Abstract
Introduction/Background: On the North Coast of NSW, low urgency presentations to EDs by those aged 15-24 years are amongst the highest in the country, with presentation rates higher for Aboriginal people.
Healthy North Coast (HNC) embarked on a primary care access initiative to reduce low urgency ED rates through an innovative digital front door that provides a 24/7 nursing triage service and direct referral into general practice and community pharmacy through a regionally distributed urgent care model.
Who did you involve and engage with? A series of codesign workshops were undertaken with consumers (including young leaders), GPs, allied health professionals, nurses, Local Health Districts, Aboriginal Medical Services, national subject matter experts and future providers, to understand issues and elicit potential solutions for new innovative approaches to primary care access.
Codesign sessions included reimagining primary care access in the region; idea generation; consumer testing where consumers provided feedback on the suggested ideas collected and an exploration of the desirability, feasibility, and viability of their solutions.
Two dominant themes emerged from the final session: technology enabled care and improved access to same day care, which led to the commissioning of North Coast Health Connect (NCHC).
What did you do? Launched in late 2022, NCHC, delivered by Amplar Health, Pharmaceutical Society of Australia, general practices and community pharmacies, provides 24/7 registered nurse triage via phone or webchat that has the innovative functionality of being able to book quarantined general practice and community pharmacy appointments. The service offers an integrated distributed model of urgent care where appointments can be secured in any regional town where a general practice or community pharmacy is participating. Elements of the service are the first of its kind in Australia to date. The service ensures urgent health concerns are assessed quickly by a health professional and enables access to appointments with local doctors and pharmacists through an integrated booking system.
What results did you get? What impact did you have? The George Institute for Global Health has been contracted to independently evaluate the service over the next 5 years.
There has been good uptake by the community with over 2800 calls and webchats already made. The service is increasing access, choice, and control to the community by supporting local people to receive health advice quickly wherever they are and in a way that suits them.
What is the learning for the international audience? Immersive co-design, empowering consumers to identify and prioritise expectations and placed-based solutions are critical to designing services to meet local community needs.
Although urgent and same day care may be unplanned, it is highly predictable. Meeting this demand can be addressed by building scheduled capacity within the existing primary health care system thereby investing back into regional health care.
What are the next steps? NCHC sits within a rapidly evolving urgent care landscape. It is hoped that other referral points can be added to the service over time and integrated with urgent care improvements occurring at national and state level and with the national service HealthDirect.