We’ve partnered with a PHN in Victoria to co-design, accredit and deliver whole-of-practice training that makes primary care more accessible, trauma-informed and stigma-free for people experiencing or at risk of homelessness in rural and remote communities. Client, funder and location details are intentionally de-identified.

The Importance of Primary Care Capacity Building

Strong primary care systems require the capacity to respond effectively to the needs of diverse and vulnerable populations. Primary care capacity building helps healthcare organisations improve service accessibility, strengthen workforce capability, and develop sustainable models of care that address community health needs.

Through evidence-based strategies and collaboration with healthcare providers, organisations can improve coordination, reduce barriers to care, and create more equitable health outcomes.

From needs analysis to action: what we learned

Part One showed how health unravels without a safe place to live. Our training needs analysis with general practices and community services confirmed the practical barriers and the appetite to fix them.

Hidden homelessness is common and complex. People are couch-surfing, in motels or cars, moving between towns; continuity, medication storage and follow-up become fragile. Standard appointment models rarely fit this complexity.

“It’s heartbreaking to see patients sleeping in their cars outside our clinic we’re seeing it more.” GP 

Affordability and identification are gatekeepers. Scripts, gap fees and specialist costs force trade-offs with food and fuel; lost ID or unstable Medicare access can block care at the door.

“Clients tell us they often have to choose between medication or meals.” Community worker 

Rural realities magnify risk. Sparse transport, distance between towns and centralised services turn a simple check-up into an ordeal especially if you’re managing trauma, mental ill-health, or chronic disease.

Stigma shuts the door. Fear of judgement in waiting rooms and past negative encounters deter people from seeking help; the most powerful fixes here are cultural and operational.

“For people in these communities, there’s shame and stigma seeing a GP… one of our GPs goes to the car park to see patients if they feel this way.” GP 
“Past negative experiences with healthcare can leave lasting scars every interaction needs patience and compassion.” GP 

System fragmentation is real. Disconnection across mental health, AOD and primary care leaves people bouncing between services. Teams want practical tools to coordinate care not just more brochures.

What we’re building together

With practices across the Primary Health Network (PHN), Larter is co-designing a tiered training program for whole-of-practice teams (front-of-house, nurses, GPs, practice managers). The program is:

• RACGP CPD–accredited, so participation counts toward annual professional requirements
• Delivered as online e-modules (flexible, scenario-based) with in-person workshops across Local Government Areas to strengthen local networks and pathways
• Built from what teams told us they need most: ways to reduce stigma, deliver same-day care for complex needs, and keep continuity when phones/addresses change.

“We understand sometimes people need more than medical care. We go the extra mile with practical assistance.” Practice team member 

The three tiers (co-designed with practices)

• Tier 1 Foundations: homelessness literacy; challenging stigma and bias; health equity; scripts and environmental cues that create a safer experience from reception to consult.
• Tier 2 Intermediate: same-day care (wounds, vaccines, brief mental-health screening), rapport and risk identification (family violence, suicide, substance-related harm), continuity when contact is unstable, and practical resource kits.
• Tier 3 Advanced: complex chronic disease in resource-limited contexts; safer prescribing and deprescribing; harm-reduction; using long-acting formulations where adherence is hard.

How and where the training will roll out

• E-modules that offer short, case-based learning for onboarding and refreshers.
• Practice-based workshops and facilitated sessions to stress-test workflows (flexible appointments, “safe-space” signage, walk-in slots, transport scripts, medication-storage workarounds).
• Regional networking & professional development events delivered across selected LGAs with neighbourhood houses and local services to map referral routes and agree warm-handover protocols.
• Communities of Practice facilitated in quarterly forums to share cases, troubleshoot barriers (ID, My Health Record visibility, after-hours options), and invite experts in family violence, AOD and youth mental health.

“It’s a complex issue that needs collaboration across sectors working together is how we’ll build a more supportive environment.” Community Partner 

What whole-of-practice change looks like

Front-of-house

• Welcome without prerequisites: pathways for people without ID or fixed address; privacy-preserving intake; de-escalation skills and scripts
• “No wrong door” checklists that turn first contact into a health-access opportunity.

“Our frontline staff juggle a lot; with the right scripts and de-escalation skills, first contact can be transformational.” Practice Manager 

Nurses

• Rapid health/risk checks; opportunistic vaccines and wound care; medication navigation; warm handovers to community services
• Light-touch follow-up methods that work even when phones or addresses change.

GPs

• Short-consult frameworks that still create traction (one health priority + one safety check + one concrete next step)
• Safe prescribing in the context of malnutrition, unstable storage and polypharmacy; harm-reduction conversations that reduce shame and increase uptake.

Practice managers

• Policies for flexible scheduling, walk-ins and “car-park consults” where dignity or safety is a concern
• Simple equity dashboards to monitor progress without adding admin burden.

“You always wonder and hope… wishing you knew they’re okay.” GP 

Five operational shifts every practice can make now

1. Welcome without prerequisites: see the person, not the paperwork; clear pathways for no-ID/no-address; visible statements of safety and inclusion
2. Short consults that still help: one priority + safety check + next step; nurse-led follow-up; warm handovers
3. Medicines that fit life: simplify regimens; plan for storage instability; pharmacy partnerships and vouchers where available
4. Partner where trust already exists: bring the clinic to neighbourhood houses and community hubs; agree scripts and feedback loops
5. Plan for rural constraints: reserve walk-in slots around transport schedules; bundle care to reduce return trips; use telehealth intentionally.

“We’re reserving more same-day slots and bringing services closer to where people already feel safe.” — Nurse 

Policy settings that help and how we’ll operationalise them

Larter welcomes the Bulk Billing Practice Incentive Program (BBPIP) commencing 1 November 2025. For practices that participate, BBPIP adds an extra 12.5% incentive on every $1 of MBS benefit from eligible services, split 50/50 between the GP and the practice a lever to remove cost as a barrier to care for people doing it tough.

Additionally, from 1 November 2025, practices that choose to bulk bill can apply this to standard GP consultation items for all Medicare card holders not only children and concession-card holders with expanded bulk-billing incentives supporting that shift.

What Larter is doing to assist practices:

• Build a business case and scheduling model that uses BBPIP to sustain low-barrier access (same-day appointments, longer consults when needed).
• Embed practical workflows (billing, documentation, data capture) that make equity improvements measurable and sustainable.

Measuring what matters

We’ll partner with clinics to track a few meaningful metrics:

• Access and affordability: proportion of bulk-billed consults for people without stable address/ID; on-the-day care delivered; scripts filled via pharmacy partners.
• Continuity and safety: successful follow-ups when contact details change; brief mental-health screens and safety checks completed.
• Process: utilisation of low-barrier walk-in slots; number of warm handovers to community partners.
• Learning health system: quarterly Communities of Practice to review barriers, share micro-innovations and agree the next tests of change.

Supporting Equitable Access to Healthcare Services

Improving healthcare access for people experiencing homelessness requires coordinated approaches across health services, community organisations, and funding bodies. Larter supports healthcare organisations to understand system challenges, evaluate service models, and identify opportunities to improve healthcare delivery.

Conclusion

Strengthening primary care capacity is essential to creating healthcare systems that can respond effectively to the needs of vulnerable populations, including people experiencing homelessness. By improving service coordination, building workforce capability, and addressing barriers to healthcare access, organisations can create more inclusive and sustainable models of care.

Larter supports healthcare organisations, Primary Health Networks, and community service providers through evidence-based consulting, evaluation, and strategic insights. By understanding community needs and measuring what works, healthcare systems can make informed decisions that improve service delivery and contribute to better health outcomes.

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