Healthy North Coast Practitioner Newsletter by Healthy North Coast

November 2014 | Edition 6

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

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GP Focus

AMS Focus

AgedCare Focus

Pharmacy Focus

AlliedHealth Focus

inside 3. GP Focus 12. AMS Focus 16. Aged Care Focus 18. Pharmacy Focus 21. Allied Health Focus 24. Healthy North Coast News 26. Events 27. 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 November is ‘Movember’

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The Movember Foundation uses ‘Movember’ to raise awareness and funding for men’s health issues such as prostate and testicular cancer, and mental health. Visit http://au.movember.com/ to find out how your practice can participate.

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Other related online resources include: •

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The Cancer Council has a range of men-focussed fact sheets, such as “Get Checked – Men” http://goo.gl/ rOGH52 The Prostate Cancer Foundation of Australia has information packs for recently diagnosed men, which can be downloaded or ordered from http:// goo.gl/P09bfx Beyond Blue has a whole section of their website dedicated to information and resources about depression and anxiety in men http:// goo.gl/EwF4ba

World COPD Day, 19 November One in seven Australians over the age of 40 has COPD, and half of those who are experiencing symptoms do not know they have it. On World COPD Day, 19 November 2014, the Lung Foundation is aiming to raise awareness of the prevalence and impact of COPD to help people improve their lung health and well-being. General Practices can get involved by holding their own activities to raise awareness about the symptoms, risk factors and treatment for COPD, such as: 3

A static display, with posters, balloons and Lung Health Checklists Inhaler Device Technique checks Risk Assessment and Screenings of interested patients/customers

The Lung Foundation can help practices do these or other activities. Visit http://goo. gl/nsDc7Y for more information. The Lung Foundation also offers online training to support nurses and other health care professionals, in their work with community and patients with lung disease. Visit http://goo.gl/cMVqZ9 for more information.

Antibiotic Awareness Week, 17-23 November Antibiotic Awareness Week calls on us all to preserve the miracle of antibiotics, and provides an opportunity to highlight the problem of antimicrobial resistance and promote the safe and judicious use of antimicrobials. Antibiotic Awareness Week is a great opportunity to educate patients on the use of antibiotics and how they are ineffective against viruses. Visit the Australian Commission on Safety and Quality in Healthcare at http://goo.gl/ J9tZfM for more information. NPS Medicinewise also offers a number of online courses on antimicrobials. Visit http://goo.gl/6PpOZP for more information.

Conducting quality health assessments in General Practice Following the Department of Health’s recent advice about practice nurses’ role in facilitating health assessments, the RACGP and APNA have released the information sheet ‘Conducting quality healthcare assessments in general practice’. The sheet includes MBS billing information and advice on maintaining quality health records. Visit http://goo. gl/9d30W7 for more information.

RACGP Green Book: Putting Prevention into Practice The RACGP has released a second edition of ‘Putting prevention into practice: guidelines for the implementation of prevention in the general practice setting’. Created by a multidisciplinary team of experts for use by general practitioners, practice nurses and practice staff, the guidelines are intended to be a practical resource designed to strengthen prevention activities in general practice. Visit http://goo.gl/jnPCoE for more information.

Dementia Medication Short Film Alzheimer’s Australia has recently launched a short film, ‘Antipsychotics & Dementia: Managing Medications’ for healthcare professionals working with people living with a diagnosis of dementia. Visit http://goo.gl/S5hNYC to view the film.

GPFocus PAL UPDATE RACGP Emergency Response Planning Tool

New resources for people with pain after spinal cord injury

The RACGP’s online Emergency Response Planning Tool (ERPT) has been developed to assist general practices to better prepare for, respond to and recover from the impacts of emergencies and pandemics. The ERPT is a practical tool that guides you through a series of planning templates, where critical information about your practice can be entered and saved. This information will be used to create an emergency response plan which is individually tailored to your general practice. Your customised emergency response plan can be saved online and/or printed as a hard copy resource. Visit http://ow.ly/DHZWj for more information.

After spinal cord injury (SCI), 70% of individuals experience chronic or persistent pain which impacts upon activity levels, mood, sleep, and quality of life. A recent survey found that 91% of individuals with SCI pain consult their general practitioners for assistance with pain, and 80% of health care professionals working with people with SCI feel that they are inadequately resourced to manage SCI pain. In response to this, a series of resources have been developed through a partnership between the Agency for Clinical Innovation (ACI) Pain Management Network and the NSW State Spinal Cord Injury Service, with support from the Lifetime Care and Support Authority (LTCSA). The new online resources include:

Brainman’s Pain Management Resources To coincide with opening of the 15th World Congress on Pain in Buenos Aries, Argentina, a world leader in pain education is making a return to the online stage. Brainman, the “brainchild” of the team at Hunter Integrated Pain Service at John Hunter Hospital and Hunter Medicare Local, has become a YouTube celebrity since making his debut in late 2011. Since that time, Brainman’s first film, ‘Understanding pain and what to do about it in less than five minutes’, has received almost 500,000 views and been translated into nine different languages. Now the University of Washington and The University of South Australia have joined the team to collaborate on two new videos. The first, ‘Brainman stops his opioids’, holds the succinct message that opioids are no longer recommended for chronic non-cancer pain. The second video shows the choices Brainman makes as he transitions toward an active evidence-based approach. You can view the new videos at Brainman’s very own YouTube Channel http://ow.ly/DHBaq.

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Personal stories about successful strategies used by people with spinal cord injuries to manage chronic pain Complementary resources for consumers The ‘SCI Pain Navigator’ clinical decision support tool

Visit http://ow.ly/DHBjB for more information.

World Diabetes Day, 14 November Use World Diabetes Day to promote proactive diabetes management in your practice. Visit http://ow.ly/DHCkb for more information.

Insulin pump service in Port Macquarie for people with Type 1 Diabetes JK Healthcare in Port Macquarie is excited to be able to offer an insulin pump service for people with Type 1 Diabetes. Jodie Kennett, Credentialed Diabetes Educator and Accredited Practising Dietitian, and the team at JKHealthcare, can assist with the purchase of the pump, arrange existing pump upgrades and provide ongoing pump education. Contact JKHealthcare by phone on 6583 7717 or email admin@jkhealthcare.com.au for more information. An official launch of this service will be held on 22 January 2015 for health professionals and interested patients. However, there is no need to wait for this date to register your interest in the service. Invitations to the launch will be sent out closer to the date.

GPFocus PAL UPDATE New research project launches at Port Macquarie and Coffs Harbour hospitals NCML is delighted to report that the Diagnosing Potentially Preventable Hospitalisations (DaPPHne) project will begin at Port Macquarie and Coffs Harbour hospitals in the coming weeks and will continue for around four months. This important research project explores potentially preventable hospital admissions among people with chronic disease who are 45 years and older. The research is being run by University Centre for Rural Health (University of Sydney) researchers in close collaboration with, and funded by, the NCML, the Mid North Coast Local Health District and the NSW Agency for Clinical Innovation. The aim of the research is to generate an evidence base identifying modifiable factors driving potentially preventable admissions for chronic conditions amongst community-dwelling people, to improve measures of health system performance and develop effective interventions to reduce preventable admissions. Patients participating in this study will have consented to the research team approaching their GP for a telephone interview regarding the patientâ&#x20AC;&#x2122;s health and the care they have received in the past 12 months. GPs of participating patients will be contacted by the research team to discuss participation in the research. It is anticipated that participation will take 15-20 minutes. GPs will be reimbursed for their time. We encourage all GPs who are approached to participate in this project, which should provide more robust insight into potentially preventable admissions than currently exists. Any questions please contact: Dr Jennifer Johnston, Project Manager on 6620 7570. Pictured: Mid North Coast Local Health District Director of Allied Health and Integrated Care, Bronwyn Chalker; University Centre for Rural Health Research Fellow, Dr Jennifer Johnston; Port Macquarie Base Hospital Emergency Department Director, Dr Steven Ross; PMBH Registered Nurse, Colleen Boyd and UCRH Lead Researcher Dr Megan Passey. 5

