Evaluation of the Priority Primary Care Centre program in the Western region of Victoria, Australia.

Abstract

Background/aim: Priority Primary Care Centres (PPCCs), akin to Urgent Care Centre (UCC) models of care, have been recently established across Victoria, Australia, with the aim of reducing emergency department (ED) demand by providing access to free, general practitioner (GP)-led services to attend to patients who may require urgent medical attention for non-critical conditions. This qualitative evaluation explored the perceived effectiveness and impact of the PPCC model on alleviating ED/system demand and patient and clinician experiences of care in three regional Victoria locations. Population/setting: Residents living in the Western Victorian region. Methods: Semi-structured interviews were conducted with clinical and non-clinical PPCC staff, PPCC patients, ED clinicians, and Western Victoria Primary Health Network (WVPHN) staff during the six-month period between September 2023 to March 2024. Implementation science frameworks informed exploration across key constructs and a thematic analysis identified themes relevant to reach (current service activity), effectiveness (perceived impact on alleviating system demand), adoption (satisfaction with service and quality of care from patient and staff perspectives), implementation (facilitators and barriers), and maintenance (opportunities for improvement). Results/findings: A total of 50 respondents participated in interviews: 27 patients (54%), 15 PPCC clinicians (30%), 3 ED clinicians (6%), 3 WVPHN staff (6%), and 2 PPCC administrative staff (4%). Findings show that PPCCs serve a diverse demographic by offering accessible, affordable care for low to moderate acuity issues. Most inappropriate visits are low acuity and more suited to general practice, with high acuity cases are less common. PPCCs help divert low to moderate acuity cases from EDs, reducing healthcare system pressure and filling gaps in areas with limited GP access and long ED wait times. Many patients felt PPCC access prevented ED visits and appreciated the convenience, welcoming environment, and no-cost service of PPCCs. While PPCCs and EDs generally collaborate well, there’s room for better engagement. Community awareness is growing, but broader messaging is needed. PPCCs attract and retain staff by offering diverse cases and a broad scope of practice. Key success factors include an experienced workforce, effective planning, and collaborative partnerships, while challenges involve poor community awareness and inadequate planning. Improvements can be made through better education, marketing, streamlined pathways, and enhanced service models. Conclusion: Findings from this study identified key insights and opportunities to guide enhancements to improve reach, adoption and effectiveness of the PPCC model of care. PPCCs may be a key interdependent piece of the puzzle to alleviating demand across primary to tertiary services, but unlikely the sole answer to reducing ED demand. Findings also suggest that the PPCC model has been implemented with a high level of success and is a valuable resource in helping to alleviate patient demand across primary to tertiary services. Future endeavours to improve the PPCC service model should focus on enhancing planning, infrastructure, operations, workforce, and awareness to ensure the optimisation and sustainability of PPCCs to fill identified gaps in meeting growing population health needs. Translational impact/implications for future practice: Impacts on future funding models, models of primary and secondary care.