Health Performance Council Aboriginal Leaders Forum 31 st May 2017 1
Acknowledgement of Country We acknowledge and respect the traditional custodians whose ancestral lands we are meeting upon here today, the Kaurna people. We acknowledge the deep feelings of attachment and relationship of the Kaurna people to their country. We pay respect to Aboriginal people present and their ancestors. 2
Aboriginal Health Priority Area 3
Vision To reduce the impact of chronic disease experienced by Aboriginal and Torres Strait Islander people living in South Australia through the delivery of collaborative, appropriate, well coordinated, evidence based strategies to successfully implement the priorities in the South Australian Aboriginal Cancer Control Plan 2016 2021, South Australian Aboriginal Heart and Stroke Plan 2017 2021, and the South Australian Aboriginal Diabetes Strategy 2017 2021. 4
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Guiding principles in all plans Ensure equity in access to services Use a holistic approach in the provision of services Ensure a family centred approach to service provision Invest in building relationships with Aboriginal people Provide culturally safe healthcare services Services should be underpinned by cultural knowledge and scientific evidence Invest in Aboriginal leadership and Aboriginal staff in services provision Prioritise prevention activities whenever possible Build local capacity to deliver patient centred services Involve all key stakeholders in governance Promote a system that encourages innovation and adaptation Ensure system wide and service accountability 6
Diabetes Strategy Prevention DIP T2DM Early Detection Management and Complications Diabetes in Pregnancy Priority Groups Research, Data, Pop. Monitoring State wide Healthy diets. Prediabetes intervention PHC access Health checks POC Testing S/W Model of Care. Management Complication reduction and management Medications, devices Technology. CQI State Model of Care. Needs Assess. Targeted prevention Early detection Priority groups: Child & adolescents. Homeless. Prisoners. Mental health pts Freq Flyers Disability. SA Research program. Data capacity and usability. Continuous population monitoring. Responsible governance Equity in Access Integration & coordination Workforce Culturally Safe Care Monitoring & Evaluation Social Determinants Sustainable Funding Systems & Infrastructure Partnering with the Community 7
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SA Aboriginal Heart and Stroke Plan 2017-21 Cross Sector Primary Prevention Diagnosis Acute Care 1: Comprehensive primary health care services 2: Develop a state wide model for enhanced regional and remote services 3: Maintain and expand the existing SA Rheumatic Heart Disease Control Program 4: Enhance acute and ongoing care of children and adolescents 5: Establish awareness and prevention campaign/s across SA 6: Increase CVD risk assessment and management in all primary care settings 7: Timely access to non acute diagnostic services 8: Coordinate state wide specialist outreach service plan 9: Warning signs and symptoms of heart attack and stroke 10: Reducing the out of pocket costs of ambulance services 11, 12: Transfer and retrieval services protocol 13: a) Maintain and expand iccnet CHSA and b) Regional TIA/CVA system of care 14, 15, 16: Hospital excellence in Care and Aboriginal Health Practitioner/Nurse Coordinator positions in key hospitals 17: Develop a state wide approach to a rheumatic valvular surgery centre of excellence Transport Accommodation Technology Workforce Ongoing Care 18, 19: Systematic discharge and central referral service that ensures continuity of care 20: Culturally appropriate, evidence based cardiac and stroke rehabilitation services 21: Build capacity in primary health care for CVD secondary prevention 22: Culturally appropriate palliative and end of life care 9
Deaths from cardiovascular disease, by Aboriginal status and age, SA 2006 2012 10
SA Aboriginal Cancer Control Plan 2016-21 > Awareness and prevention > Screening and early detection > Diagnosis and staging > Treatment > Care co ordination > Supportive care > Workforce > Outcomes data and research > Collaboration and consumer engagement 11
Age at cancer diagnosis in South Australia 12
South Australian Aboriginal Health Partnership (SAAHP) SA Health AHCSA Commonwealth Department of Health SA Health received the completed plans June 30 2016 SAAHP had prioritised the implementation of the 3 Plans for the next 5 years SAAHP asked the authors of the plans to consider: Implementation options Across plan priorities Authors presented ideas and concepts to an extended SAAHP on July 25 Outcome Recommendations that included: Work towards the establishment of the SA Aboriginal Chronic Disease Consortium as part of the SA Academic Health Science and Translation Centre A focus on the implementation of the 3 Plans, highlighting on Across plan priorities and condition specific priorities Consideration of seed funding to setup the Consortium and the Coordinating Centre Ensuring SAAHP is part of the ongoing governance and a key reporting group.es
The Governance Structure The SA Aboriginal Chronic Disease Consortium SA Aboriginal Health Partnership SA Academic Health Science and Translation Centre Executive SA Aboriginal Chronic Disease Consortium Executive Group SA Health (Each LHN, TH), AHCSA, SAHMRI/Translation Centre, Adelaide PHN, Country SA PHN, Community Reference Group Representatives, Condition Specific Leadership Group Representatives Community Reference Group Coordinating Centre/ Operations Group/ Secretariat Heart & Stroke Leadership Group Diabetes Leadership Group Cancer Leadership Group 14
SA Aboriginal Chronic Disease Co chairs Executive Group Co chairs Alex Brown and Kerri Reilly Community Reference Group Co chairs Sandy Miller and Kym Thomas Heart & Stroke Leadership Group Co chairs Nola Whyman Phil Tideman Diabetes Leadership Group Co chairs Sharon Bilney David Jesudason Cancer Leadership Group Co chairs Amanda Mitchell Ian Olver 15
