Refugee Transition to General Practice – Coffs Harbour – Coffs Doctors

Refugee communities experience significant barriers to accessing ongoing primary healthcare, including language and cultural barriers, unfamiliarity with the Australian health system, trauma-related needs, and difficulty finding general practices with the capacity and confidence to provide culturally responsive care. As a result, many refugee patients experience fragmented care and poorer health outcomes. This project addresses these needs by building the capability of mainstream general practices to provide high-quality care for refugee patients, supporting safe and supported transitions from the Refugee Health Service into ongoing general practice care, strengthening collaboration between services, and improving access to sustainable, equitable primary healthcare across the region.

The project uses a collaborative, capacity-building approach to support the transition of refugee patients from the Refugee Health Service into mainstream general practice. A dedicated Social Worker works with participating practices to coordinate patient transitions, strengthen referral pathways, address barriers to care, and provide ongoing support. General practices receive education, mentoring and practice support funding to build their capability to deliver culturally responsive care, while community outreach helps improve awareness of available health services and how to access them.

The project has been designed and delivered in partnership with the Refugee Health Service (RHS), which has extensive experience supporting refugee communities and understanding their health needs. The model has been informed by the RHS’s experience of the challenges refugee patients face when transitioning to mainstream general practice and by ongoing collaboration with participating general practices to identify barriers and practical solutions. Community outreach and education activities with refugee and multicultural communities also provide opportunities to hear directly from community members and adapt the project to better meet their needs. Regular engagement between HNC, the RHS and participating practices supports continuous refinement of the program throughout implementation.

The program delivers a range of activities to support the successful transition of refugee patients into mainstream general practice, including:

• – Coordinated transition of patients from the Refugee Health Service to participating general practices.
• – Dedicated Social Worker support for patients and general practices throughout the transition process.
• – Development of referral pathways and communication processes between the Refugee Health Service and general practices.
• – Education and support for participating general practice staff to build capability in refugee health and culturally responsive care.
• – Practice support funding to assist with the additional time and resources required to establish care for refugee patients.
• – Community outreach and education with refugee and multicultural communities to improve awareness of primary healthcare services and how to access them.
• – Ongoing collaboration, quality improvement and evaluation to strengthen the model and inform future implementation.

– Improve access to ongoing, culturally responsive primary healthcare for refugee patients.

– Build the capability and confidence of mainstream general practices to care for refugee patients.

– Support safe and coordinated transitions from the Refugee Health Service to general practice.

– Develop and evaluate a sustainable model for refugee transition to primary care.