Participate in research â&#x20AC;&#x201C; Q Fever GPs are invited to participate in a research survey exploring the knowledge base and subsequent treatment of Q Fever in the North Coast region. From 2001-2006 the government funded a vaccination program, which saw a significant decrease in the infection notification rate of Q Fever. Abattoir workers had previously dominated the epidemiology, however since being provided with vaccines, the incidence has significantly decreased. Q Fever can not only have a significant impact acutely, but has serious long-term complications which is not only a burden to the affected individual and their direct families, but also to the health care system. With better treatment in addition to available vaccines, the burden of Q Fever can be minimised. The aim of this project is to work in conjunction with the North Coast public health unit to identify the gaps in knowledge and overall understanding of Q Fever in clinicians on the North Coast of NSW. Results will be used to identify training needs of rural practitioners. Data collection is anonymous and completely de-identified. The survey can be accessed at https://www.surveymonkey.com/s/qfever and should take less than five minutes to complete. If you have any questions, please contact the project coordinator, Patrick Lindsay by email pjl378@uowmail.edu.au or by phone 0434 022839. Additionally you may contact the Public Health Unit in Lismore on 02 6620 7585 or 02 6620 2196. All participation and feedback is greatly appreciated, and will hopefully assist in reducing the burden that Q Fever in our community.

GPFocus PAL UPDATE Participate in needs assessment – Adult survivors of child sexual assault Reaching Out Service for Adult Survivors of Childhood Sexual Assault (ROSAS) is currently undertaking a survey of all health and community services professionals in the Northern Rivers. The aim of the survey is to conduct a broad based needs assessment of the supervision, training, support and information needs of a range of professional services who come into contact with adult survivors of child sexual assault. The results of the survey will determine how ROSAS supports professionals through training, support and information so that they may meet the needs of the adult survivors whom they come into contact with in their work. The survey can be completed at: https:// www.surveymonkey.com/S/NRJ9959. All participation and feedback is greatly appreciated.

Participate in research – Primary Care Management of Gout General Practitioners and GP Registrars are invited to participate in a study to investigate the management of gout in primary care in the Northern Rivers, NSW and how it relates to current practice guidelines being conducted by Karolina Kanczuga-Byszewski who is a 3rd year medical student at the University of Wollongong. It will be supervised by Dr. Douglas Gray, a rheumatologist from Ballina, NSW. This study is part of the course requirement during the student placement in your community. If you choose to be included in this study, you will be asked to complete an anonymous survey by the medical student who is conducting the research. The survey should take approximately 10 minutes to complete. Apart from the time taken to complete the survey, we can foresee no risks or burdens for you. 6

Your involvement in the study is voluntary and you may withdraw your participation from the study at any time and you may withdraw any data that you have provided to that point. The research project will provide important information about the management and treatment patterns of different gout presentations in primary care. Undertaking a research project within the community is a course requirement for the University of Wollongong for medical students. It will assist Karolina in undertaking research and interpreting results of research, which is an important skill in her professional life as a doctor. The project will investigate an aspect of the medical practice and the wider community and may be a basis for future research. Findings from the study will be published in a report to the University and will be presented to other medical students and staff at the University. Findings may also be published in scientific and/or medical journals and presented at conferences. A copy of the final report will be available to any interested person by contacting the university. Please note that individuals will not be identified in any reports or publications arising from this research. This study has been reviewed by the Human Research Ethics Committee of the University of Wollongong. If you have any concerns or complaints regarding the way this research has been conducted, you can contact the UOW Ethics Officer on (02) 4221 4457. Thank you for your interest in this study. If you would like further information about this study please contact Professor Peter McLennan on (02) 4221 4183 Please click on the link to complete the survey: https://www.surveymonkey. com/s/DV5TVB6

Participate in research – Breast Cancer workforce The McGrath Foundation has engaged JustHealth Consultants to undertake a study examining the demand for Breast Care Nurses in Australia. This study will build on a workforce study undertaken in 2010 and will examine changes in work practices and demand to update the projected workforce needs. To develop an accurate picture of the current workforce and to inform the modelling of the future workforce needs, we are seeking the assistance of breast care nurses and organisations that provide breast care nurse services to complete a short survey. •

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The survey for organisations providing breast care nurse services can be accessed at http://ow.ly/ DLGot The survey for breast care nurses can be accessed at http://ow.ly/DLGzz

Early responses would be much appreciated. If you have any questions regarding the survey or the project please contact: Laura Gane BCN Programme Manager McGrath Foundation 02 8962 6100 Yasmin Birchall Project Manager JustHealth Consultants 02 6162 0780

GPFocus PAL UPDATE Domestic Violence Support Carey Amor Domestic Abuse Consultancy Service (CADACS) is an independent consultancy service, the first of its kind based in Port Macquarie, specialising in the delivery of training and professional development for services working in the fields of domestic violence and also offering a service as a single referral point for a victim of domestic abuse. Levels of training across government and non-government organisations vary significantly and are often inadequate to meet the needs of the client and help achieve the best outcome for victims of domestic and family violence. CADACS practical insight and understanding of domestic violence (spanning over 15 years), in all sectors of the community, gained both in the UK and Australia enables the company to offer specialist domestic violence services, including training and assessment, referral, local knowledge throughout rural and regional NSW, and an opportunity to be the one referral point of contact for GPs. Our business, supported by the AMA, can offer extensive industry knowledge and experience, including the new DV reforms and all aspects of its contents comprising of the DVSAT (Domestic Violence Safety Assessment Tool), developing and implementing individual Safety plans for clients, representation of the client at the Safety Action Meetings, working closely with all other service providers to ensure that information sharing protocols are adhered to and that the client is supported throughout the referral process. We can provide case management of each client and a feedback report to the GP for their records. We can tailor this experience to provide comprehensive online training modules or face to face presentations and workshops for busy practitioners and all staff who may encounter patients who disclose DV within their consultation.

For further information contact CADACS on mobile 0421 880 542 or email Carey. Amor@cadacs.com.au.

PREVENTATIVE HEALTH Quit for New Life (Q4NL) program

Contacts:

What is Q4NL?

Hastings Macleay Clinical Network Kristine Horn Phone: 1300 662 263 Mobile: 0477 391 422 Fax: 6588 2910

Q4NL is a state funded program which supports women who identify as having an Aboriginal baby to quit smoking during pregnancy and to stay quit after the birth of their baby. We have two Q4NL workers employed to work with women and their families to offer a range of support options. These include: • • • • •

Advice on quitting smoking Free nicotine replacement therapy (NRT) for up to 12 weeks Brochures with information on smoking and quitting Quitline for counselling support Follow-up quit support

Coffs Harbour Clinical Network Lynette Vella Phone: 1300 662 263 Mobile: 0477 322 218 Fax: 6568 2391 Northern NSW Local Health District Christine Sullivan Phone: 02 6674 9517 Mobile: 0417 474 417 Fax: 02 6674 9599

How to access the Quit for New Life (Q4NL) program If you work with women who smoke during prenatal or postnatal periods and who are Aboriginal or identify as having an Aboriginal baby, then you can refer clients to the Q4NL program. In addition, partners and other people living with the woman will also be offered support to quit smoking, including free NRT. This not only assists householders to quit smoking but also supports the woman in her efforts to quit and provides a ‘smoke free’ home. Meet the Q4NL Team Kristine Horn has been with us since 2013 supporting the Port Macquarie area, and Lynette Vella has recently joined the team to support the Macksville and Coffs Harbour area. Christine Sullivan is the Cessation Support leader for Northern NSW Local Health District, supported by two Aboriginal Health Promotion Officers (Laurel Rogers and Ronella Phillips), and a Cessation Support Officer (Jenni Dann).

