Healthy North Coast Practitioner Newsletter by Healthy North Coast

July 2014 | Edition 2

Healthy North Coast practitioner newsletter North Coast Medicare Localâ&#x20AC;&#x2122;s premier communication for General Practice, Aboriginal Medical Services, Aged Care, Pharmacy and Allied Health

3 1

GP Focus

AMS Focus

AgedCare Focus

Pharmacy Focus

AlliedHealth Focus

inside 3. GP Focus 11. AMS Focus 13. Aged Care Focus 15. Pharmacy Focus 19. Allied Health Focus 20. Healthy North Coast News 22. Events 23. Classifieds

GPFocus

PAL UPDATE General Practice Emergency Medicine Training Program NCML is proudly sponsoring a series of five, three hour workshops on emergency medicine which will be delivered by the University Centre for Rural Health. The series of workshops will be held in simulation labs in Lismore, Murwillumbah, Grafton, Coffs Harbour and Port Macquarie commencing in August 2014. The workshops are free and targeted at General Practitioners and Practice Nurses. Participants will be able to practice emergency skills as a team while undertaking immersive scenarios that replicate emergencies that occur in the general practice environment. General Practitioners and Practice Nurses can choose to attend any of the following workshops: • • • • •

Airway Management Breathing Management Circulation Management Cardiovascular Management Disability Management

Accreditation is currently being sought by RACGP, ACRRM and APNA. Flyers and registration forms will be circulated soon. Enrol early as places will be limited.

prevention and management of wounds. Recognised by the RACGP, ACRRM and ACN, this education program provides two points per module for ACN members, and depending on the modules completed, up to 40 points for RACGP and 30 points for ACRRM members. Visit http://bit.ly/1iS4TI7 for more information. New Aged Care/Geriatrician in Coffs Harbour Dr Vaibhar Tyagi commenced working as a Geriatrician and Physician in Coffs Harbour on 4 June 2014 from the Coffs Harbour Campus Medical Centre in the Specialist Medical Centre opposite Coffs Harbour Health Campus. Dr Tyagi has a special interest in dementia, memory problems, recurrent falls and active ageing. All patients aged 65 and older will be bulk-billed. Fax 02 6652 2449 or email info@ chcmedical.com.au to refer to Dr Tyagi. Please contact Ellen on 02 6652 2448 for more information.

Online Wound Management Education

Online learning for Practice Nurses - National Bowel Cancer Screening Program

The WoundsWest Online Wound Education Program is a free evidencebased program that aims to improve

An online course, developed in conjunction with Cancer Council Australia, for Practice Nurses provides

an understanding of the risk factors and symptoms of bowel cancer, different screening tests for bowel cancer, features of the National Bowel Cancer Screening Program and duty of care associated with the management of program participants. The Australian Practice Nurse Association is offering this course free to members and at a special rate of $59 to nonmembers. Visit http://bit.ly/UKZ6ZT to access the course. Australian Absolute Cardiovascular Disease Risk Assessment Calculator The Australian Absolute Cardiovascular Disease Risk Assessment Calculator is an evidence-based calculator produced by the National Vascular Disease Prevention Alliance for health professionals and their patients. Visit www.cvdcheck.org.au to access the tool. ACI Pain Management Network The Agency for Clinical Innovations, Pain Management Network has a range of pain resources for health professionals and consumers. Visit http://bit.ly/NPQwFe to access the Toolkit for Clinicians.

GPFocus PAL UPDATE PEN CAT Recipes

QI Connect

To make better use of your PEN Cat data extraction tool, a range of different recipes have been devised. These tools will help you to improve the quality of care for your patients, identify your patients at risk and maximise your business potential.

The Improvement Foundation’s QIConnect website offers valuable news, resources and webinars to help improve your practice. Visit www.improve.org.au to register and gain access to ‘Absolute Risk Assessment’ webinar with Robert Grenfell at http://bit.ly/1qK3ipY.

Visit http://bit.ly/1wzrhJ1 to access the recipes. If you would like to have the PEN Cat tool installed in your practice, contact your Provider Assistance Liaison (PAL) officer in your local NCML branch: Tweed Valley: (07) 5523 5599 Lismore: (02) 6622 4453 Coffs Harbour: (02) 6659 1800 Port Macquarie: (02) 6583 3600 Kempsey: (02) 6562 1055

RACGP Infection prevention and control standards The RACGP Infection prevention and control standards for general practices and other office-based and communitybased practices (5th edition) have been published. This guide will assist health professionals and other staff implementing procedures involving infection prevention and control.

Innovations in Cancer Treatment and Care Conference Developing a quality cancer system will be the theme of the Cancer Institute NSW’s third annual Innovations in Cancer Treatment and Care Conference to be held on Friday 17 October in Sydney. This is a free conference for NSW attendees. Those who are currently working on or have recently completed a project designed to improve cancer care are being strongly encouraged to submit an abstract. Abstract submissions close on 15 August 2014. Registrations for this event are now open. Early registration is encouraged to ensure your place. Visit http://bit.ly/1qM0tCC for more information.

Visit http://bit.ly/1m7PGkr for further information.

ABORIGINAL HEALTH Webster Packing available for Care Coordination and Supplementary Services patients The Care Coordination and Supplementary Services (CCSS) program provides care coordination, access to specialist and allied health services and some medical aids for Aboriginal clients who live with a chronic disease. Patients must be referred by their general practitioner to access this program.

CCSS clients are now also able to access Dose Administration Aids. This is similar to, but not the same as, the Quality Use of Medicines Maximised in Aboriginal and Torres Strait Islander Peoples program through Aboriginal Medical Services and the Pharmacy Guild. When a client nominates a pharmacy, a CCSS coordinator will contact the pharmacist to confirm costs per week and billing details.

If you are aware of Aboriginal and Torres Strait Islander patients who are not accessing this program and would benefit please refer them to the CCSS Coordinator in their region: Tweed Valley: (07) 5523 5500 Lismore: (02) 6622 4453 Coffs Harbour: (02) 6659 1800 Kempsey: (02) 6562 1055 Port Macquarie: (02) 6583 3600

GPFocus eHEALTH UPDATE Over 140 (85%) general practices across the NCML region have registered and prepared to participate in eHealth. In addition, up to 50 (35%) community pharmacies and 150 allied health professionals are also registered and preparing to participate in eHealth. Therefore, it is highly likely that your patients will interact with health care providers who have access to eHealth records.

Improving Data Quality

Who and why will eHealth benefit?

Getting the best out of any health record system requires appropriate policies and procedures for record making, record keeping and risk management. It also requires appropriate staff training to ensure the system is used to its maximum capability and upgraded as needed.

In a growing technological age, parents are keen to have electronic ways to monitor and manage their child’s health care. With the eHealth record parents can access their child’s ‘Blue Book’, immunisation records and health alerts with the touch of a button on their smart phone. Patients with chronic/complex conditions repeat their ‘story’ to health care providers often. This increases the risk of errors in communication, and frustration for the patient. These patients will benefit from an eHealth record by having one place for a large amount of their health care data, including past medical history, medications, pathology, radiology and referrals. Health care providers will be able to access a greater amount of relevant information to support decision making and care options for their clients. Older People who are likely to have more medical history, multiple medications and hospital admissions find their eHealth record reassuring. No longer do they have to worry about remembering all of the names and/or doses of their medications. In addition, information about Advance Care Directives and emergency contacts are also available in the eHealth record. All patients can and will benefit from having medical information readily available to health care providers.

Good quality data is not just an accreditation requirement. Safe and highquality healthcare depends on the sharing of health information from quality health records. (Recent local feedback indicated that in some areas up to 75% of eHealth summaries included in referrals were inaccurate).

