Central West Health and Rehabilitation

P: (08)9965 0697 F: (08)9964 7528

News

Surfing Technique Evaluation - Lachie Jul 8th, 2015

Emerging Surf Skill Evaluation

Bottom Turn

Forehand

Backhand

Re-Entry

Forehand

Backhand

Cutback

Forehand

Backhand

Snap

Forehand

Backhand

Floaters

Forehand

Backhand

Finishes

Forehand

Backhand

Direct Debit Service Agreement and Terms Jun 25th, 2015

This is your Direct Debit Service Agreement with CENTRAL WEST HEALTH AND REHABILITATION (ABN 92160328803). It explains what your obligations are when undertaking a Direct Debit arrangement with us.

How to contact us

You can contact us directly or alternatively contact your financial institution. These should be made at least 7 working days prior to the next scheduled drawing date. You may contact us as follows:-

Phone: 08 99650697

Email: info@centralwestrehab.com

Mail: 4/12 Urch street Geraldton WA 6530

Definitions

account means the account held at your financial institution from which we are authorised to arrange for funds to be debited.

agreement means this Direct Debit Request Service Agreement between you and us.

banking day means a day other than a Saturday or a Sunday or a public holiday listed throughout Australia.

debit day means the day that payment by you to us is due.

debit payment means a particular transaction where a debit is made.

direct debit request means the Direct Debit Request between us and you.

us or we means CENTRAL WEST HEALTH AND REHABILITATION (ABN 92160328803) you have authorised by requesting a Direct Debit Request.

you means the customer who has signed or authorised by other means the Direct Debit Request.

your financial institution means the financial institution nominated by you on the DDR at which the account is maintained.

Debiting your Account

By entering into a Direct Debit Service Agreement or by providing us with a valid instruction, you have authorised us to arrange for funds to be debited from your nominated account.

If the debit day falls on a day that is not a banking day, we may direct your financial institution to debit your account on the following banking day. If you are unsure about which day your account has or will be debited you should ask your financial institution.

Amendments by us

We may vary any details of this agreement or a Direct Debit Request at any time by giving you at least fourteen (14) days notice.

Amendments by you

You may change, stop or defer a debit payment, or terminate this agreement by providing us with at least 7 days notification by writing to:

4/12 Urch street Geraldton WA 6530

By Email at: info@centralwestrehab.com

Your Obligations

It is your responsibility to ensure that there are sufficient clear funds available in your account to allow a debit payment to be made, and to update your credit card details after expiry of your credit card.

If there are insufficient clear funds in your account to meet a debit payment:

you may be charged a fee and/or interest by your financial institution; if fees or charges are incurred by us as a result of a dishonoured direct debit payment, we may pass the fees and charges on to you; and you must arrange for the debit payment to be made by another method or arrange for sufficient clear funds to be in your account by an agreed time so that we can process the debit payment. You should check your account statement to verify that the amounts debited from your account are correct.

Dispute

If you believe that there has been an error in debiting your account, you should notify us directly on 08 99650697 and confirm that notice in writing with us as soon as possible so that we can resolve your query more quickly.

If we conclude as a result of our investigations that your account has been incorrectly debited we will respond to your query by arranging for your financial institution to adjust your account (including interest and charges) accordingly. We will also notify you in writing of the amount by which your account has been adjusted.

If we conclude as a result of our investigations that your account has not been incorrectly debited we will respond to your query by providing you with reasons and any evidence for this finding in writing.

Accounts

You should check:

with your financial institution whether direct debiting is available from your account as direct debiting is not available on all accounts offered by financial institutions.

your account details which you have provided to us are correct by checking them against a recent account statement; and

with your financial institution before completing the Direct Debit Request if you have any queries about how to complete the Direct Debit Request.

Confidentiality

We will keep any information confidential. We will make reasonable efforts to keep any such information that we have about you secure and to ensure that any of our employees or agents who have access to information about you do not make any unauthorised use, modification, reproduction or disclosure of that information.

We will only disclose information that we have about you:

to the extent specifically required by law; or for the purposes of this agreement (including disclosing information in connection with any query or claim).

