La Perouse Aboriginal Community Health Centre
South Eastern Sydney Illawarra Area Health Service
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Show / HideExcellence in program and service delivery
Background: From 2001 following the closure of the Prince Henry Hospital at Little Bay, La Perouse Community Health Services provided health care for approximately 2000 local Aboriginal people and was limited to the (2 room) Arrunga Clinic - until the La Perouse Aboriginal Community Health Centre (ACHC) was opened in 2006.
From 2007, Gail Daylight, Area Manager of Aboriginal Health, South East Sydney Illawarra Area Health Service (SESIAHS) working initially with Geriatric Medicine and Community Health at the Prince of Wales Hospital (POWH), set out to develop, within La Perouse ACHC, an integrated Aboriginal Community Health Service using a life-cycle approach from infant care to aged care – including:
- Primary Health Care
- Community Health
- Health Promotion
- Public Health
- Tertiary Health Care
Aboriginal Medical Service, Redfern, has supplied a GP Clinic, initially one day per week. Due to local demand of the local Aboriginal community, this clinic has increased to 2 days.
The consultation and liaison processes with existing Aboriginal services and community controlled organisations are detailed in the section on program development below.
Rationale for the program
The aims of the enhanced clinic include:
- To remediate a lack of local health care for the La Perouse Aboriginal community following the closure of Prince Henry Hospital services in 1998.
- To improve access to local Health Services for the La Perouse Aboriginal Community.
- To improve access to POWH tertiary Health Services for the La Perouse Aboriginal Community.
- To improve utilisation of Health services by the La Perouse Aboriginal Community.
- To improve the Health status of the La Perouse Aboriginal community.
- To document the health status of the Randwick Botany Aboriginal community aged 45 to 64 and 65 years and over within the "Koori Growing Old Well Study" of c.700 Aboriginal people.
The clinic also provides a location and focus for the community in its engagement with the Aboriginal Health Education Officers (AHEOs) based at Community Health, Prince of Wales Hospital who work in with and/or conduct various Aboriginal health programs including exercise classes, chronic disease support programs and smoking cessation programs.
The key objective was to develop a localised point of service for the La Perouse Aboriginal community that could become a developmental focus for clinical, community and research related health concerns that grows to meet their changing needs over time. See performance data in detail below for the year 2008.
Development of the program
- SESAHS built the new La Perouse ACHC - Gail Daylight, Area Manager Aboriginal Health and POWH Community Health and Geriatric Medicine (Kristin Mbothu, Professor Tony Broe, Dr Simon Chalkley)
- SCH Community Health (Dr Karen Zwi) instigated the new services in liaison with:
- La Perouse Local Aboriginal Land Council
- Gujaga Child Care Centre
- Aboriginal Health Education Officers/Aboriginal Hospital Liaison Officers
- Redfern Aboriginal Medical Service
- Aboriginal & Islander Health Worker Journal
- POWH Diabetes Service
- POWH Geriatric Medicine Services
- Royal Hospital for Women
- Sydney Children's Hospital
- Northern Network ENT Services – Sydney Hospital; SCH, POWH
- POWH Cardiology
- The Langton Centre
- Adolescent Mental Health Services
- Adult Mental Health Services
- Drug and Alcohol Services
- NSW Aboriginal Health Vascular Disease Program
- SESIAHS Aboriginal Chronic Disease Coordinator Margaret Broadbent and POWH
- Community Health AHEOs "Walgan Tilly" NSW Health Chronic Disease Program
Implementation
We established an integrated, multi-disciplinary Aboriginal Health Service at La Perouse providing more than 30 clinics and services monthly and serving c.2000 Aboriginal people in Randwick and Botany local government areas. These clinics include:
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Primary Health Care
Community Health and Health Promotion
Aboriginal Health Education Officers (AHEOs) in:
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Tertiary Clinical Services in:
Domiciliary Visits
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As identified above, this is an ongoing process as some health issues are addressed and new issues arise during the clinical treatment and community discussion phases. In addition, referral to Prince of Wales Hospital, Royal Hospital for Women, Sydney Children’s and other health services is facilitated by having local clinic-based contact with individuals and the community.
Evaluation
- Monthly: Aboriginal Health-Link Advisory Committee (AHLAC) sets projects and follows up on commitments.
- Community Consultation: a sustained process through the six community members on the Aboriginal Health-Link Advisory Committee
- Quarterly: ACHC Governance Committee Meetings
- Clinic statistics and attendances.
- Development of a life-cycle approach to the "Koori Growing Old Well Study" subsequently funded by the NHMRC commencing at La Perouse and including appointments of Aboriginal Project Officers and Research Assistants.
- Presentations on the health of urban Aboriginal communities and Aboriginal Health and Ageing Research across Australia as listed below for 2008 with further presentations and media coverage coming.