CLINICAL TIP Avoid routine multiple daily selfglucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia. Once target control is achieved and the results of self-monitoring become quite predictable, there is little gained in most individuals from repeatedly confirming. There are many exceptions, such as for acute illness, when new medications are added, when weight fluctuates significantly, when A1c targets drift off course and in individuals who need monitoring to maintain targets. Self-monitoring is beneficial as long as one is learning and adjusting therapy based on the result of the monitoring. choosingwisely.org

GPFocus NEW TO HEALTHPATHWAYS – OCTOBER 2014

Management

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COPD is a disease that requires constant collaboration and communication both internally across clinicians within a hospital and externally, between the hospital, GPs, and specialist treatment centres.

Routine Antenatal Care Thyroid Disease in Pregnancy Hypertension in Pregnancy Anaemia in Pregnancy Heart Conditions in Pregnancy Gestational Diabetes Renal Disease in Pregnancy UTIs in Pregnancy Asthma in Pregnancy Palpitations in Pregnancy Termination of Pregnancy Medical Obstetric Psychological Risk Factors Genetic Screening for Fetal Anomalies Breast Screening Epilepsy in Pregnancy Hyperemesis Medications in Pregnancy & Breastfeeding Factor V Ledien (FVL) in Pregnancy Nuchal Translucency Scan Routine Antenatal Check

HEALTHPATHWAY TOPIC OF THE MONTH - COPD The Mid and North Coast HealthPathways program is currently localising COPD pathways that will be available on the website mid-November. You will find the latest diagnostic, management and local referral information for patients with COPD. Pathways in development: • • • • • • • • • •

COPD Assessment Optimising Function in COPD COPD Management Differentiating COPD from Asthma End Stage/Palliative Care COPD Exacerbations of COPD Preventing Deterioration in COPD Medications in COPD Evaluation of Spirometry Results Spirometry Testing & Interpretation

Incidence COPD is one of the top Potentially Preventable Hospitalisations (PPH) for the Mid North Coast Local Health District. PPH are conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management. On the Mid North Coast, COPD accounts for over 7,000 bed days a year, with an average stay of 6.7 days.

By following detailed management guidelines hospital admissions can be reduced. COPD Work Group Members: • Dr Stephen Chung, VMO Physician • Dr David Gregory, Clinical Lead/Facilitator • Dr Amanda Wijerante, General Practitioner Registrar • Dr Warwick Yonge, General Practitioner • Sue Lesmond, Respiratory Liaison CNS2/Pulmonary Rehabilitation Coordinator • Maree Kennedy, Respiratory Educator, Community Health • Dr John Roberts, VMO Intensivist, MNCLHD Clinical Lead • Dr Steve Ross, Director of Emergency, Port Macquarie Base Hospital • Vanessa Gartrell, Activity Based Management Project Officer, MNCLHD • Siobhan Breedon, Practice Assistance Liaison, Medicare Local • Fiona Ryan, Project Officer, HealthPathways

Feedback – GP Antenatal Shared Care Education Session On 11 October 2014, 27 General Practitioners from the Coffs Harbour region attended the HealthPathways GP Antenatal Shared Care Education session. Due to the overwhelming response from this event and for the GPs that were unable to attend on the day, a repeat education session will be held prior to Christmas (date to be advised). NB: Pathways have only been localised for the Mid North Coast area at this stage. Northern NSW clinicians now have access to HealthPathways and will begin to see local service information 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 on 6583 3600 or fryan@ncml.org.au.

GPFocus IMMUNE RESPONSE School-based vaccination program (2014)

varicella vaccination catch up, the parent/student may request to have the HPV vaccination at the same time (despite advice to complete the schedule in year 8). Please be aware, an HPV consent form with records of dosage is still lodged in the school program with the Public Health Unit. The HPV vaccine should not be given unless you can confirm that the recommended interval time between doses is adhered to and you notify your Public Health Unit to remove the consent form from the school program. This will avoid the child getting a further HPV dose at school.

Students who missed vaccine doses in 2014 will be offered the following: Year 7 Missed Gardasil vaccination (3 dose schedule not completed) Students will receive a letter advising they will be able to complete the HPV schedule at school in year 8. Year 7 Missed Varicella The varicella vaccination was offered only once in most schools, either late Term 3 or early Term 4. Students away on that date would have missed the opportunity to be vaccinated. Students will receive a letter advising them to go to their GP for this vaccination. (Please read NOTE 3). Year 7 Boostrix The Boostrix vaccination was offered on three occasions (Term 1, and a catch-up available in Term 2 and either late Term 3 or early Term 4). In the rare event that the child was away on all three occasions, they will receive a letter informing them to have the vaccine from their GP. Year 9 Boys Gardasil A student who hasn’t completed the three doses will receive a letter advising them to complete the course with their GP. The letter will state the dates of previous HPV doses. In the event of a student refusing vaccinations at the school, or relocation, a letter may also be issued to parents stating ‘please continue vaccination with GP’.

Information on the 2015 school vaccination program will be supplied in a future newsletter.

Ebola virus disease (EVD) update NSW Health has an Ebola information site which includes a NSW GP alert and other fact sheets at http://ow.ly/DHE2L. Key points include: • •

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The outbreak of Ebola virus disease (EVD) in West Africa is continuing The risk of EVD infection is extremely low unless there has been direct exposure to the body fluids of an infected person Be alert for febrile travellers with a history of travel to West Africa in the 21 days prior to illness onset Seek urgent advice from an infectious diseases physician Suspected cases must be notified immediately to your local Public Health Unit on 1300 066 055

NOTE:

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1. Students will be advised to take the vaccine action letter with them to their GP. This will ensure that general practice staff know which vaccine is required, and in the case of HPV, when previous doses were given. 2. To ensure vaccines are available, or to allow the practice to order vaccines in, students will additionally be advised to notify the practice of the reason for their appointment. 3. There is concern that when a student is away for the third vaccination visit and subsequently receives a letter informing them to go to the GP for

Consider EVD in patients with fever (>38°C) and a history of travel to an affected area in West Africa within 21 days of illness onset. The onset of symptoms is sudden and includes fever, myalgia, fatigue and headache. The next stage may include symptoms that are gastrointestinal (vomiting, diarrhoea), neurological (headaches, confusion), vascular, cutaneous (maculopapular rash), and respiratory (sore throat, cough) with prostration. Cases may develop a septic shock-like syndrome and progress to multi-

organ failure, sometimes accompanied by profuse internal and external bleeding. The case-fatality rate for Zaire strain of EVD cases during previous outbreaks is estimated to be between 50% and 90%. Visit the Department of Health at http:// ow.ly/DHEoK and the Centre for Disease Control and Prevention of USA at http:// ow.ly/DHEv1 for more information.

Pertussis vaccination - recommended in third trimester of pregnancy There have been 1,729 pertussis notifications to NSW Health so far this year, and the tragic death of a sevenmonth-old baby from this illness in the Hunter region highlights the importance of pertussis vaccination. Health professionals are urged to encourage pregnant women to receive whooping cough vaccine in their last trimester of pregnancy, not only to protect the mother but to offer the best protection to their newborns. The mother gains protection, and passes antibodies to the baby in the womb, which in turn provides protection for the newborn. Children of mothers that received dTpa in their pregnancy should receive an additional booster of dTpa in the second year of life (at approximately 18 months).

