The Northern Health Advanced-Practice Physiotherapy Pelvic Health Clinic is helping to streamline care for women with urinary incontinence and pelvic organ prolapse.
Urinary incontinence and prolapse imparts not only physical and psychological harm on affected patients but can also be a financial burden. Whist delay to appropriate assessment and treatment compounds these impacts, this effect is more pronounced among migrant women, who must overcome more barriers to seeking help before being placed on waiting lists to receive care.
The impact of prolonged wait times is exaggerated by the cultural norms of many of our patients, with research demonstrating that incontinence interferes while participating in sacred practices, including prayer for Muslim women.
Although physiotherapy is recommended as first line management for urinary and pelvic organ prolapse, patients within the Northern Health catchment are routinely referred to gynaecology first, where they can wait up to five years for assessment before being referred on to the pelvic health physiotherapy for management, where they can expect to wait another six to 12 months before commencing treatment.
These combined waiting times means that patients with pelvic organic prolapse, and urinary incontinence can wait up to six years from referral to commencing treatment, with symptoms significantly impacting their ability to participate in work, exercise, social and cultural activities.
With a clear need to streamline care to provide more timely access to the appropriate service and to allow for earlier intervention, the Northern Health Advanced-Practice Physiotherapy Pelvic-Health Clinic was born.
The clinic, which opened in September 2023, provides more timely access to appropriate management and reduces the need for specialist intervention for patients referred to Northern Health’s Gynaecology department with incontinence or prolapse.
This innovative model of care sought to mitigate the impact on the services providing treatment by developing digital education modules to support patients’ ability to self-manage in the community while waiting for follow-up physiotherapy.
Northern Health’s clinic is also the state’s first tertiary pelvic health service with specifically developed digital health resources catering to the socially, culturally and linguistically diverse population that Northern Health service.
Since the commencement of the clinic, over 430 patient referrals have been resolved from the Gynaecology waitlist, without needing direct Gynaecology input. The success of this initiative has led to it receiving ongoing funding through the new Women’s Health Clinic to be established at Northern Health.
Satisfaction surveys were sent to patients and involved staff, with many citing the positive impact the clinic has had on improving healthcare.
“I’m so pleased that I had the opportunity to do this role – the case conferences with the specialists have been an excellent learning opportunity, and being able to intervene with patients earlier has been very rewarding.” – AP Physiotherapist (Pelvic Health).
“This clinic is invaluable to the health service which allows for more appropriate screening and triaging of patients to quicker and more appropriate management which will improve their QOL and outcomes.” – AP Physiotherapist (Pelvic Health).
“This is a wonderful service and has been well received by our patients. It ensures they are not wasting time in the system waiting for gynae only to be referred back to physio” – Gynaecologist.
“Extremely thorough and helpful.” – Patient.
“I am very happy with physiotherapist who assisted me today she is very professional. Thank you very much.” – Patient.
“The lady I had was wonderful and made me feel very comfortable.” – Patient.
“It was very friendly and comfortable experience. Thank you.” – Patient.
“I was pleasantly surprised how smooth the appointment was.” – Patient.
“Would I recommend the physio I saw? Yes. She was lovely.” – Patient.