Notice

If you wish to notify us in writing about anything relating to this agreement, you should write to

CENTRAL WEST HEALTH AND REHABILITATION

4/12 Urch street

Geraldton WA 6530

By Email at: info@centralwestrehab.com

We will notify you by sending a notice by email to the email address you have provided in the Direct Debit Service Agreement.

Any notice will be deemed to have been received on the third banking day after posting

After Hours Gym - Waiver Jun 24th, 2015

This is an important document and you, or your guardian, should read it carefully. By completing the Central West Health and Rehabilitation After Hours Membership Waiver, you acknowledge that you have read and understand these terms and conditions.

Joining a gym is a ‘recreational activity’ involving physical activity. Physical activity and sport in general contain inherently dangerous elements, and participation involves an assumption of risk. Accidents can and do happen which may result in personal injury, death or property damage. Prior to joining, you should ensure you are aware and comfortable with the risks involved, including those risks associated with any health condition you may have.

To the best of our knowledge, the facilities and physical activity programs offered by Central West Health and Rehabilitation have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the activities. Because of the nature of the programs made available at Central West Health and Rehabilitation, and the equipment, which is an integral part of many of the activities, there is an inherent risk of injury which characterizes any exercise activity resulting in a practical limitation placed on Central West Health and Rehabilitation in its efforts to prevent injuries to participants, whether actively participating in exercises, utilizing the equipment or taking advantage of the various other facilities at the Centre.

Central West Health and Rehabilitation enlists your assistance in assuring that the facilities and the equipment are utilized in a proper manner so that the inherent risks which exist under the control of the Centre, as well as those outside the control of the Centre and partially within the control of each individual participant, are minimized by the participant’s thoughtful and cautious use of both the equipment and the facilities.

In consideration of the above factors, the undersigned participant acknowledges the existence of risks in connection with these activities assumes such risks and agrees to accept the responsibility for any injuries/illness sustained by him/her in the course of his/her use of the facilities and/or the equipment.

More specifically, the participant acknowledges and accepts risks in one or more of the following are as:

The use of exercise equipment.

Participation in related as well as unsupervised activities which are made available in the gym and other activities that may take place outside the Centre.

Possible injuries or medical disorders arising out of the participant’s exercising at the facilities, such as heart attack, stroke, heat stress or other injuries which may arise such as sprains, broken bones, torn muscles, torn ligaments, etc.

Accidents or injuries which occur within the facilities provided by Central West Health and Rehabilitation such as locker rooms, dressing rooms, and showers.

It is recommended that participants consult with their doctors or other trained health professional before engaging in any activities which are a part of your planned exercise program.

As the gym user, it is important you acknowledge the existence of and the need for certain rules and procedures concerning the use of the equipment and facilities that are a part of the Central West Health and Rehabilitation as set out in Appendix 2. He/She agrees to abide by those rules and to make every individual effort to assure that the equipment and facilities are kept in safe and usable condition. Any breach of the rules in Appendix 2 may lead to your gym membership being cancelled, or prosecution for more serious breaches.

By signing this form, you acknowledge, agree, and understand that commencing a gym membership may involve risk. You agree and undertake any such risk voluntarily and at your own risk. You acknowledge that the assumption of risk and warning above constitutes a 'risk warning' in accordance with relevant legislation, including the Civil Liability Act 2002 (WA).

It is possible for a supplier of recreational services or recreational activities to ask you to agree that statutory guarantees under the Australian Consumer Law (which is Schedule 2 of the Competition and Consumer Act 2010 (Commonwealth) do not apply to you (or a person for whom or on whose behalf you are acquiring the services or activities).

If you sign this form, you will be agreeing that your rights (or the rights of a person for whom or on whose behalf you are acquiring the services) to sue the supplier in relation to recreational services or recreational activities that you undertake because the services or recreational activities provided were not in accordance with the guarantees are excluded, restricted or modified as set out in Appendix 1.

Print Waiver to Sign

Next - Gym Safety

Centrals - Cardio Equipment Treadmills Jun 23rd, 2015

A treadmill is a piece of exercising equipment that consists of a conveyor belt rotated either manually or by a motor. The user will normally walk, jog or run on this device.

