30

Jun
2025

Local health solutions in action: First round of Primary Care Impact Grants recipients announced

Pictured L-R: Haley Hodgson – Director Maclean Medical, Julian White – Senior Manager Primary Care Advancement at Healthy North Coast, Sue de Lacy – Diabetes Clinical Nurse Specialist at Northern NSW LHD, Monika Wheeler – CEO Healthy North Coast, Luke Elias – Director Primary Health Programs & Partnerships at Healthy North Coast.


Healthy North Coast is pleased to announce the first successful recipients of its new Primary Care Impact Grants – innovative, locally designed projects that will support high quality care for people with chronic diseases across the region.

18 grants with a total value of $897,420 have been awarded in this first round, with funding going directly to general practices, Aboriginal Medical Services, allied health businesses and other local providers across the Mid North Coast and Northern NSW, to test and scale creative solutions to current health care challenges.

Healthy North Coast CEO Monika Wheeler said the response to the initiative has shown the depth of commitment across general practice and allied health services to improving care for local communities:

“Chronic diseases are the leading cause of death and disability in Australia, but we know that nearly 40% of this burden could be prevented by early intervention and addressing risk factors.

“GPs, nurses and allied health practitioners delivering care every day across our region are well placed to see where change is needed. These grants are about equipping those frontline providers with funding to test new approaches that reduce the impact of chronic diseases in our community.”

The Primary Care Impact Grants are part of Healthy North Coast’s commitment to strengthening the region’s primary health care system through the Australian Government’s Primary Health Network program.

$3.4m in total funding has been made available for the coming year with future rounds still to come. This includes $1.8m through the MyMedicare Multidisciplinary Teams initiative and $1.6m through Primary Health Network program funding to support the management of complex and chronic disease in high-risk populations.

Haley Hodgson, Director at Maclean Medical, was thrilled to be amongst the successful recipients:

“We’re incredibly proud to receive this funding to support a coordinated, multidisciplinary model of care for chronic conditions like diabetes, heart disease, dementia and Chronic Obstructive Pulmonary Disease (COPD) in the Clarence Valley,” Ms Hodgson said.

“This grant allows us to expand access to timely care, especially for patients in rural and underserved areas, and to pilot new ways of working collaboratively across general practice, allied health and nursing teams.”

The Primary Care Impact Grants are designed to support continuous quality improvement in primary care. The grant applications were reviewed using an evaluation rubric that assessed community need, health equity, efficiency and feasibility of each proposal, by a panel of health experts.

Successful proposals had a data-informed and evidence-based approach to meeting the needs of their communities, with a focus on reporting outcomes to drive continuous quality improvement.

“These are grassroots innovations with the potential for big impact,” Ms Wheeler added.

Each grant recipient will provide valuable data back to Healthy North Coast to assist with evaluation of this innovative new initiative.

More information on the Primary Care Impact Grants, including for local health professionals interested in applying for future rounds, is available on Healthy North Coast’s website.

List of Round One Primary Care Impact Grant recipients:

Multidisciplinary Team Care Grants:

  • Dunoon General Practice – Multidisciplinary frailty intervention program – $65,040
  • Hastings Physio and Health + Werin Aboriginal Corporation + PCYC Port Macquarie – Group based chronic disease prevention program for Indigenous Australians – $75,000
  • Maclean Medical Centre – Diabetes, heart disease, dementia, arthritis, COPD & anxiety program – $64,000
  • Dr Tenell Holborow, Port Macquarie – MDT care for residents in aged care – $40,000
  • The Health Lodge Integrated Medical Centre – Supporting families living in water-damaged homes following the 2022 Northern Rivers floods – $50,000
  • Bulgarr Ngaru Medical Aboriginal Corporation – Expansion of Youth Program – $75,000
  • Maria Clinic – Improving outcomes for patients with Type 2 diabetes in Casino – $74,880

Total Multidisciplinary Team Care Grants awarded: $443,920

 

Chronic Disease Prevention Grants:

  • Prema House, Lismore – Nurse-led clinic to address chronic disease and cancer risk in Richmond Valley – $30,000
  • Scotts Head Medical Practice – Iron infusion service for patients with iron deficiency anaemia (IDA) – $15,000
  • Kennedy Drive Medical Centre, Tweed Heads – Prevention-focused chronic disease program centring on mental health – $29,500
  • Woopi Medical Centre – Practice-wide chronic disease prevention and management program – $50,000
  • Rekindling the Spirit – 48-week Aboriginal Healthy Lifestyle Program – $50,000
  • McKay Street Surgery, Macksville – Early detection, education, lifestyle change, and coordinated care – $30,000
  • The Physio Movement, Woolgoogla – Pain management program to address chronic musculoskeletal pain – $50,000
  • Rose Avenue Medical Practice, Coffs Harbour – Raise awareness of hypertension and promote early detection – $50,000
  • OneBridge, Ballina – Nurse-led chronic disease prevention and management program targeting individuals experiencing homelessness, poverty, and chronic illness – $50,000
  • CHC Medical, Coffs Harbour – Chronic disease screening program to detect and manage diabetes and cardiovascular risk – $50,000
  • One more grant TBC – $49,000

Total Chronic Disease Prevention Grants awarded: $453,500

 

More information about each of the round one grant recipients can be found on Healthy North Coast’s website.

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 Pilot

Strategic Priority Area: One team

The Deteriorating Resident Response Tool (DRRT) has been developed to guide RN’s in Residential Aged Care homes (RACHs) to better understand, anticipate and make clinical decisions responding to the deteriorating health of residents.

The objective of the DRRT is to give RACH staff clear information to triage and provide appropriate care for a range of residents’ health conditions, and, in turn, prevent unnecessary presentations to ED.

The tool has been designed together with a specialist geriatrician, consulting with stakeholders such as Residential Aged Care Managers, NSW Ambulance, GPs, and experts from Mid and North Coast LHDs.

The pilot commences in March with four participating RACHs. Evaluation measures will include effectiveness in building RN confidence and reported reduction in unnecessary hospitalisations. Findings will inform a future planned, region-wide implementation.

North Coast Care Finders Program

Strategic Priority Area: No one is left behind

The Care Finders program is a free region-wide service to support vulnerable older people who have no-one else to help them, to learn about, apply for and set up support services.

Care finders can help people understand what aged care services are available, set up an assessment, and find and choose services. They also help people with access to other supports in the community, both accessing services for the first time and changing or finding new services and supports.

Healthy North Coast is pleased to announce that, following a comprehensive procurement process, 2 organisations, EACH and Footprints, have been commissioned to deliver Care Finder services. With additional funding secured, this vital service will now continue through to 2029.

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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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