National Primary Health Care Partnership Position Statement on Primary Health Care Reform

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1 National Primary Health Care Partnership Position Statement on Primary Health Care Reform The NPHCP believes that a strong primary health care system is essential to keeping consumers, their families and carers at the centre of health care service delivery. There is now growing recognition of the crucial role that primary and preventative health care can play in reducing acute care and hospital costs. To improve health outcomes throughout the community, Australia s primary health care system must provide an effective, comprehensive and timely response to people s total health needs, through direct access to expert multidisciplinary health care. To achieve this, there must be a true partnership between all of the health disciplines and government, underpinned by new models of care and funding which provide increased access to services. To be fully effective, primary health care must be based on mutual respect for the diversity of professional skills, together with a working knowledge of the expertise of other disciplines so that appropriate referrals can be made. The NPHCP is committed to working together to achieve a national primary health care system which: Puts the consumer at the centre of discussions and decisions about their health and the delivery of health care; Provides a multidisciplinary team approach to health care with all primary health care professionals; Improves access to the right training and education, resources and ongoing support to build up a sustainable health care workforce; Allows for flexible and innovative solutions to meet local health needs and remove barriers to ensure seamless patient care; Promotes comprehensive evaluation of the effectiveness, efficiency, quality, safety and sustainability of new models of service delivery and supports the broader roll out of models with demonstrated efficacy; Provides quality, safe, and measurable patient care based on best-practice and clinical evidence; and Includes a focus on prevention and early intervention. To achieve this vision, the National Primary Health Care Partnership calls for reform in three key areas of the health system: 1. Equity of Access 2. Multidisciplinary team care 3. Primary Health Care Network.

2 This vision is consistent with the policy direction of the Australian Government, which has announced a progressive reform agenda to address the health challenges facing Australian communities. This health reform agenda includes the establishment of the National Health and Hospitals Reform Commission, a National Preventative Health Taskforce, the National Primary Care Strategy and review of the Medicare Benefits Schedule. 1. Equity of Access The NPHCP calls for an integrated primary health care system based on the principles of universal access, where the needs of the consumer and the community are placed at the centre of health service delivery. Irrespective of location, language or socio-economic status, Australians require access to health services that meet their needs at the right time, delivered by the most appropriately qualified health professional with the competency to provide the required service, in the right place, at the right price. To achieve this, the primary health care system must: 1. Recognise the diversity of Australia s geographic regions, culture and language, education and socio-economic status and enable the development of local/regional/state/national solutions to address the current and future health needs; 2. Deliver services that are culturally safe and appropriate where cultural safety and awareness are a core component of health professional education and training starting at an entry level and continuing as part of life long learning; 3. Commit to addressing disparity in health outcomes between indigenous and non-indigenous Australians through the promotion of equitable access to comprehensive primary health care directed at promoting health and wellbeing including through an emphasis on prevention and early intervention; 4. Provide flexibility of funding arrangements to meet the demographic health profile of a region, allowing pooling of funds across jurisdictions and programs to enable the delivery of integrated and coordinated primary health care services; and, 5. Be based on the principle of universal access to health care, currently partially provided by Medicare, and provide comprehensive, integrated health care as determined by the needs of the patient. 2. Multidisciplinary team care Equity of access can be significantly improved by promoting and strengthening multidisciplinary team care approaches. Multidisciplinary care is delivered by a range of highly-skilled, specificallytrained health professionals and ensures that consumers are able to access the right type and level of care, at the time they need it. 2

3 The benefits of multidisciplinary care, particularly in relation to preventing and managing chronic disease, are now well recognised and documented. 1 A primary health care system that supports effective teamwork can improve the quality of patient care, increase innovative approaches to care and assist in addressing workforce issues such as skills shortages and burnout. Effective multidisciplinary team work is dependent on all members of the team receiving education in interdisciplinary and multidisciplinary care approaches commencing at entry-level qualification and continuing throughout their professional careers. Multidisciplinary care requires regular communication and sharing of patient information among members of the team and other parts of the health care system. This is necessary to reduce duplication in assessment, treatment, taking patient history, and ordering diagnostic tests and interventions, thus improving patient outcomes. Communication and information sharing should be electronically enabled and protect and promote consumer privacy. Critical to the success of primary health care multidisciplinary teams is the creation of equitable access to funding and remuneration for all members of the health team and funding structures that support the collaboration of a multidisciplinary team. Without equitable access to funding sources, such as the MBS, efforts to provide multidisciplinary, consumer focussed care are compromised. Equal access to financial incentives and payment systems will enable timely referrals, allowing patients to receive affordable and accessible care from the most appropriate health professional. 3. Primary Health Care Networks To facilitate genuine consumer-focussed multidisciplinary care all disciplines needs to be involved in the governance, planning and evaluation of service delivery. Localised primary health care networks, with governance and management structures that reflect the spectrum of professionals working in primary health care would improve communication, facilitate effective team-based care and reduce fragmentation in service delivery. Within this governance structure, consumer representation is essential. Primary health care networks would provide greater opportunities for joint education and an increased understanding of the specific role of each health professional in the primary health care sector, thereby strengthening team work and referrals. They would also support an increased number of entry level professional placements and the opportunity to introduce future practitioners to community based multidisciplinary care. 1 Commonwealth of Australia (2007) Australian Coordinated Care Trials 2007: Part 2 - Evaluation Approach and Summary Findings of the Second Round of Coordinated Care Trials, Commonwealth of Australia; Eagar, K. et al. (2005) Lessons from the National Mental Health Integration Program Aust Health Rev 29 (2): ; Zwar, N. et al. (2006) A systematic review of chronic disease management. Australian Primary Health Care Research Institute, Canberra. 3

4 Primary health care networks would facilitate effective and rapid communication systems to facilitate multidisciplinary care, by assisting in the targeted roll out of secure messaging and ehealth technologies. Such initiatives are seen as critical to improving access to primary health care services for all Australians, including in areas of geographic, cultural and socio-economic disadvantage. 4

5 Background Nineteen (19) national peak health organisations representing over 100,000 frontline health professionals working in the primary health care sector have come together to form the National Primary Health Care Partnership (NPHCP).The NPHCP provides an advocacy body and voice for the Australian primary health care sector. The NPHCP works together to improve strategies to strengthen the primary health care sector and improve the health of Australians by increasing team-based care. 5