brookton healthy community forum workshop brookton 25 th february 2013 1
TRANSCRIPT
1
BROOKTON HEALTHY COMMUNITY FORUMWORKSHOP
Brookton 25th February 2013
2
PROGRAM1. Welcome
2. Recap on health service planning
3. Overview of Health Needs Survey results
4. Key findings and directions
5. Discussion
6. Next steps
SURVEY THEMES 1. Respondents2. Proximity3. General Health4. Medical conditions5. Health checks6. Injury7. Mental wellbeing8. Self harm or suicide9. Relationship, parenting or family problems10. Health & fitness11. Eating habits12. Health & wellbeing13. Brookton Health Centre and other services14. Important aspects of health services15. Services that address health issues16. Drugs and the community17. Aged Care
3
RESULTS OVERVIEW (RESPONDENTS)
5
Brookton popula-tion
Households Returns0
100200300400500600700800900
1000
934
455
167
RESULTS OVERVIEW (RESPONDENTS)
6
Live in Brookton Visiting0
10
20
30
40
50
60
70
80
90
100 99.4%
0.6%
RESULTS OVERVIEW (RESPONDENTS)
7
0-4 5-9. 10-14.
15-19
20-29
30-39
40-49
50-59
60-69
70-79
80+0
5
10
15
20
25
30
% returns% Population
9
RESULTS OVERVIEW (RESPONDENTS)KEY POINTS
18% return is statistically valid Majority of respondents over 60 years of age Very low returns from young people and Aboriginal people Results are based on “self-reporting” and provide very useful
overall picture rather than rigorous science Comparisons with WA population are “indicators” only Information essential to health service planning
11
RESULTS OVERVIEW (PROXIMITY)
PROXIMITY TO BROOKTON HEALTH SERVICE
> 30 mins 30-60 mins0
102030405060708090
10090%
10%
12
RESULTS OVERVIEW (PROXIMITY)
PROXIMITY TO NEAREST HOSPITAL
> 30 mins 30-60 mins > 60 mins0
10
20
30
40
50
60
31%
54%
15%
13
RESULTS OVERVIEW (PROXIMITY)
ARE YOU A REGULAR USER OF BROOKTON HEALTH SERVICE?
Yes No0
102030405060708090
100
45%
55%
15
RESULTS OVERVIEW (GENERAL HEALTH)
SELF RATING OF GENERAL HEALTH
Excellent Very good Good Fair Poor05
101520253035404550
7.1%
30.1%
45.5%
16.1%
1.1%
18.1
40.7%
30.5
8.2
2.6
BrooktonWA
17
RESULTS OVERVIEW (MEDICAL CONDITIONS)DIAGNOSED MEDICAL CONDITIONS – SELF REPORTED
High blood pressu
re
High choleste
rol
Arthriti
s
Angina/heart
prob...
Asthma
Mental h
ealth
Cancer
Diabetes
Stroke
05
101520253035404550
BrooktonWA
19
RESULTS OVERVIEW (HEALTH CHECKS)LAST HEALTH CHECK
Blood pressure Blood cholesterol Blood sugar Full Medical0
20
40
60
80
100
NeverIn the last yearIn the last 1 - 2 yearsMore than 3 years agoNot sure
Health Checks
Perc
enta
ges
(%) o
f Res
pons
es
21
RESULTS OVERVIEW (SERIOUS INJURY)INJURY IN LAST 12 MONTHS REQUIRING MEDICAL ATTENTION
(n=158)
No Yes0
10
20
30
40
50
60
70
80
90
100
80.4%
19.6%
22
RESULTS OVERVIEW (SERIOUS INJURY)CAUSE OF INJURY
Falls Sport Machinery/tools
Animal bite/sting
0
10
20
30
40
50
60
51.6%
9.7% 9.7% 9.7%
RESULTS OVERVIEW (SERIOUS INJURY)WHERE DID INJURY HAPPEN?
