Coronavirus disease (COVID-19)
recent updates for primary care.

Page last updated: 9:30am, 31 July 2020

The following is a summary of recent advice for general practices, pharmacies and other primary care providers.

Please visit our COVID-19 homepage for urgent updates.

MBS: Whole of population telehealth

COVID-19 Telehealth MBS items can now be claimed.

Changes to these MBS telehealth items came into effect on 20 July 2020:

From 20 July 2020, GPs and other medical practitioners working in general practice can only provide telehealth where they have an existing and continuous relationship with a patient in order to provide telehealth services. Patients can now only access telehealth services under the Medicare Benefits Schedule (MBS) through their regular GP or practice.

This means patients will be eligible telehealth services from GPs and other medical practitioners if they have seen their GP or another medical practitioner or health practitioner (such as a practice nurse of Aboriginal and Torres Strait Islander health worker) within the same practice at least once in the preceding 12 months.

However, this requirement does not apply in areas under stage three restrictions in Victoria.

  View fact sheets for the new MBS items

Visit MBS Online for all the items and the latest information.

Visit our telehealth page for more telehealth resources.

Requirement to notify WorkSafe of COVID-19 incidents

From 28 July 2020, employers are required to notify WorkSafe immediately on becoming aware that an employee or an independent contractor or a contractor’s employee has received a confirmed COVID-19 diagnosis and has attended the workplace during the infectious period.

Self-employed persons are also required to directly inform WorkSafe immediately on receiving a confirmed COVID-19 diagnosis if they have attended the workplace during the infectious period.

The infectious period begins on the date 14 days prior to the onset of symptoms or a confirmed COVID‑19 diagnosis (whichever comes first), until the day on which the person receives a clearance from isolation from the Department of Health and Human Services.

Visit the WorkSafe Victoria website for more information.

Electronic prescribing

New electronic prescribing hub on the Australian Digital Health Agency website

The Australian Digital Health Agency has published a new page on electronic prescriptions. There are also dedicated pages for prescribers and dispensers.

These pages include the key information clinicians will need to know in the lead up to electronic prescribing, which has been accelerated and is scheduled for the end of May 2020.

Interim arrangements for e-prescribing to support telehealth (from NPS Medicinewise)

Ahead of the introduction of electronic prescribing later in the year, please be aware interim arrangements are now in place for prescribing to make supply of medicine more convenient following a telehealth consultation.

Under the interim arrangements, a digital image (such a photo, scan or pdf) of a prescription can be sent electronically by the prescriber to the patient’s pharmacy of choice. This electronic copy can be used by the pharmacy to supply the medicine and claim from the PBS in the same way as a paper prescription. The pharmacy may communicate directly with the patient to arrange payment and to organise collection or home delivery of the medicines.

Alternatively, the paper prescription can be sent by post to the patient. The prescription can then be taken to a pharmacy by a family member or friend.

As part of the National Health Plan, electronic prescribing is being fast-tracked. Work to upgrade healthcare providers’ clinical software is well underway and is expected to be ready by May 2020. The Australian Government has announced the interim arrangements for prescribing will remain in place until 30 September 2020, or until full electronic prescribing rollout is implemented. 

Factsheets summarising these interim measures are available for prescriberspharmacists and consumers.

For more information, see the Australian Government Department of Health website.

Electronic prescribing webinars

NWMPHN recently held two webinars presented by adoption and clinical use leads from the Australian Digital Health Agency:

 Electronic prescribing update for GPs and practice managers: Webinar held on 9 June 2020

 Electronic prescribing update for pharmacists: Webinar held on 11 June 2020

Fact sheets for primary health care workers supporting people with disability

The Commonwealth Department of Health has developed five fact sheets for health professionals regarding supporting people with disability during the COVID-19 pandemic, including one fact sheet specifically for GPs and other primary health care workers.

These fact sheets have been developed as part of the implementation of the COVID-19 Management and Operational Plan for People with Disability, and are available on the Department’s website.

ATAGI Guiding Principles for maintaining immunisation services during COVID-19

Immunisation providers will need to adapt their procedures and practice to comply with measures in place, including physical distancing, to reduce the transmission of COVID-19. This is to ensure that immunisation services can continue to be conducted safely without exposing health care workers, vaccinees, their caregivers and the wider community to undue risk.

