Issuu

CONNECT MAY 2020

adelaidephn.com.au

IN THIS ISSUE

CEO Foreword

Commissioning Matters

Our Response to COVID-19

Respiratory Clinics

Supporting Telehealth Providers

PIP, WIP and Accreditation

Electronic Prescribing

Membership Update

Aboriginal Screening Program

Pushing for Change

HealthPathways Update

Immunisation Hub

Supporting Palliative Care

headspace Peer Worker Project

Central Referral Unit

An Update on CSP Mental Health Services

Supporting our CSPs

Primary Care in Action

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. Please note, with the support from communities we consulted with, the term Aboriginal is used across this publication as an all-encompassing term for Aboriginal and Torres Strait Islander people and cultures.

Hello from Deb

Well these are certainly challenging and stressful times as we continue to flatten the curve and deal with the COVID-19 pandemic. Our sympathies and thoughts are with the families and friends of those who have died. We remain passionate and committed to ensuring support for our primary health care providers, particularly our GPs, pharmacists and frontline health professionals who continue to provide care to people. We also continue to do our best to support our regionâ€™s community members who are experiencing our health system in quite different ways throughout this pandemic. We know that there are still lots of people out there with multiple chronic conditions and those that have ongoing health issues who still need support and care. The swift introduction of telehealth â€“ whether via computer/tablet or phone was a much welcomed initiative from the Commonwealth, as were the expansions on various items and to a broader range of MBS providers. Keeping our community safe alongside our frontline health professionals is supported by us all.

You will find a dedicated COVID-19 page on our website where you can access resources, bulletins, GP Respiratory Clinic details and more. Adelaide PHN, with our colleagues from Country SA PHN, are embedded in the SA Control Centre. The Control Centre continues to monitor issues/concerns/logistics/supplies and centralised tasks and communications. It continues to be a very effective and efficient way to ensure that everyone works together accordingly. We continue to be the distribution point for surgical masks from the National Medical Stockpile – these masks are being distributed to all general practices, community pharmacy, Aboriginal Community Controlled Health Organisations and other allied health providers. We are also ensuring supply of P2/N95 masks for our GP Respiratory Clinics, along with gowns, gloves and testing swabs. SA Health has also been assisting us with extra PPE stock from the State’s Medical Stockpile – a great collaborative effort to ensure we keep our frontline health professionals as safe as possible. We are actively encouraging GPs to conserve PPE stocks – sending patients to testing centres or the GP Respiratory Clinics (where full kit PPE is being maximised) wherever possible. Whilst PPE supplies are beginning to flow again, we are not out of the woods yet. Supplies were indeed critically low, and we need to ensure that we can continue to maintain supply, most especially now that elective surgery will recommence soon. We are also doing our very best to support our commissioned service providers (CSPs) through this pandemic. We totally understand that contract deliverables for most have changed in modality or have had to be postponed until restrictions are completely lifted. If there is anything else we can do to support you, please let us know. We are committed to ensuring that none of our CSPs will be disadvantaged due to difficulties in delivery during this time. Last but by no means least – we continue to support our membership, already part way through a re-structure and our staff, ensuring that we keep them involved and as safe as possible over this period. Stay safe, well and (I’ve always wanted to say this), be careful out there! Warm regards,

COMMISSIONING MATTERS News from our development and commissioning team Adelaide PHN receives funding from the Australian Government Department of Health to commission services which respond to the health needs of the Adelaide metropolitan community. Below is a summary of our recent commissioning activities and announcements.

Update: Continuity of Service Program Commissioning soon and pre-tender briefing Adelaide PHN will soon be inviting applications from suitably qualified and experienced organisations to deliver the Continuity of Service (CoS) Program and will be holding a pre-tender briefing to support potential providers with preparing their application. This program will provide psychosocial support activities for clients who previously accessed support under Partners in Recovery (PIR), Support for Day to Day Living in the Community (D2DL) and Personal Helpers and Mentors (PHaMs) and who have been found ineligible for the National Disability Insurance Scheme (NDIS). The services will be commissioned via an open tender process (Request for Proposal (RFP)) which we anticipate releasing early in June 2020. The services will form part of the Commonwealth Government’s Psychosocial Support for People with Severe Mental Illness measure. Commonwealth Continuity of Support (CoS) Guidance can be found here.

Overview of services to be commissioned: Supports delivered under this program will be predominantly group based, focused on building individual capacity, and provide additional targeted one on one support at times of increased need according to the person’s individual plan. These services, in partnership with families and carers (as appropriate), will provide a range of non-clinical community based support to these individuals to achieve their recovery goals.

The four key aims of the CoS Program are to: • • • •

Increase personal capacity, confidence and self-reliance Increase social participation Streamline access to appropriate services Provide flexible and responsive support at times of increased need

The pre-tender briefing will be held via Zoom on Monday 1 June 2020 between 2.30PM - 3.30PM. Organisations interested in participating in the Pre-Tender Briefing webinar are asked to register via Eventbrite. A Zoom link will be emailed to registrants. We encourage interested applicants to register to receive alerts via Adelaide PHN’s Tenderlink portal: tenderlink.com/adelaidephn.

Update: headspace Marion Centre Request for Tender The Request for Tender for headspace Marion Centre closed on 21 February 2020. A preferred provider has been identified and Adelaide PHN is now in contract negotiations and anticipates announcing the preferred provider before the end of May 2020. Keep an eye on our website. The headspace Marion Centre aims to deliver support and services for young people aged 12-25 years, with or at risk of, mild to moderate mental illness. The preferred provider will establish and deliver these services.

Have you read our

COMMISSIONING HANDBOOK? Adelaide PHN’s Commissioning Handbook – The Service Provider’s Guide is available via our website. This handbook is a great resource that not only articulates our expectations but also provides some useful tips to aid the commissioning process for our current and future partners.

