Advancing equitable access to health care

Based in the heart of the largest social housing estate in Victoria and running the State’s only safe injecting room, this organisation continues to charter new territory. Those within and outside the organisation are deeply invested in the organisation’s success. For many people, this is one of the few places where they feel safe, respected and understood. They trust staff will listen and help. The approach to developing this strategy was truly placed based. It was built around conversations with diverse locals including substance users, young people, single parents struggling to support families, and non-English speaking community members. These discussions provided a nuanced understanding of local challenges, surfaced community ideas on new ways to consider solutions, and confirmed entrenched inequity cannot be shifted by tweaking business as usual. Continuing to build social capital with the community and key stakeholders was seen by the leadership team to be as important as creating a robust strategy. Through the process, the leadership strengthened its resolve and commitment to work with community to embed disruptive approaches to accessing health, wellbeing and other social determinants of health support.

When it comes to health care in regional and rural Victoria, often the public hospital is the only option, and choice of specialists is limited. Under the direction of a new CEO and leadership team, Rapid Impact supported the creation of an ambitious strategy to grow a private hospital. Not only are new treatments available, but the overall number of doctors has increased allowing more options for patients. Community members no longer have to leave town for major surgery, and soon, cancer treatment will also be available locally. Even during COVID, the private hospital delivered on its strategy, and its aspirations for its next plan are even more ambitious.

The Victorian Government introduced legislative changes to the Mental Health Act, and to support these, funded a pilot program in seven health services (18 psychiatric units) to reduce the use of seclusion and restraint of patients. We partnered with a local forensic health expert, and a government team, to customise and translate the UK Safewards program into a format and approach suitable for the Victorian psychiatric setting. This involved understanding the theory and practice of Safewards, creating innovative delivery methods and establishing a learning network of professionals who had the confidence to embed and institutionalise the initiatives at each of their respective workplaces. 

The release of the Royal Commission into Victoria’s mental health system, and the mental health burden from COVID-19 which is so significant that it is referred to as the shadow pandemic, confirms the unmet and escalating demand for psychiatrists. Rapid Impact supported consultations across health services in Victoria to determine how to strengthen psychiatric rotations for junior doctors to increase the overall mental health capability of all doctors in training, as well as the attractiveness of psychiatry as a post-graduate specialty area.