Calls for beefed-up health collaboration

Formalised agreements between hospitals and Primary Health Networks (PHNs) would help reduce ‘blurred responsibilities and misaligned incentives’, the Productivity Commission (PC) says.
 
The proposal, outlined in the final version of the PC’s ‘Delivering quality care more efficiently’ report, would use the National Health Reform Agreement as its ‘main lever’, according to its authors.
 
It put ‘collaborative commissioning’ involving Local Hospital Networks (LHNs) and PHNs at the heart of its proposal, calling for them to work together more to address local needs and to ‘develop programs of work, monitor progress and report on outcomes’.
 
However, its final report still includes no mention of funding for support for general practice multidisciplinary teams, general practice-based pharmacists, and health assessments, all suggestions included by the RACGP in its original submission.
 
The college has also previously outlined its support for improving the way PHNs work, including in its response to the PC’s interim report in September.
 
‘Greater flexibility is necessary for PHNs to adapt services to meet the needs of their regions,’ the RACGP stated.
 
‘Pooling of funds is a straightforward way to reduce service duplication and fund larger services which can take advantage of economies of scale and greater resourcing without increasing the funding burden on government.’
 
The RACGP said GPs ‘must be involved in collaborative commissioning and supported to do so’, while PHNs and LHNs should be ‘able to act locally on social determinants of health’ using a similar model to Aboriginal Community Controlled Health Organisations (ACCHOs).
 
‘Overall, we are optimistic that greater collaboration with ACCHOs and LHNs would encourage underperforming PHNs to improve,’ the college stated.
 
A newsGP poll run 12 months ago found more than half of respondents rated the performance of their local PHN as ‘poor’ or ‘very poor’.
 
The PC said higher quality and more efficient care would come from ‘developing an ecosystem of collaboration that enables greater uptake of effective interventions’.
 
‘Governments have already recognised the benefits of collaboration between these interdependent organisations, but blurred responsibilities and misaligned incentives have hampered its adoption across the system,’ its authors stated.
 
‘Even when new collaborative models of care deliver positive outcomes, the current system does not allow them to be scaled or sustained.’
 
Authors said reforms should help longer-term planning and reduce preventable hospitalisations by 5%.
 
The PC’s interim report had raised a potential target of reducing potentially preventable hospitalisations by 10%, but authors concluded this was too ambitious in the short term.
 
The Commission also proposes setting up a National Prevention and Early Intervention Framework, a suggestion supported by the college on the proviso it is informed by GP expertise.
 
Investing $1.5 billion into a prevention and early intervention fund over five years could save governments $2.7 billion over 10 years, the PC said.
 
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PHN Primary Health Network Productivity Commission