Commissioned Integration Initiatives
GLAD
GP Liaison in Alcohol and other Drugs (GLAD) is a partnership with St Vincents Hospital Network, Sydney Local Health District and South Eastern Sydney Local Health District. It assists public drug and alcohol services to work collaboratively with general practice, improving professional relationships between specialist services and GPs, and ultimately, the health and wellbeing of the community. There were 471 referrals from/consults with GPs during 2023-24, and 1,307 occasions of service.
Support and advice for GPs and their patients is available Monday to Friday, including:
- Phone advice
- Assessments and treatment plans
- Collaborative/shared care
- Referral pathways
- Education for GPs and patients
- Practice visits.
”“I think the first thing is that it was my GP who sent the referral. She [the GLAD nurse] called me to arrange times and was always willing to accommodate me…it was just all really well organised. I feel I can be honest with my GP and the drug and alcohol nurse. I wish everyone could have the same support. The nurse gave me plenty of information on all aspects of the plan. The withdrawal was not nice but it’s done and I have not had a drink since.”
Patient feedback
”“GLAD has been an amazing service to link my vulnerable patients to the Local Health District’s drug and alcohol service. I hope this service will continue to expand to provide valuable specialist care to the community. Excellent support and education for patients and for me as a GP. Patient feedback on interactions always excellent regarding communication style and support.”
GP feedback
Case study
A 63 year old woman with a 20 year history of escalating alcohol use and dependence presented to the LHD Drug and Alcohol Service for an assessment to obtain assistance with her alcohol use. She was drinking 12 standard drinks daily and had a one year period of abstinence from alcohol, approximately 10 years ago. The client described a number of stressors in her life, including family conflict. She works four days per week in the retail industry.
Following the assessment, the GLAD nurse contacted the client’s GP to discuss the client’s situation and to determine his willingness to manage an outpatient withdrawal for the patient, with the support of the GLAD nurse. The GP was not confident in doing so, given he had not done this previously. The GLAD nurse discussed the medications to be prescribed to manage the withdrawal, and medication to assist the client to remain abstinent following the withdrawal. The nurse also advised the GP of the support and assistance that would be provided to both him and the client during this process. The GP agreed to manage the outpatient withdrawal with the support of the GLAD nurse. Arrangements were also made for the client to see a counsellor with the LHD Drug and Alcohol Service. She has engaged well and continues to attend on a regular basis. The client is gradually working on the stressors in her life and remains abstinent from alcohol.
By prescribing the medication for this patient, with the support of the GLAD Nurse, the GP is more confident in providing this treatment for other clients in the future. He now understands the support and advice that is available to him for any situations involving the management of alcohol or other drug problems amongst his patients.
GP Antenatal Shared Care (ANSC)
In 2023-24, Central and Eastern Sydney PHN supported Royal Hospital for Women to implement electronic antenatal eReferrals. This change is expected to streamline the referral process, improving accuracy and communication and reducing the administration burden, allowing GPs to focus more on patient care.
In 2023-24, Central and Eastern Sydney PHN appointed an external consultant to conduct a process evaluation of the GP ANSC program. High levels findings include:
- Patient-centered care: The GP ANSC model continues to positively impact individuals, by delivering personalised care and supporting continuity throughout pregnancy.
- Collaboration: Strong partnerships between hospitals services, LHDs and GPs notably enhance service delivery within the maternity care system
- Stakeholder goodwill: A large cohort of committed and knowledgeable healthcare providers, including GPs, hospital executives and liaison midwives, support the shared goals of maintaining the model as a safe and credible option for women with normal, low-risk pregnancies.
The PHN will work with LHD partners in 2024-25 to consider the recommendations from the evaluation to further enhance primary and acute care integration, provider experience and patient experience.
The GP ANSC program promotes continuity of care and patient choice through a model that shares clinical responsibility for a pregnant woman between their GP and local hospital. Central and Eastern Sydney PHN staff provide administrative and governance support, communicate key program updates, collaborate with HealthPathways and facilitate an extensive CPD program.
In 2023-24:
850
GPs were involved in the ANSC program.
820
participants attended 18 ANSC CESPHN run events.