Responsive delivery by CheckUP Outreach services

In early 2020, CheckUP provided funding through the Australian Government Department of Health Outreach Programs (the Programs) to more than 150 health care organisations. The primary aim of the Programs is to address the high need for health services in areas of market failure, particularly in regional, rural and remote Australia. The financial support provided through the Programs had enabled the delivery of essential primary and secondary health outreach services with an average of 330 visits per week to 198 communities across Queensland.

However, as the COVID-19 pandemic reached Australia, and a Queensland public health emergency was declared, new challenges emerged both for CheckUP’s staff, and for our providers delivering health services into isolated communities.

The new normal: working from home

As an organisation tasked with the coordination of a vastly geographically-distributed workforce, CheckUP had an existing decentralised office structure with staff based across Brisbane, Cairns, Longreach, and Townsville. This capacity to operate effectively across large geographical distances significantly enhanced our ability to respond to the unique challenges presented by the COVID-19 outbreak.

Within our organisation, we had implemented Microsoft Teams in October 2019, so we were able to quickly adapt to work-from-home arrangements with existing IT system capability within a one-to-two-week period. From the first day working from home, we established a twice daily catch-up in what we called “Outreach Musters”. These meetings ranged from three mins to 45 minutes depending on the updates and issues that needed to be worked through and provided an opportunity for regular social connection. We began with the view to scale these meetings back once the team adapted to working from home. However, after four weeks, the team unanimously voted to continue with the twice daily frequency. One team member commented that they feel closer to the team and have a better understanding of the bigger picture of our team's work now, compared to when we were working in the office.

The show must go on: Maintaining access to essential health services

The COVID-19 pandemic presented a wide range of additional barriers for our Outreach providers delivering essential health services and the communities who access them. This became apparent to us as we observed a reduction in allied health and medical specialist service delivery under the Outreach programs, compared with the same period in 2019. Feedback collected from service providers helped us to understand the reasons why this had occurred. Key themes identified in this feedback included:

• travel restrictions - state and local. Inconsistent decisions within communities and facilities around what constituted an essential service
• reduced availability of flights no longer viable to sustain Outreach models
• increased consultation times required to fulfill COVID-safe practices
• reduced facility capacity to provide support eg: patient transport, bookings, room availability etc
• unwillingness of patients to leave home to attend appointments
• clinician unable to continue Outreach due to financial impact to home practice
• clinician unwillingness to travel due to risk of unknowingly transmitting the virus to others in vulnerable communities.
• clinician unwillingness to travel due to concerns about own health.

CheckUP worked closely with communities and service providers to design and implement tailored solutions to address these challenges as they emerged. Between July 2020 and February 2021, more than 1200 Outreach service variations have been issued in response to changing situations to modify funding and delivery models and maintain access to essential health services. During this period, Outreach providers have consistently demonstrated that they are both willing and able to adapt their services to overcome barriers and meet community needs if they are appropriately supported to do so.