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Health Bulletin July 2023

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Access to oral Covid‐19 antivirals in the community: are eligibility criteria and systems ensuring equity?

The Medical Journal of Australia has published an article calling for increased access to antiviral medication in Australia to “reduce existing disparities in hospitalisation and death”.

The call comes amid “substantial” community transmission, as well as workforce, bulkbilling, and availability pressures on the healthcare system.

Current antiviral eligibility includes:

  • Anyone who is 70 years of age or older, regardless of risk factors and with or without symptoms.
  • Anyone who is 60-69 years of age or older with one additional risk factor for developing severe disease.
  • Anyone who is 50 years of age or older with two additional risk factors for developing severe disease or have had past Covid-19 infection resulting in hospitalisation.
  • First Nations people, 30 years of age or older and with one additional risk factor for developing severe disease or have had past Covid-19 infection resulting in hospitalisation.
  • Anyone who is over 18 and immunocompromised.

New Zealand has demonstrated an attempt to ensure equity by extending prescribing powers to pharmacists. This reduces barriers to accessing treatment by reducing the need to consult a doctor or nurse.

It is also hoped that antivirals will avoid “considerable burden on affected individuals and the health system” by reducing prolonged illness or “long Covid” which 5-10% of people are estimated to experience. However, with current availability restrictions, people in the “most affected group (35–49-year-olds)” are excluded from antiviral treatment.

To read more, please click here.

80 new purpose built 4WD ambulances will reach patients in challenging terrain

The NSW Government has unveiled 80 new 4WD ambulances to be used to tackle challenging rescues across the state. The vehicles, which are modified Toyota Landcruiser 200 Series, promise to handle bush and sand, offering greater safety for paramedic and patients whose care lies beyond difficult terrain.

Health Minister Ryan Park explained the vehicles are part of providing first responders with “the most modern and up to date equipment, to help them delivery the highest quality care.”

The modifications include the inclusion of a stretcher and medical equipment, reducing the vehicles to 3-seaters. The new fleet replaces a set of aged “work horse” Landcruiser Troop Carriers, tailored to providing support in remote and rural settings that is sometimes demanded of paramedics. While providing effective patient care, the vehicles are equally valuable for their ability to keep paramedics safe as they respond in trying circumstances.

The new 4WD vehicles are not intended to replace the road fleet, but instead will provide a valuable additional capability for the most difficult rescues. NSW health suggests that there will be times where patients are collected from areas of “bush, sand, water mud (or) snow” and taken to a road, where they can be transferred to a regular road ambulance. This enables the health service to combat Australia’s notorious terrain while “delivering the best possible pre-hospital care.”

To read the NSW Health release, please click here.

Psychological screening tool hopes to improve patient safety

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) have developed an “easy-to-use traffic light system” screening tool, to ensure “the highest possible psychological safety of patients”.

From July 1, the medical regulator will change requirements around patients who “may need to be referred for psychological or psychiatric assessment before [cosmetic] surgery”. To date, screening patients for further assessment has been as informal procedure.

ASAPS have designed 13 questions to screen patients for any factors that may negatively influence their capacity to make a “good decision”, such as body dysmorphic disorder. From this screening, clinicians will decide whether to proceed, refer their patient for further assessment, or halt the procedure.

The tool is not designed to reduce the number of patients receiving surgery, but rather make sure that it is appropriate for patients to move forward with their chosen surgery. According to research done by the Australasian Foundation for Plastic Surgery (AFPS), 16% of healthcare disputes concern plastic surgery. Of those 26% claimed that they were not properly informed by their practitioners before consenting, and 39% said they were not made aware of the potential lack of benefit of the surgery.

As a result, by using this tool, patients’ dissatisfactions and the associated litigation are hoped to be mitigated.

To read more, please click here.

Medical regulator Ahpra probes drug prescription allegations at Victorian prison

Medical regulator Ahpra is investigating allegations that opioid replacement drugs were improperly provided at the Fulham Correctional Centre by a prison worker. Fulham Correctional Centre is a men’s prison run by private contractor GEO Group Australia (GEO) in Gippsland.

The allegations centre around a staff member at Fulham Correctional Centre who prescribed drugs such as methadone to prisoners despite not holding relevant qualifications.

Ahpra were unable to comment on the specific allegation, however, noted they were aware of concerns related to practices at the facility and confirmed they were investigating whether a regulatory response is required.

A prison worker told the Australian Broadcasting Corporation (ABC) they had observed the prescribing of drugs at the prison without being overseen by a properly qualified health professional.

ABC reports that the prison worker made referrals to Ahpra after raising the issue internally and feeling as though nothing had been done.

The spokeswoman from the GEO said that “GEO takes all allegations seriously” and has informed both Corrections Victoria and Justice Health. GEO informed ABC it had conducted its own enquiries and referred the allegations to Ahpra.

To read more, please click here.

