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Public Submission to DHHS Green Paper

23 Feb 2015 posted by:
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Care Assess has provided a response to the DHHS Green Paper – Delivering Safe and Sustainable Clinical Services  (Rebuilding Tasmania’s Health System) – titled “Improving Tasmanian’s Health At Home”.

Summary

The goal of the Tasmanian health system should be quality care that is coordinated, centred on people’s needs and focused on maximising their wellness through the provision of preventative and pro-active services as well as responsive healthcare, and delivered in the community wherever it is effective and efficient to do so.

Care Assess’ overarching response to the question of how can the Tasmanian Government deliver safe and sustainable clinical services is to highlight the need for increased clinical care within the community. An increased and continued policy focus is required on delivering improved health and wellbeing outcomes through:

  • Improved clinical sustainability through increased access to quality home health care alternatives, including community care substitutes for hospitalisation;
  • Improved discharge planning through the involvement of community health professionals working within the hospitals;
  • Reduced avoidable admission and readmission rates through development of widespread hospital avoidance and post acute programs; and
  • Improved community care to promote active and healthy independence, and provide preventative support for clients with chronic health conditions.

To achieve DHHS’ stated goals for the Tasmanian health system, it should provide increased opportunities for:

  1. Services that support Tasmanians to lead independent and active life-styles, feel safe at home and stay connected to their communities;
  2. Community-based services that support Tasmanians with chronic health conditions that enable them to live well and avoid unnecessary complications or crises;
  3. Community-based services that support Tasmanians with complex or multiple conditions, enabling them to remain as well and independent as possible and to avoid deterioration or complications in their complex health conditions;
  4. Community-based rapid response services that provide urgent care for people when their health or independence rapidly deteriorates, including effective alternatives to hospitalisation;
  5. Community-based hospital alternatives, including access to home healthcare substitutes for hospital services;
  6. Hospital discharge planning by independent community-based health professionals. Hospital and home care providers should work together to ensure patients can leave hospital once their health treatment is complete with good post-discharge support in the community to reduce the likelihood of an emergency re-entry into hospital. From a client’s first contact with the Tasmanian hospital system, discharge planning should start – and patients and their carer(s) should be involved with their plans and goals to leave hospital;
  7. Community-based reablement services and home rehabilitation when needed that prevent permanent disability, greater reliance on care and support, avoid hospital admission/re-admission or unnecessary length-of-stay, and provide adequate periods of assessment and recovery before any decision is made to move into long-term care. System-wide access to reablement and rehabilitation should be provided for services delivered outside the hospital setting and in the consumer’s home whenever possible;
  8. Tasmanian’s to make positive choices regarding entry into long-term care after reablement and rehabilitation services and other alternatives have been comprehensively exhausted. Residents of care homes should consistently receive the same access to all necessary healthcare services as people living at home;
  9. Better support and planning for people who want or need it when nearing end of life. All end-of-life care services should provide informed choice and control to people, including the ability for people to remain at home during their end of life stage if possible and desired; and,
  10. Community-based care coordination services that are planned around the full range of people’s individual needs, and that truly prioritise prevention and support for maintaining people’s independence at home. For people using more than one service, the system should provide access to community-based health professionals that independently coordinate care, ensuring that all providers and services work together in an integrated way. This would improve quality and service value by better ensuring people benefit from the right mix of services (of those that are available), in the right place at the right time.

The areas that Care Assess is particularly focused upon delivering best practice services throughout the State include:

  • Wellness services including basic home support, short term home enablement and reablement services;
  • Allied health care services particularly hospital-based, residential-based and home-based exercise physiology and occupational therapy;
  • Community and primary care based care coordination services, case management and chronic diseases self-management services;
  • Rapid response hospital avoidance services including urgent and coordinated/integrated primary and community care;
  • Technology based support and care services including the use of assistive technology and telehealth;
  • Supported hospital discharge services including clinical post acute care;
  • Other alternatives to hospital services;
  • Home and residential-based reablement services;
  • Home and residential-based rehabilitation services;
  • Residential care GP services, including comprehensive health assessments;
  • Home and residential-based advanced care planning;
  • Home and residential-based end-of-life services; and
  • Independent assessment and care coordination services for people using multiple services.

To read full response, go to Care Assess Public Submission to DHHS Green Paper – 20 February 2015.

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