22

Jul
2024

2022 Northern Rivers flood experience influences national ‘GPs in Evacuation Centres’ guidelines

Healthy North Coast and local GPs have partnered with The Royal Australian College of General Practitioners (RACGP) and other Primary Health Networks to develop guidelines that will make it easier for disaster-affected communities to receive access to GP services in the immediate wake of a disaster.

The resources provide clear guidance on how to provide safe clinical care in an evacuation centre context. The resources also make recommendations about how disaster response agencies can connect with local GPs and include them in their disaster planning.

The North Coast of NSW is one of the highest disaster declared regions in the country for frequency and severity across all three measures of fire, flood and storm. Together with South East Queensland, it has been labelled a disaster ‘hotspot’ in Australia.¹

“At one point during the 2022 Northern NSW floods, Healthy North Coast and local GPs were supporting 31 evacuation centres. There were no guidelines around how to do this because primary health care has not traditionally been included as part of the disaster response. That is finally starting to change now,” said Monika Wheeler, CEO of Healthy North Coast.

“It’s vitally important that our GPs and other primary health care professionals are supported so they can deliver swift and effective health care for those impacted by natural disasters and that they’re properly embedded into the wider healthcare response.

“It’s been great to contribute to this important work, sharing some valuable lessons that we’ve learned in the North Coast region over the past few years.”
The guidelines were the result of 18 months of extensive co-design and development.

RACGP President Dr Nicole Higgins said it is essential for GPs and local health authorities to work together in both disaster planning and response:

“The 2022 Northern NSW floods were devastating for local GPs and practice teams,” she said.

“We’ve seen that where GPs, Primary Health Networks, and other local health authorities do work together to plan against disasters, their patients are safer during emergencies, practices can be back to full capacity sooner, and patients who need health care experience fewer disruptions. Chronic health conditions don’t pause in an emergency.

“GPs also can and do provide emergency medical care, and many of us have done extra training to do so. Work like this is important so when disasters strike, disaster response knows who to call and the assistance they can provide. GPs who can be part of the immediate response should be included in planning, and it’s vital for our patients that general practices come back online as soon as possible. This proactive work by Healthy North Coast is an excellent move.”

Local GPs Dr Liz Hicks and Dr David Glendinning voluntarily provided GP services at the Goonellabah and Lismore evacuation centres respectively and were active contributors to the new resource.

Dr Liz Hicks, GP at First Light Ballina and Healthy North Coast Educator, said she looked forward to seeing GPs being properly integrated into local and state disaster planning:

“The best place for GPs and patients in a disaster is their regular general practice. However, with a disaster of the scale we had in 2022, where many people are displaced and multiple clinics shut down, then accessing GPs in evacuation centres is the next best option.

“It was a stressful and chaotic time. I am proud to have played a role in the creation of this resource and hope any GP around the country who may find themselves in the position of working in an evacuation centre in the future, has some clear guidance and support in their role.”

Dr David Glendinning, GP at Goonellabah Medical Centre and Chief Clinical Information Officer at Northern NSW Local Health District, added his endorsement:

“Disasters place local GPs on the front lines, but without being part of a coordinated response, they are an under-utilised resource. It’s essential that governments connect with local GPs before an emergency occurs, so that GPs can be incorporated into the disaster management strategies and be as effective as possible.

“With the publishing and adoption of these guidelines, we as GPs will be in a much better position to look after the health needs of our communities when (not if), the next disaster occurs.”

The guidelines can be found on RACGP’s website, along with a new resource for GPs on providing care in evacuation centres and a position statement.

Other info:

Working with RACGP on these guidelines is but one of many initiatives that Healthy North Coast has invested in the area of disaster management to support primary health care services. Others include:

  • Disaster Ready Primary Care workshops to support and enhance the North Coast primary care workforce’s resilience and preparedness for future disaster shocks and stresses.
  • Workforce Support and Wellbeing grants to provide rest and relief for healthcare professionals in the region, promoting resilience and offering opportunities for debriefing.
  • Community Wellbeing and Resilience grants, funding local place-based initiatives that support communities to recover from the health and wellbeing impacts of natural disasters and building their capacity to face future compounding challenges.
  • Establishment of the Lismore Primary Health Care Precinct at Southern Cross University Health Clinic, where flood-impacted primary care providers were given a new home and Lismore residents were provided access to vital primary health services, including the in-person Head to Health Hub.

 

Image of GSAC evacuation centre, Goonellabah. Courtesy of Dr David Glendinning. 

