A1258690708wtEgr

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Primary care strategyGPV forum September 2009
Professor Hal Swerissen Dean, Faculty of Health
Sciences Pro Vice Chancellor (Regional) La Trobe
University
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National Reform Agenda

• COAG
• National Health and Hospital Reform Commission
• Primary Health Care Strategy
• Other (eg. prevention task force)

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The Aim of Reform
Compression
Morbidity
Current
15 10 5
0 10 20 30 40 50 60
70 80 90 100 110
Age
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COAG Health Ageing (Nov 08)

• Financial commitment over 5 years (hospitals)
• Health workforce
• National objectives and outcomes
• Health prevention
• National partnerships
• Prevention
• Indigenous health
• E health

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NHHRC Proposals

• Taking responsibility
• Connecting care
• Facing inequities
• Driving quality performance

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Primary Care ?
AH
Pharmacy
AH
GP
GP
Pharmacy
HOSPITAL
Home care
AH
CHC
Community care
Pharmacy
Sub acute
Residential care
GP
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Trends
Large Bed Based Care
Home
Smaller bed based units
Online and virtual
Home
Community
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Integrated Health Care
Person centred health care
Integrated service delivery
Partnerships and networks
Funding and systems
Policy and programs
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Population Groups and reworked services

• Prevention
• Simple (one modality) primary care
• Acute, sub acute and post acute care
• Chronic and complex care

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NHHRC Primary care

• Commonwealth responsibilities
• Comprehensive primary health care centres
• Chronic and complex condition enrolment
• Performance outcomes
• Shared care arrangements
• Discussions of primary health care
• Extended scope and practice

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Draft National Primary Health Care Strategy

• Changing health system
• Demand pressures
• Variable access
• Poor integration
• Concern about safety and quality
• Capacity issues

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Building blocks

• Regional integration
• Information and technology, including eHealth
• Skilled workforce
• Infrastructure
• Financing and system performance

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Priorities for reform

• Improving access and reducing inequity
• Better management of chronic conditions
• Increasing the focus on prevention
• Improving quality, safety, performance and
  accountability

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• Universal access to MBS PBS
• Target programs better technology use
• Integrated care for chronic conditions
• Better information on quality for patients
• A focus on outcomes

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Next steps

• Build on existing organisational structures
• Systems development/e health, referrals,
  guidelines), development planning
• Funding/commissioning for specific areas (eg
  chronic and complex conditions)
• Develop divisional/area based reporting,
  accountability and incentives

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Integrated Primary Care
Improved outcomes reduced costs
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Organisational options

• Vertically integrated organisations
• (eg. Area Health authorities)
• Network organisations
• (eg. Primary care trusts)
• Capacity building organisations
• (eg. Divisions of general practices)
• NB Area based or enrolment based

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Primary Care Network Organisations

• Independent practices and agencies
• Common systems for referral, care planning,
  communications etc.
• Agreed practice guidelines
• Integrated planning, co-ordination,
  commissioning, performance management and
  capacity building for population
• Agreements with acute, sub acute, residential and
  providers

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The big picture

• Funding, management provision
• Which level of government?
• What structure of provision?
• Commonwealth take over
• Program alignment
• Commonwealth State partnership

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Thank You