Meeting local complex health needs by building the capacity of general practice: the University of Queensland GP super clinic model

Jared M Dart, Claire L Jackson, Helen J Chenery, Paul N Shaw and David Wilkinson
Med J Aust 2010; 193 (2): 86-89. || doi: 10.5694/j.1326-5377.2010.tb03807.x
Published online: 19 July 2010
Stakeholder analysis

As part of the proposal-development process, UQ analysed relevant population health statistics and consulted with local stakeholders like general practitioners, Divisions of General Practice, the Royal Australian College of General Practitioners (RACGP), Queensland Health services and other peak bodies (eg, Diabetes Australia Queensland).

Local population health statistics (Box 1, Box 2) were used to determine appropriate geographical locations, local health issues and local use of the Medicare Benefits Schedule.2-4 Together, these rapid qualitative and quantitative approaches identified the following problems:

Qualitative data obtained during stakeholder interviews are summarised below.

The University of Queensland GP super clinic initiative

UQ’s involvement in the GP Super Clinics Program is a perfect demonstration of its commitment to engagement, learning and discovery. By developing GP super clinics that meet pressing local health needs, UQ is engaging with the community, health professionals, and government and non-government organisations. Super clinics also provide an ideal opportunity to model successful interprofessional practice and provide interprofessional education. The two super clinics located on UQ campuses (Pharmacy Australia Centre of Excellence and UQ Ipswich) will be fully integrated into the health programs operated by UQ’s Faculty of Health Sciences. Likewise, super clinics offer a rich research environment in areas such as health-service design, health economics, e-health, social and behavioural aspects of health, and interprofessional practice.

To guide our involvement in the GP Super Clinics Program, we have developed a set of key objectives (Box 3).

Governance and business model

The diagram in Box 4 outlines the governance structure for the UQ GP super clinics. In short, there are local reference groups, a broad university-funded steering committee, and a university-funded super clinic advisory group that informs clinical, educational and research initiatives. UQ has also funded a 0.6 full-time-equivalent position of Director of GP Super Clinics to facilitate the development of the program. The clinics will operate on a mixed-billing business model, with GPs remunerated on a percentage of billing, not by salaries.

Advanced care hubs — collaboration with local providers

Our clinical-service and business models focus on enhancing the capacity of local general practices. Data show that most patients are highly satisfied with their “usual GP”.5 However, GPs often need to rely on other specialist medical and non-medical staff to facilitate optimal care for their patients. Likewise, many GPs develop specialised skills in an area of interest — so-called GPs with special interests or GPs with advanced skills. Within multidoctor practices, GPs occasionally refer patients to their colleagues who have additional skills in a particular area (eg, mental health, skin cancer medicine, women’s health). In ideal scenarios, these GPs would be supported by specialist colleagues who provide advice and patient consultations as required. This practice occurs, often, on an informal basis.

Inala Primary Care, one of the Brisbane Southside spokes, operates a complex diabetes service for the surrounding area. In this model, GPs who have undertaken advanced diabetes care training through the UQ Master of Medicine (General Practice) work as clinical fellows, and are supported by a multidisciplinary team and an endocrinologist. They provide appropriate and defined care for referred patients, working closely with the patient’s usual general practice team. Unpublished data show that patient outcomes are equivalent or superior to those of control patients treated at the outpatient service.

Our model, based in part on this experience, uses practice nurses, GPs with advanced skills, specialists and allied health professionals to manage patients with complex problems and to formalise this practice on a regional basis. Local GPs are encouraged to work sessions in their areas of special interest, and to develop locally appropriate clinical pathways based on available evidence and resources. These GPs will either hold, or be assisted to obtain, advanced qualifications in this area of special interest. This approach enhances the capacity of the local region, improves timely and appropriate access to specialised advice in an appropriate community-based location, addresses significant and emerging workforce pressures, and recognises the valuable role of “generalist” and “specialist” GPs in managing complex patient types. The model is illustrated in Box 5.

We are also fortunate to have a key partnership with Mater Health Services, which is the largest non-government provider of health services in south-east Queensland, and will provide specialist medical, nursing and allied health support in our Brisbane Southside super clinics.

Extended-capability pharmacy — supporting effective and safe practice in primary care

Having hospital-based clinical pharmacists as part of a collaborative team has been shown to improve patient safety and appropriate prescribing.6 However, community-based pharmacist support for GPs has been lacking,7 with schemes such as the home medicines review program having been underused, perhaps as a result of a lack of access or awareness. Yet, our stakeholder feedback suggested that many GPs would value appropriate and timely advice from pharmacists, especially when managing patients with complex conditions. At UQ, we developed a model for an extended-capability pharmacy and sought commercial providers to commit to providing this service in our Ipswich, Logan and Annerley sites. The Annerley GP super clinic site, based in the Pharmacy Australia Centre of Excellence, is adjacent to the University’s School of Pharmacy. These pharmacies will be involved in collaborative advanced medication management programs for patients with chronic diseases.


There are a number of issues associated with the GP Super Clinics Program, and some resistance from the general practice sector has been reported in the media. However, we believe that our GP super clinic model has considered the concerns of GPs, patients and other stakeholders, and that it addresses the needs of these groups while providing an excellent opportunity for the university to be involved in innovative service delivery, community-based education, primary-care service design and evaluation. We are currently constructing and refurbishing facilities before commencing operations in late 2010. Interested parties are encouraged to contact us via email at

3 University of Queensland GP super clinic objectives

  • Jared M Dart1
  • Claire L Jackson2
  • Helen J Chenery3
  • Paul N Shaw4
  • David Wilkinson5

  • Faculty of Health Sciences, University of Queensland, Ipswich, QLD.


Competing interests:

Jared Dart is the sole Director of iHealth Solutions Pty Ltd, which was contracted to develop the super clinic proposal for the Redcliffe Hospital Foundation (Redcliffe super clinic, August 2008) and the UQ (Ipswich and Brisbane Southside super clinics, January to June 2009).

  • 1. Australian Government Department of Health and Ageing. GP super clinics national program guide. Canberra: The Department, 2008. (accessed Jun 2010).
  • 2. Medicare Australia. Statistics. Divisions of general practice statistics reports [database on the internet]. Canberra: Medicare Australia, 2009. (accessed Jun 2010).
  • 3. Population Health Information Development Unit. Population health profile for Divisions of General Practice: supplement. Report No. 74a. Adelaide: Public Health Information Development Unit, 2007; Mar.
  • 4. Population Health Information Development Unit. Population health profile for Divisions of General Practice. Report No. 74. Adelaide: Public Health Information Development Unit, 2005; Nov.
  • 5. Allan J, Schattner P, Stocks N, Ramsay E. Does patient satisfaction of general practice change over a decade? BMC Family Practice 2009; 10: 13.
  • 6. Nissen L. Current status of pharmacist influences on prescribing of medicines. Am J Health Syst Pharm 2009; 66 Suppl 3: S29-S34.
  • 7. Ackerman E, Williams ID, Freeman C. Pharmacists in general practice — a proposed role in the multidisciplinary team. Aust Fam Physician 2010; 39: 163-164.


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