1. HealthOne NSW Chronic Care Forum 2007 Responding to the Challenge 19-20 September 2007 Inter-Government and Funding Strategies Branch NSW Department of Health

2. 1 HealthOne NSW A NSW government initiative to deliver integrated primary health and community care services Goal: to provide patient centred, continuing, coordinated and comprehensive care through a strong, integrated and sustainable primary care sector Funding: NSW Government has committed: –capital funding of $40m over 5 years (06/07 – 10/11) –recurrent funding of $12.3m over 4 years (07/08 – 10/11)

3. 2 HealthOne NSW services - Core characteristics (1) 1.General Practice and Community Health staff working together as members of a multi-disciplinary team 2.In a formal organisational arrangement that is different from either a conventional General Practice or a conventional Community Health Service

4. 3 HealthOne NSW services - Core characteristics (2) 3.Providing coordinated and integrated services for a local community, that encompass: Health promotion and illness prevention Early detection and early intervention Continuing care for people with chronic and complex conditions 4.Including planned care for those who need it

5. 4 HealthOne NSW services - Core characteristics (3) 5.Underpinned by integration of systems for client record keeping and information sharing 6.Providing a locale for clinical education and training, and research 7.With health care consumers and the local community as active participants in services planning and care delivery

6. 5 What are we aiming to do?  Prevent illness, reduce the risk and impact of disease and disability, and build personal and community resilience  Improve chronic disease management in the community  Reduce avoidable hospital admissions  Improve service access and health outcomes, especially for disadvantaged and vulnerable groups  Create better experiences for people using health services (ie improve patient journeys through the system)  Strengthen the participation of consumers and communities in health care and health service decision making  Build a sustainable model of health care delivery

7. 6 HealthOne NSW – a work in progress  Two EOIs released in 2005 and 2006 respectively  Wave 1 (EOI 1) – seven HealthOne NSW services announced  EOI 2 - eight wave 2 and eleven wave 3 proposals approved in March 2007 for progression –Wave 2: project plans reasonably well developed, strong partnerships evident –Wave 3: proposals require further development and partners to be confirmed

8. AREA HEALTH SERVICE EOI 1 WAVE ONE EOI 2 WAVE TWOWAVE THREE Hunter New EnglandManillaForster Tuncurry Quirindi Raymond Terrace Greater SouthernCorowa Cootamundra JindabyneDeniliquin Batehaven Harden South Eastern Sydney Illawarra Sussex Inlet Sydney South WestElderslieCanterbury Greater WesternMolong Rylstone Blayney Gulgong Canowindra Coonamble Dareton-Wentworth Broken Hill North CoastPottsville, Yamba Sydney WestMt DruittRouse Hill, Auburn

9. Mt Druitt - Wave 1 - Western Sydney AHS Challenges  Urban area with very disadvantaged communities, including refugees and Aboriginal people  38% population have income below the poverty line  Lots of solo general practitioners Service Model  Hub – community health centre  Spokes - individual general practices and satellite centre  Community health staff and GPs, with other services such as housing, child support  Focus on young families with parenting issues, young people with mental health problems and older people (over 70 years) with chronic diseases

10. Molong – Wave 1 – Greater Western AHS Challenges  Small rural town with an ageing population  Limited access to allied health and specialist medical care  Limited transport infrastructure Service model  Nursing services, GP services and specialist services will be co-located  Strong local government involvement  Local and visiting allied health services  Outreach services will be provided to neighbouring towns

11. Raymond Terrace – Wave 2 - HNEAHS Challenges  30km from Newcastle but no direct public transport  Growing and young population (41% under 24), with large Aboriginal population and high proportion of single parent families Service model  Port Stephens Council leading master planning for health/welfare precinct which will include early childhood and family services, library, private diagnostic and allied health services etc  Community health services (eg. community nursing, allied health, women’s health, D&A) and largest GP practice will be co-located at HealthOne NSW service (part of this precinct)

12. 11 Key challenge  Bringing together different clinical providers with very different business models and funding sources: –public sector Community Health staff (employed by Area Health Services) –private-for-profit General Practices (typically fee-for- service subsidised by Medicare) –(potentially) other private sector providers, eg. community nurses, allied health practitioners, pharmacists (may be funded by consumers, GPs accessing MBS items, Divisions of General Practice)

13. 12 Key issues for every site  Model of service delivery – what services will be provided, by whom, to whom, where and when  Corporate governance – the decision making and accountability arrangements that will ensure that the service operates efficiently, effectively, legally and ethically  Clinical governance arrangements – that will ensure patient safety and clinical quality  IM+T arrangements – to allow sharing of clinical records and efficient team communications  Facility requirements and capital funding implications

14. 13 Expert advice  Waves 1 and 2 – Expert advice up to value of $15,000  Wave 3 – Expert advice up to value of $7,000  Able to access nominated people with expertise in: –consultation and facilitation –corporate governance –business modelling –financial management / resourcing –integrated models of care and service delivery –information management and technology –capital planning

15. 14 Evaluation Framework 1.STRUCTURE: Does the HealthOne NSW service have an organisation and structure that can support an effective, integrated and sustainable health service? 2.PROCESS: Does the HealthOne NSW service have systems and processes that enable health professionals to provide integrated care? 3.OUTCOMES: Do the services provided meet the needs of patients and the local community? 4.SYSTEM: How well does the service function as part of the wider network of health and community care services?

16. 15 Shared: - identity - vision - strategic purpose - responsibilities - resources - benefits Networking Co-operation Co-ordination Collaboration Partnership Building partnerships