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CONNECT AUGUST 2021
adelaidephn.com.au | enquiry@adelaidephn.com.au | 8219 5900
In this issue...
Connect August 2021 | Adelaide PHN in Action
4...
Welcoming our New CEO
6...
Commissioning Matters
8...
Supporting the Response to COVID-19
10...
Primary Health Care Awards Coming Soon
12...
HealthPathways SA Update
14...
Health Care Homes Program Wrap-up
16...
Shingles... Which Vaccine?
20...
Supporting NAIDOC Week
22...
Membership Update
24...
Greater Choice for at Home Palliative Care Measure
28...
Digital Health Update
36...
Primary Care in Action
Cover photo: Bank Street, Adelaide CBD
We acknowledge the Kaurna peoples who are the Traditional Custodians of the Adelaide region. We pay tribute to their physical and spiritual connection to land, waters and community, enduring now as it has been throughout time. We pay respect to them, their culture and to Elders past and present.
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PHYSICAL DISTANCING IS ONE OF THE BEST THINGS WE CAN DO TO STOP THE SPREAD OF CORONAVIRUS.
1.5 METRES
So let’s all avoid crowded places and try keeping 1.5 metres apart whenever and wherever we can. It won’t be forever, and it’s a way we can all play our part in helping stop the spread of coronavirus.
SWAP
Handshake
SWAP
Wave
Face-to-face
FaceTime
SWAP
Big night out
Movie night in
WHERE PHYSICAL DISTANCING IS NOT POSSIBLE, ALWAYS PRACTISE GOOD HYGIENE. FOR MORE PHYSICAL DISTANCING TIPS, VISIT STOPTHESPREAD.SA.GOV.AU sahealth.sa.gov.au/COVID2019
facebook.com/SAHealth
@SAHealth
Connect August 2021 | Adelaide PHN in Action
WELCOMING OUR NEW CEO
Michelle McKay Hello!
What a brilliant first few weeks I’ve had at Adelaide PHN. The staff have been extremely welcoming, and the Leadership Team have been busy getting me up to speed on all things Adelaide PHN! Having come from a clinical background, with experience in the public and not-for-profit health sectors, and a personal commitment to servicing the community, I am very eager to dive into the wonderful work that Adelaide PHN is doing in the primary health care space across our region. Until then, I will be taking the time to reflect on the organisation’s vision, purpose, and strategic priorities. From what I have seen in my first few weeks, I know that I have a wonderful team of people who are committed to our organisation’s key values and delivering on our purpose. I very much look forward to working with the Board, Leadership Team, and staff, and to build upon the strong foundations and achievements of the organisation. I am also extremely grateful for the hard work and support from our Interim CEO (now Deputy CEO), Sarah Murray, during this transition phase.
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I have also had the opportunity to meet with some of our stakeholders and members through various meetings. I very much look forward to meeting and engaging with more of our stakeholder groups over the coming months. In terms of exciting things to come, we will be hosting our annual Primary Health Care Awards in October. This year, Adelaide PHN is looking to recognise the hard work and dedication of primary health care organisations across our region who have been responsive to our community’s needs in an everchanging environment. Nominations for the awards will be opening to all current Adelaide PHN commissioned service providers, general practices, membership groups and those involved in our partnership activities. Award categories and more information will be provided shortly – stay tuned! This edition of Connect covers an array of activities and achievements from the last few months – covering our continued support for COVID-19, an update on our recent membership recruitment, a wrap-up from our Health Care Homes program, and what we’ve been doing in the digital health space. Stay safe and enjoy the warming weather! Warm regards, Michelle McKay, CEO
Connect August 2021 | Adelaide PHN in Action
Commissioning Matters An update on commissioning Adelaide PHN receives funding from the Australian Government Department of Health to commission services which meet the health needs of the Adelaide metropolitan community. Below is a summary of our recent commissioning activities.
UPDATE MENTAL HEALTH IN RESIDENTIAL AGED CARE EXPANSION
Adelaide PHN is pleased to announce the expansion of commissioned mental health services within residential aged care facilities (RACFs) in metropolitan Adelaide. Relationships Australia South Australia (RASA) has been delivering the Supporting Emotional Wellness in Aged Care Program since January 2020, which provides in-reach low intensity groups and psychological therapies, individual sessions to residents, and mental health literacy training to RACF staff. This program expanded from 1 August 2021 to include low intensity individual sessions, which will support residents,who are who are ‘at risk of’ or present as mildly depressed or anxious but do not have a diagnosis, and mental health literacy training for families. One-to-one individual sessions will be available for: • Residents/people transitioning into aged care facilities to receive support to develop collaborative strategies to address transition issues; • Residents who are having trouble settling, adjusting to changes, or coping with loss; • Residents with mild to moderate needs where low intensity/early intervention social support has been identified as beneficial; and • Residents with a history of mental illness for which they received services before being admitted to a RACF which could not be continued Additionally, the referral pathway for these services will be expanded to include referrals from allied health practitioners, family, friends, other community services and self-referral. Referrals are to be sent to MHRACF@rasa.org.au. Please refer to our website’s directory listing for service and referral information.
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COMMISSIONING UPDATE ALCOHOL AND OTHER DRUGS (AOD) TREATMENT SERVICES PROGRAM 2021-2023
In late 2019, Adelaide PHN commenced a review and re-design of the AOD Treatment Services program within the region. Underpinned by the Needs Assessment, this process was focused on understanding new and emerging substances of concern and enabling priority populations access to high quality AOD treatment services. The design centered around supporting consistent, high quality service delivery and resulted in the creation of the new Adelaide PHN Treatment and Quality Framework. The framework translates the Needs Assessment into a well-defined, outcomes-focused service model - developed collaboratively, drawing on expertise, experience, capabilities, knowledge and data from all key stakeholders. It also seeks to avoid service duplication - aligning with both the National Quality Framework for AOD Treatment Services and the SA Specialist AOD Treatment Service Delivery Framework, and aiming to set out a complementary mix of services to that commissioned by Drug and Alcohol Services SA (DASSA). In November 2020, Adelaide PHN approached the market and invited applications from suitably qualified and experienced organisations to provide services in line with the new framework. As a result of this process, Adelaide PHN is pleased to confirm the following providers have been commissioned from 1 July 2021: • Mission Australia - Drug and Alcohol Youth Outreach Service - young people aged 10 - 25 • Uniting Communities - Streetlink - young people aged 10-25 with complex needs • Mission Australia - Partners Towards Wellbeing - other population-based priority groups • Thorne Harbour Health - Alcohol and Other Drug Service - LGBTIQ people • Nunkuwarrin Yunti - Harm Minimisation Team - Aboriginal and Torres Strait Islander people • PsychMed - The Matrix Program - methamphetamine • Offenders Aid and Rehabilitation Services of South Australia (OARS) Rehabilitation Treatment Services - people in contact with the criminal justice system Information on the specific AOD treatment services available within this program and how to refer can be found via our website’s directory listing. Adelaide PHN looks forward to working with the service providers and other key stakeholders over the next two years to ensure that appropriate and quality AOD treatment services continue to be provided to people within the Adelaide PHN region.
