March 2013 - Hunter New England Health - NSW Government

HNE Health Matters
Issue 81 March 2013
A gift of
brotherly love
8
FROM IRELAND TO MOREE
SNAPIF & FALLS PREVENTION
NATIONAL STANDARDS
FRAGILE-X SYNDROME TESTING
STAFF AND COMMUNITY MAGAZINE FOR THE HUNTER NEW ENGLAND LOCAL HEALTH DISTRICT
Our Vision: Healthy people - now and into the future
Our Values: Collaboration, Openness, Respect, Empowerment
WE WOULD LIKE TO ACKNOWLEDGE THE TRADITIONAL OWNERS OF THE LAND COVERING HUNTER NEW ENGLAND LOCAL HEALTH DISTRICT AND
REMIND PEOPLE THAT WE LIVE AND WORK ON ABORIGINAL LAND.

Features
Message from the CE
the recruitment process simpler
– and it has worked a treat. (See
page 3)
4
SNAPIF
Entries for both the Quality Awards
and the Achievement Awards
open this month (page 7), and I’d
like to urge everyone to consider
nominating a colleague, leader or
vollie who has gone above and
beyond.
EXCELLENCE
AWARDS2013
Quality & Achievement
6
7
National standards
Saluting Excellence
MICHAEL DiRIENZO
CHIEF EXECUTIVE
This month’s edition of Health
Matters draws together a wonderful
collection of stories which reflect
just how diverse and interesting
our staff, volunteers and external
partners really are.
Many managers would agree that
recruiting health professionals to
work in rural and remote areas can
be challenging. The team at Moree
Community Health partnered with
an external organisation to make
In an example of essential clinical
care overcoming financial and
geographical challenges, I’m happy
to say HNE Health was able to
play a part in helping a Papua New
Guinean man undergo a successful
kidney transplant. The story of the
Kendaura brothers is heartwarming.
(Page 8)
Finally I’d like to encourage
everyone to take part in this year’s
Your Say staff survey. We want to
find out what is working well and
what we need to work on or do
differently so that we can improve
the culture in our workplaces. Your
Say will be open from 25 March to
26 April. (Page 14)
Your say . . .
13 Volunteer profile
Would you like help to promote the good work of a HNE Health staff member,
team, unit or service If so, HNE Health Matters is one way to do so.
Will your idea ...
• Show that your facility or team is dedicated to high quality, patientfocused
care
• Lend itself to a good photo/interview opportunity
Pictured on front cover - steven kendaura, and dr kapiro kendaura
• Be recent, revealing and relevant to readers
If you have a story idea, please email HealthMatters@hnehealth.nsw.gov.au
or call the Communication Unit on 4985 5522. Readers are encouraged to
provide feedback on HNE Health Matters and comment on stories. Please
email us at HealthMatters@hnehealth.nsw.gov.au
HNE Health Matters is produced by the Communication Unit of Hunter New England Health.
This bimonthly newsletter is distributed to staff across the organisation and to
supporters across the region. If you’re a community member who would like
to be added to the mailing list for this magazine, please call (02) 4985 5522
and we’ll add your details to the database.
Stories are written by the Communication Unit team. Contributions by staff
are also welcome - please contact the Editor at
HealthMatters@hnehealth.nsw.gov.au
Publication costs are subsidised by income raised from advertising.
Editor: Janelle Kelly
Communication Unit, Hunter New England Health
Phone: (02) 4985 5522
Email: HealthMatters@hnehealth.nsw.gov.au
Advertising enquiries: Phone (02) 4985 5522
We would love to hear what you think about HNE Health Matters. Send
your feedback via the contact details above.

