Providing free health care to kids

Accessing healthcare can be difficult and daunting for some children, particularly those from disadvantaged backgrounds. Similarly, it can be hard for those living in outer metropolitan or remote areas. Unmet health care needs in some instances can get in the way of a student’s ability to learn.

Background

The Victorian State Government made a 2014 election commitment to roll out primary care services into 100 disadvantaged secondary schools through its Doctors in Secondary Schools initiative.

At such a scale, this new program is the first of its kind in Australia and it is being overseen by the Department of Education and Training Victoria (DET) which offers learning and development support, services and resources for all Victorians, from birth through to adulthood.

The objective of the $43.8 million project is to provide increased medical and health support to adolescents by contracting general practitioners (GPs) to provide on-site health advice, treatment and support to students at selected schools on a sessional basis. The program will fund GPs to attend up to 100 Victorian government secondary schools up to one day a week to provide medical advice and health care to those students most in need. A practice nurse will also work with the GP to support clinical care coordination.

The program makes a valuable contribution to achieving the Government’s Education State targets of 'happy, healthy and resilient kids' by providing free and accessible preventative health care and medical advice for young people.

DET collaborated with the University of Melbourne to ensure all GPs engaged in this program receive training to work with adolescents. Associate Professor Lena Sanci from the Melbourne Medical School is the expert advisor to DET and leads the Doctors in Secondary Schools training program in conjunction with world-renowned experts from the University, including: Professor Susan Sawyer , Chair of Adolescent Health in the Department of Paediatrics; Professor Patrick McGorry AO, Executive Director of Orygen and Professor of Youth Mental Health; and Melbourne Graduate School of Education’s Professor Helen Cahill.

The recent Victorian Budget 2018/19 provided funding to continue the program up to December 2021.

Challenge

DET identified a large proportion of students whose health needs weren’t being addressed and a number of schools that had difficulty accessing primary healthcare.

The Doctors in Secondary Schools program was developed as an innovative approach to help tackle those issues and support better outcomes for adolescents in Victoria, especially those living in at risk areas.

To establish a high-quality service, appropriate for its target cohort, DET had to ensure that all GPs engaged to be a primary service provider would have adolescent health training at the highest level possible. All participating GPs were required to undertake special training in adolescent healthcare and ongoing professional development. The objective was that they would be equipped to tackle important health issues encountered in schools based on the latest evidence-based approach to adolescent healthcare.

This is a great opportunity to make stigma-free health care more accessible to high school students Orygen Executive Director Professor Patrick McGorry AO

Solution

The University of Melbourne developed a bespoke training program of a series of face-to-face workshops tailored specifically for GPs. Doctors participating in the program will receive world-class training and advice from leading experts in the field of adolescent health and wellbeing. Under this training program, school-based GPs and nurses have access to face-to-face workshops, follow-up webinars and optional online learning modules on a range of issues including mental health, migrant and refugee health, alcohol and drugs and sexual health. They will also be able to seek guidance from an expert psychiatrist through weekly tele-psychiatry case management and mentoring sessions.

To deliver this comprehensive training program, the University of Melbourne has shaped a collaborative partnership with Australia’s leading adolescent health organisations including:

The training program will also deliver regionally-based workshops (through our delivery partner, headspace) to strengthen relationships and knowledge between GPs based at regional schools and local youth-focused mental health services. These activities are also delivered in consultation with, and with support from, the Primary Health Networks and DET.

Outcome

There are enormous benefits in bringing health care to schools. Improving student health has a direct effect on their ability to learn and thrive. Having a health service onsite, means students are less likely to miss out on school to attend appointments.

The training program will also assist GPs and nurses to build young people’s health literacy by taking the time to help them understand their health issues, promote healthy lifestyles and ways of accessing health care in the community when they leave school.

The program will significantly increase the pool of doctors in Victoria who have a greater level of understanding of, and skills in, working with adolescent health needs and approaches.

The University of Melbourne has been able to bring together Victoria’s leading adolescent health organisations, meaning the GPs and practice nurses delivering the program in our schools are guided by the best in the field. The use of 1:1 student role plays in the clinical training is already proving to be an innovative addition to the preparation of clinicians to provide a youth-friendly service in our schools. Dr Claire Tobin, Principal Medical Advisor, Department of Education and Training

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