A Regional Approach to the Planning and Delivery of the RHOF and MOICDP in Queensland

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1 CheckUP & QAIHC Working in Partnership A Regional Approach to the Planning and Delivery of the RHOF and MOICDP in Queensland Background CheckUP, in partnership with the Queensland Aboriginal and Islander Health Council (QAIHC) was recently confirmed as the jurisdictional fundholder to lead the planning and delivery of services under the newly established Rural Health Outreach Fund (RHOF) and the Medical Outreach Indigenous Chronic Disease Program (MOICDP) in Queensland. As an experienced fundholder, having worked with a suite of Commonwealth funded outreach services programs for more than 10 years, CheckUP welcomed the establishment of these two new funds which represent a significant opportunity to drive an integrated approach to the delivery of outreach medical specialist, GP, maternity and specialised allied health professional services across the state. Working collaboratively with Medicare Locals (MLs) and Regional Aboriginal and Islander Controlled Health Organisations (RAICCHOs), CheckUP and QAIHC will effectively and efficiently plan for the delivery of outreach services to those living in urban, regional, rural and remote locations, including Aboriginal and Torres Strait Islander communities. Our Expertise Our expertise in managing complex outreach programs is guided by a strong governance framework and detailed planning which clearly articulates all the key activities, milestones, budget, timeframes and reporting required. To drive and support the smooth and effective implementation of the RHOF and MOICDP, CheckUP is able to: Our Partner Drive a collaborative person-centred approach to coordinate and deliver primary health care. Establish relationships and proactively engage with a diverse range of stakeholders at the state, regional and local levels. Provide training and development programs aimed at improving workforce skills and capacity in the primary health care sector. Address the unique needs of Queensland s decentralised population, Aboriginal and Torres Strait Islander peoples and other disadvantaged groups. Lead and facilitate change management to improve systems and enhance patient outcomes through the application of a quality improvement approach. The Queensland Aboriginal and Islander Health Council (QAIHC) is the peak body representing the Community Controlled Health Sector in Queensland and is the partner organisation working with us to deliver services under these two new programs. page 1 of 6

2 CheckUP has maintained a strong working relationship with QAIHC over a number of years, formalising the relationship through a partnership agreement in May The partnership exists at a number of levels across both organisations including Board, CEO, management and staff. Together, CheckUP and QAIHC have undertaken a number of joint activities to address health and access issues and drive the implementation of the COAG Closing the Gap measures in Queensland. Joint Board Meetings are held regularly and QAIHC has openly acknowledged and supported CheckUP s commitment to Closing the Gap. QAIHC has a long standing and successful working relationship with GPQ, and now CheckUP which is formalised through our Commitment to Partnership agreement. QAIHC values the organisation s collaborative approach and their commitment to the realisation of tangible outcomes towards improving the health of Aboriginal and Torres Strait Islander people. Mr Selwyn Button, CEO, QAIHC. (October 2012). Our Staff CheckUP has experienced and qualified staff to plan and deliver the RHOF and MOICDP, with first hand experience in: Working in collaboration with Medicare Locals (MLs), QAIHC, the Department of Health, RAICCHOs, Community Controlled Health Organisations, the Department of Health and Ageing, and other key stakeholders to identify and map service need in Queensland communities. Developing and applying strategies to recruit and retain medical specialists, GPs and allied health providers to deliver services locally. Liaising with local communities, providers and organisations, in conjunction with the MLs, to ensure on the ground support and coordination occurs on a regional/local level. Working with QAIHC to source appropriately qualified staff in the Aboriginal and Torres Strait Islander communities. Understanding the importance of delivering services in a culturally appropriate manner. A Regional Approach As an experienced fundholder and based on consistent feedback from stakeholders, key partners, providers and a number of state and national reviews a regional approach will be adopted to deliver services under the RHOF and MOICDP in Queensland. In determining the proposed regional boundaries to be established for the identification, planning, coordination and delivery of services under the RHOF and MOICDP, the following factors were considered in detail: Geography (ML, HHS, RAICCHOs) Patient flow/transient populations Referral pathways - GPs and others Location of tertiary referral centres Demand for follow up care/services eg surgery Access to Community Controlled Health Organisations and services Proposed number of Outreach Services Regional Coordinators Location of Regional Coordinators page 2 of 6

