Local services

Silver Book - Part C

Last revised: 02 Aug 2023

Introduction

This chapter outlines the services and health professionals that visit RACFs. Information about local aged care providers is available through numerous sources, including:

the My Aged Care Find a provider tool to search for a provider
local HealthPathways via primary health networks
local hospital networks/departments.
in-reach services
discussing with colleagues the services they refer to
discussing with your aged care service the services they refer to.

Services/health professionals that visit RACFs

Allied health aged care services

Allied Health Professions Australia provides a list of professionals that can provide a range of services in aged care facilities, including:

audiologists
occupational therapists
optometrists and orthoptists
dental services
podiatrists
physiotherapists, osteopaths and chiropractors
exercise physiologists, occupational therapists and physiotherapists
art therapists and music therapists
dieticians
speech pathologists
psychologists
specialist nursing services, such as diabetes educators and wound care.

Accessing allied health aged care services

The My Aged Care website provides a referral point for older people to access assessment and funding for the allied health services they need (refer to Part C: My Aged Care).

There are differences in the types of allied health services that can be accessed in the community compared with in RACFs. These are outlined below.

Allied health services provided in the community

Allied health services provided for those living in the community are funded through a GP chronic disease management plan or though Medicare-funded mental health services. The Department of Veterans’ Affairs and private health insurance also fund allied health services. Some services may require a co-payment, because rebates may not cover the full cost of the treatment. Access to allied health professionals, medical specialists and services may also be available through community health centres and programs funded by primary health networks.¹

Allied health services provided in RACFs

Access to allied health services is limited in RACFs and depends on whether the RACF is funded to include the service and the services are available in the area (eg access to mental health services in RACFs).

Geriatricians

A geriatrician is an expert in the medical diagnosis and management of the health of older people across the complexity of the multiple conditions that may be present in older patients and in the diagnosis and management of geriatric syndromes.² For example, people who are diagnosed with dementia must have medications started by a geriatrician. Access to geriatric and specialist support in aged care is determined by their availability in a patient’s area and is particularly difficult to access in regional and remote areas.

Pharmacists

Medication management in RACFs is complex and requires the involvement of residents and their families with the multidisciplinary healthcare team including doctors, nurses, carers and pharmacists (refer to Part A: Medication management and Part B: Principles of medication management and Collaboration and multidisciplinary team-based care).

Residential medicines management reviews provide an important support for the treating GP in the quality use of medicines and are described in other chapters of the Silver Book (refer to Part A: Medication management, Polypharmacy, Deprescribing and Palliative and end-of-life care and Part B: Principles of medication management).³ Accredited pharmacists, credentialed pharmacists on staff at the RACF and GPs can work collaboratively to decide on doses, appropriateness, dose form, optimum delivery device, monitoring, drug interactions and contraindications with certain medicines.

Support groups

There are many resources, services and support groups available for a particular need or situation (eg caring for someone living with dementia, chronic disease, incontinence, mental health condition, hearing, vision and oral health difficulties, disability or someone nearing the end of their life). Carer Gateway provides carer-specific in-person telephone and online services.

Disease-specific support groups that people and their families/carers can access include:

Resources

Support lines and support groups for older people

Appendix A

List of Australian primary health networks (PHNs)

State/territory	Primary health network
ACT	Capital Health Network
NSW	Central and Eastern Sydney PHN Covers the city area down along Sydney’s coastline to Waterfall, then as far west as Punchbowl and Homebush It also includes Lord Howe Island Hunter New England and Central Coast PHN Covers Gosford to Taree along the NSW coast, then inland to Tenterfield and west to Moree Murrumbidgee PHN Covers Khancoban to Boorowa and Young, then west to Hillston and Tooleybuc Nepean Blue Mountains PHN Covers St Clair and Penrith, then north to Mogo Creek and west to Katoomba and Portland North Coast PHN Covers Camden Haven, then north along the NSW coastline to Tweed Heads, and west from Woodenbong down to Mount Seaview Northern Sydney PHN Covers all the northern Sydney suburbs up to the Hawkesbury River, from Manly and Epping to Laughtondale and Avalon COORDINARE – South Eastern NSW PHN Covers Eden to Wollongong along the NSW coastline, then west along the NSW–Victoria border to Thredbo and north to Binalong South Western Sydney PHN Covers Bankstown to Wingello, then to Nattal in the west Western NSW PHN Covers Oberon to Mildura, up along the South Australian border, then east along the Queensland border to Lightning Ridge Western Sydney PHN Covers Homebush Bay to Mount Druitt, and north to Wisemans Ferry
NT	Northern Territory PHN
Qld	Brisbane North PHN Covers Indooroopilly to Redcliffe, and north to Kilcoy It also includes Bribie Island and Norfolk Island Brisbane South PHN Covers Wynnum to Inala and Beenleigh, and south to Rathdowney It also includes North Stradbroke Island Central Queensland, Wide Bay, Sunshine Coast PHN Covers Springsure and Rubyvale to Yeppoon and south to Caloundra Darling Downs and West Moreton PHN Covers Stanthorpe and Texas to Ipswich, Proston and Taroom Gold Coast PHN Covers Coolangatta to Jacobs Well and west to Canungra Northern Queensland PHN Covers from Dysart to Thursday Island at the top of the Cape, and from Croydon to Richmond in the west Western Queensland PHN Covers Thallon to Kowanyama, and along the NSW, South Australian and Northern Territory borders
SA	Adelaide PHN Covers Adelaide, down to Sellicks Beach and Kangarilla and north to Angle Vale and One Tree Hill Country SA PHN Covers all of South Australia apart from Adelaide It also includes Kingscote Island
Tas	Tasmania PHN
Vic	Eastern Melbourne PHN Covers Lalor to Kew to Rowville then to Warburton East and north-west to Wandong Gippsland PHN Covers Cowes and Loch to Omeo and Mallacoota Murray PHN Covers Mildura and Murrayville to Marysville and Corryong. North Western Melbourne PHN Covers Melbourne city and Preston to Lancefield, then south to Bacchus Marsh and Little River South Eastern Melbourne PHN Covers Bunyip and Lang Lang to Portsea, then north to St Kilda and east to Gembrook Western Victoria PHN Covers Geelong to Dartmoor, then up the South Australian border and east to Patchewollock
WA	WA Primary Health Alliance Consists of three PHNs: Perth North Covers Perth city and Cottesloe to Two Rocks along the WA coast, down to Bullsbrook, Chidlow and Pickering Brook Perth South Covers Fremantle and Cloverdale, south to Waroona and east to Bedfordale Country Western Australia Covers all of WA apart from Perth

References

Allied Health Professions Australia (AHPA). Access to allied health services. AHPA, 2022 [Accessed 8 July 2022].
Australian and New Zealand Society for Geriatric Medicine (ANZSGM). Information for the public: What is a geriatrician? ANZSGM, n.d [Accessed 8 July 2022].
Pouranayatihosseinabad M, Zaidi TS, Peterson G, Nishtala PS, Hannan P, Castelino R. The impact of residential medication management reviews (RMMRs) on medication regimen complexity. Postgrad Med 2018;130(6):575–79.

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