Wednesday, December 17, 2008

ACT Walk-in Centres

ACT Health made a presentation to a group of HCCA consumer representatives on the ACT Health Walk-in Centre initiative on Monday 15 December.

The concept of a walk-in centre in ACT has not been fully developed and consumer input is being sought. ACT Health is seeking public comment on Walk-in Centres in the ACT a discussion paper, by 28 February 2009. The Discussion Paper is available at
What is a walk-in centre? This question was asked a number of times on Monday. The answers given were not entirely satisfactory. A team from ACT Health went to the UK to look at a number of the National Health Service models. The ACT centres are likely to have a number of the features that the UK models have. The term walk-in means that consumers walk in off the street, ie there is no need for an appointment.

Features of the UK centres include: the centres are often nurse-led services; they sit between a hospital emergency department and a GP surgery, the types of cases treated will be those that are acute or have minor acuity, for example centres don’t handle breast lumps, rectal exams, childhood vaccinations or provide medical certificates. The centres are not designed to provide ongoing care but operate 365 days a year, 8am to 9pm iare the most common opening hours, busiest times are 12-2 lunchtime and 4-6pm after work. As the centres are part of the NHS they are free, including any GP consultation.

The UK staffing model varies some involving GP’s, many being led by a nurse practitioner or advanced practice nurse – the staffing structure for the ACT has not yet been determined.

It is yet to be decided what aspects of the NHS centres will be incorporated in the ACT centred. The differences in the UK and ACT/Australian health systems, such as the salaried vs. private practice role of GPs, will also impact on the centres services. Allied health and other services to be provided in the ACT such as diagnostic services is also a matter for consideration.
The desirability of including both oncology and mental health services was raised.

It was considered that evaluation should be built in to the development of the centres and this should be done at the beginning.

Members views on the role and services of walk-in centres would be very welcome to inform the HCCA submission to ACT Health in late February 2009.

Tony and Kerry

Tuesday, December 16, 2008

The importance of hand hygiene

We met last week with Carmel Spence, Infection Control Officer from Calvary Hospital. Carmel came to the HCCA office with Erica Webber, the Volunteers Coordinator at Calvary to present Adele Stevens with an award for her work as a consumer representative on the Infection Control Committee.

Health care associated infections are a major and growing issue in the quality and safety of health care. It has been identified by the Australian Commission on Safety and Quality in Health Care as a priority area and the highest priority area to reduce the risk of health care-associated infections is to improve health care worker hand hygiene.

The Daily Telegraph has published a story on the action NSW Health is taking that demonstrates the importance of this. The article is entitled NSW doctors told wash hands or be fired
"Under the first significant commitment by the Government, following Commissioner Peter Garling's inquiry into hospitals, doctors who continually fail to wash their hands will be disciplined, then dismissed."
Hand Hygiene Australia built on the work of recent research and identified the critical times when Hand Hygiene should be performed.

We will organise a time for Carmel to speak with members in 2009 about hand hygiene and infection control in health care settings.

Sunday, December 14, 2008

A year in review: 2008

This year HCCA celebrated our 30th birthday. We are the oldest health consumer organisation in Australia.

Consumers must be meaningfully involved in setting the agenda and priorities of health services if we are to have a health system that is responsive, respectful, accessible and affordable to all. There is a strong health care consumer movement that works to achieve this. We are proud of the role we play and appreciate the strong contribution our members make.

This year we have supported more than 50 active consumer representatives. This year they have spent more than 500 hours at committee meetings, 200 hours travelling to and from meetings and about 300 hours reading papers and preparing for meetings. And this does not include the hour is they spend building and sustaining their networks.

This year we have trained 15 new consumer representatives to add to our pool of committed and experienced reps. We are looking forward to working with them over the coming years.

Each year we survey our reps to help us evaluate our representative program. We are currently analysing the results of this year’s survey. I want to share with you some of the findings as I think it is useful in thinking about the contributions our consumer representatives make to the ACT community.

We asked our reps why consumer participation is important in health care. They responded overwhelmingly that it because it
• improves the quality and safety and quality if services and
• provides a way for consumers to shape the services we use

We asked our reps what we achieve with the consumer representatives program. And they responded that it
• improves the quality of services,
• increases policy makers and service provider's understanding of what health consumers want and
• brings about cultural change

Most of our reps say they feel that their contributions frequently influence the committee. This is an important measure.

We also surveyed ACT Health staff who work with consumer representatives and their responses are very interesting.

The ACT staff who responded said consumer participation is important in health care because it provides a way for consumers to shape the services they use

When asked what HCCA achieves through the reps program 75% of staff increases policy makers’ and service providers’ understanding of what health consumers want.

Kerry Snell will be analysing the results of the survey in January and will report at the first consumer representatives forum for the year. We will also include a summary in Consumer Bites.

I would like to thank the great staff team that we have in the office. We have had a busy and successful year and even managed to have a bit of fun. The HCCA office will be closed between 24 December 2008 and 2 December 2009 inclusive (so that the staff can recharge).

We want to thank you for your contribution this year. It has been a busy year, especially with the service planning processes and the Capital Asset Development Program. I hope you all have a restful summer break and look forward to continuing our work in the new year.

Best wishes


Sunday, December 7, 2008

Nursing and Midwifery Stakeholder Reference Group

I attended the first Stakeholder reference Group for the Department of Health and Ageing on 14 November 08.
Rosemary Bryant explained that the main purpose of the group is to provide a means for two-way exchange of information and advice between the CNMO and key nursing and midwifery experts. Members of the group are representatives of their respective organisations.

Maternity services review
Over 900 submissions have been received. The submissions have been prepared by consumers, health professionals and peak bodies.
The Chief Nurse and Midwifery Officer (CNMO), Rosemary Bryant, commented that there were lots of areas of agreement across the submissions including the importance of continuity of care, support for midwifery led models, and indemnity issues facing midwives. The Department is currently analysing the submissions and writing a report for the Minister of Heath, Nicola Roxon. It is up to the Minister whether this report will be made public. I think that this is a very important document that would contribute significantly to that this become a public document.

There was considerable discussion of membership of the Stakeholder Reference Group. In particular, there was discussion of the need for aged care nursing to be represented. The distinction between community based nursing and residential facilities was drawn.

The place of Community nurses around the table was also raised. This is a significant workforce for consumers, especially vulnerable people. With our work at Health Care Consumers Association we have heard a range of issues from advocates regarding competency standards and scope of practice of community nurses.

One issue that affects the wider consumer movement is that there is not a professional association for community nursing. The ACCNS folded around two years ago. For consumers this means that we need to work across a number of bodies to raise any issues we may have about standards and practice. This includes: the registration Boards, the Nursing Federation, the College of Nursing and Midwifery, deans of nurse education, CRANA and chief nurses in each jurisdiction.