Priority Health Needs in
Gippsland
Prepared for Gippsland Medicare Local by
1. About this report
Gippsland Medicare Local represents six Local Government Areas – Bass Coast, Baw Baw, East
Gippsland, Latrobe, South Gippsland and Wellington. Gippsland Medicare Local's responsibility is to
fund programs, provide education and coordinate services to strengthen the primary health care system
and support better health outcomes for the Gippsland community.
GML recently conducted a health needs assessment to guide our annual service planning cycle for
2014-15. The health needs assessment identified seven key priority health areas that GML will focus on
over the next year and this report summarises the health outcome data and the stakeholder and
community consultations that helped to identify these priorities.
A number of organisations publish detailed regional health profiles and these are excellent resources for
people with an interest in the health outcomes for Gippsland residents. Gippsland's most recent
population health profiles can be accessed from our website www.gml.com.au.
People can also request a copy of the entire range of data considered in our report to the Australian
Government by contacting us on 03 5126 2899 or info@gml.org.au.
2. Introduction - About population health
Population health sees the health of a community as a " … capacity or resource for everyday living that
enables [people] to pursue [their] goals, acquire skills and education, grow and satisfy personal
aspirations." 1
A population health approach to primary care service planning sees health as influenced by multiple
factors and conditions including social, economic and physical features of the community, individual
health practices, individual capacity and coping skills, human biology, early childhood development and
access to health services.1 Therefore a population health approach considers not just measures of
disease and injury but also the range of risk and protective factors that ultimately determine good health
outcomes.
A population health needs assessment considers all of these factors with the goal to identify strategies
and changes that both maintain and improve the health and wellbeing for the entire community and
reduce unequal health status between social groups.
Gippsland Medicare Local's population health needs assessment and planning framework (see below)
describes the principles and actions that underpin our approach to assessing Gippsland's health needs
and planning the responses to these needs.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Figure 1: Gippsland Medicare Local's Population Health Needs Assessment and Planning
Framework 1
Principle
Actions
Focus on the health of
populations
Determine the indicators to measure and analyse population health
status and health status inequities to identify health issues and
assess contextual conditions, characteristics and trends
Address the determinants of
health and their interactions
Determine indicators for measuring the determinants of health and
their interactions, to link health issues with the determinants
Base decisions on evidence
Use the best evidence available at all stages of program and policy
development and explain criteria for including and excluding evidence
Draw on a variety of data and generate data through mixed research
methods
Identify and assess effective interventions
Disseminate research findings and facilitate policy uptake
Increase upstream
investments
Apply criteria to select priorities for investment, balancing short and
long term investments
Influence investments in other sectors
Apply multiple strategies
Identify the scope of action for interventions
Take actions on the determinants of health and their interactions
Implement strategies to reduce inequities in health status between
population groups
Apply a comprehensive mix of interventions and strategies
Apply interventions that address health issues in an integrated way
and improve health over the life span
Act in multiple settings
Establish a coordinating mechanism to guide interventions
Collaborate across sectors
and levels
Engage partners early on to establish shared values and alignment of
purpose
Establish concrete objectives and focus on visible results
Identify and support a champion
Invest in an alliance building process
Generate political support and build on positive factors in the policy
environment
Share leadership, rewards and accountability among partners
Involve the community
Capture the public’s interest
Contribute to health literacy
Apply public involvement strategies that link to overarching purpose
Demonstrate accountability
for health outcomes
Constructing a results-based accountability framework, ascertaining
baseline measures and setting targets for health improvement
Institutionalise effective evaluation systems
Promote the use of health impact assessment tools
Publicly report results
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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3. Our needs assessment and planning process
Gippsland Medicare Local used a four-step process to assess the health need in the region and decide
on the seven key priorities for focus in 2014-15. This process is summarised in the diagram below and
described in the next section. A checklist of our needs assessment activity is at the end of this
document.
• Establish governance structure
• Prepare project plan
Plan
• Review 2013 Interim Needs Assessment and collect, analyse and interpret population heath data
• Consult the community and stakeholders and consider the services and capacity in the catchment
Assess need • Identify themes and list health needs (triangulation)
Establish
priorities
• List the catchment's priority health needs and review the evidence base for interventions
• Analyse the capacity in the region to respond to those needs
• Shortlist priority needs and confirm shortlist with stakeholders
Confirm
priorities
• GML Board of management endorses the priorities
• Allocate funding
• Communicate outcomes to stakeholders and the community
a. Plan
As a first step, Gippsland Medicare Local established the governance for the needs assessment project
and prepared the needs assessment project plan. The Gippsland Medicare Local Strategic Leadership
Group guided and made decisions about the needs assessment project. Key project partners and
stakeholders provided advice to the Strategic Leadership Group. This phase of the needs assessment
produced the Comprehensive Needs Assessment project plan, Gippsland Medicare Local's internal
resourcing plan and the method we would use to assess health need and establish priorities for action.
b. Assess need
The needs assessment commenced with reviewing our previous health status profiles and plans to
support healthier outcomes for the Gippsland community, including:

