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NACCHO/RACGP - Lauren Trask
- 1. NACCHO/RACGP Partnership Project: NACCHO Conference 5 November 2019 We are proud to acknowledge the traditional owners of lands and waters across Australia and pay our respect to Elders past and present
- 2. “…increase awareness and use of the National Guide, and to support patient centred, high quality primary healthcare for Aboriginal and Torres Strait Islander people.”
- 3. Where we came from… In 2000 National Guide conceived by A/Prof Sophia Couzos and the late Dr Puggy Hunter (on behalf of NACCHO).
- 4. Phase Two; • Access to high quality preventive healthcare • 715 health check as a positive experience realising positive health outcomes • Clinicians having resources and information available to support provision of culturally responsive, high quality healthcare for Aboriginal and Torres Strait Islander people (mainstream practices).
- 5. What we were asked to do •Establish and roll out APCCs in ACCHSs and mainstream general practices
- 6. What we did •1 face to face •Webinars •Establishment of # involved •Measures requested •Measures developed
- 7. What is next – the recommendations Informed software vendors workshop Informed 715 templates Informed resource development
- 8. What we were asked to do •Develop/review the three MBS Item 715 health check templates
- 9. What we did 1. Infants and preschool 0-5 years 2. Primary school age 5-12 years 3. Adolescents and young people 12-24 years 4. Adults 25-49 years 5. Older people 50+ years
- 10. What is next - the recommendations Making the templates available Communicating when and where the templates can be located Support the MBS taskforce review to reflect the provision of item 715 across 5 specific age groups
- 11. What we were asked to do •Scope existing clinical software to understand the capacity to undertake a good health check
- 12. Department of Health DoH materials are available for download at www.health.gov.au/715- health-check For hard copies of brochures and posters, contact: info@33creative.com.au
- 13. What we did 1. Two roundtables with vendors 2. Vendors report capacity to create fields to capture data
- 14. What is next - the recommendations • Co-design the workflow, user interface and technical specifications for the MBS Item 715 health check: • Define set of data requirements for an MBS Item 715 health check • Structured atomic data (enter once, use many times) • Develop an agreed information model • Define user interfaces • Evaluate efficacy with clinicians and consumers.
- 15. What we were asked to do •Develop resources for mainstream health services
- 16. What we did •Webpage; housing templates, project documents & resources: • MBS Item 715 health check templates • Good Practice Tables • National Guide in HTML • National Guide Check • Updated RACGP Identification Audit
- 17. What is next - the recommendations Review and test
- 18. Success measures •Stakeholders •Relationships •Appetite for change •Systematic process
- 19. Key messages Patient-centred healthcare •what is acceptable and valuable to patients •supports cultural safety in the experience of accessing and receiving healthcare
- 20. Key messages Screening as a component of primary healthcare: •consistent messages •health assessments as a part of preventive healthcare
- 21. Key messages Quality of the MBS Item 715 health check: • What is included (elements) • The experience
- 22. Key messages Workforce: • the importance and value of MBS Item 715 health checks being offered by multidisciplinary teams
- 23. Key messages Ways of working: the value of respectful, inclusive, collaborative co-design with broad representation as the most effective way of working
- 24. Any questions or comments?
- 25. Contact Details The RACGP Aboriginal and Torres Strait Islander Health Faculty Phone: 03 8699 0576 Email: aboriginalhealth@racgp.org.au https://www.racgp.org.au/cultural-safety
Editor's Notes
- Acknowledgement of country: Acknowledge Larrakia Nation Acknowledge Aunty Ada Parry the cultural educator at RACGP Acknowledge Aunty Dawn – NACCHO Guilia Fabris other members from RACGP Leanne Kate Mary Tim Respects to QAIHC Background of project 2 year joint project with NACCHO and RACGP Funded by Department of Health
- The RACGP and NACCHO have a strong history of working in partnership. Following the March 2018 launch of the third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (National Guide), and associated podcast series, NACCHO and RACGP have continued our partnership to increase awareness and use of the National Guide, and to support patient centred, high quality primary healthcare for Aboriginal and Torres Strait Islander people.
- 2001, NACCHO commenced work with support coalition of non-government organisations. 2003, NACCHO completed first version. 2005, 1st edition published jointly with the RACGP (funding from the Australian Government Department of Health and Ageing). 2012, 2nd edition published with a NACCHO-RACGP partnership. 2016, NACHO-RACGP partnership formed again for the development of the 3rd Edition. Funded by the Australian Government Department of Health. Launched in Feb 2018
- The teams at RACGP and NACCHO have worked towards: Aboriginal and Torres Strait Islander people receiving high quality preventive healthcare based on the latest evidence (National Guide) Enabling MBS Item 715 health checks to be a positive experience and investment for Aboriginal and Torres Strait Islander people’s health, contributing to positive health outcomes GPs and practice teams having resources and information available to support provision of culturally responsive, high quality healthcare for Aboriginal and Torres Strait Islander people (mainstream practices).
