Flexible Fund Guidelines
Practice Incentives for
General Practices Fund
Final as at
January 2014
Structure of this document.
This document is in three parts:
Part A: Practice Incentives for General Practices Fund Overview
Part B: Incentive payments component of the Fund
Part C: Grant component of the Fund
Together they comprise the Fund Guidelines.
PART A: Overview of the Practice Incentives for General Practices Fund
A.1
Fund Background
The Australian Government is introducing a new, flexible way to fund many of the nation’s health
priorities, better reflecting the more responsive, connected health system it is creating as part of its
reform agenda.
Under this strategy, a number of existing health programs are being consolidated within larger,
flexible Funds. This will reduce red tape, increase flexibility and more efficiently provide evidence
based funding for the delivery of better health outcomes in the community. The Practice Incentives
for General Practices Fund (the Fund) is one of these flexible Funds.
In the 2011-12 Budget, the Australian Government allocated funding of around $1.055 billion over
four years to the Fund.
The Fund consolidates the activities of several existing Practice Incentives Program (PIP) initiatives
and the General Practice Immunisation Incentive (GPII) Scheme and will provide a larger, flexible
funding pool predominantly for incentive payments to general practices or Indigenous health
services or general practitioners (GPs).
The Fund can also be used to support targeted grants or one-off activities and some procurement
activities.
A.2
Fund Objective
The Objective of the Fund is to better support general practice activities that encourage continuing
improvements and quality care, enhance capacity, and improve access and health outcomes for
patients. The Fund will reflect national health priorities and allow responsiveness to existing and
emerging health challenges.
A.3
Fund Value
The total value of the funds available under the Fund is $1.055 billion over four years from 2011-12.
The Department of Health will determine the final allocation between incentive payments and
grants and procurements but, initially, it is anticipated that approximately $3 million per annum will
be reserved for grants and procurements with the remainder being allocated to incentive payments.
Only a small amount is proposed to be used for procurements.
A.4
Changes to Guidelines
The Fund Guidelines may be varied from time-to-time by the Australian Government as the needs of
the Fund dictate. Any amendments will be made available to applicants for grants and other
participating parties as required.
PART B: Incentive payments component
B.1
Introduction
The Fund consolidates the activities of several existing PIP initiatives and the GPII Scheme and will
provide a larger, flexible funding pool for incentive payments to general practices or Indigenous
health services or GPs.
B.2
Fund Priorities
The Fund Priorities have been designed to reflect current national health priorities and may be
adapted over time to adequately address emerging health needs.
Incentive payments to general practices and GPs will be made to support the following Priorities (in
alphabetical order):
Chronic disease management
To encourage general practices and GPs to better manage patients with a chronic disease. The
existing PIP incentives that fall under this Priority are the PIP Asthma Incentive and the PIP Diabetes
Incentive.
Practice capacity and infrastructure
To support general practices and GPs to make quality infrastructure improvements including
encouraging practices to keep up to date with the latest developments in eHealth. The existing PIP
incentives that fall under this Priority are the PIP eHealth Incentive, the PIP Quality Prescribing
Incentive and the PIP Teaching Incentive.
Primary health care for Aboriginal and Torres Strait Islander peoples and
other disadvantaged groups
To encourage general practices to better manage the clinical care of Aboriginal and Torres Strait
Islander patients, and other disadvantaged groups. The existing PIP incentive that falls under this
Priority is the PIP Indigenous Health Incentive.
Primary health care for older Australians
To support general practices and GPs to provide quality care for older Australians including those in
Commonwealth-funded Residential Aged Care Facilities, and those with dementia. The existing PIP
incentive that falls under this Priority is the PIP Aged Care Access Incentive.
Primary health care in rural Australia
To support general practices and GPs in rural and remote Australia in providing quality primary care.
The existing PIP incentives that fall under this Priority are the PIP Procedural GP Payment and the PIP
Rural Loading.
Prevention and early detection
To encourage general practices and GPs to undertake activities that focus on early detection and
prevention of disease. The existing incentive programs that fall under this Priority are the GPII and
the PIP Cervical Screening Incentive.
B.3
Roles and responsibilities
Minister:
Within the overall Priorities and Objective of the Fund, the Minister has the authority to make
changes to the incentive programs under the Fund to best meet the Priorities and to determine the
eligibility requirements for the incentive programs.