COVID-19 Continuing our support for the local response Distribution of PPE to primary care Adelaide PHN has continued to distribute vital Personal Protective Equiptment (PPE) to frontline primary health care workers across our region. This stock including surgical masks, P2/N95 masks, gloves, gowns and hand sanitiser - has been supplied from National and State Medical Stockpiles with some additional PPE items sourced privately and funded by Adelaide PHN. Ensuring supply and availability of PPE to those who need it most has certainly been a challenge for everyone involved in the COVID-19 response. Worldwide PPE shortages were further exacerbated in Australia with local supplies impacted by recent bushfires. Adelaide PHN has been working alongside providers to prioritise supplies according to established need and suppporting best practice use of all precious PPE items. This diligence has helped us maximise limited supplies, ensure the safety of both frontline health care workers and community members, and support the continuation of essential primary health care services across COVID-19. Whilst this en-masse distribution is far from business as usual for our organisation, the response from most providers has been very positive. It has allowed us to build stronger relationships with primary health care providers across our region and even allowed us to employ a small team of causal staff as temporary couriers, most of whom were health workers whose employment had been impacted by COVID-19. This

team has been sorting, filling orders and distributing to local general practices, pharmacies, Aboriginal community controlled health organisations and other allied health providers. Providers can find more about our website’s Mask and PPE distribution page. Keeping providers up to date Adelaide PHN has continued to play a leading role in the COVID-19 communication to general practice and other primary health care providers across the Adelaide metropolitan region. Since February, we have expanded our website’s COVID-19 Provider Information page and our internal response team has been curating a daily (now three times a week) ‘To The Point’ bulletin. This e-newsletter is delivered direct to the inbox of local GPs and other providers, and collates the relevant updates from the SA Control Centre and our state and federal response partners.

We have also been collaborating with the Royal Australian College of General Practice SA&NT (RACGP), Australian Medical Association SA (AMA) and SA Health to facilitate what was a weekly (now fortnightly) webinar series for GPs covering topics such as testing, clearance of COVID-19 and epidemiology. Find an archive of these bulletins and webinars on our websiteâ€™s COVID-19 Provide Update page.

Since 31 January 2020,

weâ€™ve delivered over

87,000 surgical and P2 masks to general practices and other primary health care providers across Adelaide

METROPOLITAN GP RESPIRATORY CLINICS available across the Adelaide region Supported by Adelaide PHN, four Commonwealth-funded dedicated Respiratory Clinics have opened in the last few months across the metropolitan area to support the local response to COVID-19 and build the capacity of our local health system. Since opening, these clinics have been supporting the assessment, testing and diagnosis of anyone experiencing mild to moderate respiratory symptoms. The Central Adelaide Respiratory Clinic was the first to open in the state on Thursday 9 April followed by the Reynella Respiratory Clinic on Thursday 16 April. The opening of the North Eastern Respiratory Clinic on Tuesday 21 April coincided with Premier Steven Marshall’s announcment of a testing ‘blitz’ across the state. The Athelstone Respiratory Clinic has only recently opened on Monday May 11. The Respiratory Clinics are continuing to work tiresly, complementing the SA Health-funded testing services operating across Adelaide, to reduce pressure on hospitals and frontline health workers. With specially trained and dedicated staff, these Respiratory Clinics have maximised the use of PPE across our region and allowed our primary health care workforce to return their focus on running flu clinics, expanding telehealth services and managing the ongoing care of patients with chronic health conditions. Unlike the other COVID-19 testing services across Adelaide, the Respiratory Clinics offer some unique benefits. All patients attending a Respiratory Clinic receive a GP assessment of their respiratory symptoms (not just swabbing for COVID-19) and, where appropriate and follow up care is required, the Respiratory Clinics can support clinical handover back to a patient’s usual GP. If you are experiencing respiratory symptons such as fever, shortness of breath, sore throat, cough, fatigue or runny nose, book an appointment at a GP Respiratory Clinic online via this link or over the phone: • • • •

North Eastern Respiratory Clinic - 08 7089 5799 Reynella Respiratory Clinic - 0478 455 771 Central Adelaide Respiratory Clinic - 0401 142 608 Athelstone Respiratory Clinic - 0482 050 687

For more information visit: adelaidephn.com.au/respiratoryclinics.

SUPPORTING TELEHEALTH PROVIDERS Adelaide PHN has been expanding provision of healthdirects video call service. Initially, this service was offered to general practice and our commissioned service providers, but is now being offered to a broader range of health care providers where telehealth services are supporting patient outcomes. This allows access to a purpose-built telehealth system, with a waiting room that patients access through a single organisation specific link. Patients and providers can conveniently access this service via their smartphones or another smart device with a camera and microphone, including laptops and computers with a webcam setup. The preferred approach for substituting a face to face consultation is video conferencing. However, in response to the COVID-19 pandemic, providers will also be able to offer audio-only services via telephone if video is not available. There are separate MBS items available for audio-only services. No specific equipment is required to provide Medicare-compliant telehealth services. Services can be provided through widely available video calling apps and software such as Zoom, Skype, FaceTime, Duo, GoToMeeting and others. The Department of Health’s position is that, under these exceptional and temporary circumstances and for the new temporary MBS telehealth items only, the practitioner’s documentation in the clinical notes of the patient’s consent to assign their benefit as full payment for the service would be sufficient. However, providers should make an effort in obtaining patient consent. Alternative options include via email and Australia Post.  If you are a health care provider, in the Adelaide metropolitan region and are looking at implementing video conferencing appointments, Adelaide PHN will be continuing to give support and can be contacted at:  digitalhealthinfo@adelaidephn.com.au.

Adelaide PHN has developed the ‘Quick Guide to Telehealth’ patient resource that can be used by GPs, nurses and other providers who are offering telehealth services to their patients.

Your Quick Guide To

TELEHEALTH TELEHEALTH IN 3 STEPS

Telehealth is the provision of health care services over the phone or via video using a computer or mobile device

1. Book an appointment Your health care provider may offer a telehealth appointment or you can request one. Talk to your provider to confirm the process so you know what to expect and how to prepare.

2. Your health care provider will call you at the booked time

3. Receive the same care but over video or phone

You will receive a call via the device or phone number confirmed at the time of booking. Just like a face-to-face appointment it’s a good idea to be ready ahead of time for the call.