Impact of the program on the target group
With more than 2400 occasions of service in 2008, we believe that the centre has been a tactical and strategic success. It is also becoming the location for other forms of engagement with the La Perouse community including consultation and research participation activities.
The performance data provided below for 2008 illustrates the range of health-related services the centre is providing and the scope of health consultations the community is engaging in. The fact that the centre is supported by a range of processes at the Prince of Wales Hospital campus as well as directly at the centre is, we believe, proving to be a beneficial approach to ensuring continuity of care and customisation of services for the community.
Obviously this is an ongoing task to ensure communication and service provision match the shifting needs and concerns of the community.
La Perouse Aboriginal Community Health Centre
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No. |
Key Performance Indicator |
Outcome |
| 1 | Number and type of occasions of service for all primary health care services provided at La Perouse Health Facility |
Total occasions of service in the period: 1230, comprising:
Total number of adult health checks conducted by midwives, nurses, health workers and allied health workers in the period: 184 Total number of child health checks conducted by midwives, nurses, health workers and allied health workers in the period: 70 |
| 2 | Number of adult and child health checks provided at La Perouse Health Facility |
Total number of adult health checks conducted by doctors only in the period: 101 Total number of child health checks conducted by doctors only in the period: 67 |
| 3 | Number, type and outcome of community engagement activities including the development of an SRA with the La Perouse Community |
Three La Perouse Aboriginal Health Link Committee meetings held during the period. Meetings involve stakeholders from Prince of Wales Community Health, and members of the local La Perouse Aboriginal Community. These meetings include discussion on aspects of the SRA. |
La Perouse Aboriginal Community Health Centre
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No. |
Key Performance Indicator |
Outcome |
| 1 | Number and type of occasions of service for all primary health care services provided at La Perouse Health Facility. |
Total occasions of service in the period: 1189 comprising:
Total number of adult health checks conducted by midwives, nurses, health workers and allied health workers in the period: 126 Total number of child health checks conducted by midwives, nurses, health workers and allied health workers in the period: 32 |
| 2 | Number of adult and child health checks provided at La Perouse Health Facility. |
Total number of adult health checks conducted by doctors only in the period: 72 Total number of child health checks conducted by doctors only in the period: 26 |
| 3 | Number, type and outcome of community engagement activities including the development of an SRA with the La Perouse Community. |
Three La Perouse Aboriginal Health Link Committee meetings held during the period. Meetings involve stakeholders from Prince of Wales Community Health, and members of the local La Perouse Aboriginal Community. These meetings include discussion on aspects of the SRA. |
These data show that just over 2400 occasions of service were provided in the 2008 calendar year across the full spectrum of child and adult health services. The data may not cover some activities, such as the cardiac clinics, for which data was not available at the time of writing this application.
Aboriginal Health and Ageing Presentations 2008
This is a list of presentations conducted on the research to date with more invitations accepted and submissions submitted. The subject of Aboriginal ageing is of considerable interest within Aboriginal communities including La Perouse, Kempsey and elsewhere as well as amongst a wide range of health care providers and researchers. The work being piloted at La Perouse will continue to attract attention in the coming months and years.
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ATSI Community Care Urban Workforce Workshop Indigenous Health Summit, HACC Outcomes Group – Department of Health Aboriginal Community Care Conference AAG Aboriginal Workshop Michael Price Memorial Lecture HACC Indigenous Gathering |
DCRC National Dementia Research Forum SEIHS Research Forum Aboriginal Workshop Pfizer NSW Masterclass AAG 41st National Conference NGO Research Forum Engaging Aboriginal Communities in Research |
Media Coverage
SBS Living Black "Lost Memories" segment, Monday, 16 March, 2009
See: http://news.sbs.com.au/livingblack/lost_memories_563601
Research Funding
The research component of this proposal has so far attracted:
What is the burden of dementia in urban dwelling Indigenous Australians?
Broe G.A., Jackson-Pulver L., Chalkley S., Grayson D., 2008-2010
A Pilot Test of a Modified KICA in Urban Aboriginal Populations.
Broe G.A., Jackson-Pulver L., Grayson D., Chalkley S. and Flicker L.
Primary Dementia Collaborative Research Centre (DCRC), 2008-2009
A Pilot Test of a Modified RUDAS in an Urban Aboriginal Population
Hill E.M., Broe G.A., Jackson-Pulver L.
Alzheimer’s Australia, 2008-2009
Indigenous People with Dementia: A Literature Review
Broe G.A., Jackson-Pulver L. Arkles S., Kelso W. and Draper B.
Primary Dementia Collaborative Research Centre, Duration 2006-2007.
Ageing Well Ageing Productively Network
Broe G.A.
ARC/NHMRC, Duration 2005-2010
Ageing Well Ageing Productively Network
Broe G.A.
University of New South Wales, Duration 2005-2010
Contact
Associate Director, Community Health
South Eastern Sydney Illawarra Area Health Service
Phone: 02 9382 8066
