Embedding nurse practitioners into specialist homeless services can help to improve healthcare access for vulnerable children, a unique pilot program has shown.
Led by researchers at Flinders University's Caring Futures Institute, the team established a clinic led by nurse practitioners (NP) - specialised nurses who can diagnose and prescribe medication - within one of South Australia's faith-based homeless services.
Between December 2019 and March 2021, 66 children of parents experiencing housing instability were able to receive health assessments and appropriate referrals, while the researchers assessed the clinic's use.
"Children aged under 14 represent almost a quarter of Australians accessing homelessness support, which often leads to then missing crucial health checks, vaccinations, and suffering from untreated conditions," says Associate Professor Yvonne Parry, whose work aims to improve health access for children.
"Alongside homelessness, the children and their family can also be experiencing financial hardship, lack of transportation, and social stigma, all of which make it harder for them to receive timely medical attention.
"A NP-led clinic such as this can help to bridge that gap, ensuring vulnerable children receive timely and comprehensive healthcare."
The researchers found the most common conditions identified amongst the children were developmental delay, low immunisation rates, and tooth decay.
Many had urgent health concerns requiring immediate intervention, with 40 percent of the children receiving a referral to a specialist.
"These results highlight the pressing need for targeted healthcare models designed to reach vulnerable populations," says Associate Professor Parry.
"Nursing practitioners are trained to provide comprehensive care, including diagnosing conditions, prescribing treatments, and ordering tests, making them well-equipped to address the complex needs of children in high-risk situations.
"Our study's findings suggest that expanding NP-led models could be an effective strategy for improving child health outcomes and reducing long-term healthcare costs."
In addition to its healthcare benefits, the authors say the NP-led model presents a cost-effective alternative to traditional healthcare delivery for governments, with the nurse practitioner Medicare rebate significantly lower than that of general practitioners.
"The lower cost of NP-led services enables more children to receive necessary care without placing additional financial strain on the healthcare system," says Associate Professor Parry.
"This, combined with the service's effectiveness demonstrated in our pilot, makes a strong case for policy changes that support the wider implementation of NP-led healthcare services across Australia.
"Without NPs, these children remain invisible to the health system with unaddressed health and developmental needs.
"We need policymakers, healthcare providers, and community organizations to work together in a bid to improve the long-term health and wellbeing of this vulnerable population."
The team hopes to run more clinics in the future, pending funding.
The paper, 'An innovative nurse practitioner-led service for children from families living in housing instability' by Alicia Bell, Yvonne K. Parry, Matthew Ankers, Nina Sivertsen, Eileen Willis, Sally Kendall and Huahua Yin is published in the journal Primary Health Care Research & Development. DOI: 10.1017/S1463423625000118
