In aged care, conversations about innovation often focus on clinical models, workforce reform or digital systems. Yet one of the most significant barriers to health and wellbeing for older people remains strikingly simple — getting to care in the first place.
For many residents living in aged care homes across regional Australia, access to primary healthcare is shaped not by availability of services, but by transport. Missed appointments, delayed diagnoses and preventable hospitalisations are often downstream effects of a system that assumes mobility, family support and public transport infrastructure that simply don’t exist.
Transport as a Health Equity Issue
The Northern Rivers region exemplifies these challenges. Communities are geographically dispersed, public transport options are limited, and primary care services are under pressure. For residents with mobility issues, cognitive impairment or limited family support, attending off‑site medical appointments can become a barrier that compounds over time.
Transport is not a ‘nice to have’. It is a determinant of health — influencing access, continuity of care and health outcomes.
Yet transport is rarely designed with aged care residents in mind.
Designing a Different Approach
Recognising this gap, St Andrew’s Ballina, with funding support from Healthy North Coast, has launched the Resident Transport Initiative — a community‑led, clinically governed model designed specifically to support aged care residents to access primary and specialist healthcare.
This activity is funded by Healthy North Coast through the North Coast PHN program.
The initiative was not developed in isolation. It was co‑designed with residential aged care facilities, GPs, allied health providers, residents, families and First Nations representatives. Throughout the design process, one message was consistent: transport needed to be reliable, dignified, culturally safe and clinically integrated.
What Makes This Model Different?
Unlike traditional transport services, the Resident Transport Initiative is embedded within clinical governance structures. This means transport is aligned with care plans, risk assessed on a per‑resident basis, and supported by trained volunteers who understand the unique needs of older people.
Key features include:
- Volunteer training in aged care awareness, infection control, manual handling and cultural safety
- Clear protocols linking transport to clinical decision‑making
- Strong coordination between aged care staff and primary health providers
- Ongoing data collection to measure impact, safety and quality
Transport is treated not as an administrative task, but as part of the care pathway.
Early Learnings: Access Changes Outcomes
While still in its early stages, the initiative is already reinforcing an important truth: when access barriers are removed, care improves.
Residents are more likely to attend appointments. Families report reduced stress. Clinicians benefit from improved continuity and communication. Over time, these changes are expected to contribute to reduced preventable hospital transfers and better health outcomes.
Perhaps just as importantly, residents experience greater autonomy and confidence — the dignity that comes from knowing that access to care is supported, not rationed.
A Model for Regional Innovation
The Resident Transport Initiative reflects a broader shift in aged care innovation: moving away from siloed solutions and toward integrated, community‑driven models that address real‑world barriers.
It also demonstrates the value of targeted, place‑based funding. Relatively modest investment — when guided by evidence and strong governance — can unlock system‑level benefits.
As the aged care sector continues to navigate reform, workforce pressures and increasing complexity of resident needs, solutions like this remind us that innovation does not always require technology or scale. Sometimes, it requires listening closely, designing intentionally, and recognising that access itself is care.
Looking Ahead
St Andrew’s Ballina is committed to evaluating the initiative over time and sharing learnings with the broader sector. Our aspiration is that this model contributes to future thinking about how aged care, primary health and community services can work more effectively together — particularly in regional and rural settings.
Because when we design services around people’s lived realities, the impact reaches far beyond a single appointment or journey. It strengthens systems, builds trust, and ultimately leads to better ageing outcomes for all.
