Healthy North Coast Practitioner Newsletter by Healthy North Coast

December 2014 | Edition 7

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

NOTE: Due to the holiday period, there will be no January 2015 edition of this newsletter. We’ll be back to our regular schedule in February 2015. Happy holidays to you and your families!

inside 3. GP Focus 11. AMS Focus 13. Aged Care Focus 14. Pharmacy Focus 16. Allied Health Focus 19. News 21. Events 22. Classifieds

Would you like a hard copy of this newsletter? If so, please email your name and postal address to healthynorthcoast@gmail.com and write “Copy of Healthy North Coast Practitioner Newsletter” in the subject line.

GPFocus

PAL UPDATE Free interpreting service available to GPs The Department of Social Services’ Doctors Priority Line is a free phone interpreting service which helps medical practitioners to communicate with their non-English speaking patients. The service has recently been expanded to cover holders of any type of temporary protection visa, as well as non-English speaking Australian citizens and permanent residents. It offers access to 2600 qualified interpreters and covers more than 160 languages and dialects. General practitioners and eligible medical specialists can use the Doctors Priority Line when providing services that are: • •

claimable under Medicare delivered in private practice

Doctors must register for a Translating and Interpreting Service (TIS) National client code before accessing the service. Register at http://ow.ly/EXXUD.

Useful Online Resources Wound Care eLearning Wound care and management is an integral part of Aged Care and General Practice. Wendy White WoundCare and Wound Juice have developed 6 x 1-hour On Demand webinars, ‘Delivering the Juice on Wound Care’. For more information, visit http://ow.ly/EXYVh.

Smoking Pack Years Calculator

DVA Case Formulation Training Program

Do you find it difficult to calculate your patients’ smoking pack years score easily? People who smoke often vary their smoking habits over the years, which can make it difficult to create a pack score. This smoking pack year calculator simplifies the task and can easily be added to your desktop. You can find the calendar at http://ow.ly/EXZ86.

The Department of Veterans’ Affairs (DVA) has released a free online case formulation training program, which outlines the approach to treating veterans with comorbidities. The program focuses on identifying the presenting problems and helping to set priorities for treatment. For access, visit http://ow.ly/EXZRC.

AMLA Alliance Resources available on APNA Website Due to the closure of the Australian Medicare Local Alliance on 30 June 2014, their range of printed and electronic resources is no longer available via their website. APNA has been granted a free, non-exclusive sub-licence to use a number of these resources, including ‘Expanding Your Practice: A Learning Module for Nurses in General Practice’ and ‘Teamwork in Primary Care: A Guide to Roles, Responsibility and Accountability’. Visit http://ow.ly/EXZfh. NSW Kids & Families Youth Health Resource Kit The Youth Health Resource Kit assists workers to deliver effective and youth-friendly health services. The kit contains up-to-date and comprehensive information about youth health needs for people aged 12-24 and provides skills and practical steps for workers. For more information, visit http://ow.ly/EXZLN.

Medical Reception Induction Program The program is designed to provide new medical receptionists with the information they require to work in your medical centre, as well as the policies and procedures of general practice. These training programs are being offered for $199 (normally $299) per practice, with a limit of 5 reception inductions if purchased before the 31st December 2014. Visit http://ow.ly/F7lIG. Did you know that Medicare offers online e-learning modules? A brand new program, “Introduction to Compliance within Medicare”, was recently added – great for new practice staff. You can find this and other learning modules at http://ow.ly/EY0kl.

ABORIGINAL HEALTH Refer to page 11 for an update on the Closing the Gap program.

GPFocus PAL UPDATE Diabetes in the Spotlight - Insulin Pump Therapy Insulin Pump Therapy involves using a small subcutaneous cannula under the skin and a pump to deliver rapid-acting insulin in small, precise, flexible doses. People who benefit from Insulin Pump Therapy are those: •

With fluctuating glucose levels: rapid acting insulin is absorbed more predictably and precisely than multiple daily insulin injections. Patients using Insulin Pumps are 4 times more likely to reach their target HbA1c level.

•

With frequent hypoglycaemia: there are many complications associated with frequent hypoglycaemic episodes. Studies have shown that Insulin Pump Therapy can reduce these episodes by up to 84%. It is also useful for managing those with hypoglycaemia unawareness.

•

Tired of multiple daily injections: these patients can take up to 120 injections per month, often leading to poor compliance and missed injections. Those using Insulin Pumps only need to change their infusion set 10 to 12 times per month. Wanting better control: the Insulin Pump can be programmed with different basal rates to provide tighter control to suit various needs. Complications such as cardiovascular and kidney disease, nerve damage or retinopathy are significantly reduced. Experiencing dawn phenomenon, needle phobias or who are very sensitive to insulin and therefore require small frequent doses.

In regard to patients’ diets, Insulin Pump Therapy provides great flexibility and freedom. Patients can decide what they want to eat and then program the pump to provide the insulin dose needed. This is done with a pre-programmed wizard in the pump and requires the patient to enter the amount of carbohydrate to be consumed. Education with a Dietician is required to learn sources of carbohydrates, quantities and how to achieve an overall balanced diet. Gone are the days of eating to match your insulin – now your insulin matches your food! For more information about Insulin Pump Therapy, contact the Diabetes Education Teams at your local Community Health. In Port Macquarie, Jodie Kennett at JK Healthcare can also offer advice and assistance. Call 6583 7717 or email admin@ jkhealthcare.com.au.

GP information pack for new alcohol interlock program coming early 2015 The new mandatory alcohol interlock program begins in NSW on 1 February 2015. Under the new program, people convicted of serious and repeat drink driving offences will be required to have a breath testing device called an alcohol interlock installed in their vehicle, which is linked to the vehicle ignition. In order to start the vehicle, drivers will need to provide a breath sample to the device to show that no alcohol is present. Up to 6,000 offenders across NSW could join the new program each year. GPs have a critical role in the delivery of this program. They can be involved at three stages: •

At program entry: each participant is required to attend a medical consultation to engage, motivate and support this person to re-think their drinking before they can obtain an interlock licence.

•

During the program: participants who continue to attempt to drink and drive may receive letters recommending that they visit their doctor to discuss their drink driving behaviour. This also gives doctors an opportunity to refer participants for further alcohol dependency assessment and treatment.

•

Last six months of program: participants who fail to show that they can separate drinking and driving may be referred to attend a Fitness to Drive Assessment before they are allowed to return to driving without an interlock installed in their vehicle.

The information pack for GPs will be available in early 2015, and will provide advice and resources to help patients address drink driving problems and participate in the program.

GPFocus PAL UPDATE

eHEALTH

Ex-Service Organisations

HealtheNet Update

The Association of Far North Coast Ex-Service Organisations help recently separated veterans and their families whose lives have been affected by their service.

HealtheNet is due to be rolled out in Mid North Coast and Northern NSW LHDs by March 2015. This program offers health providers access to:

Far North Coast Legacy Far North Coast Legacy provides opportunities for social get-togethers, support for children and other assistance. For support, please contact Beth Green, Welfare Support Officer, on 02 6622 8113 or mobile 0414 499 113.

