New osteoarthritis clinic at Auburn Hospital

Osteoarthritis patients Michael Sultana and Stanley Allen during a physiotherapy session at Westmead Hospital, which they were referred to following a clinic at Auburn Hospital.

Reduced pain and avoiding surgery are some of the expected benefits for patients of a new ‘one-stop-shop’ for osteoarthritis.

Patients are now being treated as part of the new Osteoarthritis Chronic Care Program (OACCP) at Auburn Hospital, the first of its kind in Western Sydney Local Health District.

Osteoarthritis is a chronic condition caused by the wearing down of the cartilage at the ends of bones. The painful ailment affects 1 in 11 Australians – a figure predicted to grow with the country’s ageing population.

The new service aims to improve care for patients by allowing them to see a range of different clinicians in a single appointment, avoiding multiple hospital visits.

Carolyn Aiken, 53, has been suffering from osteoarthritis for 15 years and believes she will need surgery in the long run.

Currently she manages her pain with hydrotherapy and medication, but she’s unable to get on the floor to play with her granddaughter or do many household tasks.

The Rooty Hill resident said she found the clinic helpful and it will change the way she does hydrotherapy.

“It was more convenient for me having them all there, not needing to run around making different appointments with all the specialists,” Carolyn said.

“It’s definitely a step ahead in medical practice, especially in the public system, to see the teams working together and coming up with more holistic treatments instead of just medication or surgery.”

Westmead Hospital physiotherapist Jonathan Young (centre) works with patients following their initial assessment at the Auburn clinic.

Rheumatology advanced trainee Dr Beverly Ng said the clinic is a “one-stop shop” for people to receive intervention from a medical, physiotherapy and dietetic perspective.

“The objective is to optimise osteoarthritis care through less invasive measures, such a lifestyle changes, while patients are waiting for surgery. There’s the potential to get patients off the surgery list with symptom management and improvement in quality of life” Dr Ng said.

“Two things that have been shown to be beneficial are weight loss and strengthening the thigh muscles, but patients may not have been shown how to do that in a structured way.”

Dr Ng explained that the pain of osteoarthritis can lead to a fear of exercise, which creates a harmful cycle when patients’ symptoms get worse as a result of their sedentary lifestyle.

Auburn Hospital consultant Dr Tien Tay (back left), advanced trainee Dr Beverly Ng (back right), physiotherapist James Chen and dietitian Sophie Feng (front) with the patients of the first osteoarthritis clinic.

Under the new program, patients initially attend a clinic at Auburn Hospital, and are subsequently followed up at 3, 6 and 12-month time points to monitor their progress.

Most patients would be eligible for referral to follow-up physiotherapy and dietetic programs at Westmead Hospital, giving them the knowledge and regular feedback needed to make beneficial lifestyle changes.

Dr Ng said the program also involves understanding patients’ mental health and the impact of the condition on their quality of life, as part of a holistic approach to care.

Patients are given the tools to track their own progress and monitor their improvement in mobility and everyday activities.

Osteoarthritis severely limits movement in the right knee for Michael Sultana (left), but he still completes daily exercises including walking, stepping and cycling to manage his condition.

The program is still in its early stages but, based on patient feedback and demand, could be rolled out to other hospitals or community care centres within the district.

Commencing in 2017/18, OACCP is one of 13 NSW Health initiatives being rolled out as part of the Leading Better Value Care program, which aims to support local health districts to deliver improved outcomes and experiences for patients and better value for the health system.

Western Sydney Local Health District received $800,000 in 2018/19 to continue implementing eight Leading Better Value initiatives, of which approximately $300,000 was assigned to the OACCP.

The 2019 NSW Government budget committed $24 billion in recurrent funding as part of a record $26.7 billion health budget in the 2019/20 financial year. 

NSW Health is finalising individual budget allocations, for the coming year, with a focus on improving health services and patient care, supporting families and boosting jobs in regional and rural communities.