Immunisation protects individuals and the community from vaccine preventable diseases (VPDs). If scheduled vaccine doses are missed or delayed, or overall vaccination coverage rates are diminished, there is a risk of resurgence of some well-controlled VPDs or outbreaks of some VPDs, such as measles, during and/or after the COVID-19 pandemic. This will put further strain on the health care system.

Importantly, preventing influenza through vaccination is essential in reducing strain on the health care system.

  Read the Australian Technical Advisory Group on Immunisation's Guiding principles for maintaining immunisation services during the COVID-19 pandemic

Temporary changes to requirements under s19AA and 19AB of the Health Insurance Act 1973

To support doctors responding to the COVID-19 pandemic the Department of Health is implementing a number of short term measures to waive or streamline Medicare program requirements. These will ensure eligible doctors can continue to satisfy their obligations under section 19AA and 19AB of the Health Insurance Act 1973 and provide Medicare services to patients in their current practice.

There will be an automatic six-month extension of s3GA placements and 19AB exemptions expiring from 1 May 2020, including extension of locum placements. These extensions will be processed on a month-by-month basis (approximately six weeks in advance of expiry) and all extensions will be confirmed with each doctor via letter or email. No application form will be required for these extensions.

Note that there are some conditions attached to these changes, which are detailed in the attached table. In addition, doctors who are within 6 months of reaching the maximum participation period will be reviewed by the Department before an extension is granted. The review will include consideration of a doctor’s prior 3GA program participation and progress to fellowship (including exam history). Doctors who are not granted an extension will be notified by email/letter by the Department.

The Department is also waiving program requirements that can no longer be met due to the current circumstances, including:

  • All program milestones will be suspended for six months ie doctors will not need to complete fellowship exams or apply to college led fellowship programs.
  • Extensions will not count towards program participation maximum
  • For current AMDS doctors, evidence of Advanced Life Support re-certification will be waived for six months.

The Summary of Changes document explains the changes and any conditions. The Q&A document also provides information on possible questions individuals may have.

While we anticipate these extensions will continue for up to 6 months, the Department will review the need for such changes regularly and will cease these measures when no longer required. Any placement already extended will remain in place until the amended expiry date.

A message from the Ombudsman and Commissioner

The office of the National Health Practitioner Ombudsman and Privacy Commissioner is available to support health practitioners and the community during the COVID-19 pandemic. The office has provided a statement for health practitioners.

COVID-19 and the National Cervical Cancer Screening Program

The cancerscreening.gov.au website has been updated to provide health care providers with guidance about managing cervical screening participants during the COVID-19 pandemic.

The Department of Health is closely monitoring the impact of the COVID-19 pandemic on health services. The National Cervical Screening Program (the Program) is encouraging health care providers to continue to offer routine screening and follow up. However, we recognise under the current circumstances that patients may be feeling uncomfortable or worried about attending for screening, and health care providers/clinics have different capacities and arrangements for managing their patients.

The Program is receiving a number of enquiries from health care providers about how best to support their patients during this time. The Program has developed overarching guidance to assist clinician decision-making on screening appointments including deferral and rescheduling, depending on individual patient circumstances. In addition, the Department has developed guidance for the management of patients requiring further investigation and treatment during the COVID-19 pandemic due to the cancellation of elective surgeries. This guidance is supported by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian Society for Colposcopy and Cervical Pathology.  

DHHS Recommendations for influenza vaccination

With COVID-19 spreading across Australia, this year it is more important than ever to ensure that patients receive the seasonal influenza vaccination. Influenza vaccination should be given as soon as possible. The regular influenza season may coincide with the peak of the current COVID-19 pandemic, potentially placing additional burden on the Australian health system.

  • Influenza vaccine distribution to immunisation providers has commenced. Adjuvanted influenza vaccines are available for people aged 65 years and over.
  • From the 1st of May, the flu vaccine will be mandatory for people wanting to visit an aged care facility (including aged care workers).
  • Claims that influenza vaccination may increase the risk of coronavirus infection have been circulating on social media. There is no convincing evidence to support these claims.
  • To ensure compliance with physical distancing measures, DHHS has recommended that systems are implemented to regulate the number of people entering your practice or immunisation venue.
  • Vaccines should not be administered to people sitting in vehicles. Clients must not wait in their vehicle post vaccination. This is in case of an immediate adverse event following vaccination.
  • For guidance and service delivery models for providing immunisation services, please see our Victorian immunisation services factsheet (Word)

Visit the DHHS website for more information.

