This update provides information to help primary care providers tackle current challenges, including COVID-19. Submissions can be sent to covax@murrayphn.org.au

View previous editions here.

GP-led Respiratory Clinic Panel Program
The Commonwealth Department of Health and Aged Care is inviting up to 150 existing and accredited general practices to apply to be part of the GPRCP Program. The program is a panel arrangement and aims to ensure there is surge capacity available to respond to subsequent COVID-19 waves or future respiratory health emergencies.

Key dates

• 19 January, 2pm - Enquiry cut-off (including extension request)
• 2 February, 2pm - Closing time (for responses)

Mosquito borne diseases
The Victorian Department of Health has advised that Murray Valley encephalitis (MVE) virus has been detected in mosquitoes at additional locations across northern Victoria. Clinicians should test for MVE virus and other mosquito-borne diseases in patients with a compatible illness. 

A reminder that a case of Japanese encephalitis (JE) virus infection was recently identified in a resident from the Campaspe local government area. Clinicians must also consider and test for JE virus - notifying the Department of suspected cases immediately by calling 1300 651 160 (24 hours). For more information click here and see below.

• DOHAC resources including the new ‘Ozzie vs Mozzie’ campaign 
• Social media pack that includes posters is available for the promotion of prevention messages to the community. 

Flood recovery

• Focus on Emergency Response is a quick-reference resource for health staff and includes links to relevant clinical pathways.
• The Disaster Response Network (DRN) is a national network of Australian Psychological Society psychologists who volunteer to help those affected by disasters. Email covax@murrayphn.org.au to access support for front-line workers.
• General practice and pharmacy staff and their immediate family members can access Murray PHN's confidential Employee Assistance Program for free support. Call 1300 361 008 (24/7) and quote Murray PHN General Practice.

Japanese Encephalitis (JE) Virus

Stock of JE vaccines remains limited and vaccination is restricted to specific priority groups. Primary care providers are reminded that JE vaccine remains free-of-charge for eligible people. 

The Victorian Department of Health has advised that: 

• All JE vaccine orders must be sent to the Immunisation Unit at immunisation@health.vic.gov.au for approval, and requests for JEspect can only be approved once a patient has undergone a clinical assessment 
• Orders of JEspect will now be restricted to GPs and Aboriginal Health Services and will require approval by the department.
• Dose two of JEspect should be deferred for all persons until notified by the department.  

Further information is available here. Contact immunisation@health.vic.gov.au for assistance with vaccine ordering.

Vaccine breaches
To avoid vaccination errors, please ask every question on the eligibility checklist to ensure the correct vaccine is chosen. If you are unsure which vaccine to administer, do not vaccinate and refer the individual to a medical practitioner.
 
The Department has provided mandatory eLearning. Pharmacists and nurse immunisers must complete online training before administering JE vaccines

Reporting vaccinations
Recent changes to the Australian Immunisation Register Rule 2015 (AIR Rule) means that it is now mandatory for all vaccination providers to report Japanese encephalitis vaccines to the Australian Immunisation Register (AIR).

Please enter the correct brand of vaccine and not the generic name as well as route of administration (ID vs SC). Reporting these vaccinations to the AIR means that the register contains a complete and reliable dataset and can monitor immunisation coverage and administration. It also means that individuals have a complete record of their vaccinations. More information for Victorian immunisation providers can be found here.

Local councils are now providing JE vaccinations as part of their vaccination program:

• Moira Shire
• City of Greater Shepparton
• City of Wodonga Council
• Campaspe Shire Council
• Swan Hill Rural City Council

COVID vaccination provider bulletin 12 January

Vaccine updates
As outlined in the most recent bulletin:

Moderna 6+
All Moderna 6+ vaccine doses have now expired. Providers should ensure any remaining stock is reported as wastage in CVAS and appropriately disposed of.

Moderna 6 months to 5 years
ATAGI recommends two primary doses of this vaccine, except for those with severe immunocompromise who require three primary doses. 

Pfizer shelf-life extension
The following Pfizer vaccines have been approved for a shelf-life extension to 18 months from manufacture, follow the links to see relevant batch numbers: 5-11 years, Bivalent and 6 months to 5 years. Contact the Vaccine Operations Centre (VOC) on 1800 318 208 or via COVID19VaccineOperationsCentre@health.gov.au if you have any questions.

2023 Influenza program
NSW Health will begin the influenza vaccination program as soon as supplies of vaccine are available from the Australian Government. They recommend that pharmacist immunisers ensure access to all pharmacist-approved NIP vaccines by following the Guidance for Pharmacist Immunisers. 