A review of the publicly available health data by Monash University epidemiologist, Dr Margaret
Stebbing (May 2013); and

Gippsland Medicare Locals 2013 Interim needs assessment report and annual plan for the
Australian Government (May 2013).
Building on this work, Gippsland Medicare Local collected more recent population health data from the
following sources:
 Australian Bureau of Statistics
 Public Health Information Development Unit
 Department of Employment and Workplace
Relations
 Victorian Department of Health
 Victorian Population Health Survey
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Gippsland Medicare Local surveyed stakeholders and the community and approached local stakeholders
and our internal program area for feedback and advice on health needs. All these sources of information
were brought together and analysed to identify key themes and the health needs for the region.
c. Establish priorities
Gippsland Medicare Local reviewed the evidence base for interventions to respond to the health needs
identified through our initial assessment of need, including relevant policy documents from the
Australian, Victorian and local governments, academic research and other reports.
Each health need identified in the previous stage was analysed in terms of its impact, acceptability,
changeability, and resource feasibility (see figure 2 below). This process enabled us to develop a
shortlist of priority issues and interventions that Gippsland Medicare Local and our partners could focus
on to make a real change in the Gippsland community.
Figure 2: Gippsland Medicare Local's Issue Analysis Framework2
Impact: What are the conditions/factors that have the most significant impact, in terms of
severity and size, in health functioning?
Changeability: Can the most significant conditions/factors be effectively changed by
those involved in the assessment?
Acceptability: What are the most acceptable changes required for the maximum
positive impact?
Resource feasibility: Are the resource implications of these changes feasible?
As the final step in establishing our seven priorities, Gippsland Medicare Local consulted with key
stakeholders to make sure our decisions were sound. We also explored existing partnerships and levers
for action and discussed opportunities to collaborate to address health needs during these consultations.
d. Confirm priorities
Gippsland Medicare Local presented an overview of our needs assessment methodology and the
established priorities for funding to the Gippsland Medicare Local Board, who endorsed the results.
Gippsland Medicare Local is continuing to plan resources and allocate funding to address the seven
health priorities. The final step in our needs assessment process for this cycle is to create this document
to inform the Gippsland community of our plan for 2014 - 2015.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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4. Health priority areas for 2014-15
Our needs assessment identified seven priority health needs for the Gippsland community:
1. Aboriginal health – need for targeted and culturally responsive services;
2. Access to services – gaps in access to primary care services, impact of socio-economic
disadvantage on health, and immunisation gaps;
3. Ageing – increasing demand for primary care services for older people, increasing prevalence
and incidence of dementia, and ageing primary care workforce;
4. Children and families – gaps in allied health services for vulnerable children, impact of family
violence on health, and gaps in perinatal health services;
5. Chronic disease – increasing prevalence of chronic diseases;
6. Mental health – high need for coordinated mental health services; and
7. Young people – gaps in youth specific health services and need for targeted sexual health
services.
Gippsland Medicare Local has already allocated some resources to these priorities through such
programs as Access to Allied Psychological Services and Partners in Recovery to support mental health,
as well as Closing the Gap programs to support Aboriginal health.
Reducing health inequalities and improving health outcomes is a complex task. Gippsland Medicare
Local will collaborate and partner with local health services and other agencies to plan, deliver and
measure activities to respond to the health needs of the Gippsland community. Over the coming year,
Gippsland Medicare Local will continue to gather evidence on health needs to increase our
understanding of specific local needs as well as monitor emerging issues and trends.
In the remaining sections of this report, we present the supporting evidence for each of the seven priority
health areas.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Aboriginal health
Gippsland's Aboriginal and Torres Strait Islander population age profile is quite different to that of nonAboriginal and Torres Strait Islander people due to the impact of the higher fertility rate and lower life
expectancy for Aboriginal and Torres Strait Islanders, as seen in Figure 3 below.
Figure 3: Comparative population age pyramid for Aboriginal and Torres Strait Islander and nonAboriginal and Torres Strait Islander populations in Gippsland 4
Retirees (65+ years)
Older Adults (45-64 years)
Adults (25-44 years)
Young people (15-24 years)
Children (5-14 years)
Pre-school (0-4 years)
30
20
10
0
10
20
30
Non Aboriginal and Torres Straight Islander population
Aboriginal and Torres Strait Islander population
Aboriginal and Torres Strait Islander people in Gippsland present to the emergency department, and are
hospitalised, at over twice the rate of the broader community, primarily due to the greater impact of
chronic disease on this population. The most common reasons for hospitalisations include: diabetes
