Table 2.

Illustrative quotes for theme “Needs/support and resources GPs require to manage urgent care patients in the community”

Keeping GPs informed to ensure continuity of care	“I would've thought that by this day and age we would've had a way where a doctor's referral was flagged on a hospital system with a discharge summary and other documentation was automatically sent back to the GP.” [Participant 16; male; 50 years] “Once the patient gets to ED, the GP then loses track, completely, of what's going on with the patient (…) [GPs] often express frustration that hospitals aren't very good at thinking about what happens when the patient leaves the front door of the hospital. They're not very good at pre-planning discharge, and the quality of their discharge summaries sometimes is inferior. Sometimes the discharge summaries come too late, when the GP needed really critical information about medication.” [Participant 2; female;52 years] “When you give the patient (…) a referral letter, you're never sure if the doctor is actually gonna get it. Does it get lost in triage? Where does it go? So that's why verbal handover can be useful for those that you're really worried about. And when someone really seems to be acknowledging what you're saying and understanding what you need from them, then that's really good.” [Participant 8; female; 35 years]
Clear referral pathways	“…we need to provide them with really clear pathways [so they] know who to ring, how to easily get through to someone, who's gonna be on the other end…it can be very difficult for them trying to navigate our system and to know how to get… how to get through to the right department or the right specialist.” [Participant 2; female; 52 years] “…ohh I mean gosh, it will be wonderful once things are electronic, but right now it's literally just writing caps lock urgent referral on the fax. And then sometimes, for someone I’m really worried about, I will call the on call, but even then it's an open ended way to try and safety net. You're never sure whether it's worked or not…” [Participant 8; female; 35 years]
Timely knowledge and decision-making support	“…there's a cardiologist who I listened to once, give a talk at the Primary Health Network and he said, ‘look, here's my mobile number’. He put it up on the screen, said ‘I'm more than happy for you guys to text me if you've got any questions’. And then I did. I texted him, and now when I have a patient that I wanna refer, I'll send him a WhatsApp and he always replies quickly. I've even sent him an ECG before and he was really great (…) With a website, I'm not quite sure if that would be useful because if it's got generic information about-…this is how to treat, say, bronchiolitis, it's probably likely something the GP already knows, it's just that this individual scenario needs to be tailored and we need advice on how to tailor it. So that's why I think talking about the actual case is much more useful than just-…it's not the clinical information we necessarily need, it's how to apply it.” [Participant 8; female; 35 years] “…a lot of referrals could be avoided if-…sometimes if you could just ask one or two questions of a specialist, you know (…) so-…and that's what makes the health system inefficient and that's what clogs it up and that's what makes managing patients so much harder and takes so much longer. You know, you’ve got to then-…end up referring them to a specialist and they don't get in to see the specialist for five or six weeks, when you could probably ask a couple of pointed questions to a specialist immediately.” [Participant 13; male; 47 years]
Adaptable funding model	“…to have a flexible and adaptable funding model. (…) GPs can be on the phone for like, half an hour to find out what (…) do I do with this patient's long COVID (…) They can't really bill for that.” [Participant 4; male; 34 years] “…three assessments a day (…) Your standard GP just cannot do that. (…) So, you know, that talks to the funding structure and the model of general practice and primary care that's used in Australia at the moment. So it would be access to enough resources to deliver the clinical assessments, deliver the frequency of remote monitoring, being able to respond to what that monitoring and assessment is telling you…” [Participant 6; male; 47 years] “…we get paid for the encounter that we're with the patient. And so, it's sort of difficult to work out how you'd kind of incorporate that model of care… I think one of the problems we've got here is that we want to move into new innovative models of care that our funding model doesn't support.” [Participant 11; female; 50 years]
Awareness of existing support	“…knowing what support is available to them to be able to keep their patients at home or in their place of residence and not have to send them to hospital. So, if they don't have an avenue by which they can get support, the default would be to send to ED because they're concerned about the patient (…)” [Participant 5; male; 38 years] “I even feel like within the…the hospital, people don't know what's there (…) even when I work in ED, some of the bosses say ‘yes, we do iron infusions in ambulatory care’ or ‘no, we don't do iron infusion’. Nobody knows. And it made me feel better realising that it’s not just because I'm in the community.” [Participant 8; female; 35 years] “Yeah, I think (…) some of the PHN resources are great and I just wonder about whether they're aligned with LHD advice lines and that sort of thing, because I mean ideally the LHD advice lines should be looking at the health pathways systems that the PHN's have set up and directing GPs into some of those where it's appropriate.” [Participant 11; female; 50 years]