If you need any follow up care that requires face-to-face care, this can be arranged during your appointment.

Top tips to get the most out of your telehealth appointment Prepare for your appointment • Think about what you need to ask your health care provider - consider writing a short list

Prepare your space • Find a quiet, private and comfortable place to sit • Ensure you have everything you need ready such as a glass of water, tissues, pen and paper

Prepare your device • Ensure you have downloaded and installed any software (if required) • Consider a trial run with a friend - check your internet connection, practice using your webcam, and make sure your audio is working • Charge your phone, computer or mobile device or plug it in during the appointment • Headphones can help with sound quality: if available, have these ready to go

• Consider a ‘do not disturb’ sign for the door

This content is based on a new patient resource by Adelaide PHN. Find a printable copy here or visit adelaidephn.com.au/resources

PIP, WIP AND ACCREDITATION DURING COVID-19 In recognition that general practices, Aboriginal Medical Services and Aboriginal Community Controlled Health Organisations across the nation have been impacted by COVID-19, the Department of Health and Services Australia have undertaken work to implement a number of temporary measures under the Practice Incentives Program (PIP) and Workforce Incentive Program (WIP) to help ensure business continuity. These measures are designed to make it easier for practices to continue to manage the impact of COVID-19 and to continue providing quality care to their communities during these challenging times.

PIP QI The PIP Quality Improvement (QI) Incentive has been temporarily doubled for two quarters. Participating practices will now receive $10 per SWPE (increased from $5 per SWPE), and the quarterly payment cap has been raised from $12,500 per quarter to $25,000 per quarter. There is a requirement for practices to continue to offer face-to-face consultations as an eligibility requirement for the increased payments. This will be monitored though MBS claims data. It is expected that practices will remain open for face-to-face consultations for at least four hours per business day.

In addition, for practices participating in the PIPQI, Primary Health Networks (PHNs) have been advised to inform the Department if a practice has been unable to submit their PIP Eligible Data Set data as a result of the impacts of COVID-19 on their practice. These practices will receive a PIP QI payment for the 1 February 2020 to 30 April 2020 quarter. Arrangements for the 1 May to 31 July quarter will continue to be monitored and advice provided as the COVID-19 response evolves.

e-PIP For practices participating in the PIP Electronic Health (eHealth) Incentive, pre-payment compliance arrangements will cease during this interim period and payments will be made to participating practices. Compliance (including post-payment compliance for the interim period) will resume once business arrangements return to normal during the recovery phase of the pandemic. Arrangements for the 1 May to 31 July quarter will also continue to be monitored and advice provided as the COVID-19 response evolves.

WIP For the Workforce Incentive Program (WIP) – Practice Stream, due to the transition from the Practice Nurse Incentive Program (PNIP) to the WIP, automatic payments based on last quarter’s participation information will not be possible. Given this, practices can either: o submit a quarterly confirmation statement (by the due date of 30 April 2020) to receive their incentive payment on time; or o submit their quarterly confirmation statement after this date to receive their payment approximately two weeks after lodgement.

ACCREDITATION The Department recognises that COVID-19 may impact processes that practices undertake to ensure accreditation and/or are unable to access accreditation services through their accrediting organisation due to COVID-19. The Australian Commission on Safety and Quality in Health Care has released advice which can be found here.

If you or your health care organisation would like further information and/or support in relation to accreditation, PIP payments , please contact Adelaide PHN’s dedicated practice support team at practicesupport@adelaidephn.com.au. More information can be found via aapm.org.au.

ELECTRONIC PRESCRIBING Recent changes have been made to legislation to allow electronic prescriptions to be used to supply medicines in Australia. Although paper prescriptions will still be available, this provides another way for Australians to access their medicines. There will be no changes made to the basic steps of getting a prescription – a GP or other medical practitioner will still have to prescribe it, and a pharmacist will still need to dispense it – but it does offer more flexibility to patients. Patients still have the right to receive a paper prescription if they wish and electronic prescribing also supports the patients right to choose the prescriber and the pharmacy that supplies their medicines. Prescriptions still need to comply with all Commonwealth and State/Territory requirements. Electronic prescribing has started to come into action now as a result of the recent COVID-19 pandemic, but over the year, this process will be refined and there will be two options for electronic prescribing. Changes are required in both prescribing and dispensing software, so not all medical practitioners and pharmacies will be able to implement this straight away.

Token model The first option to be available will be the token system. This is where a prescriber will be able to create a token (a QR code) for accessing the legal prescription. This token will be sent to the patient via an app, SMS or email. The pharmacist will then be able to scan the code to unlock the legal prescription from a secure delivery system. If the patient has any repeats on the prescription, they will be sent a new token for the next supply. This will be available from the end of May 2020.

Active script list model The second option will be for a nominated pharmacy to have a list of all the patient’s active prescriptions in their software. This model will ensure that problems such as multiple medicines and lost tokens are better managed. This model will only be available later in the year and more detail will be released at a further date.

COVID-19 interim arrangements During the COVID-19 pandemic, special arrangements have been put in place to assist with the challenges faced by the quick introduction of telehealth consultations. GPs and prescribers create a paper prescription and send a clear image of it to the pharmacist via fax, text message or email. The pharmacist can then dispense the prescription as though it is the paper prescription and supply it to the patient. Repeats can be kept at the pharmacy or provided back to the patient.

Benefits Electronic prescribing benefits patients, prescribers and pharmacists as well as broader benefits at a system level. Benefits include: • Reducing administrative tasks (e.g. effective management of prescription requests). • Supplementing delivery of telehealth services to ensure continuity of patient care. • Providing an opportunity to protect community members and healthcare providers from exposure to infectious diseases • Maintaining patient privacy and integrity of personal information.