complications, dental conditions, Chronic Obstructive Pulmonary Disease (COPD), convulsions/epilepsy
and asthma.7
Our data analysis highlighted other key differences in the socioeconomic and health outcomes for
Aboriginal and Torres Strait Islander community members and these are summarised in Figure 4 below.
Figure 4: Differences in health and socioeconomic outcomes for Aboriginal and Torres Strait
Islander and non-Aboriginal and Torres Strait Islander populations 4
Percentage of Gippsland population that:
Aboriginal and
Torres Strait
Islanders
Non-Aboriginal
and Torres Strait
Islanders
Had a weekly person income under $400
49
40.7
Had a weekly personal income over $1000
9.7
18.8
Were unemployed
15.6
5.6
Had paid for or was purchasing own home
39
74
Are living in state-owned housing
22
3
Are living in houses that need one or more extra bedrooms
8.1
1.8
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Percentage of Gippsland population that:
Aboriginal and
Torres Strait
Islanders
Non-Aboriginal
and Torres Strait
Islanders
Are single parent families
35
12.6
Are living in households without children
37
58
Approximately 630 children live in Aboriginal and Torres Strait Islander families without a job in the
region and a lower percentage of Aboriginal and Torres Strait Islander young people are in secondary
school at age 16 (55.4%) compared to Gippsland as a whole (78.5%)3.
It is vital that Aboriginal and Torres Strait Islander people have access to health information about
chronic disease and general practitioners (GPs) are able to support Aboriginal and Torres Strait Islander
people to better manage their health and avoid hospitalisation. The indicators of disadvantage, lower life
expectancy and the greater impact of chronic disease for Aboriginal and Torres Strait Islander people
demonstrate the need for culturally appropriate, targeted and accessible health services for Aboriginal
and Torres Strait Islander people, across the life span.
Stakeholders reported a high rate of teenage births for Aboriginal and Torres Strait Islander women,
particularly in East Gippsland and older data from 2004-06 indicates the teenage birth rate in Aboriginal
women in the Gippsland region was almost four times higher than that of non-Aboriginal women (303.6
compared to 77.35). Figure 5 below shows a lower immunisation rate for Aboriginal and Torres Strait
Islander children under 3. This data and stakeholder reports indicate a need for both tailored perinatal
health services for Aboriginal and Torres Strait Islander women and targeted immunisation programs to
promote a healthy start to life for Aboriginal and Torres Strait Islander children.
Figure 5: Immunisation rates for Gippsland children 2012 – 2013 per 1000 population 6
Rate of children fully immunised at:
Age 1
Age 2
Age 3
Aboriginal and Torres Strait Islander children
89.8
93.3
97.0
All Gippsland children
92.9
95.4
94.2
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Access to health services
The Gippsland region is geographically large and a greater number of GPs and other primary care
services are generally located in larger towns, requiring people who live in more isolated area to travel to
access primary health care. Public transport gaps across Gippsland mean that some people simply
cannot access health services without high travel costs or relying on others for transport. If there are not
many GPs in their local area (Figure 6 below), people may have to wait considerable time for an
appointment.
Figure 6: General practitioners per 1000 population, Gippsland Local Government Areas 8
1.13
1.11
1.24
1.12
1.47
1.35
When people have difficulty accessing the primary health services they need, such as an appointment
with a GP, they may choose to attend an emergency department or delay seeking care until their
condition worsens to the point where they need to go to hospital.
Emergency department primary care type presentations are when people attend an emergency
department with health conditions that could potentially be managed by a GP and other primary care
providers. In Gippsland, the primary care type presentation rate is 197.9 per 1000 population, compared
to 112.3 for Victorian average. Figure 7 shows that over half of the emergency presentations for
residents of Bass Coast, Baw Baw, East Gippsland, Latrobe and Wellington Local Government Areas
were categorised as primary care type presentations.
Figure 7: Primary care type presentations to Gippsland emergency departments by Local
Government Area 2011-12 9
Bass Coast
Baw Baw
East
Gippsland
Latrobe
South
Gippsland
Wellington
Rate per 1000 pop
204.0
206.4
202.7
213.6
55.4
245.7
% of all ED
presentations
46.0
50.8
51.8
53.1
42.2
57.5
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Ambulatory Care Sensitive Conditions (ACSCs) are health conditions where good primary health care
can potentially prevent the need for hospitalisation, or where early intervention can prevent
complications or more severe disease. Chronic ACSCs are selected chronic conditions, such as
diabetes, that can be managed by primary care providers to prevent the condition worsening and
requiring people to attend hospital. Acute ACSCs are acute diseases or conditions, such as a kidney
infection or dental condition, that may not be preventable but the person may not have to attend hospital
to treat the condition if there is access to adequate primary care services. The map below shows the rate
of hospital admission for acute and chronic ACSCs for the region.
Figure 8: Rate of hospital admissions acute and chronic ACSC for Gippsland Local Government
Areas 10
Acute ACSC admissions
Chronic ACSC admissions
Stakeholders, service providers and community members reported the following gaps in the availability
of primary care services:




