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Several potential sources of bias have crept into the EMP process due to process modification which is detailed in
the attached report. It should be noted that some of these process modifications were made to address practical,
administrative needs without which the EMP could not easily function.
EMP Costs and Resourcing
The External Medical Panels are resource intensive. Attendance of four panel members at each panel amounts to
$10,000 without factoring in travel costs, Medical Advisor resource, the administrative cost of a full-time
administrator and a stenographer.
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Current Utilisation
The EMP had been meeting monthly. There have been no 2019 meetings. Approximately five cases were
discussed at each meeting. While there is no good quality data on the wait time from referral being received to
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the case being discussed by the EMP, it was not uncommon for the claim to have to wait at least two months to
be considered.
Next Generation Case Management (NGCM)
As part of the refinement of the NGCM model for roll-out, the majority of BAU internal panels are being
discontinued e.g. Support Needs Assessment Panel, LOPE Panel, National Consistency Panel. Instead, where
support is required this wil be met using the Recovery Support model. Where a claim requires comprehensive
review this can be achieved by co-ordinated written advice, involving Clinical and Technical advisors as
appropriate.
The EMP were considered out of scope of the Phase 3 Design of Recovery Support and therefore a decision was
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not made on if it should continue or not.
Discussion
The consensus from Clinical Services is that the External Medical Panel should be discontinued taking into account
the resource consumed, the direction of Next Generation Case Management, the new Technical and Clinical
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Services operating models and Chris Howard-Brown’s Post-Implementation review.
The clinical group discussed ways in which improvements can be made in the identification and management of
claims with complexities present to promote improved client outcomes.
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• Identification of Psychosocial barriers: Ensuring that psychosocial barriers are identified early in the life of a
claim by influencing the practices and skills of Case Owners, internal advisors and providers.
• Recruiting wider areas of specialty into the Principal Clinical Advice Team and the development of the
clinical competency framework will improve ACC’s capability to provide targeted, credible and specialised
advice.
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• Long-term claims are clinical resource intensive in terms of file review and making recommendations. The
specific questions Case Owners ask have not always been clear and well-articulated resulting in
unnecessary complex reviews. Case Owners require more specific guidance around which cases would
benefit from a comprehensive clinical review with discussion occurring between the Clinical Advisor and
Case Owner before the Clinical Advisor embarks on the comprehensive case review. Additionally,
consultation with Technical Services will also provide guidance as to whether a comprehensive clinical
review is indicated when revocation of cover or suspension of entitlements is being considered.
• More focused internal review, with involvement of the appropriate specialties, wil help determine the
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best way forward and determine when an external specialist review is required. This will avoid the past
practice of obtaining multiple external specialist reviews without a robust rationale for doing so.
Accident Compensation Corporation
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• Acknowledge in complex cases where maximum recovery has occurred to avoid clients being subjected to
multiple assessments and treatments which are highly unlikely to make any difference to the outcome for
the client.
Recommendation
It is our recommendation that the External Medical Panels are discontinued, with claims requiring complex review
being directed to Clinical and/or Technical Services for response and support for the Case Owner.
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Implementation
There are currently no scheduled meetings of the External Medical Panel. If the above recommendation is
approved, the next steps would be
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• Communication to Client SD staff that the EMP process has been discontinued, guidance given about how
to seek advice in complex cases using the existing Clinical and Technical advice channels
• Remove content on CHIPS and create Promapp content
• Official y inform the EMP members that the panel has been discontinued
Please contact myself or any clinical staff listed on this memo if you would like to discuss this further. Otherwise
please indicate whether you approve the proposed cessation of the EMP.
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Accident Compensation Corporation
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Document Outline
