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6. New developments in rural training pathways and the vertical integration agenda - Interaction of the RCTS network with other networks (eg IRCTNs, RTPs, PHNs)
Ms Janet Quigley, Assistant Secretary Primary Care Policy and Evaluation Branch
- The Department is working on strategic long term policy for primary care.
- System design - mental health interface / close links between research and future work in primary care.
- 2014 Budget announced the acceptance of all recommendations from the Horvath report including the cessation of funding for Medicare Locals and introduction of Primary Care Networks from July 1 2015.
Primary Health Networks (PHNs) (See Appendix 6.)
- Designed to build links, reduce fragmentation and improve integration between health professionals.
- There will be fewer PHNs to create economies of scale.
- There will be general practice lead clinical councils reporting to the Board.
- Community advisory council to give the community a voice and allow for local accountability and patient centred decision making.
- PHNs will become regional purchasers and commission services rather than being service providers although they can become service providers where there is market failure.
- PHNs will adopt best practice, be outcomes focussed and operate in line with the government agenda to reduce red tape.
- PHNs will analyse health needs of the population, find innovative solutions for their area and better target resources to meet the regions’ needs.
- PHNs will be focussed to research and best practice. Research supports PHNs and PHNs support research agendas.
- Best buys, best values, innovation in design and delivery, best practice purchasing and commissioning.
- The timeframe for development of PHNs is tight. The Department is currently developing policy parameters to be signed off by government. PHNs will be up and running from 1 July 2015.
- The Minister is keen to ensure that all entities can apply. PHNs could be state government, private health insurer, consortia, former Medicare Locals, or not for profit organisations.
Discussion included the following issues:
- PHNs will be clinically appropriate, independent entities with their own board structures.
PHNs and LHNs footprints
- Ideally LHNs and PHNs will work together.
- Once boundaries are determined there will likely be a reasonable amount of congruence.
- There will be a smaller number of PHNs than LHNs nationally. PHNs will have to deal with multiple LHNs. Eg: Victoria has 86 LHNs.
PHNs and GP continuing medical education
- Discussions are taking place with the relevant Departmental Divisions.
- A body of work is taking place around KPIs. There will be a tiered approach. There will not be a re-tender if PHNs don’t meet KPIs in first 3 years.
- The final report is under consideration. The objective of the strategy is to improve efficiency and create opportunities for future improvements.
- Research is critical to everything to do with primary care.
- The government has an agenda to do things innovatively and differently than in the past.
- There are monthly round tables and forums with people from CREs / various experts on primary care issues.
- The Primary Care Policy and Evaluation Branch expect to put a report to the Minister’s office by end of year.
Medical Research Future Fund
- The Fund is dependent on the GP co-payment and will take 20 years to mature before it starts giving out funding.
Medicare Locals vs PHNs
- The Horvath Review highlighted that the scope of work varied, roles and responsibilities were not clear. Better efficiencies can be achieved if PHNs are bigger and aligned with LHNs. PHNs will refocus in line with Commonwealth priorities and patient outcomes. The government is keen on driving competition via a broader group of entities.