Adelaide PHN has a dedicated digital health team to assist health care providers in relation to digital health platforms and initiatives. If you or your health care organisation would like further information, support or training on digital health, you can contact the team at digitalhealthinfo@adelaidephn.com.au. More information about electronic prescribing, can be found at: digitalhealth.gov.au/get-started-with-digital-health/electronic-prescriptions

Membership Update Adelaide PHN is a membership-based organisation and benefits from the experience and knowledge of our membership groups. Our membership contributes to the understanding of our region through consultation and our annual needs assessment process. We work alongside both those experiencing and delivering primary health care across our region. Through our commissioning and integration activities we partner with government, private and non-government organisations. These partnerships support us to address barriers, foster connectivity and support access to timely and responsive health services and systems. Whilst we were only required by the Commonwealth to have one Clinical Council and one Community Advisory Council we began our membership with three of each to reflect the regional metropolitan areas of Adelaide. Between 2015 – 2019, our membership model consisted of: • • • •

Board of Directors Membership Advisory Council (MAC) Three Clinical Councils (CC) Four Community Advisory Councils (CAC) including one Aboriginal and Torres Strait Islander • One Health Priority Network (HPN): Network Leadership Group (NLG) assists in coordinating the HPN. Adelaide PHN’s revised Membership Model In late 2019, our membership model was reviewed to be more efficient, effective and integrated. Evidence from five years of consultation demonstrated the experiences and health issues facing community members, service providers, clinicians and primary health care workers across our nine councils were the same. As a result, we’ve established that a focus on integrating the metropolitan regional experiences would provide a greater leverage in our advocacy role. These changes have been made following extensive consultations with our existing membership. We look forward to implementing the new model over the coming months and will keep you up to date.

ABORIGINAL SCREENING PROGRAM The Aboriginal Screening Program, funded by Adelaide PHN and delivered by Cancer Council SA, is now in its second year of operation. The program provides an opportunity for Aboriginal and Torres Strait Islander people to have face to face, open discussions about cancer. Aboriginal Community Ambassadors have been recruited to the program and trained by Cancer Council SA to deliver culturally appropriate cancer information. At the centre of the program are yarning circles which are led by the Community Ambassadors. Aboriginal and Torres Strait Islander people who attend the yarning circles are encouraged to discuss fears, ask questions, receive information and share experiences about cancer. In these sessions the Community Ambassadors also discuss common cancer myths and deliver prevention and screening messaging. Enabling people to have a yarn and discuss their concerns helps them to connect with their community and helps to break down any barriers that may exist with regards to cancer and cancer screening. The yarning circles have been a great success and have resulted in many people who have never screened, or are under screened, completing their health checks. The Community Ambassadors and Cancer Council SA staff facilitate connections between the attendees and health professionals who can provide screening and health checks. A number different Aboriginal and Torres Strait Islander community organisations across metropolitan Adelaide have kindly hosted a yarning circle. While the yarning circles are currently on hold due to COVID-19, there are many more planned and will be resumed as soon as restrictions are lifted.

As part of the program, culturally appropriate screening information resources have been developed and these can be downloaded from the Cancer Council SA website. For more information about the Aboriginal Screening Program or about the yarning circles, please contact Nora Sevallos, Aboriginal Programs Project Officer, Cancer Council SA, on 8291 4277 or nsevallos@cancersa.org.au. More information about the program can also be found on Adelaide PHNâ€™s Directory of Services webpage.

PUSHING FOR CHANGE Adelaide PHN has been taking part in the The Push-Up Challenge to raise awareness of mental health concerns and help keep our staff active and engaged across COVID-19 isolation. 45% of Australians will experience mental health issues at some point in their life. The Push Up Challenge is all about raising awareness of mental health and actively pushing (up) for change! For Adelaide PHN, particpating in this challenge has been a great way to support our staff to try incorporate three activites known to promote better mental health into their daily routines: exercise, community building, and learning about mental health. Only half way through, our participation has already seen some gains - we’ve achieved some fitness goals (our comms coordinator has transitioned from knee push ups to whole sets of full push ups!), we’ve met co-worker’s pets (particpating via Zoom as part of COVID-19 working from home arrangements), we’ve broken up our work days and started raising some funds for headspace centres across the Adelaide region.

Track our organisation’s progress via: https://bit.ly/2WH5Jzk Get involved, donate or find out more at: thepushupchallenge.com.au

HEALTHPATHWAYS

Winter wellness pathways Our HealthPathways SA GP Clinical Editors and team have been busy revising winter wellness related pathways for primary care. The Influenza pathway has been updated for 2020 and includes detailed information on indications for testing and indications for the use of anti-virals and post-exposure prophylaxis. The pathway also provides guidelines for those working in residential care facilities. The Pandemic Influenza pathway provides useful information on infection prevention and control and how to prepare a comprehensive pandemic plan for your clinic. In conjunction with key South Australian experts, the Influenza Immunisation pathway has been updated to include information on all influenza vaccines available for this influenza season including details of patient eligibility for funded vaccines. The pathway provides guidance on conducting influenza vaccine clinics during the COVID-19 pandemic. The Immunisation in Children (< 10 years), Immunisation in Children and Adolescents (10 - 19 years), Immunisation in Adults and Immunisation in Pregnancy pathways and their related referral pages have also recently been updated. Respiratory and sleep medicine pathways are currently being reviewed with updates to be released in May 2020.

COVID-19 impact on clinical care The COVID-19 pandemic will continue to have a widespread impact upon health care delivery and patient care in South Australia. Key organisations and peak bodies continue to release new clinical guidelines and patient resources across a wide range of conditions in order to provide guidance to health care professionals during the pandemic. HealthPathways SA’s GP Clinical Editors have created a new “COVID-19 Impact on Clinical Care” page which contains links to all of these guidelines and resources so they can be accessed by GPs and clinic staff in one easy online location. The page is being updated regularly as new guidelines and resources are released. Examples of information on this page include links to: • Australian Asthma Handbook: new section on managing asthma during the COVID-19 pandemic • Information from the RACGP and NDSS with guidance about diabetes management • Current status of the national cancer screening services including BreastScreen, the National Cervical Cancer Screening Program and the National Bowel Cancer Screening Program • Information from ASCIA and the Australasian College of Dermatologists regarding caring for patients with immunodeficiency or those taking immunosuppressants / biologics • Information about managing antenatal patients and women requiring long-acting reversible contraception Information which is specific to COVID-19 infection is available on the “COVID-19 Information Page”. To support health professionals working under challenging conditions at this time, HealthPathways SA can be accessed without registration. Please contact at southaustralia@healthpathwayscommunity.org to find out more.