Extensive waiting times at some GP clinics, particularly in more remote or disadvantaged
communities, resulting in people attending hospital instead of a primary care service.
Potential funding cuts to primary care services could negatively impact access to primary care.
Limited GP access in some locations in East Gippsland with examples of some clinics closing
books to new patients, putting increased but preventable pressure on hospitals.
Standard non-emergency general practice appointments can be up to 6-8 weeks wait time.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Ageing
When compared to the Victorian average, Gippsland has higher rates of persons over 75 living alone
and a higher percentage of people needing assistance with daily activities3. Figure 9 shows how
Gippsland's ageing population is predicted to grow from 2012 to 2026.
Figure 9: Predicted ageing population by Local Government Area 2012 to 2026 3
2012
2026
% of population
aged 65+
number of people
aged 65+
predicted % of
population aged 65+
predicted number
of people aged 65+
Bass Coast
23.8
7 267
29.9
12 536
South Gippsland
20.5
5 696
31.1
9 639
Baw Baw
17.0
7 559
23.5
12 619
Latrobe
15.9
11 786
24.6
19 070
Wellington
17.3
7 315
29.6
14 004
East Gippsland
24.0
10 351
32.1
17 406
A recent projection study of prevalence and incidence of dementia highlights the significant future impact
of this condition across the Gippsland region as the population ages (see Figure 10).
Figure 10: Estimated prevalence of dementia for 2010, 2030 and 2050 - Gippsland Local Government
Areas 11
16000
14000
Prevalence
12000
Wellington
10000
South Gippsland
8000
Latrobe
6000
East Gippsland
4000
Baw Baw
2000
Bass Coast
0
2010
2030
2050
Year
Overall, Gippsland has a lower rate of high-care aged care places than the Victorian average and a
higher rate of low care places (Figure 11 below).
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Figure 11: Aged care places in Gippsland 14
Rates per 1000 eligible population
Home and
Community
Care clients
High care
Low care
Bass Coast
82.7
28.1
53.3
Baw Baw
57.6
32.2
42.7
East Gippsland
83.2
45.8
39.3
Latrobe
62.1
19.7
57.4
South Gippsland
63.9
31.5
46.7
Wellington
53.8
36.1
39.6
Gippsland
67.4
36.6
47.3
Victoria
48.5
42.2
45.7
Aged care places
The increasing and rapidly ageing profile for the Gippsland region highlights the need for community and
health services to plan, coordinate and deliver more services in the home and dedicated aged care
places in the future.
Local clinicians stressed the importance of raising awareness of Advance Care Planning (ACPs) as a
progressive, proactive and responsive approach to planning end-of-life health care decisions and other
stakeholder feedback suggested that Gippsland's ageing health workforce is leading to GP shortages in
some areas, particularly East Gippsland.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Children and families
According to the 2011 Census, in the Gippsland region there were an estimated 24 835 families caring
for 45 215 children under the age of 153. Many of Gippsland families are experiencing some
disadvantage such as living in a sole parent household or in a household where neither parent has a job.
Figure 12: Families in Gippsland 3
7,000
6,000
Single parent families with
children under 15 years
Jobless familes with children
under 15 years
Children under 15 years in
jobless families
Total families with children
under 15 years
Number
5,000
4,000
3,000
2,000
1,000
0
Bass Coast
South
Baw Baw Latrobe Wellington
East
Gippsland
Gippsland
Local Government Area
The Australian Early Development Index (AEDI) measures five areas or domains that are important for
healthy child development and good predictors of adult health, education and social outcomes. They are:
physical health and wellbeing, social competence, emotional maturity, language and cognitive skills and
communication skills and general knowledge. The percentage of Gippsland children developmentally
vulnerable on one or more domains (Figure 12) is higher than the Victorian average in all Local
Government Areas, indicating a need for range of prevention, early intervention and treatment services
to vulnerable children and families.
Percentage
Figure 13: The percentage of Gippsland children developmentally vulnerable on one or more AEDI
domains 3
30.0
25.0
20.0
15.0
10.0
5.0
0.0
1 or more
domains
2 or more
domains
Local Government Area
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Family violence and child abuse/neglect contributes to the vulnerability of children12. In 2008 - 2009,
there were 1454 referrals to child FIRST and Integrated Family Services and 669 Child Protection
substantiations13. The East Gippsland child FIRST catchment had the highest number of referrals to