23
Home Work Farm Recreation area
Other0
102030405060708090
100
53.3%
20%16.7%
6.7%3.3%
25
RESULTS OVERVIEW (WELLBEING)FELT SAD OR DEPRESSED WITHIN LAST YEAR? (n=160)
59.4%
40.6%
No Yes
RESULTS OVERVIEW (WELLBEING)HOW OFTEN? (n=62)
26
Some of the time Most of the time Almost all of the time
0102030405060708090 85.5%
9.7%4.8%
RESULTS OVERVIEW (WELLBEING)DID YOU HAVE SOMEONE YOU COULD TALK TO AND EXPRESS
YOUR FEELINGS? (n=66)
27
Yes N00
10
20
30
40
50
60
70
8072.7%
27.3%
28
RESULTS OVERVIEW (WELLBEING)FELT LONELY OR ISOLATED WITHIN LAST YEAR? (n=160)
73.1%
26.9%
No Yes
RESULTS OVERVIEW (WELLBEING)HOW OFTEN? (n=41)
29
Some of the time Most of the time Almost all of the time
0102030405060708090 85.4%
12.2%2.4%
RESULTS OVERVIEW (WELLBEING)DID YOU HAVE SOMEONE YOU COULD TALK TO AND EXPRESS
YOUR FEELINGS? (n=52)
30
Yes N00
10
20
30
40
50
60
70
80 75%
25%
32
RESULTS OVERVIEW (SELF-HARM OR SUICIDE)SERIOUS THOUGHTS OR SELF HARM OR SUICIDE WITHIN LAST
YEAR? (n=151)
93.8%
6.2%
No Yes
RESULTS OVERVIEW (SELF-HARM OR SUICIDE)DID YOU OR ARE YOU RECEIVING HELP?
33
No Yes0
10
20
30
40
50
60
70
8072.7%
27.3%
35
RESULTS OVERVIEW (RELATIONSHIP/FAMILY PROBLEMS)SERIOUS RELATIONSHIP, PARENTING OR FAMILY PROBLEMS
WITHIN LAST YEAR? (n=159)
80.5%
19.5%
No Yes
37
RESULTS OVERVIEW (HEALTH & FITNESS)EXERCISED IN PREVIOUS 2 WEEKS? (n=157)
Not at all 1 or 2 times 3-5 times 6 or more times
0
10
20
30
40
50
21.5%
29.2%24.4% 24.9%
38
RESULTS OVERVIEW (HEALTH & FITNESS)WHAT MIGHT HELP YOU TO BE MORE ACTIVE?
0 5 10 15Number of Responses
Other
Access to a recreation centre
Taking up a regular sporting activity
Access to a gym
Access to walking tracks/footpaths
Attending a regular exercise session or class
Access to a swimming pool
Joining a walking group
Having a friend to walk with
40
RESULTS OVERVIEW (EATING HABITS)HOW OFTEN FOODS EATEN?
Takeaway foods more than once per week
At least 1 serve of fish per week
At least 3 serves of vegetables per day
At least 2 serves of fruit per day
0 10 20 30 40 50 60 70 80 90 100
2
35
39
38
11
21
13
25
56
11
2
7
30
2
2
32
46
28
Always Usually Sometimes Rarely Never
Percentages (%) of Responses - How Often Foods Eaten
Serv
es o
f Foo
ds E
aten
42
RESULTS OVERVIEW (IMPROVE HEALTH & WELLBEING)ARE THERE THINGS YOU CAN DO TO IMPROVE YOUR HEALTH &
REDUCE CHANCE OF GETTING SICK? (n=155)
No Yes Not sure05
101520253035404550
44.5%
32.3%
23.3%
43
RESULTS OVERVIEW (IMPROVE HEALTH & WELLBEING)WHAT COULD YOU DO TO IMPROVE YOUR HEALTH?
Exercise more
Eat better/less
Lose weight Quit smoking0
5
10
15
20
25
30
35 32.2%
23.7%
8.4% 8.4%
45
RESULTS OVERVIEW (BHC & OTHER HEALTH SERVICES)DO YOU THINK BHC RESPONDS TO COMMUNITY CONCERNS AND
IS A GOOD COMMUNITY ORGANISATION? (n=157)
Not sure Yes No0
10
20
30
40
50
60
48.4%
36.9%
14.7%
RESULTS OVERVIEW (BHC & OTHER HEALTH SERVICES)IF YOU WERE SICK OR INJURED WHERE WOULD YOU FIRST SEEK
HELP? (n=163)
46
Brookto
n HS
Beverle
y Hosp
ital
Doctor/G
P
Metro
hospita
l
Pingelly
Hospita
lOth
er
HealthDire
ct
Narrogin
Hospita
l05
10152025303540
33.7%
17.7%
12.7% 12.2% 11%
6.1%3.6% 3%
47
RESULTS OVERVIEW (BHC & OTHER HEALTH SERVICES)HOW WOULD YOU GET THERE? (n=157)
Own car Ambulance Other0
10
20
30
40
50
60
70
80
90 85.4%
7% 7.6%
48
RESULTS OVERVIEW (BHC & OTHER HEALTH SERVICES)WHICH HEALTH PROFESSIONALS DO YOU CURRENTLY SEE?
