CLINICAL COUNCIL CHAIRS & MEMBERS

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1 EDITION 16 December 2015 January Chronic Care Weekend 4 Hillston Outdoor Gym Sussan Ley Visits MPHN 5 Barham and District Medical Centre Congratulations Amy Geach New Clozapine Coordinator for Young 6 Mental Health Reform National Ice Taskforce 7 Australia s Mental Health System 8 Taking Action to Combat Ice 9 Taking Action to Combat Ice 10 Murrumbidgee PIR 11 Identifying and Responding to Elder Abuse 12 Expansion of Australia s Immunisation Registers New Service for Carers 13 What is the National Services Directory? 14 Integrated Care Coordination Pregnancy and Diabetes Planning for the Best Start 15 Decision Assist Medications 16 CPD Events From the CEO s Desk It has been a hectic few months for the Board and Management of the Murrumbidgee Primary Health Network in establishing a structure which ensures we are connected with and have input from clinicians, providers and the community. I am pleased to report that we now have in place four (4) Clinical Councils, a Community Advisory Committee and a Stakeholder Reference Group with broad representation of health professionals/providers and community members from across our large geographic area. The purpose of the Clinical Councils is to support and advise the MPHN Board using expert specialised knowledge to ensure high quality, evidence based, cost effective, patient centred, and outcome driven primary healthcare across the MPHN in line with national and local priorities. The GP chairs of the four Clinical Councils will have direct input to the Board through participation on MPHN s Planning & Integration Committee. CLINICAL COUNCIL CHAIRS & MEMBERS Border Dr Marion Magee Chair Border Sector Adam Reinhard Pharmacist Lockhart Pharmacy Alam Yoosuff GP/VMO Finley Medical Centre Heinz Deiter GP Corowa Medical Centre Jeremy Carr Physiotherapist Back on Track Physiotherapy Kathleen Rhodes Nurse Manager Culcairn MPS - MLHD Riverina Dr Jacques Scholtz Chair Riverina Sector Christine Britton Integrated Care Coordinator MPHN Daniel Rankin Physiotherapist Cootamundra Lee Francis Psychologist Young Mark Douglass Pharmacist Harden Pharmacy Dr Nang S S Win GP Boorowa Medical Centre Stephen Ross GP Young Medical Centre Wagga Dr Jennifer Bell Chair Wagga Sector Dr Aine McGovern Clinical Psychologist CSU Amanda Cooper Pharmacist Uranquinty Pharmacy Helen Hulme-Jones RN, Diabetics Educator Riverina Diabetics Education Jane Goddard GP Kooringal Medical Centre Kimberley Aylward Dietitian - Headspace & CSU MPHN & CSU Nutrition Clinic Dr Pankaj Banga GP Wagga Health Service - MLHD Paul Colenso Physiotherapist Riverina Physiotherapy Centre Robert Dow Specialist Community MH Clinician Community Mental Health Service MLHD Western Dr Damien Limberger Chair Western Sector Belinda Guest Community Midwife/RN Hillston Medical Centre - MLHD Carrie Stewart Community Pharmacist Mulhall & Close Pharmacy Dr Sultan Noormolideen GP Griffith Medical Centre Emma Kelly Mental Health Social Worker Mental Health & Wellbeing Counselling Karen Ingram Aboriginal Outreach Worker MPHN Leanne Kennedy Pharmacist Griffith Sally Hill Physiotherapist Leeton Physiotherapy Centre Irene Grigoris Specialist Griffith Medical Centre Riverina Pulse December 2015 January

