“General practice provides person centred, continuing, comprehensive and coordinated wholeperson health care to individuals and families in their communities” (www.racgp.org.au).
As our population ages, the numbers of people developing cancer, living with and/or surviving cancer increases, creating pressure on specialist services. In Australia, GPs already play a leading role in the cancer continuum in prevention and early detection of cancer, in survivorship and in palliative care. GPs also provide ongoing holistic care for other health needs. An enhanced role for GPs has been envisaged in the acute phases of cancer treatment.
Limited randomised trials of various models of shared care involving GPs during both acute treatment and immediate post-acute treatment phases have been undertaken both in Australia and internationally. Generally, both patients and GPs are positive about the experiences in primary care. While systems of health care vary, there is evidence emerging that shared care can improve process outcomes such as patient and GP satisfaction, GP knowledge and confidence in managing people with cancer as well as improving patients’ perception of care. Outcomes regarding risks and safety require larger sample sizes and longer term follow up, but to-date generally no additional harms have been found in primary care interventions.
Safe acceptable shared care models need to be based on a common objective of improving care for patients with expectations shared by specialists, GPs and patients. Improved quality of care may include improving access and flexibility, and is underpinned by excellent systems to enhance communication among all parties.