Meningococcal death A toddler who contracted meningococcal disease died in a Townsville Hospital in early October. The incidence of Meningococcal C disease has declined since the introduction of the Meningococcal C vaccination on the National Immunisation Program (NIP) at 12 months of age; there are no Meningococcal C notifications to date in 2014. However, 17 cases of Meningococcal B have been notified to NSW Health this year, the majority of which are in the 0-5 year age group. Meningococcal B (Bexsero) has not made it onto the NIP. The vaccine is licenced in Australia, and some parents are making the decision to purchase the vaccine to protect their child. All parents should be advised that the vaccine is available. Recommendations for use of Bexsero are available at http://ow.ly/ DHEYB.

GPFocus MENTAL HEALTH Talking about suicide: what to do when someone is feeling suicidal? On average, six people die by suicide in Australia each day. Suicide is a preventable cause of death, yet it continues to be a prominent public health concern, with the number of suicide deaths accounting for 1.5% of deaths from all causes. A 2013 review of current information, programs and approaches identified several core principles when discussing suicide, along with resources for people discussing suicide. Many people who are considering suicide give warning signs or signals. Often there has been an event that is a trigger or ‘tipping point’ for them. This can include recent loss, major disappointment, change in circumstances, and onset or reoccurrence of mental health issues. If you believe someone may be contemplating suicide, best practice is to ask directly about your concerns, without judgement. Examples are: “Are you having thoughts about suicide?” or “Are you thinking about killing yourself?” Let the person know that while many people think about suicide, there are alternatives to acting on those thoughts. It is important to talk with the person in order to find out what is happening for them. Understanding the influence of individual, social and environmental factors, such as previous attempts, mental health illness, social isolation, gender (male), and drug and alcohol issues can assist in your assessment. Protective factors, such as mental and physical wellbeing, social connectedness, financial and relationship stability, and personal resilience can improve a person’s ability to cope when they are struggling with life. A person’s risk of suicide is heightened if they have had previous suicide attempts, if they know someone who has died by suicide, and if they have experienced a recent loss or crisis. Asking if the person 10

has a current suicide plan is another indicator of risk: how they will do it, when they will do it and any preparatory steps already taken. One example is: “Have you decided how you would kill yourself?” People who (1) demonstrate little concern about if they live or die, (2) have a history of previous suicide attempts and (3) have a detailed plan on how they will take their life are classified as high to acute risk of suicide. People who report suicidal ideation yet do not meet these three criteria are classified as being at low to moderate risk of suicide (Reference: Modified Scale of Suicide Ideation). Once you have determined the level of risk, take steps to keep the person safe. Involve the person in identifying people who can help support them and resolve the problem. This can be professionals, a service such as a helpline or people who have previously supported them (family, friends and community). This may also mean breaching a person’s confidentiality and/or contacting emergency services. Psychological services can assist the person with how they are feeling and to learn coping skills. This includes addressing mental health issues, feelings of hopelessness, improving the ability to deal with difficult and overwhelming emotions, teaching problem-solving skills, and building supports and resources. If you have a patient at mild to moderate risk of suicide and they hold a Health Care Card or are experiencing severe financial hardship, they can assess free psychological services through the Healthy Minds Suicide Prevention Service. People referred to the Suicide Prevention Service are given priority: they are contacted within 24 hours of referral and are seen by an allied mental health professional within 72 hours. The Suicide Prevention Service provides intensive follow-up and focussed psychological interventions. Suicide Prevention Service sessions are provided in addition to the allocated number of Healthy Minds sessions.

Referrals to Healthy Minds Suicide Prevention Service can be made on the downloadable referral form at http:// ow.ly/DHGo5. Patients at acute and immediate risk of suicide should be referred to the local mental health service. For more information about Healthy Minds, including the Suicide Prevention Service, please call the team on 1300 137 237. Other suicide prevention websites and helplines: • • • • •

Conversationsmatter.com.au Mental Health Access Line: 1800 011 511 Suicide Call Back Service: 1300 659 467 Salvo Care Line: 1300 36 36 22 (Regional NSW) Lifeline Crisis Support Line: 13 11 14

GPFocus NATIONAL PRESCRIBING SERVICE Antibiotic Awareness Week 17-23 November One in four Aussie parents have leftover antibiotics or unfilled antibiotic prescriptions to be used “next time”. A survey conducted in 2013 found that one in ten people have taken left-over antibiotics without first speaking to their doctor or pharmacist, and parents are more likely to hold onto the medicines for next time they or their children get sick. During antibiotic awareness week, running from 17-23 November 2014, Australians are reminded that the development and spread of antibiotic resistant bacteria is one of the greatest threats to human health today. Globally - and in Australia we’re facing a return to the pre-antibiotic era where even minor infections can cause death due to overuse of antibiotics worldwide. It seems most people know that bacteria are becoming resistant to antibiotics, yet too few recognise the extent in Australia. Findings released by NPS Medicinewise in 2013 show that 32% of people think antibiotic resistance is a major health problem in Australia, however only half of this group considered

the possibility that antibiotic resistance could affect them or their family. Findings also found that most Australians are putting their faith and the responsibility in health professionals to solve this problem, while only half think they can stop the spread of superbugs in the community. Antibiotic awareness week promotes that antibiotic resistance is everyone’s problem, so we all need to be part of the solution! Learn more about antibiotic resistance and appropriate use of antibiotics at www.nps.org.au/antibiotics.

Current educational meeting programs Current educational visits and small group case-based meeting programs currently offered include: • •

Contact your local NPS facilitator to book a visit: Tweed Valley Jill Hayward (07) 5523 5500 jhayward@ncml.org.au Northern Rivers Sally Herbert (02) 6622 4453 sherbert@ncml.org.au Mid North Coast Michael Driscoll (02) 6659 1800 mdriscoll@ncml.org.au Hastings/Macleay Lesley Burrett (02) 6562 1055 lburrett@ncml.org.au

Exploring Inhaled Medicines Use and Asthma Control Back to basics for fatigue - Use a diagnostic approach

ABORIGINAL HEALTH Close the Gap services - register your interest in a cultural awareness session The Closing the Gap (CTG) program aims to reduce the gap in life expectancy between Aboriginal and Torres Strait Islander people and non-Indigenous Australians. North Coast Medicare Local (NCML) employs Aboriginal Health Program Officers, Care Coordination and Supplementary Service workers (CCSS) and CTG Outreach workers from Tweed Heads to Port Macquarie. Aboriginal Health Program Officers work with primary health care providers, community service providers and Aboriginal communities to improve access to mainstream primary health care for Aboriginal and Torres Strait Islander people. One effective way we do this is by facilitating cultural awareness sessions for GPs and allied health staff. 11

CCSS Care Coordinators are available to assist Aboriginal and Torres Strait Islander people with diabetes, cardiovascular disease, chronic respiratory disease, chronic kidney disease and/or cancer, to help manage their health and gain access to services. NCML’s Closing the Gap team are organising FREE cultural awareness training sessions for general practice teams across the North Coast. If you would like to register your interest in one of the upcoming sessions, or have one of our friendly CTG or CCSS workers visit your practice to have an informal chat with you and your staff about the programs, please contact the Aboriginal Health Program Officer in your area.

