Ms Jane Doepel1, Ms Catherine  Clarke1, Ms Betty  Mareko1, Ms Corina Billingham

1Tores And Cape Hospital And Health Service, Thursday Island , Australia


The Torres Strait and Northern Peninsula Area stretches from the tip of Cape York to within 4km of PNG. There are 23 island communities spread across 48,000 square kilometres. The  population of 10,886  ( 81% indigenous ) 1 receive  very limited outreach  allied health services from the hub on Thursday Island

The sequelae of diabetes, high incidence of osteoarthritic knees and high set housing are some of the factors influencing balance and falls in this population

If older Torres Strait Islander people are unable to age at home or are hospitalised they are forced to be hundreds of kilometres over the ocean away from home and family

The team used the Calderdale Framework to establish skill sharing between the physiotherapy , occupational therapy and Podiatry services to address the issues of providing timely  assessment and interventions for balance and falls prevention in the older population.



  • Using the Calderdale framework helped focus the project and gave rigour and  clear direction
  • Clinical tasks shared included a balance of assessment and interventions
  • Training each other takes time. Competing priorities and travelling on outreach meant time was difficult to quarantine.
  • Staff turnover was identified early as a high risk and proved to be so. Managing to implement the training phase and sustain the changes required engagement from all levels and ongoing commitment.

Take Home Message

Skill share is a valuable service delivery model in remote contexts


Jane graduated 1985 with a BApp Sc (Physiotherapy) in Sydney and has a Master Public Health and Tropical Medicine form JCU (1997 ). She began her career working as a generalist in rural & remote communities. She has worked in NSW, WA and Qld and also in Timor Leste helping to develop the Community Based Rehabilitation Facilitator program. She has always worked in teams and understands the unique perspectives & skills that each profession contributes
Working for a some years in Early Childhood Intervention and being part of the change of service model to a key worker model helped Jane develop greater understanding of how we can blur boundaries and share skills to improve outcomes for patients . Jane has brought that understanding to helping develop a skill share model in the Torres Strait where she has been working for the past 4 years

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