The Department of Health have recently made a few changes to the AMDS program guidelines, so our team have put together the following information for doctors wanting to know more.
Please note, this is just a quick overview of the AMDS Program, if you have specific questions or you need help, please let us know.
The purpose of the AMDS Program is to offer non-VR GPs the opportunity to gain general practice experience in after-hours settings and access a Medicare Provider number.
Commonwealth’s defined after-hours period is
Yes, the AMDS program covers both accredited clinics and home visit services during the Commonwealth defined after-hours period.
No. While there are many clinics who offer ‘after-hours’ appointments, the clinic is required to be accredited as an AMDS, and both you and the location must be approved by the Department of Health. An outline of the revised eligibility criteria for joining this program has been provided below.
REVISED ELIGIBILITY – THE DOCTOR
A non-VR recognised GP must be able to meet the eligibility criteria before approaching an AMDS and applying to join the Program:
REVISED ELIGIBILITY – THE PRACTICE
For a clinic to be eligible for the AMDS Program, it must be able to meet the following criteria:
Non-VR recognised GP’s can access the AMDS Program for a maximum of up to 6 years. During the application process, potential applicants must be able to demonstrate that they are actively working towards their FRACGP or FACRRM by providing evidence that they are continuing professional development either through the RACGP CPD program or ACRRM PDP Program they must also demonstrate they will become a VR GP by attaining their qualification within this time frame.
In our experience, After-hours AMDS roles are assessed at a maximum of 50%. For example, if you worked for the full 5 years on this program, you would have accrued a total of 2.5 years GP experience to be assessed by RACGP or ACRRM. After Hours experience will make up a total of 2.5 years of your experience and RACGP require 18 months to be during the in-hours period or “fully comparable”.
A doctor approved for the AMDS Program does not technically meet the definition of a “GP” provided in clause 1.1.1.A of the Health Insurance (General Medical Services Table) Regulations 2017 (GMST Regulation). For this reason, AMDS doctors are subject to restrictions on the MBS items they may claim for after-hours deputising services they may provide while participating on the AMDS Program. The next paragraph will clarify.
CLINICAL MATTERS THAT ARE OUTSIDE OF THE SCOPE OF DEPUTISED CARE.
The AMDS program is in place to provide GP services to patients outside of the normal hours of operation. It is not intended to take the place of regular GP services- the guidelines speak specifically about After-Hours GP taking instruction from the patients regular in-hours GP and referring the patients back to their regular in-hours GP.
Therefore, it is not appropriate that deputising doctors who are employed by an AMDS, provide care to patients who present with symptoms or circumstances that can be addressed by their normal GP.
Here are some examples of the types of consultation requests that are deemed to be the sole responsibility of a patient’s normal GP. These requests are deemed to fall outside of the deputising activity that may be performed by a non-VR doctor who has received access to the MBS during the after-hours period under the conditions of the AMDS Program.
HEALTH PROMOTION ACTIVITY THAT REQUIRES ONGOING CARE:
For example: after hours doctors are encouraged to provide brief interventions regarding smoking, alcohol or recreational drug use but would refer to the usual GP for medication and management of smoking cessation or opiate withdrawal.
MANAGEMENT OF CHRONIC DISEASE:
Examples that would be considered inappropriate include:
PROCEDURES THAT REQUIRE RESUSCITATION FACILITIES:
Examples that would be considered inappropriate include:
PROCEDURES THAT MAY NEED A CHAPERONE, GOOD ILLUMINATION OR SPECIFIC EQUIPMENT:
Examples that are considered inappropriate include
Examples that are considered inappropriate include:
AMDS doctors are not completely prohibited from prescribing medicines to a patient who has not been referred for a deputised attendance by their normal GP. Under the revised Guidelines, AMDS participants will remain eligible to prescribe medicines to unreferred patients if they identify a genuine clinical need to issue a prescription.
AMDS participants are prohibited from issuing multiple repeats for medications prescribed. A single prescription can be issued for up to a month’s supply. To obtain further repeats patients will need to see their usual GP or practice. This change seeks to encourage continuity in prescribing in recognition of the increase in multimorbidity and polypharmacy.
These Guidelines consider that a patient ‘running out of a prescribed medicine’ is a recognised challenge in general practice and offer scope for an AMDS Program participant to prescribe as a means of preventing significant harm to a patient who has not been referred by their normal GP. These Guidelines do limit the ability of these doctors to prescribe multiple repeat medicines as a routine practice and confirm that participants should not be issuing repeat prescriptions as a matter of patient convenience and must identify a genuine clinical need.
CLAUSE 8.3 OF THE REVISED GUIDELINES PROVIDES THAT IT HAS BEEN ENGAGED BY A PRACTICE PRINCIPAL BEFORE IT DEPUTISES TO PATIENTS OF THE PRACTICE. WHAT DOES THIS CLAUSE MEAN?
ARE AMDS PROVIDERS RESTRICTED FROM DEPUTISING ON BEHALF OF GENERAL PRACTICES THAT ARE NOT ACCREDITED ACCORDING TO THE RACGP STANDARDS?
CAN AN AMDS PROVIDER DEPUTISE ON BEHALF OF AN AFTER-HOURS CLINIC?
CAN A GENERAL PRACTICE ENTER INTO AGREEMENTS WITH MORE THAN ONE AMDS PROVIDER?
If you are looking for further guidance on the AMDS Program or would like to ask further questions about 3GA programs options, this is something our team can help you with. Contact us directly on firstname.lastname@example.org.
Information for this blog has been taken directly from:
People Medical Consulting are a team of professionals with a passion for guiding those specialising in the Medical industry to find their career pathway and settle into Australia. Working with both Australian trained and Overseas trained professionals, we have extensive experience in Recruitment of General Practitioners, Migration for all with a special emphasis on Medical and Document Assistance for those requiring support with RACGP, AHPRA, 19AA and 19AB Medicare Exemptions.