Connect August 2021 | Adelaide PHN in Action
Supporting the Response to COVID-19 Playing a key role in the South Australian Response Adelaide PHN continues to play a key role in the South Australian response to COVID-19, including supporting the coordination of the vaccine roll-out. Since the beginning of the year, Adelaide PHN has supported the • Onboarding of over 200 general practices as part of the vaccine roll-out (providing both AstraZeneca and Pfizer) • Four Commonwealth Vaccination Clinics vaccine roll-out (providing both AstraZeneca and Pfizer) • An Aboriginal Community Controlled Health Service (providing both AstraZeneca and Pfizer) • Weekly vaccines allocation in general practices • Transfer of vaccines from clinics to reduce potential wastage • PPE coordination and dissemination - over 35,700 N95 masks and 200,000 surgical masks (as well as gowns, gloves and hand sanitizer) • Coordination and support for RACF staff vaccinations. Approximately 74% of aged care staff in SA have had at least one COVID-19 vaccine dose • Coordination and support for residents in RACF vaccinations. Approximately 82% of residents in SA have had at least one COVID-19 vaccine dose. We are deeply appreciative of the overwhelming and positive support received by our general practices throughout the vaccine roll-out. We will continue to keep practices, providers and our community up to date with the latest COVID-19 information as it becomes available. Our dedicated COVID-19 team can be contacted via 8314 3698 or covid19@adelaidephn.com.au. Please visit adelaidephn.com.au/covid-19 to access relevant links, resources, and updated information.
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Respiratory and Vaccination Clinics Adelaide PHN continues to support the four GP-led Respiratory/ Vaccination Clinics across the Adelaide metropolitan area to support the assessment of anyone experiencing mild to moderate respiratory conditions, or those eligible to receive their COVID-19 vaccine. If you are experiencing respiratory symptoms such as fever, shortness of breath, sore throat, cough, fatigue or runny nose, or are eligible to receive your vaccine, book an appointment at a GP Respiratory/Vaccination Clinic online or over the phone via the details provided. A reminder that from 30 August 2021, all individuals aged over 12 years are eligible to be vaccinated. Please visit the SA Health website for eligibility criteria and more information. For more information about the Respiratory Clinics or to access updated resources, please visit adelaidephn.com.au/covid-19.
You can book a COVID-19 test or vaccination online or over the phone via: Adelaide Central Respiratory Clinic/ Adelaide Central Vaccination Clinic (257 Fullarton Road, Parkside) • Book COVID-19 testing online via this link (Adelaide Central Respiratory Clinic) • Book COVID-19 vaccinations online via this link (Adelaide Central Vaccination Clinic) • Call 0475 724 107 North Eastern Respiratory Clinic/ Northern Vaccination Clinic (1185 Main North Road, Pooraka) • Book COVID-19 testing online via this link (North Eastern Respiratory Clinic) • Book COVID-19 vaccinations online via this link (Northern Vaccination Clinic) • Call 7089 5799 Reynella Respiratory Clinic/ Vaccination Clinic (216 Old South Road, Old Reynella) • Booking online via this link • Call 0478 455 771 Athelstone Respiratory Clinic/ Vaccination Clinic (33 Fox Ave, Athelstone) • Booking online via this link • Call 08 8166 2125
Connect August 2021 | Adelaide PHN in Action
Adelaide PHN’s
Primary Health Care Awards Nominations opening soon Adelaide PHN’s Primary Health Care Awards are opening soon! The Primary Health Care Awards are designed to celebrate the outstanding achievement in improving the health and wellbeing of our community across the Adelaide metropolitan region. This year, Adelaide PHN is looking to recognise the hard work and dedication of primary health care organisations across our region who have been responsive to our community’s needs in an ever-changing environment. Award categories will be announced shortly. Prizes include • First prize Professional development sponsorship to the value of $3,000, trophy and framed certificate, and picture and article in our November Connect newsletter. • Second prize Professional development sponsorship to the value of $1,500, trophy and framed certificate, and picture and article in our November Connect newsletter. Awards are open to any Adelaide PHN commissioned service provider, Health Care Homes practices, Care Connections sites, and those who are part of Adelaide PHN’s partnership activities. Awards will be announced and presented at our Annual Primary Health Care Awards Dinner on Saturday 23 October 2021. Details to follow. Please contact us via enquiry@adelaidephn.com.au should you have any questions.
This article was written by a member of the Corporate Services team
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25–74 years old
CERVICAL screening
YEARS
EVERY
5
A simple test could save your life. Talk to your GP about cancer screening today.
Connect August 2021 | Adelaide PHN in Action
HealthPathways SA update Supporting your patients with chronic pain Did you know: one in five Australians will experience chronic pain in their lifetime? In SA, a GP focus group involved in a SA pain project estimated that 25% of their patients experienced chronic pain. Chronic Pain within General Practice The majority of chronic pain is managed in the primary care sector with GPs responsible for patient care. Managing patients can be complex, and often requires a collaborative, multidisciplinary approach with the GP playing a central role within the treatment team. In supporting your patients consider: • A GP Management Plan and Team Care Arrangement to help develop a multidisciplinary care team. Information on billable MBS items are available on HealthPathways SA: Chronic Disease MBS Items • Online or tele support services to help patients with self management: Find out more here • Pain management plan e.g., ACI Pain Management Network – Quick Steps to Manage Chronic Pain in Primary Care Access information to support assessment, management and care for your patients experiencing chronic non-cancer pain on HealthPathways SA: including information on medication management and referral pathways for specialist, allied health and mental health.
“Management of chronic pain is a challenging issue to navigate for GP’s. The pathway combines easy to follow clinical advice with links to resources for patient self-management, as well as links to community resources and key referral pathways in South Australia.” Dr Simon Lockwood, GP Clinical Editor
Thanks to South Australian GP Simon Lockwood, and Pain Specialists Dr Tim Semple and Dr Porhan Kang for their effort and work in development of the pathway Chronic Non-cancer Pain in Adults - Community HealthPathways South
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The HealthPathways SA team celebrate
250+ available pathways!
Visit the HealthPathways SA site to find out more
Support for patients with perinatal depression and anxiety Information to support care for your patients experiencing perinatal depression and anxiety is now available on HealthPathways SA, including information on assessment, non-pharmacological treatments and referral options for community and mental health support.
“It is so important that GPs are confident with identifying women who are at risk of, or who have developed perinatal depression and anxiety. Assessing and managing these women well is critical not only for their health, but also for the health of their babies and families. The Perinatal Depression and Anxiety pathway has been developed in conjunction with a leading South Australian perinatal psychiatrist. The pathway outlines the referral pathways and available support services within SA. This resource is invaluable in terms of supporting South Australian GPs in this complex area of clinical practice.“ Dr Katrina Couchman, GP Clinical Editor.
HealthPathways wishes to thank Dr Ros Powrie (Perinatal Psychiatrist) who developed the pathway with Dr Couchman, and all those who provided feedback on the draft for their time and valuable contribution to pathway development. For all queries, please contact the HealthPathways South Australia team: enquiries@sahealthpathways.com.au.
This article was written by a member of the HealthPathways SA team
Connect August 2021 | Adelaide PHN in Action
Health Care Homes Program wrap-up After several years of hard work and transformation, Health Care Homes (HCH) wrapped up on 30 June 2021. HCH was a Department of Health program that ran in 106 general practices and Aboriginal Community Controlled Health Services (ACCHS) in 10 PHNs around Australia (as at June 2021). The program originated from the recognition that one in four Australians have at least two chronic health conditions and require care from different health professionals who often work in different locations. It was also recognised that there is often a lack of coordination and communication between the different parts of the health system involved in a patient’s care team, causing frustrations for patients and their families/carers, risks to patient safety and increased costs to the health system. As such, HCH was introduced as an opportunity to improve the coordination of care for patients with chronic and complex conditions. When HCH commenced, involved practices enrolled patients into their HCH. The patients were risk stratified with the CSIRO Risk Stratification Tool. A new bundled payment system was trialed, allowing the general practices to step away from the Medicare fee for service model for their enrolled patients’ chronic conditions, and to trial new and innovative ways for managing these patients. In June 2021, there were 7,810 patients enrolled in 106 HCH practices around Australia. Of these, 13 HCH practices and 1,732 patients enrolled were in Adelaide. The HCH practices and their patients found the program to be a great success and improvement to health care. The bundle payment enabled easier access to health care as different consulting methods could be trialed. The practices could trial telehealth consults prior to its introduction to Medicare during COVID. Telehealth enabled patients to access care remotely when they couldn’t attend face to face consults due to work/carer responsibilities, mobility/transport access issues and other reasons. Telehealth helped patients to remain up to date with their care and provided more efficient and convenient access to scripts and repeat referrals (with appropriate discretion). Some practices used the bundle payment to fund group exercise classes and falls and balance classes for healthy ageing. Group classes provided opportunities for peer support, more efficient health activities (reaching a greater section of the population) and social connectedness. It also provided funding opportunities for exercise physiologists, physiotherapists and other allied health providers outside of the standard EPC visits funded by Medicare.
