From tropical Darwin

I am writing this blog from tropical Darwin as I am attending the AGPN National Forum - sometimes I get to go to the most interesting places in my role at APNA and rarely see any of the sights. However we have had the opportunity tonight to go to a reception at the final Mindil Beach markets before the wet sets in - fantastic atmosphere and amazing sunset.

More importantly, the Minister of Health presented to the conference this morning and released the Discussion paper for the National Primary Health Care Strategy whose importance cannot be overstated for practice nurses. It presents, I think, a once in a generational opportunity to reconfigure some aspects of primary health care to deliver a better quality, more accessible health service to all Australians. APNA will be providing a submission and I encourage all and any members/practice nurses to make their views known to us on what they want to see in such a policy. I know nurses eyes sometimes glaze over when I talk policy but this can be the difference between you being able to offer services such as lifestyle risk factor counselling, CDM, continence advice, women's health, sexual health as a respected member of the clinical team without having to have for example a GP sticking his head in the door in order to claim an MBS item number. It is a real chance for nurses to have input into how you want to see your role develop.

Judy Evans, from Walker Evans Consulting, and previous APNA President, presented today as well on the role of nurses and CDM - and I can say she did not hold back! She presented the evidence for an autonomous and collaborative role for nurses in CDM, not 'for and on behalf of', how nurses want to be nurses not doctors and provide better nursing care in general practice, how nurse led CDM can result in better patient satisfaction and is as safe and effective as GP led care. Look for her presentation when it comes on the AGPN website.

Monday week ago, I attended an all day meeting of the Coalition of National Nursing Organisations which is always extremely interesting- sitting in a room full of reps from around 50 specialty nursing organisations. We had an agenda item on primary health care and APNA and ANF offered to assist some of the smaller nursing orgs with an interest in PHC to provide submissions to the National Primary Care Strategy. It is always heartening to see that APNA is one of the larger specialty nursing groups, with significant capacity to support its members unlike some of the really small totally volunteer based groups.

On Monday, between dropping and picking up hubby from day surgery, I participated in a Peak Body reference group run by the National Indigenous Health Equality Council, looking specifically at identification of indigenous people in the mainstream general practice setting. Identification is important for ensuring that indigenous Australians get access to specific medical benefits and treatments that are funded for them, and has been traditionally poorly done in mainstream general practice. It would be fantastic if there was a practice nurse out there who is interested in this area as I am a bit at sea as to why this is difficult and what could be done by practice nurses to improve the situation. Let me know if you are interested.

Away from the policy/lobbying/networking arena, we have had a couple of very distressing calls this week from nurses who have either resigned or been fired from some very dysfunctional practice working environments. Can I just reiterate that you must ensure that you have a contract of some sort stipulating termination requirement and if you are experiencing situations at work that concern you, document as you go along who said what etc.

We have also had a couple of calls about GP Medicare fraud where GPs are claiming for GPMPs without seeing the patients, unqualified personnel doing 4 year old health checks etc. As nurses are not the provider registered with Medicare, you are not legally liable for anything as far as we can see. However, you can report GPs to Medicare Fraud section anonymously, although we understand the difficulties. We understand they take an educative rather than a punitive approach in the first instance. In cases where the fraud is extreme, we have to remember that it is taxpayers money and would we be as comfortable ignoring it if it was Centrelink payments that were being fraudulently claimed.

Finally it has been a pleasure to read some of the best practice award nominations. Finalists are currently being contacted and we will let you all know as soon as we have notified all finalists. the winner will be announced on the 15ht November so look out for these and if you know the nurse, make sure you pat them on the back as the competition this year has been fierce!