Six month specialist referral proposal rejected by MBS Taskforce

Medical politics

By Michael Woodhead

1 Mar 2021

A recommendation to extend the specialist to specialist referral validity period from three months to six months has been rejected by the government’s MBS Review Taskforce.

The proposal was made by the Taskforce’s Specialist and Consultant Physician Consultation Clinical Committee (SCPCCC), following complaints from consumers and providers that the relatively short three month duration of referrals created serious problems for many vulnerable people with chronic diseases.

“Examples include cancer patients who are receiving multi-modality treatment where the radiation oncology treatment lasts longer than three months,” the committee noted.

The SCPCCC made a recommendation to increase referral validity to six months and mandating a copy of the referral be sent to the patient’s GP “aiming to increase patient convenience and reduce the incidence of expired referrals.”

“The Committee believes that extending the specialist to specialist referral validity period will maintain GP involvement and reduce the frequency of need for patients to obtain a re-referral without compromising the quality of care,” it said.

However in its 2020 report to the health minister the MBS Taskforce said it would not agree to the recommendation, citing concerns about continuity of care, and the principle that “GPs should remain actively involved in the patient’s care when being referred between specialists.”

“The Taskforce noted that this issue had been examined by a number of its clinical committees. The Taskforce supports the critical role of the GP as part of the broader health system and noted that the three-month limit facilitated regular ongoing contact between patient and GP,” it said.

“The Taskforce therefore recommends retaining the specialist-to-specialist referral validity of three months.”

In its final report to the minister the MBS Taskforce backed several other proposals on specialist MBS items made by the SCPCCC.

  • Replace standard attendance items with  time-tiered attendances items
  • Remove consultant physician complex plan items
  • New framework for telehealth
  • New simplified framework of case conference items
  • Financial transparency: making cost and outcome data publicly available to enable discussion with the GP at the time of referral
  • Incentive payments to consultant specialists to adopt My Health Record
  • A new specialist to AHP referral pathway, such as gastroenterologists referring to psychologists to treat IBS

After reviewing more than 5,000 MBS items the Taskforce made its final report to the Minister for Health on 14 December 2020. Its recommendations are not final and have to be approved by the minister and government to take effect.

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