Recommendations to improve compliance include: •

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Review the strengths and weaknesses of your health record system – design relevant policies and procedures to act on these strengths and weaknesses Capitalise on your clinical software’s decision support features (for example, an allergy alert for penicillin prescriptions, pregnancy status for contraceptive prescriptions, asthma status for beta blocker prescriptions, and suicide risk for patients with a mental health diagnosis) Capitalise on automated features (for example, prompt for a diagnosis before a record can be closed or prompt for a prescription that is contraindicated for a particular diagnosis) Ensure every health professional in the team has protected access to the system – each member of the team can then exercise their individual professional obligation to produce and maintain quality health records

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Join an independent ‘software users group’ to share knowledge about the capabilities and limitations (The Healthy North Coast Network can support this – see page 20 for more information)

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Make sure you meet accepted standards for information security (for example, the RACGP Computer and information security standards)

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Provide initial and ongoing training for clinical and administrative members of the team to support the optimal use of clinical software and correct linkages with compatible management software for improved efficiencies

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Develop a checklist for your practice that identifies areas for improvement (for example, the use of decision support features or upgrading to an electronic health record system)

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Conduct a quality improvement activity to improve data quality. Clinical Data Audit tools, such as Canning (free download at http://bit.ly/1o1zTmy) or PenCAT (available free through NCML PAL Officers) can help with this

Other useful websites to improve data quality include: http://www.racgp.org.au http://bit.ly/1nIV9vL Contact your local Provider Assistance and Liaison officer for more information: Tweed Valley: (07) 5523 5599 Lismore: (02) 6622 4453 Coffs Harbour: (02) 6659 1800 Port Macquarie: (02) 6583 3600

GPFocus AFTER HOURS – SLEEP TIME UPDATE May 2014 After Hours Activity Reporting Reminder Thank you to practices that have already submitted their May 2014 After Hours Activity reporting. General practices participating in the After Hours PIP are reminded that the May 2014 reporting was due on 30 June 2014 in preparation for the next quarterly payment. This information is also used in health planning to understand the after hours primary health care demand of communities. The reporting template can be found at http://bit.ly/V5Wfeo. Please organise report submission as soon as possible if not already completed. Additional reporting will not be required until early 2015.

May 2014 Quarter PIP Statement

2014/15 After hours Agreement

General practices participating in After Hours PIP are also reminded that a copy of the recently received DHS May 2014 Quarter PIP Statement should now be forwarded to the NCML After Hours Program Manager if not already done so. The SWPE information contained in this statement is the basis for the August PIP payment. NCML does not get direct access to this information by any other means at this point in time. Please email to afterhours@ncml.org.au or fax a copy to 02 6618 5499.

Practices participating in the NCML After Hours Program should have received a Variation notification via post. This was sent in the first week of June 2014 and details the extension of the Interim Agreement to 30 June 2015. Following the recent release of the Horvath report into Medicare Locals, the NCML Board has decided to retain the existing payment formula and structure. Please phone David Lacey on 02 6618 5421 if your practice has not received the Variation.

NATIONAL PRESCRIBING SERVICE Exploring Inhaled Medicines Use and Asthma Control Asthma is one of the most common chronic conditions managed by Australian health professionals but may not realise that many patients are living with poor asthma control and consider it to be normal. North Coast Medicare Local, in partnership with NPS MedicineWise, is currently offering the Exploring Inhaled Medicines Use and Asthma Control Program which provides an opportunity to discuss accurate, independent and practical information about inhaled medicines use and asthma control.

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Please contact your nearest NPS Program Officer for more information or to book a free educational visit:

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Tweed Heads – Jill Hayward jhayward@ncml.org.au Northern Rivers - Sally Herbert sherbert@ncml.org.au Mid North Coast – Michael Driscoll mdriscoll@ncml.org.au Hastings-Macleay – Lesley Burrett lburrett@ncml.org.au

NPS Program Officers will be providing educational visits and case study discussions to general practitioners, practice nurses and pharmacists from July 2014.

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This program coincides with the updated Australian Asthma Handbook and will be a great opportunity for health professionals to learn about changes in asthma management.

The NPS program Safe Use of Medicines in Older People has been rolled-out with most medical practices receiving a visit or case study in the past four months. The following points are a useful summary of what the program promoted:

ABORIGINAL HEALTH

The program will focus on: • Assessing symptom control and risk factors for poor outcomes • Role of adherence and inhaler technique in asthma control • Provision of written, individualised information enabling guided patient self-management.

10 points about using medicines in older people

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• •

•

• • •

Use non-pharmacological treatments first – medicines should not replace effective psychosocial care Use a low dose and increase slowly – start with half the usual adult dose, adjust based on tolerability and response Use the lowest number of medicines – with the simplest dose regimens Use a limited range of medicines – understand their effects in older people Provide simple verbal and written instructions for every medicine and repeat prescription Anticipate adherence issues – use alternatives to tablets or capsules where needed and avoid child-proof containers Consider current medicines as the cause of new symptoms before looking elsewhere – do not assume symptoms relate to old age Regularly review treatment – stop medicines no longer indicated, adjust dose with declining kidney function People are central to quality use of medicines – seek input and treat the person NOT the disease Make medicines count – consider the appropriateness of prescribing and medicines burden, when in doubt DON’T

GPFocus PREVENTATIVE HEALTH Free Child Weight Management Program for Local Families Go4Fun, a free evidence-based program designed to prevent and treat overweight and obesity in children and their families, is taking registrations for programs commencing mid-July. Health professionals across the North Coast are encouraged to refer appropriate families. Funded by the Department of Health and supported by NSW Health, Go4Fun is a comprehensive family-based educational program for 7-13 year olds who are above their healthy weight. The primary parent or carer is also required to attend. Go4Fun comprises two after school sessions per week during one school term. Sessions focus on healthy nutrition, personal goal setting and fun physical activities which increase skills and confidence and improve fundamental movement skills. Evidence shows that Go4Fun helps children: • Reduce BMI • Increase physical activity levels • Increase self-esteem • Reduce their sedentary behaviours

Term 3 programs are scheduled to run in: • Coffs Harbour, South West Rocks, Port Macquarie and Wauchope • Casino, Banora Point and Maclean Go4Fun is not a diet but provides a responsible, reliable and effective foundation for healthy living. Children and families learn skills and information that will help them manage their weight in a healthy, sustained way. Health professionals can refer families interested in participating by calling 1800 780 900 or texting 0409 745 645 for a confirmation call back. For more information including orders of brochures for your practice, please contact: •

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Margo Johnston via phone 02 6562 0324 or email margo.johnston@ ncahs.health.nsw.gov.au for Hastings, Macleay, Coffs Harbour, Bellingen and Nambucca areas. Freyja Smith via phone 02 6620 7504 or email Freyja.Smith@ncahs.health. nsw.gov.au for Casino, Banora Point and Maclean areas.

General program information and registration is available at: www.go4fun.com.au Supporting GPs managing and preventing epidemic of Type 2 Diabetes in Australia 13-19 July is National Diabetes Week which aims to raise awareness of Type 2 diabetes prevention. RACGP in partnership with Diabetes Australia has released guidelines for Type 2 Diabetes management 2014-15: http://bit.ly/1uk8iB5 The guidelines address various responsibilities of managing diabetes including: • Prevention • Structured care and patient education • Lifestyle modification • Evaluating the patient with diabetes • Managing glycaemia, cardiovascular risk, microvascular and other complications This tool can be utilised for prevention of diabetes and care to minimise its severity.