From Ireland to Moree, with no regrets
Attracting health professionals to work in rural and remote areas is
rarely an easy undertaking, particularly if they are overseas-trained.In
fact, the process is notoriously challenging. Recruiters need to navigate
the red tape associated with visas, sponsorship and qualifications. They
also need to ‘sell’ the unique lifestyle that comes with country centres.
But for the team at Moree Community Health, a recent overseas-trained
nursing placement has proven refreshingly straightforward. And the
keys to success have been a simple networking partnership, combined
with some old-fashioned country hospitality.
Margaret Hayes travelled more than 15,000 kms to take up her position
as a Child and Family Health Nurse at Moree, and says she has had no
regrets since arriving in Australia in November last year.
“Moving your family to another continent is not an easy decision – in
fact, many people warned us off the idea," Margaret said.
"But we have felt really supported and encouraged every step of the way."
Along with her husband Eamonn and two boys Timmy (15) and Jacob
(8), Margaret has found life in Moree "wonderful", with the welcome
received from locals described as "warm in every way".
“My advice to others considering working in a rural area is to keep
an open mind, and try not to have any preconceived ideas," said
Margaret.
"It will be different to what you might be used to, but if you take people
and situations as they come, there are many, many benefits to living in
the country".
For Margaret, the professional transition from Northern Ireland to
Moree has been smooth. She had spent the past 12 years working
within regional communities as a Health Visitor, the UK-equivalent of a
Child and Family Health Nurse.
The transition was certainly made easier, however, thanks to the
practical backing she received from HNE Health and the Rural
Doctor’s Network (RDN).
Moree Community Health’s Anne Lemmon worked closely with Emer
O’Callaghan from the RDN’s Rural Health Professionals Program to
secure Margaret’s placement, after recruitment for the child and family
health position had proven unsuccessful for more than six months.
"If it wasn’t for Emer and the Rural Health Professionals Program team,
we would never have found Margaret, and she might not have found us,”
Anne explained.
The Hayes family with Anne Lemmon (right)
“Emer guided us throughout, from initially putting us in contact with
Margaret, then during the interview, vetting and appointment processes.
She helped us arrange the relevant Australian training Margaret was
required to complete before she could officially be appointed.
“Although she’s based in Newcastle and I’m in Moree, Emer and I
were able to establish an excellent working relationship via phone
and email. She really has been a joy to work with and is an excellent
communicator, and the end result is a staffing appointment that we are
extremely happy with.”
Anne also went above and beyond the call of duty in an effort to make
Margaret and her family feel at home. She inspected rental properties
on Margaret’s behalf and emailed her the relevant photos, collected
Margaret and her family from the train when they arrived in Moree, and
arranged a welcome barbecue at her own home. A gift basket was also
arranged via Tourism Moree, which featured local food and information
about the region and events.
It really has been an invaluable experience in how to attract overseastrained
staff to a regional community,” Anne said.
“Working with Emer and the team has given me the confidence to
pursue other overseas applicants and consider sponsorship, and to
think outside the square when it comes to recruitment.”
Tamworth redevelopment to benefit mums and bubs
Mums and their babies from across the New
England North West will soon be cared for in
one of the newest maternity units in the state.
Next year construction will begin on the new
Tamworth Hospital building, which will include
the new maternity unit, birthing suites and
special care nursery.
"The brand new maternity unit, featuring 10
single rooms with private ensuites, will give
mums more privacy before and after they give
birth,” said Tamworth Hospital Maternity Unit,
Nurse Unit Manager Maureen Dawson.
“Having private ensuites in each room will
mean mums can stay in their room to use the
bathroom rather than making the sometimes
tiring walk to the shared bathroom at the end
of the corridor.”
An extra delivery room will be included in the
new birthing unit, taking the capacity from
three to four birthing rooms complete with
island baths.
“We have one older, shared bath in our current
unit, so it’s excellent that all women will have
access to a bath right in their delivery suite,”
says Mrs Dawson.
The new special care nursery will include 12 places
compared to the six cots currently available.
In time, and with more planning, the special
care nursery will care for babies born at 32
weeks. Right now all babies born under 34
weeks are transferred to a more specialised
hospital for care.
“The change will mean we can care for
children who have more serious conditions
such as respiratory distress, and fewer
families will have to follow their baby to a
larger centre,” Mrs Dawson said.
hnehealth.nsw.gov.au 3

SNAPIF - a happier, healthier community
There is a new word for preventative health around the health service: It's S-N-A-P-
I-F. The acronym helps everyone remember how to minimise the risk of ill health,
infectious disease and injuries.
Here’s how we spell out our Preventive Care program.
Falls
prevention
When it comes falls prevention life begins at
50. It’s an excellent time to review your level of
fitness, to avoid having a fall further down the
track.
S
Smoking
make a plan to quit the habit
Up to 30 per cent of NSW residents aged 65
or older suffer a fall at least once a year. In the
Hunter New England region in 2010/2011, we
saw 4500 people who were over 65 presenting
at hospital with fall injuries.
N
Nutrition
eat more fruit and vegetables
The latest NSW Population Health Survey
calculates that up to 42 per cent of falls can be
prevented by well-designed exercise programs.
The programs that have the biggest effect
on fall rates involve activities that challenge
balance and develop lower limb strength as well
as those undertaken for more than two hours a
week over a six-month period.
A
Alcohol
reduce unsafe drinking
There’s someone in our organisation who
devotes her working life to keeping our
community standing firmly on two feet and
walking with strength and confidence.
P
Physical
find a physical activity and make it part
of your regular routine
She's Sue Green and she is the Community
Falls Injury Prevention Strategies Project Officer
for Hunter New England Population Health.
“People believe that falls are something that
happens to somebody else,” Sue said.
I
Immunisation
ask your GP about protection against
infections and diseases
“But everybody is at risk of falls, and the biggest
predictor of having a second fall is having the
first fall.
“If you catch people before they fall or when
they’ve had their first fall, we can refer them
F
Falls
work on ways to reduce the risk of falls,
particularly if you are older
Ultimately all these choices have an important bearing on the wellbeing of our
communities. There’s one choice in particular which not only improves the health of
people over 50; it can also improve mood, confidence and social networks.
It’s exercise and in Health Matters this month, we look at the final letter in our
acronym: F. It’s all about falls injury prevention.
class participants at the australian tai chi institute, broadmea
4