Child FIRST and Integrated Family Services but the lowest numbers of child protection substantiations.
The Latrobe and Baw Baw child FIRST catchment had both a high number of referrals and
substantiations.
Figure 14: Referrals to Child FIRST and Integrated Family Services and substantiated child
Protection notifications by Gippsland Child FIRST catchment, 2008-2009 13
Child FIRST
catchment
Referrals to Child FIRST
and Integrated Family
Services
Child protection
substantiations
South Coast
216
137
Latrobe and Baw Baw
306
341
Wellington
150
103
East Gippsland
782
88
Family violence incident rates in Gippsland (15.1) are much higher than the Victorian average (9.1), with
some areas reporting very high numbers of family violence incidents as seen in Figure 14 below.
Figure 15: Family violence incident reporting rates for Gippsland Local Government Areas
Local Government Area
Bass Coast
14
11.2
South Gippsland
7.6
Baw Baw
11.1
Latrobe
23.9
Wellington
13.2
East Gippsland
15.1
Victoria
9.1
0.0
5.0
10.0
15.0
20.0
25.0
Rate per 1000 population
Feedback from multiple stakeholders identified gaps in perinatal health services and supported the need
to invest in prevention and early intervention, particularly for vulnerable families such as families with
young mothers, Aboriginal families, families exposed to violence and economically disadvantaged
families.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Chronic disease
Chronic diseases such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are
leading causes of death and disability in Australia15. Reducing risky health behaviours can prevent many
chronic diseases. Common chronic disease risk factors include tobacco smoking, excess weight,
physical inactivity and poor diet16. The health behaviour of Gippsland residents identifies a number of
risk factors for chronic disease:
Percentage of people in Gippsland in 2010 who17:
Males
Females
Were current smokers
21.2
17.6
Were non-smokers
40.4
53.2
Were overweight
45.5
28.2
Were obese
20.3
21.0
Were meeting dietary guidelines for vegetable consumption
4.9
11.6
Were sedentary
6.0
6.9
Were meeting physical activity guidelines
57.0
62.4
Always wear a hat and sunglasses for sun protection
47.5
39.2
Had ever consulted an eye care professional
77.2
80.6
Blood pressure
85.3
83.9
Cholesterol
58.7
56.6
Diabetes
51.3
54.1
Bowel screen
41.8
35.0
Breast screen
-
61.63
Cervical screen
-
60.73
Had the following health checks in the past two years
Gippsland has high numbers of avoidable deaths and high incidence of hospitalisation arising from
chronic disease (Figure 15 below).
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Figure 16: Rate of premature death per 100,000 population by cause, Gippsland Local Government
Areas 3
Bass Coast
South
Gippsland
Baw Baw
Latrobe
Wellington
East
Gippsland
Cancers
97.7
89.9
100.4
119.7
123.9
113.3
Circulatory system
diseases
42.9
43.3
40.2
63.7
53.5
54.9
Endocrine,
nutritional and
metabolic diseases
5.4
6.4
6.0
10.8
7.7
5.6
Respiratory system
diseases
9.6
13.3
13.6
16.2
15.8
17.5
Prevention and early intervention activities to encourage healthy behaviours and regular health checks
may help to reduce the high prevalence of chronic disease in the community.
Stakeholders advised that more diabetes educators, physiotherapists and primary care nurses are
needed to help combat rising prevalence of chronic disease, particularly as population grows and ages.
Cardiac and pulmonary rehabilitation programs and improved care pathways for people with Chronic
Obstructive Pulmonary Disease could reduce the impact of chronic diseases on the community.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority health need: Mental health
The percentage of people who have a high or very high degree of psychological distress in Gippsland
(13.1%3) is higher than the Victorian average highlighting the increased need to provide services to
specifically address the mental health and wellbeing aspects in Gippsland, across all age groups and
settings.
Figure 17: Percentage of the population reporting high or very psychological distress by Local
Government Area 12
20
Percentage
15
10
5
0
Bass Coast Baw Baw
East
Gippsland
Latrobe
South Wellington
Gippsland
Gippsland
Victoria
Local Government Area
Mental health indicators and the usage patterns for mental health services indicate that the burden of
disease for mental illness and the resulting burden on psychological health services in Gippsland are
extremely high. Gippsland rates of both drug and alcohol clients and registered mental health clients are
above the Victorian average. Mental illness is the leading cause of years lived with a disability in the
burden of disease in Gippsland. Deaths due to suicide or self-inflicted injury are higher than the