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HCH saw the introduction of funded nurse-only consults, where nurses could educate, counsel and motivate patients. There was greater recognition by the care team and the patients of the important role played by nurses. This extra support has seen patients come off pain medications, feel more confident, lose weight effectively and safely, and has contributed to fewer hospital admissions and ED presentations. Some HCH practices trialed the Ward Round concept. Nurses and/or medical practice assistants met with doctors and then followed up with patients, organising pathology forms and measures to be performed for a patient prior to their appointment with the doctor. This helped to avoid patients slipping through the cracks and made care more efficient. The HCH practices utilised Inca, an electronic shared care planning portal. Inca meant up-to-date patient health information was easily accessible to all members of a patient’s care team (including their doctor and nurse team, allied health, specialists and for some practices, the hospital). Patients could use Inca to access their own notes, documents, summaries and referrals, as active members of their care team.
Inca was also implemented into two Northern Adelaide Local Health Network (NALHN) Hospitals, a big step in the journey towards efficient and timely information sharing between primary and tertiary health care. HCH practices reported that the HCH funded focus on the quadruple aim and clinician experience helped them to discuss burnout and burnout prevention more frequently. It also helped identify opportunities to enhance workplace wellness. Strategies included avoiding work on days off (scheduling work appropriately), ongoing peer support, healthy physical and psychological habits within clinics (e.g. healthy eating, exercise at lunchtime, lunch daily and lunch together whenever possible, etc.). This has facilitated modelling of healthy habits for trainees and younger/ newer members of teams and building healthier practice cultures. Overall, the HCH Program was a big success for the involved general practices and improving the health outcomes of their patients. It demonstrated how a patient centred medical home model and coordinated patient care could work towards achieving the quadruple aim of primary health care.
This article was written by a member of Adelaide PHN’s Integration and Design team
Connect August 2021 | Adelaide PHN in Action
Shingles... Which Vaccine? An message from our Immunisation Hub Coordinator While COVID-19 has disrupted the world and the COVID-19 Vaccination Program has had a huge focus, notification of some other diseases has also been affected. Take influenza (flu) for example, closed borders, wearing masks, hand hygiene, staying home if we are unwell (instead of soldiering on!) and social distancing has significantly reduced the amount of flu notifications in Australia. For example, between 1 January and 24 July in 2019, there were 21,872 flu notifications in South Australia. Then the pandemic came in early 2020 and reduced flu notifications to 1,572 for the same period. This year, for the same period, we have only had 16 notifications. However, one disease that has not been greatly influenced by all the COVID-19 measures we have in place, is shingles. Generally, SA Health receives between 1,200 and 1,900 notifications per year. Currently, as at 24 July 2021, there are 1,414 notifications.
What is shingles? Shingles is a reactivation of the varicella-zoster virus (VZV) the same virus that causes chickenpox earlier in life. After a bout of chickenpox, the virus stays and locks itself away in the roots of spinal nerves and certain nerves in your head. However, at some stage, in some people, the virus activates, and irritates the nerve it has chosen to lay in.
This usually happens when our immune system ages, hence why shingles is more common as we age, or when our immune system is under stress through medical conditions or immune suppressing treatments. Will I catch shingles from someone else? You can’t catch shingles from someone who has shingles. Shingles comes from within you so if you have had chickenpox, you have the virus laying in your nerve system. However, the fluid in the blisters of the shingles rash is infectious and may cause chickenpox infection in someone who has not had chickenpox before. People are advised to keep the blisters covered until they are dry and crust over. What are your chances of having shingles? By the time we reach 80 years of age, about half of us will experience shingles. Most cases of shingles (over 70%) occur in people aged over 50 years. This means that there are 6.5 infections per 1,000 population in people aged 50–59 years to over 14 infections per 1,000 population in those aged over 70 years. How bad can it get? Well, pretty bad! Apart from an exceptionally painful, irritating, and unsightly rash, there is a risk of complications such as secondary bacterial infections and nerve palsies.
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The most common is persistent chronic neuropathic (nerve) pain known as postherpetic neuralgia. This is when the pain lasts for 3 months or more from the start of the rash. The risk of postherpetic neuralgia also increases with age from approximately 1 in 10 cases in 50–59-yearolds to 1 in 4 cases in those aged over 80 years. The pain is usually severe and very difficult to control and can last from months to years. Can I reduce my chances of contracting shingles disease? YES! The best way to reduce your chance of experiencing shingles is to get vaccinated! If you reduce your chance of having shingles, then you reduce your chance of experiencing postherpetic neuralgia. There are two vaccines to protect against shingles available in Australia. Both are for use in people aged 50 years and older: Zostavax is a live-virus vaccine and is given as a single dose. This vaccine is FREE for people at 70 years of age. Until 31 October 2021, people aged 71 to 79 years can receive this dose FREE as part of a catchup program. If you, or anyone you know is in this age group, be aware of this vaccine and talk to your GP about receiving a dose. Studies demonstrate that the effectiveness of preventing shingles with Zostavax vaccine differs with the age of the recipient, however reducing the incidence of postherpetic neuralgia was similar across age groups.
Overall, the vaccine is around 51.3% effective in preventing shingles and about 66.5% effective in preventing postherpetic neuralgia. Being a live-virus vaccine, it is not suitable for some individuals. A risk assessment will be undertaken by your doctor or practice nurse before the vaccine is administered. Shingrix is a non-live vaccine and is given in a two dose schedule, two to six months apart. This vaccine is NOT FREE for anyone. You will need to see your GP and obtain a prescription. Studies demonstrate this vaccine provided 97% protection against shingles in healthy adults aged 50 years and older, and 91% in healthy adults aged 70 years and older. The protection from postherpetic neuralgia was also high, about 89 – 91%. Can I have the vaccine if I have had shingles? YES! If you have had shingles before, you can receive the shingles vaccine. It is suggested that the shingles vaccine can be given at least 12 months after an episode of shingles. Can I have Shingrix if I have already had Zostavax vaccine? People who have previously received Zostavax can receive Shingrix if they wish to increase their protection against shingles. It is recommended to wait at least 12 months between receiving Zostavax vaccine and receiving Shingrix vaccine.
Connect August 2021 | Adelaide PHN in Action
A word from our Immunisation Hub Coordinator on COVID-19 vaccines Now, once again, let’s mention the COVID-19 vaccination! The Immunisation Hub continues to support providers and residential aged care facilities with the rollout of the COVID-19 Vaccination Program. We continue to stress that both COVID-19 vaccines used in Australia are safe and effective. Both the Pfizer and AstraZeneca COVID-19 vaccines may have very rare, serious side effects …. like all other medications. These serious events are very rare. Vaccine recipients are made aware of these side effects and are informed of what symptoms to watch for. These side effects can be well managed and treated, especially when diagnosed early.