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In urgent or unforeseen circumstances the Minister can introduce new incentive programs and/or
waive eligibility criteria for the incentive programs.
Department of Health (the Department):
The Department will have overall responsibility for implementing and managing the incentive
payments component of the Fund and the payments will be administered by the Department of
Human Services (Human Services).
The Department will be responsible for managing the incentive payments component in accordance
with the Memorandum of Understanding (MOU), Business Practice Agreements (BPA) and Business
Rules between the Department of Health and the Department of Human Services.
The Department will be responsible for ensuring that any documentation relating to the incentive
payments component is in accordance with the Fund Objective.
Department of Human Services (Human Services):
Human Services will be responsible for administering the incentive payments component of the
Fund, including making payments to general practices and GPs. Human Services will administer the
incentive payments component on behalf of the Department under the MOU, BPA and Business
Rules.
The responsibilities of Human Services include:
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Assessing general practices and GPs applying for payments under the incentive payments
component of the Fund.
Processing forms relating to the incentive payments component of the Fund including the
PIP and GPII application, and patient registration forms.
Creating and maintaining appropriate computer systems to administer the payments under
the incentive payments component of the Fund.
Processing payments for the incentive payments component of the Fund.
Maintaining relevant online systems.
Collecting data around the incentive payments component of the Fund;
Managing relevant helplines.
Managing audits of general practices and GPs participating in the incentive payments
component of the Fund.
Communicating with general practices and GPs about the incentive payments component of
the Fund.
Providing payment statements to practices and GPs participating in the incentive payments
component of the Fund.
Publishing quarterly news update regarding the incentive payments component of the Fund.
Publishing guidelines for the incentive payments component of the Fund.
General Practices and General Practitioners:
General practices and GPs will be responsible for applying through Human Services for the individual
payments available under incentive payments component of the Fund and meeting the relevant
eligibility requirements of the incentive programs.
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PIP Advisory Group:
The PIP Advisory Group consists of representatives from the medical profession and will provide
advice to the Department on the development and implementation arrangements relating to the
incentive payments component of the Fund. The Terms of Reference for the PIP Advisory Group are
included in the PIP Advisory Group Member Guidelines.
B.4
Timeframes
The Fund is an ongoing initiative commencing on 1 July 2011 and will continue until 30 June 2015.
The timeframes for the individual incentive programs vary. Unless otherwise specified, any new
incentive programs will have a fixed four year period. If appropriate, an evaluation will be
undertaken before the incentive program ceases to inform the future arrangements for the
incentive program. Practices will be provided with as much notice as possible prior to any changes
to the incentive programs.
B.5
Eligibility
Access to the incentive payments component of the Fund will predominantly be for general
practices, GPs and/or Indigenous health services. General practices or Indigenous health services
accessing incentive payments under the Fund must be accredited or registered for accreditation and
meet the eligibility requirements of each of the individual incentive programs in which they are
participating.
B.6
Funding Principles
Any new incentive must meet the Objective and Priorities of the Fund.
The Department will also assess any proposed new incentive programs against the following
Principles to assist in determining whether it should be funded.
Fits with National Priorities
Proposed incentive programs should be consistent with the national health priorities.
Quality Improvement
Proposed incentive programs should encourage a change or improvement in general practice rather
than fund activities that are already common practice.
Most appropriately pursued through general practice
Proposed incentive programs should be more appropriately pursued through general practice than
through other health facilities such as hospitals and specialised clinics.
Administratively simple
Proposed incentive programs should be designed so as not to impose an unnecessary administrative
burden on practices. However, in some instances it may be necessary for new administrative
requirements to be adopted to facilitate best practice care.
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Cost effective
Proposed incentive programs should be compared with existing programs and alternative funding
models to ensure that the incentive is the most cost effective method of engendering change and
improved outcomes.
Duplication
Proposed incentive programs should be considered in light of existing government
initiatives/programs to ensure financial incentives are not being duplicated.
Applies to general practice
The incentive programs should generally be targeted towards general practices and Indigenous
health services. However, payments may be targeted to GPs if deemed appropriate.
Introducing a New Incentive Program
The Minister has the authority to introduce new incentive programs under the Fund.
