1:38

Thanks so much, Scott. I'm really, really excited about talking

1:39

to you today.

1:42

Thanks so much for having me. I'm good today, thanks Scott.

2:14

A rarity where I'm not in the clinic.

2:17

And so I'm at home on my balcony, looking

2:17

out over the district with my dog Stanley

2:22

sitting at my feet. So today's a good day.

2:26

And yeah, I think running a business is

2:26

stressful and it's really a first for me,

2:34

but emergency departments are stressful

2:34

too.

2:38

And hospital systems are under stress,

2:38

which impacts, you know, the ability to

2:46

provide excellent service and do as much

2:46

as we want to do for people and as much as

2:55

we know we can do for people.

2:58

And I think that sort of brings it back

2:58

without going on too much of a tangent, it

3:03

brings it back to why we set up Heal in

3:03

the first place.

3:07

to provide a better alternative for people

3:07

than going to an emergency department and

3:13

to do it with exceptional five-star

3:13

service.

3:16

And combining those two has just been a

3:16

magical formula that the success of the

3:23

business is unbelievable.

3:25

And we are offloading public emergency

3:25

departments and providing a better

3:30

alternative. So, you know, it's really just filling

3:31

that.

3:35

gap between general practice and the

3:35

hospital that until now was quite a large

3:42

gap and we're doing our bit to support

3:42

people and keep them in community.

4:12

I'm going to go ahead and close the video. Yeah, well, it's a long story.

4:53

And it was two years in the planning

4:53

before we opened the doors.

4:58

And we've just had our first birthday.

5:00

So there's three years of work.

5:03

And yeah, of course, prior to that, the

5:03

idea originated at a conference, actually,

5:09

I went to a pediatric conference in the

5:09

States about seven years ago, and heard

5:15

about the concept of virgin care.

5:18

And their perspective is a standalone

5:18

independent clinic that services the need

5:25

of the community and provides a cheaper

5:25

and a better alternative to going to

5:31

expensive hospital systems and emergency

5:31

departments.

5:34

And I reflected on this at the time and I

5:34

thought, well, hang on.

5:40

So we know that emergency departments in

5:40

Australia discharge 70%

5:45

of patients that present there the same

5:45

day.

5:48

So most of those 70% of people don't

5:48

actually need hospital level care and

5:54

could be supported in community with the

5:54

appropriate infrastructure and staffing

6:01

skill mix. And so at the time I really had zero

6:03

capacity to do anything.

6:08

Both of our boys were just babies.

6:11

Life was taken up with changing nappies

6:11

and doing bottom up.

6:14

doing bottles, harrowing times.

6:20

But, you know, as they sort of grew up,

6:20

yeah, it's tough.

6:28

It was definitely tough. And I was juggling three different rosters

6:30

at the time as well.

6:33

So I was working at the John Hunter and

6:33

also on board the Westpac helicopter and

6:40

then doing shifts at Lake Macquarie

6:40

private emergency department.

6:47

And really sort of through a combination

6:47

of a culmination, I suppose, of my skills

6:52

and experience working across a diverse

6:52

range of populations, demographics across

7:00

Australia. I spent time working in New South Wales,

7:00

Queensland, Alice Springs, Perth.

7:07

And some of that time has been spent in

7:07

the private system.

7:15

innovate and change within the public

7:15

health system, because I was just a little

7:19

fish in a big pond. And it seemed like the longer I was in

7:21

that role as an emergency specialist.

7:26

So running, you know, Maitland, John

7:26

Hunter, emergency departments, ensuring

7:31

flow of patients into the hospital and

7:31

safe discharge home.

7:39

But I guess after a while you sort of just

7:39

rinse and repeat and it's the same every

7:45

day. And I felt constrained in that system.

7:49

Like I had a lot more energy and

7:49

motivation to do much more, but I wasn't

7:53

able to do it internally.

7:56

And so to build a standalone independent

7:56

clinic that can function in community and

8:03

bridge that gap between general practice

8:03

and the emergency department required.

8:09

an approach of basically starting from

8:09

scratch and building a business from

8:15

scratch based on a concept and an idea

8:15

that a really strong passion and totally

8:25

100% committed that this was going to

8:25

solve some of the crisis and some of the

8:31

problems facing public hospitals and to

8:31

divert patients and keep them.

8:38

in community when they can be safely and

8:38

effectively managed there.