2 From the CEO s Desk continued The MPHN will also be informed by our local communities through our 32 Local Health Advisory Committees informing a single Community Advisory Council which will provide the community perspective to the MPHN Board to ensure that decisions, investments, and innovations are patient centred, cost-effective, locally relevant, and aligned to local care experiences and expectations The appointees are: Border Sector Linda Swales Deniliquin Riverina Sector Pamela Ellerman Batlow Western Sector Gayle Murphy Narrandera Wagga Sector Vacant The Stakeholder Reference Group will, through effective communications and strategies, connect with stakeholders to achieve a broad understanding of the primary health needs of the region so as to provide advice to the MPHN Board to ensure high quality, evidence based, cost effective, patient centred, and outcome driven primary healthcare across the MPHN in line with national and local priorities. The practices/organisation providers appointed include: Bland Shire Council Adele Casey Griffith City Council Anne Napoli Lord & Wells Optometrists Anthony (Tony) Lord Leeton Physiotherapy Centre Bruce Gilmour Boorowa Council David Evans Rural Physiotherapy Ellen McMaster Dr Duncan s Surgery Geraldine Duncan Imaging Associates Glen Dean Turvey Tops Pharmacy Hani Fanous Wagga Women s Health Centre Jan Roberts Narrandera Shire Council Cr Jim Howard Griffith Aboriginal Medical Service Lisa Penrith Kurrajong Waratah Noelene Hogan Kooringal Medical Centre Dr Tracey Purnell Nancye Piercy Chief Executive Officer Murrumbidgee Primary Health Network Boundaries and Sectors BOUNDARIES PHNs LGAs SECTORS WESTERN RIVERINA WAGGA WAGGA BORDER MPHN LGAs BERRIGAN BLAND BOOROWA CARRATHOOL CONARGO COOLAMON COOTAMUNDRA COROWA DENILIQUIN GREATER HUME SHIRE GRIFFITH GUNDAGAI HARDEN HAY JERILDERIE JUNEE LACHLAN (PART) LEETON LOCKHART MURRAY MURRUMBIDGEE NARRANDERA TEMORA TUMBARUMBA TUMUT URANA WAGGA WAGGA WAKOOL YOUNG 2 Riverina Pulse December 2015 January 2016

3 Chronic Care Weekend The MPHN s sixth Chronic Care Weekend was held October in Wodonga. CoastCityCountry Training was a co-sponsor, and this will be our last event together due to their closure at the end of this year. Once again the popularity of this weekend ensured places filled up quickly, requiring us to close registrations for the family program after only a couple of weeks. This year we had 42 GPs and five practice nurses attend the education, whilst 26 partners and 39 children attended various social activities. This year presenters included Associate Professor Adriaan Venter, Associate Professor Michael McCready, Professor Tim Lambert, Professor Gerard Carroll, Dr Max Graffen and Ruth Crawford. Topics covered were Lung Function Interpretation, Atrial Fibrillation, Cardio-metabolic health, Acute Coronary Syndrome and Frailty. Top: Professor G Carroll Middle: Socialising before dinner Above: Associate Professor M McCready Top: District Court Judge (aka Wagieh Mahrous) Middle: Participants at workshop Above: Partners program Riverina Pulse December 2015 January

4 Hillston Outdoor Gym The Hillston Outdoor Gym has been officially opened to the community. The gym has been four years in the making with original plans commencing back in 2011 by the Healthy Hillston Committee. A grant of $20,000 from Bendigo Bank helped ensure its completion this year. Located at the Lake Woorabinda Reserve, the gym value adds to the existing recreational areas of the lake including barbeque and playground, skate park and local pool. The gym comprises 20 pieces of equipment in three stations. Thank you to those who provided grants and donations including Bendigo Bank and Southern Phones, Hillston Lions, Western Rosella farming, Agristar, Angus Potter Memorial fund and contributions from health night events, street stalls and fitness and wellbeing classes in the community. To improve the health and wellbeing of the Hillston community, the outdoor gym hopes to make exercise accessible, safe and appropriate for all ages, genders and cultures. Sussan Ley visits MPHN On Wednesday 16 December the Minister for Health, Sussan Ley, stopped by the MPHN office for a brief meeting with Nancye Piercy and Dr Max Graffen, before officially opening the new Wagga Rural Referral Hospital. Minister Ley chatted with staff and also visited headspace Wagga Wagga. Shane Thomas, Maja Asmus, Julie Bailey, Tamara Ball, Nancye Piercy and Minister Sussan Ley Minister Sussan Ley, Nancye Piercy and Max Graffen 4 Riverina Pulse December 2015 January 2016

