General Practitioners' Collaboration with Service Coordinators: What Makes it Work? Lessons from the SA HealthPlus Coordinated Care Trial

In the past, a number of factors have been identified that discourage collaboration between GPs and other health professionals in providing care to patients with chronic illness. These include financing arrangements, lack of time and lack of knowledge of the role of other professions. This paper uses data from the independent evaluation of the SA HealthPlus Coordinated Care Trial to examine the factors that encourage and inhibit collaboration between general practitioners (GPs) and Service Coordinators (a role introduced by the trial and carried out by nurses and allied health professionals). Both quantitative and qualitative methods were used to evaluate the role of the GP and the Service Coordinator in the trial. These data were analysed to determine what factors encouraged and inhibited collaboration. Results indicated that effective communications, knowledge of and respect for each other's roles and responsibilities, and a clearly perceived benefit from collaboration were the most important predictors of successful collaboration for both parties. These results also suggest strategies for increasing the likelihood of collaboration between GPs and others such as the location of the Service Coordinator in the practice and ways of dealing with GP workloads and communication needs. These findings are relevant to recent policy initiatives including the MBS Enhanced Primary Care item numbers, the employment of practice nurses, and allied health staff via Divisions of General Practice.