Culturally Safe Hub: Spoke Model for NSW

Officially opened in late October, the Gadigal Eye Clinic is a central hub from which telehealth eye services can be provided to patients throughout NSW. With a dedicated room for patients, their family, and carers, the clinic is culturally welcoming for Indigenous Australians referred to Sydney for important treatments, such as cataract surgery, and complex eye problems, such as retinal and corneal disease.

The clinic was the vision of Professor Gerard Sutton, ophthalmologist and Foundation Board Director. It has eventuated as a result of a collaborative effort involving Sydney Eye Hospital Foundation, Sydney Eye Hospital, Brien Holden Institute, Optometry NSW, Rural Doctors Network, and Prince of Wales Hospital, with the support of Health NSW.

To date, fundraising by the Sydney Eye Hospital Foundation has helped raise AU$200,000 towards creating the clinic and the Foundation has committed to continued financial support.

The Gadigal Eye Clinic is the evolution of what was formerly the Bicentennial Eye Clinic

Enabling Tele-Vision

The Gadigal Eye Clinic is the evolution of what was formerly the Bicentennial Eye Clinic, which has operated since 2014 and has treated over 90,000 patients with a focus on corneal, retinal, and general eye care.

In its modern guise, the clinic will become the hub to a progressively expanding network of outreach centres kitted out with state-of-the-art, user-friendly retinal cameras. GPs and nurses will use the cameras to capture detailed medical images, which will be relayed to specialists at the Gadigal Eye Clinic, aiding in the diagnosis of eye issues and development of treatment plans. The cameras are already in use at an outreach centre in Moree, northern NSW, and work to expand the network to Tamworth, in the northeast of the state, is underway.

Professor Andrew Chang, Head of Ophthalmology at Sydney Eye Hospital and Chair of the Sydney Eye Hospital Foundation, described the ‘Tele-Vision’ telehealth initiative as a “game changer for our outreach capabilities”.

“It’s estimated 35% of Indigenous adults have never had an eye examination, and when a condition or disease is diagnosed, they are waiting longer for surgery accounting for 11% of the health gap,” he said.

“By introducing virtual capabilities here at the Gadigal Eye Clinic and linking to regional centres, we aim to reduce some of the barriers to receiving timely care.”

Prof Chang said allowing local teams to connect with specialists without the patient needing to travel “is crucial for those in remote areas”.

… the concept for the new clinic had come about because “we simply asked, ‘how can we help?’

Closing an “Unacceptable” Gap

Addressing the audience at the clinic launch, Prof Sutton acknowledged the “many hard-working people and organisations” that contributed to its establishment.

Describing the gap in the delivery of eye services across Australia as “unacceptable” especially for “Indigenous Australians for whom the barriers are not just geographical and financial but also cultural”, he said the concept for the new clinic had come about because “we simply asked, ‘how can we help?’”

Together the working group came up with a three-stage strategy to:

1. Complete a digital mapping exercise to identify where the need is in NSW, where optometrical support is located, and where ophthalmic care is lacking (this will be ongoing),
2. Establish a quaternary referral and culturally welcoming eye clinic, and
3. Establish ‘Tele-Vision’, a virtual hub-spoke model of care to connect patients in regional areas to specialists at Sydney Eye Hospital and Prince of Wales Hospital.

For patients, Prof Sutton said bringing the strategy to fruition will limit the necessity and frequency of long-distance travel, and reduce the financial burden of eye disease. He said it will also be a cost saver for Health NSW.

Most importantly, with patient travel and accommodation coordinated by Aboriginal Liaison Officers, a dedicated space with artwork by Aboriginal artist and Yuin man, Billy Reynolds, and hospital grounds transformed with guardian stones and Australian native plants, he said the Gadigal Eye Clinic provides a culturally sensitive, higher level of care.

Aboriginal people are three times more likely to suffer from visual impairments than non-Aboriginal Australians

NSW Government Support

The launch was attended by the Minister for Health, the Hon Ryan Park MP, and the Minister for Aboriginal Affairs and Treaty, the Hon David Harris MP, as well as the Member for Sydney, Alex Greenwich MP.

Echoing Prof Sutton’s concerns, Mr Harris said, “Closing the gap to improve health outcomes for Aboriginal people and to do so in a culturally safe and appropriate way is a top priority of the Minns Labor Government, and the Gadigal Eye Clinic is a perfect example of this.”

Mr Park acknowledged the role that virtual health services can play in the care of remote communities as well as the broader population. “We know that Aboriginal people are three times more likely to suffer from visual impairments than non-Aboriginal Australians. They are also four times more likely to have diabetic eye disease and 12 times more likely to have a blinding cataract.

“This clinic will address these statistics, acting as a hub for in-person as well as virtual care services for eye patients throughout rural and regional NSW.”

Mr Park continued, “The Gadigal clinic will provide world-class care in an environment that prioritises the needs and comfort of the clients – by doing so, we can provide the best patient-centred and holistic healthcare.

“I’m really proud Sydney Eye Hospital (is) embracing virtual care, as it goes a long way to ensuring all communities have the very best standards of healthcare, whether they are in rural, regional, remote or large metropolitan areas.”