Tweed Heads Susan Parker Pavlovic (07) 5523 5517 sparker-pavlovic@ncml.org.au Lismore Monika Wheeler (02) 6620 4453 mwheeler@ncml.org.au Coffs Harbour Helen Lambert (02) 6659 1800 hlambert@ncml.org.au Port Macquarie Annie Orenshaw (02) 6583 3600 aorenshaw@ncml.org.au

AMSFocus

‘Background Artwork’ by Alison Williams

PAL UPDATE

New Tools designed for service providers and for Aboriginal and Torres Strait Islander patients North Coast Medicare Local (NCML) has produced a number of convenient tools for providing care to Aboriginal and Torres Strait Islander patients including: •

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A ready reckoner providing MBS item numbers most regularly used for Aboriginal and Torres Strait Islander patients, including a health assessment the requirements for a Health Assessment for Aboriginal and Torres Strait Islander people (MBS item number ‘715’) and follow up items A ready reckoner that includes medication and pharmacy programs available to Aboriginal and Torres Strait Islander people A flyer with Aboriginal specific Child Dental Benefits Scheme for families with children 2 – 17 years old A wallet-sized information card called ‘Sprocket for your Pocket’ detailing services available to Aboriginal and Torres Strait Islander people on the Mid North Coast A new flyer for Aboriginal and Torres Strait Islander patients with information on health support available from NCML

Please contact the Aboriginal Health Program Officer in your area for copies: Tweed Heads Susan Parker Pavlovic (07) 5523 5517 sparker-pavlovic@ncml.org.au Lismore Monika Wheeler (02) 6620 4453 mwheeler@ncml.org.au Coffs Harbour Helen Lambert (02) 6659 1800 hlambert@ncml.org.au

Port Macquarie Annie Orenshaw (02) 6583 3600 aorenshaw@ncml.org.au

November is ‘Movember’ The Movember Foundation uses ‘Movember’ to raise awareness and funding for men’s health issues such as prostate and testicular cancer, and mental health. Visit http://au.movember. com/ to find out how your practice can participate. Other related online resources include: •

•

The Cancer Council has a range of men-focussed fact sheets, such as “Get Checked – Men” http://goo.gl/ rOGH52 The Prostate Cancer Foundation of Australia has information packs for recently diagnosed men, which can be downloaded or ordered from http://goo.gl/P09bfx Beyond Blue has a whole section of their website dedicated to information and resources about depression and anxiety in men http://goo.gl/EwF4ba

A static display, with posters, balloons and Lung Health Checklists Inhaler Device Technique checks Risk Assessment and Screenings of interested patients/customers

The Lung Foundation can help practices do these or other activities. Visit http:// goo.gl/nsDc7Y for more information. The Lung Foundation also offers online training to support nurses and other health care professionals, in their work

with community and patients with lung disease. Visit http://goo.gl/cMVqZ9 for more information.

AMSFocus

‘Background Artwork’ by Alison Williams

PAL UPDATE Dementia Medication Short Film

World Diabetes Day, 14 November

Alzheimer’s Australia has recently launched a short film, ‘Antipsychotics & Dementia: Managing Medications’ for healthcare professionals working with people living with a diagnosis of dementia. Visit http://goo.gl/S5hNYC to view the film.

Use World Diabetes Day to promote proactive diabetes management in your practice. Visit http://ow.ly/DHCkb for more information.

New resources for people with pain after spinal cord injury After spinal cord injury (SCI), 70% of individuals experience chronic or persistent pain which impacts upon activity levels, mood, sleep, and quality of life. A recent survey found that 91% of individuals with SCI pain consult their general practitioners for assistance with pain, and 80% of health care professionals working with people with SCI feel that they are inadequately resourced to manage SCI pain. In response to this, a series of resources have been developed through a partnership between the Agency for Clinical Innovation (ACI) Pain Management Network and the NSW State Spinal Cord Injury Service, with support from the Lifetime Care and Support Authority (LTCSA). The new online resources include: • • •

Visit http://ow.ly/DHBjB for more information.

Participate in needs assessment – Adult survivors of child sexual assault Reaching Out Service for Adult Survivors of Childhood Sexual Assault (ROSAS) is currently undertaking a survey of all health and community services professionals in the Northern Rivers. The aim of the survey is to conduct a broad based needs assessment of the supervision, training, support and information needs of a range of professional services who come into contact with adult survivors of child sexual assault. The results of the survey will determine how ROSAS supports professionals through training, support and information so that they may meet the needs of the adult survivors whom they come into contact with in their work. The survey can be completed at: https:// www.surveymonkey.com/S/NRJ9959. All participation and feedback is greatly appreciated.

‘Background Artwork’ by Alison Williams

AMSFocus PREVENTATIVE HEALTH Quit for New Life (Q4NL) program

Contacts:

What is Q4NL?

Hastings Macleay Clinical Network Kristine Horn Phone: 1300 662 263 Mobile: 0477 391 422 Fax: 6588 2910

Advice on quitting smoking Free nicotine replacement therapy (NRT) for up to 12 weeks Brochures with information on smoking and quitting Quitline for counselling support Follow-up quit support

‘Background Artwork’ by Alison Williams

AMSFocus NEW TO HEALTHPATHWAYS – OCTOBER 2014

Management

• • • • • • • • • • • • • • • • • • • •

AgedCareFocus PAL UPDATE ISBAR workshops recap ISBAR stands for Information, Situation, Background, Assessment, Recommendation and is used as a communication tool in acute health care settings. North Coast Medicare Local (NCML) offered ISBAR workshops across our region in September and October to Quality Improvement partners. In NCML’s northern region, the workshops called ‘ISBAR as a Communication Tool’ were run in partnership with North Coast TAFE. On the Mid North Coast, the workshops were run onsite at various Residential Aged Care Facilities. The workshops have been highly effective, with participants agreeing that the simplicity of the method ensures that the learning is easy to provide to all levels of their organisation. Further evidence for ISBAR training can be found in the academic journal BMC Medical Education, which cites that after six months, 54% of people remember the acronym and 94% use ISBAR for telephone referrals. Workshop participants have chosen to implement the ISBAR method of communication in their facilities using a variety of methods according to organisational needs. Some chose to use a staff meeting, while others ran a workshop. One participant made a presentation to their Executive, which resulted in a decision to incorporate it in their organisational policies and procedures. Future ISBAR workshops will be based on the identified needs of the areas. For more information about these and future ISBAR workshops in your area, please contact your local NCML Provider Assistance Liaison Officer. Tweed and Northern Rivers Diana Anderson 07 5523 5516 danderson@ncml.org.au 16

Grafton and Clarence Valley Erin Priest 0409 175 316 epriest@ncml.org.au Mid North Coast Kate Hillenbrand 02 6659 1800 khillenbrand@ncml.org.au

Older Persons Assessment and Liaison Services (OPALS) OPALS is a liaison service that works with older people living in the community and residential aged care facilities. Qualified staff, all highly-experienced in modern dementia and behavioural management, can provide support through the following programs: •

•

Older Persons Assessment and Liaison telehealth (OPAL-T), a program that uses confidential teleconferencing to liaise with medical specialists Delivery of the Memory Assessment Service (MAS), a program that can offer a quick tick memory test through to complex neuropsychiatric testing Delivery of a Behaviour Intervention Program (BIP), a program that offers assessment advice and education in the management of difficult behaviours

OPALS can assist with: • • • •

Assessment, conducted by professional clinical nurse consultants Case planning and management Advocacy Ongoing support and communication with the client, their family and GP

Patient Scenario Colin’s memory started to fail, he struggled to keep up with his day-to-day activities and Sandra gradually moved into the role of carer. They asked their GP for help and he referred them to OPALS. Over the following six months, Colin was diagnosed with Alzheimer’s disease using teleconferencing. OPALS assisted Colin and Sandra with care strategies and enrolled them in a living with memory loss program. Sandra is attending a carers’ support group and they are looking at planning for the future, considering legal, financial and other life decisions. OPALS also provided ongoing support and communication with the patient, their family and GP. Visit www.askopals.com.au, email office@askopals.com.au or phone 1300 856 625 for more information.

