Local solution streamlining community paediatric access

  • Bushfire skies near Eden, New Years Eve 2019-2020. [Images Dr Miller]
    Bushfire skies near Eden, New Years Eve 2019-2020. [Images Dr Miller]
  • The team from DG Kids clinic, at the Rural Health Pro National Rural and Remote Health Awards, 2023 (photo supplied by Dr Miller)
    The team from DG Kids clinic, at the Rural Health Pro National Rural and Remote Health Awards, 2023. [Image Dr Miller]
  • Djing.gii Gudjaalalali logo designed by Aboriginal Stage 3 students and teachers, Eden Public School 2022.
    Djing.gii Gudjaalalali logo designed by Aboriginal Stage 3 students and teachers, Eden Public School 2022.
By
Dr Corin Miller
Djing.gii Gudjaagalali Eden, Sapphire Clinic Merimbula, South East Regional Hospital Bega, PhD Candidate University of NSW
Issue
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Eden, on the lands of the Thaua people of the Yuin Nation, is situated on the Far South Coast of NSW. The region is known for being an ideal family holiday destination, with crystal clear waters and majestic natural beauty.

The Eden community was directly impacted by the Black Summer fires of 2019-2020, with many locals losing their homes and livelihoods. The loss of tourism caused by the Covid pandemic further compounded this issue. Eden lies within the most disadvantaged quintile of the Index of Relative Socio-economic Advantage and Disadvantage. Geographically isolated, the nearest city is four hours away, and the closest hospital and Aboriginal Medical Service is a 90 minute round-trip.

The district’s paediatric service, covering ~30,000 square kilometres, secured its first local paediatrician in 2019. Despite this services’ admirable advancements in staffing levels and service provision since then, the need for outpatient paediatric specialist care in the region remains vast. In late 2023, 70% of the paediatric outpatient clinic waiting list and 49% of current patient load were referred for behavioural, mental health, development or learning needs. Like much of rural Australia, waiting times for “non urgent” outpatient paediatric care can be more than two years. The window for early intervention for children can be missed, resulting in life-long negative impacts. Innovative, integrated models of care are essential to optimise the use of available resources and streamline the care journey for rural children and families.

Recognising her student’s need for wellbeing support, and with the aim of encouraging them to stay in school for as long as possible, Ms Viv Chelin, Principal of Eden Marine High School, created a dedicated Wellbeing Hub for her school in 2019. This re-purposed demountable building was the ideal site for Dr Corin Miller, Rural Generalist with Advanced Skills in Paediatrics, to establish an outreach clinic. Building on the work of Our Mia Mia school clinic in Nowra, and adjusted to suit local context, Djing.gii Gudjaagalali was born.

The clinic’s name was gifted by the local Aboriginal community and translates to “Children Stars” in the Thaua language. Starting from humble beginnings, and with the support of competitive grants, the clinic has continued to grow. Referrals are now accepted from a network of schools, including Eden Marine High School and six local primary schools. Southern NSW Local Health District Coastal Network’s paediatric team now conduct their outreach clinic within the Wellbeing Hub, alongside the Djing.gii Gudjaagalali team. By working closely with the invaluable Wellbeing Health In-Reach Nurse Coordinator (WHIN-C), Nicole Bax, the families of the Eden area are supported to navigate the health system. The clinic’s GPs work closely with the school and the WHIN-C, gathering all required information and enabling the specialist paediatrician’s time to be used more efficiently.

Competitive grant funding was secured to provide private allied health assessments for financially vulnerable children likely to meet criteria for the National Disability Insurance Scheme (NDIS). This limited funding has helped students who have never had access to supports, and who are unable to pay for them privately, bypass the two-year waiting list for a public multidisciplinary assessment required to access the NDIS. The increase in local NDIS funding availability then builds capacity in the private system, meaning private providers can support the limited capacity of the public allied health service.

Developed in direct response to community need, Djing.gii Gudjaagalali Kids Clinic is bridging the gap between Health, Education and social supports for children and families. A tiered, horizontally and vertically integrated model of care, Djing.gii Gudjaagalali is improving health and educational outcomes for children and bringing care closer to home for priority populations.

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