The Royal Australian College of GPs (RACGP) has called on all local health authorities to empower GPs to volunteer and practice as part of response teams in evacuation centres during disasters in a letter, and urged GPs to work with them to coordinate care.
The College has also released new resources to help state and local authorities responsible for disaster management to connect with local GPs and include them in their disaster planning, and a new position statement on the role of GPs in emergencies.
The RACGP's Key recommendations for the inclusion of GPs into evacuation centres propose:
- local Primary Health Networks (PHNs) can play a critical role in establishing lists of GPs and other medical personnel who can assist in emergencies ahead of time
- general practices be designated and prioritised as essential services during disasters
- dedicated funding be allocated to general practices for preparation, response, and recovery from disasters
- reductions in red tape that affects GPs in emergencies, including Medicare compliance activities
- the RACGP and public health networks (PHNs) be included in national, state, territory and local government disaster and emergency planning groups and committees.
The RACGP has also created a new resource to guide GPs working in evacuation centres during an emergency.
RACGP President Dr Nicole Higgins said GPs who have volunteered to work at evacuation centres during disasters in some regions have been unable to keep practices operational or assist at evacuation centres due to a lack of planning and coordination with disaster teams ahead of time.
"When disaster strikes, local GPs are on the front line, but to help their communities, it's important they're part of a coordinated response," she said.
"There have been times when GPs have had to be turned away from evacuation centres because the planning simply hasn't been in place. That's not a matter of poor judgment by emergency responders or a reflection on those GPs' capabilities, it's that the planning and policy settings weren't there to recognise the training GPs have to treat evacuees in emergencies. General practice is the responsibility of the Federal Government, while emergency planning is handled by state and territory governments. We need to ensure state, territory and local governments include the capabilities of their local GPs in their disaster management planning and response, and local GPs make contact before an emergency.
"In many parts of Australia, good disaster management practice has really improved coordination between GPs and local health authorities in emergencies, especially after the Black Saturday and 2019-20 bushfires. That showed in the safety the Nepean Blue Mountains response provided to its communities, for example. We are far, far more able to respond and keep people safe in disasters if the planning has already happened, and it's important that emergency response planners consider what GPs can bring to the table, and that GPs engage with them.
"GPs can and do provide medical assistance in emergencies. It's part of our training. Many GPs, and especially GPs in rural and regional areas, have also completed additional emergency medical training and work shifts in emergency departments of their local hospitals. We need to make sure they're ready to go and the teams running evacuation centres know who to call when disaster strikes."
Lizz Reay, CEO of Wentworth Healthcare, provider of the Nepean Blue Mountains Primary Health Network, said general practice must be formally included in disaster response and recovery plans and that PHNs have an important role to play in helping to coordinate this.
"We're a strong advocate for the importance of the role of primary care in emergencies to be formally recognised at national, state and regional levels and for PHNs to play an essential role by helping to coordinate and support GP preparedness, before and during a disaster," she said.
"This can be both within a GP's own practice being impacted by a disaster or assisting at an evacuation centre. We can provide one point of contact for emergency operation centres and facilitate the sharing of intel, ensuring the local primary care response is incorporated into the overall coordinated disaster response. We can also advocate for the needs of the community on the ground on behalf of primary care, for example as we did during the recent floods, achieving telehealth exemptions in disaster declared regions."
Ms Reay said the value of GPs in disaster response was clear when devastating bushfires swept through the Blue Mountains in October 2013, causing mass evacuations. Many residents had fled their homes without their regular medication or scripts, whilst others were experiencing minor cuts, wounds, respiratory complaints, and elevated anxiety.
"The need for GP support at these crowded evacuation centres was identified early on, to reduce the burden on emergency services and hospital resources," she said.
"At the request of the hospital, our organisation helped identify local GPs to assist in the response and developed a roster for GP attendance at the evacuation centres. This was all done on the run. This highlighted to us the need for primary care to be officially recognised in emergency management plans and for GPs to be prepared prior to disasters, to improve response and recovery outcomes and to ensure community safety.
"Learning from that disaster, our organisation advocated to be included in our local emergency response plan and led the development of several documents and resources, created with input from the various GP groups, for use as part of our disaster preparedness strategy. This meant that during the 2019-20 bushfires, we were better prepared and were included in our local emergency management process.
"Some of our preparations included, among other things, having an active register of local, credentialled volunteer GPs who could work at evacuation centres if needed and who had also received additional training in disaster medical management. We developed resources and tools needed by GP volunteers at emergency evacuation centres such as role descriptions, triplicate pads of patient summary forms and prescription pads, a GP vest to clearly identify volunteer GPs, and medical packs with supplies to complement the GP's own Prescriber Bag, or "doctor's bag" of emergency use medicines. Together with our PHN, registered volunteer GPs are also involved in scenario planning activities to ensure they are well equipped to undertake the role in a disaster."
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