How good is a single dose? Well, since it is the Olympics, we will call a single dose a “participation certificate”. Receiving the second dose will give you a “gold medal!!”. This is why Angela Newbound, our Immunisation Hub Coordinator, not only ‘talks the talk’ but ‘walks the walk’ and has now received her second dose of the AstraZeneca vaccine!! Her vaccination certificates are like Olympic Games gold medals…. she is very proud to have them!
Both vaccines have the same outcome, which is reducing serious illness and death from the COVID-19 infection. If you are currently eligible for the COVID-19 vaccine, please make an appointment and get vaccinated as soon as possible. There is a risk in waiting to get vaccinated. Another outbreak may occur and you will not have the required protection from COVID-19.
Photo: Angela Newbound Immunisation Hub Coordinator
This article was written by Adelaide PHN’s Immunisation Hub Coordinator
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South Australians have done a great job helping stop the spread of COVID-19. And with the arrival of effective vaccines proven safe around the world, we can all play our part to protect ourselves, our loved ones and SA.
21033.5
ROLL UP TO PROTECT YOURSELF AND YOUR LOVED ONES.
Connect August 2021 | Adelaide PHN in Action
NAIDOC Week Adelaide PHN supports NAIDOC week The O’Sullivan Beach/Lonsdale Football Club Reconciliation Round for 2021 was an inspiring grass roots community event held in southern Adelaide. The football club is truly committed to reconciliation by ‘building respectful relationships between First Nations people and the wider Australian community to enable both to work together to close the gap, and to achieve a shared sense of fairness and justice’. Anthony Bernhardt who is long standing team member of the Adelaide PHN commissioned Aboriginal health program – Integrated Team Care, is leading the reconciliation work which the O’Sullivan Beach/Lonsdale Football Club is committed to. The event was attended by a number of key Aboriginal Elders and community members, including a number of Adelaide PHN commissioned service providers. The pre-match opening ceremony brought both clubs and officials together on the oval and were greeted to country by Karl Telfer. Karl is a senior man from the Mullawirra meyunna - Dry forest people/family clan (Grandfathers line) which is known today as the Kaurna Nation from the Adelaide region. The Hon Katrine Hildyard member for Reynell and the Hon Kyam Maher Shadow Minister for Aboriginal Affairs spoke of Reconciliation in our community and identified the gaps that need to be addressed.
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Elders and their families were treated to a luncheon on the day, which was supported by Sonder. Schania Czygan, Indigenous Health Project Officer, Sonder, coordinated this aspect of the day and it was a great opportunity for families to catch up and be part of reconciliation in the south. Adelaide PHN had the honor of sponsoring the Reconciliation Round A grade football team guernseys. Doug Clinch Snr is one of the life members of the football club and not only designed the Reconciliation Round guernsey, but also the Reconciliation Round medal. The event was a resounding success and has been considered the building block to progress the event as a permanent feature at the O’Sullivan Beach/Lonsdale Football Club for the Reconciliation round.
Please refer to our Innovate Reconciliation Action Plan to see where we are on our reconciliation journey. You can also access a list of commissioned Aboriginal health services via our website’s directory.
Photo: O’Sullivan Beach/Lonsdale Football Club
This article was written by a member of Adelaide PHN’s Integration and Design team
Connect August 2021 | Adelaide PHN in Action
Membership Update An update from our membership team We held our first combined membership meeting on Wednesday 16 June 2021, for the Annual Needs Assessment consultation. The meeting was held locally at The Precinct Conference Centre in Thebarton. We had a total of 29 members in attendance, spanning our Community Advisory Councils, Network Leadership Group and Aboriginal Community Advisory Council. The interactive workshop - hosted by the Enzyme Group and led by Adelaide PHN’s Data Quality and Support team - sought to refine the issues, needs and opportunities of health and services across our region. A report has been produced as a result of the consultation and the Data Quality and Support team are currently undertaking a deep dive and thematic analysis of the workshop findings; to further refine our Needs Assessment report to the Commonwealth in November 2021.
Photo: Adelaide PHN combined membership groups
2021 Membership Recruitment Membership recruitment for this year commenced on Monday 17 May 2021 with Expression of Interest closing Friday 2 July 2021. We received numerous applications from a range of high calibre clinicians, community members, and strategic thinkers and influencers. New members are appointed for a sitting term of two years with the option to be reappointed for a further two years. Adelaide PHN will be appointing the new members in the coming weeks, in time for our first meeting of the new financial year. We will introduce the new members to you in the next edition of Connect – stay tuned. This year saw several members retire; we thank them for their contribution towards improving the health outcomes of people in our region.
These articles were written by a member of Adelaide PHN’s Integration and Design team
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Connect August 2021 | Adelaide PHN in Action
Greater Choice for at Home Palliative Care Measure An update from our Palliative Care Improvement Coordinators
The first and second phase of the Greater Choice for at Home Palliative Care (GCfAHPC) measure was implemented from January 2019 – June 2021. The GCfAHPC measure aims to improve the coordination of palliative care through the PHNs. This measure is important because across South Australia, evidence shows that being cared for and dying at home is most people’s preference. The goals of this measure are to: • Improve access to the best palliative care at home • Support palliative care services in primary health and community care • Make sure you get the right care, at the right time and in the right place to reduce unnecessary hospital visits • Generate and use data to improve services • Use technology to provide flexible and responsive care, including after-hours care In South Australia, approximately 70% of deaths are expected and due to a life limiting illness, however many people do not have a good death and without reference to their hopes and wishes, beliefs or preferences.
Older Australians entering residential aged care facilities increasingly experience cognitive decline, disability, frailty and illness and most residents do not have an advance care plan which communicates their health care decisions, wishes and choices. A significant barrier to advance care planning is a lack of clinician and community awareness, skills, support and comfort in initiating advance care planning conversations. Advance care planning benefits everyone including the person, their family, carers and health professionals and can ensure people receive the care they actually want. Phase 1 and 2 of the GCfAHPC measure (2019 -2021) focused on recruiting qualitative improvement coordinators and implementing a quality improvement process in advance care planning and in residential aged care. In phase 1, Adelaide PHN worked with eight residential aged care organisations and 28 facilities. 21 facilities transferred into phase 2 of the measure. The quality improvement coordinators worked with senior leadership in the residential aged care organisations, recruited a lead nurse in each residential
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aged care facility, worked in partnership with a specialist palliative care consultant to provide training, education, coaching and mentoring, and developed an advance care planning tool kit for the residential aged care facilities. Phase 1 of the measure established the foundation for the quality improvement activity. Phase 2 continued to develop this work and the summary below highlights the key outcomes at the completion of the measure in June 2021. • Successful quality improvement in the advance care planning process was achieved in all the residential aged care facilities • All new admissions and residents who experienced a change in their health status had an advance care planning meeting/s • On average, an 80% increase over baseline in the number of residents who had an Advance Care Directive or a My Life Decisions document that provided details of the resident’s health care decisions, choices and wishes • On average, an 80% improvement over baseline of advance care plans reviewed at care plan review and at any time of change or deterioration to the resident’s health status • The Supportive and Palliative Care Indicators Tool (SPICT) and Surprise Question have become recognised tools in all facilities, on average, 70% of residents had been assessed using the SPICT and Surprise Question • The implementation of a non-statutory advance care plan called My Life’s Decisions for residents who were unable to complete the statutory Advance Care Directive
• All facilities involved GPs in the completion of SA Health’s 7 Step Pathway to reflect the advance care plan and facilitate transfer between the facility and hospital • 160 nurses received advance care planning and palliative care training and were tasked to share their learning in their facility • 120 personal care workers received training about palliative care and how to care for a resident when they were dying. 10 facilities supported the role of a “palliative care champion” for personal care workers • The establishment of a support and knowledge sharing network for lead nurses • The development of an advance care planning resource based on the quality improvement process • Implementation of facility practices which acknowledge and respect the death of the resident • The sharing of learnings from the measure with SA Health to support the planning of activity under their strategic priorities • A major change has been the involvement of the resident in an advance care planning meeting/s. Process mapping at the beginning of the measure demonstrated the practice of defaulting to family members to complete an advance care plan. Facilities used a variety of advance care planning documents most commonly the good palliative care plan. These documents focused on the residents wishes regarding resuscitation and were mainly determined by the family
Connect August 2021 | Adelaide PHN in Action
Adelaide PHN has received continued funding for the GCfAHPC measure from 1 July 2021 – 30 June 2025 and has commenced the planning process, currently meeting and discussing with key stakeholders the opportunities for further activity against the measure. The principles guiding the planning process are: • Ensuring the quality improvement measure aligns to Adelaide PHN priorities • Incorporating the learnings from the 11 PHN pilot sites • The involvement of the Adelaide PHN commissioned workforce, specifically those supporting Aboriginal and Torres Strait Islander communities • Partnership work with organisations in South Australia tasked to implement the National Palliative Care Strategy 2018, the Implementation Plan 2020, the Strategic Framework 2021-2026 • Alignment of activity with the Government’s Response to the Review of the Advance Care Directive Act 2013 which acknowledges the requirement to support South Australians in the community to complete an Advance Care Directive • Learnings from national and international compassionate community models of care for general practice and primary care and the Palliative Experience in the Palliative Approach (PEPA) training for general practitioners • Utilise the learning from phase 1 and 2 and its potential translation to support providers of palliative care through homecare packages • To ensure data supports and provides direction for phase 3 • To ensure the use of technology is incorporated into future proofing the measure
The GCfAHPC team will provide regular updates as this work progresses. For further information, please contact our Palliative Care Improvement Coordinators, Julie Armitage or Lyn McVee on 8219 5900.
