Supporting rural Medicare Locals - challenges and opportunities. Australian Medicare Local Alliance

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1 Supporting rural Medicare Locals - challenges and opportunities Australian Medicare Local Alliance

2 Supporting rural Medicare Locals - challenges and opportunities Claire Austin CEO Australian Medicare Local Alliance 7 April 2013

3 Health Reform A stronger primary care system supported by joint planning with states and territories and the establishment of Medicare Locals. A new framework for funding public hospitals. Transparency, accountability Increased transparency and accountability across the health and aged care system.

4 AML Alliance Peak national body representing 61 Medicare Local (ML) primary health care (PHC) organisations Established in accordance with the National Health Reform Agreement (2011)

5 Medicare Locals Respond to national, state and local health needs/priorities identifying gaps. Coordinate Primary Health Care and broker partnerships connecting care Engage/collaborate with local stakeholders, e.g. LHNs, aged care, social care, consumers

6 Rural MLs: common challenges Rural Medicare Locals are presented with unique challenge Access to health services in rural communities Equity of access and health outcomes Workforce issues Attraction and retention Registration pathway requirements and challenges Consideration of family needs Access to professional development and mentoring Provision of care in multiple settings Capacity and resources Providing coverage in rural and remote settings

7 Rural MLs: common challenges Disparities in social determinants Higher proportion of ATSI people Availability and affordability of housing, particularly in mining towns Poorer health outcomes when compared to metropolitan counterparts Higher prevalence in lifestyle related disease Obesity Mental health Primary and secondary care integration Multi purpose and non-acute services Workforce vulnerability

8 Rural MLs: common challenges After Hours Services Models differ greatly from urban settings GP likely to be providing services in multiple settings. Nursing triage/models of collaboration

9 Medicare Local /Local Hospital Network Interface: common challenges Funding Role delineation Clarification of ML/LHN role in primary health care Lines of communication and responsibility Roles of other not for profits, human service agencies. Data sharing Structural barriers Focus on prevention Primary versus secondary prevention Workforce Need rural generalists

10 What are the solutions? Workforce initiatives The 5 Year Overseas Trained Doctor Rural Locum Relief Program National Rural Health Student s Network Rural Health Workforce Australia has developed a series of documentaries entitled Seachange, Treechange, Lifestyle Change. Specialist outreach programs Partnerships delivered/commissioned Opportunity to align population health needs planning with workforce planning

11 What are the solutions? Telehealth Use of videoconferencing or skype for consultations can reduce financial stress, decrease waiting times, be less disruptive for families and improved continuity of care. Workforce integration Resourcing ongoing funding and momentum Other Partnerships to expand geographic coverage, especially in fringe areas Co-operative AH GP services and rosters Training Pharmacists on common AH presentations Nurses on prescribing Funding/supporting transport services Support RACFs, aged and palliative services Promoting Person Centred Electronic Health Records Different models mentoring and support

12 ML/LHN Solutions Data sharing Joint needs assessments New business opportunities Coordination of services planning and implementation Ensuring efficiency and reducing duplication

13 Example: ML/LHN: engagement at three levels North Coast NSW ML Board and Executive Engagements Cross board membership NCML/LHDs CEO interaction Process and Structure Engagement Shared planning and service design Agreements and MoUs Projects and Partnerships Community Health in General Practice Aboriginal Medical Services Telemedicine Aged Care Emergency

14 Action where to from here? Whole of system approach Systems integration Joint planning Data sharing Consider other human service agencies Priority setting Finding a common ground and places to start Remember the neighbourhood approach Keeping people well and out of hospital

RURAL HEALTH WORKFORCE STRATEGY

RURAL HEALTH WORKFORCE STRATEGY A STRONG PLAN FOR REAL CHANGE 1 We re ready. Over the last four years, we ve been working hard developing our vision for the future of South Australia. Not just policies,