Statement following the General Practice Contracted Provider Caucus Meeting

The General Practice Contracted Provider Caucus (the Caucus) met on Tuesday 22 February 2022 for what would have been a routine planned meeting in advance of the next PSAAP* meeting which was scheduled for Wednesday 9 March 2022.

Unfortunately, the PSAAP meeting has been cancelled without consultation with the Caucus and a discussion about rescheduling the PSAAP meeting is awaited.

In the meantime, the Caucus meeting went ahead to enable Caucus members to discuss a range of other agenda items as well as to work with the PSAAP Contracted Provider Representatives (CPRs – who are both members of the Caucus) – Dr Mark Peterson and Dr Angus Chambers, to prepare for the PSAAP meeting once it is rescheduled.

COVID Management and Care in the Community:

The Caucus discussed the increasing workload for general practice and the disturbing theme of additional demands being placed upon general practice by the Ministry and DHBs without advance planning, no consultation, with very little notice and without agreement regarding funding for the costs of the additional work.

In this regard, the Caucus endorsed the Red Letter issued by the New Zealand Medical Association (NZMA) on 22 February 2022 which raised serious concerns regarding “significant and growing demands and expectations of General Practice with little or no engagement or effort to agree the details and terms of the services implemented”.

The same theme applied to the Caucus discussion regarding suggestions that the Government was about to announce the public will be able to access Rapid Antigen Testing (RATs) from general practices. Again, there has been no engagement with Caucus or Caucus members and no discussion regarding the cost of providing this service and the associated advice for patients, or the capacity constraints upon general practices at a time when staff numbers are also being reduced through COVID positive infections.

The Caucus agreed that there appeared to be a very concerning disconnect between central policy makers and the “real world” on the general practice front-line.

The Caucus agreed to write to the Ministry of Health, in urgency, with regards the potential announcement re RATS testing and the general lack of engagement, planning or consultation around service announcements.

ASRFI:

The Caucus discussed how the Annual Statement of Reasonable Fees Increase (ASRFI) could be calculated for 2022 (and the associated process of how the 2022 capitation increase will be informed) given that the November 2021 PSAAP meeting unanimously agreed that the current ASRFI methodology was not fit-for-purpose.

The Caucus endorsed a proposed paper on this subject for presentation to the rescheduled PSAAP meeting.

Capitation Funding Review:

The Caucus discussed a potential general practice capitation funding review, which it is led to believe is being undertaken by the Transition Unit (within the Department of the Prime Minister and Cabinet). However, despite representing all general practice contracted providers, the Caucus has not been consulted about the review, it has not had sight of the Terms of Reference and it has not agreed a co-design or jointly governed process for the review – which the Caucus is concerned is being undertaken behind closed doors, without any transparency and without engagement or representation from the sector.

The Caucus noted that GenPro has written to the Transition Unit to request the Terms of Reference for the Review and for details of how the Review will be undertaken in partnership with mandated provider representatives. The Caucus discussed subsequent action which it may take subject to the response received to GenPro’s request.

Other Issues:

The Caucus discussed a range of additional agenda items which included, the Pae Ora (Healthy Futures) reform programme, the 2021 Section 88 Maternity Services Notice and, the Government’s proposed Income Insurance Scheme.

Comment:

The Chair of the Caucus (and Chair of the GP Council for the NZMA), Dr Vanessa Weenink, said, “The Caucus is the representative voice for all general practice providers and we also work as part of the General Practice Leaders Forum (GPLF) – a broader general practice forum which includes nursing, practice managers and the funders of general practice – PHOs. However, it is a real shame that instead of working proactively to support the role that general practice can play in leading the community response to COVID, we are increasingly responding to central policy announcements that are unplanned, lack consultation and fail to consider the cost of services provided by an already stretched general practice workforce.

“It doesn’t have to be this way. One of the reasons for the establishment of the Contracted Provider Caucus was to provide a single point of contact for all general practice providers and a source of significant expertise and advice to work with the Ministry of Health on the co-design and implementation of workable and sustainable service developments. That is still our aim and is the offer we continue to make to the Ministry.”