5 In the spotlight Barham and District Medical Centre The purpose built facility in Barham was constructed in 1978 and purchased with community donations. This highlights the importance the community places in providing accessible local primary health services. The Local Health Medical Trust that manages the building recently won a Regional Achievement and Community Award. Ochre Health commenced in 2009 and the Medical Centre is currently staffed by three qualified medical practitioners. Dr Pannu Harpreet, Dr Samreet (Sam) Gill and Dr Christine Martin all work full-time and provide VMO services to the Barham and District Hospital and two nursing homes Eliza House (attached to the hospital) and Murray Haven private nursing home. The Medical Centre offers a comprehensive range of health care and allied health services to the local community, including a visiting exercise physiologist and sleep technician. Currently the Medical Centre is undergoing an extension to include additional treatment / consulting rooms. The friendly staff include Wendy Hollingworth, Kerri Hird and Marlene Membrey at reception; Anne Crane, Practice Nurse, and Joan Simeon, Practice Manager. The MPHN Provider Support Team is looking forward to working together into the future. The experienced and friendly team Joan Simeon, Anne Crane, Kerri Hird and Wendy Hollingworth Congratulations Congratulations to Amy Geach of Riverina Hand Therapy who was recently awarded the Business Leader of Wagga at the Wagga Business Chamber Crow and then went on to win the Business Leader category at the Murray-Riverina Regional Awards. New Clozapine Coordinator for Young Gale Hynes commenced with Murrumbidgee Local Health Network in October. Gale has a background in general nursing and has specialised in mental health for 15 years. As the District Clozapine Coordinator, Gale s role is to support prescribers, pharmacists and mental health clinicians involved in clozapine management, ensure compliance with the Clozapine Central protocol and the continuity of clozapine supply. Due to greater access since the PBS changes from 1 July, Gale has been engaging GPs and pharmacists across the district with many having now commenced prescribing or dispensing clozapine for their patients. Gale is available to review current systems and develop sustainable models of practice to assist in ensuring the physical healthcare needs of mental health consumers are addressed. For further information please contact Gale Hynes, District Clinical Leader Mental Health Physical Healthcare and Clozapine Coordination. Phone: or gale.hynes@gsahs.health.nsw.gov.au PO Box 435, YOUNG NSW 2594 Riverina Pulse December 2015 January

6 Australian Government Funding Mental Health Reform Last month the Australian Government announced its response to the National Mental Health Commission s Review of Programmes and Services. The announcement details an exciting and welcome plan to reform mental health in Australia and improve mental health outcomes. For many years, consumers and providers have shared similar concerns about the mental health system in Australia. These include: Poor policy design driven by Government that results in a one size fits all approach Siloed programs with inflexible guidelines Unbalanced system over-servicing, underservicing, or no service at all ( people falling through the gaps ) A noisy system with complex pathways to care System-centred rather than consumer-centred care Islands of success that aren t scaled up Disjointed connections between primary care, acute care and hospital care for consumers The 31 PHNs across Australia are at the centre of this reform. PHNs have been identified as the Regional Planners of mental health, and drug and alcohol services. From June next year, $365 million will be provided to the 31 PHNs annually as part of a Regional Mental Health Flexible Funding pool. PHNs must use the funding pool to plan and commission services that meet the needs of the local communities. Previously, Medicare Locals and PHNs were required to spend their allocated funds on specific and inflexible programs despite knowing that this might not always meet the needs of the community. MPHN will work with local consumers, carers and stakeholders (particularly the Murrumbidgee Local Health District) to understand community needs through formalised needs assessment, developing a regional mental health and drug and alcohol plan, and undertaking integration activities and/or commission services required to fulfil the objectives of the plan. The Government requires that all PHNs focus on: Improved links and innovative approaches to support clinical care coordination for people with severe mental illness and complex needs; Integrating Aboriginal and Torres Strait Islander mental health and social and emotional wellbeing services at a local level; Cross sectoral approaches to early intervention for children and young people and commissioning of services to support a broader group of young people with, or at risk of, mental illness; A regional approach to suicide prevention and selfharm, including community based activities and integrated post discharge care for people at high risk of suicide; and Strategies to target services to people in rural and remote areas and other hard to reach and at risk populations. National Ice Taskforce Earlier this month the Australian Government announced its response to the findings of the National Ice Taskforce. The Government has announced a substantial package to reduce the demand for ice and the harm it is causing in communities. The package includes $285.2 for locally-based and targeted solutions. An additional $13 million is also being provided to introduce new MBS items for Addiction Medicine Specialists. Once again, PHNs will be at the centre of this exciting initiative, with $241.5 million for the delivery of further treatment services, with commissioning of these services undertaken by PHNs at the regional level to ensure local coordination and better patient management. This includes funding to support the delivery of Indigenous-specific treatment services. Next Steps A needs assessment is underway. This has involved sourcing data across primary, nongovernment, acute and hospital based settings to gain a comprehensive picture of the mental health, and drug and alcohol needs in Murrumbidgee (met and unmet). MPHN held a stakeholder meeting on 14 December. This represents the first of many targeted stakeholder meetings to come over the next six months as we begin to work with local consumers, carers, and stakeholders to build the Regional Mental Health and Drug & Alcohol Plan. MPHN will begin targeted integration activities and commissioning as early as January 2016, leading up to full implementation in July MPHN welcomes opportunities to discuss the reforms with local consumers, carers, and stakeholders. There will be many formal opportunities for involvement. We will provide regular updates on our website and in each edition of the Riverina Pulse. In the meantime, if you would like more information about the reforms, contact Jenni Campbell, or jenni.campbell@mphn.org.au 6 Riverina Pulse December 2015 January 2016