dow
Project officer, Community Falls injury prevention
strategies, sue green
into programs that will help them develop their
balance and leg strength.”
This brings us to the heart of Sue Green’s
work. For the last two years, she has been
connecting with providers of community-based
exercise programs across our district and
encouraging them to list their programs in the
NSW Health ‘Active and Healthy’ web-based
directory (www.activeandhealthy.nsw.gov.au).
The site is easy to use. Just enter your
suburb or town and you can find a range of
exercise programs available in locations most
convenient for you.
“We want everyone to know about the Active
and Healthy site,” Sue said.
As part of the Preventive Care program
everybody who comes into contact with Hunter
New England Community Health Services is
screened for health risk behaviours, including
the risk of falling.
“For people over 50 at low risk of falls, our
advice is to go off and engage in communitybased
programs, but it’s not just about physical
activity. They need to challenge their balance,
improve their leg strength and ideally, they need
to devote two hours a week,” Sue said.
Hunter New England Health has devised
exercise programs which specifically cater for
the needs of people aged 50 plus, including
‘Active Over 50’s' in the Hunter and Lower Mid
North Coast and ‘Balance and strength’ across
New England, which are supported by external
programs such as Heart Moves from the Heart
Foundation. Health also offers support to
a range of private providers to start up new
programs in towns where programs are not
currently available.
“Sometimes we recognise that external
programs don’t include enough balance and
strength content and we work with these
providers to re-design their activities,” says Sue.
There is no re-design is necessary when
it comes to Tai Chi. This graceful and
deceptively simple Chinese martial art
consistently shows evidence that participation
reduces the risk of falls.
Accredited Tai Chi providers across Hunter
New England see regular classes of older
locals, going through the gentle movements
that have such an impact on the quality of their
lives.
Nearly any activity which keeps us on our
feet and moving can help to maintain good
balance. In Tai Chi, people not only bend
off centre and test their balance; they also
improve leg strength through bending and
stepping. Yoga, Pilates and Dance are among
other activities which help to enhance balance.
The Population Health experts are looking
for one or more of these routines, when
they assess the external programs for their
potential to build balance and strength.
“We have identified external accredited
providers whose exercise programs will
develop balance and leg strength,” Sue said.
“We ask these providers to make sure that
their programs are listed in the Active and
Healthy website, using the site’s home page
registration function.
“Whenever they change their classes, they can
update their entry.”
Regardless of age, weight, health problems
or abilities, it is important for people aged
over 50 to continue to be as physically active
as possible, to help maintain their health and
independence.
“We try to get the word out to the community,
before people become sedentary or overweight.
“But even for those people who have become
sedentary, small changes can make a big
difference and all these efforts to maintain
balance and leg strength can help people
maintain independence in their own home.
“Getting involved in some form of exercise
can also put you in a better frame of mind, it
can increase your confidence at home and in
public and when you get involved in exercise
programs, you widen your social circle.”
“It doesn’t have to be a group exercise program,
but these programs are a chance to meet
new people and have a bit of fun and that’s
motivation to continue attending.”
In the perfect world, exercise is a lifelong pursuit,
but it’s not always possible. The trouble is there
are drawbacks if we don’t keep active.
Societies are looking at simple ideas around
the importance of standing, rather than sitting.
Suggestions include workplace meetings where
people stand rather than sit and meetings
conducted while teams are out walking.
Find some tips below on how to review your
basic routine.
How to stay
balanced
Exercises which challenge balance are
those where people:
• Stand with feet close together or on
one leg (movement from one leg to
the other).
• Undertake exercises while standing
with minimum use of hands to assist.
• Undertake exercises with controlled
movement of the whole body
while standing (e.g. reaching while
standing).
You can inlcude specific balance exercises
in your daily routine. For example:
• Heel to toe standing
• Knee raises
• Heel to toe walking
• Side leg raises
• Sideways walking
• Heel raises
• Stepping up a step
• Sit to stand exercises.
hnehealth.nsw.gov.au 5