DENTAL HEALTH New Dental Benefit Program for children 2-17 years of age Around 3.4 million children aged 2-17 years are eligible for the Child Dental Benefits Scheme (CDBS). The scheme offers basic dental services, capped at $1000 per child, over two consecutive calendar years. Eligible patients can be encouraged to access this benefit. Who is eligible? The CDBS is for the children of families that receive Family Tax Benefit Part A (FTB-A) or a relevant Australian Government payment such as Abstudy, Carer Payment or Youth Allowance. 7

What benefits are available? Benefits cover a range of basic dental services including: • Examinations • X-rays • Cleaning • Fissure sealing • Fillings • Root canals • Extractions Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in hospital. How do you encourage your patients to access the CBDS? 1. Ask them to call Medicare on 132 011 to check if they are eligible

2. If eligible, your patient can then make an appointment with a dentist of their choice 3. When making the appointment, it is important the patient tells the dentist that their child is eligible for the CDBS What can patients expect at the appointment? 1. The dentist must discuss the child’s treatment and costs before beginning treatment 2. A consent form will need to be signed after the discussion 3. At the end of the consultation this service will either be bulk-billed or the parent will need to pay the account and claim the benefit through Medicare

GPFocus MENTAL HEALTH Improved access to psychological services as Healthy Minds takes off

also vulnerable.

Healthy Minds is a new free mental health program for people with mild to moderate emotional and behavioural difficulties who are

Priority groups include people experiencing or at risk of homelessness, Aboriginal and Torres Strait Islander people, children, and people at risk of suicide and self-harm. To be referred, patients must have a health care card or be experiencing severe financial distress. The program is suitable for mental health issues including mild-moderate depression, anxiety, substance misuses and eating disorders. Referral process GP referral is required for patients to access Healthy Minds services.

Healthy Minds referral forms are available by contacting the Healthy Minds team at North Coast Medicare Local. All referrals should be sent directly to the Healthy Minds team. When referrals are received, the Healthy Minds Team identify the appropriate funding source and send the referral information and other paperwork to the Mental Health Professional. GPs can still nominate the provider of their choice. With over 100 mental health professionals registered for Healthy Minds, it is expected that GPs can continue to refer to their preferred practitioner. Service sites Healthy Minds is currently working in partnership with 24 community service organisations from the Queensland border to Port Macquarie. Mental Health Practitioners contracted to the Healthy Minds Program provide sessions on site from these partner organisations and also from their own consulting rooms. These

partnerships effectively double the number of access points for psychological services across the region. Each community service organisation is committed to supporting their clients to see a GP to improve their physical and mental health. Funding source Healthy Minds is an initiative of the North Coast Medicare Local and funded by the Australian Government Department of Health, using both ATAPS (Access to Allied Psychological Services) and Better Access funding. Contact Please phone 1300 137 237 or email healthyminds@ncml.org.au for more information, referral forms or to make a referral.

CLINICAL TIP Now that winter has finally arrived, this clinical tip will focus on treatment of Upper Respiratory Tract Infections in children. The American Academy of Pediatrics has said that cough and cold medicines should not be prescribed or recommended for respiratory illnesses in children under four years of age (www.choosingwisely.org). Research has shown these products offer little benefit to young children and can have potentially serious side effects. Many cough and cold products for children have more than one ingredient, increasing the chance of accidental overdose if combined with another product. 8

Dr Dan Ewald, North Coast Medicare Local’s Clinical Advisor and local GP, recently conducted a review of the evidence relating to the use of honey as a cough supressant in children. Cochrane Systematic Reviews, as well as more recent studies, were included in the review. Dr Ewald found that honey should be recommended as the first choice cough suppressant if a cough suppressant is being sought for an Upper Respiratory Tract Infection in children over 12 months of age. In all studies, the night cough tends to get better with placebo or no treatment. However, honey showed higher recovery rates.

Dose equals 2.5-10g (~1/2 to 2 tsp) honey at night or also in the day. Type does not seem to matter. Honey can be mixed with a drink. There should be caution with: • •

Prolonged use of honey as it would be expected to be harmful to teeth with prolonged use Use with children less than 12 months old due to concerns about risk of botulism from unpasteurised honey products.

GPFocus IMMUNE RESPONSE Measles Alert Queensland has had 41 cases of measles this year, mostly in the southern Queensland area. There have been two cases of measles in the Northern Rivers area in the last few months. Please be aware of anyone presenting with measleslike symptoms. The first symptoms are fever, tiredness, cough, runny nose, sore red eyes and feeling unwell. A few days later a rash appears. The rash starts on the face, spreads down to the body and lasts for 4-7 days. The rash is not itchy. Measles is usually spread by an infectious person coughing or sneezing. Measles is one of the most easily spread of all human infections. Just being in the same room as someone with measles can result in infection. People with measles are usually infectious from just before the symptoms begin until four days after the rash appears. The time from exposure to becoming sick is usually about 10 days. The rash usually appears around 14 days after exposure. A NSW Health Measles fact sheet is available at http://bit.ly/1rCcpYF. PHHA Immunisation Conference Concerns of more Measles outbreaks - New Zealand is experiencing measles outbreaks with 100 cases in Auckland alone. Australia has experienced cases imported from travellers returning from Philippines and other Asian countries. Please advise travellers born during or since 1966 to have evidence of two doses of measles vaccines before travelling. Pertussis vaccination during pregnancy is the best way to protect babies from pertussis disease. Maternal vaccination should completely close the window of susceptibility in the infant by providing immunity until this is replaced by active vaccination. Study: A case for maternal vaccination against pertussis. (Lancet Infect Dis 2007;7:614-624) 9

Timeliness of receiving the first and second pertussis vaccination at 6 weeks and 4 months is also extremely important factor in protecting babies from pertussis. Influenza vaccination in pregnancy should also be strongly encouraged to give mum and baby protection for influenza. Bexsero (4CMen B): Importance of three doses of paracetamol with vaccination of Bexsero, Meningococcal B vaccine. Following the ATAGI recommendations, children under two years should receive paracetamol (15mg/kg per dose) 30 minutes prior to injection, or as soon as possible after. A further two doses to be given six hours apart regardless of the presence of fever. It is suggested that immunisation providers weigh the child and give the first dose of paracetamol if the child hasnâ&#x20AC;&#x2122;t already received it, prior to vaccinating. Have a Meningococcal post vaccination plan to give to parent/care that includes dosage and times for next two doses of paracetamol, plus instructions of who to contact if they are concerned about the child post-vaccination, especially in regards to fever. A clinical trial in infants has shown that prophylactic use of paracetamol reduced the incidence and severity of fever without significantly affecting the immunogenicity of either 4CMenB or other routine vaccines when these vaccines were given concurrently. Further information available at under clinical advice for providers regarding the use of Bexsero at www.immunise.health.gov.au. Meningococcal B high disease risk, 4CMenB is recommended for these groups: Infants and young children, particularly those aged <24 months; Adolescents aged 15 to 19 years; Children and adults with medical conditions that place them at a high risk of IMD, such as functional or anatomical asplenia or complement component disorders. A recent death of an adolescent from Meningococcal B in an Adelaide boarding school prompted Adelaide to run a

4CMenB vaccination program for adolescents in boarding schools. Further suggestions were to consider vaccinating all students in boarding schools and those living in university campuses. Adult vaccination: Vaccination against influenza, pneumococcal and Herpes Zoster vaccines can protect adults against these diseases and help them maintain their standard of living. Studies in the elderly showed that infections from the above diseases can result in an increase in frailty and reduced capacity to remain independent. The impact of Herpes Zoster on the quality of life especially when there is the complication of postherpetic neuralgia (PHN). PHN can last for years and is caused by the virus affecting sensitive nerve systems. PHN is difficult to treat. Vaccination was said to be the best intervention. Fact sheets are available at http://bit.ly/1q1txEN. Pneumococcal: Studies have shown that the introduction of the Conjugate pneumococcal vaccine in the childhood schedule has had an indirect effect of reducing IPD in the elderly. http://bit.ly/1v7UzMf HPV Vaccination program effectiveness: The program has significantly reduced cervical abnormalities for vaccinated women within five years of implementation, with the greatest vaccine effectiveness observed for younger women. Impact of a Population based HPV vaccination program on cervical abnormalities: a data linkage study. http://bit.ly/1jPLrX7