AgedCareFocus PAL UPDATE Access to Free Allied Health Courses through TAFE Online

NCML conducted an Allied Health needs assessment in 2013/14 and found accessing continuing professional development to be the highest priority. In addition to providing multidisciplinary, face-to-face professional development sessions, NCML explored opportunities to ensure health professionals working in geographically isolated areas of our region and/or those unable to attend face-to-face events still have access to learning and development opportunities. NCML, in partnership with the North Coast Allied Health Association, is pleased to announce that local allied health professionals now have free access to online professional development through the TAFE NOW website. With NCML’s enrolment key, users will have free and unlimited access to: • • •

Allied Health course topics for allied health professionals Healnet course topics for nurses and other similar medical professionals and Generic short course topics for small businesses and self-interest

Each course takes about an hour to complete and is worth one CPD point. All courses are peer reviewed by industry professionals and endorsed by industry associations. Local health professionals can find out how to access the TAFE Now website and start completing online CPD courses by registering with Healthy North Coast at http://ow.ly/DPQdX and then visiting the North Coast Learning and Development Network.

Dementia Medication Short Film

World Diabetes Day, 14 November

Use World Diabetes Day to promote proactive diabetes management in your practice. Visit http://ow.ly/DHCkb for more information.

PharmacyFocus PAL UPDATE

Congratulations to Lindy Swain North Coast Medicare Local congratulates Lindy Swain, who was named Pharmacist of the Year by the Pharmaceutical Society of Australia (PSA) at the Pharmacy Australia Congress 2014. Lindy, who works at the University Centre for Rural Health in Lismore and Bullinah Aboriginal Health Service in Ballina, received the award in recognition of her work as a clinician, innovator, teacher and researcher in rural areas, and in particular, for her work in improving health outcomes of Indigenous Australians.

November is ‘Movember’

•

recently diagnosed men, which can be downloaded or ordered from http:// goo.gl/P09bfx Beyond Blue has a whole section of their website dedicated to information and resources about depression and anxiety in men http://goo.gl/EwF4ba

General Practices can get involved by holding their own activities to raise awareness about the symptoms, risk factors and treatment for COPD, such as:

Other related online resources include:

• •

•

• 18

The Cancer Council has a range of men-focussed fact sheets, such as “Get Checked – Men” http://goo.gl/ rOGH52 The Prostate Cancer Foundation of Australia has information packs for

•

A static display, with posters, balloons and Lung Health Checklists Inhaler Device Technique checks Risk Assessment and Screenings of interested patients/customers

The Lung Foundation can help practices do these or other activities. Visit http://goo. gl/nsDc7Y for more information.

The Lung Foundation also offers online training to support nurses and other health care professionals, in their work with community and patients with lung disease. Visit http://goo.gl/cMVqZ9 for more information.

PharmacyFocus PAL UPDATE Insulin pump service in Port Macquarie for people with Type 1 Diabetes JK Healthcare in Port Macquarie is excited to be able to offer an insulin pump service for people with Type 1 Diabetes. Jodie Kennett, Credentialed Diabetes Educator and Accredited Practising Dietitian, and the team at JKHealthcare, can assist with the purchase of the pump, arrange existing pump upgrades and provide ongoing pump education. Contact JKHealthcare by phone on 6583 7717 or email admin@jkhealthcare.com.au for more information.

An official launch of this service will be held on 22 January 2015 for health professionals and interested patients. However, there is no need to wait for this date to register your interest in the service. Invitations to the launch will be sent out closer to the date.

World Diabetes Day, 14 November Use World Diabetes Day to promote proactive diabetes management in your practice. Visit http://ow.ly/DHCkb for more information.

ABORIGINAL HEALTH Better Provision of Services to Aboriginal and Torres Strait Islander People North Coast Medicare Local (NCML) Senior Program Officer for Aboriginal Health, Emma Walke, and Academic Pharmacist Lindy Swain, from the University Centre for Rural Health, are offering a series of ‘Better Provision of Services to Aboriginal and Torres Strait Islander People’ information nights to pharmacy staff. The evenings will be packed with information, tips and tools designed to support pharmacists and their teams to build relationships with and provide culturally responsive services to Aboriginal and Torres Strait Islander people. The series kicked off in Ballina and Lismore in October and the two sessions were attended by 35 pharmacists, pharmacy assistants and retail staff. Topics included the health status and some history of Aboriginal people in Northern NSW, programs available to support patients, and tools to use in the pharmacy every day. Christine Sullivan, the Cessation Support Leader for Quit for New Life (Q4NL) talked about the program and the ease of access for both patients and pharmacy. She explained the importance of working with pregnant Aboriginal women and their families to quit smoking in a culturally safe way. Jenny Morgan from Connect, an initiative that links youth with workplaces through traineeships, also presented with a vibrant young Shylene Turner, who completed a schoolbased traineeship in a Northern Rivers pharmacy and who has graduated into a full-time Certificate III in Casino. Positive feedback was received from both events. 19

‘Save the date’ for future events: • • • • •

Grafton - 18 November 2014, 6pm at 139 Vines restaurant Tweed Heads - 2 December 2014, venue to be confirmed Coffs Harbour - 3 December 2014, venue to be confirmed Kempsey - 11 February 2015, venue to be confirmed Port Macquarie - 12 February 2015, venue to be confirmed

Registration flyers will be sent to each pharmacy closer to the date. Places at each event are limited. Please contact Emma Walke on 6618 5400 or Lindy Swain on 6620 7389 for further information.

Pictured: A recent pharmacy event.

PharmacyFocus PREVENTATIVE HEALTH Quit for New Life (Q4NL) program What is Q4NL? Q4NL is a state funded program which supports women who identify as having an Aboriginal baby to quit smoking during pregnancy and to stay quit after the birth of their baby. We have two Q4NL workers employed to work with women and their families to offer a range of support options. These include: • • • • •

Advice on quitting smoking Free nicotine replacement therapy (NRT) for up to 12 weeks Brochures with information on smoking and quitting Quitline for counselling support Follow-up quit support

Meet the Q4NL Team Kristine Horn has been with us since 2013 supporting the Port Macquarie area, and Lynette Vella has recently joined the team to support the Macksville and Coffs Harbour area. Christine Sullivan is the Cessation Support leader for Northern NSW Local Health District, supported by two Aboriginal Health Promotion Officers (Laurel Rogers and Ronella Phillips), and a Cessation Support Officer (Jenni Dann).

CONTACTS Hastings Macleay Clinical Network Kristine Horn Phone: 1300 662 263 Mobile: 0477 391 422 Fax: 6588 2910

Coffs Harbour Clinical Network Lynette Vella Phone: 1300 662 263 Mobile: 0477 322 218 Fax: 6568 2391

Northern NSW Local Health District Christine Sullivan Phone: 02 6674 9517 Mobile: 0417 474 417 Fax: 02 6674 9599

AlliedHealthFocus PAL UPDATE

World Diabetes Day, 14 November

Quit for New Life (Q4NL) program

Use World Diabetes Day to promote proactive diabetes management in your practice. Visit http://ow.ly/DHCkb for more information.

What is Q4NL?

