Embedding a Compression Garment Service Model: Improving access to lymphoedema services through sustainable workforce redesign in rural and regional facilities

Dr Fiona Hall1, Ms Julie Hulcombe1, Ms Catherine  Stephens1, Associate Professor  Susan  Gordon2

1Queensland Health, Cairns, Australia, 2Flinders University, , Australia


Background:Based on the success of a previous service model (SM) trial and in response to lobbying by consumers, Queensland Health (QH) aimed to expand and embed compression garment selection, fitting and monitoring, in service and workforce models utilising generalist therapists. Therapists received support from lymphoedema therapists via telehealth coaching and an education program.

Methods:The SM was extended through workforce planning and culture change strategies to increase service reach.  The guideline was revised expanding eligibility criteria to all adult clients with lymphoedema and including all, physiotherapists, occupational therapists and podiatrists who had completed the education program as providers of compression garment care. A Compression Garment Data Collection System was developed.

Results:The number of health services implementing the SM has doubled (12 services). The number and breath of generalists providing services and lymphoedema therapists supporting the SM has increased, including twenty-two new generalist therapists and ten new lymphedema therapists.   The revised guideline has been endorsed, the education package has been revised and the database is being used for collection of activity and costs.

Discussion:QH has promoted and expand the SM improving access to services particularly in rural and regional facilities. Access to garments has improved with expansion of garment eligibility to include all primary and   secondary lymphedema. The range of therapists eligible to prescribe has expanded contributing to improved access.   Consistent measures will be monitored and provide the basis to evaluate ongoing costs and provision of garments.  This SM has the capacity to address workforce and service provision issues on an ongoing basis.


Upon graduating Fiona worked as a counsellor and psychologist in educational, community and hospital settings in rural, remote and metropolitan locations in Australia. Following this she worked as a clinical psychologist and researcher providing mental health services for more than a decade and completing post-graduate studies in clinical hypnotherapy, acute care in the community and a Doctorate in Psychology. The last ten years in the workforce have been committed to progressing the National allied health workforce and mental health reform agendas through the management of Statewide projects and programs. Fiona lives with her family in Cairns, North Queensland and works for the Allied Health Professions Office of Queensland, where she manages statewide strategic workforce planning and policy development activities.