Young people in out-of-home care should have the same opportunities as other young people. Yet we know that these same young people have some of the poorest health and wellbeing outcomes.
While there is currently much focus on reforms in both the primary health care and the out-of-home care (OOHC) sector designed to strengthen person-centred care, particularly for people living with complex and chronic health conditions, there continues to be more to achieve to improve the outcomes for vulnerable children and young people in Victoria. Key to this is a better system response to vulnerability and complexity.
We know that the key issue for young people in residential care is their engagement with health and health services. We also know that the system response required to improve this engagement involves:
- improved service accessibility and responsiveness to specific needs of OOHC youth
- improved completion rates of OOHC health assessments
- strengthened residential staff commitment to brokering young people’s access to health services
- improved data custodianship and integration across child protection, OOHC and care teams.
SEMPHN has been working in partnership with DHHS trialling a medical home approach to address some of these barriers. The aim is for every young person in residential care to have a ‘medical home’ to provide continuity of health care. Ideally, the medical home is a multidisciplinary health clinic which is child and adolescent friendly.
The key benefits of a medical home for vulnerable young people living in residential OOHC include:
- comprehensive, whole-person care, including continuity of care, clinical integration & ehealth technologies
- relational approach to care
- shared decision-making, self-management and empowerment
- sensitivity to vulnerability and risk factors
- accessibility
- team-based care
- local healthcare pathways
- accountability, and systematic continuous quality improvement
- opportunities for patient participation in service co-design.
A systems approach for working with vulnerability
Larter supported SEMPHN in trialling the medical home approach in three sites in south eastern Melbourne. Based on this, we developed a systems approach to optimising general practice for working with vulnerability. From a primary health care perspective, a systems framework can drive a whole-of-practice approach to understanding, supporting and working through vulnerability in a way that is person-centred and ensures a safe, welcoming and inclusive healthcare environment. The following diagram depicts the building blocks which need to as a minimum underpin primary care approaches to working with vulnerable population groups, and should be used to guide next steps in building primary health care sector capacity.
Through its healthcare consulting expertise, Larter supports organisations to strengthen primary care systems, improve service pathways and develop practical solutions for complex healthcare challenges. This includes supporting Primary Health Networks, community health organisations and healthcare providers with planning, evaluation and system improvement initiatives.
Improving Primary Healthcare Access for Vulnerable Communities
Improving healthcare outcomes for vulnerable populations requires more than individual clinical services. It requires a coordinated primary healthcare approach that considers accessibility, continuity of care, workforce capability and community needs. Healthcare organisations increasingly use service redesign and evidence-based planning to create models of care that better support people experiencing complex social and health challenges.
The Role of General Practice Improvement
General practices play an important role in supporting vulnerable populations through accessible, coordinated and person-centred care. Strengthening general practice capability requires ongoing evaluation, workforce support, effective referral pathways and a focus on continuous quality improvement.
Read more in SEMPHN’s latest report on piloting the three models.
March 2018.
Frequently Asked Questions
A medical home model is a coordinated approach where individuals receive continuous, person-centred care from a trusted healthcare team. It focuses on accessibility, communication, prevention, and collaboration between healthcare providers.
General practices can improve care for vulnerable populations by creating accessible services, strengthening care coordination, using inclusive approaches, improving referral pathways, and working with community and healthcare partners.
A systems approach helps healthcare organisations address complex challenges by improving processes, communication, workforce capability, and service pathways rather than focusing only on individual issues.
Primary Health Networks support healthcare improvement by identifying community needs, commissioning services, strengthening primary care networks, and supporting initiatives that improve access and health outcomes.
Young people in residential care may experience barriers including limited access to services, fragmented care pathways, complex health needs, and challenges engaging with healthcare providers.