8:44

So that was really where I took it to

8:44

mentally and then some years later when

8:51

the boys were approaching school age, that

8:51

I realized if I could play around with my

8:58

public fraction and reduce my commitments.

9:02

And we had some savings that we could use

9:02

to kind of support us while we develop the

9:10

business model. And that was really developed through

9:14

combination of different people, including

9:14

primarily Jason Carney, who's our director

9:20

of nursing is nurse practitioner.

9:23

He's been working at the John Hunter for

9:23

many years, is really at the top of his

9:28

field when it comes to emergency nurse

9:28

practitioner, and has developed the

9:34

training program for nurse practitioners

9:34

at the John Hunter Hospital and was and

9:39

was actually the first pioneer of that

9:39

program.

9:43

So an excellent clinician and also sites

9:43

set on a better alternative for patients

9:50

and understanding that we can provide this

9:50

service and community.

9:53

So Jason and I workshopped over six months

9:53

about how this would look and what we

10:00

would need in terms of infrastructure and

10:00

staffing and equipment resources.

10:06

And meanwhile, I was working in the

10:06

background, working on funding and

10:10

financial the aspects of it.

10:15

And then I met Gavin Rose, who is our non

10:15

executive director and has 20 years of

10:23

experience in building healthcare

10:23

infrastructure, specialises in financial

10:28

modelling for clinics like this, and has a

10:28

background in finance, originally in

10:36

Sydney. So meeting

10:43

development because he was able to tap

10:43

into funding resources, generate

10:49

partnerships, for example, Hunter Imaging

10:49

Group, Labrador Pathology, and also was an

10:57

expert on building on infrastructure and

10:57

has built multiple GP clinics around the

11:06

Newcastle and Hunter region, is working on

11:06

a day hospital in Charlestown currently.

11:13

and was able to help us basically secure

11:13

the lease for the property that we're in

11:17

at Paris Street and get the financial

11:17

model to stack up.

11:27

So that all happened cohesively together

11:27

and then it was about finding the site,

11:32

which we did, in Paris Street as I said,

11:32

and then the fit out.

11:39

with the vote projects, which was amazing

11:39

experience.

11:42

They did a great job. No one had really designed urgent care

11:44

before, certainly not in this region, and

11:48

the vote project was the first for them.

11:51

So they were saying, well, what does an

11:51

urgent care clinic look like?

11:55

And Jason and I were, well, we don't know,

11:55

because we've never built one and there

12:00

isn't really one. There's a scattering of examples around

12:01

Australia.

12:05

But we knew we had the opportunity to

12:05

build it how we thought it should be

12:09

built. And that, you know, is large enough to

12:11

deal with volume and capacity.

12:16

And we can see over 100 patients a day in

12:16

each clinic.

12:20

So that's 35,000 patients a year in each

12:20

clinic.

12:26

And, you know, as an example, Maitland

12:26

Hospital sees 50,000 a year.

12:31

So that's the sort of volume we were

12:31

looking to see.

12:34

And then we needed the equipment that goes

12:34

with running a clinic like that.

12:40

So X-ray machines on site.

12:42

It's really a first for our region to have

12:42

availability or access to plain X-ray

12:49

after hours on a Saturday and a Sunday.

12:52

So I'm partnering with Hunter Imaging.

12:55

They made that really easy for us.

12:57

And we've got a radiologist and a portable

12:57

x-ray machine on site every hour that

13:01

we're open. And similarly with Laverty, the concept of

13:02

blood gas analysis or rapid blood analysis

13:10

in community. I mean, these are really expensive

13:10

machines that are normally only found in

13:15

an intensive care setting or a tertiary

13:15

emergency department like the John Hunter.

13:20

And now we have them in our clinic and

13:20

community, which can provide a...

13:24

a whole array of blood results in under

13:24

three minutes, which is just amazing.

13:29

So we can make clinical decisions on that,

13:29

and we can decide how best to treat people

13:35

in the clinic, and we can also let them

13:35

know if their illness is so serious that

13:39

they need to go to hospital for admission.

13:43

And we have other toys as well. We have a slit lamp for looking in eyes,

13:45

and a point of care ultrasound machine for

13:52

doing scanning. in certain circumstances.

13:56

And we have an isolation zone for

13:56

containing respiratory and infectious

14:00

diseases. We see a lot of COVID and RSV and we do

14:01

that really safely.