The most significant risk associated with the use of treadmills is friction burns, especially to young children playing on or near a treadmill. The results of these injuries can range from minor burns to serious burns requiring skin grafts and potential permanent loss of the use of hands or fingers.

Next - Safety Quiz

Back - Centrals Gym Safety Procedure

Centrals - Gym Safety Course Jun 23rd, 2015

The following pages provide information of exercise safety including:

General Safety and Exercise Technique

Strength Training with Free Weights

Cardio Equipment

Treadmills

Brief quiz to confirm you have watched all the videos

Next - Strength Training with Free Weights

Back - Centrals Gym Safety Procedure

Centrals - Gym Safety Procedures Jun 23rd, 2015

To the best of our knowledge, the facilities and physical activity programs offered have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the activities. Because of the nature of the programs made available, and the equipment, which is an integral part of many of the activities, there is an inherent risk of injury which characterizes any exercise activity resulting in a practical limitation placed on Centrals in its efforts to prevent injuries to participants, whether actively participating in exercises, utilizing the equipment or taking advantage of the various other facilities at the Centre.

Centrals enlists your assistance in assuring that the facilities and the equipment are utilized in a proper manner so that the inherent risks which exist under the control of the Centre, as well as those outside the control of the Centre and partially within the control of each individual participant, are minimized by the participant’s thoughtful and cautious use of both the equipment and the facilities.

More specifically, the participant acknowledges and accepts risks in one or more of the following are as:

The use of exercise equipment.

Participation in related as well as unsupervised activities which are made available in the gym and other activities that may take place outside the Centre.

Possible injuries or medical disorders arising out of the participant’s exercising at the facilities, such as heart attack, stroke, heat stress or other injuries which may arise such as sprains, broken bones, torn muscles, torn ligaments, etc.

Accidents or injuries which occur within the facilities provided by Centrals such as locker rooms, dressing rooms, and showers.

It is recommended that participants consult with their doctors or other trained health professional before engaging in any activities which are a part of your planned exercise program.

As the gym user, it is important you acknowledge the existence of and the need for certain rules and procedures concerning the use of the equipment and facilities that are a part of the Centrals as set out in Appendix 2. He/She agrees to abide by those rules and to make every individual effort to assure that the equipment and facilities are kept in safe and usable condition. Any breach of the rules in Appendix 2 may lead to your gym membership being cancelled, or prosecution for more serious breaches.

Next - General Gym Safety

Back - Centrals Gym Safety Procedure

Centrals - Strength Training with Free weights Jun 23rd, 2015

Resistance training (also called strength training or weight training) is the use of resistance to muscular contraction to build the strength, anaerobic endurance and size of skeletal muscles. When you do resistance training repeatedly and consistently, your muscles become stronger.

Resistance training can be dangerous if your technique is not right. It is important to pay attention to safety and good form to reduce the risk of injury. If you are interested in starting resistance training, make sure you have an assessment and program written for your specific needs. Make sure you follow any medical advice and are shown the exercises by a physiotherapist, exercise rehabilitation professional or qualified gymnasium instructor.

Safety tips for resistance training

Proper technique is essential. If you’re not sure whether you’re doing a particular exercise correctly, ask a qualified personal trainer, gym instructor or exercise physiologist for help.

Start slowly. If you’re starting out, you may find that you’re able to lift only a few kilograms. That’s okay. Once your muscles, tendons and ligaments get used to weight training exercises, you may be surprised at how quickly you progress. Once you can easily do 12 repetitions with a particular weight, gradually increase the weight.

Only use safe and well-maintained equipment. Faulty equipment will significantly increase your risk of injury.

Don’t hold your breath. Breathe normally while lifting by exhaling during the exertion or harder phase and inhaling during the easier or relaxation phase.

Control the weights at all times. Don’t throw them up and down or use momentum to ‘swing’ the weights through their range of motion.

Maintain a strong form while lifting, as this will prevent injury through incorrect technique. Always lift weights within your own capabilities and slow down or stop if you feel the weight is out of control or too heavy.