A better way to care:
reaching the national standards
manager of quality systems and risk, Gary martin
They say consistency is the key to achieving
your goals. That’s certainly true in the context
of providing health care for our community.
Excellence for every patient, every time is
what we want for the people we provide care
for.
One of the ways we measure if we’re
achieving this is through an accreditation
program where our hospitals and health
services are tested against a set of standards.
For the first time, a national set of standards
for safety and quality in healthcare has been
developed in Australia, bringing with it a level
of consistency that hasn’t been seen before.
The National Safety and Quality Health
Service Standards were developed by the
Australian Commission on Safety and Quality
in Health Care to improve the quality of health
care nationally.
There are 10 standards that clearly articulate
what level of health care consumers can expect.
In late 2011, the health ministers from every
state endorsed the 10 standards and agreed
to a national accreditation scheme.
“This was an historic agreement, which has
implications for the way our hospitals and
health services will be accredited,” Manager of
Quality Systems and Risk Gary Martin said.
“The Executive Leadership Team has decided
that we will transition our accreditation
program to the national standards during
2013, with the aim of being accredited
exclusively using the new standards from
2014.
“The Australian Council on Healthcare
Standards (ACHS) will continue to be our
accreditation provider.”
A national accreditation program will bring
benefits for patients as well as allowing
Hunter New England Health to benchmark
itself against the rest of the country.
“The focus is really on getting the core
things right so there’s a strong foundation
for the care we’re providing,” Gary said.
“The standards are quite demanding and
our executive team is keen for them to
become part of normal business for us.”
There are 256 actions across the 10
standards that organisations are required
to meet and all of the actions must be met
to pass accreditation.
“They will bring quite positive benefits for
patient care,” he said.
The standards were put together following
extensive consultation with the community
and senior clinicians, including some
senior doctors from Hunter New England
Health.
“Quality programs have appeared in the
health arena for over a decade and a lot
of progress has been made in that time to
improve the safety and quality of care and
decrease the number of incidents,” Gary
said.
“But there is always improvement to be made
and what impresses me about the national
standards is that they are designed to
generate real system change.
“We need to build our local health district on
good foundations and the national standards
will be an important part of this,” he said.
“The standards fit neatly with our agenda of
excellence for every patient, every time – and
having everyone demonstrating that they are
doing their jobs with excellence.”
What this means for us
Hunter New England Health has 14
“accreditation memberships” across the
district. This includes eight services within
the Primary and Community Network, one
in Mental Health and six within the Acute
Network.
Every cluster and acute network has a quality
coordinator whose job includes assisting
services with preparation for the accreditation
process.
“Clinical Governance has undertaken an
analysis at a district level to identify where
we might have gaps between what we were
required to have in place in the past and
what the new national standards will require,”
Manager of Quality Systems and Risk Gary
Martin said.
The 10 National Standards for
Safety and Quality in Health Care
Standard 1: Governance for safety
and quality in health service
organisations
Standard 2: Partnering with
consumers
Standard 3: Preventing and
controlling health care associated
infections
Standard 4: Medication safety
Standard 5: Patient identification
and procedure matching
Standard 6: Clinical handover
Standard 7: Blood and blood
products
Standard 8: Preventing and
managing pressure injuries
Standard 9: Recognising and
responding to clinical deterioration
in acute health care
Standard 10: Preventing falls and
harm from falls
“A set of recommendations has been
developed to address these gaps.”
As part of this, the Executive Leadership Team
has appointed an executive leader for each of
the 10 standards to drive the process forward
and clinical sub-committees have produced a
suite of fact sheets on every standard.
“Some services, including the McIntyre
Cluster, the Upper Hunter Cluster and Mental
Health have already undergone their own gap
analysis,” Gary said.
“The evidence requirements of the new
standards are pretty significant, so it’s
important that we are as prepared as we can
be.”
So it’s all hands on deck to prepare for the
transition.
“Everyone’s furiously working away,”
Gary said. “All of our services that require
accreditation will be tested on a minimum of
standards one, two and three by December
2013,” he said.
Hunter New England Health will transition fully
to the National Standards exclusively in 2014.
If you would like more information
contact Clinical Governance or visit www.
safetyandquality.gov.au/our-work/accreditation/
6

A fresh approach to saluting Excellence
Do you know a colleague,
leader or volunteer who
displays exceptional skills
or qualities in their everyday
work
Perhaps you know someone
who literally deserves to have
their name up in lights
Hunter New England Health’s
annual awards program helps
recognise and celebrate
outstanding individual and
team achievements, as well
as commitment to innovation
and quality of care for our
patients.
This year the awards have been refreshed to more strongly align to
HNE Health’s strategic goals and the principles of Excellence.
The overall program has been renamed the Excellence Awards, and
will feature both the Quality Awards as well as a refined number of
Achievement Awards.
“Each year our staff work tirelessly to deliver high quality care for
patients, and each year I’m pleased to hear about teams who go
above and beyond the call of duty to provide services that exceed
expectations. The 2013 Excellence Awards are designed to capture
this spirit and commitment,” Chief Executive Michael DiRienzo said.
EXCELLENCE
AWARDS2013
Quality & Achievement
The 2013 Excellence Awards dinner
will be held on Wednesday, 21
August at Newcastle City Hall. At
the event, winners of the Quality
Awards and Achievement Awards
will be announced.
The refined Achievement Award
categories now include Leader
of the Year, Clinical Team of the
Year, Support Team of the Year,
Outstanding Contribution, and
Volunteer/s of the Year. There will
also the opportunity for the Chief
Executive to give an "Excellence
Award".
Quality Award categories are likely to include Keeping People
Healthy to Avoid Unnecessary Hospitalisation, Improving Access
to Timely Quality Health Care -Improving Quality and Safety, and
Improving Access to services when and where needed, Empowering
Patients, Improving Primary Health Care in the Community,
Collaboration – Working as a team and Building the Health
Workforce
If you know of a high achiever who deserves recognition, be sure to
nominate them in this year’s awards program. Entries for both the
Quality Awards and Achievement Awards open in early March. Keep
an eye on the intranet page http://intranet.hne.health.nsw.gov.au/
awards for information as it comes to hand.
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hnehealth.nsw.gov.au 7