GPFocus IMMUNE RESPONSE GSK Immunisation grants Four grants of $20,000 each are currently on offer! The four grants will be awarded to support innovative programs that clearly aim to meet one or more of the following criteria in either childhood, adolescent and/or adult vaccines: •

Improve access, coverage and/or timely delivery as per the Australian

New to HealthPathways June 2014 • • • • • • • •

Cellulitis Heart Murmurs in Children Unsettled Infant Bariatric Surgery Croup Travel Vaccination Immunisation - Adult Immunisation - Child

HealthPathway of the Month - Cellulitis Recently added to the Mid and North Coast HealthPathways website is the Cellulitis pathway. In the pathway you will find the latest diagnostic, management and local referral information for patients with Cellulitis. Incidence Cellulitis is one of the Top 5 Potentially Preventable Hospitalisations (PPH) for the Mid North Coast Local Health District. PPH are conditions where hospitalisation is considered potentially avoidable

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National Immunisation Program schedule Improve access, coverage and/or timely delivery for hard-to-reach populations (including geographically distant populations, new Australian immigrants, refugees, asylum seekers) Utilise digital technology and/or social media to improve the Quality Use of Vaccines Improve access, coverage and/ or timely delivery for Indigenous populations

•

Improve access, coverage and/ or timely delivery for international travellers

Applications close: Friday, 15 August 2014 at 5:00pm. Visit http://bit.ly/1vwZGrf for further information.

through preventive care and early disease management. On the Mid North Coast, Cellulitis accounts for a total of 3,500 bed days a year, with an average length of stay of 4.5 days.

Note: Pathways that have been localised only cover the Mid North Coast region at this stage. Northern NSW Local Health District’s involvement in the program is pending.

Management

Visit the Mid and North Coast HealthPathways website at: http://manc.healthpathways.org.au Username: manchealth Password: conn3ct3d

Hospital admissions can be reduced by following detailed management guidelines. In particular, by utilising the services of the ‘Hospital in the Home’ team to treat patients with Cellulitis quickly and effectively. Cellulitis Work Group Members: • Dr Stephen Chung, VMO Physician • Dr David Gregory, Clinical Lead/ Facilitator • Dr Amanda Wijerante, General Practitioner Registrar • Carol Ingram, Registered Nurse, Hospital in the Home • Dr Gillian Fraser, Hospital in the Home Registrar, Port Macquarie Base Hospital

‘Background Artwork’ by Alison Williams

AMSFocus PAL UPDATE

CCSS

Online learning for Practice Nurses National Bowel Cancer Screening Program

Webster Packing for Care Coordination and Supplementary Services patients NCML operates a variety of programs specifically for Aboriginal and Torres Strait Islander people.

The Online learning for Practice Nurses course provides primary health care nurses with an understanding of the risk factors and symptoms of bowel cancer, different screening tests for bowel cancer, features of the National Bowel Cancer Screening Program and duty of care associated with the management of program participants. This course was developed in conjunction with Cancer Council Australia.

The Care Co-ordination and Supplementary Services program (CCSS) provides care coordination, access to specialist and allied services and some medical aids for Aboriginal clients who live with either/and diabetes; cancer; cardiovascular; renal or respiratory disease. To access this program patients must be referred by their GP. CCSS clients are also able to access Dose Administration Aids as a part of the supplementary services funds. This is similar to, but not the same as, the Quality Use of Medicines Maximised in Aboriginal and Torres Strait Islander Peoples program through Aboriginal Medical Services and the Pharmacy Guild.

The Australian Practice Nurse Association (APNA) is offering this course free to APNA members and at a special rate of $59 to nonmembers.

When a client nominates a pharmacy, the CCSS coordinator will contact the pharmacist to confirm costs per week and billing details. Accounts will be paid on invoice, in advance, on a quarterly basis. Your contact for this program will be the CCSS Coordinator in your area (see contact details below).

Visit http://bit.ly/UKZ6ZT to access the course.

If you are aware of Aboriginal and Torres Strait Islander patients who are not accessing this program and would benefit please refer them to the CCSS Coordinator in their region.

PREVENTATIVE HEALTH

For more information please contact your local CCSS Care Coordinator.

Refer to page 7 for information on preventative health.

Tweed Valley: (07) 5523 5500 Lismore: (02) 6622 4453 Coffs Harbour: (02) 6659 1800 Kempsey: (02) 6562 1055 Port Macquarie: (02) 6583 3600

HEALTH PATHWAYS Refer to page 10 for an update on immunisation.

IMMUNE RESPONSE GSK Immunisation grants Four grants of $20,000 each are on offer! The four grants will be awarded to support innovative programs that clearly aim to meet one or more of the following criteria in either childhood, adolescent and/or adult vaccines: •

Improve access, coverage and/or timely delivery as per the Australian National

•

• •

Immunisation Program schedule Improve access, coverage and/or timely delivery for hard-to-reach populations (including geographically distant populations, new Australian immigrants, refugees, asylum seekers) Utilises digital technology and/or social media to improve the Quality Use of Vaccines Improve access, coverage and/or timely delivery for indigenous populations

• •

Improve access, coverage and/or timely delivery for international travellers Applications close: Friday, 15 August 2014 at 5:00pm

Visit www.immunisationgrants.gsk.com.au for further information.

‘Background Artwork’ by Alison Williams

AMSFocus eHEALTH UPDATE Privacy and Security of the eHealth record The eHealth record system is expected to improve access to clinical information and enhance patients’ health outcomes over time. However a common deterrent for consumers (especially Indigenous clients) is privacy and security concerns associated with the eHealth record. Therefore, it is important to reassure patients that healthcare providers and organisations have a duty to keep their patients’ health information confidential and secure - and that this requirement extends to the eHealth record system. In addition, existing clinical standards apply to the use of information sourced from the eHealth record system. The eHealth record system implements high grade security protocols to detect and mitigate against external threats. The system is tested frequently to ensure these mechanisms are in place and robust. In other words, security is a key design element of the system, which adheres to Australian Government security frameworks. Design features include audit trails, technology and data management controls, as well as appropriate security measures to minimise the

PATIENT INFORMATION likelihood of unauthorised access to information in a patient’s record. Restricted access settings in the eHealth record system allow your patients to have significant control over their eHealth record, including setting controls around Healthcare Provider Organisation access, applying greater controls to sensitive information and choosing which information is not viewable through their eHealth record. The eHealth record system is also protected by legislation, including the Personally Controlled Electronic Health Records Act 2012 and the Privacy Act 1988, which contains penalties for unauthorised access to patients information.

HealthInfoNet is an online, innovative, evidence-based tool that is helping ‘close the gap’ in Indigenous health HealthInfoNet contains culturally appropriate resources for health practitioners working with Aboriginal and Torres Strait Islander people. A searchable database of health promotion and health practice resources also exists, which provides quick access to guidelines, tools, manuals and other resources. Visit www.healthinfonet.ecu.edu.au to access HealthInfoNet.