• • • • •

Returned & Services League of Australia The Returned & Services League of Australia can provide assistance and point of contact for all serving and former serving members of the ADF. Visit www.fncdc.org.au or email sec@ fncdc.org.au for more information. Australian Peacekeeper & Peacemaker Veterans’ Association The Australian Peacekeeper & Peacemaker Veterans’ Association offers a variety of supports including pension entitlements, advocacy services and welfare assistance. For support, please contact Pauline Maczkowiack, Pensions Entitlement Officer, on 0407 108 616.

All patient identifiers across NSW LHDs A patient’s National Individual Health Identifier (IHI) Cross-LHD discharge summaries Cross-LHD alerts, allergies, clinical documents, medical imaging studies and visit histories National eHealth Record (PCEHR) information – Medicare information, PBS, ACIR, GP shared health summaries, specialist letters, eReferrals and consumer-entered information

HealtheNet aims to link providers and support coordination of care by: • •

Sending electronic discharge summaries directly to GP desktops Sharing information in the PCeHR with other healthcare providers, e.g. other states, private hospitals, aged care facilities

NCML will continue to update readers of this newsletter on the roll out of HealtheNet in 2015. In advance of the rollout of HealtheNet in our local health districts, the Provider Assistance Liaison team at North Coast Medicare Local can assist providers with information regarding the implementation of eHealth systems. Please contact your local branches for more information: Tweed Valley: 07 5523 5500 Northern Rivers: 02 6622 4453 Mid North Coast: 02 6659 1800 Hastings Macleay: 02 6583 3600

PCeHR – Pathology and Diagnostic Imaging Reports The Department of Health (DoH) has been working with the pathology and diagnostic imaging sectors to develop a handling process for pathology and diagnostic imaging reports in the PCeHR. Under the agreed model, reports will be uploaded to the PCeHR by the provider and made available to healthcare providers immediately, allowing the requesting doctor to review the reports and consult with the patient if necessary. Patients would then be able to access the reports after a seven-day delay. Quoted in Pulse IT, a DoH spokesperson advised, “This position is supported by the majority of stakeholders including pathology providers, the Australian Commission on Safety and Quality in Health Care, clinical peak bodies, consumer groups, jurisdictions and medical indemnity insurers. The model is simple without increasing clinical risk for patients. It has limited impact on clinical workflow and reduces the risk that reports are missed and not available on the PCEHR.” Release five of the PCeHR has now gone live, featuring the capability in the clinical documents section to view diagnostic imaging and pathology reports. Once specifications for pathology and diagnostic imaging software are complete, software vendors will be able to upgrade their provider information systems and enable uploading of reports. This is expected in early 2015.

GPFocus CLINICAL TIP - Know the Signs of Stroke By the end of 2014, about 51,000 Australians will suffer a new or recurrent stroke – that is 1,000 strokes every week or one stroke every 10 minutes. Would you recognise the signs of stroke in your patients? The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking these simple questions:

Face – Check their face. Has their mouth drooped? Arms – Can they lift both arms? Speech – Is their speech slurred? Do they understand you? Time – Time is critical. If you see any of these signs, call 000 straight away. The National Stroke Foundation develops the national stroke guidelines, measures and monitors the adherence to these guidelines via the national stroke audit, and develops education and resources for health professionals to support the delivery of best practice stroke care and reduce the evidence-practice gap. Source: National Stroke Foundation

IMMUNE RESPONSE Storm Season – vaccine fridge potential power outages It’s the time of year when the North Coast experiences storms and potential power outages, including power to vaccine fridges. To safeguard vaccine stocks, consider installing a device that sends alerts (SMS, automated phone calls) when fridge temperatures go outside of their recommended range, or use a unit with uninterrupted power supply (UPS) that automatically provides battery power backup in the event of a power outage. Vaccine fridges should contain a data logger (rather than just a thermometer) to provide vital information on the length of time a fridge may have been outside the recommended temperature and help you to decide whether to discard vaccines. Some data loggers on the market also have the capability of sending SMS alerts when the fridge is outside its recommended range. For further information, contact Immunisation Project Officer Rachelle Deaker on 66224453 or email rdeaker@ ncml.org.au. 6

Course Sponsorship North Coast Medicare Local (NCML) is offering sponsorship of $400 to registered nurses working in general practice and/or an AMS to complete The Australian College of Nursing (ACN) Immunisation for Registered Nurses course. Applicants must: • • • •

Hold a Bachelor of Nursing or registered nurse equivalent qualification Be currently registered with the Australian Health Practitioner Regulation Agency (AHPRA) Hold a current CPR or BLS certificate, or obtain one prior to January 30, 2015 Be currently employed in a general practice or AMS within the North Coast Medicare Local area

For more information on the ACN Immunisation for Registered Nurses courses, go to: http://ow.ly/F0oOp.

The ACN course fee varies according to ACN membership: • •

Member $664.50 Non-member $782.00

NCML will fund $400 of total course cost to successful applicants. Numbers are limited and the submission of an application to NCML does not guarantee sponsorship. Applications close December 15, 2014. Successful applicants may commence the course in February or March. For application forms and information, please contact Immunisation Project Officer Rachelle Deaker on 66224453 or email rdeaker@ncml.org.au.

GPFocus IMMUNE RESPONSE 2015 School Vaccination Program

Year 8

Year 11 & 12

Year 7 (All Students)

•

• • •

Year 9

HPV - 3 doses (0, 2, 6 months) Boostrix (dTpa) - 1 dose Varicella -1 dose (for those that have no evidence of previous varicella vaccination or infection)

HPV - provided to students who commenced, but did not complete, HPV vaccination in year 7

There is no Year 9 HPV program for 2015, as these students would have been offered HPV vaccine in Year 7 in 2013.

MMR - students who don’t have evidence of 2 doses of MMR vaccination will receive 1 dose only at school. If they require the remaining, second dose, they will receive a letter advising them to go to their GP.

2015 School Vaccination Program occurs over 3 visits to the school Term 1

Term 2

Terms 3 & 4

Year 7 only HPV dose 1

Year 7 only HPV dose 2 , Year 7 (or dose 1 for those away in Term 1)

Year 7 only HPV dose 3 (plus catch-up for those away on previous visit)

Year 7 only Boostrix (dTpa)

Year 7 only Varicella

Year 7 only Boostrix or Varicella catch-up for those away on previous visits

NOTE: if child is away the consent form is kept for Term 2

NOTE: if child is away the consent form is kept for Term 3/4

Boostrix – if missed in Term 1 Year 11 and 12 MMR Consent forms collected and checked for evidence of 2 doses

Year 11 and 12 MMR for those with no evidence of 2 previous doses of MMR

Year 11 and 12 MMR for those who missed their MMR dose in Term 2

Catch up for incomplete HPV schedule (Year 7 2014) Year 8 students who commenced HPV vaccination in year 7 in 2014, but have not completed 3 doses

Year 8 students who commenced HPV vaccination in year 7 in 2014, but have not completed 3 doses

For General Practices •

Patients presenting at your practice for school program vaccines – please confirm with patients that they do NOT have a consent form at the school. If they are unsure, check with the parent or the Public Health Unit.

