Working with shared purpose to benefit the community and their health needs. Jacki Ward, Linda Richardson 14 th National Rural Health Conference, Cairns 26-29 April, 2017
About WAPHA The WA Primary Health Alliance (WAPHA) evolved from a partnership of like-minded organisations. WAPHA is the planning and commissioning body that has been contracted by the Commonwealth Government to operate the three Primary Health Networks (PHNs) in WA - Perth North, Perth South and Country WA. WAPHA commenced operations on 1 July, 2015 and is the single point where primary health and social care comes together at the State and local level.
Primary Health Networks There are 31 PHNs across Australia. The PHNs role is outcome based and it is to work at a system level to: Design health care models* through co-design/co-production via community engagement and clinical leadership. Shape the structure, as well as the components of supply, with an emphasis on: increasing the efficiency and effectiveness of medical services for people, particularly those at risk of poor health outcomes; and improving the coordination of care to ensure people receive the right care, in the right place, at the right time. *It is not the PHN s role to deliver services.
Commonwealth Priorities Commonwealth Key Priorities Priority Health Areas Mental Health Aged Care ATSI Health Population Health (Chronic Disease) Health Workforce ehealth
The Commissioning Framework
Country WA PHN Kimberley Broome Pilbara Karratha Midwest Geraldton Wheatbelt Northam Perth North & South Goldfields/Western Desert Kalgoorlie Southwest Bunbury Great Southern Albany
Commissioning The Country WA PHN regions of Midwest, Goldfields and South West commissioned new services for chronic disease and mental health. How did we work out the model? Looked at services being delivered and where Spoke with stakeholders, individually and in groups, including current service providers, GPs Spoke with consumers at community fora in larger towns Sought guidance at Aboriginal health planning meetings Consulted with Aboriginal reference groups Held talks with organisations such as DAA, RHW, MHC, PM &C, NGOs Talked with Police, Shires, youth services
Midwest - What we found Chronic disease services had been provided by same providers for approximately 16 years Delivery typically provided through mostly un-coordinated allied health services Service delivery concentrated on larger population centres with limited outreach Funding and services not reaching those in most disadvantaged areas Lack of community knowledge of what services were available/when
Midwest - What we did Discussed findings with the Midwest Regional Clinical Commissioning Committee Formed small working groups which included GPs, health professionals, representative of AMSs to advise on both CD and MH models Looked at: Results of all consultations Commonwealth directive (stepped care) Available funding Models had to be: Coordinated, person-centred and encourage self-management Provide sustained engagement with GPs and other primary health providers Build local capacity - workforce
Midwest - Areas of Need Areas of need were found to be: General CD services throughout the Gascoyne and Murchison AoD services in Meekatharra and Carnarvon, especially for Aboriginal and Torres Strait Islander people Lack of culturally appropriate mental health services for Aboriginal and Torres Strait Islander people in Meekatharra and Carnarvon
Midwest - Models Models were designed for each area based on local information Discussed with services providers to ensure integrated coordinated care Discussed with various Government and non-government organisations Discussed with community members and Aboriginal organisations to ensure the voice of the community was heard
Midwest - Changes Made Integrated Team Care Aboriginal specific, with two new providers of care being the AMSs in Geraldton and Carnarvon Integrated Chronic Disease Care new provider contracted to provide services in the Midwest, Murchison and Gascoyne Alcohol and other Drugs Aboriginal specific services to be provided in the Murchison and Gascoyne
Midwest - Changes Made Mental Health professional two service providers, one in Meekatharra and one in Carnarvon, to provide social and emotional wellbeing and coordination services to Aboriginal people and their families Integrated Primary Mental Health Care expressions of interest for these services are presently being evaluated
What we Learned Communicating on a large scale is hard work and developing fully integrated models is time consuming Service providers appreciated the opportunity to be able to get together to talk to each other Communities, especially Aboriginal people, felt they had been listened to Feedback after 6 months of new service provision
Questions