Introduction to integrated models of private general practice

Integrated private general practice models are arrangements through which GPs and hospital medical practitioners (often rural generalists) work together to provide planned and preventative care in the community (general practice) and acute and emergency care at the hospital.

Hospital and health services (HHSs) can work with existing private practices to share doctors who can function across both primary and secondary care and, where general practices have already closed, could step in to maintain them or open a new general practice service that is integrated with the local hospital.

Developing an integrated private general practice model requires an understanding of primary health care and the business model for general practice.

It will also require an appreciation of the role and scope of rural generalists in providing primary health care, an awareness of the enabling framework in Queensland for granted private practice arrangements and a working understanding of the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS).

The Better Practice Guide

Building integrated workforces can support the sustainability of both general practice and hospital services, preserving access to preventative and chronic disease care in the community. It will also reduce preventable presentations and avoidable admissions in hospitals and reduce the use of locum services.

The Better Practice Guide to Integrated Private General Practice (PDF 797 kB) outlines the legal and policy framework through which HHSs can become involved in delivering private general practice services, when needed, and provides guidance on the ways to implement integrated models.

Four broad models of integrated private general practice are explored in the guide (also explained in the guide summary):

  • Medical practitioners with private practice are doctors who conduct their own private general practice and are also retained by local hospitals to provide emergency and inpatient care
  • Rural GPs engaged to work part time or as visiting medical officers (VMOs) in local hospitals
  • Releasing hospital doctors and rural generalists to undertake private general practice
  • General practices operated by hospital and health services that support hospital doctors to provide private general practice care

Models of integrated private general practice

Review and consider the traits of each of the 4 integrated private general practice models.

    • A practice building is owned or leased by the MPPP or made available by the hospital and health service (HHS) or another organisation.
    • A HHS makes other facilities available to access Queensland Health enterprise systems.
    • The practice is owned and operated by an MPPP.
    • Patient records are in the custody of the MPPP.
    • Staff are employed by the MPPP.
    • Other MPPPs make independent private practice arrangements with the MPPP operating the practice.
    • MPPPs are employed by the health service on a retainer model and have hospital duties set out in the Award—see clauses 14.2 and 14.3 of the Medical Officers (Queensland Health) Award – State 2015.
    • The practice building is owned or leased by the general practice.
    • The practice is owned and operated by the general practice.
    • Patient records are in the custody of the general practice.
    • Staff are employed by the general practice.
    • Private general practitioners are rostered in the hospital as a VMO or as a fractionated SMO (part-time employment).
    • The practice building is owned or leased by the general practice.
    • The practice is owned and operated by the general practice.
    • Patient records are in the custody of the general practice.
    • Staff are employed by the general practice.
    • HHS rural generalists conduct their private practice in the general practice using a granted private practice agreement (assigned or retained) or external practice arrangements (outside employment).
    • HHS rural generalists work in combined hospital and practice rosters under agreed business protocols that provide practice management fees to the private practice.
    • Private general practitioners may or may not work in the hospital as a VMO or fractionated SMO.
    • The practice building and related ICT facilities are provided by the health service.
    • The practice is operated by the health service.
    • Patient records are in the custody of the health service.
    • Staff are employed by the health service.
    • Rural generalists conduct private practice in a general practice using granted private practice agreement (assigned or retained) or licenced practice arrangements (in the doctor’s own time).
    • Rural generalists work in combined hospital and practice rosters.

Rural generalists

Rural generalists, practicing independently or as a salaried medical officer in our hospitals, are a key resource in helping rural patients to access the right care, in the right place, at the right time, as close to home as possible.

Find out more about the National Rural Generalist Program or make enquiries about the Queensland Rural Generalist Pathway.

Medicare and private practice

Medicare billing for primary health care is vastly different to acute service funding of hospitals or private specialist care delivered in public hospitals. It is important for doctors and practice staff to develop their knowledge of the MBS, its compliance rules and the supporting processes needed to efficiently and effectively bill for services provided.

See our general practice information sheets about navigating Medicare (PDF 570 kB) and the PBS (PDF 468 kB).

Arrangements for Queensland Health clinicians to participate in private practice have existed since 1986. Private practice in the Queensland public health sector facilitates patient choice, helps to attract and retain a highly skilled clinical workforce and enhances the overall sustainability of the public health system. In rural health, private practice can be used to unlock Medicare benefits that are available to finance primary health care delivery in a community and fund the medical workforce.

Read more about Queensland’s Health Service Directive and framework for private practice in the Queensland public sector.

Last updated: 5 August 2024