14:08

And then we have a procedure room where we

14:08

do all the painful stuff to people, wound

14:14

repair and closure and fracture

14:14

management, those sorts of things.

14:17

And thinking about...

14:21

How can we build this clinic to provide

14:21

the most amount of care for people and

14:27

keep them out of hospital and do it

14:27

safely?

14:32

And so huge amounts of innovation

14:32

happening at Heal just in setting it up.

14:38

And some examples I've already given and

14:38

another one was about well,

14:44

Patients often end up in hospital because

14:44

they've got a bent forearm or a fracture

14:49

that needs sedation and management,

14:49

usually under anesthetic in the emergency

14:55

department. And how can we, because we've got the

14:57

skills to be able to do that, but how do

15:01

we get the conditions to do it safely with

15:01

a compliant patient that's not screaming

15:08

in pain and we're managing that

15:08

effectively.

15:10

And so we've brought. the green whistle into heel, which

15:12

ambulance have been using for years safely

15:19

in community. But it's the first that I'm aware of where

15:20

it's been used in a clinic with emergency

15:25

physicians and a utility in fracture

15:25

management to keep people out of hospital

15:33

and also kids with forehead and chin

15:33

lacerations.

15:38

We see a lot of that. And we've successfully...

15:41

essentially sedated kids as young as two

15:41

years old to fix their faces and put

15:48

stitches in. And those patients, they go to an

15:49

emergency department and they roll around

15:54

for hours because it needs that sedation.

15:59

And that requires a resource bay and a

15:59

senior clinician and a whole set of

16:04

criteria, which often aren't available at

16:04

short notice and often.

16:09

those patients will be asked to return

16:09

them the following morning fast.

16:12

And we're getting them in and out in 90

16:12

minutes, which is just amazing.

16:16

And they have the best experience and they

16:16

get their lollipop when they're done and

16:21

off they go. So that...

16:26

Yeah, well, everyone loves the drinks and

16:26

snacks.

16:29

That's been a massive hit.

16:32

The sparkling water on tap, Scott, I never

16:32

thought it would be such a...

16:37

popular item, but everyone raves about it.

16:41

Well, yeah, and that was sort of the other

16:41

part of the business.

16:44

I mean, patients are really surprised when

16:44

you offer them Panadol and Urefin and ask

16:50

them if they want still or sparkling water

16:50

with that.

16:54

And we're constantly surprising people at

16:54

the level of service that we provide.

17:00

And, you know, from a financial model, I

17:00

guess it boils back to the...

17:07

the point that people pay for the service

17:07

because we are privately funded, so we

17:12

don't have access to any form of

17:12

government funding or grants.

17:17

And there's various reasons for that.

17:19

But essentially, yeah, we funded the

17:19

clinic privately, we have investors, and

17:26

to provide that level of service, the cost

17:26

is $295, which includes everything.

17:32

And there's a Medicare rebate available

17:32

with that as well, so they're out of

17:36

pocket. is some about 50 or 100 bucks less than

17:37

that.

17:41

So yeah, that's complete assessment,

17:41

investigations, x-ray pathology, and any

17:48

sort of treatments, intravenous

17:48

medications, and then procedures as well.

17:53

So wound management, fracture management,

17:53

and then we throw in the boots and

17:57

crutches for free and the splints and

17:57

slings.

18:01

and people walk out the door and they know

18:01

they've got nothing more to pay and

18:04

they're going to get a kickback from

18:04

Medicare as well.

18:07

So given the fact that they're paying for

18:07

the service, we wanted to provide a

18:12

five-star service. And just noticing generally in Australia

18:15

that service is dead.

18:20

You know, I think when you go out for

18:20

coffee and breakfast in the morning and

18:24

you just see it that most people haven't

18:24

experienced five-star service, I think.

18:30

And so when they come to heal and they

18:30

experience that, they're really surprised,

18:34

particularly in a medical setting.

19:50

Yeah. Ha ha ha.

20:57

Yeah, and I think when you've got a...

21:01

Yeah, you know you've got a good business

21:01

idea when everyone asks, well, why is no

21:05

one else doing this? This sounds like a great idea.

21:10

And we couldn't answer that question.

21:13

It was just basically down to the fact

21:13

that, I guess no one...

21:19

I've done it or as I say, there are a few

21:19

examples and really I can't take credit

21:25

for pioneering urgent care in Australia,

21:25

but certainly in our region, it's a first.

