When two medical practices in Swan Hill (Victoria) closed their doors, the community’s access to primary care was on the line. Swan Hill District Health became the sole primary care provider. However, staff faced burnout, patients were frustrated, and the health service was under immense pressure. That’s when Swan Hill District Health turned to Larter Consulting (‘Larter’) to help steady the ship — and chart a course for a stronger, more sustainable future.
The challenge: Maintaining primary care services
After two of its three general practices closed – TriStar Medical Group practices closed nationally in 2022 – the town of Swan Hill and surrounds faced a major reduction in medical services. Swan Hill District Health became the community’s sole provider, acquiring The Swan Hill Medical Group.
Larter Consulting was contracted directly by Swan Hill District Health to support the transition and the ongoing strategic and operational management of the remaining GP clinic. The work was complimented by Murray Primary Health Network’s support for practices through various projects, particularly the Practice Development Program. Our Primary Health Consultant, Mario Grupta provided consultancy, and Associate Health Educator, Wendy O’Meara, conducted onsite training and implementation support part of this effort.
The practice review: Identifying core issues threatening service sustainability
To uncover operational issues and identify/prioritise solutions, Larter’s primary health consultants engaged in a multi-faceted review process including:
- Meeting individually with doctors, nurses, and practice managers
- Conducting a group issues discovery session with the whole practice team
- Working directly with the team to map out processes and develop practical, documented solutions.
We find that consulting individually and privately with clinicians is critical to demonstrate to them that we understand their world and to build trust in our resulting recommendations and implementation.
This review highlighted several key issues stemming from the merger and the increased workload. One significant challenge was the different cultures between the hospital and the acquired private general practice, leading to integration challenges. This is something we often see in our work. Communication was fragmented, and staff often felt out of the loop.
Other challenges included:
- Insufficient appointment availability, leading to patient frustration and staff stress
- Inadequate telephony system – missed calls and patient dissatisfaction
- No structured process to identify patients for chronic proactive care management
- Low staff morale
- Inconsistent systems to collect patient data at reception
- Lack of practice management autonomy
The recommendations: A path forward
Larter provided a series of recommendations and implementation support as follows:
- Improving communication
- A monthly whole-of-staff newsletter to improve information sharing and boost morale.
- Implementing “Quick Clinics”
- To improve appointment availability, a weekly “Quick Clinic” was proposed to handle straightforward appointments like repeat prescriptions and referrals, freeing up the general schedule for more complex cases.
- Enhancing the Practice Manager’s authority to make decisions, improving efficiency and morale
- Upgrading the telephone system and having dedicated internet connectivity for the medical centre
- Increasing income through enhanced administration
- Create a standardised rental agreement for visiting specialists and modifying “Did Not Attend” fees processes.
- Streamlining chronic care management
- Developing a structured system for identifying chronic care patients, managing outstanding reminders, and providing GP training on appropriate referrals to chronic care clinics.
- Skin procedures to be performed at the hospital, freeing up GP time.
Samantha Hellsten, Practice Manager from Swan Hill District Health, highlighted the value of the support from Larter consultant Wendy O’Meara:
“The visit was incredible! We felt so lucky to have Wendy join us and share her insightful, tried-and-tested industry knowledge. Wendy is incredibly warm and endearing and within minutes, it felt like we’d known her for years. She was exactly the supportive ear we needed, while always offering solution-focused ideas to help us tackle our challenges.
Her visit helped us bond even more as a team, and we’ve already implemented many of her suggestions with many more to come. We’re genuinely excited to welcome her back in a few months as we head into accreditation to show her how we’ve strengthened our clinic’s efficiency and improved patient access to care. Watch this space!”
Swan Hill District Health now has a clear roadmap to enhance community access to primary care, staff morale, and operational efficiency following the practice acquisition. The approach was centered on mutual respect, collaborative problem-solving and actions with measurable outcomes. We are excited to see their continued progress!