Increasing services to care for older people
One of the PHN's key priority areas is to enhance aged care services to delay older Australians’ entry into Residential Aged Care Facilities (RACFs), reduce avoidable hospitalisations and improve equitable access to the services that older people require. Over the past year the PHN has worked towards achieving these goals through pilot programs and community education.
What is Palliative Care? The PHN releases community explainer video
A priority across our broader community, as identified in our Palliative Care Needs Assessment, is to increase awareness of end-of-life issues and improve health and death literacy. To assist in meeting this objective, the PHN developed an educational video What is palliative Care? for National Palliative Care Week.
It is with improved knowledge and understanding that people will feel more empowered to advocate for their needs and preferences which in turn can improve their experience of care. The PHN will be involved in the delivery of a range of projects in this area including facilitation and delivery of education and the development of resources and incentive programs to improve the coordination of palliative care in the primary care sector.
Join presenter Charles Broadfoot from the PHN as he talks all things Palliative Care with Dr Ashwin Kaniah GP and Palliative Care Trainee, Angela Martin, Nurse Practitioner and Kylie Hutchinson, Death Doula.
PHN Launches Frailty Early Intervention Program
In June 2023, the PHN launched an early intervention pilot program for General Practices to participate in a frailty screening program using the FRAIL Scale, a validated screening tool.
Frailty is a common syndrome which occurs due to a combination of de-conditioning and acute illness on a background of existing functional decline that is often under recognised.
Frailty is more common in females with the risk increasing with age. People with frailty have two to three times the health care utilisation of non-frail people and experience higher morbidity and lower quality of life.
While frailty is linked with ageing, the two do not have to go hand-in-hand. Many causes of frailty can be managed, and in some cases reversed, to create better health outcomes and quality of life.
By supporting general practices to confidently screen for and manage pre-frailty and frailty, the program seeks to reduce hospitalisations and support pre-frail and frail patients to live independently at home for longer.
Incentive payments were provided to enable staff to participate in training workshops and regular meetings with frailty experts, to enhance their understanding of frailty identification and identify opportunities and referral options to change the frailty trajectory, enabling them to provide better patient care in conjunction with other medical and allied health professionals.
Participating practices report frailty scores and referral information to the PHN to provide insights into the interventions used and to inform future activities. This data will also inform the (optional) quality improvement audit that practices can complete at the conclusion of the program in March 2024.
19 practices across the region are currently participating in the nine-month frailty screening program.
Pilot of Nurse Practitioners in Aged Care
A collaborative pilot project investigating a new model of care in residential aged care facilities (RACFs) is providing valuable insights into innovative ways to improve health care for residents.
Hunter Primary Care, in partnership with the PHN, has researched, developed, and implemented a pilot Aged Care Nurse Practitioner (NP) service to increase access to and the effectiveness of primary care services for people living in RACFs.
The recent Royal Commission into Aged Care Quality and Safety highlighted the difficulty experienced by many people living in residential aged care facilities in accessing health care. Older frail residents cannot always travel to health practitioners and health practitioners cannot always leave their busy practices to provide timely medical consultations in RACFs.
The Nurse Practitioner does not replace the GP but works with the resident’s GP in conducting regular health assessments and consulting when changes in the clinical management of the person is required.
The NP model is designed to provide residents with both a proactive and responsive person-centred model of care to provide timely clinical assessment and management. A Nurse Practitioner provides a regular outreach service to residents with whom they have an established and ongoing relationship, and is familiar with the resident’s baseline health status and care goals.
The NP model of care builds on work undertaken within the Aged Care Emergency (ACE) service. The ACE service is a reactive response for acutely unwell residents that provides triage, consultancy, clinical support, and advice for staff, so that care for residents can be delivered in the facility where appropriate and transfer to hospital is avoided.
The pilot NP program was conducted in six RACFs in the Hunter region with proactive weekly visits and built-in capacity to respond to unexpected health events. One RACF General Manager involved in the pilot noted “the model is ideal, by sitting outside the RACF the NP remains wholly focused on clinical management of the residents’ conditions.”
Similarly, a GP working with two NPs at two different facilities stated they were “very happy with the two Nurse Practitioners, their work has reduced my workload significantly” and they “would like the service to extend to other facilities where my patients reside in the future.”
The research undertaken in this pilot program will be utilised to contribute to the body of knowledge underpinning Nurse Practitioners in Aged Care and Primary care. It will also contribute to changes in government policies that would enhance the cost effectiveness of the model of care.