Allied health in Hunter New England

Our dietitians are experts in nutrition. They use up-to-date scientific research to provide practical and easy to understand information to help manage a range of medical conditions. They work with you and your family to improve your health, nutrition and quality of life.

Dieticians provide assessment and counselling for infants, children, adolescents and their families on general and specific nutritional concerns through an inpatient and outpatient basis. 

Our specialty teams include: 

• diabetes and endocrinology
• oncology
• neonatal
• cystic fibrosis
• food allergy
• gastroenterology
• home enteral nutrition
• feeding difficulties related to medical conditions.

General nutrition referrals include: 

• iron deficiency
• failure to thrive
• severe childhood obesity.

Eating a balanced diet is important for good health and wellbeing. We will help you develop personalised, practical and achievable goals aimed to improve your health, nutrition and quality of life.

Our nutrition and dietetics services include:

• inpatient services, incorporating nutrition assessment, dietary intervention and education to prepare for going home
• outpatient services for ongoing nutrition support and education after discharge from hospital. We work together with specialist outpatient clinics including: 
  • cystic fibrosis
  • immunology
  • maternity and gynaecology
  • gastroenterology
  • renal
• group education sessions run by a dietitian are available in the areas of weight management and gestational diabetes
• education and research programs including clinical placements for nutrition and dietetics students from University of Newcastle and quality improvement activities.

For more information about meal services while in hospital and the importance of nutrition, visit the ACI Food and Nutrition in NSW Hospitals Factsheet.

For more information on how a dietitian can help you, visit the Dietitian Association of Australia website.
 

Occupational Therapy (OT) focuses on maximising participation and independence in everyday living skills. 

Our occupational therapists work with people who have an acute or chronic injury or illness with a focus on assessing a patient’s activities of daily living for example, showering, dressing, toileting and feeding as well as matching this to their home environment.

For children, this includes play, self-care, going to and participating in school, sport, leisure and learning skills.  If a child is having difficulty in their daily occupations, including, self-care, school learning and play, an OT can provide assessment and possible therapy, including management to address the difficulties presented.

Occupational therapists provide assessment and therapy for patients who have difficulty performing activities of daily living due to a current injury or illness. Occupational therapists use both standardised and non-standardised assessments to determine a patient’s suitability for discharge. Prescribing equipment and recommending home modifications may also be required during the discharge planning process. Common interventions include:

• pressure injury prevention
• falls prevention
• equipment prescription
• home modification
• functional retraining
• cognitive assessment
• upper limb therapy
• splinting.

Referral to external agencies for continued support post discharge may be recommended by the Occupational Therapist. Facilitation of safe and timely discharge to the client’s preferred destination is our ultimate goal.

Physiotherapists are responsible for the assessment, treatment and prevention of disorders of human movement following disease or trauma. The primary goal of physiotherapy is the restoration of normal function, or to develop a patient's maximum potential within the limitations of possible function.

In addition to various treatment techniques, physiotherapists offer patients and families education, support and advice to enable the patient to safely manage during their hospital stay and post discharge home.

Physiotherapists accept referrals for post-surgical conditions, respiratory conditions, neurological conditions, acute and chronic musculoskeletal conditions and rehabilitation, which can include mobility assessments and prescription of mobility aids.

A referral to the physiotherapy outpatient clinic can be made by a medical practitioner or another allied health professional.
 

Speech pathology provides services to inpatients and outpatients.

Inpatients: We see patients in the hospital who have difficulty with swallowing, breathing, and communicating.

Outpatients: We see eligible adult patients who have a referral letter from a specialist doctor.

Outpatient appointments
Outpatient services are provided to eligible patients who have a doctor’s referral. Speech pathologists see outpatients with:

• swallowing problems
• voice problems
• chronic cough and vocal cord dysfunction (laryngeal hyper-responsiveness)
• speech and language disorders where more information or tests are needed to aid medical diagnosis
• laryngectomy.

Making an appointment
Your doctor will send a referral letter. A manager will determine the best service to suit your needs.

Making an appointment

Your doctor will send a referral letter. A manager will determine the best service to suit your needs.