MEDICINE IN OLDER PEOPLE 10 points about using medicines in older people •

Find out more information about privacy and security at:

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www.staysmartonline.gov.au www.ehealth.gov.au http://bit.ly/1j7FxWH

• • • • • • • •

Use non-pharmacological treatments first – medicines should not replace effective psychosocial care Use a low dose and increase slowly – start with half the usual adult dose, adjust based on tolerability and response Use the lowest number of medicines – with the simplest dose regimens Use a limited range of medicines – understand their effects in older people Provide simple verbal and written instructions for every medicine and repeat prescription Anticipate adherence issues – use alternatives to tablets or capsules where needed and avoid childproof containers Consider current medicines as the cause of new symptoms before looking elsewhere – do not assume symptoms relate to old age Regularly review treatment – stop medicines no longer indicated, adjust dose with declining kidney function People are central to quality use of medicines – seek input and treat the person NOT the disease Make medicines count – consider the appropriateness of prescribing and medicines burden, when in doubt DON’T

AgedCareFocus PAL UPDATE Aged Care Reform Briefings and the Income Asset Calculator The recent Commonwealth Aged Care Reform Briefings and webinars held across the country in May/June held no real surprises for most of us in the sector. Questions were encouraged at the briefings and can still be emailed to agedcarereformenquiries@dss.gov.au Currently testing is the income and assessment calculator which is available on the My Aged Care website. This tool is expected to simplify the estimation of the costs of entering the aged care facility of your choice. Ongoing updates are available at: www.myagedcare.gov.au

Dr Tyagi has a special interest in dementia, memory problems, recurrent falls, and active ageing. All patients aged 65 and above will be bulk billed. To refer to Dr Tyagi fax (02) 6652 2449 or email info@ chcmedical.com.au. Please contact Ellen at CHC Medical on (02) 6652 2448 for further information. 10 points about using medicines in older people

NDSW Dementia Behaviour Management Advisory Service

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This service supports the care and quality of life for people living with dementia. All RACFs can avail of the service and the DBMAS worker in their area through HammondCare. To contact this service phone 1800 699 799 and a consultant from a multi disciplinary team will assess the intervention and recommendations required.

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A local DBMAS worker is also available to support the care planning for your resident and is available by faxed referral. The referral form is also available from North Coast Medicare Local by contacting Diana Anderson via email at danderson@ncml. org.au or phone on (07) 5523 5516 in the Northern NSW region or contacting Noni Kubowicz via email at nkubowicz@ncml.org. au or phone on (02) 6583 3600 in the Mid North Coast region.

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Wounds West Education

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The Wounds West Online Wound Education Program is a free evidence based program which aims to improve patient care by improving your ability to prevent and manage wounds. Recognised by the RACGP, ACRRM, and the Australian College of Nursing this education program has 2 point per module for CAN members, and depending on the modules completed up to 40 points for RACGP and 30 points for ACRRM members.

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Visit the Wounds West website for more details: www.health.wa.gov.au/WoundsWest/education/index.cfm New Aged Care/Geriatrician in Coffs Harbour NCML is pleased to advise that Dr Vaibhar Tyagi commenced working as a Geriatrician and Physician in Coffs Harbour from 4 June 2014 working from the Coffs Harbour Campus Medical Centre situated in the Specialist Medical Centre (opposite CHHC).

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IMMUNE RESPONSE Consider Herpes Zoster vaccination ( Zostavax) for those in the recommended age group of 60-79 years. Zostarvax licensed for those over 50 years and only a single dose is required. It’s currently not funded and an approximate cost is $180-$250. Vaccination of persons 60–79 years of age is estimated to prevent approximately half the cases of shingles and two-thirds of post-herpetic neuralgia cases in that population. In vaccinated people in whom an episode of shingles occurs, the pain severity and duration is reduced by 60%. Fact sheet available at www.ncirs.edu.au/immunisation/fact-sheets

AgedCareFocus eHEALTH UPDATE To date, eight Aged Care organisations within the NCML region have registered for eHealth. There are many benefits for aged care facilities to participate in eHealth, with improved communication between Aged Care facilities and Hospitals high on the agenda.

programs will just provide domestic support; however there is still a strong value proposition for community providers being able to obtain: •

Benefits of eHealth for the Aged Care sector eHealth is “the combined use of electronic communication and information technology in the health sector” World Health Organisation. Some benefits of eHealth include:

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More information available to make care decisions Increased timeliness of communication and level of information shared between aged care facilities, hospitals and general practices The ability to see dispensed and prescribed medication via the PCEHR is anticipated to give providers an additional level of clarity and information Being able to obtain relevant information about a client via the PCEHR - provides another channel for community providers to keep informed of any changes in the patient’s healthcare need Building block for the future – part of branding as a leading aged care organisation/service.

Benefits for Residential Aged Care Like many health sectors, Aged Care struggles to source information from other providers. Residential providers in particular regularly try and source information from: • • •

Hospitals: after the patient has been discharged. Some Hospitals are better than others at faxing information about the stay to the residential facility. Specialists: after the patient has visited a Specialist. General Practice: after general consultations and checkups. One rural residential provider described a client’s carer taking them to a GP, outside of the provider’s immediate area; this GP then almost always failed to provide them with any information even after multiple requests.

Benefits for Community Aged Care Community aged care organisations are likely to receive less information from other healthcare providers than residential providers do, given they don’t care for clients 24/7. They are unlikely to need clinical information for all clients, given community programs vary in level of need. For example, some

Discharge information from Hospitals: for higher care programs (where the individual has a certain level of clinical need) obtaining information about the Hospital stay will be particularly valuable for ongoing care decisions. It is rare that this information would currently be provided by Hospitals. General Practice and Specialist: as with Hospitals, it is rare that information about a client will come to a community provider, without having first requested it. Medication Management: the ability to view dispensed and prescribed medication information, for higher clinical needs programs, could give community providers relevant information for decision making purposes.

Currently, community providers find it difficult to know when a client has been admitted or discharged from Hospital. In these situations the onus is really on the individual to contact the community provider. Being able to obtain relevant information about a client via the PCEHR provides another channel for community providers to keep informed of any changes in the patient’s healthcare needs. Below are some links illustrating the use of eHealth in the aged care sector: Mecwacare using iCareHealth Melbourne’s Mecwacare uploads Event Summaries to the PCEHR using iCareHealth: http://bit.ly/1qgA4PD Feros Care using DCA Health’s The Care Manager (TCM) Feros Care rolls out WiFi for Telehealth, PCEHR: http://bit.ly/1qgAa9W

HEALTH PATHWAYS Refer to page 10 for an update on HealthPathways.

PharmacyFocus PAL UPDATE Pharmacy Awards

former member for a consecutive 25 year period or more. Nominees for Young Pharmacist of the Year must be under 35 years of age (in mid-April of the year of entry) with less than 10 years’ experience as a practicing pharmacist.

Charnwood Capital Chemist has been announced as the winner of the 2014 Pharmacy of the Year award for their innovations in professional services including:

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Nominations forms for the 2014 awards are available on the PSA website. Nominations close on Friday 29 August 2014.

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Delivery of referral-based services for vascular ulcers and lymphoedema, in collaboration with ACT Wound Services and Calvary Lymphoedema Clinic Provision of a free maternal and child health clinic to the community Provision of mental health services such as New Access coaching, in partnership with Medicare Local and Beyond Blue

Visit http://bit.ly/1pFnw0w to find out more about their work. Pharmaceutical Society of Australia Excellence Awards Nominations Open The Pharmaceutical Society of Australia (PSA) Excellence Awards acknowledge innovative practice and pharmacists who provide role models through their professionalism and raising practice standards. Nominees must be, or have been, a member of PSA and meet the following requirements: •

Lifetime Achievement Award nominees must be either a current PSA member or a retired pharmacist who was a

The Pharmacy Business Network

Visit www.guildevents.com.au for more information on the program, pre and post conference touring in Vietnam, and travel and accommodation packages. Medicines Shortages Alert Service The Therapeutic Goods Administration’s Medicine Shortages Information Initiative provides information about prescription medicine shortages in Australia. This information is provided to assist health professionals and consumers when there is a temporary disruption or discontinuation to the supply of a medicine in Australia. Pharmacists and prescribers can sign up to an alert service to receive email or RSS feed notifications of new and updated information on drug shortages at http://bit.ly/1pU185o

The Pharmacy Business Network (PBN) conference will take place between 12-14 September 2014 at the Crown Conference and Events Centre, Melbourne. The focus of the PBN 2014 is to provide the industry with tools to improve business planning, management and profitability. Find the program and register via the Pharmacy Business Network website.