Doctor
Podiatris
tNurse
Physio OT
Counsellin
g
Child Healt
h Nurse
Speech
Therapist
0
20
40
60
80
100 94.5%
47.4%
24.1% 22.1%
9.9% 9.9% 8.8%3.8%
49
RESULTS OVERVIEW (BHC & OTHER HEALTH SERVICES)DO YOU ACCESS THESE SERVICES LOCALLY?
Child Health
NurseNurse
Podiatrist OT
Doctor
Physio
Speech Therapist
Counselling
0102030405060708090 83.3%
70%65.1%
57.1%52.7%
20%
0% 0%
51
RESULTS OVERVIEW (IMPORTANT ASPECTS OF HS)IMPORTANCE OF ASPECTS OF HEALTH SERVICES
Continuity of care: that is, being able to see the same health provider each time you visit the hospital
Being able to obtain things like x-ray or pathology referrals when needed
The availability of advanced nursing skills in your town
0 20 40 60 80 100
71
85
75
24
14
21
5
1
3
Very important Somewhat important Not important
Percentages (%) of Responses - How Important
Asp
ects
of H
ealt
h Se
rvic
es
RESULTS OVERVIEW (IMPORTANT ASPECTS OF HS)ATTITUDES TOWARDS HEALTH SERVICES
52
Brookton Health Service provides the services I need
I feel comfortable using the health services
The health service is friendly and welcoming
The right kind of services are being provided for the people that live here
0 20 40 60 80 100
43
61
65
35
40
28
28
49
17
11
8
17
Agree Not sure Disagree
Percentages (%) of Responses - Agreement
Asp
ects
of H
ealt
h Se
rvic
es
RESULTS OVERVIEW (SERVICES THAT ADDRESS HEALTH ISSUES)
SERVICES TO INDIVIDUALS & FAMILIES – IMPORTANT OR VERY IMPORTANT
54
First A
id
Skin cance
r scre
ening
Women's H
ealth Clin
ic
Men's health
clinic
Youth health
Lifesty
le education
Respite
Mental health
clinic
Health educa
tionQuit
Child health
/immu
Parenting
Addiction m
/ment
0
20
40
60
80
100 94% 92%86%
80%74% 72% 69% 68% 67%
42% 41% 37%31%
RESULTS OVERVIEW(SERVICES THAT ADDRESS HEALTH ISSUES)
SHOULD THERE BE MORE SERVICES FOR YOUNG PEOPLE? (n=153)
55
Not sure Yes No0
10
20
30
40
50
60
7061.5%
33.3%
5.2%
RESULTS OVERVIEW(SERVICES THAT ADDRESS HEALTH ISSUES)
SHOULD THERE BE MORE SERVICES FOR ABORIGINAL PEOPLE? (n=131)
56
No Yes0
10
20
30
40
50
60
70 65.7%
34.3%
RESULTS OVERVIEW(SERVICES THAT ADDRESS HEALTH ISSUES)
WOMEN’S HEALTH ISSUES OF CONCERN
57
Mental health issues
Sexually transmitted diseases
Coninence issues
Cystitis
Support for mothers
Breast examination
Menopause
Family relationships
Sexual health
Bowel cancer
Mid-life crisis
0 20 40 60 80 100
45
10
36
20
22
59
28
37
20
43
23
55
90
64
80
78
41
73
63
80
57
77
Yes No
Percentages (%) of Responses - Yes/No
Wom
en's
Hea
lth
Issu
es o
f Con
cern
RESULTS OVERVIEW(SERVICES THAT ADDRESS HEALTH ISSUES)
MEN’S HEALTH ISSUES OF CONCERN?
58
Stress
Continence issues
Sexual health
Testicular examination
Sexually transmitted diseases
Bowel cancer
Family relationships
Mid-life crisis
0 20 40 60 80 100
42
17
21
30
5
43
28
17
58
83
79
70
96
57
72
83
Yes No
Percentages (%) of Responses - Yes/No
Men
's H
ealt
h Is
sues
of c
once
rn
RESULTS OVERVIEW (DRUGS AND THE COMMUNITY)DO YOU SMOKE? (n=167)
60
92.2%
7.8%
NoYes
RESULTS OVERVIEW (DRUGS AND THE COMMUNITY)DO YOU DRINK ALCOHOL? (165)
61
33.9%
66.1%
NoYes
RESULTS OVERVIEW (DRUGS AND THE COMMUNITY)HOW MANY TIMES PER WEEK DO YOU DRINK ALCOHOL? (n=108)
62
Less than 1 1 or 2 times
3 or 4 times
5 or 6 times
Everyday0
10
20
30
40
50
20.3%
25.9%
14.8%13%
26%
RESULTS OVERVIEW (AGED CARE – OVER 55 YEARS)HOW LIKELY IS IT THAT YOU WILL LIVE IN BROOKTON IN 5 YEARS?