ACCESS AND MORE INFORMATION Visit the project site to learn more about HealthPathways South Australia, to register for use, or login to the portal.

IMMUNISATION HUB Keeping updated with your routine vaccinations With the 2020 flu season approaching and COVID-19 in mind, it is timely to remind providers and community about the importance of immunisation for those from all age groups and walks of life. Immunisation providers across Adelaide are working hard to vaccinate the community against flu and other vaccine preventable disease. Clinics may be working in a different manner with social distancing practices in place, but they are still up and running and crucial in preventing the spread of disease. The flu vaccine is recommended for all persons aged six months and above. Have a chat with your GP, practice nurse, council clinic or Aboriginal health service and book in a time to get vaccinated. It is timely to remind all community members to keep up to date with their routine scheduled vaccinations. Whether you have a child, youâ€™re a person who is medically at risk, work in a high risk occupation or an older person, itâ€™s not just flu and COVID-19 that we need to be mindful of at the moment. Adelaide PHN commission Health and Immunisation Management Services (HAIMS) to deliver the Champion Nurse Immunisation Program. This program provides information and support to community members and immunisation providers in relation to immunisation. The immunisation and winter wellness related HealthPathways have been recently updated and include information regarding eligibility around immunisation as well. If you are a health professional and would like further information about HealthPathways or how to obtain a login, please visit southaustralia.healthpathwayscommunity.org

The Immunisation Hub is a joint program of the Adelaide PHN and Country SA PHN. Our team works to support both immunisation providers as well as community across South Australia. Please visit immunisationhub.com.au for more information. To get in touch with the nurses at HAIMS, please call 8152 0363.

SUPPORTING PALLIATIVE CARE Greater choice for at home palliative care measure Enabling Choice for South Australians is Adelaide PHNâ€™s response to the Commonwealths Greater Choice for At Home Palliative Care Measure. This aim of the project is to improve the process of advance care planning in residential aged care, information about advance care planning is given to the resident and family on admission. A face to face meeting is organised with resident and family to discuss advance care planning within two weeks following admission. All residents are supported to attend the meeting. For those who may have dementia the nurse initiating the conversation employs supported decision-making facilitation to ensure that the discussion focuses on what health care decisions the resident would make if they were able to tell us. If the resident is able, they are asked to complete an Advance Care Directive (SA legal document) or a document the project is piloting called My Life Decisions. Advance Care Planning is an ongoing conversation and needs to be revisited at any time of review or if the residentâ€™s health status changes or deteriorates. 28 aged care facilities have been involved in the project and each has a lead nurse who works with support from the Quality Improvement Facilitators to implement the process. A comprehensive advance care planning pathway/procedure was developed for facility staff to have a clear process to follow. Several tools have been implemented to support the advance care planning pathway/procedure which is providing a consistent approach across the 28 facilities involved.

Advance care planning training has supported the pathway with attendance of 120 aged care nurses, follow up sessions are planned in the future once COVID-19 restrictions are lifted. The training has been delivered in small groups by Dr David Holden (a Palliative Care Specialist) using role play with actors, the nurses have been able to practice facilitating advance care planning conversations in a very supported environment. COVID-19 has provided a focus on advance care planning and facilities have been adapting to having telephone, Skype and Zoom meetings with families. The pandemic has provided additional opportunities to openly discuss residentsâ€™ wishes if they were to contract the virus and what care the facility can offer as most residents chose to be cared for in their home environment. Adelaide PHNâ€™s quality improvement facilitators - whilst unable to visit and support the facilities face to face due to COVID-19 - are continuing with remote meeting alternatives with each nurse fortnightly. The project in the next two months will produce a report and a tool kit describing the advance care planning process implemented in the project and the tools used to support this.

To find out more, please contact Adelaide PHNâ€™s quality improvement coordinators on 8219 5900.

HEADSPACE PEER WORKER PROJECT Enhancing headspace services for Aboriginal and Torres Strait Islander youth project The aim of the project is to enhance the capability and capacity of headspace centres in the Adelaide metropolitan region to deliver culturally appropriate, sensitive and safe primary mental health care services for young Aboriginal and Torres Strait Islander people. Key aims include • Improved mental health and wellbeing experiences and outcomes for young Aboriginal and Torres Strait Islander people; • Increased access to, and availability of, culturally appropriate, safe and sensitive primary mental health care for young Aboriginal and Torres Strait Islander people; and • Increased representation and retention of Aboriginal and Torres Strait Islander people in the primary mental health care workforce This project forms part of a broader strategy comprising two distinct, but inter-related elements. We are happy to work in partnership with headspace and Linking Futures to implement key objectives of the project. headspace key components will be to increase the access and engagement of young Aboriginal and Torres Strait Islander people at risk of, or experiencing mental health conditions and increase employment and vocational pathways for young Aboriginal and Torres Strait Islander people in the primary mental health care workforce by employing Aboriginal and Torres Strait Islander Youth Peer Workers at each of the headspace centres. Linking Futures, a South Australian Aboriginal led company with experience in supporting clients to engage with Aboriginal and Torres Strait Islander communities, will be providing cultural advisory services to the headspace centres. Linking Futures will provide services to enhance the capacity and capability of headspace Centres to deliver culturally appropriate, sensitive and safe primary mental health care services, increase cultural mentoring and supervision pathways, provide advice and guidance on strategies, programs and services to support successful participation by and engagement with Aboriginal youth. We are pleased to announce that all four headspace centres participating in this project will have Aboriginal and Torres Strait Islander Youth Peer Workers employed by May 2020.

Photo: Fiona, Roy, Michele, Kathy, Tania and Caellyen

PROTECT YOURSELF, YOUR FAMILY AND THE COMMUNITY

COVER YOUR COUGH 1

Cover your mouth and nose with a tissue when you cough or sneeze.

Cough or sneeze into your sleeve or elbow, not your hands.

