Re: Submission to the Inquiry into the Thriving Kids Initiative

Dear Committee Secretariat,

Please find attached the submission from NursePrac Australia | Just Kids Health Clinic to the Inquiry into the Thriving Kids Initiative. As Western Australia’s only nurse-practitioner-led children’s health service, we see first-hand the systemic barriers families face in accessing timely and equitable care.

Our submission highlights practical, scalable solutions that embed equity, early intervention, and nurse-practitioner-led models into the national framework, ensuring that no child is left behind. We would welcome the opportunity to provide further evidence, case studies, or oral testimony to support the Committee’s deliberations.

Thank you for the opportunity to contribute.

Yours sincerely,

Stephanie Dowden

RN, Paed Cert, MEd, MN(NP) FACNP

Paediatric Nurse Practitioner & Director

NursePrac Australia | Just Kids Health Clinic

11 Wentworth Parade

redacted

Submission to the House Standing Committee on Health, Aged Care and Disability

From: NursePrac Australia | Just Kids Health Clinic

About Us

NursePrac Australia is the only nurse-practitioner-led children’s health service in Western Australia. Established in 2017 as a social enterprise, we provide accessible, family-centred healthcare for children and young people aged 0-18 years. Families can self-refer, avoiding GP referral barriers, and services are delivered in safe community settings such as our clinic, schools, childcare centres, and local hubs. Our Just Kids Health Clinic has supported over 6,500 children in 14,000 appointments, with 40-50% of families from low-income backgrounds.

Key Issues We Have Identified

• Severe delays in access: Children routinely face waits of 16–24 months for assessment of developmental delays and often another 12 months for a diagnosis in the WA public health system, with most private paediatricians closed to referrals or having long waiting times to be seen and costing thousands of dollars for private diagnoses.
• Equity gaps: Families experiencing poverty, trauma, housing instability, or exclusion often never engage with government pathways. Disadvantage is not limited to CALD or Aboriginal and Torres Strait Islander families but includes all children experiencing adversity.
• Missed intervention windows: Long waits prevent early diagnosis and intervention, worsening child health, school readiness, and leads to life-long poorer educational and social outcomes.
• Stigma and blame: Families report being told their concerns are “behavioural” or “poor parenting,” when children often have undiagnosed developmental disabilities. Commonly, in families living with severe disadvantage, we identify that one or both parents have an undiagnosed disability, which has contributed to their difficulties engaging in complex, confusing and inflexible services.

Our Model / Solution

• Nurse-practitioner-led clinics by expert children’s nurses: Accessible, flexible, and innovative. Families can self-refer.
• Holistic health checks & developmental assessments: Integrating physical, developmental, and psychosocial healthcare with parent support and coaching.
• Family advocacy: Support to navigate NDIS, education, and health systems.
• Allied health and Community partnerships: Collaborations with Allied Health (e.g. Occupational Therapy, Speech Therapy) and Family and Social Service providers.

• Group parent-child interventions: Building developmental skills and parent confidence in community settings.
• Regional outreach: Pop-up clinics and Telehealth extending reach to rural/remote WA.

Our Alignment with Thriving Kids Initiative

• Early intervention focus: Timely developmental assessments and interventions reduce life-long disadvantage.
• Equity principle: Services designed for hard-to-reach families, not only those already in systems.
• Community-based access: Delivering care in trusted spaces closer to home.
• Innovation and scalability: Nurse practitioners are under-utilised nationally; expanding their role can rapidly increase system capacity. Experienced nurses with paediatric skills (including Child Health/Child and Family Health nurses) can be upskilled to the Nurse Practitioner pathway allowing a career pathway and growth of the workforce.
• Partnership approach: Working with schools, Early Childhood Education and Care (ECEC), NGOs, Aboriginal Community Controlled Organisations, and local government.

Resources for Parents

Families need practical tools to identify developmental concerns early. Currently, information is fragmented, and many parents rely on inconsistent and outdated advice. We recommend:

• National rollout of validated screening tools (e.g. ASQ, PEDS) available in multiple languages and formats., including tools sensitive to detect ASD, such as ASDetect/SACS. This must be accompanied by education for providers.
• National rollout of Queensland Government The ‘Red Flag:’ Early Intervention Referral Guide for Children 0–5 years.
• Parent resources — apps, checklists, and online modules that guide families on what to look for and when to seek help.
• Community-based education delivered through ECEC/childcare centres, schools, and playgroups.
• Targeted education for ECEC staff and school-entry teachers about recognition of developmental concerns
• Targeted outreach for disadvantaged families to ensure these resources are accessible and trusted.

We frequently meet families who have had their concerns dismissed or told to ‘wait until school entry assessment’, with a lack of understanding from referrers that this will delay time to treatment and some children will ‘age out’ before being seen.

Effectiveness of Current Programs

Current and past programs have had mixed success in supporting children with mild to moderate developmental concerns. For example:

• WA Child Development Services (CDS) provide existing models of care but are struggling to manage high volumes of referrals leading to excessive wait times or premature discharge from CDS services.
• Maternal and child health checks are valuable but inconsistent in identifying developmental concerns and miss children whose families disengage before key milestone check points.
• Community playgroups and parenting programs offer support but lack integration with health pathways, with staff managing busy workloads, being under-resourced and lacking skills in identifying developmental delays.

