The COVID-19 initial assessment and management pathway includes information about vulnerable risk factors. This pathway is part of the COVID-19 suite of pathways.
Need a login? Request access here or contact info@healthpathwaysmelbourne.org.au
Better care for people with disability during COVID-19: Information for GPs and primary care providers.
Page last updated: 12:40pm, 1 December 2020
The nature of the COVID-19 response magnifies health issues and human rights concerns for people with disability. It is vital that primary care providers can continue to meet the needs and rights of people with disability during the pandemic.
People with disability are generally at greater risk of more serious illness if they contract COVID-19 as they may have chronic conditions or weakened immunity. People with disability may find it difficult or impossible to socially distance from others, including family members, carers and support workers. Some people may also find it difficult to implement basic hygiene measures and safely wear face masks.
People with disability may also find it more difficult than usual to access person-centred care, including telehealth.
Resources for people with disability and their families and carers are available on our website. The following resources will help GPs and primary care providers provide better care for everyone with disability in the North Western Melbourne Primary Health Network (NWMPHN) region during COVID-19.
The COVID-19 initial assessment and management pathway includes information about vulnerable risk factors. This pathway is part of the COVID-19 suite of pathways.
Need a login? Request access here or contact info@healthpathwaysmelbourne.org.au
The Australian Department of Health has established the COVID-19 Health Professionals Disability Advisory Service.
Health professionals can access this service by calling 1800 131 330 from 8:00am to 9:00pm, Monday to Friday.
The service provides specialised advice to health professionals responsible for the medical care of people with disability diagnosed with COVID-19 or experiencing symptoms.
This service is in place until 17 November 2020.
The Commonwealth Department of Health has published the following fact sheet:
This fact sheet provides information and guidance for primary health care staff and services, including GPs, who are providing care to people with intellectual or developmental disability during the pandemic.
People with disability may prefer to be tested at home due to impaired mobility, social anxiety, or difficulty travelling to you or other testing services. If these patients want to get tested at home, they may be able to access the Victorian Department of Health and Human Services (DHHS) Call-to-Test service:
Accessing the service
People with disability and their carers can:
More information
According to the Australian Human Rights Commission’s Guidelines on the rights of people with disability in health and disability care during COVID-19:
The statistics are clear: most GPs will regularly see patients who have disability. These include physical, sensory and intellectual disabilities, as well as psychosocial disabilities arising from a mental health condition.
The Australian Human Rights Commission has published an easy read version of its guidelines. These documents include practical examples and are recommended reading for anyone who cares for people with disabilities, including GPs, nurses and disability support workers.
The guidelines highlight:
Disability care is a broad area that includes physical, sensory and intellectual disabilities, as well as psychosocial disabilities arising from a mental health condition. There are many relevant pathways on HealthPathways Melbourne that can be found using the search function. Key pathways include:
Need a login? Request access here or contact info@healthpathwaysmelbourne.org.au
People with disability are at increased risk of poor mental health, abuse and violence during COVID-19. This is due to increased social isolation, potential disruption of services and support groups, and anxiety and stress.
The following services and resources are available:
As vulnerable members of our community, people with disability are at increased risk of abuse and violence at home and during care. This is especially true during COVID-19, which has meant increased time spent at home with family and increased stress within the home.
People have also been unable to leave home due to restrictions and reduced privacy may mean they are unable or unwilling to reach out for support. GPs should be conscious that assessing domestic violence through telehealth is difficult because they can’t be sure who else is around during the telehealth conversation.
The following services and resources are available:
The National Disability Insurance Scheme (NDIS) is a new way of providing individualised support for people with permanent and significant disabilities. People need to meet certain eligibility requirements to qualify for support under the scheme. Examples of disability given by the NDIS include physical disability, intellectual disability, and functional impairment resulting from a mental health condition.
The NDIS aims to provide support that fulfils each individual’s needs, such as home modifications, personal care, mobility aids and development of skills to help a person become more independent. It will also fund allied health and other therapy needed because of a person’s disability (such as behavioural therapy or speech therapy) but it is not intended to replace health or other public services.
GPs can assist by identifying patients who are likely to be eligible for the NDIS, directing them to current NDIS information and supporting them to apply. GPs can provide crucial evidence for patients’ access request forms when they apply to join the NDIS.
The Brotherhood of St Laurence is both the Early Childhood Early Intervention partner (for children 0-6 years old) and the Local Area Coordinator (for people over 7 years old) for the north western Melbourne region. The Brotherhood’s role is to work with individuals with disability to identify their support needs, apply to the NDIS, develop and use their NDIS plans, and link them to support and services.
