COVID-19 response for First Nations people and communities
In March 2022, Queensland Health's First Nations COVID-19 Response Team undertook a review into the COVID-19 response for First Nations people and communities.
The COVID-19 Reflections Report – an evaluation on the health system response to COVID-19 in First Nations people in Queensland captured data from face-to-face interviews, surveys, written statements, and document analysis from more than 80 key personnel across six Hospital and Health Services (HHSs) and more than 24 Aboriginal Community Controlled Health Organisations, other agencies and government departments.
Lessons identified in report
The nine lessons identified in the report include:
- First Nations leadership
- Consideration and integration of First Nations perspective
- Role of First Nations staff
- Health Service integration with other agencies
- Alignment with the Queensland Disaster Management arrangements
- Community engagement and communications
- Biosecurity arrangements and Public Health directions
- Agency-specific arrangements (vaccination rollout)
- Patient care and safety
First Nations leadership
Aboriginal and Torres Strait Islander integration at the Hospital and Health Service and Department of Health executive leadership levels is essential to ensure representation and advocacy for the Aboriginal and Torres Strait Islander workforce and the communities they serve. Where this already occurs it should be maintained, and where it does not it should be implemented and strengthened.
Consideration and integration of First Nations perspective
Health delivery, across all facets of disease and health care, to Aboriginal and Torres Strait Islander communities should be co-designed to ensure it meets the needs of the people it is serving. Co-design should occur across the Hospital and Health Service (HHS), Aboriginal and Torres Strait Islander Community Controlled Health Organisations (A&TSICCHOs), other relevant services within the community (such as Aboriginal and Torres Shire Councils), and with key community members.
Role of First Nations staff
The Aboriginal and Torres Strait Islander Health Worker and Health Practitioner workforce requires a review to align and standardise across the Hospital and Health Services (HHSs) their scope of practice (including maintaining the capability to undertake vaccinations, in extension to the Pandemic Emergency Order), clinical governance, remuneration, and engagement with and integration into the rest of the health system workforce.
Health service integration with other agencies
The Queensland Department of Health and Hospital and Health Services (HHSs) should continue to engage with the Aboriginal and Torres Strait Islander Community Controlled Health Organisations (A&TSICCHOs) in their areas to further build relationships and understand the capacity and capability of the different organisations. Through this collaboration, service delivery to community should be co-designed, as outlined in 'Consideration and integration of First Nations perspective'.
Alignment with the Queensland disaster management arrangements
That Hospital and Health Services (HHSs) should continue to build and maintain relationships with their Local and District Disaster Management Groups (LDMGs/DDMGs). Discussions should be had with these groups to consider and advocate for how other representatives from the health system (e.g., Primary Health Networks (PHNs), Aboriginal and Torres Strait Islander Community Controlled Health Organisations (A&TSICCHOs), Aged Care etc.) can be represented on the relevant groups.
Community engagement and communications
Community engagement and communications should be enabled to be developed locally so they can be contextualised to suit the needs of the community. Where state-wide messaging is required, guidelines should be developed for messaging and communications, and support provided to local Hospital and Health Services (HHSs) and other organisations to develop localised messaging that is in line with the guidelines but still suit the needs of the community, particularly for Aboriginal and Torres Strait Islander people. Further work should be undertaken to understand and integrate the power of community engagement, rather than just conventional communication methods.
Biosecurity arrangements and Public Health Directions
Further review of the implementation and operationalisation of the Federal Government designated biosecurity area restrictions and Queensland Government Health Directions to remote Aboriginal and Torres Strait Islander communities should be undertaken to inform planning for future occurrences where restrictions such as these may be required. Consideration of supply chain, access to health care, education and other services (in
and out of community) and the process of exemptions (including for community members), quarantine and cultural safety should be included.
Agency-specific arrangements
Where meetings are held by Queensland Department of Health to share information with local government or agencies that may interact with the health system, consideration should be made to extend the invitation to the relevant Hospital and Health Services (HHSs) to ensure that there is consistent messaging across the levels of the health system. Consideration should also be given to providing HHSs with advanced notification of significant changes to policy or events that will impact their planning and response requirements before it is provided to the public.
Vaccination rollout
See 'Consideration and integration of First Nations perspective' and 'Community engagement and communications.'
Patient care and safety
The continued availability of telehealth and Virtual Care models for other diseases and medical requirements should be explored to enable Hospital and Health Services (HHSs) to continue to provide culturally appropriate and safe, specialised, care to Aboriginal and Torres Strait Islander people in their communities, reducing the requirement for them to travel off country, reducing the burden on the HHS and travel system, and increasing the accessibility of specialised health care to Aboriginal and Torres Strait Islander people.
COVID-19 Reflections Report
For more detailed analysis of each of the lessons identified and what research techniques were used to gather data, download and read the COVID-19 Reflections Report .