DHHS advice to immunisation providers about ordering processes and delays

Updated 9:15am, 17 April 2020

The Victorian Department of Health and Human Services provided the following advice to immunisation providers on 16 April 2020:

Pressure on the vaccine distribution system is very high with National Immunisation Program (NIP) vaccines in great demand.

To date, 1.5 million doses of Government funded influenza vaccine have been distributed to Victorian Providers.

COVID-19 has meant OneLink warehouse staff must meet physical distancing requirements. As a result, there are additional delays in receiving vaccine orders. This is unavoidable and we appreciate your understanding and patience at this difficult time.

Influenza Program 2020

Who is eligible under the NIP?

  • Children aged six months to less than five years
  • Aboriginal and Torres Strait Islander people aged six months and older
  • Pregnant women (at any stage of pregnancy)
  • People aged 65 years and older
  • People aged six months and older with medical conditions putting them at increased risk of severe influenza and its complications

Who is eligible under the state funded program?

  • Public hospital health care workers – public hospitals run and manage this program.

Summary of government funded influenza vaccine availability

Program   Brands funded for this program   Current vaccine stock status   Additional information  
6 months to less than 5 years   Vaxigrip Tetra®   Available - Monitored   Fluarix-Tetra and FluQuadri are also licensed from 6 months of age and can be administered if Vaxigrip Tetra is not available 
At-risk program – 5 years to less than 65 years   Afluria Quad® 
Fluarix-Tetra® 
FluQuadri®  
Available - Monitored Vaxigrip Tetra is also licensed from 6 months of age and can be administered if other brands are not available  
65 years and over   Fluad Quad®   Limit 50 doses per order, per account Please see information below.  
Public Hospital Health Care Worker   Afluria Quad®
FluQuadri®
Available  

 

Avoid vaccine error administration

Afluria Quad can only be administered to those medically at risk aged 5 years to less than 65 years.

Ordering processes

  • Consider all stock before placing your order for government funded vaccines.  This will limit the number of deliveries and ensure that you receive your vaccine as soon as possible (a maximum of one order per week).
  • If there is an outstanding influenza order for your service another order will not be accepted by OneLink until your existing order has been delivered.
  • If you have the facilities to submit you order via email please do so, this is the preferred method. You should then receive automated acknowledgement and can be confident that your order has been received.
  • Vaccine order forms should be submitted to orders@onelink.com.au. Always use the most current vaccine order form – order forms are available on the health.vic website.
  • Always allow a minimum of five working days for vaccine delivery during flu season.
  • Please do not resubmit orders.

Important points to remember

  • To ensure continuity of stock supply, offer government funded vaccine to eligible groups only (see above)
  • Use the brand funded for the age range above. This will maximise vaccine availability throughout the season
  • Consider the number of eligible patients in your practice and do not over order vaccine
  • Do not book appointments unless you have vaccine available
  • Afluria Quad can only be administered to those medically at risk aged 5 to less than 65 years.

Fluad Quad – Limited ordering 

Although Victoria have predicted a vaccine uptake of 100 per cent for the over 65 group, we have seen an unprecedented early demand for vaccine this year. Vaccines ordered by providers for this group have already exhausted over 90 per cent of our forecasted supply.

To maintain continuity of stock supply throughout the remainder of this flu season we are limiting orders of Fluad Quad to 50 doses per order, per account for all providers. Orders for other age groups are also being monitored and your order may be adjusted.

Pneumovax 23 – Vaccine shortage

Please note that currently there are limited supplies of the Government Funded Pneumovax 23® vaccine. Please consider your ordering requirements when placing vaccine orders for Government funded vaccines.

Prior to the administration:

  1. Check age eligibility: Victorian Immunisation Schedule April 2020
  2. Check immunisation history and the Australian Immunisation Register.

Helpful resource: Quick guide table for planning pneumococcal vaccination in adults

More information

Visit our website or email immunisation@dhhs.vic.gov.au

For guidance and service delivery models for providing immunisation services visit, See Advice for clinicians, vaccination and medications on the DHHS website.

Thank you for your cooperation with the management of the 2020 NIP and State Immunisation Program

--

Immunisation Unit | Health Protection Branch
Regulation, Health Protection and Emergency Management Division
Department of Health and Human Services

Orders for pharmacists, vaccinations and prescription medications

Updated 20 April 2020

Vaccinations

  • Victorian pharmacists can now administer approved vaccinations outside of their normal location – through the mobile and outreach services of a hospital, pharmacy or pharmacy depot, increasing access to immunisations for all Victorians.
  • It is also easier for younger Victorians to get these immunisations from their local pharmacy. Appropriately trained pharmacists can now administer the flu shot to children 10 years of age and older.

