Background: North Sydney Local Health District (NSLHD) found 30% of the patients referred to spinal services live within the regional catchment of Central Coast Local Health District (CCLHD). Less than 25% non-urgent patient referrals required surgical opinion. This indicated a lack of regional spinal services and poor utilisation of metropolitan surgical services.
Aim: Reduce patient travel to support NSW Health’s target of net zero emissions by 2035 by extending NSLHD Royal North Shore Hospital (RNSH) physiotherapy led spinal triage services to a regional satellite clinic within CCLHD Gosford Hospital.
Methods: Travel distances and modes of transport were collected, and analysed to determine emissions avoided and time saved. Travel-related carbon emission factors were used to estimate carbon emissions for attendance at Gosford Hospital. A patient survey was used to determine satisfaction and effectiveness of the new model.
Results: 91% of patients reported they would have otherwise travelled to RNSH by car, 45% with a carer. The average return trip to Gosford Hospital saved each patient an average of 5hrs 15mins, or 59%, of the RNSH travel time. All patients were satisfied with the distance travelled, with 89% stating they would have found RNSH access difficult due to its distance and/or their pain. 95% of patients were satisfied with being assessed by a specialised physiotherapist, and 84% felt they had gained a better understanding of how to manage their spinal problem. Only 23% of patients required a referral for a surgical opinion. There were no adverse events recorded. 61% saving in patient transport related greenhouse gas emissions was achieved, average carbon emission saving per patient encounter was 19kgCO2e, which equates to annual total saving of 489kgCO2e.
Conclusion: Implementation of regional physiotherapy-led spinal services provides patient satisfaction with care and reduces carbon emissions associated with patient transport.