Our Pop-up clinics in ECEC settings identify high numbers of unrecognised developmental delays, with most never previously referred to services or still waiting for first appointments.

We recommend that Thriving Kids build on these strengths but address fragmentation and ensure equity of access.

Workforce Support and Training Gaps

The Thriving Kids framework will only succeed if workforce shortages are addressed. Nurse Practitioners are under-utilised nationally yet ideally placed to deliver timely care. We recommend:

• Expansion of NP training pathways and funded clinical placements.
• Supported training for nurses with paediatric experience to upskill in child development.
• Rural scholarships and incentives to attract NPs and allied health to underserved regions.
• Investment in cross-disciplinary training with allied health, educators, and child development specialists.
• Nationally consistent credentialing and scope-of-practice recognition for NPs.

Nurse practitioners are skilled and able to diagnose developmental delays, ADHD and ASD (either independently or in a collaborative model) but have their assessments ignored or not allowed by different systems, such as education or NDIS, leading to duplication of assessments and additional time delays and costs to families.

Domestic and International Best Practice

Internationally, mid-level providers such as Nurse Practitioners are central to child health systems:

• In Canada and New Zealand, Nurse Practitioners deliver primary paediatric care in rural and remote areas.
• In the UK, community child health hubs integrate nursing, allied health, and early childhood education.

These examples demonstrate scalable, cost-effective models Australia can adapt.

Seamless Transitions Across Systems

Families struggle with fragmented services and repeated assessments. Thriving Kids must prioritise continuity and integration, including:

• Shared referral and data systems across health, education, and community sectors.
• Co-location of services in schools, childcare, and hubs.
• Case coordination roles (e.g. NP-led care coordinators and system navigators) to guide families through multiple systems.
• Governance structures ensuring health, education, and disability services are jointly accountable.

When families are lost between systems there are often very limited resources to call on for help. This leads to further delays, costs and families giving up due to the emotional toll this takes. This scenario is very prevalent in families with the least capacity to navigate systems. Even for those of us who are experienced and vocal it can take months of advocacy to achieve any outcome.

Recommendations

1. Explicitly recognise Nurse Practitioners as providers in Thriving Kids models and funding streams.
2. Support self-referral pathways to reduce barriers for disadvantaged families.
3. Provide resources for parents — screening tools, education, digital platforms.
4. Review and integrate current programs (child development services, child health services, playgroups, ECEC).
5. Embed equity as a core design principle, ensuring reach to all children experiencing adversity.
6. Fund community-based hubs offering health checks, assessments, and wraparound therapies with the child and family at the centre.
7. Provide flexible funding for allied health (OT, speech, psychology) for families outside NDIS or public pathways.
8. Invest in regional outreach models, including telehealth and mobile clinics.
9. Strengthen workforce development for NPs and allied health.
10. Draw on domestic and international best practice to guide design.

11. Build robust evaluation and equity data systems to track outcomes.
12. Ensure co-design and governance with families, nurse practitioners, and communities.

Conclusion

The Thriving Kids Initiative is a unique opportunity to create a system that is accessible, equitable, and family-centred. NursePrac Australia offers a proven, scalable model that reduces delays, reaches disadvantaged families, and delivers care closer to home. We urge the Committee to include nurse-practitioner-led, equity-first services in the Thriving Kids framework and funding streams.

We would welcome the opportunity to provide further evidence, data, or case studies in support of this submission.

Executive Summary

Submission to the Thriving Kids Initiative Inquiry

From: NursePrac Australia | Just Kids Health Clinic

The Challenge

• Every week, 10 new children present to our clinic with developmental or behavioural concerns.
• WA families face 16–24 month waits for developmental assessment and most private paediatricians have closed their books.
• Children living in disadvantaged families (poverty, trauma, housing instability, social exclusion) are often completely left out of current systems.
• Missed early intervention leads to worsening health, school exclusion, stigma, and lifelong disadvantage.

Our Model

NursePrac Australia runs WA’s only nurse-practitioner-led children’s health service.

• Families can self-refer — no GP referral needed.
• Combining holistic health checks & developmental assessments delivered in safe community settings.
• Family advocacy for NDIS, education, and health systems.
• Trialling models that build children’s skills and parental confidence.
• Regional outreach through pop-up clinics and telehealth.

Why This Matters for Thriving Kids

• Early intervention reduces life-long disadvantage.
• Equity focus: disadvantage affects more than CALD and Aboriginal/Torres Strait Islander families — it includes all children living with adversity.
• Community-based hubs reduce stigma and increase engagement.
• Nurse practitioners offer an innovative, scalable, and cost-effective solution.

Our Recommendations

1. Recognise and fund Nurse Practitioners in Thriving Kids models.
2. Support self-referral pathways for families.
3. Embed equity as a core principle.
4. Fund community-based hubs with wraparound supports.
5. Provide flexible allied health funding for families outside NDIS/public pathways.
6. Invest in regional outreach and telehealth.
7. Build evaluation and equity metrics into the program.
8. Include families, communities, and NPs in governance.

Conclusion

The Thriving Kids Initiative is a chance to build a child health system that is accessible, equitable, and future-focused. NursePrac Australia’s proven model delivers timely care, reaches disadvantaged families, and scales effectively. We urge the Committee to ensure nurse-practitioner-led, equity-first services are embedded in the national framework.