Sep

23

2021

RACF COVID-19 outbreaks in a vaccinated world

How will a residential aged care facility outbreak look when the majority of staff and residents are vaccinated?

During the Victorian residential aged care facility (RACF) outbreaks in 2020, the transmission statistics revealed that 13% of cases were residents and 15% were staff. The mortality rate was in the hundreds.

Currently in NSW, there are 48 outbreaks, with 10 in rural areas. Of these outbreaks, 0.5% are residents and 0.4% are staff. Last week, there were 14 deaths; 10 of these were on palliative pathways and 5 were not vaccinated.

The main outbreak management issues in the vaccinated environment include:

  • Continuity of care for residents:
    • Healthy North Coast’s RACF GP Outbreak Response Framework.
    • An Australian Government fact sheet on continuity of care for GPs is being developed.
    • Advance care directives and plans incorporating COVID-19 statements that uphold residents’ wishes.
  • Deconditioning continues to be seen in residents. The use of allied health staff where possible during the outbreaks and afterwards is a priority.

Locally, meetings between the RACFs, Healthy North Coast, local health districts and the Public Health Unit (PHU) continue, ensuring preparedness and information sharing from the Ministry of Health, the Australian Government COVID-19 teams and the aged care peak bodies. The group are grateful to the ongoing efforts of the PHU staff who continue to attend despite excessive workloads. Minutes from these meetings are available to interested GPs and practice staff – please contact:

Bron McCrae
Deputy Director Healthy Living and Ageing, Healthy North Coast
[email protected]

COVID-19 HealthPathways

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Password: conn3ct3d

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Healthy North Coast acknowledges the traditional custodians of the lands across our region and pays respect to the Elders past, present and emerging. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander peoples as Australia’s First Peoples and honour the rich diversity of the world’s 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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The following guidelines are provided to set out the Department’s objectives for this funding.  

1. The funding is provided to Healthy North Coast to fund a program of infrastructure repair and relocation grants for health care providers in Lismore, NSW Local Government Area.  

2. Infrastructure refers to buildings, fitouts, and equipment. 

3. Eligible grant recipients are: primary health care providers with infrastructure located within the Lismore Local Government Area (LGA) that was damaged by the 2022 floods.  

4. For the purposes of this program, primary health care providers are: general practices, allied health (including mental health), dental practices, pharmacies, private specialists, pathology providers, drug and alcohol treatment services, and Aboriginal Community Controlled Health Services.  

5. Under funding for this grants program, eligible grant recipients may receive up to $150,000 per applicant for the purpose of rebuilding flood-damaged infrastructure (buildings or fit-outs), replacing flood-damaged equipment, or relocating to alternative premises within Lismore, NSW LGA. Where an applicant’s rebuilding, repair, or relocation costs are less than $150,000, the grant amount will not exceed the rebuild, repair, or relocation cost. Where those costs exceed $150,000, the grant amount will not exceed the $150,000 cap (apart from the exceptions noted in point 6). 

6. Applicants who have received support under the Disaster Recovery Funding Arrangements (DRFA) and/or NSW grants remain eligible to apply for the grants, but prior support will be factored into determination of the level of support available. For example, an applicant requiring $80,000 to replace flood-damaged equipment who had already received $25,000 under DRFA or NSW grant support would receive $55,000 under this program. 

7. Healthy North Coast will assess applications for support using appropriate documentary evidence of repair or relocation costs already incurred, or estimates by qualified persons of likely costs. Number of active patients will also be taken into consideration as part of the assessment. Qualified persons include licensed construction contractors (for rebuilding or refitting), representatives of equipment supply companies (for equipment replacement), or commercial real estate agents (for relocation). 

8. Healthy North Coast will ensure that grants are made only in respect of damage caused by flood events during 2022 and only for the purposes of rebuilding flood-damaged infrastructure (buildings or fit-outs), replacing flood-damaged equipment, or relocating to alternative premises within Lismore LGA.  

9. Grants may only be provided in respect of damage to premises or equipment that was uninsured, or for which insurance was prohibitively expensive. 

10. There will be additional flexibility for additional assistance highly impacted applicants to be determined by Healthy North Coast in line with all the above criteria.  