The Department will develop implementation arrangements in consultation with the PIP Advisory
Group and other relevant stakeholders for consideration by the Minister.
B.7
Probity
The Australian Government is committed to ensuring that the processes for making incentive
payments meet acceptable standards of probity and are in accordance with any incentive programspecific guidance.
Probity issues to be addressed include, but are not limited to, conflict of interest, confidentiality and
protection of personal information.
Conflict of Interest
A conflict of interest may exist, for example, if an applicant or any of its personnel or a member of
the PIP Advisory Group:
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has a relationship (whether professional, commercial or personal) with a party who is able to
influence the development or implementation arrangements (e.g. a departmental officer);
has a relationship with, or interest in, an organisation, which is likely to interfere with or
restrict the applicant in carrying out the proposed activities fairly and independently; or
has a relationship with, or interest in, an organisation from which they will receive personal
gain as a result of the introduction of new incentive programs.
Members of the PIP Advisory Group will be required to declare, existing conflicts of interest or that
to the best of their knowledge there is no conflict of interest that would affect the independence of
or prevent the member from participating in the Advisory Group.
Where a member of the PIP Advisory Group subsequently identifies that an actual, apparent, or
potential conflict of interest exists or might arise in relation to participation in the PIP Advisory
Group, the Department must be informed in writing immediately. The member must not exercise
his/her Advisory Group responsibilities until the Department has determined and advised the
member how the conflict will be managed.
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Confidentiality and Protection of Personal Information
It is a Commonwealth requirement that all confidential information and personal information are
kept confidential. This will require parties to:
 comply with the Privacy Act (1988) (‘the Privacy Act’), including the 11 Information Privacy
Principles (IPPs), as if it were an agency under the Privacy Act, and the National Privacy
Principles (NPPs);
 refrain from engaging in direct marketing (s 16F of the Privacy Act), to the extent that the
NPP and/or s 16F apply; and
 impose the same privacy obligations on any subcontractors it engages to assist with a
project for which the funds are provided.
Application forms for incentive programs under the Fund include confidentiality and protection of
personal information clauses to protect general practice and GP information. Any documentation
developed for the incentive programs will take into account confidentiality and protection of
personal information.
Members of the PIP Advisory Group are required to sign a ‘Deed of Undertaking in relation to
Confidential Information and Conflict of Interest’ form, which outline members’ responsibility to the
Department in regards to confidentiality.
B.8
Processes for Accessing the Fund
General practices and GPs will need to meet the eligibility requirements of the individual incentive
programs and apply for the incentive programs through Human Services, which makes payments on
behalf of the Department.
General practices and GPs are able to use the PIP and GPII Online system to securely apply for the
incentive programs, and maintain practice and provider details. General practices and GPs can also
complete a paper-based application form available from Human Services.
B.9
Decisions
Fund Underexpenditure:
Funding allocations will be monitored throughout the year with potential underspends identified.
Under expenditure may be used to fund unsolicited proposals or one-off grants where such
proposals will meet the Objective and Priorities of the Fund. Information about one-off grants can
be found in Part C of the Fund Guidelines.
The Minister may also direct underspends to other Priorities and incentive programs within the
Fund.
Where appropriate, the Department will consult with the PIP Advisory Group and other relevant
stakeholders on possible uses of any underspend.
Complaint Handling
Complaints relating to the incentive programs available through the Fund, must be lodged in writing
to Human Services by the authorised contact person or the owners of the practice. Human Services
will respond to the complaints in writing.
Details of the requirements for lodging complaints about the grant or procurement components of
the Fund are provided in Parts B and C.
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B.10 Conditions of Funding for Incentive Payments
Incentive Payment Arrangements
General practices, Indigenous health services and/or GPs will be required to meet the eligibility
requirements of the incentive programs in which they are participating.
Payments will be made by Human Services to practices and GPs meeting the eligibility requirements.
General practices and GPs must inform Human Services if they are no longer eligible for an incentive
payment within 14 days of ceasing to meet the eligibility requirements.
Human Services will audit practices in accordance with their compliance program to ensure practices
are meeting the eligibility requirements of the incentive programs in which they are participating.
