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MP4 Allied Health Paediatric Capacity Mapping Combined Report

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MP4 Allied Health Paediatric Capacity Mapping Combined Report MP4 Allied Health Paediatric Capacity Mapping Combined Report Date: June 2017 Background The capacity of allied health professions who work in hospitals to provide appropriate services to children and their families is dependent on a skilled workforce and service demand. The ability of these disciplines and the individual clinicians to adequately meet the demands of this service provision may be impacted by staffing establishment; allocation of hours dedicated to paediatric service provision; changes in the casemix of paediatric services; knowledge, skills and confidence of clinicians in providing services to children and their families; and professional networks within the facility and with other facilities, including the tertiary children’s hospitals. The impact of these factors on the capacity of allied health disciplines is currently unknown. The Children’s Healthcare Network Allied Health Educators (AHE) aimed to obtain information regarding the capacity of allied health disciplines in metropolitan level 4 (MP4) facilities. MP4 facilities are hospitals with designated paediatric wards. The purpose of this mapping was to: Identify allied health professionals working with children and families in MP4 facilities Establish a baseline of current allied health service provision for children and corresponding workforce allocation Identify areas of need requiring service development/capacity building Identify key areas of paediatric clinical practice requiring education and clinical support. Information was collected from allied health departments as follows: The AHE emailed information regarding the MP4 Capacity Mapping initiative to all the relevant Directors of Allied Health regarding the intent and process of information collection Contact was made with individuals or groups of allied health profession managers at the MP4 facilities either online or face to face, to further discuss and clarify relevant issues Allied health profession manager/s were provided with an online questionnaire for completion. This information has been created and compiled by the NSW Children’s Healthcare Network Allied Health Educators and cannot be reproduced in any form without their express permission. 1 Results A total of 75 responses were received from allied health departments at the following facilities: Blacktown Mt Druitt Hospital Royal North Shore Hospital Bankstown Hospital Royal Prince Alfred Hospital Campbelltown Hospital St George Hospital & Integrated Community Health Canterbury Hospital Sutherland Hospital Gosford Hospital Sydney LHD, Child & Family Health Hornsby Ku-ring-gai Hospital Service Liverpool Hospital Wollongong Hospital Manly/Mona Vale Hospital Nepean Hospital Data was provided by a range of allied health professional groups as illustrated in Figure 1. Allied health professionals are not an homogenous group and provide a varied range of therapeutic and diagnostic services in the MP4 facilities. Figure 1: Allied Health Professions Responses were submitted via an online questionnaire between April - October 2016. The results reported below are a summary of the combined information collected from the allied health departments who responded across participating facilities. Unless otherwise noted, combined results are listed in descending order of number of responses. This information has been created and compiled by the NSW Children’s Healthcare Network Allied Health Educators and cannot be reproduced in any form without their express permission. 2 Current services for children and young people Inpatient services Allied health departments currently accepting inpatient referrals accounted for 77% of the responses received. The different facilities, and professions within these facilities, identified varied referral categories and criteria reflecting differing roles and capabilities. Across the responding departments, inpatient referrals were most commonly accepted for the following clinical areas: General paediatrics Newborns and neonates Musculoskeletal and connective disorders Digestive system disorders Nervous system disorders. Inpatient referrals are generally accepted for children aged from 0-16 years or 0-18 years for the majority of departments. Departments indicated different referral criteria due to the variety of clinical caseloads covered. Those allied health departments accepting inpatient referrals accept them primarily from medical, nursing and other allied health professionals. Inpatient services provided by allied health departments were most commonly reported to include: Assessment Intervention and treatment Case discussion and planning Referral Ward rounds. Outpatient services Allied health departments currently accepting outpatient referrals accounted for 76% of the responses received. The different facilities, and professions within these facilities, identified varied referral categories and criteria reflecting different professional roles and capabilities. Across the responding departments, outpatient referrals were most commonly accepted for the following clinical areas: General paediatrics Digestive system disorders Musculoskeletal and connective tissue disorders Nervous system disorders Newborns and neonates. Outpatient referrals are generally accepted for children aged from 0-17 years although some departments reported stricter age guidelines. Those departments accepting outpatient referrals accept them from parents/carers, tertiary hospitals, community services, schools, allied health, medical and nursing professionals. This information has been created and compiled by the NSW Children’s Healthcare Network Allied Health Educators and cannot be reproduced in any form without their express permission. 3 Outpatient services provided by allied health departments were most commonly reported to include: Assessment Intervention and treatment Referral Multidisciplinary team clinics Case discussion and planning. Community services Only 53% of allied health departments providing data currently accept referrals for services provided in the community. This low response is in part due to the existence of separate Community Health facilities in some areas. The referrals accepted vary significantly according to facility and profession. Referrals for services provided in the community are accepted for children aged from 0-17 years although some departments have stricter age guidelines and focus on early intervention. Service provided by allied health departments in the community were most commonly reported to include assessment, intervention, treatment, case discussion and planning, and referral. In addition, service provision available in the community further builds on: Multidisciplinary team intervention Community visits Consultation/liaison Provision of education and information Home/school programming. Changes to service provision 55% of responding allied health departments reported that services provided for children and young people had changed over the past two years. Departments reported that these changes were the result of: Establishment of new services/clinics Impact of the introduction of the National Disability Insurance Scheme (NDIS) Increase in referral numbers and acuity Policy changes. The following priority clinical areas relating to children and young people that require further service development were identified (listed alphabetically): Adolescent youth health Anxiety Autism Spectrum Disorder Behavioural issues Brain injury This information has been created and compiled by the NSW Children’s Healthcare Network Allied Health Educators and cannot be reproduced in any form without their express permission. 4 Early intervention Mental health Orthopaedics Pain Palliative care Post-acute care Rehabilitation Special care nursery/ neonatal intensive care nursery Transition to school. Respondents also identified the following priority areas that were not clinical (listed alphabetically): Discharge/transition of inpatients Education for community/schools/preschools General service development within the hospital, community and schools Impact of NDIS Insufficient capacity Lack of dedicated paediatric staff. Workforce/staffing Allied health departments with allocated staffing for service provision to children and young people totalled only 72% of respondents. Most professions and departments reflected on a complex blend of part funding or quarantining of positions. The most common clinical areas for which departments reported having allocated staffing for service provision to children and young people were: Outpatients Paediatric ward Community health Neonatal intensive care unit/High dependency unit Special care nursery. The data collected did not allow for the accurate calculation of the percentage of total full time equivalent (FTE) allocated to service provision for children and young people for inpatient, outpatient and community services. Despite changes in population, complexity of referrals and service redesign, 75% of allied health departments reported no change to FTE allocated to service provision for children and young people over the past two years. Governance Data pertaining to the governance structures for allied health departments as it relates to service provision for children and young people was not suitable for analysis. There was significant variation in the interpretation of the term governance This information has been created and compiled by the NSW Children’s Healthcare Network Allied Health Educators and cannot be
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