Prescription medicines

  • GPs can provide a digital image of the original Schedule 4 prescription for patients who are self-isolating at home. Pharmacists may then be able to arrange home delivery of the medication.
  • During the COVID-19 pandemic, pharmacists can supply prescription medications without a prescription for one month in emergency circumstances except for Schedule 8 medicines.
  • Doctors prescribing Schedule 8 medicines for non-drug dependent patients will not be required to apply for a Schedule 8 treatment permit for the next six months, but instead check SafeScript.
  • Practitioners will need to apply for Schedule 8 treatment permits for drug dependent patients, including opioid replacement therapy.
  • During the pandemic health practitioners should take all reasonable steps to access SafeScript, as it is a very effective in providing up-to-date information about a patient’s prescribing and dispensing history.
  • Two new public health emergency orders have come into effect and can be found here.
DHHS requirements for pathology slips

Remember to include a mobile contact phone number for the patient on all COVID-19 pathology request forms.

If the test request is for high-risk patients, health care workers, aged or residential care workers or disability workers, make this clear on the slip and their results will be prioritised where resources allow.

Specimens taken from health care workers should be marked "HCW" or "URGENT – Health Care Worker".

Use one swab per patient for COVID-19 testing

There is currently a limited supply of swabs and reagent test kits for COVID-19 testing.

It is critical that clinicians limit testing to patients who meet the testing criteria

When taking specimens:

  • Use only one swab for both nostrils and throat for each patient (i.e. a total of one swab per patient).
  • Please avoid doubling up and sending swabs to both private laboratories and the Victorian Infectious Diseases Reference Laboratory (VIDRL) concurrently – testing is only required to be sent to your usual laboratory.
  • Please write clearly on the specimen request if the patient is a health care worker – mark the specimen request: Urgent – Health Care Worker
Suspension of general practice accreditation

The Australian Commission on Safety and Quality in Healthcare (ACSQA) has announced the immediate suspension of general practice accreditation activities.

The accreditation status of general practices will be maintained during the response phase of the COVID-19 pandemic. For example, a general practice that would normally have one year before its scheduled assessment, will have one year before its next assessment from the time these measures are ceased.

These arrangements will be monitored with changes anticipated in the recovery phase of the pandemic. More information is available on the ACSQA website.

Home medicines services

The COVID-19 National Health Plan includes the Home Medicines Service. This service will enable vulnerable people and people in self-isolation to order their PBS and RPBS prescriptions remotely and have their medicines home delivered to reduce their potential exposure to COVID-19.

While the details are still being confirmed, the most current information about this program is available here.

Current public health response status

The World Health Organisation officially declared COVID-19 a pandemic on 11 March 2020.

Victorian Premier Daniel Andrews declared a State of Emergency in Victoria on Monday, 16 March 2020.

On 22 March 2020, Mr Andrews announced that Victoria will proceed over the next 48 hours to implement a shutdown of all non-essential activity across our state.

The Australian Government declared a human biosecurity emergency on Wednesday, 18 March 2020.

On 30 March 2020, Mr Andrews announced stage 3 restrictions for Victoria:

  • These Stage 3 restrictions came into effect from 11:59pm on Monday, 30 March 2020.
  • They will be in place for four weeks and reviewed as required.
  • The Stage 3 restrictions mean that previous advice about staying home will become enforceable.
  • Playgrounds, skate parks and outdoor gyms will also close.
  • Visit the Victorian Government website for more information.
COVID-19 Pandemic Plan for the Victorian Health Sector

Updated 1 April 2020

The Victorian Government released its COVID-19 Pandemic plan for the Victorian Health sector on Tuesday, 10 March 2020. The full plan is available on the health.vic website.

  • Your nominated COVID-19 contact person should read the plan.
  • We are currently at Stage 2 “Targeted Action” of the plan

Note: The Victorian plan is intended as an overarching guidance document to inform more detailed planning at individual practice and institutional level. All health services should now develop or review local plans for pandemic preparedness, response and recovery.

  • The RACGP Pandemic response plan can help your practice prepare. Please note that this plan is for pandemic influenza, but the same principles apply for COVID-19.
Communications to primary care providers in our region (archive)

  Subscribe

  Go back to COVID-19 hub