Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

Key action area 6: Strengthen, skill and support primary healthcare and public health workforce to support people in making healthy choices

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‘The Primary Health Care system has an important role within the whole of society, integrated approach to chronic disease’ (Quote from submission)

The role and contribution of the primary healthcare setting in terms of preventative health are outlined in Chapter 1 of this Strategy. Around 85% of Australians visit their GP each year. Primary healthcare is therefore an important setting because it is often the first point of contact with the health system for a person seeking information about their own health or that of their family. GPs and the broader primary care workforce can provide assessment, information and support to encourage Australians to be healthier throughout their life.

In tackling obesity, it is crucial to target patients in primary care settings, at all levels of prevention. The first priority is to reduce the risk of becoming overweight – to interrupt, prevent or minimise the progress of unhealthy weight gain at an early stage, and to attempt to halt and reduce existing disability and damage associated with unhealthy weight gain.

For those who are already overweight or obese, there is a need to offer services and support to ensure that they do not continue to gain weight, and ideally to support them to lose weight. This often requires access to suitable specialist care and high-quality, expert, multidisciplinary team care.

There is evidence that programs delivered by multidisciplinary teams may be more effective at maintaining weight loss[161] when typically there is a high degree of relapse in weight loss for overweight and obese people.[162, 163] There are also clear benefits of team care in improving chronic disease management.[164, 165]

Multidisciplinary patient care teams may include health professionals from a range of areas, such as a physician, dietitian, exercise expert, nurse and behavioural therapist/psychologist.[165]

There are a range of measures that could be implemented to improve the effectiveness of the primary healthcare setting in promoting health. The approach recommended by the Taskforce is outlined in Chapter 1.

Specifically in relation to the prevention of obesity, the Taskforce recommends a focus on workforce strategies for allied health to expand the supply of the allied health workforce available, particularly within the public system and in rural areas. The Taskforce also recognises that there are a number of existing barriers to individuals accessing health services that are appropriately resourced and skilled to deliver integrated assessment, support, advice and follow up regarding nutrition, physical activity and weight loss consistent with best practice.
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Funding, implementing and promoting evidence-based clinical guidelines and other multidisciplinary training packages for health and community workers, and ensuring a quality-driven approach to prevention in primary care, are specifically recommended. Also, there are a number of existing clinical guidelines relating to overweight and obesity that have not been fully implemented due to a number of barriers. Strategies should be developed to ensure the increased awareness and implementation of best practice clinical approaches as set out in the guidelines.

It is recognised that addressing the lifestyle factors relevant to the prevention of obesity is most appropriately integrated with other risk factors for chronic disease; for example, drinking at risky levels and smoking. There is also a need to ensure Australia has an appropriate workforce with expertise in health promotion. This workforce will be essential to supporting and facilitating the cultural and organisational changes that will be required in key settings such as workplaces, local government and schools. The Taskforce believes that the approach outlined in Chapter 1 will deliver benefits in terms of achieving an integrated best practice approach to preventative health.

Action 6.1
Contribute to relevant national policies (for example, the National Primary Health Care Strategy) to ensure key actions to improve preventative health are considered and implemented in the primary care setting. These may include:

  • Expanding the supply of relevant allied health workforce and number of funded positions
  • Ensuring all individuals have easy access to health services that provide physical activity, weight loss and healthy nutrition advice and support
  • Funding, implementing and promoting evidence-based clinical guidelines and other multidisciplinary training packages for health and community workers

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