Use the full range of motion. It is important when lifting a weight that it travels through the full range of motion of the joint. This develops strength of the muscle at all points of the motion of the joint and decreases the chance of injury through over-stretching.

Wear appropriate clothing and safety equipment such as gloves. Dress comfortably and practically (for example, wear clothes that do not restrict movement and allow you to sweat easily).

Maintain correct posture and body positioning (form) to reduce the risk of injury at all times.

Once you have finished a set, gently place the weights on the floor – don’t drop them. Otherwise, you could injure yourself or people nearby.

Don’t train if you are over-tired or feeling ill.

Don’t try to train through an injury. Stop your workout immediately and seek medical advice.

Muscle needs time to repair and grow after a workout. A good rule of thumb is to rest the muscle group for at least 24 hours before working the same muscle group again.

Next - Cardio Equipment

Back - Centrals Gym Safety Procedure

Centrals - Cardio Equipment Jun 23rd, 2015

Aerobic (cardiovascular) fitness is one of the most important components of physical fitness. Cardiovascular fitness is measured as the amount of oxygen transported in the blood and pumped by the heart to the working muscles and as the efficiency of the muscles to use that oxygen. Increasing cardiovascular fitness means increasing the capability of the heart and the rest of the cardiovascular system in their most important task, to supply oxygen and energy to your body. Cardiovascular fitness is related to age, gender, exercise habits, heredity and cardiovascular clinical status.

Having good cardiovascular fitness has many health benefits. For example, it decreases your risk of cardiovascular diseases, stroke, high blood pressure, diabetes and other diseases.

Cardiovascular fitness is best improved by activities, which employ large muscle groups working dynamically. Such activities include walking, jogging, running, swimming, skating, cycling, stair climbing and cross-country skiing.

Next - Treadmills

Back - Centrals Gym Safety Procedure

After Hours Gym - Strength Training with Free Weights Jun 20th, 2015

Safety tips for resistance training

Proper technique is essential. If you’re not sure whether you’re doing a particular exercise correctly, ask a qualified personal trainer, gym instructor or exercise physiologist for help.

Start slowly. If you’re starting out, you may find that you’re able to lift only a few kilograms. That’s okay. Once your muscles, tendons and ligaments get used to weight training exercises, you may be surprised at how quickly you progress. Once you can easily do 12 repetitions with a particular weight, gradually increase the weight.

Only use safe and well-maintained equipment. Faulty equipment will significantly increase your risk of injury.

Don’t hold your breath. Breathe normally while lifting by exhaling during the exertion or harder phase and inhaling during the easier or relaxation phase.

Control the weights at all times. Don’t throw them up and down or use momentum to ‘swing’ the weights through their range of motion.

Maintain a strong form while lifting, as this will prevent injury through incorrect technique. Always lift weights within your own capabilities and slow down or stop if you feel the weight is out of control or too heavy.

Use the full range of motion. It is important when lifting a weight that it travels through the full range of motion of the joint. This develops strength of the muscle at all points of the motion of the joint and decreases the chance of injury through over-stretching.

Wear appropriate clothing and safety equipment such as gloves. Dress comfortably and practically (for example, wear clothes that do not restrict movement and allow you to sweat easily).

Maintain correct posture and body positioning (form) to reduce the risk of injury at all times.

Once you have finished a set, gently place the weights on the floor – don’t drop them. Otherwise, you could injure yourself or people nearby.

Don’t train if you are over-tired or feeling ill.

Don’t try to train through an injury. Stop your workout immediately and seek medical advice.

Muscle needs time to repair and grow after a workout. A good rule of thumb is to rest the muscle group for at least 24 hours before working the same muscle group again.

Next - Cardio Equipment

After Hours Gym - Exercise Safety Jun 20th, 2015

Following are a number of short videos on exercise safety. To confirm you have watched each there is a brief quiz.

Next - Strength Training with Free Weights

After Hours Gym - Treadmills Jun 20th, 2015

A treadmill is a piece of exercising equipment that consists of a conveyor belt rotated either manually or by a motor. The user will normally walk, jog or run on this device.