The Members The SA Aboriginal Chronic Disease Consortium Aboriginal Health Council of SA (AHCSA) SA Health LHN s, SAAS, Aboriginal Health, Transforming Health Primary Health Networks Adelaide Country SA Aboriginal Community Controlled Health Services Wardliparingga Aboriginal Research Unit at SAHMRI Other Service providers RFDS, RDWA, etc Non Govt Organisations Cancer Council, Diabetes Australia, Heart Foundation, Stroke Foundation, Kidney Australia Primary Care Services NHN, Private GP Aboriginal Community Members Specialists Cardiac, Stroke, Cancer, Diabetes 16
The Network The SA Aboriginal Chronic Disease Consortium Friends of the Consortium Government Departments (State Dept, Education, Housing, Child Protection, Families SA, Corrections) University Centres and Groups NGO s (Red Cross, SACCOS) Members of the Consortium Professional groups Specialist Colleges Aboriginal Community Groups Reconciliation SA
What s happening! Phase 1 Setup and write implementation plan Feb June 2017 Step 1 February April 2017 Step 2 May 2017 Announcement Set up Coordinating Centre and Governance Structures Consider across plan priorities and condition specific priorities Landscape scan National and State Launch May 18 Communicate with stakeholders Workshops to refine and agree on priorities Step 3 Completed 30 June 2017 Finalise plan for 2017 2021 Advocate, gain commitment to implement immediate plan including $ Advocate for ongoing support including $ Phase 2 Ongoing implementation July 2017 June 21 18
Developing the Implementation Plan/Road map by June 30 All working groups have met including the Executive Group Recognition All strategies in the 3 plans are important Need to prioritize within each plan and across plans Need to stage implementation over 5 years Condition specific leadership groups were asked to participate in a prioritization survey for their plan. Cancer 10 Priority Areas 10 priorities Heart and Stroke 22 Strategies 13 priorities Diabetes 23 Recommendations 14 priorities Community Reference Group invited to participate in the prioritization survey. May 18 Launch and workshops Workshop 1 Priorities with in each plan Workshop 2 Priorities Across Plans Workshop 3 Collect intelligence on Across plan activities 19
SA Aboriginal Chronic Disease Consortium Diabetes Priorities Heart and Stroke Priorities Cancer Care Priorities Across Plan Priorities Prevention Primary prevention Risk assessment, Screening and Management Ongoing Management Discharge systems Rehabilitation and Secondary prevention Continuity of Care Improving the Workforce Coordinating multi disciplinary care Access to specialist outreach services Culturally appropriate care Increasing Aboriginal workforce Social and Emotional Wellbeing Monitoring, Evaluation and Data
SA Chronic Disease Consortium Priorities Road Map Holistic approach Family centred and consider comorbidities Condition Specific priorities Across Plan Priorities Diabetes, Cancer, Heart and Stroke Cancer Improve cultural competency of cancer centres Diabetes Develop and implement State wide MOC for Diabetes Heart and Stroke Improve cultural competence of services in emergency situation Prevention and Early Identification 1. Implement primary prevention, health promotion strategy across the life course. 2. Undertake risk factor identification, screening, early detection and management for those 15 and older. Focus Community, Primary Health Care Services and Pregnancy Acute Management 1. Improve cultural competence of services. 2. Invest in Cancer Care Coordinators and Vascular Care Coordinators. 3. Enhance Aboriginal Liaison Officer services Focus Key hospitals Ongoing Management 1. Design and implement systematic discharge, referral and follow up 2. Develop rehabilitation and survivorship program 3. Support Self Management Focus Hospital/PHC interface and PHC Services Improve Workforce 1. Build Aboriginal workforce 2. Enhance cultural competence of mainstream workforce 3. Zero tolerance for racism Improve Access to Services 1. Enhance Specialist Outreach services incorporating video conferencing 2. Build local capacity skills and systems 3. Increase access to medication 4. Support transport and accommodation Monitoring and Evaluation 1. Improve Aboriginal identification 2. Ongoing Dashboard reporting include patient measures 3. Inform Research agenda Social and Emotional Wellbeing 1. Recognise the impact of colonialization and racism Mental health issues, Intergenerational trauma, Ongoing grief and loss, Disconnect to land and community 2. Advocate for the importance of investment in the social determinants of health
Next steps Drafting the Road Map/Implementation Plan In June all working groups meet to review the plan and there will be efforts to get $ and in kind support before June 30 The Road Map/Implementation Plan 2017 2021 will be submitted to SA Health on June 30. July Implementation will begin 22
This artwork represents the South Australian Aboriginal Chronic Disease Consortium and the interdependence of prevention, care and after care to achieving the best health outcomes for Aboriginal and Torres Strait Islander people. The three central overlapping meeting places signify the across plan priorities of the three plans. Diabetes is depicted by the blue meeting circle; heart and stroke by the red meeting circle; and cancer by the yellow meeting circle. The red, blue and yellow paths show the three plans collaborating and coming together to achieve the best health outcomes and the red paths show the Consortium reaching out to other organisations and communities, represented by the outer meeting circles, which are working together to maximise the effectiveness of the three plans. The small dots are the people going to the organisations and communities and being assisted by the work of the Consortium, and the pale blue puzzle pieces represent the organisations and communities giving the Consortium important feedback. JORDAN LOVEGROVE Indigenous Artist, Dreamtime Creative Ngarrindjeri young man who combines intimate knowledge of Aboriginal communities and illustration skills to develop outstanding Indigenous artwork which is applied to a range of print and online communications. 23
Panel Discussion What would be the best way to engage with the HPC? What would be the best way to engage with Aboriginal leaders forum into the future? 24