Participate in needs assessment – Adult survivors of child sexual assault Reaching Out Service for Adult Survivors of Childhood Sexual Assault (ROSAS) is currently undertaking a survey of all health and community services professionals in the Northern Rivers. The aim of the survey is to conduct a broad based needs assessment of the supervision, training, support and information needs of a range of professional services who come into contact with adult survivors of child sexual assault. The results of the survey will determine how ROSAS supports professionals through training, support and information so that they may meet the needs of the adult survivors whom they come into contact with in their work. The survey can be completed at: https://www.surveymonkey.com/S/NRJ9959 All participation and feedback is greatly appreciated. 21

PREVENTATIVE HEALTH

Advice on quitting smoking Free nicotine replacement therapy (NRT) for up to 12 weeks Brochures with information on smoking and quitting Quitline for counselling support Follow-up quit support

AlliedHealthFocus MENTAL HEALTH NewAccess: Caring for the Carers With National Carers Week recently (12- 18 October) placing the spotlight on the important work of more than 2.7 million unpaid carers in Australia, now is a great time to talk about how NewAccess can support these valuable team members. Without carers, where would we be? Caring for someone can be a heavy responsibility especially when it is on top of a full-time job and other responsibilities. Carers often do not find time to take care of their own worries, anxieties or low mood. This is where NewAccess – a new beyond blue initiative – can be used as an option. If you are treating someone who has a carer and you see the carer struggling to keep up, NewAccess could be great option of support. Here is a case study to see how…

He also says that he often feels as if he has nothing to look forward to, and that he and Marta are drifting apart. His Access Coach lets him know that his feelings of sadness are normal. In consultation with his Access Coach, Barry begins a program of behavioural activation to begin to schedule into his life some of the activities he has given up and also works through some materials on Dealing with Worry and Problem Solving. Barry is able to recognise that he has been mildly depressed and that his worries about Donny have been overwhelming him. The Dealing with Worry and Problem Solving skills assist him to clarify and find solutions for some of his concerns about Donny, and in discussing this with Marta, he discovers she has similar feelings. Together they plan for Donny’s future and also begin to plan some activities for themselves as a couple.

Case study: Barry and his struggle to see the future*

Although Barry will always have concerns about Donny, he begins to feel less overwhelmed and more able to manage his day to day life.

Barry is the father of Donny (16). Donny is on the autism spectrum and has behavioural and social difficulties. Barry and his wife, Marta, have cared for Donny all his life. Recently, Donny’s three siblings have left home to pursue study or work.

*This case study has been de-identified and changed beyond recognition.

Barry works as a taxi driver and Marta is a full-time carer. Donny attends school daily and is in weekend respite care once every two months. Recently, Barry has been feeling ‘down’ and is arguing a lot with Marta. He used to regularly take Donny to football games, but has stopped doing this; he is irritable at home and not sleeping very well. Barry is referred to NewAccess by Donny’s support worker. At his assessment, Barry speaks about feeling really sad when he thinks of Donny’s future. He worries about what will happen to him when he and Marta can no longer care for Donny.

How would NewAccess be helpful to carers who may be caring for someone with a long-term disability or illness? Being a carer for someone with a long-term illness or disability can be challenging. For some carers, there are times when it all feels too much and this can lead to stress and low moods. NewAccess is a self-guided Low Intensity Cognitive Behavioural Therapy (CBT) program, where trained coaches support people to develop skills in managing low mood/anxiety and life problems. Clients can self-refer, or be referred by a health practitioner or community agency. The program is offered over the phone and can suit carers who may find it difficult to attend face-to-face appointments. Phone 1300 137 934 or visit beyondblue.org.au/ NewAccessCoach for more information about NewAccess.

AlliedHealthFocus NEW TO HEALTHPATHWAYS – OCTOBER 2014

Management

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HNCNews 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. Full instructions for the platform are available at http://bit.ly/1sJgRI7.

Primary Health Network Boundary Announced for North Coast NSW The Australian Government has announced that the boundary for the North Coast Primary Health Network will be the same as North Coast NSW Medicare Local. “We are pleased with the announcement because it is our strong view that this decision is in the best interests of the North Coast NSW community,” said Vahid Saberi, Chief Executive, North Coast NSW Medicare Local (NCML). If given the opportunity to form the North Coast Primary Health Network, NCML will be able to maintain its momentum, avoid disruption to services, and build on existing partnerships and more than two years of tireless work. “The proposed roles and functions of the Primary Health Network closely align to our work, so we are optimistic our submission to become the North Coast Primary Health Network will be competitive, and hopefully successful,” Mr Saberi said.

HNCNews Mental health services directory provides a new Way Ahead The Mental Health Association NSW (MHA) is pleased to announce the official launch of the free Way Ahead Directory of mental health support services online. For the past 20 years, MHA has run two mental health information phone lines. These telephone services have been supported by a database of service providers that callers were requesting information on. This information has now become the Way Ahead Online Directory. “Some mentally ill people require a lot more than just a GP or a psychiatrist. Sometimes they need legal help, financial support and a range of other services. Running the telephone information lines has enabled MHA to tailor the information we provide to their specific requests. The Way Ahead is a truly unique directory of mental health related services and it is hoped to expand the directory to a National level in the future” says Elizabeth Priestley, CEO of MHA. Way Ahead provides other information such as factsheets about mental illness, explanations of common jargon, legislation, Medicare rebates and the structure of NSW Mental Health. Entries are constantly checked and verified.

Lismore City Council takes national honour Lismore City Council has been recognised for best practice in creating healthier communities, announced as the national winner of the 2014 Heart Foundation Local Government Awards. The New South Wales state winner beat six other finalists, in the ‘Councils with populations greater than 15,000’ category, to claim the national award. Click the link to view the complete article: http://ow.ly/Dr1AT

The Way Ahead Directory has been supported in its final stages by a number of Medicare Locals and Partners in Recovery. They were looking at developing their own online databases in isolation until hearing from a woman who had been caring for someone with a mental illness who told them about her positive experiences using the Mental Health Information line. Robert Ford, Director of Mental Health, Eastern Sydney Medicare Local, says “Way Ahead provides easy access to local mental health services. It means that we are better able to increase referral pathways and it is exactly what our health care professionals require.” It is an appropriate name, as the Way Ahead Directory will assist people, wherever they are in NSW, to find their way through our complex system of services, to find the right support they need when they need it most. For more information, vist www.wayahead.org.au.

Young Aussie men take “she’ll be right” approach to bone health More than a third of young Aussie men are taking a ‘she’ll be right’ approach to their bone health, convinced that osteoporosis is unusual in men, says Osteoporosis Australia CEO Gail Morgan. A new survey from Osteoporosis Australia (OA) spoke to more than 1000 Australian men and found significant gaps in young men’s knowledge about their risk of getting the chronic bone disease. “About 40% of the 18-24 year age group believe osteoporosis is rare in men or only occurs in women. As men age their understanding about the condition increases – 55-64 year olds (83%) are most aware of the risks. Significantly, more than a quarter of all men think it is unusual for men to have osteoporosis.

“The fact young men in particular know so little about the disease is concerning because it’s in their 20s and 30s that men need to build up their bone strength to see them protected into old age. Men can buff their bones by getting safe sun exposure, exercising and making sure calcium is part of their diet. “We found that as men age their knowledge of osteoporosis and its potential impact on them also increases, but by then preventive efforts will have less effect.” Click the link to view the complete article: http://ow.ly/Dr5tV

HNCEvents Hastings-Macleay Events 11/11/14 - NCML Wound Care Workshop for Primary Health Care Nurses, Kempsey 12/11/14 - NCML Wound Care Workshop for Primary Health Care Nurses, Port Macquarie 25/11/14 - How to Manage Diabetes in General Practice: Healthy Living with Diabetes Workshop for Practice Nurses, Port Macquarie

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

Tweed Events 8/11/14 - Spirometry Training Workshop, Tweed Heads 12/11/14 - Tweed Valley Clinical Society GP Dinner Meeting 4/12/14 - Alcohol & Other Drugs: what people working with adolescents need to know, Tweed Heads

Other Events Mid North Coast Events 10/11/14 - Wound Care Workshop for Primary Health Care Nurses, Coffs Harbour 12/11/14 - Practice Management Education for Practice Managers and Practice Staff, Coffs Harbour 26/11/14 - How to Manage Diabetes in General Practice: Healthy Living with Diabetes Workshop for Practice Nurses, Coffs Harbour 27/11/14 - How to Manage Diabetes in General Practice: Healthy Living with Diabetes Workshop for Practice Nurses, Grafton 9-14/3/15 - Eating Disorders Essentials Course, Coffs Harbour