Next - Safety Quiz

Jun 20th, 2015

After Hours Gym - Cardio Equipment Jun 20th, 2015

Having good cardiovascular fitness has many health benefits. For example, it decreases your risk of cardiovascular diseases, stroke, high blood pressure, diabetes and other diseases.

Next - Treadmills

The management of musculoskeletal disorders in the workplace Jun 16th, 2015

On balance, well-designed work carries net health benefits. Poorly designed work and unemployment are major social determinants of health inequalities. In some cases, a patient's work may have contributed to the development of their musculoskeletal disorder (MSD), or may lead to deterioration in their disorder.

Physical factors at work such as frequent or prolonged work in awkward postures or exposure to vibration may result in specific MSDs, for example, osteoarthritis of the hips in certain groups of farmers. Non-specific disorders, such as diffuse arm pain, are much less likely to be caused by physical factors at work.

Care must be taken before attributing work as the cause of an MSD; causation is usually multifactorial and work may not be the only or even the main cause. Many factors come into play, including physical and psychological aspects of the job, relationships with managers and peers and the worker's perceptions of organisational justice.

If it is believed that work has contributed to, or aggravated, a patient's disease or disorder, there is a duty to try to ensure that other workers in the same environment are not further exposed to the same risk (primary prevention). If an injuried worker is to return to the same working environment, they should endeavour to ensure that exposure to an ongoing hazard is minimised (secondary prevention).

If the patient works for an organisation that has access to injury management services, the best approach is to contact the service and explain your concerns (provided your employee consents to you doing this).

Next- Assessing Fitness for Return to Work

Physical Assessment and Return to Work Jun 16th, 2015

Work health and safety laws in Australia and other jurisdictions also require employers to provide a "safe system of work". For example, section 19 of the Work Health and Safety Act 2011 states that the "primary duty of care" is to "ensure, so far as is reasonably practicable, the health and safety of workers" by, among other things, "provision and maintenance of safe systems of work".

Pre-employment physical assessments provide vital information for such decisions, and will find more and more value as our workforce gradually ages over the coming 2-3 decades. Information gained form Physical Assessments can also be helpful in establishing pre-existing physical capacity, whch asssits in establishing return to work goals.

It is important for recruiting employers to make clear to applicants the reason why health-related questions are asked pre-employment and the purposes for which the information will be used.

Once a job has been offered, and accepted employers may, if they wish, ask additional medical questions. If a condition is revealed that might cause the candidate problems in performing the job, then adjustments must be considered. If no adjustments are possible, or the adjustment is not considered to be reasonable by the employer, then the job offer may need to be withdrawn.

It is important that an organisation ask the advice of medical/health professionals before turning down an individual for work on health grounds.

Summary

RTW is most successful if a clear return to work plan is agreed upon; the employer is willing to make adjustments to the person's job or working environment and all health-care workers involved with the patient communicate with each other .

Main Points

Be inclusive in your RTW process, by considering what injuried employees can or may be able to do, rather than what they cannot do.

It is important an employer can entertain reasonable adjustments recommended by an employees treating GP. Alternatively an employer must be ready to provide suitable alternatives to enable employees with MSDs to return to work, stay in work or access work.

There is strong evidence that return to work is most successful if it involves a partnership and understanding between employers, the worker and health-care professionals.

There is strong evidence that temporarily modified work can facilitate early return to work.

Assessing Fitness for Return to Work Jun 16th, 2015

'Worklessness' has profound negative effects on the injuried individual and their family. People who are unemployed suffer from poorer general health and they are more likely to participate in risk-taking behaviours such as alcohol and drug abuse, sexual promiscuity and smoking.

Unemployment also leads to wider social inequalities, and economic stress can impact on families with implications played out over decades. Importantly, regaining work may reverse these adverse health effects, and re-entry into work leads to an improvement in health.

There are several principles that health-care professionals need to take into account when assessing an individual's fitness for work.

Safety

It is important to consider not only if the person is likely to be able to perform their duties effectively, without harm to themselves, but also if the patient's return to work may lead to risk to others.