•

If the parent advises that their child was away on the school vaccination day and it is known that there is a consent form at the school, please advise them that the child will be caught up at the next school clinic.

•

If the child has a consent form at the school, but would now prefer to have their vaccines at the practice, please advise the parent to write a letter

of vaccine consent withdrawal and give this to the school OR contact the Public Health Unit to withdraw the consent form. Alternatively, if the child is at the practice, the nurse or GP can notify the Public Health Unit. The Public Health Unit will need to know what year and what school the student is enrolled in and if vaccine withdrawal of consent includes all the vaccines on the consent form. •

Where the student has a consent form at school, but refuses to allow the school nurses to vaccinate, a letter will be sent home to the parent advising them to take the child to the GP.

Year 8 students who commenced HPV vaccination in year 7 in 2014, but have not completed 3 doses •

If the student moves school, the parent or the school can notify the Public Health Unit and the consent card will be transferred to the new school if feasible. In the event that the consent card isn’t transferred, all attempts are made to contact the parent (via mail and mobile).

For enquires about the School Vaccination Program, contact Co-ordinator Bernadette Williams on 6620 7503 or email Bernadette.Williams@ncahs. health.nsw.gov.au.

GPFocus The Mid and North Coast HealthPathways website is an online information portal to be used at the point of care for GPs, specialists, nurses and allied health providers. It is being developed by North Coast NSW Medicare Local in collaboration with Mid North Coast and Northern NSW Local Health Districts. Pathways currently published on the portal pertain primarily to the Mid North Coast, where the HealthPathways project has been in operation throughout 2014. A Northern project team was established recently under the clinical leadership of Dr Dan Ewald. Work is already underway to ensure existing MNC Pathways are updated with Northern content. You will see lots more information relevant to GPs in Northern NSW over the coming months. NEW TO HEALTHPATHWAYS (Mid North Coast Focused) • • • • • • • • • • • • • • •

COPD Assessment Optimising Function in COPD COPD Management Preventing Deterioration in COPD Differentiating COPD from Asthma Exacerbations of COPD End Stage/Palliative Care COPD Spirometry Testing & Interpretation Medications in COPD Pulmonary Rehabilitation Evaluation of Spirometry Results UTI in Children Hereditary Haemochromatosis Smoking Cessation Advice Varicella and Pregnancy

HEALTHPATHWAY TOPIC OF THE MONTH – ORAL HEALTH Localised oral health pathways will be available on the live website in early December. You will find the latest diagnostic, management and local referral information for: • • • •

Oral Health Service Toothache Trauma to Teeth Dental Caries and Oral Checks in Children

Incidence Early childhood caries are preventable and reversible. 72% of caries in children are untreated. Dental caries in children can cause significant pain and morbidity affecting sleep, eating, learning, and social function, and in some cases require treatment under general anaesthetic. Premature loss of deciduous teeth can result in poor self esteem, difficulty eating, and can affect the position of the adult teeth.

Management Early detection and treatment of childhood caries can prevent widespread destruction of deciduous teeth. Regular review of dentition in general practice is imperative to carie detection, prevention and early dental referral and treatment. Northern Pathways Twenty-five additional new Pathway proposals have been received to date and are being prioritised. Early updates to existing pathways include: • • • • • •

Developmental Milestones Immunisation Pertussis vaccine for pregnant and post-partum women Rabies and Australian Bat Lissavirus (ABVL) Issuing a Medical Certificate of Cause of Death Local services information has been added to a range of Paediatric HealthPathways (Gastroenteritis, Enuresis in Children, Croup, Unsettled Infant, Heart Murmurs in Children) and we are working towards this information being available to GPs soon

Visit the Mid and North Coast HealthPathways website: http://manc.healthpathways.org.au Username: manchealth Password: conn3ct3d For further information, or to suggest a future pathway topic, please contact Fiona Ryan, Project Officer, Mid North Coast on 65833600 or email fryan@ncml.org.au or Kerrie Keyte, Project Officer, Northern NSW on 0429 530 274 or email kkeyte@ncml. org.au. Are you interested in being a clinical writer? See page 25 for a call for expressions of interest.

GPFocus NATIONAL PRESCRIBING SERVICE Fatigue is a common condition, with 1.5 million Australians each year seeing their GP with fatigue symptoms. To help understand the many causes of fatigue and how to manage it appropriately, NPS has launched an educational visiting program which provides useful information and resources for both patients and GPs. This coincides with the release of the new volume of Therapeutic Guidelines’ “Fatigue: diagnostic approach in primary care.” Underpinned by Therapeutic Guidelines, the program provides a framework for assessment and diagnosis, focusing on a comprehensive clinical history, targeted history and judicious laboratory investigations. While addressing the more common presentations of fatigue, the program also refers to various “red flags” which may indicate more serious pathology. The most common patient group to present to their GP with symptoms of fatigue is young to middle aged adults. Although each case needs to be assessed on an individual basis, fatigue is most often related to the demands of everyday living, rather than an undiagnosed medical condition. While most people with fatigue will get better on their own or after simple lifestyle changes, fatigue can have a negative effect on quality of life and/or cause distress. Many patients expect pathology to investigate their fatigue. Fatigue was the sixth most common reason for pathology testing in 2011-12, requested in up to 70% of GP visits for fatigue, with an average of four tests undertaken at a time. Despite this, pathology testing for fatigue provides a clear diagnosis in only 4% of patients.

In a recent survey of 501 GPs, NPS found: •

52% of GPs agreed that patient expectation of a diagnosis influenced their decisions about the use of pathology tests to investigate fatigue.

•

76% indicated they would always or often refer for pathology when patients presented with fatigue for the first time with no specific features raising suspicion of underlying disease.

•

47% always or in most situations order a diagnostic test for patient reassurance.

While clinicians understandably wish to exclude serious causes of fatigue, there are risks with over-testing: •

Requesting pathology when there is a low pre-test probability of disease increases the chance of a false positive result, with subsequent potential flow-on effects such as further testing or procedures that may not be warranted.

•

While serious conditions need to be excluded, it is important to communicate with patients that they may not need pathology testing, at least at first, and their fatigue may be addressed by managing lifestyle, psychosocial and physical causes. Despite this, in many cases fatigue is often not associated with underlying disease and may remain unexplained.

