Community engagement and planning

The TRGP aims to train, attract and retain Rural Generalists in rural and regional Tasmania, who can work with rural and regional communities to address their local health needs. This may be a Rural Generalist who:

• works as a rural GP
• provides a service at the local District Hospital Emergency Department
• has advanced skills in an area required by the community.

Website: Tasmanian Rural Generalist Pathway

Email: [email protected]

Initiative One - Allied Health Rural Generalist (AHRG) Pathway

The AHRG is a service, position or practitioner delivering allied health services that respond to the broad range of healthcare needs of a rural, regional or remote community. The AHRG pathway comprises:

• service models to address challenges in provision of the broad range of healthcare needs of regional, rural and remote communities
• workforce and employment structures that support the development of rural generalist practice capabilities
• an educational program tailored to the needs of AHRG practitioners.

This initiative aims to develop an AHRG pathway through a proof-of-concept phase of:

• four FTE supported trainee positions
• provision of four development scholarships for experienced allied health professionals.

Initiative Two - Podiatry Prescribing Scholarships

Amendments to the Tasmania Poisons Act 1971 allow podiatrists working in Tasmania to prescribe scheduled medicines if they have been endorsed by the Podiatry Board of Australia.

This initiative aims to build a critical mass of eligible podiatrists to facilitate the implementation of podiatry prescribing through scholarships for completion of required education and training.

Podiatry prescribing will enable more timely access to pharmacotherapy when it is clinically indicated and within the scope of practice of an endorsed prescribing podiatrist.

This will facilitate timely care by reducing the need for patients to visit another health professional for the same presenting concern.

Project activities aim to:

• support scholarship holders in completion of required education training and supervision
• develop a pathway to become credentialed and authorised to practice with an endorsement for scheduled medicines and the supporting resources this practice will require.

This project is developing a wellness framework to support Tasmania’s health system and empower the people of Tasmania to manage their own wellbeing.

'Wellness' refers to a state of optimal physical, mental and emotional health. It is expressive of the dynamic relationship between people and their physical and social environment.

The concept of wellness expresses a shift away from medical models of treatment to disease prevention and self-management. Consumers partner with clinicians to achieve the goal of being well rather than seeking a cure or merely being ‘treated’.

The project activities aim to:

• build and respect the personal autonomy and capacity of individual consumers
• improving their ability to engage constructively with the health system and its providers.

Project activities include:

• community consultations about what keeps people well or get in the way of wellbeing, and what the health system needs to do to support wellbeing
• training and delivery of Stanford self-management programs across Tasmania
• diabetes best practice upskilling to remotely located clinicians
• clinical scholarships to build capacity to deliver patient-centred care
• workshops for consumers and clinicians on negotiating care
• singing and dancing classes for people with Parkinson’s Disease
• services for people with persistent pain.

For more information please email Linda Proietti Wilson (Project Manager, Wellness Framework) or call 03 6777 4239.

In Tasmania, people with chronic conditions like cancer, heart disease, diabetes, arthritis, stroke and asthma are increasing.

This project is identifying and supporting new models of anticipatory care as an approach to the management and prevention of chronic conditions.

Anticipatory care is a population approach to health care. It identifies and supports people who are at risk of developing chronic conditions, with the aim of preventing or slowing down ill-health.

We received funding from the Australian Government to conduct research to better understand and learn from communities about different ways anticipatory care happens and what works well and why.

Taking an action research approach, this project will:

• increase our knowledge and understanding of how anticipatory care occurs in different communities
• better understand the enablers and barriers to anticipatory care experienced by communities
• increase our knowledge and understanding about how communities and health services can work together to engage 'at risk' Tasmanians in primary health care, including assessment and management of their health needs.

We have engaged the University of Tasmania, the Sax Institute and The Australian Prevention Partnership Centre to lead and support the action research. Four communities are participating:

• Ulverstone – Patrick Street Clinic
• Flinders Island – Flinders Island Aboriginal Association in partnership with Flinders Health Co-ordinator Group
• Northern Suburbs of Launceston – Starting Point Neighbourhood House and the Northern Suburbs Community Centre
• Clarence – Clarence City Council.

Website: Healthy Tasmania: A Tasmanian Government and Community Partnership

Flora Dean (Principal Project Officer, Anticipatory Care)

Phone: 03 6777 4276

Email: [email protected]

This project will establish and trial a GPs and pharmacist outreach program to support management of patients with addiction issues relating to re-scheduling of over the counter (OTC) codeine.

Program support focuses on members of the community with OTC codeine addiction (for pain relief, and coughs and colds).

This project will engage with our Alcohol and Drug Service (ADS), GPs and Pharmacists across the state.

The project is working to:

• improve collaboration between GPs, pharmacists and ADS
• identify patients with OTC codeine addiction issues early
• provide safe and effective support for GPs and pharmacists to manage patient addiction issues relating to the use of OTC codeine
• create more OST prescribers and dispensers in Tasmania
• increase capacity in primary care for the management of opioid addiction and the judicious use of prescribed opioids and other high risk low value affect modulating medicines
• develop an understanding of the strategic purchasing decisions that provide for the delivery of best practice addiction services in Tasmania.

This project aims to:

• build subacute related skills, knowledge and capability among the clinical workforce
• strengthen networks between acute, subacute and the primary care sector to improve the integration and coordination of care for patients.

The project will support our key policy direction to provide joined-up care along the continuum of care supported by:

• Tasmanian Role Delineation Framework (TRDF)
• Clinical Services Profile (CSP)
• Statement of Purchasing Intent (SoPI)

This is a cornerstone of the Tasmanian Government's One Health System reforms, It articulates the delivery of care across the State and enables us to ensure that there is safe and equitable delivery of care state-wide. The four projects under this action plan are:

• Project 1 - Improving collaborative care
• Project 2 - SoPI /TRDF grants program
• Project 3 - Post-acute discharge clinical redesign
• Project 4 - Telerehab.