7 Australia s Mental Health System CURRENT FUTURE Programmes and services restrained by programme boundaries and old models of care Fragmentation, duplication, service gaps and complex service structure difficult to navigate System that responds too late Lack of follow up of individual following selfharm or suicide attempt One size fits all coarsely targeted approach to primary mental health care service delivery Reliance on old models of face to face service delivery High health, social and economic cost of mental illness and suicide Commonwealth leadership focused on funding and programme delivery Through restructuring mental health programmes, and the pooled approach through PHNs, a more flexible and joined-up system will focus on the needs and views of consumers. Consumer choice and service contestability enhanced. Regionally planned, integrated and coordinated service system building on existing infrastructure, including close links between PHNs, LHNs and NDIS, and stronger local cross sectoral cooperation. Improved ease of navigation of the service system through the gateway. Effective early intervention across the lifespan and trajectory of mental illness and avoidable escalation of problems reducing long term burden on individuals, the system and Government. A commitment to developing with states and territories appropriate follow up arrangements for individuals after a self-harm or suicide attempt Evidence based approach to suicide prevention at a regional level, linking sectors. New stepped care arrangements to better match services to consumer need, making optimal use of workforce, and better targeting Medicare based services. Reduced over and under servicing people will get the right care at the right time. Innovative use of Australia s world-leading technology and the new digital mental health gateway, improving ease of access to services and information. Flexible service delivery options including low intensity services. Continued support for people with mild to moderate illness will aim to preserve access and support productivity and economic participation. Better coordination for severe will help to reduce economic and social burden on individuals, families, communities and the nation. Overall improved efficiency, optimally targeted services and a sustainable approach to mental health and suicide prevention. Commonwealth leadership role to facilitate system change and partnerships at all levels. The Fifth National Mental Health Plan will be used to seek agreement from states and territories to key partnerships. For more information and details please visit Riverina Pulse December 2015 January

8 Taking action to COMBAT ICE In April 2015, the Commonwealth Government established a National Ice Taskforce to provide advice to Government on the impacts of ice in Australia and actions needed to address this growing problem. The Taskforce found that law enforcement agencies have responded strongly to disrupt the supply of ice, but despite these efforts, the market for the drug remains strong. It recommended that governments focus action on reducing the demand for ice and reducing the harm it causes, while enhancing efforts to disrupt supply in key areas. In response to the findings of the Taskforce, and in consultation with the Australian National Advisory Council on Alcohol and Drugs, the Commonwealth Government has developed a comprehensive package of action across five key areas to tackle this problem head on. This package is supported by almost $300 million in new funding. This includes an additional $285.2 million to reduce the demand for ice and the harm it is causing through the delivery of locally-based and targeted solutions. This also includes an additional $13 million to introduce new Medicare Benefits Schedule (MBS) items for Addiction Medicine Specialists. The measures from this package will form part of the new National Ice Action Strategy, and are in addition to the current funding allocation of up to $310 million for treatment services. 1. Empower local communities and more support for families Provide an additional $24.9 million to help families and communities by providing the resources, information and support they need to respond to ice and develop solutions tailored to their local needs: Establishing a new online portal of information for parents, students, teachers and community organisations (www. positivechoices.org.au). Funding up to 220 new Community Drug Action Teams that bring together community groups to reduce drug related harms, including through local grant projects. Providing support to more than 1,200 community sporting clubs to deliver prevention messages about ice with a focus on rural, regional, remote and Indigenous communities. Delivering evidence-based interactive online resources to support families and carers of those using ice and other drugs. 2. Target prevention and education to those most at risk Enhance prevention activities and target populations known to be at risk of ice use under the existing National Drugs Campaign: Developing new evidence-based, targeted communication activities through the National Drugs Campaign to help to prevent the uptake of ice and encourage individuals and families to seek support and treatment. Enhancing school education programmes to include ice-related information to help prevent the uptake of ice. 8 Riverina Pulse December 2015 January 2016