More information about the NPS “Back to Basics for fatigue: A diagnostic approach” program can be found at www.nps.org. au/fatigue or by contacting the NPS facilitator in your region. Tweed Valley Jill Hayward 07 5523 5500 jhayward@ncml.org.au Northern Rivers Margaret Hewetson 02 6622 4453 mhewetson@ncml.org.au Mid North Coast Michael Driscoll 02 6659 1800 mdriscoll@ncml.org.au Hastings/ Macleay Lesley Burrett 0265 621055 lburrett@ncml.org.au

GPFocus PREVENTATIVE HEALTH Sugar Hit Over the Top One in five (21.2%) 2 – 15 year olds drink at least six cups (1.5 litres) of sugar-sweetened drink per day according to The Health of Children and Young People in NSW report by the Chief Health Officer 2014, released last month. Some are having more than 11 cups per day. This level of soft drink consumption is of concern to Health Promotion Managers across the North Coast. Soft drinks and other sweetened drinks are banned from sale in public schools, and strongly discouraged from sale in Catholic and Independent schools and have been since 2007, however, many children are still accessing them in large quantities. A simple swap from soft drink to tap water or low fat milk could make a big difference to children’s health (and teeth). The bonus would be saving money and having to carry heavy drink containers back from the supermarket. Many of the other nutritional indicators evaluated in the report were very positive, with encouraging signs of improvement in, for example, the percentage of children aged 2–8 years consuming the recommended amount of vegetables each day increasing from 42.8% to 54.1% in the last 8 years. The report also found that while one in four children were overweight or obese, there is an early indication that there is a decline in overweight levels overall. This could be attributed at least in part to the extensive work undertaken by Health Promotion in primary schools and early childhood centres. Health Promotion’s Live Life Well at School and Munch and Move programs operate in most schools and centers across the North Coast.

Four reasons why parents should limit their child’s soft drink consumption: •

They’re Fattening: Soft drinks are an easy way to consume too many calories, putting children at risk of getting overweight.

•

They’re Bad for Teeth: Soft drinks are usually acidic and this, plus the amount of sugar in soft drinks, can contribute to tooth decay.

•

They Ruin Appetite: Filling up on soft drinks often means kids don’t have an appetite for good food at meal times, making them picky eaters

•

They’re Expensive: Water is better for children’s health, is free and doesn’t require carrying heavy bottles or cans home from the supermarket.

View the Chief Health Officer’s Report at http://ow.ly/F0Hd6.

Jono Huddy (Lennox Head) contemplates 1.5litres of cordial

MENTAL HEALTH Refer to page 12 for information on mental health support for Aboriginal and Torres Strait Islander People.

Background Artwork by Alison Williams

AMSFocus ABORIGINAL HEALTH

Reminder: re-register patients for Closing the Gap November to February is the time to re-register Aboriginal and Torres Strait Islander patients for the Closing the Gap program. Re-registration of patients is a requirement of the Indigenous Health Incentive PIP.

PAL UPDATE Refer to page 4 for information on Insulin Pump Therapy for diabetics.

North Coast Medicare Local has Aboriginal Outreach Workers who would be happy to attend your practice for one morning in the registration period to assist patients with their registration paperwork. Please call to organise a day and time that would suit your practice recall system. Lismore: 02 6622 4453 Coffs Harbour: 02 6659 1800 Port Macquarie: 02 6583 3600

eHEALTH Refer to page 5 for eHealth updates.

In addition to outreach workers, Indigenous Health Project Officers are available to assist you with the Closing the Gap program. They work at the locations listed above, as well as: Kempsey: 02 6562 1055 Tweed Heads: 07 5523 5500

PREVENTATIVE HEALTH Aboriginal Quitline The Quitline is a free 7 days per week confidential service. Quitline Advisors are trained to support people who are cutting down or quitting smoking. The Quitline is based at the ADIS/Quitline Contact Centre located within the Alcohol and Drug Service at St Vincentâ&#x20AC;&#x2122;s Hospital Sydney.

IMMUNE RESPONSE Refer to page 7 for information about school immunisations.

There are new positions at Quitline, an Aboriginal Counsellor and an Aboriginal Quitline Coordinator. The Aboriginal Quitline Coordinator works with all Quitline staff to ensure quality service is provided to the Aboriginal and Torres Strait Islander community. The Quitline takes self-referrals or Health Workers can also refer a person to the program.

Background Artwork by Alison Williams

AMSFocus MENTAL HEALTH Mental health support for Aboriginal and Torres Strait Islander People Aboriginal and Torres Strait Islander people are twice as likely to experience a high level of psychological distress than other Australians, and are therefore at a much greater risk of mental illness. Psychological distress can include feelings of anxiety, hopelessness or worthlessness, which can indicate a vulnerability to mental illness. In addition, Aboriginal people are hospitalised with severe mental illness more than twice as often as non-Aboriginal people. The much greater prevalence of mental illness in the Aboriginal and Torres Strait Islander population is a reflection of the significant disruption to their society and has a strong context of emotional and social deprivation. Factors such as earlier mortality rates, child removals and incarceration also contribute to the higher rates of grief, loss and trauma experienced by Aboriginal and Torres Strait Islander people. Mental illness in Aboriginal and Torres Strait Islander populations is seen in a wider social and spiritual context rather than just the individual suffering from the condition, and can be likened to a â&#x20AC;&#x2DC;soreness of spiritâ&#x20AC;&#x2122; caused by the loss of social and family networks and removal from ancestral lands. Mental illness is often manifested through disturbed and/or abnormal behaviour. For Aboriginal and Torres Strait Islander people, these behaviours can include wandering around at night and sleeping anywhere, frequently moving between communities, avoidance of normal social interactions, talking incessantly and breaking taboos (e.g. mentioning the names of dead people). Additionally, the person may appear angry, restless, frustrated, lonely and mistrustful. Assessment of a mental health condition in an Aboriginal and Torres Strait Islander person can be difficult, or even inappropriate, because they can view mental health differently from the 12

mainstream European understanding. Often they do not see diagnosis or treatment as relevant because they take a more holistic approach encompassing emotional, spiritual and social factors with family and community input. These factors are important to consider and accommodate during assessment and treatment. It is important for GP practices to firstly ask if the patient identifies as Aboriginal or Torres Strait Islander, as assessment of their psychological wellbeing can be included in the Aboriginal and Torres Strait Islander health assessment (MBS item 715). GPs should also be receptive to requests to incorporate traditional remedies into the mental health treatment, especially when the community believes the patientâ&#x20AC;&#x2122;s abnormal behaviour (such as hallucinations and hearing voices) are a normal reaction to spiritual issues. When treating an Aboriginal and Torres Strait Islander person with mental illness, it is important to acknowledge other issues, such as trauma and loss, which may be impacting on the patient, but allow the patient to determine what is personally relevant. If, during the 715 Health Check or other consultation, contextual factors emerge which suggest that the person is at risk of developing a mental disorder, or if they are diagnosed with a mental disorder of mild to moderate severity, GPs may be able to refer them to Healthy Minds (ATAPs) for free psychological counselling. To be eligible for Healthy Minds, the patient should hold a Health Care Card or be in severe financial distress. Healthy Minds provides short-term focused psychological strategies, and the disorders treated are typically anxiety and depression. Referrals to Healthy Minds can be made on the downloadable referral form available at http://ow.ly/ F0Ljd and should be supported by a Mental Health Treatment Plan.

