A community health needs assessment carried out by Eastern Health in the Trinity-Conception region during the past year has revealed that while most people are generally satisfied with health services, more improvements are necessary.
The health authority spelled out its findings during an event in Carbonear on Tuesday, July 3.
Respondents to the surveys indicated high satisfaction with a number of services, such as community and public health nursing, ambulance, X-ray and blood collection services and access to family physicians. They also reported satisfaction with inpatient care received in hospitals and health centres in the Trinity-Conception area.
However, there was concern expressed about the need for additional information on local programs and services, more appropriate and affordable housing, especially among those with lower incomes, the availability of affordable transportation to access medical services and social supports, and the need for recruitment and retention of family physicians to offset anticipated retirements in the next two to five years.
Residents of the Trinity-Conception area also cited mental health as a key aspect of overall health, identifying a need for increased access to services and a decrease in the stigmatization of mental illnesses.
The needs assessment, entitled Proud Heritage, Healthy Future: Strengthening the Ties that Bind, detailed a series of recommendations aimed at addressing those concerns.
Eastern Health president and CEO Vickie Kaminski, who was on hand for the event, said significant steps have already commenced.
“In recent months, Eastern Health has enhanced mental health and addictions services in the Trinity-Conception area,” said Kaminski. “We have now awarded the contract for the planning and development of the adult residential addictions treatment centre in Harbour Grace, which will provide specialized care for complex addictions, and aggressive recruitment efforts have resulted in a full complement of three psychiatrists at the Carbonear Hospital. These services speak to both the quality of care we provide and increased access to it.”
The assessment covered an area known as Economic Zone 17, and includes the communities from Brigus Junction up the north shore of Conception Bay, down the Trinity Bay side of the peninsula, including Whitbourne.
The population of the region is 39,850 according to the 2006 census.
The assessment was launched in July 2011, and was the fifth and final needs assessment conducted within Eastern Health’s geographical jurisdiction. The assessments were initiated in 2006 by Eastern Health’s Board of Trustees and are based on ‘determinants of health,’ which include all of the things that influence our health, such as levels of employment and education, personal health practices and social support networks.
The process helps to determine what is working well in communities throughout the area and in collaboration with local residents, identifies areas for improvement.
During the past 11 months, Eastern Health has conducted more than 600 telephone interviews in the Trinity-Conception area, met with 178 local participants in focus groups, held 26 key interviews with community organizations and received 18 public submissions via phone, fax or e-mail.
An advisory committee, comprised of local residents, worked closely with Eastern Health staff to provide guidance and support throughout the process.
Members of the advisory committee included the following: Gina Bishop (Bay Roberts), Kim Crane (Tilton), Denise Strong (Old Perlican), Dale Decker (Clarke’s Beach), David Fowlow (Heart’s Delight-Islington), Gillian Janes (Project Lead, Eastern Health), Pat March (Old Perlican), Jonathan Neil (Upper Island Cove), Joyce Petten (South River), Rachelle Porter (Bareneed, Steering Committee Liaison, Eastern Health), Kelly Sheppard (Carbonear), Rosalind Snow (South River) and Reginald Stanford (Blaketown).
Eastern Health will provide six-month updates to its board of trustees on the progress of implementing the recommendations and report back to the public within two years.
Findings of the assessment were grouped into five key themes.
1. Preventive approaches and education
People want an emphasis on the preventive aspects of health, such as education and awareness about the benefits of nutrition, physical activity and healthy lifestyles.
Recommendations:
• Expand Eastern Health’s Chronic Disease Self-Management Workshops to the Trinity-Conception area.
• Approach Trinity-Conception local media to collaborate with Eastern Health on various topics related to prevention, health promotion and overall healthy living specific to the area. This would help expand on existing initiatives throughout Eastern Health, particularly through the work of the Health Promotion division and Wellness Coalitions.
2. Health services
The majority of telephone survey respondents (59 per cent) reported overall satisfaction with health services in the region. Access to and availability of health services are important, particularly mental health and addictions and family doctors. Transportation was mentioned repeatedly in the focus groups and interviews as a barrier to services, especially given the geography, the lack of public transportation and the limited availability of private transportation.
Recommendations:
• Explore new models of care delivery that involve a “hub” or group of physicians in a larger area, such as Carbonear, with outreach services to smaller communities throughout the Trinity-Conception area.
• Investigate options to expand the role of other health professionals in the Trinity-Conception area. In particular, to review the allocation and roles of Nurse Practitioners (NPs) and paramedics within Eastern Health to determine opportunities for rural communities.
• Develop a proposal to expand the use of Telehealth or other distance technologies to advance patient care in Mental Health and Addictions Services, which will build on the recent Telehealth installation for the Mental Health program in Carbonear General Hospital.
• Develop a local community advisory committee to review identified mental health issues and develop an action plan to addresses these issues.
3. Social Supports/Community-Based Supports
Social support networks and community-based services are strong in the Trinity-Conception area. While the level of commitment to supporting each other is positive, there is a sense that more could be done to identify and meet needs at the local level and promote regional co-operation.
Recommendations:
• Work with partner groups to expand peer support initiatives, including: a. Explore options to expand the Peer Support Training Program developed by the Consumers’ Health Awareness Network Newfoundland and Labrador (CHANNAL) in the Trinity-Conception area; b. Explore opportunities to expand the Friendship Corner, which is a community support group for consumers of mental health services facilitated by Eastern Health staff based in Harbour Grace.
4. Communication and awareness
It is important for various programs and services to be well communicated in Trinity-Conception for people to be aware of/knowledgeable about what is available and how to get those services.
Recommendations:
• Include contact information (e.g., phone numbers) of key health services available to residents in Trinity-Conception area in the needs assessment summary brochure that will be distributed to each mailbox in the region;
• Establish an Eastern Health Working Group to identify the best way to build and maintain an inventory of community-based organizations and resources throughout the region. This will enable easier access to contact information and increase opportunities for collaboration with community partners;
• Expand on the ongoing re-development and maintenance of Eastern Health’s website;
• Host a forum within two years between the Mental Health and Addictions program and its referral sources (especially school districts and family doctors) to develop broader awareness of each other’s roles, to discuss referral and prioritization processes, discuss how to increase peer support in the area and other related topics;
• Develop a semi-annual forum for dialogue between Eastern Health and community family doctors to share information about health services.
5. Housing
Housing and rental prices in many areas have increased while supply of rental properties has decreased due to rising demand. There is also a need for suitable housing supports for vulnerable residents, particularly those with complex mental health issues or seniors living alone in older homes.
Recommendations:
• Host a professional development session whereby Eastern Health staff, in partnership with the Baccalieu Advisory Board on Housing and Homelessness, can learn about the impact of housing on health and opportunities for collaboration.
The full report can be found on Eastern Health’s website (http://www.easternhealth.ca).