21:31

And the FACEM led, the emergency position

21:31

led model is really embryonic at the

21:36

moment. There's a clinic in Sydney and the Gold

21:36

Coast and there'll be more coming.

21:44

But I looked at those clinics and

21:48

And Pankaj, who's the director of WISE in

21:48

Sydney, he's a friend of mine.

21:53

And I thought, well, if these guys can do

21:53

it, I can do it.

21:58

You know, what's so different about them

21:58

to me that would mean that I wouldn't be

22:04

able to do this? This is really my area of expertise from a

22:04

clinical medical perspective.

22:09

And so with Jason, you know, at my side,

22:09

we're able to build this, the medical side

22:15

of it. And then with the other people on the

22:17

team, you know, we can figure out the

22:22

rest. And so Gavin for the financials, and now

22:22

we've got Alex as the business and

22:26

operations manager, and Nico as the people

22:26

experience manager.

22:30

And yeah, of course we all need each other

22:30

and it's, you know, the sum of all our

22:37

parts that is heal.

22:39

So getting the right people on your team,

22:39

of course is critical and having them.

22:46

aligned with the vision. But it's a pretty easy vision to align

22:48

yourself with because everyone sees the

22:53

benefits for community and we're

22:53

offloading public hospitals.

22:57

So it's a win-win. I think, you know, we're really delighted

23:01

with the progress that we've made since

23:06

we've opened and it's really proved, like

23:06

you said, at that meeting that you were at

23:11

recently, it's really proved that we've...

23:14

We've ticked the boxes for quality and

23:14

five-star service.

23:19

And the medical model is working really

23:19

well in terms of how we, well, the level

23:24

of care we can provide and also the

23:24

aftercare, the follow-up after people

23:30

leave the clinic is just next level.

23:34

It just hasn't been experienced before.

23:38

And that again is through these

23:38

partnerships that we have with people like

23:43

Hunter Imaging Group. the orthopedic surgeons that have

23:44

partnered with us.

23:47

You know, we have six orthopedic surgeons

23:47

providing on-call support for HEAL and

23:52

also running our weekly fracture clinic,

23:52

hand therapy service, hand surgeons, lots

23:59

of specialists actually, really keen to be

23:59

involved in community and help us support

24:07

these people. So that aspect of the business has been

24:09

great to see how well

24:14

And that actually did, I mean, it was

24:14

obviously in the planning, but it actually

24:19

did seem like it just fell into place. And I was really surprised at how well it

24:21

ran from the from the beginning.

24:26

And so, yeah, we're delighted with the

24:26

progress that we're making there.

24:57

Yeah, so we're open to the public as a

24:57

walk-in clinic.

25:02

So you don't need a referral or an

25:02

appointment.

25:05

You don't need to be in a private health

25:05

fund.

25:09

And what we see is the same breadth and

25:09

scope that you would find in an emergency

25:17

department and we'll treat.

25:20

anything that walks in the door, unless

25:20

it's life threatening or, you know, it

25:24

needs to go to hospital for admission.

25:29

So we're actually providing complete care

25:29

for about 96% of the patients or the

25:35

people that walk in our door and we're

25:35

treating them safely in community.

25:39

And there's a small cohort of people that

25:39

need to be admitted to hospital or need

25:44

more urgent investigation than we can

25:44

provide.

25:47

And so we... We do that assessment straight away and

25:48

let them know where they should go for

25:54

their care and how to get there safely,

25:54

whether it's by private car, we call an

26:00

ambulance. But all of those 96% of people that we

26:02

treat, about half of them are injuries and

26:08

the other half are illness. So we see lots and lots of injuries and

26:10

many of those are sports related and also

26:16

kids. skateboards, trampoline parks, ice skating

26:18

rink, you know, all the stuff that kids

26:23

love to get up to and also the adults then

26:23

join in and then they fall off the

26:28

skateboard or you know, yeah, lots of

26:28

cycle accidents, electric scooters etc.

26:37

Where there's, you know, an injury to a

26:37

body part, potentially a fracture,

26:48

And we manage that really effectively and

26:48

we're experts at doing that and doing it

26:53

well. And the other 50% is illness.

26:59

And illness is respiratory most commonly

26:59

and also kids and babies.

27:05

And those would probably be the top three,

27:05

would be injuries, respiratory and kids

27:11

and babies. But there's other forms of illness as

27:13

well.

