The last of the 137 promised Medicare Urgent Care Clinics was rolled out last month – and UCCs are now a permanent part of the health system, with the government pledging 1.8 billion over the next five years to keep them running.

The Albanese government has been unabashed in claiming them as a success, but what do GPs have to say?

More than three quarters of GPs (76%) said they support UCCs in principle, but only 60% viewed the initiative as a success, according to a national Healthed survey in June with more than 1600 respondents.

One GP commented that while they were, “basically in support of UCCs,” after working in one, they noticed some discrepancies between intended use and actual use. For example, the service is being used by “patients with chronic health issues who can’t get an appointment with their usual GP in a reasonable time frame. Also, patients with trivial problems that should be self-managed are using the service just to acquire medical certificates,” the GP noted.

“The concept of the urgent care clinic is good, however a lot of extra tax-payer funds have been diverted there that could have been spent better in overall general practice to give better care,” another GP said.

“In principle I support them, however they are being funded with money that should come to GP and they are seeing non-urgent cases and turning away some on weekends, plus no pathology/imaging,” one GP summed up.

Seventy percent of GPs in the survey said their practice was in an area covered by an urgent care clinic; the government says 80% of Australians now live within a 20-minute drive to one.

Since June 2023 there have been more than 3.1 million visits to UCCs, including more than one in four on weekends and one in four after 5 p.m. on weekdays.

Interim evaluation findings

An interim evaluation report released in December found that urgent care clinics were reducing emergency department presentations by around 10% nationally, with 45% of patients saying they would have sought care in an ED or called an ambulance if the UCC hadn’t been available – increasing to 48% after hours.

These figures were cited by the government without caveats as it celebrated the opening of the last UCC. However, the report notes “these proportions should be considered with caution as there are many limitations” associated with the interpretation and reporting of the ‘where would the patient have gone otherwise’ question that the data was derived from.

RACGP to develop national standards

While the RACGP has been outspoken in its concerns about UCCs, it responded to news the clinics were here to stay by announcing that the College would be developing profession-led standards to ensure national consistency and prevent fragmentation of care.

“Urgent care must be well connected to general practice,” RACGP president Dr Michael Wright said, adding that GPs working within multidisciplinary teams would be key.

Lack of continuity of care resulting from UCCs has been an ongoing concern, with Dr Wright previously pointing out that the number of presentations with a handover directly back to the patient’s usual GP dropped from 68% in the first interim evaluation to 65% in the second.

Has the initiative been a success? What your colleagues are saying

Around 350 GPs elaborated on their views in the survey. Here are some of their comments:

Depends how you define success

“It depends on how success is measured. They are serving a useful purpose at enormous expense.”

“I think in terms of delivering care – yes; in terms of its cost to the taxpayer – no.”

In support of UCCs

“From ad-hoc patient feedback, it appears that the ability to access health care services has increased with the implementation of Urgent Care Clinics.”

“I work in one and they are fabulous. All the patients say they were not able to get into their regular GP or practice. They are ill or injured and need to be seen that day.”

“It saves patients waiting at an ED for many, many hours for minor issues and treatment, especially if no GP appointments available, or after hours.”

“Good access for patients out of hours, good communication (in my area at least) with theses clinics.”

Concerns about quality of care

“Demand for ED is still excessive to what they are staffed for. My patients who have attended urgent care have received minimal/no investigations and the only management plan is return to your GP to review (actually to sort out the issue) so they are 2-3 days behind where they should be as I have to initiate swabs, CXR etc. I thought the goal was to direct away from ED and improve health outcomes.”

“I am very glad there is access to healthcare without cost. But I’m very concerned about the quality of that healthcare being provided, and especially by some of the corporate clinics. The idea is to take pressure off emergency departments. It is not meant to take the place of proper general practice care, but this is what I see…”

There are better ways to spend the $$

“I feel it would have been much less expensive to set existing practices up to provide the services supplied by UCCs. The cost per presentation is very much in excess of what it would be if existing clinics had been funded to supply the services.”

“I think it is inappropriate for the taxpayer to pay $200-250 for a patient to see a GP at an urgent care clinic, when that taxpayer money would be much better spent by raising the patient rebate for a visit with their regular GP.”

“I think it is a lot of money wasted that could have gone to supporting existing practices. In principle, I don’t oppose Government subsidised after hours care for patients, but UCC funding is like robbing Peter to pay Paul.”

Not addressing the core issues

“If they just funded and supported general practice better then these wouldn’t be necessary.”

“It has been successful, but it hasn’t helped train more GPs or improve the GP workforce capacity. In fact, it has just taken more GPs away from general practice to staff the urgent care clinics! Both sides of government have not supported or encouraged new graduates to do general practice.”

“It would be far more cost effective to increase Medicare rebates and adequately fund general practice itself than the cost of running and setting up these urgent care clinics.”

Fragmented care

“If they order tests they should follow up. Currently tests are ordered and patients are NOT contacted about abnormal results. Being sent a copy of an abnormal result requires us to contact the patient as there is NO INFORMATION forwarded about the consult and management and all of this is done with NO REMUNERATION to the cc’d GP.”

“They have taken staff away from general practice to perform ad hoc cherry picking of simple cases, and doubling up spending on complex cases by just recommending they see their GP ‘within 24hrs’ to sort things out. All this while fragmenting care.”

It depends

“We have one excellent UCC in our area, and two not so good ones. The not so good ones are part of an existing practice, which seems more interested in gaining funds than addressing the needs of patients. I feel the clinics should be set up in independent settings – e.g. hospitals, community centres, etc, and be truly neutral.”

“Patients like them, good for access on weekends etc, however communication with routine GP is often lacking, especially getting results, x-rays etc. Often x-rays are not available or reported.”

A Band-Aid approach

“These clinics serve a purpose, to catch the overflow from day-to-day general practice, when bookings are full, and outside of regular working hours. They also help unload busy EDs. However, they are no substitute for preventative care, chronic disease management and continuity of care, which can only be delivered by general practice, which is seriously under-funded, hence they are a ‘Band-Aid approach.’”