Ms Helen Malcolm1, Ms Belinda Jones1
1Hunter New England Local Health District, Armidale, Australia
Before the introduction of the National Disability Insurance Scheme (NDIS), Hunter New England Local Health District (HNELHD) received some funding to provide disability services. When HNELHD became an NDIS trial site in 2013, funding was transitioned, and HNELHD was no longer funded to provide disability services. With this change, the interface was proving to be difficult to negotiate for allied health staff. In 2016, HNELHD developed a guideline, based on the Applied Principles and Tables of Support (APTOS), incorporating three Decision Support Tools which differentiated between health and disability interventions. It was identified that a practical interpretation of this guideline was needed, particularly for paediatrics.
Three discipline – specific working groups were established, including metropolitan and rural paediatric clinicians, with co-ordination provided by the Allied Health Project Officer. Typical scenarios, where the health/ disability delineation was less clear, were identified. Using teleconferencing and email, the group met and agreed on pathways. Flow-charts for each scenario were charted, based on the Decision Support Tools from the original guideline, together with Key Learnings that could be translated to other referrals. Later amendments included linkages to additional internal HNELHD tools to manage out of scope referrals.
Three guidelines have now been developed for use by paediatric Allied Health staff (Occupational Therapists, Speech Pathologists and Physiotherapists) working within HNELHD. These guidelines provide staff with a framework to determine whether an intervention required by a child with a disability falls within the HNELHD scope of service or whether it is more appropriately provided by the Disability sector. This ensures consistency across the LHD and across the three professions.
Therapist participation provided opportunities for education and joint problem-solving around the NDIS, based on real-life scenarios. Whilst the guidelines provide a useful framework, elements of the Health-NDIS interface remain challenging, and the HNELHD NDIS process for feedback, advice or escalation is utilised for these cases.
The collaborative input into the development of these tools from a range of HNELHD allied health professionals is acknowledged.
Helen has extensive experience working as a speech pathologist in a rural health setting, and previously as a rural speech pathologist with a disability service. Since mid -2018, Helen has been working as a project officer with the Allied Health Directorate of Hunter New England Local Health District. One of her duties has been the completion of resources to support therapists, much of which was started by Belinda Jones, Performance Analyst, Rural and Regional Health Services, HNELHD.