Place your used tissues in the rubbish bin.

Wash your hands with soap and water, or sanitise with alcohol based hand gel.

sahealth.sa.gov.au/washwipecover FIS: 19040.1

CENTRAL REFERRAL UNIT Accessing mental health services in the Adelaide region during COVID-19 During these troubling and unprecedented times, it is understandable for people to feel more stressed, depressed or angry. People who do not usually experience issues with their mental health may find they experience an emergence of symptoms, and people with preexisting mental health conditions may experience a worsening of their symptoms. Early help seeking is known to be beneficial to improve people’s experience as well as reduce the longevity of their condition. As we know, a great starting point for accessing health services in the Adelaide region is to visit your local GP. Unfortunately, at the moment many people are hesitant to go to their GP for fear the visit could increase exposure to COVID-19. However, the Australian Government has introduced new temporary MBS telehealth items to help reduce the risk of community transmission. The new items became available 13 March 2020 and are available to all Medicare cardholders living in Australia. A Mental Health Treatment Plan (MHTP) can be billed on these telehealth Medicare numbers. Adelaide PHN operates a Central Referral Unit (CRU). People can be referred to mental health services via the CRU. This is a single point of entry for all Adelaide PHN commissioned services (or other services as required). The CRU triage referrals and send them to the most appropriate service based on the person’s presenting problems, their location and access considerations (eg wait times) amongst other factors. Referrals can be either MHTP or community referrals (where a MHTP is not able to be completed). To send referrals to the CRU please use Secure Messaging or fax 1300 580 249. Adelaide PHN’s Mental Health Enquiry Line is also operated by the Adelaide PHN CRU and is available 9.00AM - 5.00PM weekdays excluding public holidays. Where required, individuals can call the enquiry line and complete a referral over the phone. Our team will be able to discuss various options based on the need of the person being referred.

The services commissioned by the Adelaide PHN operate over a stepped care continuum from low intensity services (traditionally for people presenting with milder presentations, although suitable for more complex mental health conditions at times too) to services for individuals with chronic and complex conditions that require longer or more intensive treatment. Suicide prevention services are also available for those who present at a higher level of risk but remain suitable to be treated within a primary care setting. With the current COVID-19 pandemic, face to face services remain available for those who require it, though most consultations will occur over the phone or via video conferencing. The Head to Health website also has a number of useful websites and online services that people may choose to access from their homes. Visit Adelaide PHNâ€™s Directory of Services for more information about the CRU.

Send your referrals via: Secure messaging - ReferralNET or Argus Name: Central Referral Unit URN: refnet:CRU Central Referral Fax 1300 580 249

For enquiries or information: Mental Health Enquiry Line 1300 898 213

Business as usual

AN UPDATE ON OUR COMMISSIONED MENTAL HEALTH SERVICES Our CRU and many of our mental health commissioned service providers have indicated lower referrals and decreased help seeking during this time. We know that timely access to early intervention services is known to improve outcomes for individuals, as well as reducing the impact on the state based services such as the community mental health teams and Emergency Departments. Adelaide PHN is keen to ensure that stakeholders are aware of the existing service provision available and how this has been adapted in light of the current pandemic.

Mental health support and services are still available: During the COVID-19 pandemic, mental health services continue to be available through Adelaide PHN commissioned service providers. Face to face services remain available where necessary and appropriate. Where this is occurring, services are keeping those delivering and accessing services safe by adhering to hygiene practices and social distancing. Where face to face is not a requirement, individual psychological therapy has moved mainly to telehealth platforms; mostly phone-based therapy with some videoconferencing options.

Lived Experience Telephone Support Service (LETSS) All services that are phone-based support services are continuing as normal. The Lived Experience Telephone Support Service (LETSS) may be useful for people during this time and continues to operate daily from 5.00PM to 11.30PM. This service can be accessed by anyone seeking support for themselves or loved ones and callers can access brief counselling interventions as well as support with engaging with available services. Phone: 1800 013 755 or webchat via letss.org.au.

After-Hours Walk in Service Walk in clinics remain available, including Sonder’s After Hours Walk In Service in Edinburgh North. This service operates afterhours 4 nights of the week (Thursday, Friday, Saturday and Mondays) from 5.00PM to 10.00PM and is available to anyone whom feels they need to talk to someone about their mental health. No appointment necessary. More information can be found via Adelaide PHN’s Directory of Services webpage or Sonder’s website.

Please see our Mental Health Directory on the Adelaide PHN webpage for full details of all commissioned services.

If you are having difficulty getting a referral, please Adelaide PHN’s CRU via the Mental Health Enquiry Line 1300 898 213. Our team of clinical triage officers are ready to assist. As always, referrals can be sent via Secure Messaging (ReferralNet or Argus - name: Central Referral Unit/URN: refnet:CRU) or fax 1300 580 249.

CONNECTING WITH OUR COMMISSIONED SERVICE PROVIDERS As the world responds and adapts to the various COVID-19 restrictions in place, many organisations are busy doing what they have always done, that is, providing essential support to communities. The following content is a summary from an interview with Sandra Dzafic, Program Manager at ARA. More information about ARA can be found on our website’s Directory of Services.

Can you briefly outline the services you provide and the project funded by Adelaide PHN?

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ARA aims to empower communities and individuals from refugee backgrounds to actively participate in all aspects of life in Australia. ARA provides a wide range of services including advice, assistance and advocacy in the areas of settlement, migration, employment, health, community education and policy development. Funded by Adelaide PHN, the Adelaide Refugee and New Arrivals Program (ARANAP) is a project to improve refugee and new arrivals’ understanding of the Australian health system through health assessments tools and health literacy.

How has the COVID-19 pandemic affected refugee and new arrival communities?

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Our communities have been affected due to some clients’ lack of understanding of the COVID-19 safety measures, sudden interruptions in the management of their on-going health needs and medical treatments, and changes to how they access their GPs and specialist health services. Of additional importance is that those who experienced past trauma have reported an increase in anxiety and fear for their own safety and that of their family members. Other issues that have been identified are related to loss of employment, challenges with home schooling and increase in social isolation.

