Aug

28

2019

Five Considerations When Referring to Dietitians

By Amanda Clark, AdvAPD

Dietary advice is everywhere: it’s on social media, TV commercials, reality shows, documentaries and across the internet. Not to mention the advice provided by friends.

A dietitian should be an obvious choice for reliable nutritional advice, but which dietitian is right for the job? Dietitians are your on-hand qualified nutrition experts ready to help patients dispel myths and find the most practical approach to create dietary change.

When choosing a practitioner, consider that one dietitian doesn’t suit all patients.

Despite the prevailing model of care encouraging co-location of allied health in GP practices, it’s appropriate to find the right fit for your patient. One dietitian is unlikely to be both skilled and interested in renal, eating disorders, food intolerance and weight related issues. The current model creates some difficulties for primary health based dietitians in developing specialised interests and skills, but freedom to refer outside of the practice would assist with this.

For example, many people in the community assume that all dietitians are skilled in weight control due to the interpretation of the word ‘diet’. However, this too is a specialty area often requiring specialised equipment, strategies, tools and attitudes to get the most from the consulting relationship.

When selecting a practitioner, consider the following:

  • Expertise: Guide patients to an Accredited Practising Dietitian ( APD) or an Advanced Accredited Practising Dietitian ( Adv APD).
  • Matching Interests: The Dietitian’s Association of Australia hosts a Find an APD search on their website, enabling you to identify location and area of specialty to draw from. For example, you can choose a relevant postcode and ‘gastrointestinal problems’ to find dietitians comfortable in assisting patients in this area.
  • Location: Choose a practitioner in a convenient location for your patient as visits may be frequent or need to fit around work and home commitments. Convenient may be close to home or work.
  • Consultation Options: Many dietitians offer home visit, clinic, telephone or telehealth consulting services which may improve patient access and compliance.
  • Funding Options: Patients may require NDIS, Medicare, DVA or private health fund options. These are also visible via Find an APD.

What You Can Expect

Providing a written referral either to the patient or via Medical Objects is valuable to the dietitian in order to get a complete understanding of the patient’s condition, along with your (and their) expectations of the intervention. You can expect feedback after the initial assessment, when there is any significant change or an issue to confer on, and at the end of treatment. Dietitians usually appreciate any additional input you have along the way, too.

Further Developments

Stay tuned for the introduction of 20 rebated dietetic consultations per year, accessible to those with a range of eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder and atypical presentations) from November 1 2019 under Medicare. Get to know your eating disorder dietitians.

The introduction of the NDIS has introduced opportunities for individualised care plans which may involve consultations with carers and food providers, the development of meal plans, telephone support and any service format that enhances patient capacity. Seek out NDIS approved providers.

DVA are looking to introduce telehealth consultations enabling patients to access dietitians with the right expertise for their needs without needing to be local. This will be a major step forward. Look for DVA approved consultants.

There are 6,000 APDs in Australia, with 2,000 offering private practice consultations. This provides ample scope to find the right practitioner for the patient rather than using a one size fits all approach.

Amanda Clark is an Advanced Accredited Practising Dietitian, author and owner of Great Ideas in Nutrition, a North Coast dietitian practice.

Click here to visit the HealthPathway for Dietitian Services.

For a list of all localised pathways see:

Mid and North Coast Localised Pathways

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Password: conn3ct3d

For further information about HealthPathways contact:

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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