Mr Adrian Powlesland1, Ms Rachelle Pitt1, Ms Liza-Jane McBride1
1Office Of the Chief Allied Health Officer, Herston, Australia
Biography:
Adrian Powlesland is an accomplished allied health leader with over 10 years of clinical and non-clinical experience within Queensland Health. With a foundation in Nutrition and Dietetics and postgraduate qualifications in Digital Health, he brings a deep understanding of healthcare service delivery, workforce capability, and digital innovation. Adrian played a key role in the review of Queensland’s Home Enteral Nutrition Service (HENS) guidelines, enhancing service effectiveness. In his current role at the Office of the Chief Allied Health Officer, he leads statewide digital and workforce initiatives, driving system-wide transformation to improve healthcare outcomes.
Abstract:
Background:
The Home Enteral Nutrition Service (HENS) within Queensland Health supports outpatients unable to meet nutritional needs through oral intake. A statewide Guideline ensures consistent prescription and supply practices across Hospital and Health Services (HHSs). A comprehensive review was undertaken to ensure the Guideline remains contemporary, fit for purpose, and capable of delivering equitable, high-quality services to patients and their families.
Method:
The Queensland Office of the Chief Allied Health Officer (OCAHO) led the review, guided by a Project Reference Group of key stakeholders, including clinicians, finance officers, procurement teams, and HENS consumers. A published policy analysis framework was applied to assess alignment between policy statements and intended outcomes, evaluating coherence, accessibility, resource allocation, and stakeholder engagement in consideration of HENS practices and outcomes across HHS’s. Data sources that informed the review included stakeholder interviews, policy review, and evidence-based literature.
Results:
A gap analysis against policy outcomes identified challenges in equity, accessibility, affordability, and sustainability. While dietetic services demonstrated strong commitment to high-quality care, operational and policy barriers affected implementation in some settings. To address these gaps, several major amendments to the Guideline were made, including a revised funding structure eliminating patient co-payments, with service costs fully acquitted against the appropriate Tier 2 Non-admitted Patient Service Event.
Discussion:
The structured application of a policy analysis framework strengthened the review process, ensuring the revised Guideline now wholly aligns with intended outcomes and Queensland Health policy priorities. Ongoing evaluation will support effective implementation, long-term sustainability, and adherence to best practices.