Scanning the respiratory service landscape in NSW-based Aboriginal Community Controlled Health Services.

BACKGROUND

Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), disproportionately impact the Aboriginal and Torres Strait Islander population of Australia. Aboriginal Community Controlled Health Services (ACCHSs) are primary care services, established to provide healthcare in culturally safe environments for Aboriginal people. There is little information about the respiratory services for people with chronic respiratory diseases provided by ACCHSs.

AIM

To describe current provision of respiratory services of ACCHSs based in New South Wales (NSW), with a focus on identifying barriers and facilitators to providing pulmonary rehabilitation.

METHODS

A researcher-administered survey was conducted via Zoom plus a follow-up email to collect client and health workforce data. Participants were NSW-based ACCHSs, members of the Aboriginal Health and Medical Research Council (AH&MRC). Exclusions were ACCHSs that only delivered drug and alcohol rehabilitation, housing or employment services. The survey collected information related to client numbers, smoking history, COPD diagnoses, health workforce, and respiratory services with a focus on pulmonary rehabilitation programs.

RESULTS

Forty-one ACCHSs were invited to participate and 18 (44%) completed the survey. Most provided respiratory care, although variation existed in service scope and delivery. The main respiratory services provided were smoking cessation (100%), spirometry (89%) and respiratory clinics (33%). Most ACCHSs (78%), reported some access to respiratory physicians. No ACCHSs provided pulmonary rehabilitation. Main barriers included staff shortages, lack of staff training, financial constraints and lack of space. Several ACCHSs expressed interest in providing a pulmonary rehabilitation program, if appropriate resourcing was available. Ten ACCHS (56%) reported that Aboriginal clients would not access mainstream public health services for pulmonary rehabilitation. Barriers to accessing these externally available pulmonary rehabilitation programs included transportation issues, cultural considerations and geographical location.

CONCLUSIONS

ACCHSs are delivering respiratory services for Aboriginal people living with chronic respiratory diseases within constrained infrastructure and resources. Additional funding is required to improve access to best practice care for Aboriginal people living with COPD including culturally safe, evidence-based and accessible pulmonary rehabilitation programs.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12913-025-13361-w.