9 3. Further investment in treatment and workforce support Improve access to treatment, especially for rural, regional, remote and Indigenous communities, and ensure our workforce is supported to deliver effective and flexible treatment approaches: Providing a significant investment of $241.5 million for the delivery of further treatment services, with commissioning of these services undertaken by Primary Health Networks at the regional level to ensure local coordination and better patient management. This includes funding to support the delivery of Indigenous-specific treatment services. Focusing efforts on expanding early intervention and support through online counselling and information. Providing an additional $13 million to introduce new MBS items for Addiction Medicine Specialists to increase the availability of treatment. 4. Focused law enforcement Enhance existing efforts to disrupt the supply of ice through better use of intelligence and international engagement, and targeting organised crime groups involved in the ice trade: Strengthening cooperation with key source and transit countries through developing a new international supply disruption strategy for ice and its precursor chemicals and: investing $5 million in the Australian Crime Commission to deploy officers internationally to strengthen our ability to stop the supply of ice at its source; and increasing cooperation with China through a joint AFP- Chinese National Narcotics Control Commission taskforce focused on investigating organised criminal syndicates responsible for the exportation of ice to Australia. Strengthening the eligibility criteria of the Aviation Security Identification Card and Maritime Security Identification Card schemes to target serious and organised crime. Investing $10 million from the proceeds of crime account money taken from criminals to develop a pilot infrastructure platform that will inform the design and development of a National Criminal Intelligence System and enhance our ability to share intelligence with state and territory partners. Continuing work with participating states and territories to pursue a national cooperative scheme on unexplained wealth. Investing $1 million to roll out a national Dob in a Dealer campaign to encourage the public to report information on drug manufacture and distribution in their community. Disrupting the supply of ice into our regional and remote communities by exploiting existing capabilities through the Government s $74 million National Anti-Gangs Squad. 5. Better research, evidence and guidelines Provide an additional $18.8 million to enhance our evidence base, deliver new guidelines and improve the quality of data and research on ice and other illicit drugs: Establishing a Centre for Clinical Excellence for Emerging Drugs of Concern to build the evidence base for what works. Developing evidence-based guidelines to support frontline workers to respond to ice and expanding training to better support doctors, nurses and other health and community workers to provide screening and brief interventions. Increasing the quality of population data on illicit drugs. Improving our data to better understand our demand for alcohol and drug treatment. Expanding data collections that monitor alcohol and other drug misuse and overdoses to assist in the detection of emerging drug trends. This extensive package builds on the Commonwealth s current efforts to combat ice and other illicit drug use in Australia. Further information is available at Information on ice and other drugs is available at Families and individuals needing help can access online counselling at online-services/counsellingonline-org The Taskforce report can be found at December 2015 All information in this publication is correct as at December 2015 Riverina Pulse December 2015 January

10 Murrumbidgee Partners in Recovery In the Murrumbidgee region, the three areas of greatest need identified by people with severe mental illness are insufficient daytime activities, inadequate engagement of services, and lack of company and social life. Information collected by Murrumbidgee Partners in Recovery (PIR) is used to identify the unmet needs of consumers to help tailor a recovery journey that is specific to their needs and goals. The cooperative support from many services is essential for consumers to achieve these goals. Maryanne lives with a mental illness and was referred to Murrumbidgee PIR by Community Mental Health. She has seen improvement in many facets of her life. She initially reported feeling disengaged with mental health services, and was hoping for an improvement in daytime activities, social life, transport and employment or volunteering opportunities. Maryanne is proof that services working together can improve outcomes for people living with mental illness. Thanks to Intereach and Ability Links, she now has transport and has taken the initiative to start a social craft group in Wagga. The program gives Maryanne a social outlet as well as the added benefit of providing daytime activities for many others. Program participant, Rebecca, says of the craft classes The weeks that I come to craft my mood is a lot better and I take that home with me. Maryanne doesn t like to make a fuss though, I just want to give back to the community with the skills that I have. The New South Wales Mental Health Commission reports in the Living Well Strategic Plan for Mental Health in NSW, that social inclusion is a foundation of mental health and wellbeing, and is a major factor in improving people s strengths and resilience. Maryanne s capacity to help others in the community is a testament to her hard work and her recovery journey. It s been a really tough road getting here and I m not finished yet. says Maryanne. Since being involved with Partners in Recovery, my confidence has improved, certainly my self-worth, self-esteem. It s helping to build me. I want to leave the house now, before I just couldn t. Murrumbidgee PIR supports people with severe and persistent mental illness with complex needs and can be contacted on The PIR initiative is not designed to provide crisis intervention. For immediate support please contact Accessline on Participants of the social craft group 10 Riverina Pulse December 2015 January 2016