“

How have you modified your service delivery to adapt? ARA immediately developed a comprehensive COVID-19 Response Risk Management Plan which included reduction in face to face contact with the clients and an implementation of working from home policy for ARA staff. Face to face contact was restricted to urgent and crisis appointments only with a focus on online activity. ARA has also introduced an after-hours emergency helpline (0499 111 359) which is available to assist clients with crisis support, information and referral. We also provide regular service updates translated in various languages and made available to ARA clients via several forums and through direct contact with community leaders.

What are the positive learnings that your organisation is drawing from this crisis that may be implemented going forward?

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Our main focus in the initial phase was to disseminate accurate information around COVID-19 to as many clients as possible, and to reassure them that ARA is open and able to continue to provide support. We have quickly identified that a significant number of clients do not have appropriate technology, nor they have relevant skills to be able to use various platforms for successful on-line communication. While continuing to provide supports to clients over the phone, we are also assisting them to learn how to access video conferencing, emails and other communication tools in order to increase their ability to receive information in timely manner and connect better with their support networks and service providers. While the COVID-19 experience has been challenging and stressful at times, it has shown us that ARA can successfully adapt to unforeseen circumstances in short period of time. This has also proved that ARA clients are able to do the same when provided with the right support at the right time. As all global citizens are learning to adapt, some by choice and some by force, we take comfort that the ongoing but dynamic way in which we work, continues to make a difference in the lives of our communities.

ARA’S NEW AFTER HOURS EMERGENCY HELPLINE As part of the COVID-19 response, ARA has a new emergency helpline for urgent out of hours support. Phone 0499 111 359 or visit australianrefugee.org/covid-19-updates/ to find out more.

PRIMARY CARE IN ACTION The following section of Adelaide PHNâ€™s Connect newsletter includes highlights of local programs and activities affecting the delivery and experience of primary health care across the Adelaide metropolitan region. Would your organisation or practice like your activity featured in Connect? Get in touch with our communications team at comms@adelaidephn.com.au

HYUNDAI SERVICE SUPPORT DISCOUNT FOR HEALTH CARE WORKERS From April 20, HMCA together with the Dealer Council have introduced a Service Support Program for health care sector workers. The program offers Hyundai owners working in health care, a maintenance service on their vehicle at a discount of 50%. Details: • All owners working in health care (doctors, nurses, receptionists, mental health personnel and the like) • Any scheduled service conducted on a Hyundai vehicle at an authorised Hyundai dealer • Costs are split between • 50& - HMCA and the dealer; • 50% - customer • Includes all parts, labour and fluids as listed in the schedule Verification • We ask dealer service personnel to simply verify the sector the owner is working in. This can be via a name badge, business card or an email Timing • The Program will run from April 20 to May 31, 2020 • Scheduled maintenance performed within the above dates are eligible This program is designed to offer something back to the many workers across the country that are at the front line of the battle against the Coronavirus. For more information and to find your local dealer, please visit the Hyundai website.

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

NATIONAL RECONCILIATION WEEK National Reconciliation Week (NRW) is a time for all Australians to learn about our shared histories, cultures, and achievements, and to explore how each of us can contribute to achieving reconciliation in Australia. The dates for NRW remain the same each year; 27 May to 3 June. These dates commemorate two significant milestones in the reconciliation journey— the successful 1967 referendum, and the High Court Mabo decision respectively. In this together, the theme for National Reconciliation Week (NRW) 2020, encourages all Australians to reflect on the part they play – whether big or small – on our journey towards reconciliation. This unity of purpose creates a shared sense of belonging and identity; and this identity must value and include the histories, cultures and rights of Aboriginal and Torres Strait Islander peoples. Unity is of the five dimensions of reconciliation as defined by Reconciliation Australia. For Australia to become a truly complete nation, it will take the commitment and contribution of all of us.

For more information, visit the Reconciliation Australia website.

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

APNA TRANSITION TO PRACTICE PROGRAM APPLICATIONS NOW OPEN Whatever your age and whatever stage of your nursing journey you’re at, APNA’s here to help nurses flourish. APNA’s Transition to Practice Program is a 12-month education, support and mentoring program for nurses new to primary health care. Nurses transitioning into primary health care will be matched with an experienced nurse mentor. We are looking for: • Nurses new to primary health care, both recently graduated and experienced nurses • Engaged, motivated and committed nurses with 4+ years’ experience in primary health care to become clinical and professional mentors. Remuneration is provided to complete training and work with mentees. Applications open from 20 April and close 5 June 2020. Don’t let this opportunity be the one that got away, find out more at apna.asn.au/transitiontopractice The Transition to Practice Program has been funded by the Australian Government Department of Health

TURN

HELP PSYCHOSIS AROUND

Psychosis can be a frightening and often misunderstood illness that can turn a young personâ€™s world upside down. The earlier itâ€™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.

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

DR JAYA PATHI RETIRES AFTER 46 YEARS OF SERVICE IN ADELAIDE’S NORTH After 52 years practising medicine, 46 years of that at the same premises at Elizabeth North, Dr Jaya Pathi hangs up her stethoscope. Besides being the longest serving GP in the northern metropolitan area, she has been the only woman solo practitioner in the area for over 40 years. Jaya obtained her MBBS from the Osmania University in Hyderabad (India) in 1967 and started working in a public hospital and, at the same time, pursuing her Masters in Paediatrics. Soon after obtaining her MD, she along with her journalist husband, arrived in Whyalla on a Friday in 1972 and was offered a GP position the following Monday in a group practice. “That is the only full weekend I ever had”, she says in a matter of fact way. After a year, she moved to Adelaide and bought a practice that has been her workplace ever since. In the 70s, the local Lyell McEwin Hospital’s after hours emergency section was served by private practitioners working in the surrounding suburbs. Besides working in her own practice during the week, Jaya worked at the hospital on Sundays, thus toiling seven days a week in the first three years of her Australian working life. She also assisted surgeons at operating theatres and delivered babies for her patients until more staff doctors were appointed at the hospital. Some of the babies she helped are now her middle-aged patients and a few families are third and fourth generation patients with two families stretching to five generations. Jaya was honoured by the Adelaide Northern Division of General Practice (ANDGP) for providing continuous medical

service for over four decades to the local community. She served as a Director on the Governing Board of ANDGP for two terms. Recalling her venturing into start her own practice in a new country, Dr Pathi said it was a bold move. “The practice operated on a part-time basis and was run down. So I had to work hard to build it up and the absence of a woman doctor around the area helped in a way...I was wondering how a sari-clad Indian woman doctor would be received. I have been coming to work in sari from day one. Maybe it worked as a novelty then. Now my sari is a talking point for some patients who commens on it whenever I wear a new one.” Dr Pathi’s dedication, legacy and commitment to service delivery in Adelaide’s north will always be remembered. This is a summary of an article published in Sonder’s newsletter. Visit sonder.net.au