11. Healthy North Coast will provide applicants with a simple application process and make available clear explanations of the eligibility criteria, supporting documentation requirements and application process. 

Mental Health Practitioner Directory

Frequently Asked Questions

Any AHPRA or AASW registered mental health practitioner providing services in the Mid North Coast and/or Northern NSW.

Social workers, psychotherapists and counsellors are ineligible to list in the directory.

By listing, you will let GPs, other referrers and consumers know that you are practising in Mid North Coast and/or Northern NSW. You can provide information such as where you are located, the services you provide, the population groups you support and your clinical interests.

No, the directory is a free service provided by Healthy North Coast.

This directory enables you to provide real-time information about your availability to accept referrals, as well as how long people may have to wait for an appointment. You can update this information as your availability changes. This will help GPs and other referrers ensure they only refer clients to practitioners who have the capacity to see them.

It also has a range of advanced search options and supports printing and bookmarking of search results.

You can choose to display your email address and your phone number so that people can contact you directly. You may prefer not to display these, in which case people can contact you by completing an enquiry form located in the Directory. Your choices can be updated anytime.

You can indicate wait times for an appointment for a new client or that you are currently unable to accept new referrals. You can also choose whether to display or hide your contact details. You can update your choices at any time.

Yes, you can update your listing or remove it at any time by clicking the “update practitioner details” button on your listing. You will receive a secure website link to your nominated admin email that will enable you to make changes, delete or put your listing on hold. You can also show when you are taking extended leave or are not available for a specific period, rather than completely removing your listing.

We will also send you an email every three months (90 days) prompting you to check that your information is up to date.

You will be responsible for managing the information in your listing and ensuring that it is up to date. You will also be asked to check the information before it is published in the directory.

We will also send you an email every three months (90 days) prompting you to check that your information is up to date so that the directory displays accurate information.

You can read the full Terms of Use by clicking here.

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Contact our Education Team

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Nigel Cronin
Senior Manager, Education
[email protected]
0437 169 786
02 6627 3390
Based on Bundjalung Country in Lismore

Bronwyn Thirkell
Centre for Healthcare Knowledge & Innovation and Education and Events Coordinator NNSW
[email protected]
0437 027 751
02 6618 5445
Based on Bundjalung Country in Ballina

Krissi Devlin
Education and Events Coordinator MNC
[email protected]
0447 407 473
02 6659 1808
Working days: Monday Thursday.
Based on Gumbaynggirr Country in Coffs Harbour

Click image to enlarge

Update provided 21 April 2022.

As you know, Lismore Skin Clinic in Molesworth Street was destroyed in the recent floods, and we are trying to rebuild the site as soon as we can.

In the meantime we will be moving to St Vincent’s Hospital Specialist Medical Centre – Level 4, Suite 12 – 20 Dalley Street Lismore.

We hope to be up and running in the next two weeks (by early to mid May 2022) and our receptionists will soon begin calling our patients to rebook their appointments and catch up with their needs.

Once we have a firm opening date we will update this notification.

Our email address – [email protected] and our phone number – 02 6621 3500 will remain the same as in the past. Only the address changes for a while.

We look forward to seeing you soon in our new premises.

Many thanks for your patience and understanding in these heartbreaking times – stay safe.

Dr Gudmundsen and the Team from Lismore Skin Clinic

Click image to enlarge

North Coast Health Connect Overview

North Coast Health Connect provides 24/7 clinical advice from experienced triage nurses (registered nurses) via phone or webchat for North Coast consumers with acute clinical symptoms.  

The objective of the service is to support consumers to find the right care at the right time and place, whilst also empowering them to manage their own care when safe to do so. 

The service is funded by Healthy North Coast through the North Coast PHN Program, delivered by Amplar Health (Amplar) and evaluated by The George Institute. 

Triage is conducted by registered nurses who are experienced in taking calls from health consumers. Each assessment commences with the collection of pertinent demographic information and ruling out life-threatening emergencies. Triage nurses then conduct a clinical assessment to gain an understanding of the relevant acute clinical symptoms and determine the best course of action.