PREVENTATIVE HEALTH

The Pharmacy Guild of Australia Offshore Conference

Refer to page 7 for information on preventative health.

The Pharmacy Guild of Australia Offshore Conference will be held between 29 September – 2 October 2014 in Hoi An, Refer to page 9 for an update on immunisation. Vietnam. Offering a mix of clinical and business sessions, the conference will feature singer, actress and business woman Clare Bowditch, who will deliver the keynote presentation “Passion is the key to business success”.

IMMUNE RESPONSE

PharmacyFocus

Exploring Inhaled Medicines Use and Asthma Control

Asthma is one of the most common chronic conditions managed by Australian health professionals but may not realise that many patients are living with poor asthma control and consider it to be normal. North Coast Medicare Local, in partnership with NPS MedicineWise, is currently offering the Exploring Inhaled Medicines Use and Asthma Control Program which provides an opportunity to discuss accurate, independent and practical information about inhaled medicines use and asthma control. NPS Program Officers will be providing educational visits and case study discussions to general practitioners, practice nurses and pharmacists from July 2014.

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effective psychosocial care Use a low dose and increase slowly – start with half the usual adult dose, adjust based on tolerability and response Use the lowest number of medicines – with the simplest dose regimens Use a limited range of medicines – understand their effects in older people Provide simple verbal and written instructions for every medicine and repeat prescription Anticipate adherence issues – use alternatives to tablets or capsules where needed and avoid child-proof containers Consider current medicines as the cause of new symptoms before looking elsewhere – do not assume symptoms relate to old age Regularly review treatment – stop medicines no longer indicated, adjust dose with declining kidney function People are central to quality use of medicines – seek input and treat the person NOT the disease Make medicines count – consider the appropriateness of prescribing and medicines burden, when in doubt DON’T

10 points about using medicines in older people

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Over 50 community pharmacies across the North Coast Medicare Local region have registered for eHealth. Leading Pharmacy software vendors continue to develop their software products to support pharmacies participation in the eHealth record. Electronic prescriptions and the National Prescribe and Dispense Repository (NPDR) are one segment of the eHealth landscape and are of particular interest to pharmacists.

there are currently two PES providers: eRX Script Exchange and MediSecure. The GP generates a paper prescription using their existing software, which now includes a unique script exchange barcode. The e-prescription is encrypted and sent securely to the PES using existing certificates (Medicare Claims & Payment Certificates). The script can then be retrieved at the patient’s pharmacy of choice.

Rate target within designated review periods.

Visit http://bit.ly/1po2l7r for more information.

Electronic Transfer of Prescriptions

Incentives

Troubleshooting eTP

This is the secure exchange of prescription information between the medical practitioner that prescribes the medication and the pharmacist that dispenses the medication.

Ensure your pharmacy is ‘eTP active’ and eligible for the incentive package which will be up to $2,000 for those pharmacies that meet the scan rate targets. To qualify, pharmacies will need to:

To enable Electronic Transfer of Prescriptions (eTP), a Community Pharmacy must register with a Prescription Exchange Service (PES). In Australia,

1. Be eligible for the Pharmacy Practice Incentive (PPI) Community Services Support priority area; and 2. Meet (or exceed) a specified eTP Scan

If your pharmacy has implemented eRX and require support or troubleshooting advice, please send an email to eRx Script Exchange support@erx.com.au which details your organisation’s name, the dispense software that is problematic, how long the problem has been occurring and any other pertinent information. eRx will follow up on your issue and advise you when the problem is resolved.

This program coincides with the updated Australian Asthma Handbook and will be a great opportunity for health professionals to learn about changes in asthma management.

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eHEALTH UPDATE

The first Scan Rate target is expected to be 15% of all original prescriptions, and pharmacies should be aiming to achieve this rate of scanning, or higher, as soon as possible for the first review period.

PharmacyFocus eHEALTH UPDATE eTP & eHealth records Electronic Transfer of Prescriptions is the foundation for other key eHealth initiatives such as the Personally Controlled Electronic Health Record (eHealth Record or PCEHR) system. •

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If a patient has an eHealth record and their healthcare provider is using ETP and registered for the PCEHR, a copy of prescription and dispense information will flow through to the PCEHR via an ETP Prescription Exchange Service, as long as the patient has not withdrawn their consent for the information to be uploaded In the PCEHR, there is the National Prescription and Dispense View (NPDV) which is where a display of current as well as past medications are shown, including dosage details, instructions on use and the date which medication was dispensed

Apps Ordering prescriptions using your phone is the current innovation in Australian pharmacy. eRx Express App www.erxexpress.com.au Send a Script www.seksystems.com.au/customer

National Prescription and Dispense Repository National Prescription and Dispense Repository (NPDR) is an electronic record of prescriptions and dispenses for the consumer. The NPDR: •

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Allowes consumers and healthcare providers to view information from the original prescription and information from dispenses in one location Provides the full details of drug, dosage, directions, brand, the label instructions etc Can give a more detailed medication history than just one provider may have Makes it possible to see who prescribed the original prescription or who dispensed the drug

The NPDR is an enhancement of the PCEHR and came into effect on May 13th. Population of data in to NPDR will happen over time

http://www.ehealth.gov.au The Prescription and Dispense View is not a complete list of prescribed and dispensed medications as: • • •

How the NPDR will benefit providers • • • •

What you need to know The consent model is the same for the NPDV as the eHealth record. The NPDR can be accessed through Conformant clinical software (Fred and Aquarius) or through the provider portal at

The consumer can remove items from their eHealth record, and can set-up restricted access to their record; The consumer may have withdrawn consent for a prescription and dispense record being uploaded; or The prescriber and/or the dispensing pharmacy may not be participating in the eHealth record system

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You will be able to view prescribing and dispensing information that was previously unavailable. Spot trends and anomalies in consumer medication history. Quickly find details about what was supplied and by whom. Pharmacists are able to see more medication history when dispensing, making interventions and providing services such as MedsChecks and Home Medicines Reviews. Useful for emergency supplies and continued dispensing Particularly useful for Consultant Pharmacists Improved communication between Pharmacist, GPs and hospitals

rates.

Dr Ewald found that honey should be recommended as the first choice cough suppressant if a cough suppressant is being sought for an Upper Respiratory Tract Infection in children over 12 months of age.

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In all studies, the night cough tends to get better with placebo or no treatment. However, honey showed higher recovery

Dose equals 2.5-10g (~1/2 to 2 tsp) honey at night or also in the day. Type does not seem to matter. Honey can be mixed with a drink. There should be caution with:

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PharmacyFocus NewAccess - A beyondblue Program: An opportunity for pharamacies North Coast Medicare Local is offering an exciting opportunity for pharmacies on the North Coast of NSW to express interest in having a NewAccess Coach deliver services from their premises. NewAccess aims to increase the number of hard-to-reach populations, particularly men, receiving help for low to moderate anxiety and depression. Access Coaches will point them in the right direction, set practical goals and help them get back on track. If the problem is more significant, the client will be stepped up to a GP. If a NewAccess referral is accepted, the program includes up to six free sessions, either face-to-face or over the phone. NewAccess is a national demonstration project, funded by both beyondblue and the Movember Foundation. The program is evidence-based, using a guided-self approach using low intensity Cognitive

Behavioural Therapy. Access Coaches receive comprehensive clinical supervision from Flinders University. So many more people, particularly men, could receive free low-intensity support if an Access Coach was located in a local pharmacy. Pharmacies offer a nonstigmatising environment for people to talk about their physical and mental health concerns. This approach is being trialled at Capital Chemist, Charnwood, ACT (Winner of the National Pharmacy of the year 2014). Managing Partner Samantha Kourtis said she identified a need for additional mental health support in her local community of West Belconnen and is delighted one of the ACT Medicare Local’s NewAccess Coaches will be located in her private consulting room on a ten-week trial.

