Outcome 5 – Primary Care

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Outcome Strategy

This chapter reports on the major activities undertaken by the department during the year, reporting against each of the major activities and performance indicators published in the Outcome 5 chapter of the 2010-11 Health and Ageing Portfolio Budget Statements (PB Statements) and the 2010-11 Health and Ageing Portfolio Additional Estimates Statements (PAES). It also includes a table summarising the estimated and actual expenditure for this Outcome.

Outcome 5 was managed in 2010-11 by the Health Workforce Division and the Primary and Ambulatory Care Division. The department’s state and territory offices also contributed to the achievement of this Outcome.

Program Name	Program Objectives in 2010-11
Program 5.1: Primary Care Education and Training.	Provide high quality general practice training for junior doctors and GP registrars.
Program 5.2: Primary Care Financing, Quality and Access	Introduce health reforms to improve primary health care services. Improve primary health care infrastructure in Australia. Increase access to quality integrated primary health care services.
Program 5.3: Primary Care Policy, Innovation and Research	Promote innovation and research for the continuous improvement of the primary health care sector. Support quality improvement in primary care.
Program 5.4: Primary Care Practice Incentives	Encourage continuous improvements to general practice service delivery through financial incentives to support quality care, and improve access and health outcomes for patients.

Major Achievements

• A total of 31 GP Super Clinics have either commenced, provided early services or were under construction by 30 June 2011.
• Engaged the first 19 Medicare Locals to improve the integration and coordination of primary health care services for the benefit of local communities.
• Commenced operation of the after hours GP helpline to improve access to quality after hours primary care advice, information and support from 1 July 2011.
• Finalised the 2010-11 round of Primary Care Infrastructure Grants.
• Increased the number of general practice training places on the Australian General Practice Training Program to 900 in the 2011 training year, and funded placements under the Prevocational General Practice Placements Program increased to 910 in the 2011 training year.

Challenges

• Establishment of more Medicare Locals than was originally planned to ensure local responsiveness.
• The significant expansion of training programs for GP registrars and junior doctors has been a challenge to the broader training environment. Sufficient numbers of accredited training practices and general practice supervisors are needed to support this expansion and deliver training of the requisite quality to meet standards and curriculums set by the professional general practice colleges.

Trends

• Combined with previous investments, the Government will have doubled the intake of the Australian General Practice Training Program from 600 to 1,200 training places per annum over the period 2008 to 2014, with intakes of 700 in 2010, 900 in 2011 and 1,000 in 2012.
• The Australian Government will more than double the number of Prevocational General Practice Placements Program placements from 380 in 2010, to 910 in 2011, and to 975 placements in 2012 onwards. This investment is in addition to the increased funding of $41.2 million over four years announced in the 2009-10 Budget.

Program 5.1: Primary Care Education and Training

High Quality General Practice Training

Expanding General Practice Training

Supporting the General Practice Workforce

Whole of Program Performance Information

Qualitative Deliverable:	Produce relevant and timely evidence-based policy research.
2010-11 Reference Point:	Research is relevant, produced in a timely manner and is to the satisfaction of key stakeholders.
Result: Deliverable met.
General Practice Education and Training Ltd provides the department with regular policy and data reports that cover key policy and operational issues impacting on the Australian General Practice Training Program and the Prevocational General Practice Placements program, including progress in implementing the business activities and directions outlined in the Minister’s Statement of Expectations.
Qualitative Deliverable:	Effective management of stakeholders associated with the training programs.
2010-11 Reference Point:	Stakeholders participate in program development through avenues such as regular consultative committees, conferences, stakeholder engagement forums, surveys, submissions on departmental discussion papers and meetings.
Result: Deliverable met.
The department liaised regularly with General Practice Education and Training Ltd and other stakeholders including Remote Vocational Training Scheme Ltd and General Practice Registrars Australia to discuss and resolve issues associated with general practice training.
Quantitative Deliverable:		Percentage of variance between actual and budgeted expenses.
2010-11 Target:		≤0.5%	2010-11 Actual:	-0.2%
Result: Deliverable met.
During 2010-11, the department managed Program 5.1 funds effectively, and achieved a variance of -0.2%.

Program 5.2: Primary Care Financing, Quality and Access

Introduce Health Reform to Improve Primary Health Care Services

Establish a network of Medicare Locals

Each Medicare Local will be a locally run, independent organisation, funded by the Australian Government. Each will have its own region and will be responsive to the local health care needs of the population.