This article was written by a member of Adelaide PHN’s Integration and Design team
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Connect August 2021 | Adelaide PHN in Action
digital health update
Adelaide PHN’s
Digital Health Update An update from our practice support and digital health team, including relevant resources and news relating to quality improvement activities, training and professional development, integrated care, practice incentives and general support. You can get in touch with our teams by emailing Practice support practicesupport@adelaidephn.com.au Digital health digitalhealthinfo@adelaidephn.com.au
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Providing PenCS Support to Local Practices Adelaide PHN continues to offer free PenCS licences to metropolitan general practices Adelaide PHN is continuing to provide general practices within the Adelaide metropolitan region the opportunity to obtain a free licence for the PenCS software. This includes PIP QI essentials package to support the Quality Improvement Practice Incentive Program, foster broader quality improvement in general practice and improve delivery of primary health care in South Australia. The end of this quarter has seen Adelaide PHN support 241 practices across the Adelaide metropolitan region with a fully subsidised PenCS licence. Adelaide PHN will continue to offer free PenCS licensing for practices that agree to share full de-identified data set to Adelaide PHN. Practices that wish to only share the 10 PIP QI measures will need to contact PenCS to arrange to purchase a licence for their practice. For more information on licensing, training and/or resources please contact the Digital Health team at digitalhealthinfo@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
Connect August 2021 | Adelaide PHN in Action
Secure Messaging UPDATE
CRU fax disabled from 30 June 2021
Adelaide PHN’s Central Referral Unit (CRU) clinically triages referrals for primary mental health care services across the Adelaide region. This centralised point of entry allows easy access to a wide range of services commissioned across the stepped care continuum. To support the safe and secure exchange of clinical information between health care providers and our CRU, Adelaide PHN disabled the fax on June 30 and adopted the use of secure messaging. The CRU has been able to safely receive electronic referrals from HealthLink, Argus and ReferralNet. The use of post, fax or email to share patient and clinical information is an unsecure and unencrypted method of communication which poses both security and clinical risks due to the potential of interference. Secure messaging however offers security, auditability and privacy, ensuring the communication is encrypted and received by the intended recipient within the secure messaging network. There has been a great response to the use of secure messaging to the CRU from general practice since the 30 June 2021, and this has meant the CRU team are able to reject less referrals due to missing patient information, improving processing time. If your practice would like help with secure messaging, please see the following instructions on how to send a referral and add the CRU to your address book for HealthLink, ReferralNet or Argus. Copies can also be found on our website resource library.
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HealthLink Instructions EDI: adphncru
ReferralNet or Argus Instructions ID: CRU
Best Practice • Setting up your address book • Sending a referral
Best Practice • Setting up your address book • Sending a referral
Zedmed • Setting up your address book • Sending a referral
Zedmed • Setting up your address book • Sending a referral
Medical Director • Setting up your address book • Sending a referral
Medical Director • Setting up your address book • Sending a referral
*Best Practice/Zedmed Argus users need to contact Argus to activate ReferralNet to Argus sending. Adelaide PHN is also offering general practices without any secure messaging platform a free ReferralNet licence to be able to send referrals to the CRU. Please note this licence will allow you to send unlimited referrals to the CRU only, however you will still be able to receive messages from any organisation/provider. If your practice needs any support relating to this update, including adding the CRU to your address book, or would like a free ReferralNet licence, please contact the Digital Health team at digitalhealthinfo@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
Connect August 2021 | Adelaide PHN in Action
Services Australia Switching to web services in 2022 On 13 March 2022, Services Australia will switch to web services. If you use software to submit claims and transmit data to them, these upgrades will affect you. Channels to be upgraded to web services: • Medicare Online • Pharmaceutical Benefits Scheme (PBS) Online • ECLIPSE • Aged Care Online • Australian Immunisation Register (AIR) – via Medicare Online • Department of Veterans’ Affairs (DVA) – via Medicare Online The upgrades are being implemented to ensure that the claiming and data systems provided: • Are secure and stable, now and into the future • Meet current technology and security standards • Are flexible and easy to update and improve If you don’t upgrade to web services before March 2022, you may need to revert to either a manual process or alternative digital channels where available. This may create additional administrative pressure and costs for your business. Check with your software developer if you need to register for Provider Digital Access (PRODA) to conduct electronic business with Services Australia securely. Also confirm with them when they plan to transition you to web services. For more information see the Web Services eKit or contact Adelaide PHN via digitalhealthinfo@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
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Specialised Enhanced Access Grants Supporting specialist practices In late 2020, Adelaide PHN released a number of Enhanced Access Grants (EAG) targeting digital health innovation in specialist practice. The grants aimed to support specialist health clinics to actively engage in current digital health solutions with a whole of practice approach. Clinics were required to actively contribute to patient My Health Records, communicate with other health care providers via secure message delivery (SMD), map existing general practice referral pathways and establish ongoing digital health sustainability plans through existing best practice quality improvement methodology. Each quarter, clinics endeavored to meet ongoing key performance indicators to ensure the end goal of the EAG was met. One clinic who did this particularly well was Paediatrics at Burnside, who went above and beyond with their EAG and took the ongoing requirements in their stride. More than doubling the Event Summary upload requirements and almost quadrupling their outbound SMD communications from the previous year, the clinic set a high bar. Recent figures indicate additional growth on top of that as the team continues to excel.
