Jun

07

2018

Cervical Screening – Important Update

Clarification of Cervical Cancer Symptoms

Some health care providers are using low thresholds to determine whether a participant shows symptoms indicative of cervical cancer.

Pathology laboratories are getting requests for co-tests for participants with symptoms that are usually not indicative of cervical cancer.

This has led to the over-referral of participants for co-tests and unnecessary follow-up, where a cervical screening test would have been appropriate, if due.

To address this issue, a set of more specific symptoms suggestive of cervical cancer has been developed by the National Cervical Screening Program clinical advisers.

When filling out a Pathology Test Request Form, health care providers are required to describe the symptoms in more detail to help pathology laboratories understand why a co-test is needed.

The following signs or symptoms can be suggestive of cervical cancer and need further investigation:

  • Participants with abnormal vaginal bleeding (post-coital, unexplained inter-menstrual or any post-menopausal) should have a co-test, and usually will be referred for gynaecological assessment.
  • Any participant with unexplained persistent unusual vaginal discharge (especially if offensive and/or blood stained) should be investigated with a co-test, and subsequent referral for gynaecological assessment.
  • Any participant with unexplained persistent deep dyspareunia (pain during intercourse) should have a cervical screening test (if due), and subsequent referral for gynaecological assessment.

Participants with symptoms suggestive of cervical cancer are tested and managed on a different clinical pathway from those who are asymptomatic.
Symptomatic participants need diagnostic testing, not cervical screening.
More information on the cervical cancer symptoms is available on the National Cervical Screening Program website.

What is a co-test?

Co-testing involves the pathology laboratory performing both the human papillomavirus (HPV) test and liquid based cytology (LBC) test concurrently on the same specimen. The LBC test is performed irrespective of the HPV test, without requiring an further request.

When is a co-test required?

Co-testing is recommended for participants of any age with signs or symptoms suggestive of cervical cancer (see above); patients exposed to diethyl-stilboestrol (DES) in utero, and their daughters (if requested); patients undergoing Test of Cure surveillance; and patients who have been treated for glandular abnormalities.

Health care providers should refer to the Pathology Test Guide for Cervical and Vaginal Testing for what to write on the Pathology Test Request Form when ordering a co-test.

National Cancer Screening Register Update

The implementation of Release 2 of the National Cancer Screening Register (NCSR) is on schedule to be completed by 29 June 2018.

This means that all pre 1 December 2017 results will have been migrated from the state and territory registers into the NCSR to provide national cervical screening records for participants of the National Cervical Screening Program.

Until Release 2 is complete, health professionals (including GPs, health care workers, pathologists and specialists providing colposcopy services) should continue to contact their state and territory register for screening histories up to 1 December 2017.

For cervical screening histories post 1 December 2017, please contact the NSCR.

For more information, please refer to the Transition Quick Start Guide for Healthcare Providers.

Links for Further Information

Health care providers are recommended to follow the National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding and the Pathology Test Guide for Cervical and Vaginal Testing.

Colposcopists must complete and submit the Colposcopy and treatment form and information about the mandatory notification of cervical screening information within 14 days of the colposcopy episode.

Toolkit for engaging Under-screened and Never-screened women in the National Cervical Screening Program.

A subset of the clinical pathways is included in the Understanding the National Cervical Screening Program Management Pathway: A Guide for Healthcare Providers.

Resources and education materials about the National Cervical Screening Program can be accessed on the website and ordered free of charge. This includes resources to help participants understand their cervical screening results, posters to promote the National Cervical Screening Program and fact sheets on self-collection.

National Cervical Screening Program website

National Cancer Screening Register website

Fact sheet on the new pathology Medicare items for tests under the National Cervical Screening Program.

Visit the HealthPathway for Cervical Screening.

For a list of all localised pathways see:

Mid and North Coast Localised Pathways
Username: manchealth
Password: conn3ct3d

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We acknowledge the Traditional Custodians of the lands across our region, and pay our respect to Elders past, present and on their journey. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to the land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander Peoples as the Land’s first peoples and honour the rich diversity of the oldest living cultures.

Healthy North Coast is an independent, not-for-profit organisation proudly delivering the PHN program in North Coast NSW. We are committed to improving the health of our communities through quality primary health care.
The PHN program is an Australian Government Initiative.
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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.

Read the media release: Aged Care Homes Prepare for Disasters

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.

Visit the Voluntary Assisted Dying webpage

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.

The booklet includes commonly asked questions for people to ask their GP and/or specialist.

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.

View the Living with Dementia booklet (PDF)

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.

View the deteriorating resident response tool

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.

On the North Coast, Healthy North Coast has commissioned four organisations to provide this important service: EACH, Carexcell, Lifetime Connect and Footprints.

Visit the commissioned services listings to find out more, including service contact information.
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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.

Visit the commissioned services listings to find out more, including service contact information.​

Social prescribing (Healthy Me Healthy Community)

Strategic Priority Area: Securing a Healthier Future

Delivered by Feros Care, the Healthy Me, Healthy Community program aims to build individual and community connections to reduce loneliness and improve wellbeing in Port Macquarie.

The program helps people to connect with community, activities, supports and services that address their broader social determinants of health, as an alternative or supplement to a clinical approach.

Visit the Healthy Me Healthy Community service page
Read the consumer story: Jim’s confidence boost brings a new lease on life
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Digital Health in Residential Aged Care

Strategic Priority Area: Improving Lives Now

Timely access to primary health care professionals, whether through face-to-face consultation or telehealth, is recognised as an issue for many Residential Aged Care Homes (RACHs), that in some cases can lead to potentially preventable hospitalisations. RACHs require adequate telehealth facilities to support access to virtual consultations for their residents.

Project goals

  • Assist participating RACHs to have appropriate telehealth facilities and equipment to enable their residents to virtually consult when needed with their primary health care professionals, specialists and other clinicians. 
  • Provide training to participating RACH staff to support them to have the capabilities to assist their residents in accessing virtual consultation services.
  • Encourage increased use of My Health Record by RACHs, to improve the availability and secure transfer of resident’s health care information between RACHs, primary care and acute care settings.
For more information, visit the Residential Aged Care Virtual Care Project webpage
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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.
Download the 2023 Palliative and End-of-life Care Needs Assessment (PDF)

Education & training funding elibility

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

References

  1. Healthy North Coast Health Needs Assessment, 2022-2025
  2. Northern Rivers Vital Signs, 2023
  3. Northern Rivers Community Foundation Flood Impact Report, May 2023
  4. Centre for Evidence and Innovation, Participatory Grantmaking: Building the Evidence, May 2023
  5. Lee, G., Vine, K., Atkinson, A-R., Tong, M., Longman, J., Barratt, A., Bailie, R., Vardoulakis, S., Matthews, V., & Mizanur Rahman, K. (2023). Impacts of Climate Change on Health and Health Services in Northern New South Wales, Australia: A Rapid Review. International Journal of Environmental Research and Public Health, 20, 6285. 
  6. 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). 
  7. Dominey-Howes, D., Bruce, E., Stephens, R., Perkins-Kirkpatrick, S., & Sewell, T. (2016). Natural disasters are affecting some of Australia’s most disadvantaged communities. The Conversation. Natural disasters are affecting some of Australia’s most disadvantaged communities (theconversation.com).

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