The Department of Health and Aged Care (DoHAC) has published the PHN (Primary Health Network) Strategy (2023-24), which sets out the critical role of networks in supporting healthcare reform.
The document clarifies The purpose, objective and key functions of PHNs, highlighting how they drive local innovation to meet specific local health needs and support the consistent local implementation of national and jointly commissioned programs.
PHN test report and recommendations
The publication follows the Australian National Audit Office’s (ANAO) audit of the effectiveness of the performance management of the Department of Health and Aged Care’s primary health networks, which aims to assess the effectiveness of the department’s performance management of PHNs.
PHNs were introduced in 2015 as a primary health care delivery model, replacing Medicare Locals. There are 29 PHN providers across Australia, responsible for 31 PHN regions with a population ranging from 64,000 to 1.7 million people. Since the inception of PHNs, DoHAC has provided $11.6 billion in grants to support these networks.
The ANAO audit found that although the PHN delivery model was launched in 2015, there was no assurance framework in place until 2021. Although specific guidance and tools to support assurance activities have been in place since 2016, an assurance strategy and schedule was created in 2022 and a risk management plan in 2023, the ANAO said in the audit report.
The report goes on to say that DoHAC’s performance measurement and reporting arrangements for PHNs and the PHN delivery model are partially fit for purpose, but the department has not demonstrated that the delivery model achieves its objectives.
The report made eight recommendations on the following topics: ensuring PHN’s compliance with the requirements of the grant agreement; improved PHN performance measurements; PHN data backup; improved PHN performance reporting; IT systems for PHN monitoring and reporting; and evaluating the PHN delivery model. The DoHAC approved seven recommendations and agreed in principle with one recommendation (implementation of a fit-for-purpose IT system for the management of PHNs).
PHN Strategy 2023-24 – Core functions and priorities
In the recently published PHN strategy document, the DoHAC states: “In line with As the five-fold goal of successful healthcare reform, PHNs perform three core functions: coordinate and integrate local healthcare services in collaboration with Local Hospital Networks (LHN) to improve the quality of care, people’s experience and efficient use of resources; Commission primary care and mental health services to address population health needs and gaps in service delivery and to improve access and equity. and capacity building and providing practical support to primary care and mental health providers quality care.”
The department provides financial support to PHNs for overhead corporate governance and non-administrative health system improvement activities and programs to carry out specific activities in 11 areas of activity. As the PHNs fulfill their ongoing role, they have specific policy priorities each year. The priorities starting or continuing in 2023-2024, according to DoHAC, are:
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Population Health
- After-hours program reform – Focus on new program guidelines when launching after-hours operations. Engage multicultural access services for culturally and linguistically diverse (CALD) communities; Mandate access to basic services for homeless people.
- Frequent Hospital Users – Contribute to co-design work with the department, S&T departments, LHNs and others to finalize programming of the new MyMedicare incentive.
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Practice support
- MyMedicare Implementation – Support general practices with MyMedicare enrollment; Helping more practices gain accreditation; Prioritize practices and individual providers that serve senior care homes.
- Affiliated Health, Nursing and Midwifery Services – Expand PHN practice support capabilities to affiliated health, nursing and midwifery practices where possible.
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Digital health
- PIP Quality Improvement Incentive – Continue to engage and support data sharing and quality improvement practices.
- Data Security: Renewed focus on data security.
- Data Linkage and Analysis – Work with LHNs, S&T Governments, AIHW and the Ministry on data linkage and analysis initiatives.
- My Health Record – Work with Allied Health and ADHA on My Health Record compliant software development.
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Emergency preparedness
- Primary Care in Emergency Preparedness – Facilitate the integration of primary care and mental health into emergency preparedness and response.
- Prepare for Mobilization – Maintain the ability to mobilize primary care and mental health in disaster scenarios.
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Mental health and suicide prevention
- Primary Mental Health Services – Continue to coordinate and commission mental health services in the eight mental health priority areas.
- Headspace Centers – Continue to engage headspace centers to improve health outcomes for young people.
- Bilateral Schedules – Continue to participate in the activities set out in the bilateral schedules, such as joint regional planning and commissioning.
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Alcohol and other drugs
- Treatment and workforce – Continue to improve access to alcohol and other drug (AOD) treatment services and build capacity in the AOD sector.
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Health services in geriatric care
- General practice in geriatric care — Work with Residential Aged Care Homes (RACHs) to identify residents without a usual primary care physician; Assign these residents to a regular practice and family doctor. Engage primary care physicians to provide regular services in RACHs where gaps exist. Work with RACHs to make easier arrangements for GP visits.
- Improved access to care for aged care residents – Improve after-hours support and increase the availability and use of telehealth for aged care residents.
- Care Finders for Older Australians – establishing and maintaining the Care Finders network; Help people connect with relevant support.
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Aboriginal and Torres Strait Islander Health
- Holistic team support — Improve health outcomes for Aboriginal and Torres Strait Islander people with chronic conditions through better access to care coordination and multidisciplinary care and support for self-management. and increase access to culturally appropriate general care services; Collaborate with the department on the transition to direct funding.
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Workforce
- Workforce Incentive Program: Practice Stream – Contribute to the development of data collection arrangements on the use of nursing and allied health care in general practice.
- Allied Health Commissioning – Commissioning of allied health and care services targeting areas of need, with a focus on supporting MDT care for small general practices.
- Single Employer Model – Participate in the Single Employer Model (SEM) testing program for primary care physicians in areas of need.
- GP Incentive Fund – Use the expanded PHN GP Incentive Fund to address the GP shortage in areas of need.
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Emergency measures
- Emergency response in primary care – In emergency situations, you should operationalize and implement emergency response in primary care according to the requirements in the regions.
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Medicare Urgent Care Clinics (UCCs)
- Support the establishment of 58 Medicare UCCs across the country and support local integration, data collection, communications and clinical operations.