Victorian average in all Local Government Areas. Disability Adjusted Life Years (DALY) rates per 1000
population for all mental disorders in Gippsland are estimated to be 21.2 compared with 19.7 for all
Victorians5.
Figure 18: Gippsland hospital usage indicators of poor mental health
Local Government
area
Public hospital admission
rate – mental health
condition 3
Causes of premature
death – suicide and
self-inflicted injury 3
Intentional injury
treated in hospital 18
(per 100 000 pop, 2011–12)
(per 100 000 pop, 2008–2012)
(per 1000 pop, 2011-12)
Bass Coast
695.9
18.2
4.4
Baw Baw
593.7
17.3
4.3
1 017.2
13.2
5.6
Latrobe
818.3
17.3
9.0
South Gippsland
900.9
13.8
2.3
Wellington
1 092.7
15.2
6.4
Gippsland
n.a.
14.0
6
794.0
11.0
3.8
East Gippsland
Victoria
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Feedback from stakeholders identified that there is high, unmet demand for primary mental health
services/counselling. Most counselling services are utilised by the 35 - 60 year age group and many
community health services also provide alcohol and drug, problem gambling, family and financial
counselling. Many clients are financially and/or socially disadvantaged and have significant multiple and
complex mental and social health problems.
Primary care clinicians are concerned about insufficient long term mental health services for people with
serious mental health problems as well as the need for more concentrated effort in the prevention and
early intervention of mental illness. Stakeholders stressed the importance of inter-sectoral partnerships
among organisations (not just health) to improve mental health outcomes. Evidence based activities and
programs that promote social inclusion, self-esteem, connectedness and resilience are important given
the high number of people who live alone and impact of social determinants (income, housing,
employment etc.) on mental health and other health indicators.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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Priority Health need: Young people
A recent report on children and young people in rural and regional Victoria shows that, while young
people in rural and regional areas are faring well, there are disparities in outcomes compared to
metropolitan young people. The relatively poorer outcomes for young people in rural and regional
Victoria on some indicators including socioeconomic disadvantage, mental health, family risk factors,
employment and local service access issues. Factors such as disability, family violence, substance
misuse and mental illness can contribute to disadvantage19. Figure 17 below highlights some of key
health and socioeconomic outcome indicators for Gippsland young people.
Figure 19: Comparative outcome indicators for young people in Gippsland against the Victorian
average20
Outcome indicator
Gippsland
Victoria
Reporting they had someone to turn to for advice
93.3
88.6
Who felt that they could access physical health services, if needed
78.4
79.4
Who felt that they could access mental health services, if needed
58.9
70.4
Who felt that they could access dental health services, if needed
84.9
78.3
Hospitalisation rate for intentional self harm (2008-09)*
1.0
0.6
Mental illness hospitalisation rate (2009-10)*
7.4
6.7
Adolescents on community based orders (2009-10)*
2.3
1.5
Women aged 15-19 who gave birth (2008)*
18.1
10.6
Child protection substantiations for adolescent children (2009-10)*
7.4
4.4
Percentage of adolescents:
* per 1000 adolescents
Sexually active young people are at risk of unplanned pregnancy and sexually transmitted infections
(STIs). One in four Gippsland adolescents have had sexual intercourse and only 62.7% practice safe
sex by always using a condom. Chlamydia is the common STI among Gippsland adolescents. When
not treated, chlamydia can lead to long term health problems such as pelvic inflammatory disease and
infertility. Gippsland is ranked the third highest of all Victorian regions for teenage births20.
Stakeholders also reported high rates of teenage pregnancy, chlamydia cases for 15 to 24 year old
people, and reported cases of unwanted sexual intercourse suggesting a need for more integrated and
coordinated sexual and reproductive health services for young people in the region. Stakeholders
reported that the complexity of dual roles for practitioners in small towns makes it challenging to engage
with young people around sexual health.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
Page 19
Appendix 1
Item Title
Complete?
Phase 1 - Plan
Governance established (Strategic Leadership Group (or similar) appointed).
Partially
Stakeholder mapping completed and analysed – appropriate partnering and engagement plans
developed.

