Funded by the Department of Health and Aged Care (DoHA), the Workforce Planning and Prioritisation (WPP) program aims to address the gap in evidence-based, consolidated information and analysis on strengthening current and future workforce needs for the Australian General Practice Training (AGPT) program.

To enable accurate advice to the DoHA and the GP Colleges on workforce need in each state (to inform training capacity, placements and pathways), a Workforce Needs Framework (WNF) has been developed. It is a quantitative prioritisation framework that produces assessments of the highest GP workforce need for defined areas to inform GP workforce strategy and planning, drawing on demand and supply indicators.

The WNF methodology, defined and evaluated through a national working group, involved the development of separate demand (community need) and supply (access to GP services) indexes for each area. Indicators of both demand and GP workforce supply from data available were separately incorporated into two quantitative scores. Evaluative criteria were used to rate the impact/relevance, feasibility, sensitivity and governance of each of the indicators.

A key objective was national consistency for the Framework’s elements, including data sources, indicator definitions and parameters applied. However ,the model was then localised through application of knowledge specific to South Australia, including qualitative data and feedback.

The development of the draft WNF identified challenges with access, analysis and currency of available data sources, and underscored the role of clear communication in building traction with stakeholders. This presentation will showcase the development of the Framework methodology, including the challenges encountered, and discuss the current and future landscape of quantitive workforce need modelling in the sector.

The Asylum Seeker Advocacy Clinical Team (ASACT) at NSW Refugee Health Service (RHS) has over 12 years of experience providing health care to people who have encountered significant adversity and trauma, often with complex health needs.
The primary aim of this research is to evaluate ASACT within NSW RHS, and assess what is working well from perspectives of clients, staff and community partner organisations, and where improvements can be made. The secondary aim is knowledge translation through identifying broader principles of high quality care that can be implemented to meet asylum seeker health needs in other services.
Methods:
An evaluation framework, based on literature on people-centered approaches to healthcare, culturally responsive healthcare, and trauma-informed care, informed the development of an interview question schedule specific to the ASACT context. In-depth semi-structured interviews via videoconference were conducted with 9 ASACT clinicians, and 7 interviews were carried out with community partners. Client interviews are currently underway, with a target of completing 15 in total.
Data analysis followed Braun and Clarke's reflexive thematic analysis approach, involving the elicitation of themes using code tables. A deductive analysis assessed the extent of implementation of aims and indicators, alongside an open inductive approach to identify unanticipated program consequences.
Results
Findings demonstrates that ASACT provides people-centered, culturally responsive, and trauma-informed care. Staff members practice cultural humility and collaborate closely with interpreters and multicultural community groups, as well as being trauma aware. Holistic healthcare via a multidisciplinary team addressing broader social determinants of health is also provided.
Conclusion:
This study highlights the positive impact of people-centered, culturally-sensitive, and trauma-informed healthcare services. The collaboration between ASACT and community partners, as well as non-health sectors, empowers and engages refugees and asylum seekers, enabling them to actively participate in their own healthcare and ensuring genuine health equity for these clients.

Background:
While effectiveness of tele-health interventions for hypertension has been established, the evidence for economic evaluation is inconclusive, with most evidence being trial-based, with limited findings from real-world setting. The Primary Technology-Enhanced Care for Hypertension (PTEC-HT) Programme, comprising of tele-monitoring of blood pressure (BP), tele-support and tele-titration, is currently being scaled nationwide in public primary care Singapore based on positive pilot findings. This provides a unique opportunity to economically evaluate the PTEC-HT Programme in real-world setting.
Aim:
To evaluate effectiveness and cost-effectiveness of PTEC-HT Programme in improving the BP of patients with hypertension who visit the public primary care in Singapore over 6 months and 12 months.
Methods:
Aligned with the pragmatic implementation approach, a longitudinal controlled study design was adopted with historical controls assembled from the national claims records. Economic evaluation was conducted from healthcare system perspective using multivariable regression analyses to estimate the incremental health benefit and incremental cost.
Results:
For the intervention group, 427 and 338 patients were included at 6-month and 12-month analysis. In the intervention group, the improvement in BP over 6 months was maintained subsequently. For 6-month analysis, total saving was S$81.77 per patient, mainly contributed by savings from doctor consultation, laboratory services and medication. For 12-month analysis, the total saving was $222.99 per patient, which was more than twice of the saving for the 6-month analysis. PTEC-HT Programme continued to be more than 3 times cost saving as compared to the control group over both 6-month and 12-month duration.
Conclusion:
Our study showed that PTEC-HT Programme in the scaling-up phase of implementation is more effective in controlling BP status with lower direct medical cost compared to the usual care over both 6 and 12 months. Current analyses is part of longer-term economic evaluation of the PTEC-HT Programme and will guide subsequent evaluation efforts.