Peter Maree (Manager, Strategic Planning)
Email: [email protected]

Kylie Stevanovich (Project Coordinator, Health Planning)
Email: [email protected]

This project aims to increase the capability of health practitioners (particularly GPs, nurses and allied health) to:

• intervene early to prevent the patient's progression to preventable complications
• reduce the need to access tertiary services for complications associated with their condition.

This project will build capability and strengthen networks across all care settings by training health workers and other relevant people in recognising:

• brain injury
• how to integrate support systems for the person and the family in the community.

The education modules will be available online and workshops recorded to:

• improve access for more remote users
• be available to members of the community that have contact with brain injured people (for example, police, prison workers and future National Disability and Insurance Scheme workers).

Expected project outcomes include:

• improved collaboration between GPs, nurses, allied health, psychologists, psychiatrists and our services.
• earlier identification of common complications of spinal cord injury, neurological disorders and brain injury
• earlier identification of patients with persistent pain issues
• increased capability in primary care to manage these conditions and their common complications.

The Statement of Purchaser Intent (SoPI) and Tasmanian Role Delineation (TDRF) Grants program aims to build subacute related skills, knowledge and capability among the clinical workforce through the provision of scholarships and grants to local service providers.

These include both individual clinicians, departments, state-wide services or non-government organisations to support their staff in acquiring further skills or knowledge that will enhance their clinical practice in areas that directly support any of the following:

• the development of new standards models of care incorporating the subacute sector
• clinical skill acquisition that enhances delivery of current models of subacute care
• SoPI priority conditions directly
• the TDRF and CSP and expansion of services from acute to subacute
• Clinical Redesign initiatives that improve the delivery of and access to better quality and safe care.

The scope these grants create an opportunity for a range of outcomes:

• the overall quality of care for patients will be enhanced
• the skill base within the clinical workforce be developed
• further development of models of care
• enhanced collaboration across services

The program outcomes aim to:

• Improved collaboration between clinical service providers along the continuum of care.
• Upskilling and further training of the sub-acute care workforce.
• Targeting the management of those conditions that provide the highest burden of disease for Tasmania as per the SoPI priorities.
• Build service planning into the expansion of services within the TRDF.
• Improved quality of care.
• Further support or development of the shortlisted Clinical Service business cases.

REHDI is being conducted in three phases:

• Phase 1 – project scoping, literature review of best practice, mapping of current discharge processes, due for completion by end February 2019
• Phase 2 – Consultation and agreement with key stakeholders on principles and process documents due for completion October 2019
• Phase 3 – Implementation plan due for completion end March 2020

The project will deliver a framework that ensures:

• standardised discharge processes across Tasmanian hospitals
• a state-wide discharge model that will ensure timely discharge and referral processes for community care services provided by all levels of government and the private sector.
• a state-wide discharge model that will ensure patients are able to leave hospital appropriately supported to enable them to recover at home.

Erica Heeley (Principal Consultant, Community Care Reform)

Email: [email protected]

Sharon Williams (Nurse Manager, Integrated Operations Centre)

Email: [email protected]

This project will develop a telerehab program for patients.

Ambulatory rehabilitation clients who meet specific requirements for home-based rehabilitation (at home alone or with carer support) can be part of the telerehab process.

The project is delivered by our ambulatory rehab services including the Community Rehabilitation Unit.

The program provides patients with either 4G-enabled iPads or Android devices loaded with rehabilitation specific applications themselves based on a program developed by the ambulatory rehabilitation service team.

The program is monitored, and clients reviewed either face to face or via video conferencing/skype/face time processes.

The program aims to:

• reduced travel time and accommodation costs
• give better access to services to patients in rural and remote areas of Tasmania.
• Facilitate more efficient use of health staff time.

Paula Hyland (Executive Director - Allied Health)

Email: [email protected]

This project aims to improve subacute care in the Tasmanian health system by developing a clear service model and associated implementation plans for GEM and rehabilitation services.

The process will build on reforms currently underway through One Health and extend to include services outside of acute public hospitals.

The plan aims to deliver the following outcomes:

• the development of a patient-centred approach which is reflective of the patient journey through all care settings and their contribution to effective self-management
• strengthened networks and linkages between primary and specialist providers, and between the primary and acute sector
• improved integration and coordination between the primary and community health sectors
• improved culture including boundary and role clarification, data exchange and communications
• enhanced focus on both service and system level collaboration and care coordination (public, private, community, tertiary and aged) between providers and settings
• reduction in avoidable hospital presentations, admissions and re-admissions
• improved patient experience in the areas of GEM and rehabilitation.

Jane Gaetani-Black (Project Manager)
Email: [email protected]

Kerry Tucker (Project Lead GEM and Rehabilitation)
Email: [email protected]

Helen Haywood (Admin/Business Support)
Email: [email protected]

Complex patients with multiple chronic needs are frequent and expensive users of services across the full continuum of care across all sectors.

This project focuses on mapping and building capability within the subacute sector to provide integrated care for complex patients.

This Action Plan sets out two projects to improve the whole of system functioning in relation to complex patients with multiple chronic conditions:

1. Health System Capability Framework
2. Complexity Framework

These projects will be key to effective systems reform in Tasmania and will have a long term impact on the shape of future services. The deliverables of projects will inform and guide service configuration and commissioning parameters and recommendations for people with complex needs.

Katie Daly (Senior Policy Officer, Health System Capability Framework)
Email: [email protected]

Peter Maree (Manager, Strategic Planning, Complexity Framework)
Email: [email protected]