Data sources (secondary and primary) identified (including existing reports and relevant
background information from partners).

Resourcing (with appropriate capacity and capability either internal or external) acquired, and
resources are aware of their involvement and commitment.
Partially
Project Plan (including schedule, resourcing capacity and capability, methodology, measures of
success and a risk management strategy) completed and approved.

Project Plan aligned with the CNA Reporting Template and described how final outputs will be
published and distributed.

Phase 2 – Assess need
Part A – Compiled and reviewed data on health inequity, key demographic trends and decided
on special needs groups (or sub-regions) where issues/needs may exist based on evidence.

Part B - Compiled and reviewed data on health outcomes, health status and health utilisation as
well as considered available information on patient experience or consumer satisfaction.

Part C - Compiled and reviewed data/information on service provision including mapping
service capacity and considering gaps in access for vulnerable and marginalised populations.

Part D - Findings from the community profile completed in A, B and C informed the scope of
and approach to community engagement and health professional and service provider
consultations.
Partially
Part D1 - The community has been appropriately consulted (considering the most appropriate
engagement methods) including consultations with special needs groups where identified and
deemed important.
Partially
Part D2 - Health professionals and service providers have been appropriately consulted
(considering the most appropriate engagement methods) including consultations with special
needs groups where identified and deemed important.
Partially
Part E - Data and information from Parts A, B, C and D has been compiled and a final
population health profile has been completed, including consideration of normative,
comparative, expressed and felt needs. The Strategic Leadership Group (or similar) has
approved the final population profile.
Partially
Part E - A shortlist of needs, using that profile as a key input, has been generated. The
Strategic Leadership Group (or similar) has approved the final shortlist of issues/ needs.