The clinic continued to exceed expectations as they overhauled their existing general My Health Record Security and Access policy, familiarising themselves with the relevant legislation as they revamped and made the policy clinic specific. A staff training register, ongoing usage and educational requirements were also established to ensure best practice continues from their clinicians into the future. By embedding simple systematic changes Paediatrics at Burnside have been able to greatly enhance timeliness in patient outcomes and accessibility to patient information with little impact to workflow or load – a great outcome for the clinic and its patients. These grants continue to be available for the short-term future and can still be applied for if you know of, or belong to a specialist clinic who might be interested in taking the next step of their digital health journey. For more information, please get in touch with Adelaide PHN’s Practice Support team via practicesupport@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
Connect August 2021 | Adelaide PHN in Action
Healthdirect Video Call Telehealth System Supporting practices and patients to facilitate safe health consultations Healthdirect Video Call has been developed by Healthdirect Australia to make it easy for health care providers to offer their services via video consultation. Patients can connect with their health care professional from anywhere that is convenient, using everyday devices such as a smartphone, tablet or desktop computer. Healthdirect Video Call is able to support practices and patients to facilitate health consultations while staying safe during these times. The pilot program for the healthdirect Video Call platform has also been extended to 30 June 2022. This will allow for continued use for current users and is still open for anyone wanting to start using the platform. Licenses can be provided to GP services and also non-GP type primary care services classed as mental health, aged care, maternity, Indigenous health and allied health services. To request a licence, please contact Adelaide PHN’s Digital Health team via digitalhealthinfo@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
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My Health Record Training Modules Training for pathology staff With the increased uptake of the My Health Record system within Pathology laboratories, the Royal College of Pathologists of Australasia and Australian Digital Health Agency launched the new My Health Record Continuing Professional Development modules. The two modules of the eLearning course provide an overview of the My Health Record and its use in pathology and obligations with respect to privacy, security and access. Pathology staff can access these training modules here. Adelaide PHN is also continuing to work with health care providers to connect and use the My Health Record system. If your practice would like support connecting to the My Health Record, please contact practicesupport@adelaidephn.com.au.
This article was written by a member of Adelaide PHN’s Digital Health team
Connect August 2021 | Adelaide PHN in Action
ADELAIDE PRIMARY CARE IN ACTION Highlights of programs and activities affecting the delivery and experience of primary health care across the Adelaide metropolitan region
AUTISM CONNECT National autism helpline Autism Connect is Australia’s first national autism helpline. It is a free and confidential one-stop helpline service, providing expert information and advice about autism. Autism Connect supports autistic people, their families and carers, health professionals, and broader community. There are currently over 200,000 autistic people in Australia, with this number growing as understanding about autism increases. As valued health professionals, it’s likely you are providing care for autistic people. Autism Connect advisors are available to discuss anything related to autism and supporting autistic people. This includes diagnosis support, navigating the NDIS, finding local services and support and more. Autism Connect is available by phone, email, webchat or self-search online resource directory: • Phone: 1300 308 699 • Email: info@autismconnect.org.au • Webchat and search: amaze.org.au/autismconnect
This article was provided by Amaze
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Hospital-level care delivered in the comfort of a patient’s home. My Home Hospital provides treatment for a range of conditions for which in-home care is considered appropriate. Available for eligible public patients 24 hours, 7 days a week across the Adelaide metropolitan region and, from 1 July 2021, Barossa Hills Fleurieu.
For more information or to download the referral form, visit myhomehospital.sa.gov.au
FIS: 21012.6
For 24/7 clinical advice or referral support call 1800 111 644.
Connect August 2021 | Adelaide PHN in Action
ADELAIDE
PRIMARY CARE IN ACTION
SCRIPTCHECKSA Supporting prescribers and pharmacists ScriptCheckSA provides prescribers and pharmacists with real-time information about their patients’ access to monitored drugs and can help prescribers and pharmacists make safer clinical decisions about which medicines to prescribe or supply. ScriptCheckSA does not prevent health practitioners from prescribing or dispensing a monitored drug they consider to be clinically necessary. Health practitioners are still responsible for their own clinical decision making. Since its release in March 2021, 22% of medical practitioners and 52% of pharmacists have registered. Health practitioners using ScriptCheckSA are reporting that it is helping to support their clinical decision making. With one GP saying that ScriptCheckSA helped them identify a patient who was obtaining monitored drug prescriptions from other prescribers without their knowledge. Another reported that “an alert in ScriptCheckSA opened-up a conversation with my patient about the harms associated with opioids and as a result the patient agreed to reduce their dose, which they were previously resistant to.” It is expected that it will become mandatory to use ScriptCheckSA next year. A formal evaluation of the implementation is currently underway and public consultation on the proposed amendments to the Controlled Substances (Poisons) Regulations 2011 will commence in the coming months. ScriptCheckSA registration, login and access to the free online training is available at scriptcheck.sa.gov.au. More information about ScriptCheckSA, including support resources can be found at sahealth.sa.gov.au/scriptchecksa and questions can be sent to Health.RTPM@sa.gov.au.
This article was provided by SA Health
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TURN
HELP PSYCHOSIS AROUND
Psychosis can be a frightening and often misunderstood illness that can turn a young person’s world upside down. The earlier it’s diagnosed, the sooner we can turn it around. headspace Early Psychosis offers specialist services to help young people experiencing psychosis.
headspace.org.au/earlypsychosis headspace National Youth Mental Health Foundation is funded by the Australian Government Department of Health.
Connect August 2021 | Adelaide PHN in Action
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IS IT REALLY AN EMERGENCY? SA Health campaign SA Health has launched the ‘Is it really an emergency?’ campaign to encourage people that do not need to attend an Emergency Department (ED) or call Triple Zero (000) to find the best, most appropriate care for their situation. People may go to an ED or ring Triple Zero when they may not be aware of afterhours services available to them, they may require a bulk-billing service, or don’t know where else to turn. The most urgent patients are prioritised and attended to first, so non-urgent patients may have to wait to be seen. The community are encouraged to seek other health care alternatives such as pharmacies, GPs, out-of-hours medical centres, or self-care at home for nonlife threatening illness or injury. People can find alternative care options through healthdirect by calling 1800 022 222 or visiting healthdirect.gov.au. In an emergency or life threatening situation, people should always call Triple Zero (000). For general enquiries, contact the Marketing Communications team at SA Health on 8226 6599 or healthcommunications@sa.gov.au.
This article was provided by SA Health
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Consider the best health care option for you before visiting an Emergency Department or calling Triple Zero (000).
Find an afterhours or bulk billing GP clinic near you
1800 022 222
If it is an emergency, we are here for you.
Connect August 2021 | Adelaide PHN in Action
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MANUAL OF RESOURCES IN ABORIGINAL AND TORRES STRAIT ISLANDER SUICIDE PREVENTION Supporting Indigenous suicide prevention The Centre of Best Practice in Aboriginal and Torres Strait Islander Prevention (CBPATSISP) recently launched the Manual of Resources in Aboriginal and Torres Strait Islander Suicide Prevention.
The Online Manual was developed following intensive community consultation with communities, clinicians, funders and individuals and groups representing Aboriginal and Torres Strait Islander youth, crisis and postvention.
The resource is the first Online Manual bringing together a comprehensive collection of resources and tools for all people involved in Indigenous suicide prevention, including • Individual, families, Elders and community members • Clinicians and frontline workers • Primary Health Networks and funding organisations
“People told us they need help navigating the information that is out there on the internet, to know what is current, safe and relevant to Aboriginal and Torres Strait Islander people. So, we have curated the Manual as a one-stop hub to provide real, practical guidance to different user groups.
Professor Pat Dudgeon, Director of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, said the manual would help communities and professionals quickly identify culturally responsive materials to support their work.
The collection of resources includes downloadable checklists, decisionmaking tools and case studies aimed at preventing suicide and promoting positive mental health and social and emotional wellbeing.
