 6:30 pm
To RSVP or for more information on our events, contact: Frank on 9799 0933, or email office@csgpn.com.au
Central Sydney GP Network Ltd
July 2009
SHE SEES AN AUSTRALIA THAT TAKES HEALTH FOR GRANTED.SHE LIVES IN AN AUSTRALIA THAT CAN’T.
At birth, she risked a mortality rate 300% higher than for most Australians.
As she grows, her risk of being hospitalised for preventable conditions will be
500% higher, her risk of being hospitalised for care involving dialysis will be
1,400% higher, her risk of falling victim to endocrine, nutritional and metabolic
diseases, including diabetes, will be 300% higher and as an adult, she will be
200% more likely to suffer very high levels of psychological stress.
Finally, statistics say, she will die... fifteen years earlier than most Australians.
To make her future even less certain, the remote NT community where
she lives... has no access to a GP.
If you’re a GP who can help close the gap, you’re needed.
For a comprehensive information pack about current positions in the NT and
the pro-active support you can expect from General Practice Network NT
contact Dani Eveleigh Ph (08) 89821007
or email dani.eveleigh@gpnnt.org.au
TO CLOSE THE GAP... FIRST FILL THE GAPS WHERE GPs DON’T EXIST
GPNNTAUST1