This report argues that the general practice sector needs to collect the Indigenous status of patients in order to provide health interventions specific to Aboriginal and Torres Strait Islander people, suggesting effective Indigenous identification processes are not widespread in the sector, undermining both service delivery and data collection.
The Australian Institute of Health and Welfare (AIHW) was commissioned to evaluate the implementation of the National best practice guidelines for collecting Indigenous status in health data sets (the Guidelines) across health sectors as part of the National Indigenous Reform Agreement. The general practice sector was prioritised in this evaluation because it has a unique role in providing access to health interventions specific to Aboriginal and Torres Strait Islander people, as well as in providing input to data collections. This report summarises the evaluation and support project work in the general practice sector between January 2011 and December 2012. Over this period, the project investigated:
- available information on Indigenous identification in the sector
- barriers to identification and the impact of sub-optimal identification processes
- changes introduced since the Council of Australian Governments Closing the Gap commitments
- measures to improve identification.
The AIHW convened national workshops for general practice sector stakeholders in December 2011 and November 2012. These workshops provided a unique forum for stakeholders to discuss and progress issues. Outcomes from the workshops helped direct the focus of work in the sector.
Sub-optimal collection and recording of Aboriginal and Torres Strait Islander status in the general practice sector is a longstanding problem, as in other sectors. Improving this process by implementing the Guidelines is not straightforward. While state and territory governments undertook to implement the Guidelines throughout the health system, general practice is not part of their jurisdictional responsibilities. The Australian Government has some capacity to influence behavioural change but reforms require multi-layered strategies and the involvement of sector-specific stakeholders.
Consensus on barriers, enablers and recommendations for improving rates of Indigenous identification has emerged from studies undertaken in this field. These recommendations, which were supported and extended by the general practice workshops, focus on making changes through multiple channels, while ensuring these are centrally coordinated and integrated in an overall plan.
The Council of Australian Governments Closing the Gap Indigenous health initiatives, which focused on primary health care, have helped to improve identification in the sector and led to improved uptake of health interventions specific to Indigenous people. These reforms have helped to address some of the barriers to identification, but there are opportunities for further improvements and for the potential of reforms to be fully realised.
Some of the identified barriers which have not yet been addressed include the need to:
- establish a central point of national responsibility and organisation, for example, through the establishment of a taskforce of relevant government and non-government stakeholders, with the remit of improving both data collection and the service delivery outcomes
- improve clinical information systems
- inform Aboriginal and Torres Strait Islander people about the GP-mediated health interventions for which they may be eligible.