The suicide rate of Aboriginal and Torres Strait Islander people is twice that of other Australians, and four times as high among children and youth.
By responding culturally and spiritually and not just considering suicide a mental health issue, the resources in the Manual have the potential to save lives.
“The resource has the opportunity to make a real difference by bringing together the three target groups, community, funding bodies and frontline workers’ and equipping them with the tools and resources to respond to the distinctive cultural and spiritual wellbeing needs of Indigenous people”, Professor Dudgeon said.
A copy of the resource can be accessed via cbpatsisp.com.au/the-manual-ofresources.
This article was provided by CBPATSISP
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ONE STOP SCREENING SHOP Breast, cervical testing, bowel screening, well health check and education In partnership with Wellbeing SA and BreastScreen SA, Watto Purrunna are hosting two ‘One Stop Screening Shop’ sessions in September at Wonggangga Turtpandi - 11 Church Street, Port Adelaide. Women’s One Stop Screening Shop (for women aged 25-74 years) Get your breast, cervical testing and bowel screening Screening day - Friday 3 September 2021 9.00am - 4.00pm
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A copy of the flyers can be accessed via the links above. For more information and to book a spot, please call Wonggangga Turtpandi on (08) 8240 9611.
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This article was provided by Watto Purrunna Aboriginal Primary Health Care Services
Connect August 2021 | Adelaide PHN in Action
ADELAIDE
PRIMARY CARE IN ACTION
NALHN’S DIABETES SERVICE No longer offering appointments The Northern Adelaide Local Health Network (NALHN) Diabetes Centre will no longer be offering appointments for consumers with newly diagnosed type 2 diabetes. Historically these appointments have been poorly attended and unfortunately divert resources from other areas where they are needed within our diabetes service. As an alternative we recommend referral of patients with newly diagnosed type 2 diabetes to a Diabetes SA online course. Diabetes SA offer a range of online courses to help your patient understand and manage their diabetes better. Courses are free and can be done at any time provided consumers have internet access. Courses include: 1. Type 2 Diabetes and Me 2. How diabetes can affect your body 3. Healthy Eating 4. Food Label Reading 5. DESMOND 6. Diabetes and Medications 7. Hypoglycaemia 8. Travelling with diabetes They also offer educational events and webinars. You can access the course via the Diabetes SA website. Many other information sheets and resources can be found here. NALHN have taken the liberty of sending a copy of this information directly to your patient using the details provided in your referral. For all future consumers newly diagnosed with type 2 diabetes please refer them directly to the Diabetes SA resources.
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Alternatively, please view Australian Diabetes Educators Association (ADEA) site to find a credentialled diabetes educator (CDE) in primary health care. Please ensure to register all patients with newly diagnosed diabetes with the National Diabetes Services Scheme (NDSS) via ndss.com.au. NALHN continue to welcome new referrals for consumers presenting with: • Type 1/autoimmune Diabetes, Pre-existing and newly diagnosed • Type 2 diabetes – inadequate or deteriorating control; advancing complications; with commercial licencing requirements • Other diabetes types e.g. secondary diabetes; monogenic diabetes • Consumers using diabetes technology including continuous subcutaneous insulin infusion pumps (CSII), Continuous glucose and Flash glucose monitoring Please refer to NALHN Outpatient Service Information, Triaging and Referral Guidelines for more information, or visit the SA Health website.
This article was provided by NALHN
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URGENT MENTAL HEALTH CARE CENTRE A welcoming place for people experiencing a mental health crisis It’s 6pm and you’re seeing your last patient for the day, a woman with a history of complex childhood trauma who is very distressed because she got a text from her boyfriend this morning telling her that he is breaking up with her. You are concerned about her – she doesn’t have any concrete plans to harm herself but she has very little support and she lives alone. You don’t want to send her to ED because you have heard that they are ramping again and you know she will have a long wait to be seen. What do you do? Fortunately, there is a solution – it’s called the Urgent Mental Health Care Centre (UMHCC)! The UMHCC was set up by Neami National last year to try to address the gap when a person needs support to allow them to self regulate when in crisis but is not unwell enough to need admission to hospital. It is based on a model that uses the combined skills of peer support workers and mental health clinicians to assist people in a safe, calming and nurturing environment. Opening hours are from 12pm to 12am every day, with people accepted up until 10.30pm. Referrals were initially only accepted from SAAS, SAPOL or ED but can now be from GPs or as walkins. They recommend that GPs ring first to check on capacity and to discuss suitability for the service (see flyer). Age range is from 16 upwards but 16-17 year olds on section 56/57 and adults on ITOs are not accepted. On arrival at the centre, the person will first be assessed by a peer support worker who will then explain the centre set up and take them through into what is called the lounge room. This large space includes recliner chairs, shared tables, access to hot and cold food and drinks, free WIFI, a shower and clean clothes if needed and individual spaces to allow for private discussions. Pets and children can be accommodated in purpose designed rooms if required but must stay in that room while in the centre. The average length of stay is around 3-4 hours. Links can be made with other services and the person is supported to develop their own plan of care. To find out more about the service and access their resources, please visit the Neami National website.
This article was provided by a CALHN GP Liaison Officer
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HELPING SMOKERS QUIT Free health professional training to assist smokers to quit Free online training is now available to health professionals and other social services professionals to assist smokers to quit. The courses are available to South Australians through funding provided by SA Health and are available via the Quit website. The courses, developed by Cancer Council Victoria, are tailored to a variety of professions: • Alcohol and other drug services • Community and social services • Eye health professionals • General practitioners and nurse practitioners • Health services • Maternity health • Mental health • Oral health The training provides guidance on how to apply a three-step brief smoking cessation advice model (ask, advise, help) when talking to clients about their smoking and also covers: • The health effects of smoking and the benefits of quitting • How smoking is addictive • Evidence-based smoking cessation interventions • How to use Quitline services and resources to address smoking with your patients/client Smoking is consistently Australia’s number one risk factor contributing to disease burden and deaths. You can play a part in changing this statistic by addressing smoking with your clients/patients. The training can contribute to Continuing Professional Development points.
This article was provided by SA Health
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STRENGTH FOR LIFE COTA SA initiative The Strength for Life (SFL) program is an initiative of COTA SA, the peak body for older people in South Australia and is funded by the Department of Health. Each week, thousands of older South Australians are undertaking specialised strength and balance training with 100 SFL providers across the State. These sessions are led by qualified fitness professionals, physiotherapists or exercise physiologists, who tailor strength training programs to suit individual needs. Who is Strength for Life for? SFL promotes health and wellbeing for people aged 50+ (40+ for Aboriginal and Torres Strait Islanders) through progressive strength and balance training. It is suitable for all clients who can transfer independently and have no severe cognitive issues. Tier 1 and Tier 2 Providers • Tier 1 Providers involve physiotherapists or exercise physiologists directly in their program. Tier 1 may attract rebates from health funds (and sometimes from Medicare). Clients can be referred initially for primary care plans; they can transition to SFL for ongoing exercise. • Tier 2 Providers use fitness instructors to conduct their SFL programs and confidently manage participants’ long-term needs. • Co-located Tier 1 and Tier 2 Clients are triaged to determine whether they have an initial assessment with an allied health professional or a fitness professional, depending on their needs. What are the costs? • Tier 2: Participants pay a maximum of $30 for their assessment and program. They also pay a maximum of $8 per session or an equivalent monthly or weekly fee. • Tier 1: Participants pay a maximum of $55 for a full assessment with an Exercise Physiologist, They also pay a maximum of $10 per session ($8 if the session is conducted by a fitness instructor).