If the set up is right, pharmacies with an appropriate consulting room are in a great position within the primary care setting to host NewAccess coaches and their clients for appointments. For an information session at your local pharmacy or to discuss co-location opportunities with NewAccess, please contact us on 1300 137 934. To refer to NewAccess, you can either phone us yourself, or ask your client to phone 1300 137 934. We look forward to working together to bridge this early intervention gap. NewAccess – Coaching you through tough times

How do you encourage your patients to access the CBDS? 1. Ask them to call Medicare on 132 011 to check if they are eligible 2. If eligible, your patient can then make an appointment with a dentist of their choice 3. When making the appointment, it is important the patient tells the dentist that their child is eligible for the CDBS What can patients expect at the appointment? 1. The dentist must discuss the child’s treatment and costs before beginning treatment 2. A consent form will need to be signed after the discussion 3. At the end of the consultation this service will either be bulk-billed or the parent will need to pay the account and claim the benefit through Medicare

AlliedHealthFocus eHEALTH UPDATE The PCEHR Compliant sidebar for Allied Health allows allied health practitioners to: • Capture patient demographics and clinical notes • See multiple patients at the same time • Access event summary submissions • Access emergency PCEHR patient record • Access quick patient search • Maintains patient confidentiality Nitro Physio Pen Computer systems offer tablet-based patient management software intended to facilitate physiotherapists to consult alongside the patient’s bed. That means you can work from any device, at any

time, from anywhere with or without an internet connection. Features include: • • • • • • • • • • • •

Appointment book viewable by multiple staff Body diagram of multiple pain areas and with written comments Progress notes Patient demographics PCeHR integration- Event Summary upload. Selective exercise printout and email Notification for user Initial consultation Attach documents Forms filling and form template Able to adapt user built pdf documents for form filling PhotoImage document with drawing

• • • • •

and comment capability Working with multiple patients at the same time True disconnect from office desk capability Allow true offline mode from any network/wifi/3G/4G Intuitive user interface PAN Clinical Audit Tool integration (upcoming feature)

For more information about the two allied health products by PEN or to arrange a product demo, please contact PEN computer systems on 1800 762 993. Please see the table below for estimated Products prices (February 2014) and release dates regarding PEN Allied Health Products.

* Additional hosting costs may apply.

PREVENTATIVE HEALTH Refer to page 7 for information on preventative health.

IMMUNE RESPONSE Refer to page 9 for an update on immunisation.

HNCNews New Networking Platform for Health Professionals

ealthy North Coast’s new online network allows you to communicate, network and collaborate in a private and professional environment, with colleagues from across the North Coast without leaving your office. The Healthy North Coast Network is based on the functionality of other familiar social networking platforms like Facebook, LinkedIn and Twitter. With over 130 regional and professionbased networks available, the Healthy North Coast Network is ready for you to join right now. Health professionals can register for the Healthy North Coast Network by visiting http://bit.ly/VsrO2s with full instructions for the platform at http://bit.ly/1sJgRI7

Two North Coast GPs honoured in Queens Birthday List

ullumbimby GP Dr Michael Pelmore and retired Port Macquarie GP Dr Natarajan Subbiah have been recognised in the 2014 Queen’s Birthday Honours list with the pair recieving an Order of Australia Medal. Dr Pelmore received the honour for service to medicine as a general practitioner, and to the community of Mullumbimby. Dr Pelmore has been a GP at Meadows Medical Centre in Mullumbimby since 1976 and has also served the community as a Visiting Medical Officer at the Mullumbimby Hospital for 38 years. In this role he’s provided inpatient, accident and emergency, obstetrics, anaesthetics and government Medical Officer work. The well known community member is a popular Master of Ceremonies, supporting many local community events and is an energetic charity fundraiser, appearing at local theatrical and musical performances with his band.

Dr Natarajan Subbiah received his OAM for his service to rural and remote medicine as a general practitioner. Dr Subbiah worked in the New England town of Barraba from 1976 to 1995 and the Palliative Care Unit at Barraba Health Service was named after him because of the exemplary work he did in the town. Dr Subbiah worked as a GP in Port Macquarie from 1995 to 2012 with the Subbiah Family Practice. He was also involved in the introduction of the technique of syringe drive to provide better pain relief to the terminally ill patients, a technique not previously used in NSW. North Coast Medicare Local would like to congratulate both doctors for their dedication to their profession and outstanding long-term service to their communities. The full article is available at http://bit.ly/1mAYq3U

HNCNews Australia’s Health 2014 report card: experts respond

ustralians have one of the longest life expectancies in the world but are living with growing levels of lifestyle-induced chronic illness, according to the latest national health report card.

maximum of two drinks per day, which has remained constant. But the proportion of people who never drink alcohol has increased slightly, from 10.1% in 2007 to 12.1% in 2010.

health disorder sometime in their life.

The Australian Institute of Health and Welfare’s Australia’s Health 2014 shows Australians can expect to live about 25 years longer than a century ago – to 79.9 for men and 84.3 for women.

Chronic diseases are the leading cause of illness and death in Australia. Coronary heart disease remains the biggest killer, followed by:

The full article is available at http://bit.ly/1mAYq3U.

But life expectancy for Indigenous and rural Australians is much lower. Excess weight remains a considerable burden on the health system, with 63% of Australians either overweight or obese. Around 43% of Australians meet the recommended minimum levels for exercise, with just one in four over-75s sufficiently active. Almost one in five Australians (19.5%) consume more than the recommended

Understanding Younger Onset Dementia Education Video

ounger Onset Dementia is the diagnosis of dementia before 65 years of age. Initial symptoms can be missed or diagnosed as stress or depression. Early detection can be difficult as GPs generally have few patients with younger onset dementia. Healthy North Coast went along to see Dr Kossoff’s presentation on “Understanding Younger Onset Dementia”as part of Alzheimer’s Australia’s Quality Dementia Care Series. This presentation is practice and evidence-based and provides information on the types of dementia diagnosed in younger people and explains many characteristics of the changes that occur. The video also features a special guest talk from an early onset dementia sufferer Vicki Noonan and her husband Graeme Noonan. The event recording is available at http://bit.ly/1yT3zJJ

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Stroke Dementia (including Alzheimer’s disease) Cancer of the lung, breast, prostate and colon/rectum Chronic obstructive pulmonary disease (principally emphysema and chronic bronchitis) Diabetes.

On mental health, one in five Australians have had a mental health disorder in the past 12 months (3.2 million people). And 45% of adults will experience a mental

The Conversation’s health experts analyse the report’s findings on lifestyle choices, health inequalities and the cost of care.

Health Report Snapshot: • • • •

Australians can expect to live about 25 years longer than a century ago – to 79.9 for men and 84.3 for women 63% of Australians either overweight or obese. Chronic diseases are the leading cause of illness and death in Australia 45% of adults will experience a mental health disorder sometime in their life.