Enhanced access to renal dialysis services at Hornsby Ku-ring-gai Hospital: A milestone in local patient care

Hornsby Ku-ring-gai Hospital has unveiled its latest addition to the much-anticipated $265 million dollar redevelopment: the Hornsby Renal Dialysis Service. For the first time ever, kidney patients in the region can now receive life-saving renal dialysis treatment in their own community.

Recently, the New South Wales Health Minister, Ryan Park, embarked on a tour of the state-of-the-art 10-chair renal dialysis unit. After the tour, Mr. Park observed: "I am delighted that residents of Hornsby and Ku-ring-gai who need renal dialysis can now have this treatment closer to home… it will make a huge difference to lives of patients, their families and carers.”

Since its inauguration in February, the facility has already administered an impressive 1,150 dialysis treatments.

As a satellite dialysis unit of Royal North Shore Hospital, the Hornsby Renal Dialysis Service provides patients with top-tier nursing and renal management services six days a week. Now, patients can receive their essential treatments - usually three times per week - in the comfort of their own community, eliminating the need for extensive travel to other healthcare facilities.

The Hornsby Renal Dialysis Service represents a monumental achievement in bringing critical medical care closer to home for kidney patients. This milestone not only signifies progress in healthcare accessibility but also exemplifies the unwavering dedication of healthcare professionals and government authorities to prioritise the welfare of their constituents. As the hospital's transformation unfolds, the future holds great promise for improved healthcare outcomes and the well-being of the local community.

This achievement was made possible through the collaborative efforts of the healthcare professionals at Royal North Shore Hospital and Hornsby Ku-ring-gai Hospital.

Read the NSW Health update here.

Consultation on Australia’s first National health and climate strategy

The Federal Government is requesting community consultation on Australia’s first National Health and Climate Strategy to ensure the national health system can keep up with the exponential rate of climate change.

Recognition of the imminent effects greenhouse gases are having on our immediate environment and personal health has called for increased attention to be drawn to the emissions produced by the health system itself.

The Intergovernmental Panel on Climate Change has projected that the Earth is likely to experience an increase of 1.5 degrees Celsius from pre-Industrial levels as early as the 2030s.

As temperatures continue to rise, increasing the frequency of extreme weather events, the rate of food-borne, water-borne and vector-borne diseases will also go up. Lowering air quality is continuing to intensify respiratory conditions which, if left unaddressed, will exacerbate the risk of other health related concerns.

Under the broader objective of protecting the health and wellbeing of Australians from the impacts of climate change, the Strategy will assist in executing the Government’s “climate mitigation and adaptation policies”. Unaccounted for under previous climate and health initiatives, the Strategy will place particular focus on managing the resilience of Australia’s health system to combat:

  • more frequent and severe weather phenomena,
  • extreme Temperatures, and
  • declining Air Quality.

The goal will be to develop actions to:

  • reduce the carbon footprint of the Australian health system,
  • ensure the health system builds up resilience to the impacts of climate change, and
  • increase cross-sections between climate and public health policies.

To ensure comprehensive consideration of health and climate related concerns and recognition that Indigenous communities are disproportionately affected by the effects of climate change, the Government is looking to engage in public consultations with both First Nations and non-Indigenous Australians.

Read the Consultation Paper here.

Maltreated in care

The Australian Institute of Health and Welfare (AIHW) has revealed that from 275,000 reports to Australian Child Protection Agencies in 2021 - 2022, 45,500 claims of maltreatment of children have been substantiated, meaning the child has been, is being, or is likely to be maltreated.

The number of children with substantiated claims of maltreatment reflects approximately 45% of the claims made to Child Protection Agencies. The most common substantiated complaints of maltreatment related to emotional abuse (57%) and neglect (21%).

Of the 45,500 substantiated claims, 13,600 children were indigenous (4% of indigenous children) and 30,500 were non-indigenous children (.57% of non-indigenous children). Children living in very remote areas were almost four times more likely to be maltreated than those living in a major city and about one-third of the children are from the lowest socio-economic areas. The most commonly maltreated age group were infants under one year old.

The AIHW will issue quarterly reports over the next 12 months with a focus on Indigenous children in the child protection system and the safety of children in care and pathways from out-of-home care.

The Child Protection Agencies aim to ensure children have stable, long term care arrangements in place. Their protection services are scaled with consideration to the severity of risk to the child with the aims of protecting the child and supporting families. These services include intensive family support services, care and protection orders and out-of-home care, such as foster care or living with other relatives. Consistent with the overarching principle to keep children with their families, out-of-home care placements are considered a last resort and only where absolutely necessary to ensure the safety of the children.

Importantly, a substantiated claim of maltreatment does not mean that a protective order will necessarily be placed on the child. Only 22% of children who were the subject of substantiated claims of maltreatment made in 2021-22 were placed on an order within 12 months following the substantiated claim.

To read the article in Pharmacy Daily click here.

Click here to read all of the findings of the AIHW research on Child Protection in 2021-2022.

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