(n=103)
64
Very/quite likely Somewhat likely Not likely0
102030405060708090
10089.3%
7.8%2.9%
RESULTS OVERVIEW (AGED CARE)IF YOU BECOME FRAIL WOULD YOU LIKE TO STAY IN BROOKTON?
(n=116)
65
Yes Not Sure Not likely0
10
20
30
40
50
60
70
8073.3%
23.3%
3.4%
RESULTS OVERVIEW (AGED CARE)IF YOU BECOME FRAIL WHERE WOULD YOU LIKE TO LIVE? (n=118)
66
Home ILU Aged Care Home
Hospital Relative's home
0
10
20
30
40
50
60
7060%
22%
15%
2% 1%
RESULTS OVERVIEW (AGED CARE)AT THE END OF YOUR LIFE WHERE WOULD YOU LIKE TO DIE?
(n=114)
67
Home Hospital ILU Aged Care Home
Relative's home
0
10
20
30
40
50
60
50%
28.1%
12.2%8.7%
1%
RESULTS OVERVIEW (AGED CARE)DO YOU HAVE RELATIVES WHO COULD ASSIST YOU WITH YOUR
DAY TO DAY NEEDS? (n=113)
68
Yes Not sure No05
101520253035404550 46.9%
29.2%
23.9%
RESULTS OVERVIEW (AGED CARE)IMPORTANCE OF ACCOMMODATION OPTIONS
69
Staying at home Independent living units Residential aged care facility
0
20
40
60
80
100
79
6568
1826 24
35 5
Not at all important
Not important
Neither important nor unimportant
Important
Very important
Accommodation for Special Needs/Aged Care
Perc
enta
ges
(%) o
f Res
pons
es
RESULTS OVERVIEW (AGED CARE)SERVICES USED NOW, NEEDED NOW AND NEEDED IN FUTURE
70
Help with gardening
Personal alarm
Basic computer skills
Help to shower and dress
Help with cleaning
Help with cooking
Help with home maintenance
Help with shopping
Home modifications
Independent aids
Meals on wheels
Mobile library service
Nurse visits at home
Residential aged care
Seniors' activities/social group
Social visits at home
Transport
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
18
6
27
1
16
4
17
5
6
7
6
0
8
3
13
9
9
21
4
25
1
13
1
13
4
9
10
1
0
9
2
12
7
6
64
48
34
38
52
34
59
41
34
56
45
26
58
47
54
48
63
Do you use this service now?Do you think you need this service now?Do you think you will need this service in the future?
Percentages (%) of Responses
Type
s of
Sup
port
Ser
vice
s
72
KEY FINDINGS & DIRECTIONS
1. Issue – Primary Health Clinical Services Proposed Response
The availability of a first response service at the Brookton Health Centre is regarded by the community as the most important health service.
The BHC should provide a first response and support SJA responding to more serious emergencies.
The BHC should not be regarded as having an “Emergency Department” such as exists in a hospital as this is not achievable within current resourcing and licensing restrictions.
Continue first response service from BHC during opening hours.
Build links with SJA to improve capacity of all organisations to respond to genuine emergencies.
Work with SJA to provide first aid training courses for Brookton community.
Work with SJA to clarify roles/responsibilities and clinical governance issues related to care for emergency patients
Open discussions with WACHS re access to the Emergency Telehealth Service.
KEY FINDINGS & DIRECTIONS
73
2. Issue – Chronic Disease Proposed Response
The population of Brookton has higher rates of chronic disease than the rest of WA.
Respiratory disease Arthritis Cardiovascular disease Diabetes Hypertension High cholesterol
The presence of many chronic diseases is related to lifestyle.
The management of chronic disease management has shifted firmly to a focus on “self-management”.
Silver Chain is exploring potential to provide Diabetes Educator service to Brookton on a visiting basis.
Strengthen chronic disease self-management education programs.
Strengthen “healthy lifestyle” education programs including nutrition programs, alcohol and drugs education and group exercise programs.