What do I need to bring to my appointment?
Your appointment letter will tell you what you need to bring to the appointment.

Bring these items with you to any outpatient appointment:

• your Medicare or Veterans Affairs Card, tell our reception staff if you are not Medicare eligible.
• any recent reports or test results
• a list of your current medications.

How long will I be waiting for an appointment?

There is a high level of demand for speech pathology services across our District. You may have to wait for a period of time before there is an available appointment.

What happens if my condition gets worse while I am waiting for an appointment?

If you are worried that your condition is getting worse, call the doctor who referred you to speech pathology.

What do I do if I need to change or cancel my appointment?

There is a long waiting list for outpatient appointments. If you can’t attend your appointment, call your relevant facility and advise them. 

What happens if I do not attend my appointment and do not tell anyone?
If we do not hear from you and you do not turn up to your initial appointment, you will be taken off the wait list. Your referring doctor will get a letter to tell them that you did not attend your appointment. You will not be offered another appointment. It is very important that you call us before your appointment if you can’t come.

What do I do if my personal details change?
If your personal details change, please phone the relevant health facility.  Keep your postal address, email address and phone number up to date so that we can send you appointment information and SMS reminders.

What should I expect at a speech pathology appointment?
Tell our reception staff when you arrive. You will need to complete some questionnaires about your symptoms. Arrive at least 15 minutes early.

An initial appointment lasts for 1 hour. Follow up appointments usually last for 30 minutes. Sometimes minor delays can occur. You will be seen as soon as possible but cannot ‘jump the queue’ to be seen before another patient.

At your first appointment, the speech pathologist will ask questions about your symptoms. They will complete an assessment and discuss your treatment options.

The speech pathologist will write a letter to your doctor about your results. A copy of the letter will be sent to your GP.

You may need further appointments and exercises to help your condition. The speech pathologist will teach you how to do the exercises. They will check your progress each session and make changes to the exercises as needed.  The number of therapy appointments required will vary.

It is important to practise the exercises between appointments. If you feel you are struggling to do this, please tell your speech pathologist. Your speech pathologist can help you identify other options.

Do I have to pay for speech pathology services?
If you have an Australian Medicare card, you do not need to pay for speech pathology. If you are not eligible for Medicare, such as if you are an overseas resident, you will be charged for the service. Payment is required before the appointment. Once payment is made, you will receive a receipt, which you can use to make a claim against your travel insurance (if applicable). Please inform our receptionists if you are not eligible for Medicare in Australia when you call to make the appointment.
 

Our social work service provides direct support to patients, families and carers to assist with the impact of illness and treatment. Social work staff work with our nursing and medical staff within our hospital wards and Emergency Department to achieve the best possible outcome for patients.

Social workers also provide families with emotional support, information, advice and practical help when children come to hospital. Ask your nurse or doctor if you want to talk to a social worker.

Our services include assessment, counselling, coordination with community services, bereavement support, crisis intervention, education, advocacy and discharge planning. We also offer assistance with Centrelink reporting, NSW Civil and Administrative Tribunal (NCAT), My Aged Care and Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS).

The service operates Monday to Friday and provides an after hours crisis on-call service 7 days a week for urgent matters. If you need social work assistance during your stay, ask your treating nurse to make a referral. 
 

Community and Aged Care Services, Greater Newcastle Sector

We provide group aquatic programs by appointment only, for adults, living in the Newcastle, Lake Macquarie or Port Stephens areas.

The pool is located on the grounds of John Hunter Hospital, Rankin Park Campus. The Lodge Building, Lower Ground Floor, 10 Lodge Drive, New Lambton Heights.

Aim of the Hydrotherapy Rehabilitation Program

To improve and maintain the ability to manage everyday life through aquatic exercises. Exercises help with fitness, balance, posture, coordination and muscle strength.

Our group program has been developed to:

• learn a range of pool exercises under the instruction of hydrotherapy staff
• learn correct exercising techniques
• build up to a 40-minute exercise program.

