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Primary Health Tasmania introduces new commissioning model

Marina Williams
1 December 2016 

Tasmania’s leading primary health body is taking a new approach to service procurement processes to provide a sustainable model of care services to residents. Primary Health Tasmania is a non-government, not-for-profit organisation empowered to connect residents and care providers. It was one of 31 similar bodies established around Australia on 1 July 2015 as part of the Federal Government’s Primary Health Networks Programme. Health providers were previously known as Medicare Local services.

Medical providers, including physiotherapists, can apply through a procurement process, such as tenders and expressions of interest, to be commissioned or funded, to deliver a targeted service to patients within a region. Primary Health Tasmania undertakes the procurement processes via Tenderlink electronic tender. The method of payment for services is determined as per the proposal put forward within the tender process. It is an opt-in model of operation and one practitioners can choose not to participate in.

‘The focus with primary health is improving communication with communities to take a collaborative approach to introducing necessary and needed health services,’ Primary Health Tasmania’s Mark Broxton says. ‘This means improving coordination of care to ensure people get the right care in the right place at the right time.

‘At its simplest, commissioning means planning and buying services to meet the health needs of local populations. It involves understanding local priority issues and buying appropriate services that offer high-quality and safe care to address those issues in the most effective and efficient way to improve health outcomes for rural populations,’ Mark says. ‘Commissioning is different to the way we have been buying health services in the past. There is now a strong focus on ensuring outcomes for communities and populations, rather than a focus on delivering activity.’

To deliver on priorities, networks nationally must work with communities and service providers to:
  • increase the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes
  • improve coordination of care to ensure patients in need of care receive it, when required.

General practice and community health providers, local council representatives and residents have taken part in the consultations at Queenstown, Burnie, Launceston, Bicheno, Brighton and on Flinders and King Islands.

‘The goal is to keep residents well and out of hospital,’ Mark says, adding that participants gave consistent messages about the need for better communication between providers and central points of information for consumers.

In partnership with communities and service providers, the commissioning framework is designed to deliver sustainable primary health solutions. Primary Health Tasmania’s commissioning model involves four phases in a cyclical process:
  • Assessing needs—understanding what local communities need and working out the local priorities we can address based on this information.
  • Designing solutions—working with others to identify the most efficient and effective ways we can address the identified priorities.
  • Implementing solutions—procuring quality health services and initiatives and proactively working with providers to monitor performance and progress towards agreed outcomes.
  • Evaluating outcomes—assessing the efficiency and effectiveness of services and initiatives (including value for both health gains and money) against outcomes, and informing priorities for future investment in successive commissioning cycles.
‘In order to provide a service, we need to know what is required within a rural community,’ Mark says. ‘From this, we can then focus on a targeted integrated service delivery at the local level that then connects rural health services within the broader health system.

‘We aim to improve how health and community services are coordinated and connected, so a person’s health journey is as seamless as possible. All of our programs promote a person-centred approach to care that respects people’s needs and wishes, and actively involves the person, their family and carers as part of the process.’

Good person-centred care involves organising and supporting a person’s health needs across different services.

‘It is an effective way to make sure people with chronic health conditions are able to navigate a complicated system to get the care they need,’ Mark says. ‘Primary Health Tasmania will commission a range of services to help ensure those receiving health services have access to a more-connected system of care. We will work with potential tender applicants through the commissioning process to assist them in understanding the types of care and models of health service required.’

Mark stresses that commissioning is not a ‘set and forget’ model of delivering services, as there will be ongoing engagement and collaboration with communities, service providers and other stakeholders.

‘We need to ensure we provide fit-for-purpose services and initiatives that are designed and delivered to improve the health of Tasmanians,’ he says. ‘So, while we have four phases, the cycle is fluid and takes into consideration requirements of each phase.

‘For example, during the assessing-needs phase, we need to know how we will measure and evaluate population outcomes early as part of understanding the priority needs, so we can identify what we need to change. The design and implementing solutions phases then need to lead to measurable and achievable outcomes.’

Tenders to provide rural health services have closed, while those for chronic conditions, mental health and refugee health are open, with provisions to roll out later next year.

To find out more about Primary Health Tasmania and commissioning, contact primaryhealthtas.com.au or 1300 653 169.

 

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