27:17

fluid replacement, advanced infection that

27:17

needs intravenous antibiotics, eye

27:22

problems, ear, nose, and throat problems,

27:22

gynae issues, infections, STDs.

27:30

There's, yeah, a really broad scope.

27:32

Anything that's not life-threatening, we

27:32

can treat it heal.

27:36

So it really is an end-to-end service for

27:36

people when they're.

27:43

when they're in need of urgent care and it

27:43

can't wait for a scheduled appointment

27:47

with their GP. Yeah, well, yeah.

28:05

Yeah, because a lot of injuries do happen

28:05

at work.

28:10

And the problem there is, it's a big issue

28:10

for industry and businesses, is that they

28:19

need access urgently to get an assessment

28:19

for their worker.

28:23

And most of them end up in the emergency

28:23

department because there's nowhere else

28:28

that they can get seen. And these injuries at work, they're often

28:30

minor.

28:33

It might be a finger laceration or a

28:33

contusion or bruise.

28:37

It might be a minor fracture, shoulder

28:37

strain.

28:41

Yeah, lots of musculoskeletal

28:41

physiotherapy stuff and back strain, et

28:47

cetera, rolled ankles, that sort of thing.

28:51

So that's really just bread and butter for

28:51

us.

28:53

That's easy. And we now can provide the access.

28:58

to employers where they can come to HEAL

28:58

and these workers are covered by workers

29:04

compensation, right? So they're not paying.

29:08

And so the insurance companies are paying

29:08

for the service.

29:11

So no one's out of pocket. So when they turn up with their employer,

29:13

that we can see them straight away.

29:19

They got obviously the expert assessment

29:19

and treatment that we've provided at HEAL.

29:23

And then we discuss with them about the

29:23

restrictions that are...

29:27

that are going to need to be applied if

29:27

any, and the time period that those

29:32

restrictions will need to apply for them

29:32

to safely recover at work.

29:38

So I had an ankle sprain yesterday from a

29:38

brick layer who was saying, I won't be

29:46

able to go to work. And I went, well, you will because you'll

29:47

have a boot on.

29:50

Yeah, you won't be able to stand for long

29:50

periods of time and you won't be able to

29:53

walk long distances and you won't be able

29:53

to be a brick layer.

29:56

but you're still gonna be able to help the

29:56

team and be present at work.

30:00

And your employer, I'm sure, will find

30:00

suitable duties for you to do.

30:04

And the employer was like, look, he's an

30:04

apprentice.

30:06

He needs to do, he needs to catch up with

30:06

his TAFE work.

30:08

So he's gonna be at home for the next

30:08

three days doing his TAFE work.

30:12

And then we'll get him back onto site

30:12

after he's had his physiotherapy

30:15

assessment. And we'll work with them through the

30:16

injury and we'll get him back to work.

30:19

So aligning ourselves with...

30:23

The benefits of workers recovering at work

30:23

rather than being stuck at home where they

30:28

get bored, fall into bad habits, it

30:28

affects their mental health because

30:32

they're socially excluded etc.

30:35

actually prolongs the healing time for

30:35

those workers to be at home unnecessarily.

30:46

Well, talking of evidence, I think once a

30:46

worker's been out of the workforce for

30:51

longer than three months, the chances of

30:51

them returning are less than 5%.

30:54

And it's a massive problem.

31:00

And so now we can provide the urgent

31:00

access front end service, which otherwise

31:06

would require potentially a six, eight

31:06

hour wait in an emergency department, but

31:11

also setting that worker up for recovery.

31:15

putting the plan in place for ongoing

31:15

follow-up and care from community services

31:23

and ensuring that we complete that

31:23

process.

31:27

So we now have an aftercare clinic to

31:27

follow-up work cover patients because they

31:34

loved the service so much at Heal that

31:34

they wanted to come back for follow-up.

31:39

They didn't want to go elsewhere or...

31:42

didn't want to go back to the GP. Some of them do, of course, and they're

31:44

very welcome to do that.

31:47

But most people were telling us that they

31:47

wanted to, they wanted to continue with

31:51

HEAL as their provider.

31:55

And we're also not the regular, I guess,

31:55

family health provider or general

32:03

practitioner for these patients. So it's actually good in many ways to have

32:04

a degree of separation between the two

32:09

because there's no conflict of interest.

