An update from the Sustainability in Healthcare Working Group
Message from the Chair
As we all know it has been a year like no other, but despite the struggles we have all faced the new Sustainability in Healthcare Working Group has managed to progress significant work on several important policy and advocacy projects.
I genuinely believe the actions the Working Group has taken and the outcomes it has already achieved demonstrate that the model of an active group of Fellows with a dedicated focus on strategic policy and advocacy is showing its value.
Prof Mark Frydenberg AM, FRACS
1. Telehealth surveys
Authorised by the Working Group, RACS and a partner conducted an ethics-approved academic-level survey of surgeons and their patients in relation to telehealth during COVID-19. Other colleges surveyed their members, but the RACS survey of patients is one of a kind.
Encouraged by a direct email from the RACS President more than six hundred Fellows as well as eleven hundred surgical patients responded. Findings included that 93 per cent of patients were satisfied with the quality of their telehealth consultation and 88 per cent of surgeons would consider using telehealth beyond the pandemic.
Academic papers are being prepared based on the data.
2. Advocacy to extend temporary telehealth MBS item numbers
The temporary telehealth MBS item numbers were originally intended to end on 30 September 2020. RACS took the strong view that as the pandemic was far from over public access to telehealth must be maintained. RACS staff and the Working Group Chair spoke with the Minister for Health’s office and the Department of Health about these concerns and organised for the President to write directly to the Minister arguing that telehealth must remain a fundamental part of the nation’s response to COVID-19. Some weeks later the Government announced it would extend the temporary MBS item numbers until March 2021.
3. Advocacy to make telehealth a widespread and permanent feature of our health system
Leveraging the Working Group’s survey data RACS staff and the Working Group Chair held numerous meetings with Minister for Health’s office and the Department of Health regarding telehealth beyond the pandemic. There was particular interest in survey data about ‘efficiencies’ which patients gained as a result of telehealth, as this information may be persuasive when it comes to opening government purse strings. At a post-Budget briefing RACS asked Minister Greg Hunt about the Government’s plans. He responded, “our goal, our commitment and our intention is to make (the current temporary model of telehealth access) permanent”. Because of RACS’ proactive engagement RACS was then among the first stakeholders which the Department reached out to following the Budget. The Working Group Chair led RACS’ formal consultation response which was lodged following approval by Board of Council. In addition the Working Group Chair provided a response to a separate request for comment on technical standards for telehealth platforms. It appears likely that Government will take into account RACS’ views as it moves forward with telehealth in 2021.
4. Development of strategy re. restricting use of the title ‘surgeon’
In late 2019 the COAG Health Council decided to look at use of the term ‘surgeon’. Although delayed by the pandemic this process is a once in decade opportunity to achieve greater protection of ‘surgeon’ as a title. RACS staff and the Working Group Chair have developed numerous papers on the issue and had backchannel conversations with the responsible Government department. A proposal to develop a comprehensive advocacy strategy to seize the moment and potentially restrict use of ‘surgeon’ was put to EPDSB and approved. As of the end of 2020 the strategy is in the final stages of development.
5. Responses to consultations
The Working Group, through the Chair and RACS staff was also involved in RACS responses to a number of regular Commonwealth Department of Health consultations, such as a request for feedback from the MBS Reviews Taskforce - Paediatric Surgery, and a proposed amendment to MBS Explanatory Note TN.8.26, and proposed changes to s129AC of the Health Insurance Act 1973 and the Medicare compliance bill among other similar activities.
6. COVID-19 Clinical Evidence Taskforce
As Chair of the Working Group Professor Frydenberg led RACS’ engagement with the Australian National COVID-19 Clinical Evidence Taskforce, representing RACS on the Taskforce’s Guidelines Leadership Group and its Steering Committee. The Taskforce plays a key role in Australia’s COVID-19 response undertaking continuous evidence surveillance to identify and rapidly synthesise emerging research in order to provide national evidence-based guidelines for the clinical care of people with COVID-19. A RACS voice on the Taskforce is a valuable two-way conduit for evidence relating to the management of COVID-19 patients relevant to surgeons.