Do enhanced general practice services improve health outcomes and health service use? Flinders QUality Enhanced general practice Services Trial (Flinders - QUEST)

General practices (located in Adelaide, South Australia) in the intervention arm will deliver enhanced services to trial participants for a 12 month period. The enhanced services will be provided by the participant's usual general practice clinical team. Practices however will be supported (both financially and logistically) to deliver the enhanced services. The logistical support will include administrative assistance for participant recruitment and the provision of a Practice Facilitator who will support practices to incorporate the intervention elements into routine systems of care. The enhanced general practice services to be provided are as follows: (1) Enrollment with a preferred GP Intervention arm practices will record the trial participant’s preferred GP in clinical (comments field) and appointment (notes field) practice systems. This will flag to practice staff (the clinical and administrative teams) that the patient is enrolled in the trial and has a preferred GP. Participants enrolled in the Intervention arm will be provided a folder comprising trial written materials (Care Plan, future appointments and referrals). Participants will be asked to inform practice staff of their participation in the trial (and preferred GP) when making appointments. (2) Longer GP appointments GP Medicare funded appointments are time based: Level A: “Brief consultations”; Level B: “Standard consultations” (<20 minutes); Level C “Long consultations” (>20 minutes) and Level D “Prolonged Consultations” (>40 minutes). Longer appointments will be defined as Level C and D consultations. A facilitator will assist practices to make changes to practice appointment systems to accommodate longer consultations for trial participants. Each practice will decide what changes will be necessary to allow this and the best manner in which to implement the changes. (3) Follow-up after significant health events (Emergency Department presentation or hospital admission) Intervention arm participants will be contacted by clinical practice staff for practice or home based review within seven days of the participant experiencing a significant health event, where this is clinically indicated. (4) Same day appointments for children and young people experiencing acute conditions The participation of children and young people in the Intervention arm of the trial will be recorded in the clinical (comments field) and appointment (notes field) practice systems. This will flag to all practice staff (the clinical and administrative teams) that the child or young people should receive priority access to same day appointments if they (or their parents) contact the practice seeking an appointment for an acute condition.