Note that many people with disabilities are unable to access NDIS support as they may not meet the strict requirements (there are an estimated 4.4 million Australians with a current disability; around one in 10 are supported by the NDIS).
New Psychosocial Support Services are now available and can provide functional support to people with severe mental illness who are ineligible for NDIS services. These services are commissioned by North Western Melbourne Primary Health Network (NWMPHN) with funding from the Australian Department of Health.
Psychosocial Support Services can assist people to participate in their community, manage daily tasks, secure stable employment and housing, and connect with family and friends. They can help support people who are not eligible for NDIS supports.
Psychosocial Support Services use an evidence-informed, non-clinical approach. They provide support at the times when it is most needed and are flexible, timely and assist recovery. The length of support can range from eight weeks to a maximum of 12 months. Services can be one-to-one or group support. There is no requirement for a person to have a mental health plan.
Support can include the development of learning strategies and skills to help a person:
To be eligible for our Psychosocial Support Services a person must:
Anyone can refer to the service, including GPs. People can also self-refer.
See ‘Providers’ below for information on how to refer.
The following organisations provide Psychosocial Support Services in the North Western Melbourne Primary Health Network region:
Neami National provides services in northern Melbourne, including the local government areas of Darebin, Hume, Moreland, Yarra, Melbourne, Moonee Ponds and Macedon Ranges.
Contact number: 1300 052 588
Referral form
More information is available on the Neami National website.
cohealth provides services in western Melbourne, including the local government areas of Brimbank, Melton, Maribyrnong, Wyndham, Moorabool and Hobsons Bay.
Contact number: 03 9448 6880
Referral form
More information is available on the cohealth website.
Visit our System of Care search tool for more information on Psychosocial Support Services and other mental health services.
The following tips will help ensure your practice is accessible and welcoming for people with disability:
This includes ensuring you have:
Also consider supporting patients to access community transport or multi-purpose taxi programs if eligible.
This means ensuring you have:
For telehealth, note that:
Keep the following in mind when using telehealth or virtual consultations to manage patients with disability.
Assessment
Consider if your client can interact safely in this medium. Consider:
Access
Consider everything needed to interact technically in a telehealth consultation, including:
Availability
Assessing availability needs to be done as part of an initial assessment, but also needs to be performed on a per-session basis.
Preparation prior to session
When preparing for a telehealth or virtual consultation:
Beginning and during a session
When starting a session:
Remember that telehealth and especially virtual consultations can be fatiguing. Consider making the session short. It’s likely you will also have to ask more questions, as you can’t rely as much on visual cues —especially over the phone!
Ending a virtual consultation
A decision tool is available to help clinicians and consumers decide together when telehealth is a safe and effective option for care. The tool was developed in partnership between the Victorian Department of Health and Human Services and clinical experts and is suitable for all primary health care providers. It is available on the Safer Care Victoria website.
The following resources will help primary care providers support people with disability during COVID-19.
Supported Residential Services are privately operated residential homes where people with disability receive accommodation and support for daily activities.
Residential care includes group homes and respite services, usually with fewer than six residents, and Supported Residential Services that accommodate 10–80 residents.
The potential for COVID-19 to spread in these facilities and cause outbreaks and associated poor health outcomes is high, similar to the potential in residential aged care facilities. This is due partly to:
In addition, some people with disability have other chronic conditions or weakened immunity, making them vulnerable to severe COVID-19.
People with disability may also face difficulties implementing safety measures such as social distancing and wearing a mask, and basic hygiene such as washing hands.
The Victorian Department of Health and Human Services has a strategy in place that involves assessment of local Supported Residential Service providers by community health services (cohealth and IPC Health). This involves the review of systems and procedures and planning for a safe environment for residents should a COVID-19 outbreak occur. Planning involves infection control, prevention and preparedness strategies, outbreak management plans and recovery plans.
The aim is for residents to be able to remain in their home if they need to quarantine and self-isolate, unless they need to move for health reasons. However, relocation and repatriation of clients may be required in some circumstances. This is due to the complexity of the client cohort, as well as difficulties presented by shared facilities and the capacity of providers to prevent and respond to COVID-19 outbreaks.
This template assists with recording the needs of individual residents. It may be shared with services involved with working with the facility to prevent and respond where residents are exposed to COVID-19.
We recommend the following courses for GPs:
The following webinars are available to watch on demand:
The RACGP has a Disability Special Interests Group. Visit the RACGP website for more information on joining the RACGP to gain free membership of this group.
The following resources and support are available for disability support workers in the NWMPHN region during COVID-19:
DHHS: Disability services sector
This page includes information for people working in disability residential services and people who work in the community. It also includes information about PPE.
DHHS: Community services
This page includes:
Australian Department of Health: COVID-19 resources for disability services