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

LUNG FOUNDATION LUNG AWARENESS MONTH Lung disease affects almost 1 in 3 Australians and is responsible for 1 in 7 deaths, however many people tend to ignore the signs and symptoms, often not doing anything about it for far too long. As the impact of coronavirus (COVID-19) is felt across the country, now more than ever, it’s important to look after your lung health. Whilst many people may not think it, breathlessness is not normal and a persistent or changed cough shouldn’t be put down to the flu or a cold. These symptoms may seem mild but they could be a sign of lung disease or lung cancer. May marks Lung Health Awareness Month and Lung Foundation Australia is urging all Australians to know the symptoms of lung disease. Most of us know the signs of a stroke or heart attack and we know the importance of self-checks for our breast and prostate health. When it comes to lung disease, getting an early diagnosis is critical to improving outcomes and saving lives. It’s time Australians start thinking about their lung health in the same way they would their heart, skin and breast health. Take two minutes to check your lung health, and encourage your friends and family to do the same at lungfoundation.com.au/check

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

RACGP EXPERT ADVICE MATTERS CAMPAIGN The RACGP has launched a timely general practice public advertising campaign encouraging people to continue to consult with their GP to maintain their health during COVID-19. The Expert Advice Matters campaign aims to cut through health misinformation to remind the community that GPs are the best source for expert medical advice. People will be encouraged to learn more about phone, online and safe in-person consultations with their usual GP. GPs can download campaign resources, record a selfie and help share the message that general practice is still open for business. For more information, visit the RACGP website.

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

ASTHMA AUSTRALIA WINTER CAMPAIGN HELPING PATIENTS STAY WELL WITH ASTHMA THIS WINTER Many people experience an increase in asthma symptoms and find their asthma harder to control during winter. Among adults and children with asthma, emergency department presentations and hospitalisation rates peak during the winter months which is likely due to the increase in respiratory infections and the annual winter flu season. Health professionals play a critical role in providing information and support to people with asthma during this time. There tend to be more asthma triggers around during the winter season – including colder weather, colds and flu, viruses, unhealthy eating habits, poor indoor air quality and mental health and anxiety. So, if your patients experience an increase in their asthma symptoms over winter, they’re not alone. But, people with asthma don’t need to put up with these symptoms. As we move into the winter season, health professionals should urge people with asthma to remain vigilant about their choices and behaviours during this time, especially during the current Coronavirus (COVID-19) pandemic. Ensure your patients: • • • • • • • • • • •

Make an appointment for an asthma review and check of their asthma medications Improve or maintain their asthma control by: Continuing to take their regular preventer medication every day, even when well Ensuring correct use of their inhaler device(s) Attending to and improving the control of other medical conditions Managing their known asthma triggers where possible Stopping or reducing risky behaviours such as smoking Follow their written Asthma Action Plan Get the flu vaccine Know the steps for Asthma First Aid and what to do in an asthma emergency Follow advice by the Health Department on social distancing and good personal hygiene during the Coronavirus (COVID-19) pandemic

For more information on how Asthma Australia can support your patients to better manage their asthma over winter, visit asthma.org.au/winter-asthma

Are you looking for mental health support?

Go to headtohealth.gov.au to find online and phone mental health services and information.

ADELAIDE PRIMARY CARE IN ACTION

Highlights of programs and activities affecting the delivery and experience of primary care in Adelaide.

CARERS NSW AUSTRALIA 2020 NATIONAL CARER SURVEY The Carers NSW 2020 National Carer Survey is now open until 30 June 2020. Make a difference for carers across the country and have your say today! Developed by Carers NSW in collaboration with researchers from five universities and the National Network of Carer Associations, the Carers NSW 2020 National Carer Survey, is now online. Every two years Carers NSW conducts a survey to ask carers about their experiences and find out what supports they need. In 2020 for the first time this will be a national survey, providing the opportunity to increase our number of responses and find out more about what is on the minds of carers nationally. The data gathered in this research will help to advocate for carers, influence policy makers, and plan for service delivery into the future. We encourage carers to complete the online version where possible, but we understand that not everyone is able to do so. A paper copy and reply paid envelope has been included for all Carers NSW members with every copy of the April/May edition of Carers News, and carers can order paper copies through this online form. To download a printable version of this survey, please visit carernsw.org.au.

For more information about the Carer Survey, please contact the Research Team at research@carernsw.org.au or call 02 9280 4744.

EXPLORING adelaidephn.com.au Adelaide PHNâ€™s website includes information about our organisation as well as opportunities to engage with our programs, services and activities. Explore our directory to find out more about what services and activities we have commissioned.

CONNECT WITH US adelaidephn.com.au 8219 5900 enquiry@adelaidephn.com.au

Find our training and events calendar listing our local professionals development sessions for the primary health care workforce. We also offer a free career listing service for the primary health care sector. Visit the vacancies page to find out more or explore primary care career opportunites across the Adelaide region.

Adelaide PHN distributes Connect to provide beneficial and relevant information. The content is sourced from credible organisations, but please note we do not undertake extensive quality reviews. While the Australian Government helped fund this document, it has not reviewed the content and is not responsible for any injury, loss or damage however arising from the use of or reliance on the information provided herein.