Reporting
The Department will develop relevant high level performance indicators for the incentive payments
component of the Fund in consultation with the PIP Advisory Group. The Department will publicly
report against the performance indicators on a regular basis.
Evaluation
The Department will, in consultation with the PIP Advisory Group develop an evaluation strategy for
the incentive payments component of the Fund. The evaluation strategy will include incentive
programs that existed prior to the establishment of the Fund and new incentive programs developed
under the Fund.
Incentive programs that existed before the establishment of the Fund will be evaluated prior to the
end of their planned funding period unless the measure is terminating early as a result of a decision
of the Australian Government. Any incentive that does not have an end date of funding will be
evaluated as part of a rolling program of evaluation. Existing incentive programs may be terminated,
modified or continued based on the recommendations of an evaluation or as determined by the
Minister in order to meet the Priorities and Objective of the Fund.
These arrangements will provide the flexibility to cease initiatives that are no longer required or to
modify payment levels and requirements of particular incentive programs to be consistent with
Government priorities and the available evidence.
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PART C: Grants
C.1
Introduction
The Fund can be used to fund grants, which support the Objective of the Fund. At present there are
targeted grants to support the immunisation activities provided by Medicare Locals and the
Australian Medicare Local Network.
Grant rounds under the Fund will be conducted in accordance with the requirements of the
Commonwealth Grant Guidelines (CGGs).
C.2
Available Grant Funds
The Department of Health will determine the final allocation between the incentive payments and
grants and procurements but initially it is anticipated that approximately $3 million per annum will
be available for grants.
C.3
Roles and responsibilities
Minister:
The Minister for Health (the Minister) has the authority to approve grants and one-off activities that
are consistent with the Objective of the Fund.
The Department:
A Departmental Delegate may approve grants and funding for activities that are consistent with the
Fund Objective, and within the delegation arrangements, such as the procurement of evaluation
services.
For activities that are funded through targeted funding agreements, the Department will be
responsible for managing the activities including:
 Developing funding agreements or any alternative contractual arrangement.
 Monitoring the performance of projects to ensure the conditions of the contractual
arrangement are met.
 Assessing performance and financial reports, and undertaking follow up activity as
necessary.
 Making payments on acceptance of milestone reports as specified in the contractual
arrangements.
 Providing feedback to funded organisations on the overall project following the conclusion
of activities.
Funded Entity:
A funded entity is responsible for the efficient and effective delivery of services in accordance with
the obligations contained in any funding agreement or contractual arrangement entered into under
the Fund. Funded entities are also responsible for:
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Ensuring they meet the specifications of the funding agreement or other contractual
arrangement.
Ensuring the project is managed in a cost effective and efficient manner.
Maintaining contact with the Department and advising of any emerging issues that may
impact on the success of the project.
Reporting on project performance and expenditure in accordance with the contractual
obligations.
Assisting with evaluation activities as necessary.
C.4
Timeframes
The Fund is an ongoing initiative commencing on 1 July 2011 and will continue until 30 June 2015.
Specific activities under the grant arrangements will be funded and rolled out in line with agreed
Australian Government timelines.
C.5
Eligibility
At present targeted grants are limited to the immunisation activities provided by Medicare Locals
and the Australian Medicare Local Network. There are currently no open grant application
processes under the Fund.
C.6
Funding formula
The allocation of funding to Medicare Locals for immunisation activities is based on a funding
formula that takes into account the characteristics of each Medicare Local, such as rurality and
Aboriginal and Torres Strait Islander population.
C.7
Probity
The Australian Government is committed to ensuring that the grant processes meet the acceptable
standards of probity and are in accordance with the published guidelines.
Probity issues to be addressed include, but are not limited to, conflict of interest, confidentiality and
protection of personal information.
Conflict of interest
A conflict of interest may exist, for example, if an applicant or any of its personnel:
 has a relationship (whether professional, commercial or personal) with a party able to
influence the development or implementation arrangements e.g. a departmental officer;
 has a relationship with, or interest in, an organisation, which is likely to interfere with or
restrict the applicant in carrying out the proposed activities fairly and independently.
Applicants for grants will be required to declare conflicts of interest as part of their applications.
