Integrative Care is the approach of connecting general practices, hospital services, and community-based health providers to create a coordinated, patient-centred system of care. Rather than patients navigating disconnected services, integrative care aims to ensure providers are communicating effectively and treatment is coordinated around the patient's whole journey.
The Integrative Care Committee in our region brings together representatives from general practice, St George Hospital, allied health, and CESPHN to address systemic communication gaps and develop practical solutions to care coordination challenges.
Our Division Representative Dr Wayne Cooper attends these meetings and ensures that the GP perspective — particularly around referral pathways, discharge communication, and outpatient access — is well represented.
Fragmentation between hospital and community services is one of the most common sources of poor patient outcomes. GPs often receive inadequate discharge summaries, delayed specialist letters, or referrals with no feedback — the Integrative Care Committee works to address these systemic issues.
These are the areas where better integration between GPs and the broader health system delivers the most tangible benefit to patients and providers.
Timely, complete discharge summaries are critical for safe transitions of care. The committee works with hospital systems to improve the quality and turnaround time of discharge communications to GPs.
Clear, accessible referral pathways reduce delays and errors. The committee liaises with hospital departments to clarify referral criteria, expected wait times, and the right channels for urgent vs. routine referrals.
Allied health, mental health, and community care services are most effective when GPs are informed and engaged. The committee helps map available community resources and improve how GPs access and communicate with them.
Medication discrepancies at care transitions are a leading cause of adverse events. The committee supports processes that ensure GPs receive accurate and current medication lists after hospital episodes.
Connecting GPs with mental health services — including step-up, step-down, and crisis support — remains a priority. The committee addresses gaps between primary mental health care and hospital-based services.
For patients with multiple chronic conditions, care coordination between their GP, specialists, and allied health team is essential. The committee explores models that support GP-led coordinated care.
If you're encountering problems with discharge summaries, referral processes, or hospital-GP communication, please contact us. Our representative can raise these issues at the committee level.