Kidney transplant a gift of brotherly love
Steven Kendaura would do anything for his
big brother, but the gift that Steven offered did
cause some turmoil for Kapiro Kendaura.
Steven, a robust 36-year-old school teacher,
wanted to donate one of his kidneys to save
his brother’s life.
“Steven’s a healthy sort of bloke and for him
to go into all that… it’s a big stress for him,
psychologically and physically, and he’s got a
young family, so I was really troubled inside,”
Kapiro Kendaura said.
But Steven’s mind was set and his decision
was part of a cascade of events and kindness
which saved Kapiro's life and restored him to a
community that depends on the 38-year-old.
Kapiro Kendaura is a doctor. He was acting
Director of Medical Services at Goroka
Hospital in Papua New Guinea, when kidney
failure turned him into a patient; a patient with
only months to live.
Needing specialist care, Kapiro was
transferred to Port Moresby Hospital, where he
confronted the idea that time was closing in.
“I’ve been into the grave, walking in the valley
of death,” he said.
But a chance encounter spun destiny’s wheel.
John Ferguson, the Director of Infection
Prevention and Control for Hunter New
England Health, was making one of his regular
lecture tours to Port Moresby, when he learned
of Kapiro’s situation.
The PNG medical fraternity was fundraising
to pay for Kapiro’s care and dialysis, but the
money was running out.
Dr Ferguson went to work on a complex plan;
a plan that would involve diplomats, medical
authorities in both countries, the specialist
transplant team at John Hunter Hospital, and
the staff of Hunter New England (HNE) Health.
Money was donated by staff to a special fund
to aid Kapiro’s medical rescue.
When Steven stepped forward, offering
himself as a donor, the plan accelerated, but
urgent visas were required, including medical
clearances to allow Kapiro’s transfer to
Australia. He had suffered TB as a child and
there would be no transfer until tests showed
he was clear of disease.
The brothers have a strong Christian faith and
they prayed as the obstacles were steadily
moved aside.
Travelworld Newcastle stepped in to pay for
some of the airfares and in late October 2012,
the Kendaura brothers arrived at John Hunter
Hospital. They met their transplant physician,
Dr Paul Trevillian, who is director of the
hospital’s transplant unit. The men were also
introduced to the transplant surgical team,
director of infection prevention and control, dr john feguson, steven kendaura, dr kapiro kendaura & director o
Dr Phillip Sprott and Dr Munish Heer, and
transplant coordinators, Ann Stein and Deidre
Davidson.
As Kapiro attended dialysis sessions, Steven
was briefed about the process and prepared
for the donation of his kidney. His wife Andi
and their daughter were with him all the way.
“I’ve been a bit scared because I’ve never
been through any kind of major operation so I
was a bit fearful, but I know that the good Lord
is with us and everything will run smoothly.
“My faith helps me through the operation,”
Steven said.
In early December, the transplant went ahead.
Three days later, Dr Trevillian shared a crucial
message:
“Great news! Kapiro’s biopsy shows no
rejection. Steven is also making an excellent
recovery."
Today, two months since surgery, Kapiro is
doing very well and he’s about to resume
work in Goroka, this time as the head of the
region’s new clinical school.
Kapiro will need years of ongoing support
in PNG and might he need assistance to
maintain treatment with the expensive
immunosuppressive medication.
Acts of compassion and kindness can often
resonate into the future, and we’re seeing that
now.
The staff fund which helped the Kendaura
family will stay in operation, operating as the
PNG Compassionate Project Fund, ready to
lend support for future medical rescues.
Back in PNG, Kapiro confronts a troubling fact
about kidney disease in his country.
“Right now, 90 per cent of people with kidney
problems die, because we don’t have dialysis
set up in public hospitals," he said.
His faith and his energy are now squarely
focused on these machines.
Kapiro says he doesn’t know how to thank all
the people who stood with him on his journey.
But he may be staring at the answer. His
benefactors could think of no better result
than a campaign to save even more people,
in a country that struggles to achieve the level
of medical care other countries accept as
normal.
Kapiro will work to build his medical networks
in Australia and around the world, hopefully
finding ways to source the dialysis equipment
that could extend the lives of so many of his
compatriots.
8

Keeping kidneys viable
Dr Paul Trevillian is also a proud advocate of the newly established Hunter Transplant
Research Foundation.
The partnership with the Hunter Medical Research Institute, the foundation is conducting
translational research into projects that will directly benefit patients undergoing renal
transplantation.
The Foundation has two main goals:
• The first is the investigation of ways to maintain the condition of kidneys from a
deceased donor. For all the advances in transplantation, kidneys still suffer damage
while diffused in cold solutions. The bodies of recipients detect that damage and try to
kill the damaged cells, complicating recovery. The researchers are looking for ways to
mask the damage in donor kidneys to minimise the rejection process in the recipient.
• The second crucial arm of the research involves transplantation tolerance. The team
is looking for ways to give initial treatment to transplant recipients, which would mean
they don’t have to take anti-rejection drugs for the rest of their life.
Potentially, it’s research that will increase the availability of viable donor kidneys and
improve the longer term survival of donor recipients. This research also has the potential
to discover a range of benefits outside of transplantation, assisting patient groups such as
stroke and heart attack victims.
You will hear much more about this ground-breaking team.
f tansplant services dr paul trevillian
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hnehealth.nsw.gov.au 9