- APCC 1 face to face Establishment of # involved Measures requested Measures developed
- Implications for the project: The new templates will not be available with the other resources There is an opportunity to scope up a proposal to test templates Rationale
- Development of three MBS Item 715 health check templates - for children, adults and older people
- Development of three MBS Item 715 health check templates - for children, adults and older people 5 x 715 templates Dr Mary Belfrage is the clinical lead on template development for RACGP and NACCHO Harmonisation process recognised the work that the sector had undertaken to review and develop templates based on local need Reference group with representation across the nation Round table in May The consensus therefore was not to include them in the templates, keeping in mind these templates are for all clinicians, all patients, in all settings. The recommendations are really about minimum content for a useful health check. The Department of Health have elected to wait until the new Descriptor and Associated notes for the MBS Item 715 are available to release the templates. This should occur about March 2020. NACCHO and the RACGP are meeting to discuss a proposal to test the templates. Rationale
- Implications for the project: The new templates will not be available with the other resources There is an opportunity to scope up a proposal to test templates.
- Development of three MBS Item 715 health check templates - for children, adults and older people
- The Department of Health have recently developed a suite of communications materials to increase the awareness of and uptake of 715 Health Checks. These materials include posters, brochures, podcast, case studies and an animation.
- INSERT RECOMMENDATIONS Second and final software vendor meeting held at NACCHO office. Software vendor input into recommended next steps received and included in final report Over the last 12 months NACCHO and the RACGP, in consultation with software vendors, scoped the changes required to meet the needs of practice teams in delivering quality health checks. A community of interest has formed and are positioned to realise: Maintained liaison with software vendors and existing complementary projects (i.e. CSIRO), An iterative and agile process that will support a standardised approach in the delivery of an MBS Item 715 health check, while enabling local variation Ensure consistent access and use of age appropriate 715 template through patient information and recording systems
- These are recommendations that are being made by the partnership. We are at the cutting edge of change and having access to the resources required is paramount. Some of the ideal is oput of reach but certainly the conversations have begun and it is a watch this space Key activities to achieve this (taking a standards based approach): Co-design the workflow, user interface and technical specifications for the MBS Item 715 health check: Define set of data requirements for an MBS Item 715 health check Structured atomic data (enter once, use many times) Clinical use cases Develop an agreed information model Define user interfaces and how information in software is rendered or used by and for – GPs, nurses, AHW/Ps, patients Proof of concept Acceptability by patients Evaluate efficacy with clinicians and consumers.
- Keeping in mind this part of the project is about ensuring access to high quality healthcare for Aboriginal and Torres Strait Islander people regardless of where care is sought
- New webpage being launched in October, housing templates, project documents and resources: MBS Item 715 health check templates - so we all want the templates… Good Practice Tables National Guide in HTML National Guide Check – units written by National Guide authors Updated RACGP Identification Audit – Category 40 Activity The next slide will show examples of draft materials
- Update MBS requirements to reflect recommendations for provision of Item 715 health checks Test and evaluate the five new MBS Item 715 templates to understand user acceptability for both clinicians and Aboriginal and Torres Strait Islander patients including adaptability to local needs and priorities Align update of five MBS Item 715 templates with each National Guide update so that they occur simultaneously to ensure consistency and currency with evidence based practice Test and evaluate Good Practice Tables with mainstream general practices to determine usefulness and acceptability Ongoing development of resources to support high quality culturally responsive primary healthcare that meets patient priorities (e.g. data quality, value based care) to support provision of high quality health checks eg a “how to” guide to increase the number of high quality health checks in both ACCHO and non-ACCHO parts of the primary health sector continuing to use a highly collaborative co-design methodology at all stages of development of resources through extensive stakeholder consultation and partnership (e.g. PHNs and mainstream GPs, NACCHO Affiliates and ACCHOs, NATSIHWA, AAPM, APNA) including testing and evaluation of usefulness and acceptability of all resources Explore the use of social marketing to support effective implementation and use of resources Make resources widely available including on PHN Health Pathways
- The broad and diverse group of stakeholders that gave their time and resources
- Patient-centred healthcare: the prime importance of always holding in mind what is acceptable and valuable to patients including what supports cultural safety in the experience of accessing and receiving healthcare The message reinforced in phase one with clinicians was to work with the person that sits in front of you The recent Murri rugby league carnival – QAIHC When a young person was asked if they would’ve got the health check if they didn’t have to – the response was ‘yeah, for sure’ and I get my family to as well’ – often we see the data but this statement is so powerful in demonstrating the experience of the person walking through the door of a great health service. It is the story that sits behind behaviour and attitude change.
- Health literacy is of utmost importance Screening as a component of primary healthcare: consistent messages, especially from clinicians, about health assessments as a part of preventive healthcare, which itself is a part of comprehensive primary healthcare, including concerns about other aspects of primary healthcare being undervalued Dr Vicki Slinko – “Lauren – as doctors we don’t learn this stuff”
- Quality of the MBS Item 715 health check: being dependent on both what is included (elements) in the health check and how it is experienced by the patient/Community, with many concerned about the risk of prioritising the numbers of health checks claimed, at the expense of the usefulness and value to the patient of those health checks What is not included and the robust discussion around the reasons why Then there is the question of being placed to respond to Stolen generations? Treaty and constitutional recognition? Land rights and native title? Cultural identity? Racism and marginalisation?
- Workforce: the importance and value of MBS Item 715 health checks being offered by multidisciplinary teams including Aboriginal and Torres Strait Islander clinicians and all providers being appropriately remunerated. It is understanding the processes that link to one another and how we value each member of the team delivering quality healthcare
- Ways of working: the value of respectful, inclusive, collaborative co-design with broad representation as the most effective way of working. Understanding that ACCHO sector came from market failure – there is so much value in what we do and how we do it. We use the terms of engagement bt this is part of a bigger project that is reflected in the manner of true ways of working together