 

¹ Sewell, T., Stephens, R., Dominey-Howes, D., Bruce, E., & Perkins-Kirkpatrick, S. (2016). Disaster declarations associated with bushfires, floods and storms in New South Wales, Australia between 2004 and 2014. Scientific Reports (6). Retrieved 17 April 2024 from https://www.nature.com/articles/srep36369#Fig5

Contact for media enquiries

Sam Brunning

Phone: 0439 968 437

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Our regional partners

  • Local Health District partners in our footprint: Mid North Coast Local Health District (MNCLHD) & Northern New South Wales Local Health District (NNSWLHD)
  • Aboriginal Medical Services (AMS)
  • The Royal Australian College of General Practitioners (RACGP)
  • Australian College of Rural and Remote Medicine (ACRRM)
  • Rural Doctors Network (RDN)
  • Rural Clinical Schools & Regional Training Hubs
  • General Practitioners
  • Registrars and International Medical Graduates
  • North Coast Allied Health Association (NCAHA)
  • Local Councils
    Pharmaceutical Society of Australia (PSA)
  • Universities including: Charles Sturt University (CSU), University of New South Wales (UNSW), Southern Cross University (SCU)

Aged Care Disaster Management Planning

Strategic Priority Area: One team

North Coast is identified as the region most likely to be impacted by climate change in Australia and also forecasted greatest growth in those 65+.

Healthy North Coast takes a lead role in ensuring the older population and the sector that supports them are prepared for, can respond to and recover from disasters and other emergencies.

We have led eight regional disaster management capacity building workshops, bringing together SES, community organisations and the aged care sector.

We have also developed disaster preparedness tip sheets for both residential and community aged care providers.

Voluntary Assisted Dying

Strategic Priority Area: One team

In May 2022, the NSW Parliament passed the Voluntary Assisted Dying Act 2022. Effective from Tuesday, 28 November 2023, eligible people have the choice to access voluntary assisted dying. 

Healthy North Coast has developed a webpage for both health professionals and consumers, with links to available information and resources.

Living with Dementia resources

Strategic Priority Area: No one is left behind

Healthy North Coast has worked with people living with dementia, their families and local service providers to develop an information booklet that will help them connect with local and national supports along their journey.

Highly regarded by a range of professional supporting those on or starting the dementia journey, the booklet includes commonly asked questions for people to ask their GP and/or specialist.

“It’s a fantastic resource and I give it to everyone on their first diagnosis. Its easy to read, so well planned and thought through and has lots of really useful information, tailored to the region.
I also find it very helpful when educating clinical staff.”

−Geropsychiatric Nurse Practitioner, Mid North Coast.

The resource is available in digital and printed copies, with more than 5,000 distributed across the region. An e-version is available to clinicians via the Dementia and Cognitive Impairment HealthPathway.

Deteriorating Resident Triage Tool

Strategic Priority Area: One team

Empowering aged care teams to deliver safer, more consistent care.

The Deteriorating Resident Triage Tool (DRRT) supports aged care staff to confidently recognise and respond to signs of resident deterioration. It enables timely, evidence-based decisions, strengthens communication with health services, and promotes early intervention and effective care planning, helping residents receive the right care, at the right time, in the right place. By doing so, it reduces unnecessary Emergency Department presentations and improves resident outcomes.

Developed in collaboration with a specialist geriatrician and informed by input from Residential Aged Care Managers, NSW Ambulance, GPs, and clinical experts across the Mid and North Coast Local Health Districts, the DRRT is practical, relevant, and aligned with contemporary best practice.

Aligned with the Strengthened Quality Standards:

  • Standard 1 – The Person: Respects resident preferences and Advance Care Directives.
  • Standard 2 – The Organisation: Strengthens governance and clinical oversight.
  • Standard 5 – Clinical Care: Supports early recognition and escalation of clinical deterioration.

North Coast care finders program

Strategic Priority Area: No one is left behind

Care finders is a free service to assist older adults connect to aged care services and supports. Care finders support older people who experience significant barriers to accessing services, and walk alongside their clients at their own pace, to understand their individual situation and support them to work through the steps to address their needs. Care finders assist people with access to other supports in the community. They can provide connections both with accessing services for the first time, and with changing or finding new services and supports if their needs change.

Care finders can:

  • Provide information about local aged care services
  • Help to set up an assessment with My Aged Care to access support, and
  • Find services that are targeted and available to help.

The care finder program has been extended to June 2029 and is provided by the following organisations. Each (Lismore, Coffs Harbour, Clarence Valley, Richmond Valley, Port Macquarie-Hastings, Kempsey, Nambucca and Bellingen) and Footprints (Kyogle, Tweed, Byron and Ballina).