How does hydrotherapy work?
Due to the buoyancy of the water, hydrotherapy exercise gives people the opportunity to perform exercises they may not normally be able to do on land. This increased buoyancy reduces the load taken through the joints such as the knees and hips. The warmth and hydrostatic pressure of the water also help improve blood flow and reduce muscle spasm.

Referrals:
Medical referral is required from a General Practitioner or Physiotherapist with GP clearance. 

Contact the Hydrotherapy Service:
The Hydrotherapy Team
Locked Bag 1, Hunter Regional Mail Centre 2310
Phone: (02) 4921 4110
Fax: (02) 4924 5732
Email: HNELHD-JHHHydrotherapy@health.nsw.gov.au
 

Music, art and child life therapy aim to provide creative therapeutic interventions that empower children, young people and their families to be partners in their care. Non-threatening child-centred experiences develop trust and are individually designed to promote self-expression and growth, optimising potential for wellbeing.

Making an appointment

Referrals for allied health require a referral from a health professional involved in your child's care. This includes GP's, paediatricians, early childhood nurses and other allied health professionals and specialty teams. Specialist referrals from the hospital will receive priority.

Contact us

Paediatric Allied Health enquiries can be made via the John Hunter Hospital switchboard on (02) 4921 3000.

Please ask for the paediatric allied health department and the discipline you would like to speak with.

Music therapy is delivered by a registered music therapist. The music therapist is a proficient musician who has a broad knowledge and understanding of music and is also a qualified therapist whose training has included the applications of music therapy and substantial clinical training in a variety of settings.

Music therapy programs involve a range of musical applications including: 

• instrument playing
• singing and vocalising
• composition
• song and lyric writing
• music and movement
• listening
• improvisation
• performance.

The music therapist draws on a variety of therapies including: 

• psychology
• physiology
• social and behaviour sciences
• human development.

These therapies can help with a range objectives including: 

• socialisation
• communication
• relaxation
• stimulation
• pain or stress management
• emotional expression or coping
• self-esteem
• motivation
• independence
• physical and motor skills 
• cognitive skills.

Benefits of music therapy

Music provides a diversion from the hospital environment and can help with stress, anxiety and pain relief. Music is also a form of communication and expression which can be helpful when exploring thoughts and feelings about being sick.

For seriously ill children, soothing guitar music and simple relaxation techniques help reduce discomfort and pain. During these times, children often say they don't hurt anymore.  After one of these experiences recently, a nurse commented that the music was "better than morphine".  Other nurses have commented that the music is so relaxing; they could listen to it all day.

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Video transcript

Music therapy

Cohen was born premature with complex medical problems.

He has been in hospital for over 165 days.

Music therapy is helping Cohen through his lengthy stay.

When the music therapist plays, Cohen starts to settle.

The soothing music helps with stress, anxiety and pain relief.

Cohen responds to changes in the music.

When stimulating music is played, Cohen starts to dance.

Promoting gross motor movement.

By the end of the session, Cohen’s mood had completely changed.  

The child life specialists at John Hunter Children’s Hospital are qualified professionals, usually with a background in education.

The work of a child life specialist is founded on a theoretical framework resulting in an integrated program of play activities, effective communication, preparation, rehearsal of coping techniques, and emotional support.  They work across all inpatient wards of the hospital as part of a multidisciplinary team. Child life specialists see both inpatients and outpatients by referral, providing individualised play sessions.

Child life specialists support children, young people and their families by helping them understand their treatment; providing information and support for medical procedures; and providing therapeutic recreational activities during their stay.

Child life specialists engage children in role play with medical equipment to gain insight into their understanding of their care and coach children and families to develop relaxation and coping strategies.

Children make sense of their environment through play - it provides opportunities to explore create and learn. Child life therapy allows children and young people to develop coping strategies that support them during hospitalisation, and minimising psychological trauma.