Clinician opinion
Palliative Care Research
Calvary Mater Newcastle
Conducting research in palliative care is imperative to ensure that
people with palliative care needs receive quality, evidence-based
care. It is important that regardless of whether or not a patient with
palliative care needs is seen by a palliative care service, the patient
will have the same access to evidence-based recommendations.
Many people do not realise the difficulties involved in accessing
medications faced by patients who wish to remain in their own
homes.
For people who want to receive palliative care at home, often they
are unable to access or afford the medications they need. This is
a particular problem for patients who are living lengthy distances
away from specialist palliative care services.
The use of medications to help maintain quality of life during the
terminal phase is an important aspect of palliative care currently
being addressed under the National Palliative Care Program. One
of four key goals of the program is to improve access to palliative
care medications in the community.
The Department of Palliative Care at Calvary Mater Newcastle first
became involved in clinical trials in August 2008; since then we
have expanded in both the number of studies we are involved in
and the number of designated research staff.
Most of the clinical trials conducted in our unit are funded by the
Palliative Care Clinical Studies Collaborative who were formed
under the National Palliative Care Program.
Supporting access to appropriate medicines to help maintain
comfort and function during the terminal phase of a person’s life
when people are being cared for at home is one the main focus of
the collaborative.
The research we do assists to gain the evidence to support the
addition of medications to be listed on the pharmaceutical benefits
for palliative care. This will allow a greater number of people
receiving palliative care to access their medicines in the community
at a more affordable cost.
Naomi Byfieldt, Clinical Trial Coordinator and Conjoint Professor
Katherine Clark, Director
Love your work
Annie Inder
Nursing Unit Manager,
Upper Hunter Community
Health
Tell us about your role. Can
you describe a typical day
Busy! Unpredictable!
There’s no such thing
as a typical day. Liaising
with staff, clients and
other service providers
is part of everyday, as is
reviewing and adjusting
service delivery to meet the
needs of our community
and our organisational
goals, while providing the
best community nursing
services possible.
When and why did you decide
to become a nurse and
what have been the most
significant changes you've
noticed
nurse unit manager, Annie inder
After working as a legal
secretary and becoming bored with an Arts degree, I decided training
as a nurse (yes, hospital-based) meant I could learn useful information
and earn money at the same time. I was attracted by the opportunity
to make a positive difference in the lives of people when they are most
vulnerable.
The most significant change I’ve noticed in nursing is moving the focus
back to the patient, with improvements in quality and patient safety.
What do you love about your job/what do you find most challenging
I love the unpredictable nature of my work, and I respect the expertise of
the highly skilled nursing team caring for clients from pre-birth to earth
and beyond.
Most challenging is supporting and leading these wonderful people
to juggle the demands upon them to provide the best care for the
community, and implement services in an atmosphere of changing
expectations.
What would you say to someone considering coming to work for Hunter New
England Health
I’m really proud of HNE Health’s adoption of Excellence. I believe it
has made a huge difference to the way we conduct our business. I feel
privileged to be a part of our new culture and would encourage others
who aim for excellence in healthcare to join our team.
What do you do in your free time that helps you create a work/life balance
I have a farming husband and four children who all keep me busy. I
must read to keep sane, and wish I could see more movies (the closest
cinema is 1.5 hours away). I need coffee with friends, and listen to audio
books on the long drive home from work. I am partial to both focused
and unfocused shopping, as well as compiling rosters and 90-day action
plans. Work/life harmony… I’m working on it!
10

Kaleidoscope news
Mothers support newborn testing for Fragile X Syndrome
Hunter Genetics GOLD Service Genetic Counsellors Jackie Boyle_Louise Christie and Carolyn Rogers
Fragile X Syndrome (FXS) is the most common cause of inherited
intellectual disability, affecting one in 4000 males and one in 6000 females.
Children with FXS do not have any physical features of the condition
at birth, which means the diagnosis is often delayed until parents or
health professionals become concerned about the child’s developmental
milestones.
In the first study of its kind in Australia, the Genetics of Learning Disability
(GOLD) service at Hunter Genetics has found overwhelming support for
newborn screening for FXS in postnatal mothers.
Genetic Counsellor Louise Christie said worldwide, FXS testing is not
currently included in routine newborn screening. In this study, mothers
were offered the option of including FXS testing into their newborn’s
routine newborn screening by testing DNA extracted from the ‘heel prick’
sample.
“Newborn screening for FXS can provide an earlier diagnosis, alleviating
the diagnostic odyssey for parents and allowing access to earlier
interventions,” Ms Christie said.
“It can also inform parents and extended family members of the FXS in the
family and the option of future reproductive choices.
“In Australia, the mean age of diagnosis is 5.5 years and many families
have a second child before the diagnosis is made,” she said
The study demonstrated a high uptake of newborn testing for FXS (94%)
with 2000 male and female newborns tested. Even though there is no cure
for FXS, mothers considered an early diagnosis as beneficial and wanted
the information to prepare for a child with additional needs.
More than two thirds of mothers wanted the information to assist in future
reproductive planning. Mothers showed little concern that the testing could
also detect carriers of FXS and the health implications for adult carriers.
The research was undertaken in collaboration with the Department of
Obstetrics and Gynaecology at John Hunter Hospital, the Department of
Molecular Genetics and Newborn Screening Program at The Children’s
Hospital, Westmead and is being published as a feature article in the
American Journal of Medical Genetics Part A in February 2013.
A smarter way to earn
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hnehealth.nsw.gov.au 11

