Findings from the NSW Child Health Network Report Improving Education and Clinical Support for Allie

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Supporting our Paediatric Allied Health
Clinicians

• Findings from the NSW Child Health Network Report
  Improving Education and Clinical Support for
  Allied Health Professionals Working with
  Children
• Virginia Binns Director of Allied Health
• Sydney Childrens Hospital
• Alison Jones Chair, Division of Allied Health
• The Childrens Hospital at Westmead
• Margaret Piper Director of Community Child
  Health Allied Health
• Kaleidoscope in Greater Newcastle

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New South Wales

• Covers area of 801, 430km2
• Paediatric population of 1.4 million (22)
• 17 Area Health Services (AHS)
• 195 hospitals treating children plus their
  associated community services
• 3 hospitals manage tertiary care

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NSW Child Health Network

• Emergence and progression of the 3 Child Health
  Networks strongly supported by the agenda and
  philosophy of the NSW Governments Action Plan
  for Health
• Greater Eastern and Southern - SCH
• Greater Western - CHW
• Northern - JHCH
• Broad role to improve the health and safety of
  children

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NSW Child Health Networks (cont)

• AIMS
• Improve access to care for children and their
  families
• - appropriate
• - as close as possible to where they live
• Ensure standards of care
• - best practice
• - treatment guidelines for common conditions
• Improve access to clinical expertise available in
  the three childrens hospitals
• Involvement of consumers
• Improve quality of care

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NSW Child Health Network (cont)

• BENEFITS
• Safety and quality ensured through consistent
  application of current guidelines, standards and
  protocols
• Improved access to services
• Improved linkages between childrens hospitals
  and local hospitals both metropolitan and rural
• Provide network wide approach to
  multidisciplinary postgraduate training and
  research
• Population base and framework for certainty
  around future development of services

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Metropolitan Hospital Networks
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Rural Hospital Networks
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Background to Project

• Fundamental issue identified in the NSW Rural
  Health Report is to attract and retain health
  professionals
• Key issues influencing rural Retention and
  Recruitment
• - professional isolation
• - lack of peer support
• - lack of access to professional
  development

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Background to Project (cont)
Background to Project (cont.)

• Allied Health recruitment and retention a major
  problem across NSW but more so in rural and
  remote areas
• 1400 allied health FTEs are employed by health
  in rural NSW (22 of publicly employed workforce)
• Many allied health professionals (AHPs) work as
  generalists across a wide range of acute and
  chronic conditions and age groups
• Require extensive range of clinical skills
  often do not retain sufficient competencies to
  optimise outcomes for such a diverse population

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Background to Project (cont)

• 12 AHPs in rural areas are recruited directly
  after graduating, thus
• - little experience in working with
  children
• - no local discipline specific support
• - no access to discipline specialist
  support or supervision

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Who was involved in the Project?

• Statewide Steering Committee
• Project Officer
• Allied Health Professionals who work with
  children in NSW
• Planning Manager/Co-ordinators of the 3 NSW Child
  Health Networks

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How were the Allied Health Professionals involved?

• Survey
• Employment Site
• Caseload and Work Peers
• Current access to Education
• Clinical support
• Clinical Education and support needs
• Opportunities available now

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How were the Allied Health Professionals involved?

• Focus Groups
• Internal Organisational structures that enable
  access to education clinical support
• Access to necessary educational clinical
  support to treat paediatric caseload
• Common issues re education support to Allied
  Health in the Area Health Service
• What would attendees change to improve access to
  education and support

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Results from the SurveyRespondents by Allied
Health Profession

• Speech Pathology - 112 surveys
• Physiotherapy - 89 surveys
• Occupational therapy - 75 surveys
• Social Work - 56 surveys
• Psychology - 51 surveys
• Dietetics - 44 surveys
• Other (Play therapy, Audiology, Orthotics, etc
  and unknown) 41 surveys

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Results from the SurveyEmployment Sites
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Results from the SurveyEmployment Sites
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Results from the Survey of caseload treating
children
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Results from the SurveyComposition of Allied
Health Practices
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Results from the SurveyCurrent access to
Educational Clinical Support
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Results from the SurveyCurrent access to
Educational Clinical Support
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Results from the SurveyCurrent access to
Educational Clinical Support
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Results from the Focus Groups Issues

• Increased size and complexity of the paediatric
  caseload
• Access to education and clinical support
• Access to clinical supervision and mentoring
• Access to information Technology

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Discussion

• Clinical Supervision
• Performance Appraisal
• Caseload
• Access to Education and Training
• Access to Technology

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Clinical Supervision

• Regular clinical supervision is an issue for AH
  professionals in NSW
• No one-size fits all model
• Must be adapted to meet local needs
• Innovative approach to clinical supervision is
  needed especially for AH professionals in
  remote areas
• Robust and sustainable system is paramount

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Performance Appraisal

• Participation in Performance management and
  appraisal should be an expectation
• Regular performance appraisal is an issue for AH
  staff
• AH professionals report to non-clinical line
  managers
• Programme of performance management needs to be
  operationalised

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Caseload

• Increasing size and complexity of cases
• identified as an issue due to
• Other services/ organisations offering less
  direct treatment
• Significant advances in medical practice and
  technology
• Community Expectations
• Availability of and access to improved equipment
  and technology
• Lack of resources identified as major issue in
  ability to provide appropriate services in a
  timely manner

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Access to Education and Training

• Essential for all staff including
• Sole practitioners
• Those working in isolation in specialised fields
• Generalist staff
• Education and Training is recognized as an
  essential component of AH work
• Opportunities for training and accessing external
  courses less for those in rural areas and
  non-Childrens hospital staff

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Cont

• Ready acceptance that education is a shared
  responsibility, although costs can be prohibitive
• Improved access will result in competent
  up-to-date clinicians who feel valued

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Access to Technology

• Has the potential to
• address gaps in relation to education and
  support
• Increase productivity and work satisfaction
• Assist in retention of staff
• Reduce training time and associated costs
• Create equal opportunities
• Not all allied health practitioners have access
  to computer based technology
• Video conferencing is limited

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Conclusions and Recommendations

• Project has provided important and valuable
• information with regard to the educational
• and support needs of allied health
• professionals working with children in the
• NSW public health system

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Conclusions and Recommendations

• Report provides a practice overview of the issues
  confronting AH professionals working with
  children
• Recommendations provide a frame work for
  addressing many of these issues
• Issues identified have been grouped into five
  categoriesclinical supervision, performance
  appraisal, caseload, access to education and
  training and IT

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Where to From Here?

• Project Report has been sent to
• NSW Health
• Three Child Health Network co-ordinators in NSW
• Wide distribution throughout Allied health
  networks
• Further submissions for funding to implement the
  recommendations are occuring

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• Copies of the report can be obtained by e-mail
• Margaret.Piper_at_hnehealth.nsw.gov.au