For health care to be effective, services must address the health needs of patients, in locations that are convenient to access, at an affordable cost and at the time they are needed (Peart et al. 2020). Research suggests that a measure of reasonable access is the ability to reach a primary healthcare service within 60 minutes of your community (Gardiner et al. 2020).  

Service gaps in our region are particularly pronounced in rural areas as travel distances often make it difficult for patients to receive the specialised services they need. Our region would benefit from increased access to a range of care services, especially in rural areas.  

• For the theme of access, healthcare workers in the region commented on inconsistent access to health services, difficulty in accessing mental health services, and long wait times to see a health professional (Health Workforce Queensland 2023).  

• Nationally, we have seen more people delay or not get prescribed medications due to cost. This increased from 4.4% in 2020–21 to 7.6% in 2022-23, the highest we have seen in the past five years (ABS 2023). 

• Additionally, the proportion of adults in our region who were referred to a medical specialist and waited longer than they felt acceptable to get an appointment increased from 16.5% in 2017–18 to 17.2% in 2019–20. This number has increased nationally from 21.7% in 2020-21, to 27.9% in 2022-23 (ABS 2023). 

• Residents in our region identified a key theme that (Health Consumers Queensland 2023b):

1. the cost of medical services and lengthy wait times are a critical barrier to receiving care.
2. the proportion of people who did not see or delayed attending their local general practice due to cost was 1.9% in 2019–20, compared with the national average of 3.8% (AIHW 2021)
3. the percentage of adults who did not see or delayed seeing a dentist, hygienist or dental specialist due to cost was 23.9% in 2019–20, compared with the national average of 19.1% (AIHW 2021).

• The region is experiencing significant population growth which has the potential to add further demand on current health services offered in the region (QGSO 2023).

• Residents in our region shared they are experiencing (Health Consumers Queensland 2022): 

1. long travel distances as necessary services are not locally available 
2. difficulty affording care especially in tandem with transportation and accommodation costs  
3. long wait times to get an appointment; no same-day appointments offered locally, when needed 
4. not enough time during their appointment to discuss all details they felt were relevant to their care.

• Residents told us that when it comes to service availability and access, they would like to see (Health Consumers Queensland 2022):

1. more local services, especially bulk-billing services, in the region; they also noted that some existing general practices have full patient lists 
2. primary care services available after hours, including general practice and pharmacy; this can help reduce use of hospital emergency departments for lower-urgency care 
3. increased access to transport and telehealth options to obtain health care, especially for vulnerable persons in regional and rural areas 
4. more promotion and information about available services, health promotion campaigns with improved consumer engagement
5. increased primary, specialised, and allied health services offered locally, especially in rural areas 
6. more allied health services that are culturally safe and with increased access to interpreter services 
7. more affordable allied health and disability support services, such as more bulk billing, and options to obtain repeat referrals. 

Content last updated 28 February 2024 

Both acute and chronic health conditions often require the involvement of more than one healthcare professional and support service. Seamless coordination and communication between these different services can improve the quality of care that patients receive (Roberts et al. 2023). 

For transition care to be effectively provided, services should be coordinated using robust care pathways and appropriate referrals. Improvements in both health service and patient outcomes are observed upon providing quality care at a patient level. Resources are needed to support patients and their families at times of transition care (Roberts et al. 2023). 

Our region can benefit from increased care coordination during patient handover and discharge and by utilising digital health tools like HealthPathways. 

• As of January 2024, around one in seven people (13%) who regularly attend a general practice in the region had two or more chronic conditions; the Somerset (22%), South Burnett (21%) Goondiwindi (18%) and Southern Downs (18%) regional areas reported higher rates (DDWMPHN 2024).

• HealthPathways was designed to increase awareness and coordination of local care options to healthcare providers and consists of clinical pathways, referral pathways, support services and resources specific to the Darling Downs and West Moreton regions (DDWMPHN Annual Report 2023). Within the past 12 months, there has been increased interest in strengthening care coordination in the following pathways: 

1. Darling Downs Region: Request for Specialist Online Advice, Antenatal- First Consult, and Glucose-Lowering Therapy – Excluding Insulin (DDWMPHN 2024).  
2. West Moreton Region: Antenatal- First Consult, Shared Maternity Care, and Hypertension (DDWMPHN 2024). 