Tips to help your child during their stay

• Ask as many questions as you need to make sure that you have the information to help your child.
• Be honest with your child, give them clear and simple descriptions that you think they will understand.
• Allow your child the opportunity to ask questions about their stay.
• Have your child help pack for hospital
  • Bring a favourite toy or comfort item. 
  • Make sure that all items are clearly labelled
• Bring along familiar activities to engage your child during their stay.
• Think about what helps your child to relax
  • breathing exercises
  • listening to music
  • reading a favourite story or talking.
• Notice all the positive things that your child accomplishes and reward them with praise.
• Wherever possible maintain routines such as sleep times during hospitalisation.
• During medical procedures, provide comfort by talking to your child, holding them for comfort (discuss with nurse), and engage them in a familiar activity, book or song.

Art therapy is delivered by an art therapist who is experienced and qualified in visual art, counselling, child development and education and has an understanding of the varied health conditions that occur within a clinical setting.

Art therapy has many components and contributes to the total well-being of the child or adolescent whilst in hospital. Art therapy sessions may be utilised for the young person to express feelings about stress, anxiety, pain or fear and can also provide opportunities for creative exploration.

Art is also utilised in the treatment of brain injury or mental illness to assist other clinicians in aiding neurological and physical recovery.

Parents have been included in the program at different times to help with stress management.

Benefits of art therapy

Art therapy provides stimulating and creative experiences that promote the release of serotonin or endorphins. These chemicals are natural neurotransmitters that can improve mood, dampen pain and regulate sleep. High levels of stress and inactivity due to illness and hospitalisation can reduce overall levels of these chemicals.

Art also creates a distraction that allows patients to think of something positive instead of focusing on their ill-health. It also gives them something they can control. Creative projects are designed to have a successful outcome for the patients and consequently boost their self-esteem and confidence as well as help them to relax.

Art therapy provides an opportunity for the young person to be viewed holistically and not only as a patient. It can also be utilised as a means for them to express how they feel about their illness or to visualise their level of recovery or discomfort. Patients often find it easier to communicate visually many concepts that they would be struggling to explain with words.

Psychologists at John Hunter Children's Hospital provide a range of assessment, diagnosis, therapeutic intervention and consultation services for children, young people and their families.

Inpatient services

The paediatric clinical psychology service aims to improve the psychological and mental health wellbeing of inpatients referred to the service and their families or carers and facilitate admission and/or discharge from John Hunter Children’s Hospital.

It is recognised that children and young people in hospital may be experiencing:

• psychological and behavioural problems associated with a medical illness or disorder
• physical or medical-like symptoms where psychological and/or relational issues may be contributing to the presentation
• significant psychosocial issues in relation to physical illness or disability including: 
  • difficulties in adjustment or non-acceptance of major disability
  • treatment adherence
  • parenting difficulties in the face of illness.

The paediatric clinical psychology service provides psychological assessment, therapeutic intervention and consultation for children and young people admitted to John Hunter Children’s Hospital and their families.

John Hunter Children’s Hospital’s neuropsychologists provide a multidisciplinary assessment and diagnostic service for children with specific learning difficulties.  

This covers: 

• neuropsychology
• speech pathology
• occupational therapy
• medical problems.

Assessments aim to identify specific reasons for delays in learning and recommend appropriate intervention programs and strategies.

• Neuropsychological assessment for children and adolescents.

Assessments cover memory, attention, executive function, verbal and non-verbal abilities, behaviour and emotional adjustment where there is an acquired brain injury or effects on cognitive function, behaviour or schoolwork due to medical conditions or their treatment.  Assessments are designed to assist in understanding the child’s strengths and weaknesses and in managing and rehabilitation areas of weakness. 

Clinical psychology assessment and intervention is provided for oncology and haematology patients at John Hunter Children’s Hospital for children and adolescents. The psychology clinic operates one day a week and accepts referrals from the paediatric oncology consultants and paediatric oncology social worker. The clinic accepts referrals for both inpatients and outpatients and also provides a service to the patient’s siblings and parents if needed.

The clinical psychologist provides a service to children and adolescents who are undergoing active treatment for cancer, as well as those who are post-treatment or accessing the late effects clinic. The main clinical areas that present include: 

• anxiety
• depression
• childhood behavioural problems
• trauma
• grief
• bereavement.

