7.1 Issues affecting consumers

Background

Members of Reference Group 2 identified the need to explore the issues that would affect consumers if training was expanded into a broader range of settings. This need was reaffirmed by members of both Reference Groups 1 and 3. In addition, the need for consumer communication and engagement was highlighted in the consultations held between PricewaterhouseCoopers (consultants for Reference Group 1) and the medical specialist colleges.

It is anticipated that a two stage process will be required to involve consumers of health care in this initiative and support its implementation.

The first stage will be a communication process to identify key issues for consumers arising from increased specialist training in an expanded range of settings. Communication could be undertaken in a targeted fashion through live interactive broadcasts and focus groups, with representatives from consumer organisations and private individuals.

The second stage of the process would be an engagement campaign which responds to the issues identified in the first stage. It would be rolled out in line with the phased implementation of the initiative and would be linked to strategies for engagement with specialist colleges, jurisdictions and other relevant stakeholders - such as general practitioners making specialist referrals.

Issues to be explored

Some preliminary issues that would be useful to explore in the consumer communications include:

• patient consent to the services provided by specialist trainees
• patients' acceptance of specialist trainees within private health insurance schemes
• patient education about the medical education and training that has already been undertaken by specialist trainees
• the type of information that should be communicated to patients.

The proposed expansion of specialist training settings may also impact on the delivery of health care services in Indigenous communities. Discussions with the Office of Aboriginal and Torres Strait Islander Health and representatives from Indigenous communities will also be required on the most culturally sensitive way to implement the proposed changes.

Methods of communication

A range of communication methods will be needed to gain an understanding of the views held by a representative sample of patients from different service delivery settings and locations around Australia.

One method proposed for consulting with consumers in regional and rural areas is the use of a satellite network.

In addition to live interactive broadcasts on the satellite network, a questionnaire could be used to gain the views of a larger sample of consumer representatives over a longer period of time. The information from the questionnaires could also provide some quantitative data to support the qualitative data from the consumer consultations.

A series of focus groups may also be useful, providing an opportunity to gain the views of consumers in metropolitan areas. A range of representatives could be present at such focus groups including patients, carers and service providers such as general practitioners.

Consumer expertise should be sought on the following issues - the types of consumer representatives to be engaged, the issues to be explored during the consultations, and the type of information to be provided to consumers before the sessions.

This should become a responsibility of the governance structure established to manage implementation.

Engagement strategy

The content and timing of an engagement strategy will depend on the outcome of the first stage of the process. It is anticipated that such a campaign would target two particular groups - patients and service providers or clinicians.

The strategy would provide information to consumers on matters such as the rationale of the initiative, the skills and qualifications of specialist trainees, the continuum of medical training and the different roles and responsibilities of medical students and residents, and patients' rights to informed consent and informed financial consent for treatment provided by specialists and trainees.

Service providers and clinicians who do not currently interact with specialist trainees would need detailed publications outlining the workplace and professional implications of the scheme. They should be provided with workplace training (particularly when the scheme is being introduced) and have access to profession-focused forums. During the initial phase, information could also be sent to professional journals and publications for articles or editorial pieces. Providing information to GPs will be especially important, given their role in referring patients in need of specialist services.