Inclusive approach

Individuals do not need to be symptom free to work. Many medical conditions, and virtually all minor health problems, have minimal implications for work and should not prevent employment.

The majority of people who are off work due to MSDs return to work within 4 weeks without vocational rehab advice or intervention. The priority at this stage is to support and encourage restoration of function and to avoid exacerbating disability, as there is evidence that occupational outcomes for most people with MSDs are improved by early return to some work.

Once an individual has been off work with an MSD for 4 weeks, an intervention to assist return to work is more likely to be required. By 26 weeks of absence, incapacity is likely to have become entrenched and rehabilitation becomes much more difficult. Therefore, the period of 4-26 weeks is often referred to as the ‘window of opportunity’ for effective return-to-work management.

Medical fitness should be assessed in relation to the particular demands of the work, such as hours; shiftwork; exposure to physical, chemical, biological and psychosocial hazards; work relationships; physical work environment; and requirement to travel.

An in-depth knowledge of the workplace and the duties of the job invaluable when assessing a employees fitness for work. Another reason this process should be done by the workplace injury management co-ordinator or injury management provider. OH service. If such a person is not available majority descisions regards fitness to work are therefore undertaken by general practitioners (GPs) or hospital-based health professionals. These individuals often have limited knowledge of an employees workplace and roles.

Assessment of work capability is complex, and despite its importance, there is very limited scientific evidence to base RTW decisions on in part as there is no standard or valid methodology for assessing suitability for RTW used over all professions.

Outcomes from fitness for work assessments may range from ‘fit’ to ‘unfit’, with intermediate categories such as ‘fit subject to work modifications’, ‘fit with restrictions’ or ‘conditionally fit (temporarily, permanently)’. Workplace modifications to improve or adjust working conditions should always be considered.

Suitable Duties

Adjustments to work may be temporary or permanent, and they may take many forms. They may include shorter working hours, different shift patterns, avoidance of manual handling or transferring someone from a physical to a sedentary post.

For example, an employee with arthritis may benefit from starting work slightly later in the morning to allow time for the medication to take effect and early morning stiffness to reduce.

It is important to consider how individuals travel to work. Employers may be able to provide workers with a parking space to facilitate their access to work. Individuals who use public transport may temporarily or permanently benefit from travelling before or after the rush hour, so as to ensure that they get a seat.

Return to Work

Patients should be forewarned that they are likely to experience disproportionate fatigue on return to work. This symptom is likely to be more prominent in individuals with inflammatory MSDs. This can be mitigated in some cases by simple strategies such as returning to work on alternate days for the first week; returning in the middle rather than the beginning of the working week; and, if possible, working shortened hours, gradually increasing to usual working hours over a period of a few weeks.

Next - Pre-employment Physical Assessments

Diabetes Support Group Jun 15th, 2015

Centrals - Physical Activity Readiness Questionnaire Jun 11th, 2015

The following is a standardised Physical Activity Readiness Questionnaire. If you answer yes to any of the following questions it is strongly recommended you discuss your answers with your Doctor or a suitable health professional.

Once completed you will be provided a link to continue the gym use process.

Centrals - After Hours Gym Safety Questionnaire Jun 11th, 2015

To confirm you have completed our gym safety induction please answer the following questions.

Gym Program - Beginner 1 Jun 8th, 2015

Lunge

Half Pushup

Lat Pulldown

Seated Row

Bicep Curl

Tricep Pushdown

Lateral Dumbell Raise

Sidge Bridge

Bird Dog

Gym Program - Beginner 2 Jun 8th, 2015

Leg Press

Bench Press

Lat Pulldown

One Arm Row

Bicep Curl

Tricep Pushdown

Lateral Dumbell Raise

Sidge Bridge

Bird Dog

Medical Observer - Pharmacyâ€™s $19b deal a â€˜politicalâ€™ move May 29th, 2015

This article was written by Flynn Murphy and appeared in today's Medical Observer.

DOCTORS and consumer groups say the government has folded to the pharmacy sector with a new $19 billion agreement that puts politics above patient care.