KEY FINDINGS & DIRECTIONS
74
3. Issue – Aged Care Proposed Response
31.4% of Brookton’s population is aged over 60 years compared with 19.6% for the rest of WA.
73.3% of people in Brookton over 55 years would like to stay in Brookton if/when they get frail population and 60% of these people say they would like to live in their homes as they get older. 50% of people over 55 years say they would like to die in their own home.
Less than half of respondents over 55 years said they have a relative who can assist them with day to day needs.
The Federal Government’s policy document “Living Longer, Living Better” heralds an increasing focus on more care for the elderly at home and less reliance on institutional care.
Further, as the population ages, there will be increased need for higher level care which can only be delivered at a nursing home or via Extended Aged Care at Home (EACH) Packages.
Given the above, there is a strong and growing requirement for community and home based aged care services in order to meet the needs of the community.
Continue to strengthen full range of HACC services.
Engage with Brookton Shire re the potential to establish Brookton as an “aged friendly” community.
Engage with Brookton Shire re current availability of Independent Living Units (ILU) and plans for growth in number of units. ILUs should be designed to enable residents to age in place.
Continue to explore requirement for CACP and EACH packages.
Continue to build close relationship with Kalkarni.
Strengthen falls prevention programs for the elderly e.g. “Stay on Your Feet”.
KEY FINDINGS & DIRECTIONS
75
4. Issue – Mental Wellbeing Proposed Response
The prevalence of mental illness in Brookton is comparable to the rest of WA. However, self-reported rates of feeling sad, depressed, isolated & lonely are high.
Strengthen community mental wellbeing programs e.g. “Act, Belong, Commit”.
Continue/strengthen counselling services.
Consider other strategies to reduce isolation and loneliness.
Silver Chain have introduced a weekly visiting Nurse Practitioner service to focus on clients with mental health in conjunction with WACHS mental health team.
KEY FINDINGS & DIRECTIONS
76
5. Issue – Allied Health Services Proposed Response
Allied health services currently provided in Brookton are well utilised. The majority of people receiving allied health services elect to do so locally rather than travel to other locations.
Continue to provide and strengthen as required, the range of allied health services currently in place.
Explore requirement for gender-specific health programs e.g. Men’s and Women’s wellness Clinics.
Develop alternative models of service delivery e.g. Therapy Assistant’s program.
Explore access to allied health services via telehealth.
KEY FINDINGS & DIRECTIONS
77
6. Issue – General Practice Proposed Response
Approximately half of the people who see a GP in the Shire of Brookton elect to access the visiting service at BHC.
There are several reasons for this relatively low level of utilisation including the part-time nature of the service and the fact that there is no community pharmacist in Brookton and patients who need a script may elect to have the script filled after visiting the doctor in Pingelly or Beverley.
Open discussions with the Shire of Brookton re the potential to extend the hours of the visiting GP service or introduce alternative GP services.
The existing visiting fortnightly female GP service should continue.
KEY FINDINGS & DIRECTIONS
78
7. Issue - Access to specialist medical services Proposed Response
31.4% of Brookton’s population are currently over 60 years of age and 63% of residents over 55 years believe they will require assistance with transport in the future.
Visiting medical specialist services to Brookton are limited and to see a specialist a road trip to the metro area or Narrogin is required.
Stakeholders have advised that reliable transport for people unable to provide their own transport is a major issue affecting access to medical specialists and other services.
Establish high level of telehealth capability at BHC enabling patients to see medical specialists via videoconference where logistical possible and clinically appropriate.
Explore potential for community based road transport service for people who need to access medical specialists services in other locations.
KEY FINDINGS & DIRECTIONS
79
8. Issues Requiring Further Examination Proposed Response
Barriers to access for Aboriginal people.
Requirement for specific health services for Aboriginal people including Aboriginal Health Workers and Aboriginal health clinics.
How do we engage the community re all this?
Over the next 2-3 years services delivered by Pingelly Hospital will gradually transition to a primary health care focussed model of care. SIHI will provide funds to support this service reform as well as capital required for a new primary health care centre. There may be opportunities for new services in Pingelly to also support Brookton residents and visa versa.
• Through engagement with the Aboriginal community in Brookton, assess barriers to using health services and strategies to address those barriers.
• Better publicising of range of services currently available.
• Better publicise improvements in services achieved.
• Seek approval of Shire to publicise Health Service Plan on its website.
• Brookton Healthy Community Forum to undertake periodic review of Health Service Plan.
• Continue dialogue with WACHS/SIHI re potential to share services.