32:13

So that's been a real success and now, you

32:13

know, we just, I think we've got over a

32:19

hundred contracts with various

32:19

organizations and some of them are very

32:23

large. I mean, the Hunter region, as you know, is

32:24

full of industry and mining and shipping

32:32

and trains and there's so much going on

32:32

that and a lot of it is.

32:40

I wouldn't say remote, but it's difficult

32:40

to access health care, certainly on up the

32:45

Hunter. And providing that service now is really

32:47

groundbreaking and really catching on.

32:53

So that's an area of growth for us.

32:56

You know, it's one thing to rely on the

32:56

man on the street to come in and put his

33:01

hand in his pocket and pay for the care,

33:01

but not everyone has 295 to do that.

33:06

We totally get that. but when the worker is not paying out of

33:08

pocket and it's all covered by insurance,

33:12

it's just a total non-brainer.

33:16

And we also then are. Yeah, so are we.

34:20

We're delighted to work together. It's great.

34:24

And yeah, I think the whole industry

34:24

landscape will change as people catch on

34:32

that the service is available. And we're just trying to keep up at the

34:34

moment with some of that demand.

34:40

And I'm looking at other ways that we can

34:40

grow the business.

35:30

Yeah, I mean, it was interesting how it

35:30

all came about because we obviously

35:36

started developing our model and were

35:36

committed before we heard the announcement

35:43

from government that they were rolling out

35:43

the Medicare urgent care clinics.

35:48

And so it's been really interesting to

35:48

watch.

35:53

I think there. You know, there are 50 or 54 clinics

35:54

around Australia.

35:57

In our region, there were two clinics

35:57

earmarked for Cessnock and Tamworth, and

36:02

another couple on the Central Coast.

36:06

And the Cessnock Clinic has opened.

36:09

We applied for funding for urgent care

36:09

clinics because we were already open at

36:15

that time. So, you know, you want to build an urgent

36:16

care clinic, like we've already done it.

36:22

And this is what it should look like. And this is how you do it.

36:27

But government had a slightly different

36:27

model, which was a GP-led model in

36:33

existing GP infrastructure.

36:35

So not a standalone independent clinic

36:35

with purpose-built design like ours.

36:42

And so we saw that as probably low volume

36:42

and the fact that it was bulk-billed.

36:49

and meant that it was going to attract

36:49

people who wanted a quick free appointment

36:54

with their GP. And I think largely that is what has

36:56

happened.

37:01

I think it's still great for community

37:01

that they've got access to urgent care,

37:07

but the lack of infrastructure funding, I

37:07

suppose, and the staffing model that the

37:15

clinics have is quite limited in terms of

37:20

the volume and also the scope.

37:23

Yeah, yeah. And some of the clinics don't have X-ray

37:25

on site, for example, so that, you know,

37:31

that when we're talking about 50% of

37:31

people, you know, having injuries and

37:35

needing an X-ray, that's a real

37:35

restriction on the scope of practice.

37:40

So I'm not convinced that these clinics

37:40

are offloading emergency departments, but,

37:48

But certainly our goal is to continue to

37:48

do as much as we can in community.

37:54

We weren't unfortunately eligible in the

37:54

end for the government funding because the

37:59

criteria were for existing accredited

37:59

general practice and that's not what we

38:06

are. So we missed out and that's an unfortunate

38:06

sequence of events and just down to the

38:12

timing again. But there are other opportunities within

38:14

the public health system.

38:17

that we're seeking to pursue.

38:21

I mean, we built this clinic to be

38:21

available to everyone, right?

38:27

At the moment, the financial model is

38:27

private and no funding.

38:32

So people will need to pay for the

38:32

service.

38:35

But we can see public patients in our

38:35

clinic with government funding.

38:40

And that was actually what we proposed to

38:40

government and to the LHD in a 40-page

38:45

document. that we masterminded explaining with all

38:46

the cogs and wheels about how this was

38:50

going to work in terms of phoning an

38:50

ambulance or being referred from general

38:55

practice or being referred from an

38:55

emergency department to our clinic and

39:01

having X number of spots per day publicly

39:01

funded and paid for by government.

39:09

And that's still what we want to achieve.

39:11

We're just trying to figure out how to do

39:11

that.

39:15

and to demonstrate, you know, I guess, now

39:15

that we've been open for a year, we've got

39:19

stronger data and we can start to build

39:19

that case to say, we're here to help.