As general practice shoulders the burden of an MBS rebate freeze, the massive funding boost for pharmacies includes a doubling of the allocation for pharmacy-delivered primary care to $1.26 billion.

Health Minister Sussan Ley introduced the legislation on Wednesday, telling parliament the Sixth Community Pharmacy Agreement would let the sector “innovate and transition from a focus on medicines supply to medicines management and pharmacy services”.

As previously revealed by Medical Observer, wound care programs, staged supply of medicine for mental health, and basic arthritis checks are likely beneficiaries of $600 million in new and expanded pharmacy services.

No specifics have yet been announced. A $50 million Pharmacy Trial Program will be established to decide which of the services meet the cut, and new and existing programs will need to be approved by the Medical Services Advisory Committee (MSAC) to be funded.

Existing services like medication adherence and medication management programs, including clinical interventions, have been allocated $613 million.

That’s despite what RACGP head Dr Frank Jones says is a lack of evidence such programs have worked.

“We wrote a strongly worded letter to the minister [in March] suggesting that there was little evidence provided – at least publicly – that what pharmacists were doing was improving patient care,” Dr Jones said.

“After that there was not really much feedback; negotiations continued between the department, the minister and the pharmacists.”

Dr Jones said the government had “given in” to the pharmacy sector.

“Our views were very plain right from the start – we really wanted to know where these dollars were going to improve patient care.”

A Pharmacy Guild of Australia spokesman said pharmacy-delivered programs were evidence-based and he did not expect any of the current programs to be knocked out by the MSAC.

He ruled vaccination programs out of the process, saying they were paid for by patients rather than the government.

Dr Brian Morton, AMA chair of general practice, said it was “amazingly short-sighted and hypocritical to give such a massive handout to the pharmacists – specifically the massive handout for expanding their scope of practice and doing primary care”.

“It’s not the way to design a healthcare system. If you’re treating a minor wound, a pharmacist would have a direct conflict of interest – are they going to sell them the cheapest dressing? Or a particularly expensive one? An ointment that could be complementary?”

Dr Morton said the money should be spent on establishing a Practice Incentives Programme payment for GPs to employ non-dispensing pharmacists in their clinics.

“That’s where there will be significant returns to quality prescribing,” he said.

Dr Jones said the agreement was a “political decision” and questioned whether it was good scientific practice to hand out the money before a two-year pharmacy review had been carried out, particularly in light of a scathing audit report about the previous agreement.

“Why didn’t we look retrospectively at what’s happening to see whether we’re spending money sensibly, as opposed to doing it prospectively when the money’s actually been given to them?”

The Sixth Community Pharmacy Agreement is one plank of the government’s five year Pharmaceutical Benefits Scheme Access and Sustainability Package, which also includes an agreement with the Generic Medicines Industry Association.

An agreement with Medicines Australia will see drug manufacturers absorb around $6.6 billion in PBS cuts.

Medicines Australia CEO Tim James said: “In response to the government’s budgetary challenges, we have agreed to meet all of the government’s savings targets… Our members have been given a number of undertakings and concessions regarding any future price-related savings throughout the life of the agreement.”

Medicines Australia and the Pharmacy Guild had both rattled their sabres in the lead-up to the federal budget, but observers say the guild came out on top while the medicines body bore the brunt of the government’s quest for budget savings.

Consumers Health Forum head Leanne Wells welcomed the measures to bring down the prices of some drugs, to announce the listing of new drugs and the introduction of an optional $1 discount on prescription medicines – which is still being fought by the guild.

But she called the pharmacy agreement a “lost opportunity to drive reforms to loosen the grip of pharmacy owners on the anti-competition rules and provision of patient services”.

Australian Doctor - Diabetes Care Project fails on cost May 25th, 2015

This article was written by Michael Woodhead and appeared in today's Australian Doctor.

A three-year trial of capitation and pay-for-performance funding for GP diabetes care has shown they are much more expensive than the existing MBS items.

The $34 million Diabetes Care Project program involved 184 general practices and 7781 patients with type 1 or type 2 diabetes and was meant to test alternatives to the current MBS items for chronic disease management.