This clinic works in consultation with the Hunter and Northern NSW Youth Cancer Service (15-25years) that operates out of the Calvary Mater Hospital but due to the often overlapping nature of the two clinics, all referrals are initially discussed between the consultants and clinical psychologists from both teams.

Learn more about our cancer services.

A clinical psychologist provides assessment and intervention for outpatients referred to the Children’s Complex Pain Service at John Hunter Children’s Hospital as part of a multidisciplinary team.

The clinical psychologist’s role is to educate children and their carers in strategies for managing complex pain that are alternate or in addition to medication. These include:

• CBT (Cognitive Behaviour Therapy)
• relaxation Techniques
• pacing of activities.

The psychologist also educates the family as to the working of the nervous system with respect to pain and the effects of stress to assist them to understand why the strategies are helpful. Sometimes anxiety management is part of the process. Behavioural management is also useful at times. Pacing may include return to school planning and reorganising sleep patterns is sometimes a necessary part of management. 

The speech pathologist will discuss the difficulties your child is having and will ask you about any relevant medical history and about your child’s development (e.g., at what age your child walked and talked). Your child’s communication may then be assessed through observation and formal testing. The speech pathologist will discuss the assessment results with you and if required, make a therapy plan with you.

This therapy plan may include:

• ideas and activities to do at home
• clinic appointments
• therapy groups
• consultation with teachers
• home, school or preschool programs
• consultation with other people working with your child
• review of progress
• referral to other agencies.

The service has several aims:

• to assess, diagnose and treat children referred to the service.
• to provide appropriate services to children.
• to educate families, parents and carers.
• to contribute to student clinical education.
• to disseminate clinical information to professionals in the Greater Newcastle area.
• to work in close conjunction with other services to establish and maintain a holistic approach to care.

Information and eligibility criteria for funding supports can be accessed through the National Disability Insurance Agency (NDIA).

The National Disability Insurance Scheme (NDIS) funds individualised supports for eligible children with permanent and significant disabilities, their families and carers.

Parents can refer; however, any other agency or health professional can refer a child to the service. Referrals can be made by phoning the Referral and Information Centre on (02) 4924 2590.

Once a referral is received it will be directed to the appropriate speech pathology community health centre.  There are waiting lists for speech pathology services which vary between sites.  An estimated waiting time will be advised when a referral is made.  Please contact the Referral and Information Centre for updates on waiting times. A speech pathologist will contact the family as soon as an appointment time is available.

Community based speech pathology services are affiliated with The University of Newcastle. As part of your child’s treatment, they may be seen by a speech pathology student supervised by a senior speech pathologist at one of our student unit sites.

Community based speech pathology is also provided as specialist services including Feeding Clinic, Aboriginal Outreach clinic – Nikinpa, Hanen and Ultrasound Clinic.

Hearing issues are a common source of speech and language delays. If your child has a history of repeated ear infections or has not had a hearing test in the last 12 months, it is suggested that you organise an assessment whilst your child is on the waiting list.

For children three years and under, a hearing assessment can be organised through:

• Australian Hearing Services
  Phone: Kotara on 131 797 or Maitland on (02) 4937 9700.

For children over three and a half years and over, a hearing assessment can be organised through:

• Child and Family Health Nursing
  Community Health Centres (this is a free service)
  Locations: Waratah, Toronto Polyclinic, Raymond Terrace Health Centre and Tomaree

Audiometry clinics (hearing checks) are conducted by an audiometry nurse for children aged from 3.5 years to 18 years (still at school) if there are hearing concerns.

To access a clinic, an audiometry referral (PDF 1.18MB) is accepted from medical professionals, speech therapists (within the local government area), child and family health nurses, schools/preschools, other health professionals. A GP referral is required for all out of area clients.

• Private audiologist (check online).

Communication milestones

These resources have been produced by Speech Pathology Australia, which outline the talking and understanding milestones for children aged 1-5 years. View the Children's Communication Milestones.

Stuttering

What is stuttering?

Stuttering is a disorder that affects the fluency of speech. Find out more about causes, getting help, treatment and facts on stuttering.