Medicare Locals will make it easier for patients to navigate the health system. They will improve the planning and coordination of services at the local level, support the delivery of a range of primary health care initiatives, including addressing service gaps and inequities, and improve collaboration between practitioners and service providers across the health system.

In 2010-11, the department developed guidelines for the establishment of Medicare Locals. The department took into account the views of key stakeholders including 220 submissions received in response to a public discussion paper on Medicare Local governance and functions.

The Invitation to Apply process for the first group of Medicare Locals closed on 5 April 2011, with the department receiving 59 high quality applications. In June 2011, the Minister for Health and Ageing announced 19 preferred applicants to become the first group of Medicare Locals. The department provided establishment funding for the first 19 Medicare Locals⁶⁹ on 1 July 2011. Arrangements for the second and third groups will be in place by 1 January and 1 July 2012, respectively.

In 2010-11, the department also worked with states and territories to determine geographical boundaries for each Medicare Local catchment area to ensure local responsiveness. A number of factors were taken into account, including alignment with Local Hospital Networks, natural population catchment areas, configuration of health services and patient referral patterns between services. In developing Medicare Local boundaries, the department considered approximately 190 submissions from interested stakeholders, including health professionals.

Medicare Locals will build on the work currently undertaken by the Divisions of General Practice Network, taking on broader roles and responsibilities so that primary health care services are designed around the needs of patients, and strongly oriented towards prevention, early intervention and high quality integrated care located in the community.

In 2010-11, the department put in place arrangements for the Australian General Practice Network to support the Divisions of General Practice Network to transition to Medicare Locals. This included providing change management support for Medicare Locals. The Australian General Practice Network provided support to the Divisions of General Practice through a number of activities, including transitional information, change management sessions and workshops.

Qualitative Deliverable:	Consultations with stakeholders on implementation arrangements, development of program guidelines for Medicare Locals.
2010-11 Reference Point:	The first Medicare Locals commence in mid-2011.
Result: Deliverable met.
The first 19 Medicare Locals commenced establishment activities from 1 July 2011. Figure 2.4.5.1: Location of the first 19 Medicare Locals Text version of this chart
Detailed maps and profiles of Medicare Locals are published on the yourhealth.gov.au website.
1. Western Sydney 2. Hunter Urban 3. New England 4. Murrumbidgee 5. Inner East Melbourne 6. Barwon 7. Inner North West Melbourne 8. Northern Melbourne 9. Metro North Brisbane 10. Gold Coast		11. Greater Metro South Brisbane 12. Townsville-Mackay 13. West Moreton-Oxley 14. Central Adelaide and Hills 15. Country North South Australia 16. Perth North Metro 17. South West Western Australia 18. Tasmania 19. Australian Capital Territory

Qualitative KPI:	Framework for measuring and reporting the impact of the Medicare Locals is established in a timely and effective manner.
2010-11 Reference Point:	Performance and reporting framework is developed in consultation with stakeholders and experts.
Result: Indicator met.
In 2011, the department engaged in a number of workshops and bilateral meetings with key stakeholders, including states and territories, peak bodies and other data agencies, in developing the Performance and Accountability Framework (the Framework). The Framework sets out the performance indicators that the National Health Performance Authority will report against and the processes for determining appropriate performance criteria to assess health service providers.

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Improve Primary Health Care Infrastructure

GP Super Clinics and Primary Care Infrastructure Grants

In 2010-11, the department continued to work in collaboration with state, territory and local governments and funding recipients to establish 64 GP Super Clinics around the country. A total of 31 GP Super Clinics have either commenced operations, provided early services or were under construction by 30 June 2011.

Table 2.4.5.1: Locations of GP Super Clinics

Victoria
Ballan	Bendigo	Berwick
Portland	Wodonga	Geelong
New South Wales
Blue Mountains	Grafton	Gunnedah
North Central Coast	Queanbeyan	Riverina
Shellharbour	Southern Lake Macquarie	Port Stephens
Queensland
Brisbane Southside	Bundaberg	Cairns
Gladstone	Ipswich	Redcliffe
Strathpine	Townsville
South Australia
Modbury	Noarlunga	Playford North
Tasmania
Burnie	Clarence	Devonport
Western Australia
Midland
Northern Territory
Palmerston

The department has also made significant progress in implementing the remaining 33 GP Super Clinics. As at 30 June 2011, nine funding agreements had been executed to establish GP Super Clinics in Coffs Harbour, Nowra, Port Macquarie, Tweed Heads, and South Central Coast (New South Wales), Cobram, Hume City and West Melbourne (Victoria), and Karratha (Western Australia). The department also commenced negotiations with preferred applicants for a further three GP Super Clinic locations.