Three's company
Team Leader, Jennifer Duncan,
Project Officer, Aimee Stazak & Data
Analyst Rhonda Walker
team leader jennifer duncan, project officer, aimee stazak & data analyst, Rhonda walker
The team responsible for delivering a clinical
services plan for the Hunter Valley is a meeting
of three very different skill sets.
Team Leader Jennifer Duncan, Data Analyst
Rhonda Walker and Project Officer Aimee
Stazak – the Leader, the Number Cruncher
and the Task Master – make up the Hunter
Valley Health Services Planning Team. Each
brings something different to the team and their
different backgrounds are serving them well.
Leadership is nothing new for Jennifer. In
addition to running a busy household (complete
with two very hyperactive puppies); she has
managed occupational therapists at Maitland
Hospital and throughout the Newcastle area and
been involved in the redesign of rehabilitation
services at Maitland Hospital.
The Hunter Valley project presented the
opportunity to apply her skills in a different way.
“I felt really inspired when this project came up. It
seemed like a really good opportunity to connect
with the community and staff across the region,”
Jennifer said.
“The transition from managing a large team
providing frontline services across a large
geographical area to having a small team in the
next room has been an exciting challenge. We
really support one another and everyone brings
something to the table.”
Rhonda, who comes from a data management
and epidemiology background, couldn’t
agree more. “I really enjoy our team – we all
communicate well with each other and we
work well together because we have similar,
straightforward natures.”
In addition to working in HNE Health, Rhonda
also lectures in Quality and Safety in Health
Care at the University of Newcastle, and says
her two roles complement one another.
“Working with students and their projects
exposes me to the practicalities and challenges
faced by health professionals. These insights
help me keep the people in mind when I’m
working numbers as part of the planning team.”
Aimee also takes her work into the classroom,
but as a student. In between renovating her
house, planning a wedding and working fulltime
on the project, she is also studying for a Masters
of Health Services Management.
Although she has worked in Planning and
Performance for a number of years, she
still loves working in such a dynamic and
challenging environment.
“I’m really enjoying the project because we’re
out talking to the community and working
towards equitable health outcomes for
everyone in the Hunter Valley. Plus, I can use
the theoretical knowledge I am learning in my
studies and apply it practically in my work,” she
said.
“Jennifer and Rhonda have such a passion for
Health, we work really well as a team.”
The Leader, the Number Cruncher and the Task
Master have embarked on the second round of
staff and community consultations throughout
the Hunter Valley, responding to issues and
concerns raised in earlier consultations and
consolidating plans for the future of health
services in the region.
Visit www.hnehealth.nsw.gov.au/hunter_
valley_health_services for more information.
Alternatively, direct any questions to the project
team (email hne-hvp@hnehealth.nsw.gov.au or
call 02 4939 2280).
12

Volunteer profile
Alysha Gill,
Occupational
Therapy Volunteer
When Alysha Gill proudly graduated from the
University of Newcastle in 2012 with a Bachelor
of Occupational Therapy (Honours), she
graduated with experience most of her fellow
students did not have.
For the past eight months 23-year-old Alysha has
been a volunteer with the Occupational Therapy
Department at John Hunter Children’s Hospital.
The motivation to volunteer came about following
a three month placement at the children’s
hospital for her degree.
“I enjoyed the placement so much I enquired
about becoming a volunteer while completing my
degree,” Alysha said.
“I do not see volunteering as a commitment, but a
fulfilling experience. I know every time I leave the
hospital I have made a difference in some way,”
she said.
John Hunter Children’s Hospital Occupational
Therapist Rachael Fallon said having a volunteer
who was in the later stages of their degree also
assisted the Occupational Therapy Department
with handwriting sessions and the evaluation of
groups.
“As Alysha had already spent time with us as a
student she already knew how groups were run
and was great assistance with guiding the clients
during the group’s sessions,” Rachael said.
“Having Alysha as a volunteer has provided
therapists with additional time to run groups and
the OT assistant to attend to other client matters.
Alysha has seen her time to date as a way
of giving back to the community and gaining
valuable training.
“My university lecturer encouraged all students
to engage in paid or un-paid work that had
transferrable skills to occupational therapy,”
Alysha said.
“I thought this was excellent advice, which is why
I pursued volunteering following my placement.
“There are many opportunities to learn new skills
which are relevant to future career paths,” she
said.
Fresh faces welcomed
Every year HNE Health sees a changing of the
guard as we welcome a new intake of nursing
and midwifery graduates.
Nurses and midwives play a major role in
coordinating care, and they are vital in our goal
to deliver excellence, for every patient, every
time.
New grads can choose to work in a range
of clinical settings, from our largest facility
John Hunter Hospital, to some of our smallest
facilities such as Barraba Multipurpose Service.
New graduates can also choose to spend their
(L-R) Federal Member for Parkes Mark Coulton, Debbie Key, Susan Sargent,
Sherri Shannon, Jessica Martin, Melissa Nelson, Claire Horton and NSW
Minister for Mental Health The Hon. Kevin Humphries.
first year in our mental health facilities.
Six new midwives joined maternity units across
the New England region last month (February)
following their graduation from HNE Health's
Rural Midwifery Education Program.
After a challenging year of full-time study
and on-the-job training with dedicated senior
midwives at Armidale, Inverell, Moree, Narrabri
and Tamworth, Claire Horton, Melissa Nelson,
Debbie Key, Sherri Shannon, Susan Sargent
and Jessica Martin entered the workforce as
fully fledged midwives.
All six graduates plan to
continue working in the
New England region.
Claire and Melissa are
at Armidale, Debbie is
at Inverell, Sherri takes
up a post in Moree,
Susan is in Narrabri, and
Jessica is working in
Tamworth.
Now in its 20th year,
the program has trained
more than 95 midwives,
many of whom have
stayed within the region
providing care in local
maternity units.
Between the
Flags
The Clinical Excellence Commission will
next month (April) conduct a number of
site visits within HNE Health, to support
the progress of the Between the Flags
program.
Feedback will be sought from clinicians
and managers on the successes and
challenges of the program, with HNE
Health’s Clinical Governance team
coordinating the visit.
The Between the Flags program is
designed to establish a 'safety net' in all
NSW public hospitals and healthcare
facilities that reduces the risks of
patients deteriorating unnoticed and
ensures they receive appropriate care in
response if they do.
The program uses the analogy of Surf
Life Saving Australia's Lifeguards
and Life Savers who keep people
safe by ensuring they are under close
observation and rapidly rescue them,
should something go wrong. For more
go to: www.cec.health.nsw.gov.au/
programs/between-the-flags
hnehealth.nsw.gov.au 13