11 Identifying and Responding to Elder Abuse The Preventing and responding to abuse of older people: NSW interagency policy, 2014 identifies five distinct types of elder abuse: physical; psychological; sexual; financial abuse; and neglect. Financial and psychological abuses are the most frequently reported abuse types. It is common for two or more abuse types to occur concurrently, with psychological abuse often coexisting with another abuse type, such as neglect. The Elder Abuse National Report ( ), states 6,104 phone calls were made to state-based agencies across Australia that work to respond and prevent elder abuse, but this figure only scratches the issue s surface. It has been suggested that 4.6 per cent of older people nationally may experience abuse, and many of these incidences go unreported. Sadly, elder abuse is typically inflicted by someone the older person trusts often their own children. Many people are not surprised to discover sons are perpetrators in 32 per cent of reported cases, but are surprised to learn that daughters are almost equally represented at 31 per cent. Elder abuse is a significant health issue for older people. Older people experiencing psychological abuse are more likely to sustain physical symptoms. The risk of hospitalisation is more than twice as high for older people who experience elder abuse compared with their peers. The risk of death is three times as high compared with peers who have not experienced abuse. Meet Eileen Eileen is an 81-year-old widow and sees a GP occasionally. She has complex care needs: NIDDM and attends an outpatient clinic at the local hospital every few months. She also has hypertension and spinal osteoarthritis. She does not receive community services at home. Eileen s son, Keith moved in 18 months ago after his marriage broke down. His mental health problem (bipolar) is managed with medication, according to Eileen. Eileen is very protective of Keith; he does his best but he has been unable to hold down a job since the separation. Keith is receiving the carer s payment as arranged by the GP. Keith doesn t like visitors or strangers coming to the home. Keith collects all Eileen s mail and intercepts her phone calls. Eileen s only other family are two adult children who live overseas. When Eileen presents today at the clinic, she appears less alert than usual; she is limping and has a laceration on her forehead and upper right arm. Eileen has seen to these injuries herself. The receptionist has noticed Eileen s dirty bandage and has called you to take a look at Eileen, prior to her appointment. You take Eileen aside and ask her if you can have a look at her injuries. Eileen is somewhat noncommittal about her injuries but mentions Keith drinks a fair bit and can get rough. Contact the NSW Elder Abuse Helpline & Resource Unit The NSW Elder Abuse Helpline & Resource Unit (EAHRU) is a government-funded service that receives up to 120 calls per month. EAHRU acts as a central point for information, support and referrals for anyone who experiences, witnesses or suspects elder abuse. All workers have a responsibility to respond to abuse of older people in our community. Preventing and responding to the abuse of older people: NSW interagency policy, Staff at this specialist unit can work with you to develop a response plan which supports the rights and best interests of an older person experiencing abuse. Riverina Pulse December 2015 January

12 Expansion of Australia s Immunisation Registers This update provides information on the work being undertaken to expand the scope of Australia s two existing immunisation registers; the Australian Childhood Immunisation Register and the National Human Papillomavirus (HPV) Vaccination Program Register, to improve vaccination coverage rates across the entire Australian community. What changes are being made to the registers? From 1 January 2016, the Australian Childhood Immunisation Register (ACIR) will broaden to capture immunisation information for young individuals under the age of 20 years, enabling implementation of the Australian Government s No Jab, No Pay measure. The ACIR currently records vaccinations given to children aged less than seven years. From September 2016, the ACIR will expand further to become the Australian Immunisation Register (AIR) to capture all vaccines administered throughout a person s life (birth to death), given through General Practice and community clinics. This will include all vaccines funded under the National Immunisation Program, as well as private vaccines given through general practice. This whole of life register will be ready to support the zoster virus vaccine being available on the National Immunisation Program (NIP) for 70 year olds (including a catch up programme for year olds), which is planned for November Other vaccines funded for adults under the NIP, which include seasonal influenza vaccine and pneumococcal vaccine, will also be captured by the AIR. From the 2017 school year, the HPV Register will be expanded to become the Australian School Vaccination Register (ASVR), which will capture all adolescent vaccinations given through school programmes. Vaccines to be recorded include varicella (chickenpox), the diphtheria, tetanus and pertussis (whooping cough) booster, and the HPV vaccine. This will provide tools such as recall and reminder systems to improve adolescent vaccination rates. The expansions are subject to the passage of legislation. What are the benefits of these changes? Expansion of the registers will broaden and improve immunisation data capture. This will lay the foundations for future work to move towards one integrated system, that captures and reports on all vaccines given in Australia from birth to death, providing one front door for consumers and vaccination providers. This is an important step to improve immunisation rates overall, by better understanding the current coverage of vaccines. At present, the coverage of vaccines given to adults is not well understood as there are no comprehensive national data collected for these vaccines. Vaccination providers will have secure access to a range of due and overdue reports, which will allow them to monitor vaccine uptake in both young children and older Australians. This will help to identify areas of low coverage within Australia and enable targeted effort and information to boost immunisation rates in these areas. Individuals will have access to a record of all vaccines recorded in the AIR and ASVR. Information on the No Jab, No Pay measure and register expansions will be updated on the Immunise Australia website at New Service for Carers Australia s 2.7 million carers now have access to a new service to support them in their caring roles. An initiative of the Australian Government, Carer Gateway provides information about the services and support available for people who care for someone with a disability, chronic illness, dementia, mental illness, or who are frail due to age. Carers can phone Monday to Friday, 8am to 6pm for information about services and support available. The Carer Gateway at has a range of information including practical advice on how to care, details about financial and respite support, and how to adjust when caring ends. An interactive service finder helps carers identify local services, including Commonwealth-funded organisations delivering carer support services. This new service does not affect how carers currently access their existing support services. For more information visit 12 Riverina Pulse December 2015 January 2016

