New $12m program rolling out regional diabetes care

From L-R: Richard Nankervis (CEO of Primary Health Network), Michael DiRienzo (CEO of HNELHD), Professor Frances Kay-Lambkin (Institute Director of HMRI), Professor Chris Levi (HMRI Board Member), Associate Professor Shamasunder Acharya (Clinical Lead for Diabetes Alliance Program)

The Hunter Medical Research Institute (HMRI), Hunter New England Health Local Health District (HNELHD), the Hunter New England Central Coast Primary Health Network (HNECCPHN) and the University of Newcastle are improving access to diabetes care in rural and regional areas.

The five-year program, worth $12.4m, will see the creation of a ‘medibus’, equipped to be a clinic on wheels, to bring diabetes care to vulnerable communities across the health district. This builds on the existing work of the Diabetes Alliance Program (DAP) developed by Associate Professor Shamasunder Acharya, Clinical Director of Endocrinology at HNELHD and his team.  

Michael DiRienzo, Chief Executive of HNELHD says delivering DAP through a medibus model of care – dubbed DAP+ – will be especially important for rural communities with limited access to general practitioners.

“The bus will allow us to take specialist multidisciplinary teams including endocrinologists, diabetes nurses, dietitians, Aboriginal health workers and podiatrists to rural and remote towns that may not have access to these services locally,” said Mr DiRienzo.

“These clinical teams will provide training to local providers, and directly care for patients in a way that empowers them to better manage their own condition.”

One in 10 people in the Hunter New England region have diabetes and over half of them are yet to be diagnosed. Those in disadvantaged areas are more likely to develop the disease and are less likely to receive timely treatment. It is one of the health system’s biggest challenges, costing an estimated $14.6 billion each year – and its unmanaged progression leads to higher rates of heart attack, amputations, strokes, kidney failure, blindness and even premature death.

“DAP+ is specifically designed to improve evidence-based diabetes care in rural and remote areas, so it’s fitting that we will be able to drive our specialists to where they’re needed most and deliver the program on the ground,” said Mr DiRienzo.

“A key part of this partnership between HMRI, HNELHD, HNECCPHN and the University of Newcastle, is evaluating the DAP+ program to ensure its success,” said Professor Frances Kay Lambkin, Institute Director of HMRI.

“Having evidence that we’re making an impact on reducing the burden of this disease in rural and regional communities will not only allow us to continue delivering DAP+ but will also show its value for rollout in other parts of NSW and further afield.”

Richard Nankervis, Chief Executive Officer of the Hunter New England and Central Coast PHN said DAP+ is an evolution of the successful Diabetes Alliance program that has been running in the Hunter New England region since 2015.

“Our core needs assessment demonstrates that rural areas of the HNECC PHN region have a lower proportion of services to address and treat diabetes compared to the major and inner regional areas. This is concerning given the incidence of diabetes in adults in the HNECC region (12.3%), is higher than the NSW state average (11.3%).

“DAP+ will ensure that people in our region can access gold standard care, leading to improved clinical outcomes,” said Mr Nankervis.

The model of care can also easily be customised for rapid application to other chronic and complex health conditions, which could have a big impact on health outcomes for rural and remote communities.

University of Newcastle Vice-Chancellor, Professor Alex Zelinsky, AO, said the Diabetes Alliance Program’s expansion to rural and regional communities through the medibus initiative was a wonderful example of cross-institution collaborative health research making an impact in our regions.   

“The research of Laurate Professor Clare Collins AO,  Professor Ronald Plotnikoff, and Professor Julie Byles that helped develop the proposal for the funding, will contribute to making a tangible impact on the health and wellbeing of our communities.

“The University of Newcastle is proud to be a key partner of this project, which reflects our commitment to supporting better, healthier living.”

The Colonial Foundation has made an initial donation to the program, which enables the critical first stage scale-up of the program across the Hunter New England Local Health District. 

André Carstens CEO of the Colonial Foundation says the partnership was a natural fit to their priorities to develop a workable solution to a challenging problem.

“At the Colonial Foundation, our vision is to help all Australians live a fair, healthy and fulfilling life.

“The expected outcomes from this program are immense. Not only will our rural and remote communities receive better diabetes care at-scale, but we anticipate there will be spill-over effects on the health system including economic benefits due to the preventable nature of this chronic disease,” said Mr Carstens.