Abstract
Literature suggests that there is a paucity of dedicated concussion clinics in Australia, with the ones that exist being privately owned and usually offering discipline specific services (e.g. physiotherapy) (Nguyen, McKay, Ponsford, Davies, Makdissi, Drummond, Reyes, Makovec Knight, Peverill, Brennan & Willmott, 2023). Whilst the long-term impact of concussions, for instance, traumatic encephalopathy syndrome, dominates media coverage, everyday concussions, especially at the community level, require more consideration. Concussions need to be identified and managed appropriately using best practice care. This is usually provided initially, by a General Practitioner or Emergency Department. However, if concussion symptoms are prolonged, a multidisciplinary team of concussion experts are best placed to provide the required holistic care.
Prior to 2022, there was no adult public concussion clinic in NSW and only one public paediatric concussion clinic at Sydney Children’s Hospital, Westmead. The need for more clinics was apparent, and overseas literature suggests that multidisciplinary management made the most gain in regard to patient outcomes (Jaganathan & Sullivan, 2020). Therefore, the Northern Sydney Local Health District (NSLHD) established a multidisciplinary Concussion Clinic at Royal North Shore Hospital (RNSH) in 2022. This was the first of its kind in Australia, where a true multidisciplinary approach was at the centre of the model of care. While there are many multidisciplinary clinics in Australia, the difference is that this one had the multidisciplinary team (MDT) playing a combined role in the assessments and discussions with the patient, all seeing the patient together in real time. This made for better understanding of events, concussive mechanisms, recovery timelines, symptom causes, patient examination, and a diverse but cohesive evidence-based approach to treatment and management. There was less repetition for the patient, optimised resource and time allocation per patient, increasing quality and effectiveness of care while reducing wait times to access appropriate services, notwithstanding increased patient satisfaction.