Regional collaboration with key eye stakeholders in the Geelong region of Victoria has enabled the establishment of an Aboriginal Access Clinic at Barwon Health to reduce wait times for cataract surgery
Geelong is derived from the local Wathaurong/Wadawurrung Aboriginal name Djillong, when translated means, ‘tongue of land’ or ‘peninsula’. Geelong has the largest population of Aboriginal people in Victoria outside metropolitan Melbourne, with more than 3000 Aboriginal people living in the region. The region comprises of suburban, coastal and country areas, it is situated 75km south west of Melbourne.
The National Eye Health Survey published in 2016, investigated the rates of vision impairment and blindness for Indigenous and other Australians. It showed that Aboriginal and Torres Strait Islander Australians have three times more blindness and three times more vision loss than other Australians. Although up to 94% vision loss among Indigenous people is preventable or treatable, not all Indigenous people are accessing the eye care services that they need.
For the region of Geelong, it was unclear whether Aboriginal people were accessing eye care services
The Roadmap to Close the Gap for Vision (2012), refers to this journey as a ‘leaky pipe’, in which there are many points along the pathway of care that patients can drop out of the system. It calls for all elements of the system to work collaboratively to successfully stop the leakage.
To determine whether there were any gaps or barriers in accessing eye care services, the Geelong Region Aboriginal Eye Health Project Advisory group was established in 2016. The group comprised of a number of organisations and stakeholders*, who had influence over the eye care journey and worked in partnership with the local Aboriginal Community Controlled organisation within a framework of self-determination and Indigenous control.
Aboriginal self-determination has been crucial to our achievements in eye health developments within the Geelong region. Aboriginal participation from Wathaurong, the Aboriginal Health team at Barwon Health and the Deakin School of Optometry, have driven our plans, and led the way. Without their guidance and support our work would not have hit the mark so profoundly nor have been so well embraced by the local Aboriginal community
The group used the Indigenous Eye Health calculator to measure gaps and monitor progress at various points on this eye care journey (from eye exams through to treatment, service access and receiving glasses) and established that there was a significant shortfall in Aboriginal eye health services and outcomes in Geelong.
Collectively, the group decided to focus its initial efforts on improving access of Aboriginal patients into Ophthalmology – specifically focusing on cataract surgery. Barwon Health set out to increase attendance to appointments and reduce wait times for cataract surgery as a starting point. This work was championed by Barwon Health ophthalmologist, Dr Ben Clark, Nurse Unit Manager of Outpatients, Dianne Day and the Aboriginal health team at Barwon Health.
In 2017, the Barwon Health Aboriginal Access Eye Clinic was established where two dedicated appointments (new patients and review patients) were allocated each month for Aboriginal patients.
To date, the clinic development has resulted in a significant increase in numbers of Aboriginal patients receiving care. The wait time between booking and surgery has also dramatically reduced, with Aboriginal patients waiting equal or less than non-Indigenous patients, of 90 days. Substantial work has gone into ensuring the success of this clinic and improving pathways to care.
The establishment of the fast track pathway was fairly straight forward. The bigger issues is probably around identification and trying to ensure that patients are identified on their referral as Aboriginal or Torres Strait Islander. Ben Clark, Ophthalmologist, Barwon Health
Many road blocks were addressed along the way to improve access to the clinic, including improving identification of Aboriginal patients by making changes to referral templates and by developing cultural resources.
There has been real commitment from Barwon Health to address the identification of Aboriginal patients across the health system to improve access to eye care services and support health system change.
No additional funding was required for this work, and the initiatives were funded through existing resources. The appointment times were existing, and when not being used by Aboriginal patients they can be allocated to non-Indigenous patients.
Pictured: Barwon Health Ophthalmology recognised during NAIDOC Week 2019 as they receive an award for ‘Innovation and Change in Aboriginal Health’ for their work in improving Indigenous access to cataract surgery in the Geelong region.
Since its first meeting, more than three years ago, the Geelong Region Aboriginal Eye Health Project Advisory group continues to meet regularly to work on solutions to address the other inequities identified.
Other areas of work include:
- engagement of local optometrists and ophthalmologists
- involvement of student optometry
- exploring outreach service options
- community art competition for regional eye care
This is a partnership built on trust and integrity with sincere efforts to address health system reform through a shared understanding of the local Indigenous community needs, and by stakeholders investing time and resources to bring sustainable results and strong partnerships. By working collaboratively, the region is well on its way to close the gap for vision.
This work of the group is replicable and provides a great example of health system reform that can be used in other regions across Australia.
*Aboriginal Health Barwon Health, Wathaurong Aboriginal Cooperative, Barwon Health Ophthalmology Clinic, Indigenous Health Deakin University, Victorian Aboriginal Community Controlled Health Organisation, Indigenous Eye Health University of Melbourne, Western Victoria Primary Health Network, School of Optometry Deakin University, Australian College of Optometry, local optometrists including OPSM Waurn Ponds, Colac Area Health
If you have any questions relating to this ‘story’ please contact Libby Lesock, Aboriginal Health Policy and Projects, at Barwon Health via email firstname.lastname@example.org or by telephone (03) 4215 0765.
This 'Share your Story' article was published 12 Dec 2019.