Multidisciplinary Teams in General Practice Request for Proposal

Overview Country SA PHN is seeking proposals for the commissioning of Multidisciplinary Team (MDT) in General Practice projects. Country SA PHN aims to work collaboratively with small or solo general practices, Aboriginal Community Controlled Health Services (ACCHS) and community service providers across the Country SA PHN region to design and implement MDT care for priority populations who are experiencing or at risk of chronic illness. Priority populations may include Aboriginal and Torres Strait Islander people, and people who are financially disadvantaged. About Multidisciplinary teams (MDT) are made up of multiple health practitioners from different disciplines, who collaborate to deliver comprehensive care that addresses as many of a patient's needs as possible. They may include a combination of general practitioners (GPs), practice nurses, community health nurses, allied health professionals and/or health educators. MDT care delivered through general practice has the potential to improve access to clinically appropriate care, strengthen care coordination, reduce pressure on GPs, and enable the broader primary healthcare workforce to operate at full scope of practice. MDT care is critical in general practice, particularly in rural and remote South Australia where longstanding workforce shortages make it difficult to meet community health needs. Rates of MDT care arrangements in Country SA are among the lowest in Australia, highlighting opportunities to strengthen coordinated care for people with chronic disease (AIHW, 2022d). Purpose The purpose of this Request for Proposal (RFP) is to enable prospective small and solo general practices, ACCHS, and community service providers to design and implement MDT care in their communities. Project activities will support the timely detection and intervention of chronic conditions to reduce disease progression and severity, while also strengthening general practice engagement and collaboration with allied health and nursing providers. Objectives Through commissioning MDT models of care, Country SA PHN seeks to: Increase access to community-based care Strengthen chronic disease management Reduce avoidable hospitalisations Support greater collaboration between general practice and allied health and nursing providers Scope Project activities are flexible, though must focus on: Supporting the timely detection and intervention of chronic conditions to reduce disease progression and severity Strengthening general practice engagement and collaboration with allied health and nursing providers Delivering activities where they are most needed and can be sustained over time