Abstract
Background: Low urgency presentations to emergency departments by those aged 15-24 years are high on the North Coast of Australia. Healthy North Coast Primary Health Network is implementing an initiative to improve access to primary health care and reduce emergency department presentations through an 24/7 nursing triage service that supports centralised bookings into general practice and community pharmacy.
Approach: Following data analysis and validation, a series of codesign workshops were undertaken with consumers, GPs, allied health professionals, nurses, Local Health Districts (hospitals), Aboriginal Medical Services, national subject matter experts and digital triage providers, to understand issues and elicit potential solutions for new innovative approaches to support access to primary care. Codesign included ideas generation, consumer testing and an exploration of the feasibility of solutions. Two dominant themes emerged: technology enabled care and improved access to same day care.
North Coast Health Connect was launched in late 2022 and is delivered by Amplar Health, the Pharmaceutical Society of Australia, 20 general practices and 20 community pharmacies. The service provides 24/7 digital nurse triage via phone and webchat and a centralised booking system into free general practice and community pharmacy appointments across 12 local government areas, comprising of half a million residents. The service offers a digital integrated distributed model of urgent care where free same day GP appointments can be secured for new patients. Elements of the service are the first of its kind in Australia to date.
Results: 25,000 calls and webchats have been made, with 25% of callers diverted from emergency. Over 2,000 general practice and 150 pharmacy consultations have been booked through the centralised booking system.
The George Institute for Global Health is independently evaluating the service over the three-year service delivery period. The theory of change continues to evolve. New initiatives are being added to the program as learnings are identified. The evaluators have noted how the program is evolving alongside rapid Australian primary health care policy change brought about due to increasing pressure on acute and primary health services.
Implications: Although urgent care may be unplanned, it is highly predictable. North Coast Health Connect is enhancing primary health care access by enabling patients to receive digitally enabled triage wherever they are at their time of need. Empowering patients to identify and prioritise place-based solutions was critical to designing a service that met their needs. Digital triage connected to face to face services can improve access and integration in a fragmented and complex service environment. There is untapped capacity in general practice for same day care, even in locations where wait times are long. It is hoped that other referral points can be added to the service over time and integrated with other urgent care improvements occurring at national and state levels and with the national telephony service healthdirect.