News in brief...
50 years of nursing in Bingara
Judith Abra is taking some time to reflect and celebrate as she marks 50 years of
nursing, mostly achieved in her home town of Bingara.
She started training at St George Hospital in Sydney on 31 January,
1963 and by1967 she was fully qualified, and working back at Bingara,
a place she cherishes for its people and landscape. It’s also the place
where she met her husband Trevor and raised two sons.
“I am so glad for my career. I wouldn’t have been who I am without it.
It has been a wonderful journey,” Judith said.
Judith attempted to retire 10 years ago, but she kept the door open to
part-time duty, so the work never stopped.
“I’ve had lots of wonderful moments, good times, sad times, but the
good outweigh the bad," she said.
“The worst part of a country hospital; you deal with the emergency and
you deal with knowing the person. You become very strong.”
The staff of Bingara MPS helped Judith celebrate with a dinner at The
Playhouse Barraba.
Friends and colleagues join judith to celebrate her 50 years of nursing
There’s another celebration still ahead; 11 nurses who started training
at St George on that very same Thursday back in 1963 will join Judith for a dinner at
Bingara’s Imperial Hotel later this year.
Hunter Valley Health
Services planning project
The next round of consultations for the
Hunter Valley Health Services Planning
Project has begun.
population and ageing health infrastructure,
the plan is likely to show that business as
usual is not an option,' Dr Carter said.
Your say staff
survey
The project team (see Three’s Company
on page 12) will again be consulting widely
with HNE Health staff, clinicians and
community representatives from across
the Hunter Valley as it continues to build
a picture of the type of health services
needed for the future and how they should
be organised to deliver the best possible
health outcomes and value for our limited
health dollars.
“The team is reporting back on service
needs and challenges raised in initial
consultations last year and discussing
where to from here,” Director of Planning
and Performance Dr Sue Carter said.
But the consultations are just one part of
the puzzle. Data, policy directions and
reviews of the relevant literature will also
inform the clinical services plan for a
proposed new hospital in the Maitland area
and the existing network of public health
services in Maitland, Cessnock, Dungog,
Singleton, Muswellbrook and the Upper
Hunter.
"With a growing population, increasing
demand for health services, an ageing
“Healthcare and how we deliver it is
constantly changing and the cost is ever
increasing.
“Changes in thinking and new and
innovative models of care and service
delivery are needed if our health services
are to remain sustainable and affordable.”
The NSW Government has committed
$20million toward planning for improved
health services for the people of Maitland
and the Hunter Valley and to acquire land
for the proposed new hospital.
Expressions of interest to identify possible
sites for the proposed new hospital closed
at the end of January and the many
submissions received are now being fully
evaluated. That process, like the clinical
services planning, will be completed midyear.
See the project website at www.hnehealth.
nsw.gov.au/hunter_valley_health_services
for details and updates.
The Your Say workplace survey is just that – your chance
to have a say about what is working well and what isn’t.
“I want to hear what you say – this is your chance to
make a difference,” HNE Health Chief Executive Michael
DiRienzo said.
The workplace survey opens on 25 March and closes on 26
April.
“Your Say offers staff the opportunity to give their views
about issues which have an important influence on the
satisfaction and engagement with work,” Mr DiRienzo said.
“We want to find out what is working well and what we need
to work on or do differently so that we can improve the
workplace culture.”
Staff can find a link to the confidential and independently
run survey on the HNE Health intranet.
“It doesn’t take long to complete and is an opportunity to
really have your say.”
Your Say is being conducted across all of NSW Health and
the results will be available and fed back to individual Local
Health Districts later this year.
14

Social pics...
The NSW Minister for Health The Hon. Jillian Skinner toured the North
West Cancer Centre. She looked through the region's first radiation
therapy service, meeting new specialist staff along the way, before
meeting patients in the new medical oncology unit.
1. State Member for Tamworth Kevin Anderson MP, Radiation
Therapist Josh Herden, Radiation Therapist Alison McSkimming
and NSW Minister for Health and Medical Research The Hon.
Jillian Skinner.
2. Registered Nurse Emma Bates, State Member for Tamworth
Kevin Anderson, NSW Minister for Health The Hon. Jillian Skinner
and RNs Cameron Sipple and Alicia Cummins
After more than 28 years of dedicated service, Maitland Hospital
General Manager Executive Assistant, Sharon Carmody has retired.
Work colleagues farewelled Sharon at a morning tea in February.
3. Maitland General Manager Trish Wilson and retiring executive
assistant Sharon Carmody.
4. Admissions Clerk Lisa Stanaway, Acting Patient access Manager
Bernadette Bilney and Nurse Unit Manager Karen Cheers.
5. Management Accountant Velda Sturt, Clinical Support Officer
Sherril Jones and Ward Clerk Maria Stuhr help guest of honour
Sharon Carmody cut her farewell cake.
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hnehealth.nsw.gov.au 15

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