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Psychological services in residential aged care homes

Strategic Priority Area: Improving Lives Now

Healthy North Coast commissions two service providers to deliver psychological therapies and supports for older people with, or at risk of developing, a mental illness and who are living in residential aged care homes (RACHs).

The aim of the program is to both provide direct support to residents and their families and carers, as well as upskill the RACH workforce to respond to the needs of residents presenting with mental health concerns.

Healthy Towns. Healthy Communities.

Strategic Priority Area: Securing a Healthier Future

Connection and a sense of belonging are protective factors for both individual and community health and wellbeing. Evidence highlights that the social determinants of health play a critical role in addressing many of our regions health challenges.

That’s why Healthy North Coast has long been committed to supporting communities to strengthen and to build social health. Our initiatives, including contemporary ‘Social Prescribing’, help people to connect to activities, supports and each other, and assist communities to integrate services and bridge gaps.

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Telehealth in Residential Aged Care

Strategic Priority Area: Improving Lives Now

The Royal Commission into Aged Care Quality and Safety identified several critical areas affecting aged care residents and our health system. Key challenges include:

  • Limited access to general practitioners (GPs) and allied health professionals in aged care facilities.
  • Difficulties accessing out-of-hours services

Telehealth offers valuable opportunities to enhance support for residents living in aged care homes. Funded by the Commonwealth Department of Health and Aged Care, this initiative provides telehealth equipment and staff training as part of the response to the Royal Commission’s findings.

By improving access to primary care clinicians, specialist services, and other service providers through telehealth, we can significantly enhance health outcomes for residents, reducing unnecessary hospital transfers and emergency department visits.

The selection of telehealth equipment was guided by our Healthy Ageing Strategy (HAS), a comprehensive digital discovery questionnaire, and consultation workshops with various stakeholders. These efforts included interviews with residents to understand their attitudes toward telehealth, ensuring the initiative meets their needs and preferences.

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Greater Choice at Home Palliative Care Program

Strategic Priority Area: Improving Lives Now

Aims to provide people who have life limiting conditions the opportunity to exercise choice and receive high quality care at home, harnessing improved and better coordinated supports and services that meet their individual needs.

Program objectives:

  • Improve access to palliative care at home and support end-of-life care systems and services (in primary health care and community care)
  • To enable the right care at the right time and in the right place (to reduce unnecessary hospitalisation)
  • Generate and use data to support continuous improvement of services across sectors
  • Use available technologies to support flexible and responsive palliative care at home, including in the after-hours.

These objectives will contribute to achieving the following intended overarching outcomes of:

  • Improved capacity and responsiveness of services to meet local needs and priorities
  • Improved patient access to quality palliative care services in the home
  • Improved coordination of care for patients across health care providers and integration of palliative care services in their region.

Education & training funding elibility

Funding is open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.

Workforce Locum support and R&R funding criteria

  • Available to primary care services in disaster impacted communities within the Healthy North Coast footprint.
  • Available to support short-term workforce coverage, allowing clinicians to rest and recover.
  • Workforce-support funding in total is capped for each site, over a 12-month period:
    • $10k for GPs and/or
    • $5K for nursing and/or
    • $5k administration support and/or
    • $5K allied/pharmacy and other.
  • Funding is not to be used to fill gaps in staffing that have not been able to recruit to and not to replace existing staff.
  • Healthy North Coast will assess requirements and approve available funding directly with the service requesting support.
  • Priority will be given to sites that have immediate, short-term workforce support needs.
  • Requests will be reviewed and supported on a case-by-case basis.
  • Program funding administered via RCTI Agreement (Recipient Created Tax Invoice) to be paid monthly, or on completion of the placement (whichever comes first).
  • Practices will be required to complete a request for payment form monthly, or on completion of the placement (whichever occurs first).

Wellbeing Flexible Funding Criteria & Eligibility

  • Open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.
  • Activity must be purposeful, with the aim of increasing the wellbeing of your team.
  • Requests will be assessed on a case-by-case basis, with funding allocated based on team size.*
  • Following approval by Healthy North Coast, funding will be administered via RCTI Agreement (Recipient Created Tax Invoice) upon providing proof of expenses.
  • Funding cannot be used for the purchase of alcohol, or any other goods or services where the vendor cannot quote their Australian Business Number.
  • Planned activities must occur prior to 30th June 2024.
  • Funding will not be available for retrospective activities.
*Team Size
(Total staff and contractors)
Funding Available
Small (1-5)$500-$1500
Medium (6-20)$1500-$4000
Large (>20)$4000-$5000

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