RACGP Standards for general practices – development of the 5th edition

Between June and October 2016, the Royal Australian College of General Practitioners (RACGP) asked for stakeholder feedback on the second draft of the RACGP Standards for general practices (5th edition) (the Standards).  Feedback was also sought surrounding the corresponding Resource Guide and the revised Patient Feedback Guide.

The RACGP also conducted a large-scale pilot with 66 AGPAL accredited practices across Australia to test the second draft of the 5th edition Standards and received a large amount of feedback from multiple stakeholders on more than 650 items for consideration.

Feedback was delivered through multiple avenues including written feedback to the RACGP Standards Unit, a prepared survey and verbally.

A summary of the feedback

As a result of feedback from the first draft, the following changes were implemented within the second 5^th edition draft for further review, these areas included:

• The addition of the ‘Demonstrating how you meet this Criterion’ section – a list of some of the mandatory and optional ways a practice can choose to demonstrate how they meet the Criterion.
• The removal of the word ‘should’ throughout the Standards to leave only ‘could’ and ‘must’.
• Changes to requirements for the presence of a third party during a consultation with a GP. In the first draft, practices were required to obtain patient consent and document the presence of any third party. In the second draft of the Standards, practices are required to obtain patient consent and document that consent only when the third party is introduced by the practice.
• Changes to the order of the Standards in the Core module so that Standard 1 is now ‘Communication with patients’.
• Changes to Indicators so that some are not flagged.
• The simplification of some of the language used in Standard 3 ‘Practice governance and management’ of the Core module.

Summary of stakeholder feedback

The recent feedback received on the second draft of the 5th edition Standards, the Resource Guide and the Patient Feedback Guide as part of the third consultation phase was comprehensive and constructive. The feedback has been summarised below.

General feedback on the second draft of the 5th edition Standards:

• Antimicrobial stewardship: Throughout the development of the Standards, stakeholders have advocated for the inclusion of antimicrobial stewardship in the Standards.
• My Health Record: A number of stakeholders referred to My Health Record and the fact that it has not been mentioned in the Standards.
• Advance care planning: Throughout the development of the Standards, stakeholders have advocated for the inclusion of advance care planning in the Standards.

Second draft of the Resource Guide

• Include additional resources in the areas of health records and information privacy.
• Removal of resources that have become out of date and/or replaced.
• Include a link to the Resource Guide in the 5th edition Standards introduction page.

Patient Feedback Guide

• The patient feedback requirements do not allow after-hours services to collect feedback in a meaningful way.
• The patient feedback process does not adequately address the needs of Aboriginal and Torres Strait Islander people.
• Additional information on the volume of questionnaires required and what constitutes a full-time equivalent GP.
• Additional information to assist practices with understanding the importance of conducting patient feedback to improve quality in health care.
• Additional information on the RACGP approval process for patient feedback methods.
• Additional information on the need to protect patient identities when they are involved in patent feedback.
• Additional information on when patient identities can be known and when to ensure they remain unidentifiable and confidential.
• Additional information to alert practices to the potential for overburdening or over-representing patient groups in the feedback process.

Next steps

• Feedback received from this consultation phase and the large-scale pilot was considered by the RACGP Expert Committee – Standards for General Practices and has been used to inform the third draft of the 5th edition Standards.
• The feedback from this consultation phase will also be used when updating the next draft of the Resource Guide and Patient Feedback Guide.
• The RACGP will launch the 5th edition Standards in October 2017.
• Further information can be found at racgp.org.au/standardsdevelopment

References

This information has been extracted from the RACGP Standards for general practices (5th edition) Third consultation phase – summary document released in early December 2016.
This document can be downloaded from http://www.racgp.org.au/your-practice/standards/standardsdevelopment/

The RACGP has also released further information relating to specific Criterion recommendations, available on the RACGP’s website.