The nurses are guided by over 180 clinical decision support algorithms which; in turn, are informed by strong clinical evidence and practice globally. Amplar has used and continually improved these algorithms for over a decade, undertaking many millions of interactions with consumers in Australia. In addition, they have also improved the algorithms to fit our local conditions here on the North Coast.

Despite the robustness of these decision support tools, all registered nurses maintain the autonomy to override the algorithm outcome if they make the clinical determination the patient needs higher acuity care (or lower care in limited circumstances).

Where it is determined the caller is not able to manage their symptoms at home, the nurse who conducts the triage assessment may refer the caller to a wide range of services in the acute and primary care health system including:

  • ambulance response — 000
  • the nearest Emergency Department
  • see a general practitioner (GP) in 2 hours, 6 hours, 12 hours, 1-3 days or by routine appointment. View more information.
  • where no face-to-face GP appointments are available, attend an HNC GP telehealth appointment in 2 hours, 6 hours or 12 hours. View more information.
  • dental services
  • see a community pharmacist within 24 hours (read more below)
  • connection to a mental health support phone line or other phone lines where appropriate.

Amplar monitors the clinical quality of the triage service to ensure it continues to align with best practice (ISO 9901:2015). Amplar has a dedicated Clinical Governance Team, overseen by a medical practitioner, who ensures patient safety and service effectiveness are always front of mind.

In partnership with participating general practices in the Healthy North Coast region, North Coast Health Connect will provide a more integrated approach to patients who need a consultation with a GP urgently.

When the triage assessment indicates the patient should consult with a doctor, the triage nurses will endeavour to assist the patient to find an available appointment with their own general practice in the first instance. Where that GP clinic is integrated with the triage service, the nurse will also be able to book that patient into a GP appointment directly, saving time and stress for the patient and GP clinic admin staff.

This integration will also focus on increasing access to those without a regular GP, by booking the patient directly into an integrated GP clinic where possible.

Healthy North Coast’s GP Telehealth service will be available to callers who are triaged as needing a GP appointment when no face-to-face appointment can be found and the presentation is suitable for a telehealth appointment.

In partnership with the Pharmaceutical Society of Australia, North Coast Health Connect has developed a new low-acuity referral option to see a community pharmacist within 24 hours. These referrals are arrived at through the standardised clinical algorithms. Referrals are restricted to the current scope of Australian pharmacist practice.

The consumer will receive a private 1:1 consultation with a community pharmacist, supported by evidence-based guidelines. The type of management interventions provided by the pharmacist include:

  • Provision of tailored health education and care advice
  • Supply of a non-prescription medicine
  • Escalation to another health professional

The inclusion of community pharmacists as a North Coast Health Connect referral point provides an additional option for face-to-face healthcare advice and reassurance, as well as access to evidence-based treatments for patients who do not need urgent care. It also assists North Coast Health Connect to leverage maximum health system capacity for North Coast health consumers.

North Coast Health Connect Overview

North Coast Health Connect provides 24/7 clinical advice from experienced triage nurses (registered nurses) via phone or webchat for North Coast consumers with acute clinical symptoms.  

The objective of the service is to support consumers to find the right care at the right time and place, whilst also empowering them to manage their own care when safe to do so. 

The service is funded by Healthy North Coast through the North Coast PHN Program, delivered by Amplar Health (Amplar) and evaluated by The George Institute. 

Triage is conducted by registered nurses who are experienced in taking calls from health consumers. Each assessment commences with the collection of pertinent demographic information and ruling out life-threatening emergencies. Triage nurses then conduct a clinical assessment to gain an understanding of the relevant acute clinical symptoms and determine the best course of action.

The nurses are guided by over 180 clinical decision support algorithms which; in turn, are informed by strong clinical evidence and practice globally. Amplar has used and continually improved these algorithms for over a decade, undertaking many millions of interactions with consumers in Australia. In addition, they have also improved the algorithms to fit our local conditions here on the North Coast.

Despite the robustness of these decision support tools, all registered nurses maintain the autonomy to override the algorithm outcome if they make the clinical determination the patient needs higher acuity care (or lower care in limited circumstances).

