WA Primary Care Roundtable puts focus on health system integration

A few weeks ago, Health Minister Roger Cook actioned an election commitment with the first meeting of the WA Primary Health Roundtable.

The Roundtable was a key recommendation of the Reid Review and was considered to be an important opportunity to identify the primary care priorities in working towards sustainable health system integration.

The Roundtable brought together key stakeholders from health including primary and acute care, aged care, mental health, private hospitals and private health insurers. The conversations were robust and thoughtful and explored how the players in the system can work together, particularly on the integration between primary and hospital care.

In his opening remarks, Minister Cook acknowledged that each of the 12 Sustainable Health Review priorities identified in the Review’s Interim Report involve primary care at their core. If you haven’t already, I encourage you to consider the Interim Report’s recommendations and the role of general practice in achieving them. The Minister acknowledged WA Primary Health Alliance’s (WAPHA) role in working with the State government to improve coordination of services, and involving GPs in co-designing new models of care and approaches to joint planning, co-commissioning and pooled funding opportunities for Commonwealth and State.

There is increasing interest from both Commonwealth and State governments on health system integration. In particular, the role of primary care and the Primary Health Network’s (PHNs) ability to broker the necessary partnerships that will enable sustainable solutions to fragmentation and dysfunction. The Productivity Commission, Grattan Institute and the Australian Hospitals and Healthcare Association have each described the foundations of integration that include an enhanced role for PHNs in this space. With our current stability and bipartisan support, WA’s PHNs have the particular advantage of being coordinated within the whole-of-state WAPHA model. The new Commonwealth/State Coordinated Care Bilateral Agreements provide further impetus for integration of primary health care, acute care, specialist and allied health services.

Professor Hal Swerissen from Grattan Institute was the keynote speaker at the Roundtable and highlighted the opportunities for WA to reduce demand on institutional and hospital services through investment in primary care. The architecture for this exists in the collective political will to create an overarching governance agreement at the primary and acute system manager level (WA Health and WAPHA) that provides for a reorientation of the health system towards care that is patient centred, outcomes focused and value based.

GPs represented at the Roundtable overwhelmingly spoke of the need to work together to improve the interface between hospital clinicians and GPs. Commonly asked was: How do we better organise transfer of care between hospitals and general practice? A large part of the solution is improving the understanding of doctors in training and hospital based specialists about what GPs do, their skills and the importance of the ongoing relationship GPs have with their patients. It was agreed that understanding and trust is needed to recognise the conditions that can be well managed in general practice and what information exchange between clinicians will better support continuity of care for patients.

The Roundtable tackled some of the elephants in the room that impede us in supporting people as they navigate across the levels of our health system. These include our funding structures and federated system that encourage episodic care, creation of silos and professional demarcation. We need to start with the patient – begin planning integrated services and models of care based on an understanding of the needs of individuals and what their journey through the health system is going to look like.

WAPHA is committed to leading these conversations and engagement across the health system. We will use our expertise and influence to facilitate the governance arrangements, evidence based decision making, workforce reorientation and pooled funding models to enable the partnerships and innovation that will drive transformational change in health system integration across the State.

Learne Durrington
CEO WA Primary Health Alliance