While general practice has an important role to play in preventing, diagnosing and addressing the range of issues that present in young people living in out-of-home care settings, GPs and primary care face many challenges in responding to these complex needs.
Out-of-home care (OOHC) is provided for children and young people up to 18 years of age who require alternative care settings because of issues relating to abuse and neglect in their usual family/home settings. In 2014 there were over 43,000 Australian children and young people living in out-of-home care, nearly doubling over the past decade. The Australian Institute of Health and Welfare also reported that:
- 41% of those in out-of-home care were in foster care, 48.5% were living with relatives and more than 5.5% were in residential care
- 35% of children in out-of-home care were Aboriginal or Torres Strait Islander
- Children are remaining for longer periods in OOHC.
Children and young people in OOHC are vulnerable and diverse. They exhibit increasingly complex behaviours and often have high unmet health needs and poor access to health services. The National Standards for Out of Home Care (2011) seek to ensure that these children and young people have their physical, developmental, psychosocial and mental health needs assessed and attended to in a timely way:
- Children and young people entering care are to have their health needs assessed and receive specialised services to respond to their health challenges.
- The child or young person’s physical, developmental and psychosocial and mental health needs are to be identified in a preliminary health check.
- Children and young people are to have their own written health record which moves with them if they change placements.
As the largest provider of primary health care, general practice has an important role to play in preventing, diagnosing and addressing the range of physical, neurological, developmental, psychological and behavioural issues that present in many children in these settings. However, GPs and primary care face many challenges in responding to the complex health needs of children in OOHC .
The South Eastern Melbourne PHN (SEMPHN) works with the local community and primary healthcare providers – including GPs, practice nurses, specialists, pharmacists, and allied health practitioners – to develop local solutions to keep people well and out of hospital where possible.
As part of a more comprehensive approach to improving primary health care access for marginalised groups, SEMPHN wanted to better understand the challenges that general practice faces in responding to the health needs of children in OOHC. SEMPHN engaged Larter to conduct a needs assessment to inform a pilot phase to better equip and support GPs.
Larter has worked hard to refine our approach to project management, client partnership and stakeholder consultation. Our approach to working with clients makes every consulting project unique – we listen carefully to clients’ needs, think deeply about the best approach and collaborate to design a solution.
The needs assessment was undertaken in the following phases:
Phase 1: Qualitative research and consultation (February–March 2016)
Larter undertook qualitative research with:
- general practice principals and staff
- organisational carers/staff/clinicians residential settings
The phase also included desktop review of existing literature and resources.
Phase 2: Development of funding and care models (March-April 2016)
Funding and care models were explored to determine the most appropriate models for general practices within the SEMPHN region.
Phase 3: Needs assessment report (April 2016)
- GPs and primary care face many challenges in responding to the complex health needs of children in OOHC.
- PHNs are well positioned to better equip and support general practitioners in the provision of primary care for children in OOHC in collaboration with other key stakeholders.
- More effective funding and care models need to be designed to support the provision of primary care for children in OOHC.
Larter is an Australian-owned consulting firm providing high quality consulting services to the health and community services sector. Read more about our team and how we work towards a stronger primary health system.
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