During 2010-11, the department also conducted 12 community consultations to give local communities an opportunity to provide input to their new GP Super Clinics. The final community consultation was conducted in July 2011.

In addition, the department is implementing infrastructure funding through the Primary Care Infrastructure Grants initiative. These grants will provide upgrades to around 425 general practices, primary care and community health services and Aboriginal Medical Services to improve access to integrated GP and primary health care.

Qualitative Deliverable:		GP Super Clinics and Primary Health Care Infrastructure initial grant round underway.
2010-11 Reference Point:		GP Super Clinic and Primary Care Infrastructure initial grant round advertised, assessments undertaken and negotiations commenced by 30 June 2011.
Result: Deliverable met.
In October 2010, the Minister announced the roll out of 28 new GP Super Clinics, including 13 community consultation processes, four direct funding processes and 11 competitive funding processes. As at 30 June 2011, 12 of the 13 community consultations had been held, and Invitations to Apply for the four direct and 11 competitively funded locations closed in December 2010. The first round of Primary Care Infrastructure Grants closed on 20 August 2010 and the second round closed on 10 June 2011. Approximately 240 applications were short listed for grant funding in the first round and assessment of second round applications commenced on 14 June 2011.
Quantitative Deliverable:			Estimated number of grants awarded to establish GP Super Clinics.
2010-11 Target:			9			2010-11 Actual:			10
Result: Deliverable met.
In 2010-11, the department executed ten GP Super Clinics funding agreements for: Cobram, Hume City, Wallan, West Melbourne (Victoria), Coffs Harbour, South Central Coast, Nowra, Port Macquarie, Tweed Heads (New South Wales), and Karratha (Western Australia).
Quantitative Deliverable:			Estimated number of grants awarded to upgrade or extend existing general practices, primary and community care services or Aboriginal Medical Services.
2010-11 Target:			200		2010-11 Actual:			137
Result: Deliverable substantially met.
As at 30 June 2011, the department had executed 137 funding agreements from the first round of Primary Care Infrastructure Grants. Following the impact of natural disasters throughout Australia in early 2011 and the impact these had on the availability of the construction workforce to undertake small scale infrastructure projects, the estimated number of Primary Care Infrastructure Grants was revised down to 90 grants in the 2011-12 Portfolio Budget Statements.
Qualitative KPI:	GP Super Clinics and Primary Care Infrastructure initial funding round is implemented in a timely and efficient manner.
2010-11 Reference Point:	A GP Super Clinics and Primary Care Infrastructure funding round underway prior to 30 June 2011.
Result: Indicator met.
The first round of Primary Care Infrastructure Grants closed in August 2010 and the second round of Primary Care Infrastructure Grants closed in June 2011. Invitations to Apply for the next 28 GP Super Clinics opened in a staggered approach, the first 16 closing in December 2010, and eight closing between March and May 2011. Invitations to Apply for the four remaining GP Super Clinics will be issued in 2011-12.
Quantitative KPI:	Number of GP Super Clinics that commence delivery of services, including early services.
2010-11 Target:	12			2010-11 Actual:			1170
Result: Indicator substantially met.
GP Super Clinics that commenced delivery of services (including early services), in 2010-11 included: Geelong (Victoria), Brisbane Southside (Annerley – Stage 1), Ipswich (Stage 1), Gladstone, Townsville (Queensland), Burnie and Clarence (Tasmania), Shellharbour (New South Wales) and Playford North, Modbury, and Noarlunga (South Australia). The GP Super Clinics Program is a construction program. The completion and opening of a GP Super Clinic is dependent on a number of external factors, including whether the clinic will be a refurbishment of existing premises or a newly constructed facility and the availability of suitable land/buildings to acquire. The timeframe is also dependent upon local planning and development approvals, tender process for construction, availability of construction workforce and materials and weather conditions which may impact on construction. In 2011-12, the department will continue to work closely with funding recipients to ensure timelines are met.

