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A Public-Private Rural Physiotherapy Service

Murrumbidgee Local Health DistrictMurrumbidgee Primary Health Network
Project Added:
18 January 2016
Last updated:
18 January 2016

A Public-Private Rural Physiotherapy Service

Summary

This project established a partnership between the local health district, Primary Health Network (PHN) and private physiotherapists, to pool resources and deliver physiotherapy services in rural communities. 

This project was a finalist in the Integrated Healthcare category and the recipient of the NSW Health Secretary Award for Integrated Care in the 2015 NSW Health Awards.
Watch a video on this project (opens in a new tab).

Aim

To improve access to physiotherapy services for residents of rural communities where no services currently exist.

Benefits

  • Reduces inefficiencies caused by low volumes of work in any one area.
  • Reduces duplication of services in rural communities.
  • Maximises funding through pooled income streams.
  • Improves the recruitment and retention of clinical staff in rural areas and enhances existing services by expanding the role of Allied Health Assistants (AHAs).
  • Engages consumers, clinicians and healthcare organisations through strong partnerships and pooled resources.
  • Improves the management of chronic disease and reduces avoidable admissions.

Background

MLHD has experienced a long-term shortage of physiotherapists. Alternative solutions, such as providing AHAs to meet the demand for allied health services, still requires access to relevant health professionals who can provide training, supervision and clinical assessment. A solution was required to meet the demand for physiotherapy services in rural communities.

Implementation

  • Community consultation and a needs assessment was undertaken in collaboration with health executives, clinicians, clients and consumer participants.
  • A model of care was developed, which pooled three funding streams (NSW Health, PHN and private funds) to produce a sustainable service to four rural communities. The cost of service was directly linked with the volume of work required, rather than engaging the therapist on a sessional basis.
  • MLHD, PHNs and private physiotherapists developed a shared governance arrangement and service level agreement.
  • The physiotherapist provided consumer-focused care, developing care plans in liaison with clients to achieve their goals. Private clients could access the physiotherapist directly, while public clients required a referral from a health service manager or general practitioner.
  • The physiotherapist delegated clinical work to AHAs in accordance with MLHD governance guidelines, which increased the frequency of therapeutic interventions between site visits.
  • The service targeted acute admissions, post-acute and aged care, with a focus on those eligible for the Commonwealth Chronic Disease Management Program.

Key dates

  • Pilot phase: June 2014 – December 2014.
  • Expansion phase: January 2015 – June 2015.

Project status

  • Sustained - the initiative has been implemented and is sustained in standard business.

Implementation sites

  • Alwaali Medical Centre Berrigan
  • Berrigan Multipurpose Site
  • Finley Health Service
  • Jerilderie Health Service
  • Urana Multipurpose Site (Community Health) 

Partnerships 

  • Back On Track Physiotherapy, Corowa
  • Hume Medicare Local (now Murrumbidgee PHN

Results

  • During the pilot project, 754 physiotherapy and AHA service events were delivered, incorporating chronic disease, private clients, acute and post-acute care.
  • Preliminary data shows a reduction in potentially preventable hospitalisation rates for two pilot sites in the 2014-15 financial year, compared to the previous year.
  • Long-term data will explore the impact on avoidable hospitalisations, length of stay and falls rates in the target communities.
  • Physiotherapy services are now provided in four rural communities, where previously they did not exist or were only provided periodically.
  • Procuring private physiotherapists proved to be an efficient way to use a small amount of funding effectively. The model provided services to four communities, while the original funding would have only purchased a two-day a week service to one facility.
  • The cost of the service was directly linked to the volume of work required, which was shown to be effective for rural communities where low volumes of work exist in any one area.
  • General practitioners report better outcomes for patients who can now access physiotherapy services locally without having to travel out of town.
  • A falls program has been instigated at Finley, which was not previously possible without the physiotherapy service.
  • The project has since expanded to incorporate Berrigan and Jerilderie.

Awards

  • 2015 NSW Health Awards Recipient - NSW Health Secretary Award for Integrated Care
  • 2015 NSW Health Awards Finalist – Integrated Healthcare

Lessons learnt

  • The success of the project hinged upon consistent communication between team members and partner organisations. Clear definitions of the scope of service and governance arrangements helped staff negotiate unexpected outcomes and minimised the risk of miscommunication.
  • Through standardised contractual arrangements, this model is able to be easily replicated in rural settings where local private providers can be engaged.

Further reading

Contact

Catherine Maloney
Director Allied Health
Murrumbidgee Local Health District
Phone: 0477 334 428   
catherine.maloney@gsahs.health.nsw.gov.au 

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