39:25

We actually do want to offload ED and if

39:25

people can afford to pay, that's great.

39:31

But for people who can't afford to pay,

39:31

government should pay.

39:36

And to be honest, you know, we do it at a

39:36

fraction of the cost of care in a hospital

39:41

emergency department and people think... you know, going to an ED is free.

39:45

It's not free. It costs a lot of money.

39:48

Yeah. Hospital level care is super expensive.

39:51

And a presentation at an emergency

39:51

department is an average of $600.

39:55

And we're doing it for less than half of

39:55

that.

39:59

So financially, we just feel that's the

39:59

most socially and economically sustainable

40:05

model is to have a hybrid system where we

40:05

can see private and public patients under

40:11

the one roof. So we're pursuing that.

40:15

And we're also talking to ambulance

40:15

because you know ambulance is, ambulance

40:19

ramping in hospitals obviously a massive

40:19

problem when you can't offload the patient

40:24

and those ambulances are then not

40:24

available for community when they need

40:28

them. But we can offload those ambulances and

40:30

many people who call an ambulance don't

40:35

need to go to hospital. So it's about linking in with those

40:36

services and.

40:40

And developing the relationships, Scott, a

40:40

lot of it is, you know, the ongoing

40:44

conversation, the patience, the time, the

40:44

trust that you need to develop and

40:52

continue just sort of pushing, pushing

40:52

what we know is the right thing to do for

40:59

people and open up access to heal for

40:59

everyone.

41:45

Ahem. Well, I think, you know, we, as we grow,

41:53

we're going to need more staff and some of

42:02

the medical staffing, the medical

42:02

workforce can be a challenge.

42:06

It's difficult to change mindsets for

42:06

doctors and emergency specialists,

42:12

particularly who have spent their career

42:12

working in a public health system to step

42:18

out into community and do something

42:18

different.

42:20

So. We're constantly challenged by that, but

42:21

as we move forward, more and more doctors

42:27

are coming and choosing to come and work

42:27

with us.

42:29

I'm really excited by the engagement with

42:29

general practice as well.

42:33

Again, we have emergency physicians on the

42:33

team, but we also have specialist GPs that

42:39

really value coming to work in a

42:39

procedural heavy, busy clinic like ours,

42:45

where there's a real broad scope.

42:48

and getting back to doing that wound care

42:48

and fracture management and so on.

42:53

They're really enjoying that as a break

42:53

from the norm.

42:58

So we're encouraged. We're encouraged by that.

43:01

That there's a lot of growth still to do

43:01

with the business and financially.

43:05

We we we.

43:08

Of course, we want to encourage people to

43:08

come to heal.

43:10

And so there's a lot of marketing

43:10

promotion about the service.

43:13

But most people hear about heal through

43:13

word of mouth.

43:16

So. That's Newcastle for you, you know, I

43:17

think it's really important that, yeah, we

43:23

just continue to provide that great

43:23

service and people will keep talking about

43:26

it. But also the work cover and the corporate

43:28

cover that we're planning to provide an

43:38

extended service for large organizations

43:38

that would include a triage line, for

43:43

example. and priority service on arrival and also a

43:45

family benefits scheme for workers.

43:53

So we're working through that at the moment. And then these ongoing discussions with

43:55

ambulance and the LHD.

43:58

And so those are not so much challenges.

44:03

They're just part of the development of

44:03

the model and allowing us to be successful

44:09

in what we're doing. Because we know the model is successful,

44:11

but to be financially successful, we still

44:15

need to create, develop more of these

44:15

opportunities.

44:22

And one of the most exciting opportunities

44:22

that we've got at the moment is with

44:28

sports clubs. So we were heavily engaged with community.

44:32

Last year during sports season, we were

44:32

down at number two with our gazebo and

44:37

handing out flyers and ice packs and

44:37

lollies for the kids.

44:42

And this year we sponsored four teams

44:42

across the region and really engaging with

44:48

those teams and listening to them about

44:48

what some of the issues are that they

44:52

have. So there's an education management piece

44:52

there about when you need to call an

45:00

ambulance to go to hospital and when you

45:00

can come to urgent care.

45:04

But there's also a big.

45:06

push now within the sports clubs to safely

45:06

and effectively manage concussion.

45:13

And concussion in high impact sports is a

45:13

big problem and it's obviously been quite

45:19

topical in the media. And I think people are starting to realise

45:22

now that, you know, they really need to

45:26

follow the guidelines and to look after

45:26

their players.

