Reaching new heights in neuroimmunology: a proposed model of care for the Murrumbidgee Local Health District.

Background: Access to specialised medical services in regional and remote areas of Australia faces significant challenges, resulting in delays in diagnosis and treatment, and ultimately poorer patient outcomes. This issue is prevalent across medical disciplines. This article focuses on neuroimmunology services in the Murrumbidgee Local Health District of regional New South Wales, and strategies to enhance comprehensive care for patients with these conditions.

Aim: We propose a comprehensive new model of care for individuals affected by neuroimmunological disorders, identifying the needs of key stakeholders and emphasising earlier diagnosis and treatment to improve overall health outcomes. This will be achieved via a novel 'hub-and-spoke' model of metro-regional care, prioritising integration with primary healthcare services.

Methods: A comprehensive literature review was conducted to assess existing evidence of national specialist services in regional settings and previously established models of care for delivering medical services in rural and remote Australia. Planning and implementation involved canvassing the needs of general practitioners, specialists, medical trainees, nurses and patient advocates via a comprehensive questionnaire and educational meetings.

Results and conclusions: The implementation of specialist neuroimmunology service, partnering metropolitan based specialists and established regional neurologists, is a scalable model of care. Data on referral pathways, time to diagnosis, treatment, and satisfaction are under evaluation to assess improvements qualitatively and quantitatively in clinical outcomes (HREC Ref: 2024/ETH01053). Pathways for referral and monitoring for patients on immunotherapy will be standardised and streamlined. This initiative aims to reduce wait times and time to diagnosis, lower adverse health outcomes and increase patient and clinician satisfaction.