3 What do the regions look like? The regions have been established in consultation with Queensland MLs and QAIHC, in addition to consideration of the RAICCHOs and Hospital and Health Service boundaries, patient flow to secondary and tertiary services and transient population flow. The regions and boundaries will be: Far North - Far North Queensland ML North West - Central and North West Queensland ML Northern - Townsville Mackay ML Central - Central Queensland ML and Wide Bay ML South West - Darling Downs and South West Queensland ML and West Moreton Oxley ML South East - Sunshine Coast ML, Metro North Brisbane ML, Greater Metro South Brisbane ML and Gold Coast ML. The role of the Regional Coordinator Resourcing will be allocated to support the establishment of the Regional Coordinator role, based in MLs and RAICCHOs, to drive the establishment of six Regional Planning and Coordination Committees across Queensland. (See attachment) To establish a process for strong cross sectoral regional planning, six Regional Coordination and Planning Committees will hold Regional Planning Forums biannually. The forums have been designed to ensure the services provided per region are both complementary to, and integrated with the existing services, activities and resources. The Regional Coordinator/s will be responsible for leading the forums while the MLs and RAICCHOs will be responsible for improving coordination of the primary health care services being delivered, tackling local health care needs and service gaps, and supporting population health planning. CheckUP will work directly with regions and stakeholders that know their communities intimately to understand the services currently being delivered and where gaps exist. This regional approach, coupled with CheckUP s collaborative work at the state level, will provide a detailed and thorough understanding of the services currently in place across all sectors, and most importantly those that are needed. Service Access and Equity To ensure equitable access to services and using the valuable data and information provided by the six Regional Coordination and Planning Committees CheckUP will: Identify health needs and corresponding service gaps, prioritising locations across Queensland Assess workforce supply versus community need Analyse local community health trends page 3 of 6

4 Map service provision Collect and collate service delivery and provider data to inform planning Work with the Regional Coordinators to support local/regional need identification, planning and service review Integrate outreach services with other programs locally and across regions Identify appropriate models of service delivery Ensure access is enhanced for Aboriginal and Torres Strait Islander people Determine and assess local workforce availability and supplementary supports needed Assess infrastructure and equipment needs Utilise existing service providers by either directly contracting or subcontracting the service Monitor and review the services delivered against the Activity Work Plan Convene an annual Stakeholder Consultation, Planning and Review Forum Having QAIHC as a consortia partner means the voice of the Aboriginal and Torres Strait Islander Community is heard at every point in the decision making process. The Governance Structure As the fundholder for both the RHOF and MOICDP, CheckUP will plan the programs together using the Project Governance Framework (see attachment). The inclusive nature of the framework provides the flexibility to accommodate the needs of both programs supported by a robust health needs identification and planning process. What does it look like? The three tiers of the framework address the program s objectives comprehensively - at the governance, strategic and service delivery level (see attachment). An Outreach Services Project Governance Committee will be formed and will oversee the project to ensure the programs are delivered efficiently and effectively across Queensland. Three sub-committees which report to the Project Governance committee will be the: The Financial Governance Sub-Committee - overseeing the financial management of the programs. The Planning Data and Delivery Sub-Committee - overseeing the planning, delivery, data analysis and review of services. The Clinical Governance Sub-Committee - overseeing the development, implementation and monitoring of the Clinical Governance Policy and Framework which guides the delivery of all services under the funds. Past experience has shown this is essential for the effective management and ongoing review of services. page 4 of 6

