When Murrumbidgee Primary Health Network (MPHN) set out to improve access to primary care for older people living in rural residential aged care homes, the plan was simple: recruit a nurse practitioner to support communities experiencing thin market conditions.
It didn’t work out that way.
After receiving funding through the General Practice Aged Care Incentive Thin Markets Activity, MPHN initially planned a nurse practitioner model. When recruitment efforts were unsuccessful, MPHN returned to its partners, including general practices and residential aged care homes, to refine the approach. Together, they developed a more flexible model that could be tailored to each location.
MPHN Acting Senior Lead Priority Populations Shelley Gledhill said the setback ultimately led to a stronger solution.
“When we first went out and had the market failure, it was disheartening,” Ms Gledhill said.
“But when we re-consulted with GPs and residential aged care homes on what the model could look like, everyone was very engaged and supported a model that enabled practice nurses to work at the top of their scope.”
The result was the Murrumbidgee Aged Care Access Network, a flexible nurse-led model designed for each community.
Across the Murrumbidgee region, many rural towns have a single general practice and limited access to other health services. Some communities have no local hospital, and residents travel long distances for care. For older people living in residential aged care homes, those challenges can be even greater.
Rather than developing a one-size-fits-all solution, MPHN worked with participating practices and aged care homes to design local models of care. In some communities, GPs and practice nurses travel together to aged care homes. In others, practice nurses visit first, undertaking assessments, wound care, catheter management, education and advance care planning, enabling the GP to focus on residents with more complex clinical needs.
One example is Moulamein, a small rural community with no hospital and a residential aged care home supporting residents with high care needs. A GP makes the 140 km round trip from Barham to provide care, supported through the nurse-led clinic model. In Hillston, residents rely on a Griffith general practice, with the GP and practice nurse travelling 220 kms return to provide local access to primary care.
To help practice nurses work at the top of their scope, MPHN provided access to the Australian Primary Health Care Nurses Association’s Transition to Practice Program, as well as scholarships, mentoring opportunities and a Community of Practice. The impact has been significant.
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