Changes to Public Health Units
Public Health Units (PHUs) were established in 2020 to manage cases and outbreaks of COVID-19. PHUs are now transitioning to work in prevention and control of notifiable conditions previously managed by the Victorian Department of Health as listed below:

Loddon Mallee PHU has provided an outline of new responsibilities and requirements for working with primary care here. GPs will be contacted for further information once a condition has been identified. 

PPE
Murray PHN no longer has stock of Personal Protective Equipment (PPE). Distribution from the National Medical Stockpile (NMS) has now ceased as outlined in the National COVID-19 Health Management Plan for 2023.

COVID-19 testing
Victoria’s state-run PCR testing sites closed on 31 December 2022. Local councils have been supported to provide free RATs to all Victorians until June 2023. People who require a PCR test now need to visit a GP, GP respiratory clinic or have a GP referral to a private pathology provider. For more on testing click here.

Changes to MBS items for telehealth
Until 31 December 2023, a temporary exemption is available for COVID-19 positive patients from the established clinical relationship requirement for Telehealth MBS eligibility. Under these arrangements, a GP or OMP can provide a telehealth consultation to patients who do not meet the established clinical relationship requirement and who have received a positive COVID-19 test result up to seven days earlier. More information is available in this factsheet.

COVID-19 antivirals
New resources have been uploaded to the Victorian Department of Health webpage – see resources section below. Murray PHN also has a comprehensive list of resources and information, including:

• COVID-19 Positive Community Care and Treatment HealthPathway
• PBS fact sheet with information for prescribers and pharmacists
• Find participating community pharmacies
• COVID-19 drug interactions

A helpline (03 8290 3801) staffed by Alfred Health pharmacists is available 8am-5pm every day to support prescribers of COVID-19 oral antivirals.
Any covid medicine queries can be directed to covid+pathways@health.vic.gov.au 

Support for homebound individuals
Murray PHN can help to engage a primary care vaccine provider for homebound patients. Click here for eligibility criteria and referral. For more: covax@murrayphn.org.au

Vaccination clinics
Local primary care vaccination providers are available here. 

GP respiratory clinics
GPRCs provide free care for Victorians with respiratory symptoms. If your health service is located near Wodonga and lacks capacity or adequate PPE to manage patients with respiratory symptoms, please refer them to:

• Wodonga Respiratory Clinic (Central Medical), 224-226 Beechworth Road, Ph: 02 6067 2437 - click here for opening hours and bookings.

In-reach COVID-19 vaccination clinics
Primary care vaccination providers are encouraged, where possible, to conduct in-reach COVID-19 vaccination clinics for aged care and disability support workers and residents. The Practice Incentives Program (PIP) payment for in-reach has been extended until 31 January 2023. Program details are outlined in this factsheet.

Supporting the disability sector
Murray PHN is helping disability providers and liaison officers to engage primary care providers for in-reach vaccinations. If your practice can assist, email: covax@murrayphn.org.au

Practices can also access support and resources from disability liaison officers in: 

• Albury/Wodonga
• Bendigo/Loddon Mallee
• Shepparton/Goulburn Valley
• Wangaratta/North east

Royal Melbourne Hospital (RMH) – fax errors 
The RMH have advised of a technical issue with referral software in December 2022. Some areas of the hospital may not have received referrals sent from 5-9 December. Read the statement, including follow up actions, here.  

Education and training


Murray PHN is conducting a survey to determine what your education needs are for 2023. Local primary healthcare professionals are encouraged to complete a short survey to help us plan and prioritise education events in 2023. Click here to take part.

Online learning

• Victorian Department of Health Immunisation eLearning – JEV and Influenza
• Victorian Department of Health and VICNISS: Infection prevention and control free online learning package
• NSW Health: Fit testing and fit checking videos 

• Health Issues Centre: Covid antivirals – How do they work, who should use them and how do we increase uptake (7 September)

New and updated resources

• Vic DoH – Evusheld FAQs (20 December 2022)
• Vic DoH – Evusheld information for consumers
• NCIRS – Vaccination from community pharmacy guidelines
• DoHAC posters – Childrens Remember to check; Babies remember to check; Vaccine preparation and administration don't forget to check
• COVID-19 Referrals and Escalation of Care HealthPathway
• Vic DoH - JEV vaccine eligibility checklist for the public; JEV vaccination consent form
• Agriculture Victoria – flood response
• Better Health Victoria – JEV information in your language
• Health Translations (Victorian DoH) – JEV in Victoria