• Residents said that when it comes to supporting healthcare service coordination, they would like to see (Health Consumers Queensland 2022): 

1. more information about referral pathways 
2. better communication between health professionals about their care and strategies to assist them, with an emphasis on integrated models of care 
3. increased involvement in plans about their care, such as general practice management plans 
4. appropriate discharge planning and timely discharge summaries 
5. improved community supports, especially in mental health and allied health. 

Content last updated 28 February 2024 

Digital health is a comprehensive term for technologies that collect and share health information to improve health outcomes including mobile health applications (SMS reminders for appointments, cycle tracking, step tracking), electronic prescriptions, electronic health records (My Health Record), telehealth appointments, wearable devices (such as smart watches), and AI.  

Digital health tools can be used in tandem with face-to-face appointments to provide more comprehensive care to patients. A mixed methods approach to care allows patients to receive care within the community, even in regional and rural areas. The use of digital health tools provide a way to maintain timely access to quality care while reducing travel and wait times (Gajarawala & Pelkowaski 2021). 

Our region can further increase the awareness and use of digital health tools, including building digital health literacy, to improve access to health care and care coordination. 

• The Digital Inclusion Index for our region was 69.0, this is 4.2 units below the national average of 73.2. The gap is largest in Cherbourg (59.5), South Burnett (65.1), Southern Downs (66.4), and Goondiwindi (67.1) areas (Digital Inclusion Index 2022) (Thomas et al. 2024). 

• Medical workers stated that a lack of locally available services increases reliance on digital and telehealth options (Health Workforce Queensland 2023). 

• Incentives, such as the availability of Medicare Benefits Schedule items for telehealth, were seen as important for supporting the ongoing use of digital health tools (Health Workforce Queensland 2023). 

• Residents said that when it comes to integration of digital health tools, they would like to (Health Consumer Queensland 2023a): 

1. know what digital health tools are available by their healthcare providers  
2. know more about how to use digital tools, through community programs or workshops  
3. have one standardised option, supported by the PHN or by their healthcare provider 
4. feel more confident with data security and privacy. 

Content last updated 28 February 2024 

After-hours general practice services, such as telehealth and home care visits, can potentially reduce emergency department demand (Ifediora & Rogers 2018, Baker et al.2020).  

Our region can further increase the availability of primary health care after hours. This can improve access to health care and care coordination, and help further improve hospital avoidance where appropriate.

• During 2019–20, more than 8 in 10 residents in the region attended their local general practice. For around one in ten people, there was a time when they needed to visit their local general practice, but did not do so (AIHW 2021a). 

• Many people experienced barriers to accessing care, such as not being able to access their preferred general practitioner (27%) and cost (2%). Fewer people in the region reported they were covered by private health insurance – 49% compared with 57% nationally (AIHW 2021a). 

• The proportion of local residents who saw their general practitioner for urgent medical care (9% of people) and after hours (7% of people) was similar to the national averages (AIHW 2021a).  

• As of June 2022, thirty-three general practices participated in the After-hours program in the PHN region (DDWMPHN 2022).

• A slightly higher proportion of females (53%) used after hours services in the past 12 months.

• Hypertension, mental health, osteoarthritis, respiratory and diabetes are the most common chronic conditions among patients using GP after hours services in the region (DDWMPHN 2022).

• From November 2021- June 22, about 41,119 patients accessed after hours GP services in the PHN region, from General Practices participating in the After-hours programme. If these were not diverted to after-hours GP services, it would have cost the health system in the region about $29.3 million if they are presented at the ED (ED presentation average cost of $729.00/person); however, the estimated net benefit to the health system in the PHN region was $26.2 million with a $426,937.25 investment by the PHN (Deloitte Access Economics 2016, The Independent Hospital Pricing Authority 2021, Darling Downs and West Moreton Primary Health Network 2022). 

• Higher numbers of after-hours practices were recorded in the Ipswich, Lockyer Valley, Toowoomba and Western Downs regional areas than in other areas. This suggests some communities may not have the same level of access to after-hours care in the primary care setting, especially in the regional areas (DDWMPHN 2021a). 

• Residents told us that when it comes to after-hours services, they would like to see (Health Consumer Queensland 2021a, Health Consumer Queensland 2021b, Health Consumer Queensland 2021c):   

1. more access to more services through telephone and video call, ideally 24 hours per day
2. more services available before and after business hours, including before and after school
3. more focus on after-hours youth services, such as access to mental health, suicide prevention, and alcohol and drug services.