1. The Australian Primary Health Care Research Institute
PHC RED Strategy 2004 National Meeting
Nicholas J Glasgow
Good morning everybody. My name is Nicholas Glasgow and I am the Director of the Australian Primary Health Care Research Institute or APHCRI.
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2. Overview APHCRI’s mission and aims APHCRI as a virtual institute
Hub and Spoke model
Collaborative model
Streams of research activity
Vision and plans
Building connections
In this session today I’m going to briefly revise APHCRI’s mission and aims;
Outline the hub and spoke model of collaborative activity that has been adopted by APHCRI;
Briefly describe the three streams of research activity that APHCRI has progressed;
And conclude with a description of the vision and plans that we have for APHCRI, in particular looking at how “building connections” will contribute to the realisation of those plans.
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3. Mission
APHCRI’s mission is to “provide national leadership in improving the quality and effectiveness of primary health care through the conduct of high quality priority-driven research and the support and promotion of best practice” 
This is the mission statement of APHCRI.
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4. Strategic Plan – Goals and Aims
Goal 1: A stronger knowledge base
Specified Aim: To strengthen the knowledge base of primary health care to inform policy and practice through the conduct and support of research
Goal 2: Uptake of research evidence
Specified Aim: To facilitate the uptake of evidence in primary health care policy and practice
Goal 3: Enhanced research capacity
Specified Aim: To enhance research capacity in primary health care through strategic partnerships and collaborations with other relevant national and international groups
Goal 4: An effective organisation
Additional Aim: To ensure that the Institute operates to the highest standards by developing and improving its organisational capacity to lead the national primary health care research network through appropriate staffing, resources and infrastructure, management practices and accountability processes
The strategic plan outlines APHCRI’s goals and aims. Thereat three goals which relate to the virtual Institute and the fourth goal is focused on the effectiveness of the organisation particularly on the ANU campus
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5. APHCRI – a virtual institute
“Hub and Spoke” model with the Hub being based at the ANU, and the Spokes being programs of research undertaken around the nation commissioned by the Institute’s Research Advisory Board.
The Hub and Spokes together form the Institute and meet the Institute’s mission and aims
$15.8 million over five years to support the Hub and Spokes
APHCRI is a virtual Institute. The hub is based at the ANU. The spokes are the programs of research being undertaken around the nation as part of the Institute’s priority driven research program. It is the hub and spokes together that form the Institute. The Australian government has provided $15.8 million over five years to support the Institute and its research programs.
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6. Elements of APHCRI Hub (ANU) Spokes Research Advisory Board
Director, a research team, and a secretariat. The Director is responsible for APHCRI’s academic, financial and management activity
Spokes
the priority-driven research projects and programs undertaken by APHCRI
vary in location, identity and duration depending on the projects and programs APHCRI supports
Research Advisory Board
has both advisory and decision-making roles
Expert Review Committees
assess proposals for research funding
APHCRI has the following elements:
The Hub
The Spokes
The Research Advisory Board
Expert Review Committees
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7. Research Advisory Board
These pictures are of the members of APHCRI’s Research Advisory Board. Professor John Marley is the Chair, Professor Linda Kristjensen the Deputy Chair. Members are appointed as individuals not as representatives and bring diverse and relevant perspectives to bear on the Boards deliberations. Pat Anderson was unable to make the group photo and so I have included a recent picture of her with a beautiful banner proclaiming “together for our health” – important words for APHCRI to which I will later return.
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8. Hub and Spoke Model
This diagram illustrates the collaborative approach that APHCRI takes to its work. The goals and aims of APHCRI as outlined in the strategic plan are achieved by the Hub and spokes together delivering against its stated aims. What this means in a practical sense is that the hub has no expectation of all the expertise in primary health care residing within itself! Spokes provide a mechanism for the relevant expertise in Primary Health Care within Australia to be both harnessed and enhanced.
