Primary health care is the backbone of a high performing and efficient health system and is most people’s first contact with the health care system.(1) The demonstrated links of coordinated primary health care to better health outcomes, improved equity, increased health security and better cost-efficiency make primary health care the cornerstone of health systems strengthening. Health systems built on the foundation of primary health care are essential to achieving universal health coverage.(2) While the Australian healthcare system is ranked one of the best in the world, we face many complex challenges to strengthen our system and improve outcomes for Australians. Primary health care presents a huge opportunity to address these challenges through reform and for transformation to high performing care.
Recently, we presented at and facilitated a full day roundtable coordinated by Brisbane South PHN, looking specifically at how to advance the role of PHNs in the integration and evidencing of multidisciplinary team (MDT) models in primary care. Primary Health Networks (PHNs) assess the health care needs of their community and commission health services to meet those needs, minimising gaps or duplication. They support health services to connect with each other to improve people’s care and strengthen the primary health care system. Together with the peak bodies; Pharmaceutical Society of Australia (PSA), Allied Health Professions Australia (AHPA) and Australian Healthcare and Hospitals Association (AHHA), 25 PHNs engaged in presentations and deep discussion on national collaborative and strategic actions required to clarify and advance the role of PHNs in integration, evidence of MDT models and allied health workforce solutions in primary care.
The first of three roundtable sessions focused on models for pharmacists in general practice, the second on the allied health workforce and the third on the application of Value-Based Health Care (VBHC) as a framework to bring together diverse stakeholders in addressing the challenges and opportunities identified throughout the day.
The challenges and strategic opportunities identified throughout the day were largely well-known – systemic themes such as fragmentation, governance, data and funding challenges. Workforce challenges were also discussed in the context of innovative models of care. The consolidation and contextualisation of the known systemic challenges enabled the recognition of opportunities within the large group of influential stakeholders to drive action in the space utilising a VBHC framework.
The recommendation for orientating the health system towards a value-based approach has been socialised in Australia over the past decade, and progress towards this aspiration continues to evolve and grow, within a growing body of global evidence.
Kylie Woolcock, CEO AHHA, facilitated a discussion that proposed the stakeholders in the room could come together identifying the different programs and initiatives applied in different contexts along a care pathway. Together, this would allow a forensic analysis of the outcomes achieved for the resources. Service providers, communities and health could then better understand opportunities to reorient place-based models of care provided by multidisciplinary teams that are person-centred and value-based.
Participants engaged in discussion of the strengths and weaknesses of the application of this VBHC approach to advance the role of PHNs in the integration and evidencing of multidisciplinary team (MDT) models in primary care. The need to move away from examining care pathways in silos was welcomed, with interest in how we could together focus on the patient as the organising principle of service delivery.
