‘A no-brainer’: how a community service is easing the pressure on the healthcare system | The Courier

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A call is being made to fund a community health service to support it to continue helping people in their homes, while easing pressure on the state’s health system and ambulance service. HMS Collective co-founder Andrew McDonell, a paramedic of 32 years, started the collective last year. With a background in nursing and completing further medical training throughout his career, starting a community service such as HMS Collective was an idea he has had since 1998. It wasn’t until he met his co-founder that the idea came to fruition in March last year. “What we worked out is that the current system isn’t good,” he told The Courier. “A lot of people are ending up in ambulances and in emergency departments who really shouldn’t be there.” He explained this was because there was a gap in services, with people often turning to Triple-0 because their situation had reached a crisis point and they didn’t know where else to turn to. “The gap is that people need somewhere to call. [Help] doesn’t need to be there in 10 minutes – it can be a couple of hours or 24 hours, but we needed a multidisciplinary team to respond to these calls,” he said. Starting in the Macedon Ranges and since expanding to Sunbury, Ballarat, Bendigo and parts of Melbourne, the service has more than 20 community paramedics and nurses who attend non-emergency incidents for which an ambulance might otherwise be called. “We’re not an emergency ambulance service. We wouldn’t send one of our community paramedics to see someone reporting chest pain and shortness of breath,” Mr McDonell said. “Our service is to try and prevent people from having chest pain and becoming short of breath. That’s our model, so therefore an ambulance won’t be used. So it’s about preventative health in the home, and it’s long-term health.” The staff are registered paramedics who are supported by nurses and allied health professionals. Retired healthcare professionals and final year students also help out as support partners – a role similar to a support carer. The community members in the collective currently treat more than 30 people each week – from the eldery to people with dementia, disabilities, mental health issues, and degenerative conditions. From wound care to welfare checks and medication management, they also assist those who have left hospital and are recovering at home, use ‘social prescribing’ and have two support dogs. The service offers people a high level of support while allowing them to stay in their homes and communities. It is based upon models in Canada, the United Kingdom and Europe where community members are treated at home for minor ailments and develop long-term relationships with staff who work proactively to prevent and treat health issues before they become serious enough to warrant hospitalisation. Importantly, Mr McDonell said that after an assessment the team was able to refer people on to other services such as general practitioners, physiotherapists, occupational therapists and mental health services. He said this was vital to prevent health issues escalating to a critical point. While anybody can call the service’s number, patients are more commonly being referred to the collective by community health organisations and general practitioners. The organisation is funded through its patients, who can pay using their National Disability Insurance Scheme or MyAgedCare funding. Patients can pay by the hour at a small cost, compared to the cost of around $2000 for an ambulance call out. Ballarat’s Kate Fyander, 24, is a final year nursing and paramedic student and has been working as a support partner with HMS Collective since mid-last year. It is one of three jobs she has, but like many of her HMS colleagues she does it to help her community and gain experience. “I’m very passionate about it. It is a privilege to go into people’s homes and help them,” Ms Fyander told The Courier. “I go out and see clients and make sure they’re doing okay, that they’re safe in their homes, taking their medications and that their vital signs are alright.” Through the job she has seen firsthand how preventative healthcare can reduce the number of people calling ambulances. Anecdotally, some patients with mental health issues have changed their behaviour, including one who had previously called for an ambulance more than five times a day but who has since stopped doing so now they know where they can access non-emergency support. “There’s a system where if something happens, one of the workers will go out to them, check over them and make sure everything’s alright,” she said. “So that prevents ambulances from being unnecessarily called too. It definitely works.” The service is continuing to grow to other parts of Victoria as more workers and patients come on board, with Colac one of the next areas for it to be launched. It estimates it is already saving around 90 hours of ambulance transport each week – equating to about $180,000 in ambulance costs and about $800,000 when including costs associated with emergency departments and hospitals. Government funding would allow the service to expand to more areas, help more people and ease the heightened strain on the healthcare system as a result of the pandemic. “It’s a no brainer – we can patch someone up, see them for a few days and then they don’t need to go to a hospital. It’s better than them not knowing what to do and not having anyone so they end up sitting in an emergency department,” Mr McDonell said. State leader of Derryn Hinch’s Justice Party (DHJP), Stuart Grimley MP, has called for funding for the service given the positive benefit it is having on hospitals and the wider health system. He became aware of the collective’s work when he had been exploring solutions to the healthcare crisis, which has seen waiting times for ambulances skyrocket. “I met with them and thought it was a brilliant solution to an issue that’s not going away – it’s only getting worse,” he said. “Our health and ambulance systems are clearly under immense pressure and HMS Collective provides a common-sense solution.” A former police officer, Mr Grimley said police had introduced a service for non-urgent calls to allow frontline officers to respond to more pressing issues. “We used to get tied up a lot of the time for damage or something that’s not urgent but during that time there could be a stabbing or armed robbery that we then couldn’t attend because we were already dealing with a broken window.” He said the Police Assistance Line had freed up officers to attend more serious jobs, and a similar model could be introduced for the healthcare system. Mr Grimley added consistent government funding would not only relieve pressure on the healthcare system now, but would also allow it to become a part of the system in future. “It’s not just a cost-saving exercise but provides enhanced patient services and lasting relationships.” In addition to financial support, DHJP argues there needs to be a more formal referral service for non-emergency outreach to HMS Collective to increase its effectiveness. Mr Grimley sent a letter to the state Minister for Ambulance Services, Martin Foley, early last year. “Unfortunately the government didn’t commit any funding and since then we’ve seen a continuation of these issues. “Paramedics do a great job but they can only do so much – it’s the system that’s failing. “We can’t just keep doing the same thing over and over and expect a different result.” He wrote another letter to the minister outlining his concerns in November and requested he meet with HMS, but is yet to receive a response. A state government spokesperson said: “As this privately run business operating in a marketplace, it cannot received funding directly from the Department of Health for the provision of public health. “However, the business is able to submit a tender directly with public health services and primary health networks, which are funded to deliver care and services – as other private businesses do.” To access the service, members of the community can contact HMS on 1300 549 249 or [email protected] If you are seeing this message you are a loyal digital subscriber to The Courier, as we made this story available only to subscribers. Thank you very much for your support and allowing us to continue telling Ballarat’s story. We appreciate your support of journalism in our great city.

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