Dialysis and kidney transplantation demand could rise by at least 45% over the next decade

he number of people receiving kidney replacement therapy for end-stage kidney disease is expected to rise by at least 45% from 19,800 cases in 2011 to 28,800 cases in 2020, according to a report released today by the Australian Institute of Health and Welfare (AIHW). While an estimated one-in-ten Australian adults (1.7 million) have measured signs of chronic kidney disease, it is often not until kidney function has deteriorated into the fifth and most severe stage, known as end-stage kidney disease (ESKD), that a diagnosis is made. ESKD is the most severe form of chronic kidney disease and results in a high health and economic burden for patients, families and communities. It usually requires kidney replacement therapy in the form of dialysis, or kidney transplantation, for patients to survive. The report, Projections of the prevalence of treated end-stage kidney disease in

Australia 2012-2020, presents three projection estimates that have been derived using different models, and also predicts the future influence of diabetes on kidney replacement therapy for-ESKD (treated-ESKD). These predictions are not intended to be exact forecasts, but rather they provide an indication of how demand for treated-ESKD may increase in future years. The number of people receiving kidney replacement therapy for their ESKD is projected to increase by at least 8,900 cases (45% increase) from 2011 to 2020 under all of the models considered, and could increase by as much as 12,700 cases (64% increase).

HNCEvents Hastings-Macleay Events

Northern Rivers Events

9/07/2014 - Herding Cats: Leading your team to a common outcome - Kempsey RSL

21-22/07/2014 - Mentoring and Working With Families YWCA, Goonellabah

10/07/2014 - Using Financial Reporting to Drive Change - NCML Office Port Macquarie

23-24/07/2014 - Designing and Managing Community-Based Projects - House With No Steps, Alstonville

16/07/2014 - Informed consent: A case study of respect for autonomy - St Thomas’ Anglican Church Hall, Port Macquarie

24/07/2014 - Richmond Valley Clinical Society Meeting ‘Considerations in the diagnosis of prostate cancer’ with Professor Frank Gardiner - La Barracca, Lismore

23/07/2014 - Navigating the Maze: Treatment Choices in Asthma Management with Dr Stephen Chung Rydges, Port Macquarie

30-31/07/2014 - Youth Mental Health First Aid - Crowley Meeting and Education Centre, Ballina

30/07/2014 - Using Financial Reporting to Drive Change - Kempsey RSL

4-5/08/2014 - Case Worker/Case Manager Fundamentals Crowley Meeting and Education Centre, Ballina

30/07/2014 - NCML PITCH Finalists Event - Rydges, Port Macquarie

6-7/08/2014 - Communicating Mindfully in Conflict and Difficult Situations - Northern Rivers Social Development Council Boardroom, Lismore

Mid North Coast Events

Tweed Events

18/07/2014 - Multidisciplinary management of facial pain - ARTISTI, Coffs Harbour

12/07/2014 - Back to Wet Lab: Advanced Anatomy of the Head and Neck - SCU Campus Gold Coast

17/07/2014 - Using Financial Reporting to Drive Change - NCML Office, Coffs Harbour

21/07/2014 - Understanding, Engaging and Researching Communication - SCU Campus Gold Coast 08/08/2014 - Focus on Minor Home Modifications - Southern Cross University Gold Coast campus

Healthy North Coast Events Calendar To access the full North Coast Practitioner events calander visit www.healthynorthcoast.org.au/practitioner-events

HNCclassifieds EXPRESSIONS OF INTEREST - HOMELESSNESS OUTREACH CLINICS Are you passionate about making a difference to disadvantaged communities? Are you looking for a challenging and rewarding experience? North Coast Medicare Local (NCML) is seeking motivated and experienced private GPs to join our dynamic team on a sub-contracting basis. NCML provides GP clinics for homeless and disadvantaged communities across all of our sites and is seeking committed and compassionate GPs for our clinics in both Lismore (on-site at The Winsome) and Tweed Heads (on-site at Fred’s Place). Hours required are flexible – ideally 2- 3 hours per week/fortnight.

NCML provides nursing and administrative support, including billing and appointment bookings, the support of a friendly multi-disciplinary team, and clinic rooms at both Lismore and Tweed Heads. Interested GPs must hold full registration with your appropriate professional registration body, have professional indemnity insurance and be eligible to claim Medicare rebates. Please contact Monika Wheeler, Program Manager Aboriginal Health on (07) 5523 5500 or email mwheeler@ ncml.org.au to express your interest or seek further information.

AFTER HOURS SERVICE CLOSURE COFFS HARBOUR After 25 years of dedicated service to the Coffs Harbour region, the Coffs Harbour After Hours Medical Service will be closing. Services cease on 30 June 2014. North Coast Medicare Local wishes to recognise the valuable contribution this service has made to the community since its establishment in 1988 and thank the Directors on behalf of the community. General Practice services operating in the after hours period in Coffs Harbour are: • • • • •

CHC Medical – 6652 2448 Coffs Harbour GP Super Clinic - 1300 364 375 Northside Health – 6652 5322 Coastal Medical Clinic – 6613 0857 Tristar – Coffs Harbour – 6651 8666

Alternatively, patients can call the GP After Hours Helpline on 1800 022 222 for health advice.

EXPRESSIONS OF INTEREST - BUGALWENA GENERAL PRACTICE Are you passionate about making a difference to the health of Aboriginal and Torres Strait Islander communities?

Heads South, and professional development opportunities.

Bugalwena General Practice is seeking a motivated and experienced private GP to join our dynamic team, on a subcontracting basis.

Interested GPs must hold full registration with your appropriate professional registration body, have professional indemnity insurance and be eligible to claim Medicare rebates.

Bugalwena General Practice provides comprehensive care for the Aboriginal communities in Tweed Heads South including dietetics, psychology, diabetes education and exercise physiology.

If you are interested, please contact Jackie Moody, Practice Manager on (07) 5513 1322 or email jmoody@ncml. org.au to express your interest or seek further information.

Hours required are 1–2 days per week. We offer nursing and administrative support, including billing and appointment bookings, the support of a friendly multi-disciplinary team, comfortable rooms located in Tweed

Would you like to advertise a ‘local classified ad’ in this newsletter? If so, email the details to healthynorthcoast@gmail.com before the 25th of each month. No cost is associated with these ads. 23

PRACTICE MANAGER REQUIRED - COFFS An opportunity is now available for full time, energetic Practice Manager / Practice Nurse Manager to lead the Coffs Harbour GP Super Clinic and its team. This position would be supported by a Management Team and Board of Directors who have been working to recruit and develop the GP Super Clinic Allied Health and Diagnostic services team as well as the capital works project team. Visit the clinic website http://bit.ly/1pTiJwS for more information. To apply, please contact Leavina Reid or Tracey Mills on (02) 6568 6100 or email CV to leavina@ bawrunga.org.au or tracey.mills@bawrunga.org.au

Contact NCML Head Office Suite 6, 85 Tamar Street, BALLINA NSW AUSTRALIA 2478 Postal: PO BOX 957, BALLINA NSW AUSTRALIA 2478 Phone: 02 6618 5400 Fax: 02 6618 5499 Email: enquiries@ncml.org.au

Northern Rivers Tarmons House, St Vincentâ&#x20AC;&#x2122;s Campus 20 Dalley Street, East Lismore NSW 2480 Phone: 02 6622 4453 Fax: 02 6622 3185 Email: nr@ncml.org.au

Hastings Macleay Office Location: Postal Address 53 Lord Street, PORT MACQUARIE NSW 2444 Phone: 02 6583 3600 Fax: 02 6583 8600 Email: hm@ncml.org.au

Tweed Heads 8 Corporation Circuit, Tweed Heads South NSW 2486 Phone: 07 5523 5501 Email: tv@ncml.org.au

Mid North Coast Suite 6, 1 Duke Street, Coffs Harbour, NSW 2450 Postal: PO Box 920, COFFS HARBOUR NSW 2450 Phone: 02 6659 1800 Fax: 02 6659 1899 Email: mnc@ncml.org.au