While the trial - one of the biggest in Australian general practice - showed that new funding models improved HbA_1c and other clinical outcomes, there was a higher overall cost of $203 per patient than existing Medicare item-based care.

The cost was so large that researchers said the funding model used in the trial would not be value for money.

The pilot of an enrolment-based ‘healthcare home' model replaced GP Medicare payments and care plans with a flexible funding model that included lump-sum payments per patient and funding for care co-ordinators.

When adopted by practices in Victoria, Queensland and SA, patients had a statistically significant 0.2% improvement in HbA_1c compared with a control group.

Improvements were also seen in outcomes such as blood pressure, lipids and waist circumference, as well as for aspects of diabetes care such as care-plan take-up, completion of recommended ‘annual cycles of care,' and allied health practitioner visits.

However, the program that offered general practices flexible payments of $200-300 per diabetes patient would not be cost-effective if implemented on a wider scale, the evaluation report concluded.

Despite reducing hospitalisation costs by $461 per patient, the Diabetes Care Project had an estimated cost per QALY of $100,000 to $250,000, well below the threshold of $50,000 deemed necessary for cost-effectiveness.

The report authors said a diabetes co-ordinated care program might be cost-effective if funding was targeted more at the highest-risk patients.

Their analysis showed that more than 60% of costs were incurred by 5% of patients with complex needs.

They therefore recommended a ‘re-calibrated' program with funding of up to $700 for high-risk diabetes patients and $100 for low-risk patients.

Dr Gary Deed (pictured), a GP with a special interest in diabetes, said the modest changes in clinical outcomes were achieved at a high cost, and one of the main lessons from the Diabetes Care Project was the need to focus on the highest-risk patients with diabetes.

"The project didn't really address the frequent flyers, the highly complex patients and their risk stratification. So really, the study may be telling us that we need more evidence before we implement broad changes to funding models in diabetes care," he told Australian Doctor.

The evaluation report also showed that when implemented without the flexible funding component, the use of IT tools for care planning and Continuous Quality Improvement processes did not improve outcomes.

Federal Health Minister Sussan Ley said the findings from the Diabetes Care Project report would be considered by the Primary Health Care Advisory Group, whose remit was to develop innovative care and funding models for people with complex and chronic illness.

It would also be used to inform the National Diabetes Strategy, with the consultation period for the advisory group extended to 31 May to allow time for feedback on the Diabetes Care Project report.

Couch to 2k Initial Questions - HBF Geraldton RunFest Program May 21st, 2015

On clicking the 'submit' button you will be provided a link to your running program and a brief clip on running technique. We are collecting a name and email address in the event that some form of correspondence is required.

Enjoy!

Do Patients Return to Sports and Work After Total Shoulder Replacement Surgery? May 21st, 2015

Total shoulder arthroplasty (TSA) is a well-established treatment option for degenerative pathologic abnormalities of the shoulder joint and has shown satisfactory long-term functional outcomes.

As life expectancy increases and shoulder replacement surgery is routinely performed in young and active patients with degenerative conditions as well as in the elderly population, new goals of shoulder joint replacement are becoming more important, such as the ability to resume sports and return to work.

The above study demonstrated a good rate of successful return to sports in patients undergoing TSA with primary glenohumeral arthritis. Overall, 57% of patients who had ever participated in sports in their lives were doing so at final follow-up. All patients that participated in sports right before surgery were successfully able to return.

The results for return to work were far less encouraging; however, it is important to note most of the study participants were retired at the time of follow-up.

While only 14% of patients were able to return to work after shoulder replacement surgery. Using statistical assumptions, the authors suggest the majority of participants (61%) did not retire or stop their work because of TSA.

30 patients (20%) had to change their work because of shoulder replacement surgery. Six patients (3.9%) of the entire cohort were not pursuing their work at the time of recent follow-up because of problems with the affected shoulders.

It is encouraging that a large proportion of patients did progress back to normal recreational activities following TSA, which would suggest that the RTW outcomes may also be more favourable in a younger, currently working population.

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