ABHI Integration: Evaluation and Sustainability

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• ABHI Integration Evaluation and Sustainability
• Sarah Bradfield
• 03 August 2009

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Year 8 Writing and experimental report
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The Plan for today
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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)

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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

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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

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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

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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!

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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

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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

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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/

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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)

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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!

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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

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Whats 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)

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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

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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

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Sarah Bradfield sarahbradfield_at_gpnsw.co
m.au 02 9239 2900