Phase 3 – Establish priorities
Assessed the impact, evidence, changeability, acceptability and resource feasibility of each
issue/need.

Considered and assessed strategies to address issues/needs and documented an indicative
Scoping Paper for discussion in selecting priorities.
Partially
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
Page 20
Item Title
Complete?
Engaged with relevant stakeholders to ensure they have bought into the set of prioritised
problems or factors.
Partially
Validated priority setting criteria and ratings and rankings of each strategy/proposal/initiative.
X
Prepared recommendations and received formal comment from the Strategic Leadership Group
(or similar) and other stakeholders identified in Phase 1 through stakeholder mapping.
X
Validated and agreed the final list of priorities including those that will be progressed by the ML
and those that will be progressed by other stakeholders (if applicable).

Phase 4 – Confirm priorities
Presented the recommendation to the ML Board and gained endorsement.
Developed action plans for each initiative and implemented a stakeholder communication
strategy
Set up the post-CNA evaluation review process.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014

Partially

Page 21
References
1. Health Canada (2001) The Population Health Template: A Framework to
Define and Implement a Population Health Approach. Ottawa: Health Canada.
2. Adapted from Hooper J. and Longworth. P (2002) Health needs assessment workbook. Health
Development Agency. Available at: http://www.hda-online.org.uk/documents/hna.pdf
3. Public Health Information Development Unit (2012) Social Health Atlas of Victorian Local
Government Areas (May 2014 release).
4. Australian Bureau of Statistics (2011) Census of Population and Housing, Aboriginal and Torres
Strait Islander (Indigenous) Profile for Gippsland LGAs.
5. Stebbing M. (2013) A snap shot of the health care needs of the population and the health service
system in Gippsland. A desktop review of available data. Prepared for Gippsland Medicare
Local. Monash University.
6. National Health Performance Authority (2014) Healthy Communities: Immunisation rates for
children in 2012–13. Canberra: Commonwealth of Australia.
7. Gippsland Health Online. All hospitalisations and all ED presentations, by aboriginality and sex.
http://docs.health.vic.gov.au/docs/health-documents-bycategory?OpenView&RestrictToCategory=Gippsland-health-online-Indigenous-Health
8. The Medical Directory of Australia, Australasian Medical Publishing Company (AMPCo) and
Estimated Resident Population, 30 June 2011, ABS Currency: 2013 (GPs), 2011 (ERP).
9. Victorian Emergency Minimum Dataset, Hospitals and Health Service Performance Division,
Department of Health, and Estimated Resident Population at 30 June 2011.
10. Victorian Admitted Episodes Dataset, Hospitals and Health Service Performance Division,
Department of Health.
11. Access Economics (2010) Projections of dementia prevalence and incidence in Victoria 2010 –
2050: Department of Health Regions and Statistical Local Areas.
12. Department of Health (2010) Victorian Population Health Survey 2008. Melbourne: Department
of Health.
13. KPMG (2011) Child FIRST and Integrated Family Services – Final Report. Prepared for the
Department of Human Services.
14. Department of Health (2013) 2012 LGA profiles data.
15. Department of Health website
http://www.health.gov.au/internet/main/publishing.nsf/Content/chronic
16. Australian Institute of Health and Welfare (2006). Webpage Chronic diseases and associated risk
factors in Australia.
17. Department of Health (2012) Victorian Population Health Survey 2010. Selected Findings.
Melbourne: Department of Health.
18. Department of Health (2013) 2012 Regional health status profiles. Gippsland region. Melbourne:
Victorian Government Department of Health.
19. Department of Education and Early Childhood Development (2013) The state of Victoria’s
children report 2011. A report on how children and young people in rural and regional Victoria are
faring.
20. Department of Education and Early Childhood Development (2011) Adolescent Community
Profiles. Summary for the Gippsland Region.
Gippsland Medicare Local Summary Needs Assessment 2014 – 2015 June 2014
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