Healthy Minds provides six sessions with a mental health professional such as a psychologist, accredited mental health social worker or credentialed mental health nurse. Listings of Healthy Minds practitioners who are culturally competent to provide services to Aboriginal and Torres Strait Islander people are available from North Coast NSW Medicare Local. A further four or six sessions can be provided on completion of a treatment review. Transport to attend sessions with the Healthy Minds mental health practitioner can be arranged by a Medicare Local Aboriginal Outreach Worker under the Closing the Gap (CTG) program. Additionally, if the Aboriginal and Torres Strait Islander patient has one of five chronic diseases (diabetes, renal disease, respiratory disease, cancer or cardiac disease), further mental health treatment may be provided under the Care Coordination and Supplementary Services (CCSS) program. The GP Management Plan (MBS items 721 & 723) must include the mental health condition requiring treatment. For more details about the CTG and CCSS programs, contact your nearest Medicare Local office. For further information about Healthy Minds services for Aboriginal and Torres Strait Islander people, please call Healthy Minds on 1300 137 237.

AgedCareFocus PAL UPDATE Useful Online Resources Wound Care eLearning Wound care and management is an integral part of Aged Care and General Practice. Wendy White WoundCare and Wound Juice have developed 6 x 1-hour On Demand webinars, ‘Delivering the Juice on Wound Care’. For more information, visit: http://ow.ly/EXYVh. DVA Case Formulation Training Program The Department of Veterans’ Affairs (DVA) has released a free online case formulation training program, which outlines the approach to treating veterans with comorbidities. The program focuses on identifying the presenting problems and helping to set priorities for treatment. For access, visit: http://ow.ly/EXZRC.

Concerned about driving while living with dementia? The NRMA and Alzheimer’s Australia NSW has launched a free guide, ‘Staying on the Move with Dementia’, to help people with dementia prepare for life without a driver’s licence. NRMA President Kyle Loads reports that, according to recent estimates, one new case of dementia is diagnosed every six minutes in Australia, some as young as 30. It is therefore critical that people living with dementia, and their carers and families, have the information they need to make the right decisions around independent mobility and safety. Download a free copy from the NRMA website: http://ow.ly/F0NaV.

Palliative Care Toolkit The Department of Social Services, under the ‘Encouraging Better Practice in Aged Care Initiative’, is offering Aged Care Palliative Approach Toolkits to each Health Approved Provider Aged Care Facility. The PA Toolkit is a set of resources designed to assist residential aged care providers to implement a comprehensive, evidence-based palliative approach to care for appropriate residents. For more information or to order your kit, visit http://ow.ly/F0MWf. Blood test developed to diagnose early onset Alzheimer’s disease University of Melbourne researchers have developed a non-invasive blood test that can diagnose early onset Alzheimer’s disease (AD). The blood test has the potential to improve prediction to 91% accuracy. Compared to organising a brain scan or undergoing a neuropsychological test, the blood test is simple and highly accessible. Due to the progressive nature of AD, the blood test requires further testing in a larger population across 3-5 years. For more information, visit http:// ow.ly/F7nLc.

eHEALTH Refer to page 5 for eHealth updates.

HEALTHPATHWAYS Refer to page 8 for an update on HealthPathways.

PharmacyFocus PAL UPDATE Phone interpreting service for pharmacies Free phone interpreting services are available to pharmacies for the purpose of dispensing Pharmaceutical Benefits Scheme (PBS) medications. This scheme is aimed at assisting pharmacists to communicate with temporary protection visa holders, permanent residents and Australian citizens about the proper use of medications. Pharmacies can register for free phone interpreting services by completing an online ‘register for a TIS National client code’ form available on TIS National’s website. Register at: http:// ow.ly/EXXUD.

•

The average-sized adult should apply more than half a teaspoon of sunscreen (about 3 ml) to each arm and the face, neck and ears, and just over one teaspoon (6 ml) to each leg, the front of the body and the back of the body

•

Follow the ‘use by’ date

•

Store sunscreen below 30°C

Download the Sunsmart Factsheet for consumers: http:// ow.ly/F0O78.

Summer Sun and Fun

Read up on Skin Cancer Stats and Issues, including information on sun protection and the Cancer Council position on nanoparticles in sunscreen: http://ow.ly/F0Oed.

With the summer sun beating down, sales of sunscreen, hats and sunglasses should be on the rise. Here are some tips and resources to help you support the customer experience in your pharmacy and create a culture of sun safety:

For more information on the safety of titanium dioxide and zinc oxide nanoparticles in sunscreens, consult the 2013 TGA literature review: http://ow.ly/F0Oiz.

•

When used correctly, SPF30 sunscreen filters 96.7% of UV radiation and SPF 50 filters 98%

•

Never rely on sunscreen alone for sun protection. Combine with sun-protective clothing, a broad-brimmed hat that protects the face, head, neck and ears, shade and sunglasses

•

Apply sunscreen 20 minutes before going outside and again every two hours

PharmacyFocus PAL UPDATE

Useful Online Resources New NPS learning module – ‘Get it Right! Taking a Best Possible Medication History’ Obtaining an accurate and complete medication history, known as ‘a best possible medication history’ (BPMH), is the first step in the medication reconciliation process and forms the basis for therapeutic decisions. The Australian Commission on Safety and Quality in Health Care and NPS MedicineWise have developed an online learning module for junior medical officers, nursing and pharmacy staff. Access the module at: http://ow.ly/F0PMZ. Did you know that Medicare offers online e-learning modules, on topics such as ‘Dispensing and claiming for Pharmacists’?

eHEALTH Refer to page 5 for eHealth updates.

Find this and other learning modules at: http://ow.ly/EY0kl. Diabetes Information and Advice Service (DIAS) DIAS is a FREE diabetes eLearning site for pharmacists and pharmacy staff accredited by the Pharmaceutical Society of Australia. On this site you will find detailed information and resources covering diabetes issues and each module of learning is assessed by a multiple choice quiz. Once all the quizzes are passed, the user will receive a certificate of completion. Access the site at: http://ow.ly/F0PY5.

PREVENTATIVE HEALTH Refer to page 17 for information on the Aboriginal Quitline.

CLINICAL TIP Refer to page 16 for information on identifying the signs of stroke.

AlliedHealthFocus PAL UPDATE Useful Online Resources Wound Care eLearning Wound care and management is an integral part of Aged Care and General Practice. Wendy White WoundCare and Wound Juice have developed 6 x 1-hour On Demand webinars, ‘Delivering the Juice on Wound Care’. For more information, visit: http://ow.ly/ EXYVh. Smoking Pack Years Calculator Do you find it difficult to calculate your patients’ smoking pack years score easily? People who smoke often vary their smoking habits over the years, which can make it difficult to create a pack score. This smoking pack year calculator simplifies the task and can easily be added to your desktop. You can find the calendar at: http://ow.ly/EXZ86. NSW Kids & Families Youth Health Resource Kit The Youth Health Resource Kit assists workers to deliver effective and youth-friendly health services. The kit contains up-to-date and comprehensive information about youth health needs for people aged 12-24 and provides skills and practical steps for workers. For more information, visit: http://ow.ly/EXZLN.

CLINICAL TIP Know the Signs of Stroke By the end of 2014, about 51,000 Australians will suffer a new or recurrent stroke – that is 1,000 strokes every week or one stroke every 10 minutes. Would you recognise the signs of stroke in your patients? The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking these simple questions:

straight away.