5 At the strategic level, Queensland will be separated into the six regions each supported by a Regional Coordination and Planning Committee. These committees will be formed to facilitate an integrated and coordinated approach to service planning and delivery. The Committees will be led by MLs and supported by the appointment of Regional Coordinators. Medicare Locals play a pivotal role in understanding and assessing the needs of the population within their area and are well placed to lead this work. The Committees and the Regional Coordinators will also manage and support the Service Delivery level. This will include on the ground service providers from General Practice, Community Controlled Health Organisations, Hospital and Health Services, NGOs and other providers in the region. What can be achieved? CheckUP has six key issues which will be addressed under the governance framework and regional approach: Strengthened data collection, evidence base and needs analysis - having a single fundholder means Queensland data will flow back to a central source rather than having it split between multiple fundholders. Being able to collect field data from across the state means CheckUP can more confidently and accurately respond to needs identified within the community and work to deliver efficient and effective multidisciplinary outreach services. Closing the Gap - increased scope and flexibility to tailor services to improve the health of Aboriginal and Torres Strait Islander people in Queensland. Regional Planning - ensuring that planning occurs collaboratively across all sectors, including the primary health care, community controlled and public hospital sector in Queensland. Service Coordination - planning services regionally, to ensure they are delivered in a coordinated and effective manner in line with community need. Service Integration - establishing service delivery models which support improved service integration and seamless patient/client care, including other Closing the Gap measures. Mental Health - developing dedicated mental health services rather than viewing mental health as a comorbidity issue. Are things improving? We will know if we are achieving our objectives by collecting data from a variety of sources, formulating baseline figures for each and then determining variations above and below them. This includes: Provider Reviews and Service Database Monitoring - these will tell us the number of services that involve both the use of public and private health services and will also tell us the number of people with a referral to a secondary or tertiary provider. Reports prepared by Regional Coordinators every quarter and Provider Reviews - these will tell us the number and type of health services provided to each region. The MLs will also provide information about who is attending the regional planning forums and which organisations are being represented. At the project governance level, we will then know if page 5 of 6

6 the regional approach is working and if provider groups and communities within regions are well represented. Cost Patient Analysis - will tell us the number of people in low socio-economic groups that utilise the outreach services and determine if there were any financial disincentives/barriers to service. This analysis will also tell us who are delivering the services and if they are drawn from the private and/or public workforce. Location Visit Reports - completed by service providers will tell us if we have aligned our data collection, analysis and interpretation correctly and developed a service map that accurately reflects the health needs of the Queensland population. Making the Links Establishing the Project Governance Framework ensures that roles are clearly defined and linkages established. The Committee will oversee the project, to ensure the efficient and effective planning, coordination, implementation and delivery of outreach services across Queensland. It will be guided through the governance of the fund through the DoHA State Advisory Forum as well as the Department of Health and Ageing. Three sub-committees will meet and report to ensure the smooth running of both programs and the delivery of services. The six Regional Planning Committees will report to the Planning, Data and Delivery Sub-Committee and will provide on the ground support to the service providers. While the Committees will be led by the MLs, the Regional Coordinators will be responsible for feeding regional committee and planning forum data back to the Planning Sub-Committee. At a strategic level, the MLs and RAICCHOs will be responsible for establishing the service delivery links while CheckUP will: Work with the Department of Health to share data and state-wide information, to inform service planning, and to reduce the risk of duplication of services, identify new service needs and progress joint initiatives/proposals. Engage all relevant Hospital and Health Services to ensure both public and private sectors are considered in the planning, implementation and evaluation of services under the MOICDP. Work with GPs in Queensland to promote the visiting services to their patients and ensuring referrals are made to services in their local area. Work with the Royal Flying Doctor Service (RFDS) - Rural Women s Health Service to focus on increasing referral pathways and sharing visit dates between GPs and the CheckUP Outreach Service Providers. Work with the Visiting Optometry Service and IRIS to ensure referral pathways and coordination of services is maximised. page 6 of 6

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