13 What is the National Health Services Directory? The National Health Services Directory (NHSD) is a free service established and supported by the Federal Government and all the State Governments of Australia, delivered by Healthdirect Australia, to enable health professionals and consumers to access reliable and consistent information about health services. The directory is a searchable repository of information on general practices, pharmacies, hospital services, emergency departments, allied health services and more, based on geographical location. Each service contains information such as contact details, location, opening hours, wheelchair access, bulk-billing services and much more. The NHSD can be found on many websites including Federal, State and Territory Governments, Primary Health Networks, peak bodies including the Royal Australian College of General Practitioners and the Pharmaceutical Society of Australia. Healthdirect Australia has content management processes in place to ensure the information in the NHSD is continuously updated. They regularly audit and review directory information and send reminders to organisations to update their details. The NHSD Service Desk receives updates about service information from consumers and providers via feedback options on the website, mobile apps (Android and iphone), NHSD widgets and other NHSD supported applications. MPHN is responsible for maintaining NHSD information on behalf of service providers in the MPHN catchment. Each service provider is also able to maintain its own information, including consent for what consumers, other providers and authorised users can see and use via the self-authorship model. Self-authorship is a way in which service providers can keep their own details up-to-date in the NHSD including services offered, contact details and operating hours. MPHN are encouraging practices to visit the NHSD to check their own listings to ensure their information is current and correct. If you would like the MPHN to make changes on your behalf, or you would like any further information on the NHSD, please contact abrie.schutte@mphn.org. au. In addition to the NHSD, Healthdirect Australia has many other useful services available so please visit their website, for more information. Introducing the healthdirect app When your patients can t see you, they can use the free healthdirect app to make health decisions safely, quickly and easily by: 9 Finding a local health service 9 Checking their symptoms 9 Searching for trusted health information Your help needed 9 Promote the app: there are free resources available 9 Check your details in the National Health Services Directory Visit for more information. Download the app. Search for healthdirect in your app store. Helping Australians make smart health choices Riverina Pulse December 2015 January

14 Integrated Care Coordination The Murrumbidgee PHN has a team of 10 dedicated Integrated Care Coordinators (ICC) registered nurses who assist in improving the patient s management of chronic disease and reduce unplanned admissions to hospital. This is achieved through good coordination of patient health needs in line with the GP management plan, and/or Team Care Arrangement and recommendations from health care providers. The team of ICCs provide support to patients including: arranging services required, ensuring there are arrangements in place for the client to get to appointments, assist the client to participate in regular reviews with their primary care provider, and participate in case conferencing. In addition, the ICCs support and liaise with other local services to avoid duplication of services and patients falling through service gaps. The ICCs assist patients to access the range of specialist, primary and allied health services required for their ongoing care. They assist in adherence to treatment regimens, for example helping with medication compliance through arranging Home Medicine Reviews. The Care Coordination team also assist clients to develop chronic condition selfmanagement skills. The program targets people over the age of 18 years with chronic disease as follows: Clients with diagnosed chronic disease Clients at risk of frequent of unplanned admissions to hospital Clients at risk of re-admission to hospital following discharge We are pleased to welcome our latest ICC team member Emma Anderson. Emma is based in Howlong, and covers Corowa, Holbrook, Culcairn, Henty, and surrounding areas. For more information please phone the Central Intake Line on ICC referral forms can be faxed to Pregnancy and Diabetes Planning for the Best Start The NDSS has recently launched new resources on planning and managing pregnancy for women with type 1 or type 2 diabetes. The NDSS Diabetes in Pregnancy National Development Programme has developed resources to help provide information for women with type 1 or type 2 diabetes who are planning a pregnancy now or in the future, including: is a website dedicated to pregnancy and diabetes information Having a healthy baby booklets providing comprehensive information on planning and managing pregnancy. Separate booklets are available for women with type 1 or type 2 diabetes The booklets can be downloaded from and Hard copies can be ordered by calling the NDSS Infoline on Twinkletoes Letting kids be kids Twinkletoes Our annual fun-filled family camp for kids (8 years and under) with juvenile arthritis and their families. Meet health professionals and other families, and BE SUPPORTED! We help families understand their child s disease by giving them the opportunity to ask the questions they don t know the answers to. Places are limited - book your spot now: arthritisnsw.org.au/camp CLOSING DATE 15TH JANUARY 2016 We don t feel like we re alone anymore February 2016 Book your place now! The Tops Convention Center, 51 Bendena Garden, Stanwell Tops NSW Riverina Pulse December 2015 January 2016