45:31

And also parents are

45:34

are tuned in to the risks of concussion

45:34

and wanting the best for their kids and

45:40

also themselves if they play sport.

45:43

So we, as an injury management centre of

45:43

excellence, are seeing concussion

45:52

frequently. There'll be a lot more of it coming in the

45:53

next couple of weeks when sport season

45:57

fully kicks off. But Saturdays at heel are definitely the

45:59

busiest day of the week.

46:04

And concussion is something that we see a

46:04

lot.

46:10

It often doesn't need to be managed in an

46:10

emergency department.

46:15

And most concussion, although it appears

46:15

quite severe initially, it does settle

46:20

with time. And most of those people don't need fancy

46:22

scans.

46:27

You know, they need an expert assessment.

46:31

And they need to be, we can tell them that

46:31

they're safe to go home with their family

46:36

and observation at home.

46:39

But they don't need to go through a CT

46:39

scanner most of the time.

46:44

So we're providing that service in

46:44

community and again, most of the time

46:50

these people are being managed safely and

46:50

effectively and being let home back into

46:56

their homes with their family to recover

46:56

there.

47:00

So that in itself, I mean, that's just

47:00

part of what we do.

47:04

But the extension of that is that if

47:04

people are signed off from sport, they

47:10

need to be signed back on. And they need someone to follow the

47:12

concussion injury, particularly if it's

47:15

severe. So of course it's a spectrum and some

47:16

people might just have a headache for a

47:20

few days, that's very minor. But some people have chronic daily

47:21

headaches that go on for months with

47:26

difficulty concentrating, light

47:26

sensitivity.

47:30

episodes of dizziness and fatigue and they

47:30

need ongoing care and follow up.

47:37

And we're working out how we can provide

47:37

that in an after care setting and provide

47:44

the extension of this service because

47:44

those concussion assessments do need some

47:51

training and experience to complete and

47:51

not everyone.

47:56

not everyone is able to easily access that

47:56

assessment and be signed back onto sports.

48:01

So then they end up sitting out for longer

48:01

than they need to.

48:05

So we're working with a number of sports

48:05

teams on that and I'm working on

48:11

developing HEAL into a center of

48:11

excellence for concussion management with

48:17

the help of some of our doctors that have

48:17

significant experience in that area in

48:23

terms of follow-up. But also interestingly, and hot off the

48:24

press this, so you're the first to hear,

48:31

interestingly, we've got support from HMRI

48:31

and unlikely funding as well for a

48:39

research study into concussion in

48:39

community and particularly in the

48:46

pediatric, in the kids population.

48:48

So that's super exciting where that's

48:48

going.

48:52

And again, like I just an absolute first

48:52

for community to be able to have that

48:56

level of care and assessment when it just

48:56

hasn't been available anywhere else.

49:02

And it's not even available in an

49:02

emergency department because in an ED the

49:07

decision is, am I gonna scan or am I not

49:07

gonna scan?

49:10

And if I'm not gonna scan, you're going

49:10

home.

49:12

And if I scan and get a normal scan, then

49:12

you're still going home.

49:15

So. It's just not the same depth of detail

49:17

that we'll be providing for players when

49:22

they have that type of injury. Well, we just really enjoyed our chat too,

49:54

Scott.

49:56

It's been great to reflect on where we've

49:56

come from and what we've done over the

50:01

last year. And I'm just really excited to see what

50:02

the rest of this year holds.

50:06

And hopefully we have more HEAL clinics

50:06

opening.

50:11

You know, this is not just a regional

50:11

Newcastle problem that we're trying to

50:16

fix. This is a national emergency department

50:16

crisis and hospital health crisis.

50:22

that we're trying to help solve. And so there's no reason why there

50:25

shouldn't be a HEAL clinic in every large

50:29

town in Australia. And so that is our goal is to

50:31

revolutionize how urgent medical care is

50:37

delivered in Australia.

50:40

So it goes beyond just this region, but

50:40

certainly as a hub for innovation and a

50:47

starting point, I think it's, we're just

50:47

really delighted with

50:51

with how much we can provide for the

50:51

region and the community.

50:54

And I'm really looking forward to working

50:54

with all of the stakeholders and partners

50:58

in community just to develop the model

50:58

further.

52:00

Thanks Scott.