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Western NSWIntegrated Care Strategy
To transform existing services into an integrated Western NSW system of care that is tailored to the needs of our rural and remote communities,
improves access to care and health outcomes, focuses on closing the Aboriginal health gap
Better Care…………Better Health…………Better Value
Every Day in Western NSW 6 residents die:
– 1 of the 6 deaths is tobacco related– 2 from potentially preventable conditions
10 babies are born (2 are Aboriginal, 1 has a low birth weight, 1 has a teenage mother)
60 are admitted to a private hospital
200 are admitted to a public hospital– 155 are <75 years old, 21 of them are children (5 Aboriginal)– 11 are potentially avoidable admissions– 3 for a mental health condition
– 587 people present to an emergency department – 73% (427) conditions that are not urgent – a majority requiring nursing or
GP intervention– 7% (39) serious illnesses/injuries requiring urgent treatment
2,800 people consult their GP
Every Day in Western NSW
Daily Cost Medicare (MBS) $334,510 Pharmaceutical (PBS) $237,565 Western NSW LHD $2,054,795
Average cost GP attendance $41 Emergency Presentation $707 Day in acute hospital $1,375
Every resident pays $10.00 per day
How would you spend your
$10.00 each day to stay healthy ??
Western NSW drivers
Rurality and remoteness
High proportion of Aboriginal population (11.1%)
The poor health outcomes experienced by the Aboriginal population
Growth in demand due to population ageing and increasing prevalence of long term conditions
High rate of admission
Multiple providers working in relative isolation
History of financial deficits
Patient experience, care co-ordination - suboptimal
Life expectancy at birth 2005-07
The Western NSW Strategic Health Services Plan and Integrated Care Strategy
The Integrated Care Strategy
• Provides the opportunity for the partners to accelerate the scale and pace of Strategic Health Services Plan implementation
• Facilitates the transformational service redesign that is required
• Mobilises primary care and LHD community to better manage care for higher complexity patients and families, and obtain better value from the available resources
Alignment with NSW State Plan & Integrated Care Strategy
Overarching program structure (1)
• Partnership governance
- Western NSW LHD accountability for delivery of the Strategy
- Partnership governance established to support collaboration in delivery of the Western NSW Integrated Care Strategy
- Built on existing bilateral partnerships between the partners, and close working relationships at strategic and operational levels
- Positive discussions with Western NSW Aboriginal community controlled health services – via Bila Muuji Inc, to also join the Partnership
• Clinical Leadership across primary and specialist care
- Clinical governance, leadership and support
- Initially medical evolving to multidisciplinary membership
Overarching program structure (2)
• Health Intelligence Unit
- Shared governance board with a strategic and evidence based focus
- Analysis to support strategic and operational management, performance reporting, evaluation
• Program Management discipline
- Transformational change will be dependent on a change management approach supported by robust program management discipline
- Identified deliverables, accountabilities and timelines
Local demonstrator sitesDemonstrating redesign of delivery models across general practice, LHD
primary & community health services, Aboriginal Medical Services, local rural hospital/MPS and specialist outpatient services
Local demonstrator site deliverables
Development of GP-led multidisciplinary models of care to manage high risk patients and those with chronic and complex illnesses (including diabetes, CVD, COPD, mental illness)
Development of integrated primary and secondary models of care that improve the patient experience and health outcomes (including maternal and child health opportunities)
Development of whole locality action to mobilse all health and social service providers
Risk stratification to identify target populations
Enrolment of identified population cohorts into integrated care plans
New business and funding models that incentivise delivery of integrated models of care
Establishing connectivity and shared care planning across multidisciplinary treatment providers and primary and secondary care services
Development of strategies that empower Aboriginal and high risk patients to participate in and manage their own and their families’ health and social needs
Development of flexible workforce strategies
Adoption of key performance indicators
Local demonstrator sites – work to date Site visits to establish capacity and willingness to participate – objectives and
redesign expectations
Development of minimum participation requirements and criteria
Identification of initiatives and implementation approaches – informed by international, national and local evidence and by learnings on a NZ Study Tour
Detailed scoping and planning, agreement on risk stratification criteria
Establishment of local leadership groups
Development of local needs profiles
Compilation of service directories
Signing of Memorandums of Understanding
District-wide initiativesEnabling district-wide implementation of an integrated approach to service delivery
Enablers and toolsIdentified enablers and tools are critical to the successful implementation and
sustainability of new models of integrated care
Rationale for the WNSW Strategy Expected benefits
- Short and long term outcomes
- Individual, population and system measures
District-wide benefits from ability to implement local demonstrator site initiatives at scale and pace
- Ability to trial multiple different approaches in different communities (size, scope and type)
- Ability to trial new funding mechanisms and incentives (including unique opportunities where GPs are also the hospital VMOs)
State-wide benefits from learnings achieved from multiple approaches
Program cost to reduce over 3 years to a sustainable service delivery model
Questions ?
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