Confidentiality and Protection of Personal Information
It is a Commonwealth requirement that all confidential information and personal information are
kept confidential. This will require each funded entity to:
 comply with the Privacy Act (1988) (‘the Privacy Act’), including the 11 Information Privacy
Principles (IPPs), as if it were an agency under the Privacy Act, and the National Privacy
Principles (NPPs);
 refrain from engaging in direct marketing (s 16F of the Privacy Act), to the extent that the
NPP and/or s 16F apply to the funded entity; and
 impose the same privacy obligations on any subcontractors it engages to assist with the
project.
The contractual arrangement with funded entities imposes obligations on the funded entity with
respect to special categories of information collected, created or held under the Agreement. The
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funded entity is required to seek the Commonwealth’s consent in writing before disclosing
confidential information.
The specific clauses governing the confidentiality provisions of any grant process will be contained in
the contract that will form part of the grant documentation available to applicants.
C.8
Processes for Accessing the Fund
The process for accessing targeted grants or unsolicited proposals will be determined on a case by
case basis but will be consistent with the Fund and Grant Guidelines and the principles of the
Commonwealth Grant Guidelines.
C.9
Decisions
The Minister or Departmental Delegate will consider the extent to which targeted grants and one off
grants will make an efficient, effective, ethical and economical use of Commonwealth resources, as
required by Commonwealth legislation, and whether any specific requirements will need to be
imposed as a condition of funding.
Funding approval is at the discretion of the Minister or Departmental Delegate.
C.11 Complaint handling
The Department’s Procurement and Funding Complaints Handling Policy (the Policy) applies to
complaints that arise in relation to a procurement or funding process. The Policy covers events that
occur between the time the request documentation is released publicly and the date of contract
execution, regardless of when the actual complaint is made. The Department requires that all
complaints relating to a grant or procurement process must be lodged in writing. Further details of
the policy are available at the 'About Us' page on the Department’s internet site.
C.12 Conditions of Targeted Grants
Contracting arrangements
Entities offered grants will be required to enter into a funding agreement or other form of
agreement with the Commonwealth (represented by the Department). A copy of the proposed
contractual arrangement will form part of any material that is made available to applicants.
Details of all grants will reported in accordance with the requirements of the Commonwealth Grants
Guidelines and other reporting obligations applying to the Department. This will include being listed
on the Department’s website.
Payment arrangements
Payments will be made on the achievement of agreed milestones subject to the provision of:
 a tax invoice for the amount of the payment
 evidence of meeting the obligations of the funding agreement
Where payments are linked to the achievement of specific milestones, payments will only be made
after the Department is satisfied that those milestones and associated obligations of the funding
agreement or contractual arrangement have been met.
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Reporting requirements
Funding recipients will be required to provide progress reports on the agreed milestones. These
progress reports may include funding acquittal requirements. The timing of progress reports will be
negotiated as part of the funding agreement. The format and framework for providing progress
reports will take into account the size, cost and relative risks of the initiative/project being
undertaken by the funding recipient.
Monitoring
The funding recipient will be required to actively manage the delivery of the project. The
Department will monitor progress against the funding agreement or contract through assessment of
progress reports and by conducting site visits as necessary.
Evaluation
The Department will from time-to-time evaluate the grants provided under the Fund to determine
whether they are effective in achieving the intended policy objective and are an efficient use of
public monies. Funding recipients will be required to provide information to assist in this evaluation
for a period of time, as stipulated in the funding agreement or contract, after the funding has been
provided.
C.13 Procurements
Any procurement undertaken for work directly related to the Objective of the Fund will be
undertaken in accordance with the requirements of the Commonwealth Procurement Rules , and
will be consistent with the Objective and Priorities of the Fund. The requirements for procurements
will be included in the documentation made available to prospective tenderers.
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Glossary of Terms
Applicants
Means any entity that applies for funding under the flexible Fund.
Departmental Delegate
Means an officer of the Department authorised under the Chief Executive Instructions to exercise a
delegation or make a decision relating to the Fund.
Human Services
Means the Department of Human Services
Funded entity
Means any entity that has been successful in a grant process under the flexible Fund.
General practice
Means general practices and Indigenous Health Services.
GPII
Means the General Practice Immunisation Incentive
PIP
Means the Practice Incentives Program
Practice Incentives for General Practices Fund (The Fund)
As described in Section 1 of these Guidelines.
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