The National Stroke Foundation develops the national stroke guidelines, measures and monitors the adherence to these guidelines via the national stroke audit, and develops education and resources for health professionals to support the delivery of best practice stroke care and reduce the evidence-practice gap. Source: National Stroke Foundation

AlliedHealthFocus PREVENTATIVE HEALTH Sugar Hit Over the Top

Aboriginal Quitline

One in five (21.2%) 2 – 15 year olds drink at least six cups (1.5 litres) of sugar-sweetened drink per day according to The Health of Children and Young People in NSW report by the Chief Health Officer 2014, released last month. Some are having more than 11 cups per day.

The Quitline is a free 7 days per week confidential service. Quitline Advisors are trained to support people who are cutting down or quitting smoking.

This level of soft drink consumption is of concern to Health Promotion Managers across the North Coast. Soft drinks and other sweetened drinks are banned from sale in public schools, and strongly discouraged from sale in Catholic and Independent schools and have been since 2007, however, many children are still accessing them in large quantities. A simple swap from soft drink to tap water or low fat milk could make a big difference to children’s health (and teeth). The bonus would be saving money and having to carry heavy drink containers back from the supermarket.

The Quitline is based at the ADIS/Quitline Contact Centre located within the Alcohol and Drug Service at St Vincent’s Hospital Sydney. There are new positions at Quitline, an Aboriginal Counsellor and an Aboriginal Quitline Coordinator. The Aboriginal Quitline Coordinator works with all Quitline staff to ensure quality service is provided to the Aboriginal and Torres Strait Islander community. The Quitline takes self-referrals or Health Workers can also refer a person to the program.

Many of the other nutritional indicators evaluated in the report were very positive, with encouraging signs of improvement in, for example, the percentage of children aged 2–8 years consuming the recommended amount of vegetables each day increasing from 42.8% to 54.1% in the last 8 years. The report also found that while one in four children were overweight or obese, there is an early indication that there is a decline in overweight levels overall. This could be attributed at least in part to the extensive work undertaken by Health Promotion in primary schools and early childhood centres. Health Promotion’s Live Life Well at School and Munch and Move programs operate in most schools and centers across the North Coast. View the Chief Health Officer’s Report at http://ow.ly/F0Hd6.

Four reasons why parents should limit their child’s soft drink consumption:

•

They’re Fattening: Soft drinks are an easy way to consume too many calories, putting children at risk of getting overweight.

•

They’re Bad for Teeth: Soft drinks are usually acidic and this, plus the amount of sugar in soft drinks, can contribute to tooth decay.

•

They Ruin Appetite: Filling up on soft drinks often means kids don’t have an appetite for good food at meal times, making them picky eaters

•

They’re Expensive: Water is better for children’s health, is free and doesn’t require carrying heavy bottles or cans home from the supermarket.

Jono Huddy (Lennox Head) contemplates 1.5litres of cordial

AlliedHealthFocus MENTAL HEALTH Mental health support for Aboriginal and Torres Strait Islander People Aboriginal and Torres Strait Islander people are twice as likely to experience a high level of psychological distress than other Australians, and are therefore at a much greater risk of mental illness. Psychological distress can include feelings of anxiety, hopelessness or worthlessness, which can indicate a vulnerability to mental illness. In addition, Aboriginal people are hospitalised with severe mental illness more than twice as often as non-Aboriginal people. The much greater prevalence of mental illness in the Aboriginal and Torres Strait Islander population is a reflection of the significant disruption to their society and has a strong context of emotional and social deprivation. Factors such as earlier mortality rates, child removals and incarceration also contribute to the higher rates of grief, loss and trauma experienced by Aboriginal and Torres Strait Islander people. Mental illness in Aboriginal and Torres Strait Islander populations is seen in a wider social and spiritual context rather than just the individual suffering from the condition, and can be likened to a â&#x20AC;&#x2DC;soreness of spiritâ&#x20AC;&#x2122; caused by the loss of social and family networks and removal from ancestral lands. Mental illness is often manifested through disturbed and/or abnormal behaviour. For Aboriginal and Torres Strait Islander people, these behaviours can include wandering around at night and sleeping anywhere, frequently moving between communities, avoidance of normal social interactions, talking incessantly and breaking taboos (e.g. mentioning the names of dead people). Additionally, the person may appear angry, restless, frustrated, lonely and mistrustful. Assessment of a mental health condition in an Aboriginal and Torres Strait Islander person can be difficult, or even inappropriate, because they can view mental health differently from the 18

HNCNews Networking Platform for Health Professionals

ealthy North Coastâ&#x20AC;&#x2122;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. Full instructions for the platform are available at http://bit.ly/1sJgRI7.

NSW Rural Health Plan On Friday 7 November 2014, NSW Minister for Health and Medical Research, Jillian Skinner, launched the NSW Rural Health Plan: Towards 2021, at the University Centre for Rural Health in Lismore. The plan is a comprehensive framework which guides rural, regional and remote health services to ensure they continue to meet the needs of communities well into the future. It aims to strengthen the capacity of NSW rural health services to provide connected and seamless care, as close to home as possible for people in rural areas. According to Chris Crawford, Chief Executive of NNSWLHD, one key aspect of the latest Rural Health Plan is a significant enhancement of Information Technology (IT) services in rural locations. This will improve connectivity of services and through the expansion of systems such as Telehealth, will also strengthen outreached service provision. Another important initiative contained in the plan, which has already been funded, is the Integrated Care Strategy. Funding is available pursuant to a tender process to support LHDs to better link up all primary health services to avoid patients defaulting to hospital care, when they can be well treated in the community setting, if the services are available and are satisfactorily connected. It is a seven year plan, so the benefits will come through gradually, as was the case with the previous Rural Health Plan, which took around eight years to implement. Importantly, the Minister has announced that the Ministerial Rural Health Committee, which developed the plan, will continue to meet to monitor and advise on implementation. To view the NSW Rural Health Plan, visit http://ow.ly/F0StB.

HNCNews Summary of GP Activity 2013/2014 The 2013/14 BEACH Report has been released. This is a continuous national study of general practice activity in Australia involving a random sample of 1,000 practising GPs who record details of 100 patient encounters, information about themselves and their major practice.

Medications

The report is produced by the University of Sydney and can be viewed at http://ow.ly/F0SH9.