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9. Declared Priorities Innovation in State/Commonwealth relationships
Innovation in funding arrangements for new or existing services/models
Innovation in organisation and linkages within the in Primary Health Care sector
The research advisory board has determined that the priorities of APCHRI’s first research program are innovation and state Commonwealth relationships, innovation and funding arrangements the new or existing services of models, and innovation in organisation and linkages within the primary health care sector.
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10. Research Program Initial priority research questions identified
National program of research in accordance with the priorities in progress
Stream 1 – funding allocated ($400,000) and program underway
Five Spokes working with the Hub
Using and refining CAS theoretical framework
Stream 2 – funding allocated ($100,000) and proposals being developed
Stream 3 – information workshop held and full proposals being to be received by COB 29th November
Up to $6,000,000 allocated to this Stream
Having identified please initial priority areas, APHCRI has embarked on three streams of research activity in 2004.
Stream one focuses on existing innovative programs addressing one or more of the three priorities, and seeks to learn new information from these existing activities. $400,000 was allocated to this stream and the programme is underway. As part of its brief APHCRI is charged with developing methodological approaches to questions within primary health care. APHCRI has developed a theoretical framework to this stream of activity using complex adaptive systems theory, and as an example of the collaborative approach taken to research by APCHRI, has refined this framework with a five spokes that are engaged in the stream.
Stream two invited potential spokes to propose potential innovative programs of research that addressed one of more of the three priorities and receive some funding to further develop the proposals for submission in Stream Three. 28 expressions of interest were received and $10,000 given to each of 10 potential spokes.
Stream Three is underway – in addition to the 10 groups who received development funding, a further nine groups are continuing to develop their proposals applying their own resources.
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11. Vision and plans PHCRED interconnectedness National linkages
Capacity development
Researcher development
Grants and awards
APHCRI
National linkages
E.g. (not exhaustive) PHCRIS, NICS, NHMRC, NPCC, ADGP
International linkages
“Together for our health”
The elements of the PHC red strategy complement each other. Capacity development within primary health care is essential in order to provide a pool of people seeking to further develop their research capabilities. Grants and awards support that further development as well is allowing different aspects of primary health care to be the focus of research activity. For example specific clinical questions are not part of the strategic focus of APHCRI. Researching clinical questions in primary health care is essential as part of the primary health care research agenda. Within PHCRED grants and awards support clinical research. For APHCRI spokes to function a pool of researchers with different skill mixes and expertise is essential. The strategy overall is a means of developing this resource.
It is not just the PHCRED strategy that is interconnected however. The Commonwealth government funds a number of bodies with mandates within primary health care. I have listed some examples of these - not an exhaustive list - to illustrate the point that APHCRI can establish linkages with many partners in order to progress the development of the primary health care system in Australia to the benefit of all.
Finally, we can learn from experiences overseas, and contribute to the learnings of other countries. APHCRI will be active in this endeavour.
“Together for our health” the vision is one of community and collaboration.
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12. Who’s challenge is it? “Not mine!” “Yours!” “Ours!” “Mine!”
A reflection from a family.
The plate and cup attest to recent food consumption.
The location is on the floor in front of the television. The room is empty.
Dirty dishes should be in the dishwasher.
Within this family, several responses to this reality are made.
The first is for a family member to insist that the dirty dishes are not mine. “I don’t know who did it but I am not responsible”
The second may be accusatory – “It was X” Not only is it not my problem, it is definitely X’s.
The third is more global – there is an acknowledgement of the fact that the issue impacts on the whole family. But the danger here is if no action results.
The final response will solve the problem – “I will take action” – note that this does not mean that the person who does this is necessarily the person who left the plate there.
APHCRI is looking to different members of the PHC community to collectively own the problems confronting PHC and take action in helping to address them.
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13. Who will judge APHCRI’s success?
Users of APHCRI's “products”
Policy makers
Professional organisations
Consumer groups
NGOs
The Research Community including participants in PHCRED
The Australian Government as funder
The ANU
Keeping focused is important – APHCRI will be evaluated, and there are different perspectives from which the assessment will be made. This slide lists four. APHCRI sits in the midst of these and seeks to actively engage all.
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14. Questions?
That’s the end. I will be happy to respond to any questions.