Where it is determined the caller is not able to manage their symptoms at home, the nurse who conducts the triage assessment may refer the caller to a wide range of services in the acute and primary care health system including:

  • ambulance response — 000
  • the nearest Emergency Department
  • see a general practitioner (GP) in 2 hours, 6 hours, 12 hours, 1-3 days or by routine appointment
  • where no face-to-face GP appointments are available, attend an HNC GP telehealth appointment in 2 hours, 6 hours or 12 hours
  • dental services
  • see a community pharmacist within 24 hours (read more below)
  • connection to a mental health support phone line or other phone lines where appropriate.

Amplar monitors the clinical quality of the triage service to ensure it continues to align with best practice (ISO 9901:2015). Amplar has a dedicated Clinical Governance Team, overseen by a medical practitioner, who ensures patient safety and service effectiveness are always front of mind.

In partnership with participating general practices in the Healthy North Coast region, North Coast Health Connect will provide a more integrated approach to patients who need a consultation with a GP urgently.

When the triage assessment indicates the patient should consult with a doctor, the triage nurses will endeavour to assist the patient to find an available appointment with their own general practice in the first instance. Where that GP clinic is integrated with the triage service, the nurse will also be able to book that patient into a GP appointment directly, saving time and stress for the patient and GP clinic admin staff.

This integration will also focus on increasing access to those without a regular GP, by booking the patient directly into an integrated GP clinic where possible.

Healthy North Coast’s GP Telehealth service will be available to callers who are triaged as needing a GP appointment when no face-to-face appointment can be found and the presentation is suitable for a telehealth appointment.

In partnership with the Pharmaceutical Society of Australia, North Coast Health Connect has developed a new low-acuity referral option to see a community pharmacist within 24 hours. These referrals are arrived at through the standardised clinical algorithms. Referrals are restricted to the current scope of Australian pharmacist practice.

The consumer will receive a private 1:1 consultation with a community pharmacist, supported by evidence-based guidelines. The type of management interventions provided by the pharmacist include:

  • Provision of tailored health education and care advice
  • Supply of a non-prescription medicine
  • Escalation to another health professional

The inclusion of community pharmacists as a North Coast Health Connect referral point provides an additional option for face-to-face healthcare advice and reassurance, as well as access to evidence-based treatments for patients who do not need urgent care. It also assists North Coast Health Connect to leverage maximum health system capacity for North Coast health consumers.

Trauma-informed care for flood-affected primary care teams 

This two-session program will assist participants in identifying the mental-health impact of natural disasters and their own mental health symptoms, including depression, anxiety, trauma, and rain phobias post-flood, as well as those of their patients. It will provide an opportunity to explore and commence self-directed healing, as well as linking with evidence-based and appropriate referral pathways.

Sessions will be run by Michaela Killips, Principal Psychologist from Mullumbimby Psychology. As a locally owned and run organisation, Mullumbimby Psychology provides a wide range of psychological services to both individuals and organisations. Michaela has significant experience supporting clients experiencing a range of mental health concerns including trauma and PTSD. Michaela has first-hand knowledge of the impacts of the recent floods, can be flexible to meet the needs of participants, and can tailor solutions for each person and the needs of their clients.

Register for your nearest program or request the program to be delivered to your whole team/practice at a date/time that suits.

  • Lismore
    Thursday 10 November and Thursday 24 November 2022
    3pm – 6pm with dinner to follow
    Venue: Invercauld House 
    Register now.
  • Mullumbimby
    Thursday 9 February and Thursday 23 February 2023
    3pm – 6pm with dinner to follow
    Venue: TBC
    Register now.

If you prefer a separate session for your entire team, please complete this registration form and provide us with your two preferred dates.

Flood-impact survey and results

The PHN primary health care services flood impact survey (May 2022) results showed:

  • 83% of responding services were concerned about staff wellbeing and burnout, followed by 67% concerned about the ability for staff to have a rest (annual leave, flexible working)
  • Of those services worried about staff retention, 67% were worried about retaining administration staff, followed by Nurses (49%) and GPs (37%)
  • Free locum services (52%), education for staff (39%) and staff debrief and wellbeing support (38%) were the top three workforce initiatives primary health care services were interested in utilising.