•

• •

Below is some data of interest contained within the report. General practitioners • • • • • •

57% male with 48% aged over 55 71% had graduated in Australia 54% had provided care in an RACF in previous month 83% worked in a practice with practice nursing staff 70% reported using electronic medical records exclusively 43% worked in a practice with its own or cooperative after hours care

Referrals and admissions • •

Six referrals recorded per 100 encounters or 10 per 100 problems managed Most frequently to medical specialists, then allied health services. Very few patients referred to hospitals or EDs

The encounters

•

Tests and investigations

• •

On average, GPs managed about 158 problems per 100 encounters Chronic problems accounted for 36%, and new problems for 37% of all problems At an average 100 encounters, 103 medications prescribed/ supplied or advised for OTC purchase; 49 pathology tests, 38 clinical treatments, 19 procedures, 15 referrals and 11 imaging tests

The patients • •

Females accounted for 57% of encounters; children under 15 years 11% 15-24 years 8%, 25-44 years 22%, 45-64 years 27% and over 65 years 32%

Problems managed •

• •

•

At least one medication was given for 51% of problems managed No repeats were given for 34% of prescriptions, and five repeats were ordered for 38% Most commonly prescribed medications – nervous system (24% of scripts), particularly opioids (7%), antidepressants (5%). For the cardiovascular system (19%), particularly antihypertensives and lipid lowering agents. Most commonly prescribed individual medications were antibiotics (cephalexin 3% and amoxicillin 3% of all scripts). Nervous system drugs - paracetamol (3%) and oxycodone (2%); and the proton pump inhibitor esomeprazole (2%)

Most commonly managed were problems of a general and unspecified nature (20%); respiratory problems (19%), musculoskeletal problems (18%), skin (18%) and circulatory (17%). Most often managed individual problems were hypertension (8.7%), ups (7%), immunisation (5.8%), URTI (4.9%) and depression (4.3%). At least one chronic problem was managed at 42% of 100 encounters and 56 chronic problems managed per 100 encounters.

• • • • •

GPs recorded orders for pathology tests/batteries at a rate of 49 per 100 encounters Chemistry tests accounted for 58% of pathology orders, the most common being lipid tests, multi-biochemical analysis, thyroid function tests and electrolytes, urea and creatinine Haematology tests accounted for 17% of pathology Almost 40% of pathology tests were generated by orders for 10 problems, led by diabetes, general check -ups, hypertension and weakness/tiredness. There were 11 imaging tests ordered per 100 encounters. Diagnostic radiology accounted for 43I%, ultrasound 41%, and computerised tomography for 12% of imaging orders

HNCEvents Hastings-Macleay 10/12/14 - Allied Health Professionals Breakfast, Port Macquarie 5/2/15 - Musculoskeletal Symposium, Port Macquarie

Mid North Coast 4/12/14 - ISBAR Workshop Series: Holistic Palliative Care, Grafton 9/12/14 - Allied Health Breakfast, Coffs Harbour 26/2/15 - Partners in Prevention: Creating Supportive Environments to Improve Health of our Community, Coffs Harbour 9-14/3/15 - Eating Disorders Essentials Course, Coffs Harbour

Northern Rivers 3/12/14 - ISBAR Workshop Series: Holistic Palliative Care, Casino 4/12/14 - Cultural Awareness Training, Lismore 4/12/14 - Kaizen Meeting, Lismore 6/12/14 - Engaging Adolescents, Mullumbimby 9/12/14 - Domestic Violence Forum, Maclean 16/12/14 - General Practitioner Breakfast, Ballina

Tweed 4/12/14 - Alcohol & Other Drugs: what people working with adolescents need to know, Tweed Heads

December 2014 - March 2015 You can view the full North Coast Practitioner events calander at: www.healthynorthcoast.org.au/practitioner-events

Other Events 3-5/12/14 - Fifty Shades of Pain Conference, Brisbane 5-6/12/14 - Chronic Disease Management Workshop, Sydney 15-18/3/15 - Managing Pain: From Mechanism to Policy, Brisbane

HNCclassifieds WOMEN’S SPECIALIST CENTRE

VRGP POSITION AVAILABLE

Dr Triveni Nanda (MBBS, DGO, FRANZCOG) has opened a private practice Women’s Specialist Centre in Coffs Harbour. Her practice provides complete and comprehensive evidence-based woman centered care including urogynecology, infertility and high-risk obstetrics services.

Macksville Medical Centre is seeking a VRGP. Position available immediately. Long established, fully computerised and accredited practice centred in Macksville with Branch Surgery in Nambucca Heads. Presently four doctor practice, seeking to increase to five. Recently fully upgraded rooms, and with improved Allied Service facilities, specialising in Chronic Disease Management, providing the following: Podiatry, Audiology, Psychology service, Sleep Clinic facility, onsite Pathology, Diabetes Educator and seeking other Allied Services. Currently negotiating X-ray and ultrasound service. Visiting Vascular Surgeon, and negotiating other Specialists. Excellent reception staff with RN & EN. Very friendly and family orientated practice.

Dr Triveni Nanda has worked as a consultant Obstetrician and Gynaecologist for over 12 Years in both India and Australia and has trained under some of the leading Australian O&G specialists and brings a rich professional history including posts at Royal North Shore, Nepean Hospital, Hornsby Hospital, Canberra Hospital and more recently Coffs Harbour Base Hospital. Referrals are welcome. Practice details: Suite 3 / 60-62 Albany Street Coffs Harbour, NSW, 2450 Telephone:02 6651 3848 Fax: 02 8208 3268 Email: info@cwsc.com.au

CLINICAL ROOM AVAILABLE - PORT MACQUARIE A clinical room within Dr Brenda Rattray’s rooms is available for lease to either Allied Health, Specialist, Mental Health Workers etc., who may require regular premises. Sessional times or a full time lease.

Little or as much as you wish after-hours work. Potential VMO at Macksville Health Campus, which is part of Coffs Health Campus. Basic services at the local Macksville Health Campus, and Specialist services between Coffs Harbour, Kempsey & Port Macquarie. Applicants need to be aware that this area is not deemed a District of Workplace Shortage (DWS) and there are virtually no DWS areas available between Port Macquarie and Coffs Harbour. That restricts OMG applicants and is beyond our control at present. But of course DWS does not apply to Australian graduates or those who hold the FRACGP. Dr Vince Edghill MbChB MRCP (UK) Telephone: 02 65 681 155 Email: edgegan@bigpond.net.au

Please contact Brenda Rattray on 02 6584 7647.

Would you like to post a local classified ad in this newsletter? Email the details to healthynorthcoast@gmail.com before the 25th of each month. There is no cost associated with these ads.

HNCclassifieds PART TIME DOCTOR Macksville Medical Centre is seeking a Part Time Doctor. Preferably, but not necessarily VRGP. Three months work and three months off would be ideal. Potential for home and vehicle could be provided, but doctor living locally on the Mid-North Coast would again be ideal. Present doctor looking not to retire but to reduce workload to combine life/ work/travel. Looking for a doctor wishing the same arrangements. Actual time away and time worked negotiable, but ideally a 2-3 months working period with similar leave time would be negotiated. Contributions also to be negotiated, however a 30% contribution to the running of the practice, as with Locums, is the ideal financial arrangement. All other monies you earn, you keep. Workload as acceptable to both parties, with as little or no after hours work, as preferred. As an example, I do very little. No VMO. For more information regarding the position, you could visit the charming Nambucca Valley, or alternatively contact me by telephone or email: Dr Vince Edghill MbChB MRCP (UK) Telephone: 02 65 681 155 Email: edgegan@bigpond.net.au

SUPPORT MEDICAL RECEPTIONIST NEEDED You must: • • • • • • • •

Be proficient with computers Have knowledge of Best Practice Software Have previous experience (2 years minimum) Be able to multi task Be a quick learner Have exceptional communication skills Be approachable Have attention to detail

