Boggabilla is a small community with approximately 800 residents, with over half identifying as being of Aboriginal or Torres Strait Islander descent. The Boggabilla Community Health Centre (BCH) is a two-nurse clinic located 116km from Moree Health Service and 10km from the Queensland border. Assisting both the community and BCH, the Goondiwindi Medical Centre (GMC) has provided an outreach service to residents from Boggabilla since 2012, initially starting as a half-day a week outreach GP clinic. Over time, this relationship has transformed, with BCH and GMC working together toward providing comprehensive care for all living within Boggabilla.
Collaboration is key
The collaboration between BCH and GMC seeks to improve access to services and education for Boggabilla residents, empowering them to actively engage in their own healthcare, which is essential to closing the gap. The ability to refer within the clinic and in the individual’s own community has led to improved compliance and follow-up for health issues and related referrals.
The clinic has zero out-of-pocket expenses for clients. We are able to provide the community with the same doctors and chronic disease nurses that they would pay to see if they were to attend the GP clinic in Goondiwindi. Our GP clinic appointment waitlist is currently one month, indicating the potential for growth into the future. Key Initiatives that have come out of the collaboration include:
- annual school visits to undertake health checks for children
- a yearly 715 health check focusing on chronic disease and management
- offering a GP clinic in the community two days per week
- collaboration with mental health services, GMC and a psychiatrist
- collaboration with a visiting endocrinologist and GMC
- a Breastscreen bus
- CPR days with collaboration between BCH, GMC and Ambulance
- podiatry and audiometry visits.
Using virtual care to break down barriers
Communication is crucial to implementing effective service delivery; for BCH and GMC, this was initially difficult due to the different systems used by NSW and QLD. To counter this, BCH created a shared online calendar of appointments that could be accessed by all providers. This approach has resulted in better attendance rates as all team members have access and a shared responsibility of ensuring patients receive appropriate care. The clinic also provides telehealth to broader areas, eliminating the need to drive or travel hours which is often unaffordable for many. The largest improvement for better patient outcomes comes down to accessibility and our drive to close the gap in improving accessibility to healthcare.
What was once a place for general nursing care has now become a one-stop-shop for not just wound dressings but immunisation, mental health, pathology collection, telehealth, specialist and GP care. Staff assist in navigating patients care when living away from home for treatment including assistance with accommodation, IPTAAS forms and confirmation of appointments, giving patients the support they need when away from community.
The success of this clinic has been the collaboration between not just the GMC but also the local police, hospital and ambulance service. Staff also work closely with the elders, community members and other health service providers to meet the objectives of improving access to health care for our first nations people. BCH staff have embedded relationships between clients and health care teams through community presence, involvement and trust. Clients are spoken to openly and honestly, with staff respecting their opinions and encouraging their feedback in the ways we can improve our service to maintain its success for the future. We meet with community elders frequently to ensure we are maintaining cultural appropriateness and value their input.
Transport access issues reduced
In the past, engagement and interaction from the community was low (12290 presentations). Since the introduction of the GMC clinic and multiagency approach, our service has increased dramatically (24607 presentations). In 2018, the clinic had 6740 face-to-face individual appointments. In 2021, this increased to 13643 and in 2022 presentations increased again to 14426. That is a 114% increase in productivity for the clinic just on individual appointments, not including telehealth, case conferencing or telephone appointments.
The ambulance service has reported fewer visits to the town and transport issues have been reduced with healthcare being provided within walking distance of patients homes, together with an option for home visiting if required. Further to this, the clinic provides flexible appointments as well as a drop-in service to enable ongoing healthcare compliance in a culturally safe manner.
This facility and program has created a culturally safe and respectful environment for all, but is of particular importance to our First Nations community. BCH is a fantastic example of how effective partnerships and teamwork can benefit of our cross-border communities.