Alexandra Howard
Director Disaster and Public Health Emergencies

Alexandra has more than ten years’ experience working in the field of post-traumatic mental health – as a clinical psychologist, educator and specialist in policy and service development. She has worked with disaster-impacted communities, emergency service and military personnel, and traumatic injury patients, as well the professionals who support them.  

Alexandra’s particular interests lie in understanding and improving psychosocial outcomes for those impacted by disasters and public health emergencies, with a particular focus on marginalised populations, and with a gender lens. At Phoenix Australia, Alexandra has led a range of service development and training projects for a wide range of private, NGO and government stakeholders; her work focusses on translating evidence into practice, and disseminating best practice through policy and training frameworks that best suit the needs of each organisation. She has published in the field of post-traumatic mental health, and has presented her work at national and international conferences. 

Dr Sara Renwick-Lau

Dr Sara Renwick-Lau is a GP with more than 20 years’ experience working in regional and rural communities. After studying medicine at the University of Melbourne, Sara completed her General Practice training while providing medical care to the community in Arnhem Land in the Northern Territory.  

For the next seven years, she worked in remote communities in the Northern Territory and helped recruit and provide medical education for junior doctors working in general practice in the bush. Since relocating to Victoria with her husband Marcus and their children, Sara has been focused on providing medical care to the people of Mallacoota.  

She is part of the leadership team at Mallacoota Medical Centre. For those that may not be familiar with the East Gippsland town of Mallacoota, it has a population of approximately 1000, and is one of just two Victorian towns that is classified as remote.   

It is also the only population in Victoria of more than 800 that is more than 30 minutes from hospital services or State-funded urgent care – with the closest hospital being in Bega, two hours’ drive away.  

The 2019/20 Mallacoota fires were among the most destructive of the Black Summer bushfires. You may remember seeing images from New Years’ Eve 2019, when thousands of people took shelter on the Mallacoota foreshore as the town was hemmed in by fire. More than 100 homes were lost, roads in and out of the town were closed for 37 days — and food and water shortages, power outages – and eventually, the impact of COVID-19, complicated relief and recovery efforts in the weeks and months following the disaster.  

The Mallacoota Medical Centre faced the bushfires in a new, purpose-built, fire-rated building that provided a safe space for community members to support bushfire response, relief and recovery. Pre-existing challenges related to the distances to secondary and tertiary health care, power insecurity and other resource issues. 

She is passionate about providing comprehensive, patient-centred care – as well as helping with the recruitment and education of doctors in regional and remote areas of Australia.  

North Coast Health Connect
Appointment Booking Service

At the end of the triage process, callers to North Coast Health Connect are offered an appointment booking service.
The appointment booking service is unique to North Coast Health Connect and will:

  • actively direct triaged consumers to general practice or community pharmacy, and
  • assist consumers to navigate their way to where they should go in the health system.

The booking service works through a digital interface between the triage nurse and your practice. The interface allows the nurse to see a unique appointment type and availability specifically for use by North Coast Health Connect:

  1. The North Coast Health Connect triage nurse cannot see the practice’s entire calendar; they can only see and select the North Coast Health Connect appointment type.
  2. The North Coast Health Connect appointment type cannot be seen by the public.
  3. The practice manages which appointments it allocates to North Coast Health Connect.

The triage nurse enters the patient details enabling the practice to make direct contact with the patient if required.

The triage nurse checks each practice’s protocol (mask-wearing, etc) for attending the practice with the caller.

If the caller has given the nurse accurate information and the person is an existing patient, the booking tool will match the patient to their existing record preventing the duplication of patient files.

The caller receives a text or email from the booking tool provider with the time of the appointment, address and phone number of the practice.

The digital interface

The booking tool software can be used by any practice that currently uses Best Practice, Medical Director, ZedMed or Genie.

To be considered a NCHC participating practice, your practice must have access to or be committed to signing up to a digitally integrated booking system (HotDoc or HealthEngine).

Digitally integrated booking system

To be considered as a NCHC participating practice, you must have access to or commit to signing up for a digitally integrated booking system (HotDoc or HealthEngine).

If your expression of interest is successful, the Healthy North Coast engagement team will contact you to discuss your booking system options and requirements.