7/11/2014 - Medical Director and PracSoft Training for General Practice Staff, Gold Coast 7-8/11/14 - Chronic Disease Management Workshop, Mercure Brisbane 13-14/11/2014 - Interpersonal Psychotherapy for adolescents and adults, Burwood 15/11/14 - Hunter Parkinsonâ&#x20AC;&#x2122;s Disease Masterclass, Newcastle 26-27/11/2014 - Grief, loss, transition and change, Burwood 3-5/12/14 - Fifty Shades of Pain Conference, Brisbane 5-6/12/14 - Chronic Disease Management Workshop, Swissotel Sydney 15-18/3/15 - Managing Pain: From Mechanism to Policy, Brisbane

Northern Rivers Events 7/11/14 - Radiotherapy Open Day, Lismore 14-15/11/14 - Short Course in Sexual Health Nursing, Lismore 18-19/11/14 - Managing an Evaluation of a Program or Service, Alstonville 19/11/14 - Hoarding and Squalor Info Session, Lismore 25/11/14 - Alcohol & Other Drugs: what people working with adolescents need to know, Lismore 6/12/14 - Engaging Adolescents, Mullumbimby

HNCclassifieds WOMEN’S SPECIALIST CENTRE

VRGP POSITION AVAILABLE

Dr Triveni Nanda (MBBS, DGO, FRANZCOG) will be opening her private practice Women’s Specialist Centre on the 17th of November 2014. Her practice will provide the women of Coffs Harbour a 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

UNIVERSITY OF NSW Port Macquarie Rural Medical School would like to thank the GPs who have responded to the invitation to become a conjoint lecturer in the Facility of Medicine. Further information will be sent shortly. For any further queries, please contact Ms. Julianne Weatherley at j.weatherley@UNSW.edu.au or A/Prof A R (Sandy) McColl at a.mccoll@unsw.edu.au.

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

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. 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 28

GPS & NURSES - LISMORE, TWEED, BYRON Passionate about making a difference? Looking for a challenging and rewarding experience? North Coast Medicare Local (NCML) is calling for expressions of interest from GPs and nurses to provide medical services at health clinics for homeless and disadvantaged people in Lismore, Tweed Heads and Byron Bay on a contractual or pro-bono basis. The Winsome Health Outreach Clinic, Lismore NCML, in partnership with Northern NSW Local Health District (NNSWLHD), the St. Vincent de Paul Society and The Winsome, has been providing an outreach health service on-site at The Winsome, a large facility owned and run by the Lismore Soup Kitchen Inc. The Winsome is a highly regarded community-based service providing valuable support for some of the Northern Rivers’ most vulnerable people. The Winsome provides accommodation for up to 17 men and daily meals for all people in need. Every Wednesday morning, an Outreach Health clinic is held on-site, providing free GP and clinical nursing services. NNSWLHD provides a Community Nurse each week. The Clinic is well-established and wellutilised. Seventy-seven patients accessed the clinic over the last 12 months, with nearly 400 occasions of service occurring. In the next six months, NCML and St Vincent de Paul are working to construct a purpose-built clinic on the ground floor of The Winsome, comprising of a doctor’s room, a nurse’s room and a reception/waiting area. Fred’s Place Outreach Clinic, Tweed Heads NCML, in partnership with the St. Vincent de Paul Society, provides an outreach health service on-site at Fred’s Place – a day centre for people who are homeless or at risk of homelessness in Tweed Heads. GP and nursing services are provided every second Tuesday afternoon from 12-3pm. Byron Bay NCML is seeking expressions of interest from GPs who are interested in providing outreach services to people who are homeless or at risk of homelessness in Byron Bay. Please contact Monika Wheeler, Program Manager on (02) 6622 4453 or email mwheeler@ncml.org.au if you are interested in contributing to these valuable services.

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

URGENTLY SEEKING GP - LISMORE FAMILY PLANNING SERVICE Lismore Family Planning offers specialist reproductive and sexual health services. We offer bulk billed services and we are looking for a Medical Practitioner to join our clinic. In addition to the Thursday and Saturday clinics at Lismore, there is an option to work at our Kyogle Outreach clinic every second Friday. You should be registered with the NSW Medical Board with current authority and provider number for NSW, and hold the SH&FPA certificate in Sexual and Reproductive Health. The position offers casual hours in Lismore/Kyogle and above award conditions.

Exciting opportunity to join a friendly and modern rural medical practice. Work full-time, part-time or flexible hours. Situated in a rural country-town setting, yet enjoy close access to some of the most beautiful North Coast Beaches. Existing patient database with occupation health opportunities, supported by a group of experienced and dedicated doctors. A fully computerised practice with full nursing and administrative support plus Allied Health on-site or within the same complex. Applicants must have basic medical training and competency in all areas of general practice. Contact Kempsey GP Clinic (02) 6583 83 83 Level 1, 35 Belgrave Street, Kempsey, NSW

PRACTICE MANAGER FOR COFFS HARBOUR GP SUPER CLINIC

Contact Julie on 6620 1870 or email applications@nrsdc. org.au.

This exciting clinic is a non-profit initiative dedicated to providing comprehensive, multi-practitioner primary health services for the Mid North Coast community.

INVITATION TO PARTICIPATE IN STUDY

This fantastic opportunity will attract a dynamic practice management professional with a successful record in program assimilation, plus the gravitas and charisma to inspire a team committed to shared objectives.

This invitation is for psychologists, social workers, clinicians and case managers working in the trauma field to participate in a trauma and growth study. Participation in this study is voluntary and the completed surveys are entirely anonymous and confidential (with exception of Sharon Black and her supervisor at CSU who is conducting the study, your name remains completely confidential). If you are willing to become involved in this research, please follow the link below. It will take you to a detailed information sheet and a questionnaire set. http://www.surveymonkey.com/s/QHXQP5H If you have any questions, please contact Sharon Black via email at scblack@bigpond.com or her CSU supervisor Dr Gene Hodgins on 02 6933 2746 or ghodgins@csu.edu.au.

GP REQUIRED - KEMPSEY

Salary and conditions to be negotiated. Generous salary packaging is available. Please send a CV (Word format, up to 5 pages) to leavina@bawrunga.com.au or ring Tracey on (02) 6568 6100, in confidence.

HNCclassifieds EOI FOR NORTH COAST HEALTHPATHWAYS CLINICAL WRITERS Expressions of interest are sought for Clinical Writers for the North Coast HealthPathways team. 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. 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 and Richmond Valley who will be supported and resourced to develop the skills necessary to write new pathways and modify existing pathways. Successful applicants would also be required 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 Employment will be on a casual basis, flexible hours, with remuneration in accordance with NCML Policy. 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 30

Calling all GPs & Allied Health Professionals who have an interest in the health of young people: headspace Port Macquarie would love to hear from you. Contact Jenny Sinclair on 02 6588 7300 or jsinclair@each.com.au for an informal discussion.

OPPORTUNITY TO JOIN AN EXCITING, INNOVATIVE TEAM - PORT MACQUARIE An opportunity exists for a General Practitioner or Registrar interested in skin cancer and musculoskeletal medicine to join the team at Greenmeadows Medical, an innovative and patient focused medical practice. Our doctors are supported by a wide range of allied health practitioners including Physiotherapy, Exercise Physiotherapist, Podiatry, Dietitian, Psychology, Social Work and Pathology. This unique integration of health care under one roof provides patients with easier access to services and better outcomes for their overall health. This practice has broad consulting hours to allow flexible working times. It offers a position that allows the GP to have an excellent work / life balance. The practice is committed to ongoing education and will pay for appropriate skin cancer & musculoskeletal medicine courses for the successful applicant. Visit www.greenmeadowsmedical.com.au to experience a virtual tour of our centre and to meet the team. For enquiries, please contact Robert Clarke on 02 55251111 or Robert@greenmeadowsmedical.com.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