Developing language skills

How can you develop your child's language skills through reading books?

The following websites provide useful information on using books to build speech, language and literacy skills:

• Developing reading skills
• Early literacy resources

Fact sheets

There are other useful fact sheets from Speech Pathology Australia, which includes:

• The Sound of Speech (0-3 years)
• The Sound of Speech (Preschool and School Aged Children)
• Helping your baby to talk
• Speech pathology and Indigenous children.

To refer your child for speech pathology phone (02) 6592 9536.

Speech pathology services can be accessed in the following locations:

The occupational therapist will discuss the difficulties your child is having and will ask you about any relevant medical history and about your child’s development for example, at what age your child walked and talked. Your child’s skills will be assessed through observation and formal testing. The occupational therapist will discuss the assessment results with you and if required, make a therapy plan with you.

This therapy plan may include:

• ideas and activities to do at home
• clinic appointments
• group therapy programs
• home, school or preschool programs
• consultation with other people working with your child
• review of progress
• referral to other agencies.

Referrals to occupational therapy can be made for Cessnock, Dungog, Kurri Kurri, Maitland and Singleton by contacting the Lower Hunter Referral and Information Centre by phone on (02) 4931 2003.

Once a referral is received it will be directed to the appropriate occupational therapy service. There are waiting lists for occupational therapy services that vary across the sites. An estimated waiting time will be advised when a referral is made.

The SeNT eReferral can be used to send referrals to Hunter New England LHD. If your GP management system does not support SeNT, you may fax a referral.

To refer your child for occupational therapy phone (02) 6592 9536.

Occupational therapy services can be accessed in the following locations:

Physiotherapists will discuss the difficulties your child is having and will ask you about any relevant medical history and about your child’s development, for example, at what age your child walked and talked. Your child’s physical skills will be assessed through observation and formal testing. The physiotherapist will discuss the assessment results with you and if required, make a therapy plan with you.

This therapy plan may include:

• ideas and activities to do at home
• clinic appointments
• home, school or preschool programs
• consultation with other people working with your child
• review of progress
• referral to other agencies.

• On arrival, check in at the reception desk. We will check we have the correct contact details on file. Appointments can run for 30 to 60 minutes. It is helpful to bring along a support person to take care of any siblings or if you are able leave siblings at home. This will allow you to focus on the information being provided by the treating physiotherapist.
• Depending on your child’s needs, they may be required to remove some of their clothing or wear shorts so their muscles and joints can be examined properly. Your child is always seen in a private and dignified environment, and they can choose whether to have family members present or not.
• The physiotherapist will explain exactly what they are doing, and a treatment plan will always be discussed with you and your child. We will involve you in all aspects of your child's care and written consent will be obtained for any procedure or test that is relevant.
• We strongly encourage the child and family to fully participate in all aspects of the physiotherapy session and we aim to make the experience as fun as possible.
• When a child’s physiotherapy care is shared or transferred to a local service, we always speak with the local team and make a plan that is agreed with the child and their family.
• If English is not your first language, we have full access to interpreters. Your referral letter will need to indicate if an interpreter is required.

• your child's blue book
• any letters for the consultants from your GP, district nurses, physiotherapist or other health worker
• a list of questions to ask.

If you would like to, it is helpful to bring along a support person to take care of any siblings or if you are able to leave siblings at home. This will allow you to focus on the information being provided by the treating physiotherapist.

Referral to the paediatric physiotherapy department at John Hunter Children's Hospital can be made by a:

• child health nurse
• GP
• specialist doctor such as paediatrician or paediatric specialist
• other health professional such as physiotherapist or occupational therapist.

Referrals can be sent through SeNT eReferral. If your GP management system does not support SeNT, you may fax your referral to (02) 4923 6422.

The referral will be triaged depending on the urgency of review and a letter will be sent to you confirming your waiting time. You will be contacted via phone to make an appointment once your child comes to the top of the waiting list.

To refer your child for physiotherapy phone (02) 6592 9536.

Physiotherapy services can be accessed in the following locations: