After Hours Homelessness Health Support services
In 2022-2023 CESPHN continued its commitment to improving outcomes for people experiencing or at risk of homelessness through funding support programs. These programs provide expanded access to primary care in the after-hours periods. The services provide assertive outreach to those on the street in the after-hours periods and support existing homelessness service providers, drop-in-centres and crisis accommodation shelters, by providing in reach primary health care clinics.
Our funded service providers, St Vincents’ Hospital Homelessness Health Primary Health Care Service and Kirketon Rd Inner City Outreach service, assisted a total of 1,330 and 628 vulnerable clients in the Inner-City region throughout the course of 2022-2023. The services aim to assist meet the primary health care needs of vulnerable and often hard to reach people particularly during times when access to primary care service provision is often not available.
Both St Vincents’ Hospital Homelessness Health Service and Kirketon Rd Inner City Outreach Service are partners in CESPHN’s Intersectoral Homelessness Health Strategy 2020-2025. This has enabled CESPHN to continue to identify shared strategic priorities to enhancing coordination between services and improve health outcomes among people experiencing homelessness. In 2022-2023, this included discussions on the development of local systems and processes aiming to join up and integrate care for clients lacking usual primary care providers.
With our region home to 35 per cent of the state’s homeless population, and with the highest rates of homelessness being in the inner city areas, extended service coverage in the after-hours periods is helping vulnerable clients with complex care needs often requiring support and care coordination with multiple providers, to access quality primary care.
After Hours Geriatric Outreach services
In 2022-2023 CESPHN built on its relationships with SESLHD and SLHD geriatric outreach services. These services provide specialist geriatric outreach to residential aged care facilities (RACF) residents and enable treatment of residents in the RACF. Treatment received is often identical and able to be delivered in the RACF and in many cases prevents the need for transferring of residents to an unfamiliar Emergency Department (ED) environment with the potential complications of hospitalisation. With CESPHN’s support these services provide fully integrated care 7 days a week with service extending into the after-hours periods. In 2022-2023 SESLHD and SLHD geriatric outreach teams provided outreach care to in excess of 3,000 and 1,500 RACF residents respectively across our 153 RACFs.
In addition to the delivery of specialist outreach care, both SESLHD and SLHD geriatric outreach teams have undertaken additional work with local RACFs in their regions to refine and develop after hours action plans for their residents. This work has resulted in improved planning for the coordination of care for residents in the after-hours periods and involved consultation with residents usual GPs and education to assist RACF staff to identify the most appropriate alternate care options for residents in the after-hours periods should their usual GP not be available.
Our geriatric outreach services play a critical role in the education of RACF staff and have continued to provide education guidance and assistance throughout 2022-2023 on topics such as management of the deteriorating patient, advanced care planning, COVID-19 measures, infection prevention control, and palliative care which assists RACF staff decision making in the after-hours periods.
2022-2023 has enabled enhanced coordination of care and transfer of information between RACFs and hospital outreach services with improvements in timeliness of communication, appropriate record management including systems for capturing and sharing relevant information with the regular GP and hospital on after-hours service assessment, treatment and advice given, with planning in place to ensure all information is eventually uploaded into My Health Record to assist the residents GP and the RACF.