Abstract
On 28 February 2022 and 30 March 2022 catastrophic flooding occurred across the Northern Rivers region of NSW with devastating impacts felt across the region. An estimated 200,000 people were impacted by 64 primary health care services temporally closing. Primary health care and Primary Health Networks are not formally recognised in disaster management arrangements but there is increasing recognition of their value in disaster response and recovery efforts. Healthy North Coast, with funding from the Department of Health and NSW Health, implemented innovative initiatives to ensure primary health care services, inclusive of general practices, Aboriginal Medical Services, pharmacies and allied health services, re-opened and stayed opened after these unprecedented flooding events.
In the flood response period Healthy North Coast worked closely with the Northern NSW Local Health District and other emergency response agencies to coordinate primary health care services where they were most needed. Once the flood waters subsided the clean-up and recovery period began. A number of health professionals participated in a survey and codesign sessions to design an innovative and integrated workforce wellbeing initiative. There was strong support by clinicians to implement a local ‘buddy’ workforce surge model. GPs, pharmacists, nurses, and administration staff supported other local health professionals to have a rest by working temporarily in their ‘buddy’s’ service. Clinical psychologists and non-clinical supports were made available for team debriefing and capacity building. Healthy North Coast also established a Lismore Health Precinct at the Southern Cross University that provided nearly 30 flood-impacted primary care providers a free consultation space. Infrastructure grants helped services to rebuild.
As of 30 June 2023, no general practices in flood impacted areas have closed since the floods. This is significant because there was a period in the aftermath of the floods that it seemed inevitable that some primary health care services would close. The cost of the rebuild and the loss and exhaustion of staff was substantial, particularly for those located in the Lismore CBD. Over 1,000 clinicians and frontline support staff have received 110 workforce wellbeing supports. 320 clinicians attended education and training specifically related to flood recovery, trauma informed care and PTSD. Further debrief and education sessions have been planned for another 400 clinicians.
Evidence demonstrates the importance of joined-up planning and strong, established relationships to enable service continuity and access in the time of a disaster. Immediate advocacy to Government was key to ensure recovery funds arrived quickly. Placed-based flexibility was a key element to success. Involving clinicians in the codesign unearthed innovative workforce models that were more integrated than fly-in fly-out models. Healthy North Coast plans to partner with an evaluator to conduct a quantitative review of the impact the flood response and recovery efforts. Further to this Healthy North Coast, alongside other primary health networks, are advocating for primary health care and primary health networks to be formally recognised and included in disaster management arrangements so that they can feed into the planning stages prior to the next disaster occurring.