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What are the benefits? SFL can have simple but life-changing results. Strength training: • Improves balance • Increases muscle strength and functional mobility • Reduces the risk of falls • Can manage the effects of chronic conditions • Can improve mental wellbeing, self-esteem and confidence and the ability to maintain an active and independent lifestyle. More than 19,000 older South Australians have progressed through the SFL program since its inception in 2004; it is one of South Australia’s most successful preventative health programs for people aged 50+. How do you join? Medical practitioners can refer their clients directly into SFL Providers here. There is also a referral form for allied health (Physio and Exercise Physiologists) Referral forms can be found via the COTA SA website.
This article was provided by COTA SA
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STAAR-SA RESEARCH PROJECT Supporting RACFs Local Health Network clinicians have been working with other cross sectoral stakeholders to test ideas that have the potential to improve transitions of care, and reduce unplanned admissions and re-presentations for older people using a ‘proof of concept’ approach. This is being undertaken by a Quality Improvement Collaborative as part of the STAAR-SA Project (State Action on Avoidable Rehospitalisations and Unplanned Admissions). Ideas tested include: • Reducing unplanned admissions for residents of residential aged care facilities (RACFs) by: • Establishing a ‘single point of contact’ with metropolitan Local Health Network Geriatricians to enable GPs, RACFs and South Australian Ambulance Service (SAAS) to seek advice about alternative care pathways for RACF residents who are at imminent risk of presenting to hospital. • Improving transition from hospital to RACF for patients with ‘challenging behaviours’ due to Behavioural and Psychological Symptoms of Dementia (BPSD) by: improving discharge communication and clinical handover, and trial of support team to assist during the transition as a ‘wrap-around’ service. • Improving end of life care planning for patients transitioning from hospital to residential care for the first time by: commencing goal of care conversations in hospital, and ensuring clear documentation in the discharge summary and 7-step pathway. • Reducing re-presentations to hospital due to medication risk by: using a screening tool to identify patients over 65 years who are at high risk of representation due to their medication risk, and recommending a GP initiated Home Medicines Review. Learnings will be used to inform system design changes to support improved transitions of care from hospital to home, both in the community and in RACFs, and to reduce unplanned admissions and re-presentations to hospital for older people. For more information please contact: Carmel McNamara, Senior Translational Project Officer, College of Nursing and Health Sciences carmel.mcnamara@flinders.edu.au.
This article was provided by Wellbeing SA
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Learn how to ask at ruok.org.au
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CLINICAL PRIORITISATION CRITERIA Supporting long wait lists for care One of the biggest challenges facing public hospital outpatients in South Australia currently is long wait lists for care. There are multiple reasons for this, including reductions in funding for public services but also related to the sheer numbers of referrals, the sparse level of detail in many of those referrals which makes accurate triage impossible and lack of transparency to the public and GPs about what can realistically be seen in a timely fashion. One measure being undertaken to address this is the development of statewide clinical prioritisation criteria (CPCs) for referrals, modelled on the ones developed by Queensland Health in 2015. South Australia is currently working on CPCs for six specialities with long waiting lists – ENT, vascular, orthopaedics, cardiology, neurology and gastroenterology. The multi-disciplinary working groups formulating the CPCs are made up of hospital based consultant specialists, allied health practitioners and nurses as well as GPs. Once developed, the CPCs will then go to the wider community for consultation before being finalised and implemented. CPCs are designed to do several things. They provide a set of agreed minimum criteria for information and investigations that must be included in a referral before that referral can be accepted for triage. They clarify what conditions can and cannot be seen in a public hospital outpatients department and in what time period those conditions are likely to be seen – while suggesting alternative pathways for GPs to either manage these conditions themselves with support as needed or refer to another part of the system, depending on which is more appropriate. This allows the patient and the GP to make a shared, informed decision about how to proceed in order to ensure management occurs in the most timely fashion and the best place. Having investigations completed and available at the time of triage not only allows more accurate triage but also means that the initial appointment in the public OPD can be both efficient and effective as care is not delayed by having to organise further tests or by unnecessary duplication of tests which have already been done but are not available for viewing. Efficient use of outpatient clinic time then means that more patients can access care more quickly and benefits the whole system.
This article was provided by a CALHN GP Liaison Officer
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UNI SA MENTAL HEALTH RESEARCH Providing solutions and opportunities for people experiencing mental health issues With one in five Australians impacted by a mental health condition during their lifetime, it is crucial that we strive for the best services, supports and solutions. At the University of South Australia (UniSA) our mental health researchers are working with clinicians and health providers on solutions and creating opportunities for people in mental distress or at risk of suicide to live a flourishing life. Information in this link provides a snapshot of some of the work they have underway: Research will enable us to better understand current mental health issues, inform clinical practices and co-design compassion-based care with lived experience knowledge and leadership, for new and improved services in our community. But critical changes, that are needed at point of care with frontline workers, will only change if we invest in research. UniSA has launched a Mental Health Research Fund to support our key researchers to address current mental health challenges. The University’s commitment to research is such that 100% of any donation goes directly to the cause. Together, we can strive for long-term wellbeing by informing both prevention and treatment of mental ill health through research. To learn more, and to donate, visit: unisa.edu.au/mentalhealth
This article was provided by the University of South Australia
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CALHN WEBINAR FOR GPS Webinar round-up The second ever CALHN Webinar for GPs was held on 9 June 2021, with an audience of over 25 GPs, consumer representatives and other clinicians. There were three speakers, Dr Pravin Hissaria from the Department of Allergy and Immunology who spoke on “COVID-19 Anaphylaxis and vaccination reactions – what does the research say? When and how to refer to the specialist vaccination clinic at the RAH, Dr Ericka Flores from the Department of Hepatology who spoke on Hepatocellular carcinoma (HCC) and diabetes audit data and tools to identify cirrhosis risk and Dr Jackie Yeoh who spoke on behalf of the CICC (CALHN Intermediate Care Co-ordinators) Team on Hospital Avoidance Services. Dr Hissaria’s presentation on the research conducted by the RAH Immunology department gave some fascinating insights as to why the guidelines for the specialist vaccination clinic had varied over time as he explained the process that led to identifying the part of the vaccine adjuvant causing anaphylaxis and clarified the newest criteria for the clinic and how and when to refer. Dr Flores spoke about her research into NAFLD (non alcoholic fatty liver disease), now rechristened MAFLD (metabolic and fatty liver disease) and linked with diabetes and the metabolic syndrome. She discussed the importance of investigating abnormal liver function tests with ultrasound of the liver and using tools such as the FIB-4 score to screen for liver fibrosis as well as fibroscans, with early referral to a hepatologist if fibrosis is detected, thus allowing monitoring for HCC with detection and treatment as early as possible.
The final presentation was on options for hospital avoidance, timely as with the increased demands on our hospital Emergency Departments over winter it is vital that GPs are aware of the alternative options that exist for patients to be managed in the community. These include Metropolitan Referral Unit, My Home Hospital, the CALHN Hospital Avoidance Supported Discharge Service (HASDS), Priority Care Centres (PCCs) and the Urgent Mental Health Care Centre (UHMCC) in the city – a lot of acronyms to remember! However, CICC (CALHN Intermediate Care Coordinators) act as the first point of contact – a team of nurses available from 8am-8pm every day to assist in guiding GPs to find the best service in the fastest time for the patient – 0475 813 345, a number to have on speed dial in any GP’s phone! Links and more information: • My Home Hospital SA Health - 1800 111 644 • Priority Care Centres Adelaide PHN SA Health • Urgent Mental Health Care Centre Neami National - 8448 9100 • Hospital Avoidance Supported Discharge Service 0435 237 270 • CICC 0475 813 345
This article was provided by a CALHN GP Liaison Officer
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Connect August 2021 | Adelaide PHN in Action
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