The first 1,000 days of life are a critical window in which the brain’s ability to change is highest, and the possibility of reducing severity and impact of disability is maximized, especially in children with Targeted Disease (TD).
TD is the most common cause of childhood physical disability (1 in 700 Australians). Access to early diagnosis of TD enables early evidence-based intervention and improved outcomes. In Western Australia (WA), the early diagnosis of TD is now possible for babies from 12 weeks of age, and with support from the PCHF our team have established a world-leading early intervention service for high-risk babies, ensuring early diagnosis of TD and improved outcomes. However, early detection of TD does not exist beyond the inner-metropolitan area, meaning babies at-risk are falling through the gaps in our health system.
TD is the third most costly health condition in Australia (3) and costs increase with severity of TD (4). For children with TD in Australia socio-economic disadvantage at birth has recently been shown to be associated with more severe and complex TD (5). Of concern we also know the rate of post-natal TD in indigenous people is three times the rate of caucasians (6). This confirms that many children with TD particularly those with the greatest need for early diagnosis and intervention services are most likely to have the least financial resources available and to live in neighbourhoods with fewer services.
Unfortunately, children with TD in rural and remote areas, those with the greatest need for early diagnosis and intervention are most likely to have the least financial resources available and live in areas with fewer services. It is vital that we build systems that detect children with TD and other common impairments early, promote early responsive parenting and support parent mental health at this very difficult time. We propose the development of a sustainable state-wide teaching and training model of care (MOC) for the early detection of TD, activity which is not funded by the Department of Health or the NDIS.
Comment: This response while abbreviated provides details on the cohort, the urgency of proposed intervention, any inequalities for access to intervention/healthcare and current funding constraints. Words in bold are particularly relevant.
Improvement is required when a response which does not include or is not clear on the following points and add needs further information to clarify relevant issues:
The importance and urgency of this particular project obtaining funding so it can be implemented.
How will your proposed solution effectively address the paediatric health issue(s) identified in your project in lay terms?
There is an urgent need to implement change within our health system in response to the evidence. The solution to addressing the issues of inequity for regional and remote families in WA and building resources for families is the establishment of a state-wide at-risk TD network Model of Care (MOC). This will enable all children and parents in WA access to early detection and diagnosis of TD to ensure evidence-based early intervention and maximised outcomes for children and their families. The proposed TD MOC network will be multi-directorate and state-wide, encompassing key clinical partners across CAHS (Neonatology, Child and Adolescent Community Health) and beyond (Western Australia Country Health Services). We are seeking funding to pilot the roll out of this network in one WACHS region to establish proof of concept and ensure the MOC can be implemented in full as efficiently as possible. The scaled-up network is designed to be self-sustainable after 3 years.
Objective: Establishing the TD MOC. To implement education and training in early diagnosis tools for clinicians in one pilot region of Western Australia.
Comment: This response while abbreviated restates the importance of the proposed project and provides an outline of the solution with clear objectives. It also links the solution (establishment of MOC) directly to the problem (access to treatment).
Improvement is required when a response which does not include or is not clear on:
The establishment of the WA MOC of teaching and training in the selected region will generate outcomes for babies and their families, the local health workforce and Perth Children’s Hospital. Details on the specific outcomes of the project are listed in Table 1, attached.
Improvement is required when a response which does not include or is not clear on:
Comment: This response while abbreviated states clear expected outcomes. Additional details can be included in a table attached to the application.
Improvement is required when a response which does not include or is not clear on:
The planned intervention will provide positive changes for paediatric health in WA with the support of external funding. There are two main ways in which this intervention has a positive impact:
Comment: This response while abbreviated states clear planned impact in specific areas.
Improvement is required when a response which does not include or is not clear on:
This model of care is innovative, as this is the first time this treatment method and patient care model has been implemented in an Australian hospital.
Or
This equipment has never been used for this purpose in an Australian public hospital before.
Or
This research will investigate the effectiveness of a new intervention never before used for this condition for this cohort worldwide.
Improvement is required when a response which does not include or is not clear on:
Please refer to the Hints & Tips for timeline and budget information.