[Background]
Population ageing in Japan is leading to rapid and substantial increases in the prevalence of multimorbidity (co-existence of two or more chronic conditions). Previous studies have shown that certain multimorbidity patterns clustered together more commonly than others in a non-random way. However, no study on multimorbidity patterns has been conducted in older people from the community-based cohort in Japan. We aimed to explore multimorbidity patterns of older adults using drug prescription data sharing system in remote islands in Japan.

[Methods]
The cross-sectional study was conducted on the data collected over a 6-year period (2014 to 2019) as part of the prospective cohort study: Nagasaki Islands Study (NaIS) in Goto city, Nagasaki prefecture, Japan. Participants aged ≥65 years were analysed (N = 3,451). Cohort data for beneficiaries’ diagnosis history and symptom-based screening linked with drug prescription data were used, encompassing a wide range of chronic conditions from a list of 39. Three commonly used clustering methods – latent class analysis (LCA), two-step cluster analysis (TCA), and multiple correspondence analysis (MCA) were performed to conjointly identify common multimorbidity patterns.

[Results]
The overall prevalence of multimorbidity among the study population was 81.05%. All three methods identified a common multimorbidity pattern of dyslipidemia and hypertension. Additionally, LCA identified another multimorbidity pattern of chronic kidney disease, dyslipidemia and hypertension; MCA identified four more multimorbidity patterns: (1) dementia, depression, and epilepsy; (2) coronary heart disease, stroke, and transient ischemic attack; (3) insomnia, neurogenic bladder, and chronic pain; (4) Parkinson's disease, and serious mental illness.

[Discussion]
This study found a high proportion of Japanese community-dwelling older adults from the NaIS suffering from multimorbidity and examined the common multimorbidity patterns. These results underpin the emerging concern about multimorbidity and suggest the need to develop effective public health interventions to prevent multimorbidity in rural Japan.

To help address general practitioner workload and workforce issue, New Zealand health policy makers have been considering whether pharmacists should become be included in general practice teams across the sector. To inform policy development, the Royal New Zealand College of General Practitioners decided to survey the approximately 80 New Zealand general practices that employ pharmacists about how they currently value pharmacists. This presentation aims to share the findings of this survey, which showed that pharmacy services can reduce workload pressures and positively contribute to outcomes for patients and practices. Other recent research shows there are pharmacists who would like to work in general practice. As practice models continue to evolve, these findings suggest that pharmacists add a great deal of value and should therefore be added to Team GP.

Objective: To investigate the relationship between body composition indexes and hyperuricemia (HUA) in Chinese adults, and the mediating effect of serum lipid on the association between body composition indexes and HUA.
Methods: Using data from the Diverse Life-Course Cohort (DLCC) 2, serum uric acid (SUA) levels and body composition data [body fat percentage (BFP), fat mass index (FMI), fat-free mass index (FFMI), visceral adiposity index (VAI)] were collected. Binary logistic regression analysis and restricted cubic spline analysis examined the association between body composition indexes and HUA. Mediation analysis was conducted to investigate whether low-density lipoprotein cholesterol (LDL-C) or triglyceride (TG) medicated above association.
Results: BFP and FMI were positively associated with the risk of HUA, FFMI was inversely associated with the risk of HUA. About 16.0%, 5.58% and 5.63% of the total effect of BFP, FMI and FFMI on HUA were mediated by TG, about 13.2%, 10.0% and 10.1% of the total effect of BFP, FMI and FFMI on HUA were mediated by LDL-C.
Conclusion: This study suggested that BFP and FMI were positively associated with the risk of HUA and FFMI was inversely associated with the risk of HUA. Serum TG and LDL-C might partly mediate above association.

1. hyperuricemia
2. body fat percentage
3. mediation effect

Introduction
Many patients visit general practitioners (GPs) for self-limiting conditions such as acute respiratory infections and musculoskeletal conditions. For such conditions, 'waiting and seeing’, while managing symptoms, is often a legitimate option. However, this option is sometimes not communicated in consultations, and little is known about the best way to do so. This study explores people’s views and perceptions about 'wait and see' option for self-limiting conditions, preferred terminology, and which factors affect their decision to seek treatment.
Methods
Qualitative semi-structured interviews were conducted with a group of 30 Australian adults. Interviews were thematically analysed by two researchers independently. Identified themes were reviewed by all authors who agreed on the final themes and the illustrative quotes.
Results
Four themes emerged: (1) Perception of the meaning of ‘wait and see’ option varied according to whether care had been sought; (2) Acceptability of a ‘wait and see’ option was influenced by numerous factors (such as the nature of the condition and its severity, patients relationship with GPs, previous experience with the same or similar conditions, work and family commitments) (3) ‘Symptom management’ was perceived as the most reassuring and preferred phrase to describe the option of ‘wait and see’, with other phrases eliciting concerns; (4) Individuals strongly desire clear, collaborative, and action-oriented communication including about the ‘wait and see’ option
Conclusion:
Level of comfort with ‘wait and see’ option differed among individuals, with numerous factors influencing its acceptability. Some phrases to describe this option were preferred more than others. A clear and balanced discussion of the available options, including a ‘wait and see’ option when appropriate, is encouraged.