ABHI Integration: Evaluation and Sustainability Sarah Bradfield 03 August 2009

1. ISO 9001 Lic QEC22546 SAI Global ABHI Integration: Evaluation and Sustainability Sarah Bradfield 03 August 2009

2. Year 8: Writing and experimental report

3. The Plan for today…

4. Australian Better Health Initiative • 5 priority areas: • 1. Promoting healthy lifestyles • 2. Supporting early detection of lifestyle and risk factor modification • 3. Supporting lifestyle and risk factor modification • 4. Encouraging active patient self management • 5. Improving integration and coordination of care • Funding for all ABHI programs will finish in June 2010 • For some state funded programs funding will continue • (HealthOne NSW, SSWAHS Diabetes Prevention Program)

5. National Network Update… • National Chronic Disease Prevention and Management Network (CDPM) • Primary care integration (ABHI) • Chronic Disease Self Management • Lifestyle Modification Programs • National PCIP SBO group - quarterly teleconferences • Evaluation through Meta-analysis of ABHI five priority areas • Potential for funds pooling of SBOs to purchase ABHI PCIP evaluation and demonstrate outcomes

6. NHHRC: A Healthier future for all Australians • Tackling major access and equity issues • Aboriginal health, Mental Health, dental, rural and remote, public hospitals and national access targets for primary care • Redesigning the health system to meet emerging challenges • Prevention and early intervention, integration and aged care, medicare review • Creating an agile and self improving health system for longer term sustainability • Consumer engagement, learning workforce, e-health, data and communication, strategic purchasing, research • Funding reform

7. What does this mean for Divisions? • Change is inevitable • Contestable environment – other agencies will compete for the opportunities • Divisions will have the chance to move into new areas of work including service delivery and will need to take a population health approach • Time frame • 6 months consultation and consideration of the 123 recommendations • 2 to 3 year time frame for changes to be put in place with stages of change

8. NHHRC – what will this mean to your partnerships? • How do your partners view change? • Fearful, excitement, threatened, cynical, in denial?? • Tips for staying on track: • Use patient journey as safe universal language • Systems will be the same no matter who owns them • Work locally – let the politics take care of itself • Remember that nothing is certain except death and taxes!

9. COAG funding commitment to “Close the Gap” • $806M over 4 years from Commonwealth with match funding of $772M from states and territories • 80 FTE indigenous outreach workers • encourage greater use of primary care services • improve cultural safety of primary health care services

10. What is Happening in NSW? • Garling Caring Together report • Community Health Review • HealthOne NSW program • Get Healthy Information and Coaching Service • Severe Chronic Disease Management Program funded through NSW Government • Walgan Tilly recommendations for Aboriginal health

11. NSW Health Reforms… • “Caring Together: The Health Action Plan for NSW” • 139 recommendations with 134 being implemented • Community Health Review • Available on NSW Health website • http://www.nswchr.net/

12. Get Healthy Information and Coaching Service … • In three months of operations… • 2402 calls • 40% want coaching with half needing GP Medical clearance • Age group 30 – 50 year olds, 80% women • TV and Radio advertising campaign generating more calls • Measure Up campaign will be run again in September and will link to this again • AHS have been funded $20K to promote service • Required to consult with Divisions (minimum)

13. Severe Chronic Disease Management Program • Director appointed • Staged development • GP NSW working with NSW Health • General Practice Council involved • Steering committees to be formed will have GP representation • DEN presentation will be made when there are more details • WATCH THIS SPACE!

14. Walgan Tilly: Chronic care for Aboriginal People • Clinical Services Redesign Project • Over 20 local solutions identified at AHS • 6 state wide solutions and 8 themes • Goals for Chronic Care program ] • Practical steps and solutions to improve access • Improve relationships between Aboriginal People and chronic disease services • Identification and sharing of best practice

15. What’s Happening at GP NSW? • Leadership: CEO – Jan Newland • Support: Chronic Disease team – taking and integrated approach to Division support for all areas of chronic disease management • Advocacy: • Collecting stories of integration and population health outcomes to promote the role of Divisions in the local community • Building links with Directors of Health Promotion and Divisions • Partnership building: DA NSW, Heart Foundation, Carers NSW, Council of the Ageing, General Medical Clinical Task Force • Building wider consultation representative of General Practice (GPs, PNs, AHPs etc)

16. Challenges of the ABHI Program… • Multiple systems for information exchange • AHS staff without devolved decision making powers • Working in partnerships is complex. • Culture of mistrust of GP diagnosis leading to lack of direct referral to services

17. Key successes for Divisions… • Building on local activities and linking Divisions programs • Addressing culture differences • Increasing scope of chronic disease clinics in General practice • Actively pursuing self management and prevention activities • Laying foundations for change • Linking to programs which will continue beyond June 2010

18. Sarah Bradfield sarahbradfield@gpnsw.com.au 02 9239 2900