The future is bright for young people in the Murrumbidgee
EPiPC Community Paediatrician Dr Lahiru Amarasena and Wagga Wagga General Practitioner Dr Marietjie Van Der Merwe with a young patient.
Since 2021 a joint initiative between Murrumbidgee Primary Health Network (MPHN) and Murrumbidgee Local Health District (MLHD) has been supporting children in the Murrumbidgee region of New South Wales through a specialised paediatric program. Four years on, the program is improving the health and wellbeing of both children and their families and building capacity among the region’s general practitioners.
Children in rural communities often experience poorer health outcomes due to a lack of access to appropriate screening, assessment and treatment services, but the Murrumbidgee region’s Enhancing Paediatrics in Primary Care (EPiPC) program was developed to help address these challenges.
Co-designed with general practice, allied health, tertiary care, CALD community, and education, Executive Integration and Partnerships, Narelle Mills said EPiPC has evolved and grown since the initial pilot program.
“Feedback from the EPiPC pilot showed an increase in confidence among general practitioners to complete screening and behavioural assessments, and when looking at pre and post event data, we can see confidence improving across the board, which is now leading to positive outcomes for children,” Ms Mills said.
“We have expanded the program to include access to speech and occupational therapy screening through our WARATAH (Wellness and Resilience Achieved Through Allied Health) for Kids program, and this year a dedicated health linker and care navigator now assists the most vulnerable families.
“The program has also developed and provided standardised screening, assessment, and referral tools to support appropriate developmental screening to facilitate treatment at an earlier age including referral to multidisciplinary assessment, and since commencement almost 850 screening assessments have been conducted, and almost 150 occasions of service have been provided through Waratah For Kids since 2023.”
Central to the program is Community Paediatrician Dr Lahiru Amarasena, who works to enhance capability and capacity of general practitioners and their teams to identify and appropriately manage the region’s most at-risk children between the ages of zero to seven who are experiencing developmental and behavioural issues.
“By increasing capabilities locally around children with behaviour and developmental issues, we hope to improve the diagnostic and management journeys for children and their families across the region,” Dr Amarasena said.
Delivered across three different streams (clinical support; enhancing GP skills, confidence and capabilities; and integrated paediatric clinics), general practitioners in nine locations (Wagga Wagga, Deniliquin, Hay, Lockhart, Boorowa, Tumut, Holbrook Gundagai and Leeton) are provided with upskilling, assessment tools and consultation support to allow vulnerable children to receive care in their own communities. This often negates travelling time and costs to access private specialist paediatricians.
Program participant, Dr Rachel James from Deniliquin Clinic has found the clinical support key to managing her youngest patients.
“Having someone like Dr Amarasena who is a trained community paediatrician, can really support you in those areas which you might not be hugely confident with. For example, I want the confidence to be able to support my patients with up to date and relevant information and screening tools so I can ensure there is nothing else this child, living in Deniliquin, a rural town, is missing out on compared with a child who is living in a bigger resourced setting,” Dr James said.
“We know any interventions put in place in those early years have a huge impact on the child’s school and home life, and into adulthood. So it’s one of the more important areas of general practice, but it can be challenging to navigate.”
While the program is certainly supporting the region’s local workforce, it’s the improved health outcomes that demonstrate the value of such an innovative program.
“Recently we learned about a three-year-old child with mild developmental difficulties and a five-year-old with sensory behaviours who were both able to access appropriate services such as allied health and child and family health nursing without requiring specialist paediatric care. This not only streamlined referrals but also helped to ease the burden on local paediatric services” Ms Mills said.
For more information about the Enhanced Paediatric in Primary Care initiative visit www.mphn.org.au/maternal-and-child