Since late March 2020, Australia has established 141 GP-led respiratory clinics with more than half situated in rural areas and 16 based in Aboriginal Community Controlled Health Services.1
With the clear remit to augment the response of primary care by providing a pathway for the in-person assessment of acute respiratory illness, the respiratory clinics have broadly been successful in managing the escalating demand for respiratory assessment in a safe manner for health practitioners and the community. Furthermore, in our community we have benefited from good engagement with local general practices and take responsibility for closing the loop with updates to a patient’s regular GP.
Our respiratory clinic has been assessing all patients with respiratory symptoms; this provides not only an opportunity to test for COVID-19 but also, critically, to deliver care for other respiratory conditions including asthma, pneumonias, and exacerbations of COPD. This focus has allowed us to rapidly become skilled in primary care management of respiratory conditions and symptoms. This opportunity to provide comprehensive care has been particularly important for people with underlying respiratory illness at a time when symptom investigation and management was challenging. The model of reimbursement is independent of time spent with each patient, allowing for greater depth of investigation and more support when required. The non-time-based funding model for respiratory clinics has also freed us to focus on in-depth work-ups of those vulnerable complex patients whose care is poorly remunerated in traditional practice.
Respiratory clinics were established through a local commissioning process, allowing for development of services that are broadly where they are needed and address community needs.
We recognise that we are a small part of a so-far successful strategy outlined by Professor Kidd,2 but critical to the experience of COVID-19 will be the consolidation of the learning from the respiratory clinics and their application to community general practice for seasonal influenza, as well as preparation of a ‘respiratory clinic in a box’3 in the event of a future pandemic, which has been demonstrated in those countries with experience from SARS.
Notes
Competing interests
The authors are both employed by a respiratory clinic funded by the Australian Department of Health. The authors acknowledge the significant support of the Central and Eastern Sydney Primary Health Network in their clinic’s development.
- © British Journal of General Practice 2020