The position supports the Medical Admin worker with casual minimum weekly hours and will provide sick day and holiday relief. Send your resume with cover letter to: The Practice Manager PO Box 1505 Port Macquarie NSW 2444 23

GENERAL PRACTITIONERS Are you passionate about making a difference for Aboriginal and Torres Strait Islander communities and closing the gap between Indigenous and nonIndigenous health outcomes? The Bugalwena General Practice is seeking a motivated and experienced private GP to join our dynamic team on a contracting basis for one day a week (Monday) to commence immediately. Other availability will be considered. Bugalwena General Practice is a bulk billing practice providing comprehensive care for Aboriginal and Torres Strait Islander people living in the Tweed Shire. GPs, Registered Nurses, a Dietitian, Diabetes Educator, Exercise Physiologist and Aboriginal Health Practitioner provide services. In addition the Practice has a strong health promotion focus and runs health workshops and fitness groups for the community. Hours required are 8.00 - 4.30pm. The Practice offers nursing and administrative support, including billing and appointment bookings, a friendly multi-disciplinary team, comfortable rooms located in Tweed Heads South and professional development opportunities. You must hold full registration with your appropriate professional registration body, have professional indemnity insurance and be eligible to claim Medicare rebates. If you are interested, please contact Monika Wheeler, Program Manager Aboriginal Health on 07 5523 5500 or mwheeler@ncml.org.au. Closing date for Expressions of Interest: 5pm, Friday 12 December 2014.

HNCclassifieds GP POSITION AVAILABLE

GP LOCUM AVAILABLE

Focus Medical Centre is a modern and sunny GP-owned practice that opened in December 2012. We are looking for a friendly and motivated GP to join our harmonious team. Focus Medical Centre is a fully equipped practice with excellent nursing and administrative support. We are fully computerised and a non-corporate practice. Sorry no DWS positions available. All consult rooms have wonderful natural light and views to the ocean.

Dr. Mark Rathbone. 30 years experience. Unconditional registration. Coastal or inland practices. Available Christmas/New Year period. Phone: 0429 979 921 Email: btlocums@bigpond.com

For enquiries contact Dr Anne Murray on 6584 6715 or email info@focusmedical.com.au.

HASTINGS RESPITE CARE Hastings Respite Care would like to advise the trial of extended service hours at 3 centres as of 1st December 2014:

FOOT CARE

• •

NCML would like to acknowledge the podiatrists who have offered to provide Foot Care Service at South West Rocks:

•

Amy Cutler Podiatry - 0405 439 471 Belreigh Podiatry - 02 6562 2254 Peter Wynd Podiatry - 02 6566 7522 Ryan James Podiatry - 02 6584 8899

Sherwood – Thursdays till 3pm (currently 2pm) Greenmeadows – Wednesdays till 3pm (currently 2pm) Laurieton – Wednesdays till 3pm (currently 2pm)

Clients attending on these days will be transported home at 3pm rather than the current scheduled time. With the extension of hours, the Saturday program will be held only once a month.

CONJOINT LECTURERS - UNSW North Coast Medicare Local, in conjunction with the Port Macquarie Rural Medical School, encourages GPs in the Hastings Macleay area to become Conjoint Lecturers with the University of New South Wales Rural Medical School. Conjoint Lecturers may participate in the UNSW medical curriculum either as clinical tutors in their rooms or as lecturers at the Rural Medical School. (Practice Incentive Payments may be available for clinic sessions). As a Conjoint Lecturer, GPs will have access to the university’s resources, such as the UNSW library and eLearning tools as well as all educational events hosted at the Rural Medical School, such as the recent GP Emergency Management program held at the UNSW Simulation Lab. For more information, please contact Ms Julianne Weatherley at j.weatherley@UNSW.edu.au.

HASTINGS RESPITE CHRISTMAS/NEW YEAR CLOSURES Dementia Respite Centres’ last day of operation for 2014 will be Friday 19th December. However, due to demand, Greenmeadows will open for existing clients 9am – 3pm on: • • • •

Monday 22nd December Tuesday 23rd December Monday 29th December Tuesday 30th December

All centres (including the administration office) will reopen on Monday 5th January 2015. Please contact Hastings Respite with any queries on 6581 4544.

HNCclassifieds EOI FOR NORTH COAST HEALTHPATHWAYS CLINICAL WRITERS Expressions of interest are sought for Clinical Writers for Mid and North North Coast HealthPathways team- for Northern NSW. HealthPathways is a tool developed by a New Zealand District Health Board and is an on-line information portal for GPs (and other professionals) on how to assess, manage and refer in the local context of available services. It is underpinned by evidence based practice. It has been very successful, being replicated across much of NZ and in many Medicare Locals in Australia.

PORT MACQUARIE DEMENTIA & COMMUNITY CENTRE On Wednesday 17 December, the Port Macquarie DMCC will be moving to 121 Bridge Street, Port Macquarie. Contact details remain unchanged: Phone: 6584 7444 Email: NSW.MidNorthCoast@alzheimers.org.au Please note: DMCC is closed for the Christmas/ New Year Period from 12 noon Wednesday 24 December to Monday 5 January.

North Coast Medicare Local, Northern NSW Local Health District and Mid-North Coast Local Health District have partnered to provide HealthPathways in the region. It is hoped to form teams of writers based in Tweed Valley, Richmond Valley or Clarence Valley. These teams will be supported and resourced to develop the skills necessary to write new pathways and modify existing pathways. Successful Clinical Writers will also be asked to work with HealthPathways working groups. A successful local Clinical Writer is likely to have these personal attributes: •

• •

• • •

Be a clinician and most likely a GP, able to work with subject matter experts (specialist medical and allied health) and distil the essential information for a GP audience. Systems thinker: i.e. able to distil a simple and clear process from a bolus of complex information and perspectives. Whole-of-System understanding: i.e. able to see relationships and impacts across the continuum of care (patient responsibility, general practice services, other community services, secondary care services). Good understanding of applying evidence to practice. A strong belief in quality improvement. Keen to work with a small implementation team that provides guidance and support.

The Mid and North Coast HealthPathways site can be accessed at: http://manc.healthpathways.org.au Username: manchealth Password: conn3ct3d Payment will be made after submission of an invoice for time based on a rate of $85.00 for each hour. For further information, please contact Dr Dan Ewald Clinical Adviser, Clinical Lead HealthPathways or Kerrie Keyte, HealthPathways Project Officer. Email dewald@ ncml.org.au or kkeyte@ncml.org.au. 25

MEDICAL RECEPTION INDUCTION PROGRAM Medical Reception Induction Program (MRIP) elearning tool, developed by Nicky Jardine, are designed to provide new medical receptionists with the information they require to work in your medical centre, as well as the policies and procedures of the general practice. Induction processes are vital to ensuring that new medical receptionists are productive as quickly as possible and also teach them the importance of their position and the level of knowledge and responsibility expected. These training programs are being offered for $199 (normally $299) per practice with a limit of 5 reception inductions if purchased before the 31st December 2014. For Further information, visit www.nickyjardine.com.

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