15 Decision Assist Medications A consensus-based medication list is now available for GPs in assisting optimum symptom control for terminally ill patients wishing to die at home. The evidence based list, which includes nine medications, was developed by an expert panel consisting of GPs, nurse practitioners, palliative medicine specialists and pharmacists under the direction of The Australian & New Zealand Society of Palliative Medicine (ANZSPM) for the national palliative care and advance care planning service Decision Assist. The list provides appropriate medications for dying patients experiencing pain, dyspnoea, nausea, agitation, delirium and respiratory secretions. The list complements the ANZSPM endorsed list of medications in terminal care in residential aged care; albeit differs somewhat in order to address the concerns held by volunteer carers in the home setting. It is hoped that the new list will improve community pharmacists knowledge around what medications to stock locally as well as encouraging more GPs to care for people with a terminal illness wishing to die at home. End of Life (Terminal) Symptom Management Medications for Older Australians Living in the Community A consensus-based list of medications suitable for use in community aged care for the management of terminal symptoms MEDICATION CONCENTRATION PACKAGED as Clonazepam liquid* (oral drops) 2.5mg/ml 10ml bottle (2.5mg/ml) Clonazepam injection* 1mg/ml Box of 5 ampoules Fentanyl citrate injection** 100mcg/2ml Box of 5 ampoules Haloperidol injection 5mg/ml Box of 10 ampoules Hydromorphone injection 2mg/ml Box of 5 ampoules Hyoscine butylbromide (Buscopan) injection*** 20mg/ml Box of 5 ampoules Metoclopramide injection 10mg/2ml Box of 10 ampoules Midazolam injection** 5mg/ml Box of 10 ampoules Morphine sulphate injection 10mg/ml AND 30mg/ml Box of 5 ampoules * Non-PBS unless for seizure control ** Not on the PBS *** Non-PBS unless for colicky pain. Unrestricted via Repatriation Schedule Decision Assist and Palliative Care Queries A phone advisory service is available for GPs and aged care staff for inquiries on the palliative approach, ranging from medication, symptom management, psychosocial support and bereavement advice to information about education. Phone for 24 / 7 specialist palliative care advice. Advance Care Planning Decision Assist also supports aged care staff, nurses, allied health and GPs through specialised education and resources via a phone advisory service. If you would like advice regarding an advance care plan in relation to a specific client, please call the National Advisory line on , 8am 8pm seven days a week to speak with an experienced advance care planning specialist. Decision Assist can provide general information regarding advance care planning legislation in your state or territory, but does not provide legal advice. For further information on Decision Assist visit Riverina Pulse December 2015 January

16 CPD Events DATE AUDIENCE TOPIC SPEAKER SPONSOR 8 March Practice Nurses, Practice Staff Infection Control Finley Margaret Jennings Marjen Educational Services 13 March GPs Antenatal Shared Care Wagga Various Speakers 21 March Practice Nurses Otitis Media Wagga Benchmarque 22 March Practice Nurses Otitis Media Deniliquin Benchmarque March Practice Nurses Audiometry Wagga Benchmarque March If you have any further enquiries on any of these upcoming CPD events please contact Erin Kelly on or at erin.kelly@mphn.org.au On behalf of the Board and staff we would like to wish you a Merry Christmas and a Safe and Happy New Year Our offices will close 5pm on 24 December 2015 and re-open Monday 4 January Wagga Wagga Office 1/185 Morgan Street (PO Box 5663) Wagga Wagga NSW 2650 T: F: E: ceo@mphn.org.au Griffith Office 46a Hyandra Street, Griffith NSW 2680 T: F: Leeton Office Level 1, Kurrajong Avenue, Leeton NSW 2705 T: F: Howlong Office Shop 3, 47 Hawkins Street, Howlong NSW 2643 firsthealth limited trading as Murrumbidgee Primary Health Network (ABN ) Primary Health Networks Programme an Australian Government Initiative 16 Riverina Pulse December 2015 January 2016