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Improve Access to Quality Primary Health Care Services

After Hours GP Helpline

GP Face-to-Face After Hours Primary Care Services

Qualitative Deliverable:	Development of new funding arrangements to be delivered in the future through Medicare Locals for the provision of face-to-face after hours GP services.
2010-11 Reference Point:	Draft program arrangements and guidelines for funding of after hours GP services through Medicare Locals developed within timeframe.
Result: Deliverable met.
The program arrangements and guidelines for funding Medicare Locals to plan and support local GP face-to-face after hours primary care services were approved by the Minister on 7 July 2011.
Qualitative KPI:	New funding arrangements through Medicare Locals for face-to-face after hours services.
2010-11 Reference Point:	Draft program arrangements and guidelines for funding of the face-to-face after hours GP services through Medicare Locals developed.
Result: Indicator met.
The program arrangements and guidelines for funding Medicare Locals to plan and support local GP face-to-face after hours primary care services were approved by the Minister on 7 July 2011.

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Incentive Payments to Support Practice Nurses

Qualitative Deliverable:		Consultation on, and development of, implementation activities for the new Practice Nurse Incentives Program.
2010-11 Reference Point:		Implementation activities undertaken and program administrative processes in place to begin first incentive payments from 1 January 2012.
Result: Deliverable met.
In 2010-11, the department met with the Practice Nurse Incentive Program Technical Working Group four times to discuss the development and implementation of the program. The Technical Working Group also assisted the department with the development of program guidelines.
Quantitative Deliverable:		Estimated number of practices participating in the Practice Nurse Incentives Program.
2010-11 Target:		Not Applicable		2010-11 Actual:		Not Applicable
Result: Not Applicable.
The Practice Nurse Incentives Program is scheduled to commence on 1 January 2012 as originally planned and published in the 2010-11 Portfolio Budget Statements.
Qualitative KPI:	Effective and timely consultation on, and development of, implementation arrangements for Practice Nurse Incentives Program.
2010-11 Reference Point:	Practice Nurse Incentives program is operational by 1 January 2012.
Result: Not applicable.
In 2010-11, the department met with the Practice Nurse Incentive Program Technical Working Group four times to discuss the development and implementation of the Practice Nurse Incentive Program by 1 January 2012.
Quantitative KPI:	Number of practices that are supported through the Practice Nurse Incentives Program.
2010-11 Target:	Not Applicable		2010-11 Actual:		Not Applicable
Result: Not applicable.
The Practice Nurse Incentive Program is scheduled to commence on 1 January 2012 as originally planned and published in the 2010-11 Portfolio Budget Statements.

Divisions of General Practice Program

Qualitative Deliverable:	Funding provided to eligible organisations within the Divisions of General Practice Network.
2010-11 Reference Point:	Timely payment and accountability of funds.
Result: Deliverable met..
Funding provided to eligible organisations within the Divisions of General Practice Network.
Quantitative Deliverable:		Number of eligible organisations within the Divisions of General Practice Network provided with core funding.
2010-11 Target:		118		2010-11 Actual:		118
Result: Deliverable met.
The department provided core funding to all Divisions of General Practice, State Based Organisations and the Australian General Practice Network during 2010-11.
Qualitative KPI:	Impact of activities and approaches used to address the national performance framework for the Divisions of General Practice Program.
2010-11 Reference Point:	Activities identified, implemented and evaluated.
Result: Indicator met.
In 2010-11, the department measured the activities and approaches used by Divisions of General Practice in addressing the national performance framework. Divisions reported biannually to the department against a series of performance indicators and all Divisions maintained accreditation.
Quantitative KPI:	Percentage of Divisions of General Practice network members that comply with required reporting against national performance indicators for the program.
2010-11 Target:	100%		2010-11 Actual:		94%
Result: Indicator substantially met.
The department in some instances provided extensions to Divisions of General Practice Network for report due dates, including ‘in principle’ approval of reports that were incomplete and/or required enhancements. System issues were also experienced by some Divisions of General Practice when submitting their reports.

Engaging Divisions of General Practice to Improve Indigenous Access to Mainstream Primary Care

Improve Care Coordination for Patients with Diabetes

Improved Access to Primary Health Care Services for Older Australians

Qualitative Deliverable:	Preliminary consultation on, and development of, flexible funding arrangements for the Improved Access to Primary Health Care Services for Older Australians initiative.
2010-11 Reference Point:	Key implementation activities undertaken, based on effective consultations with key stakeholders, to enable flexible funding arrangements to be implemented from July 2012.
Result: Deliverable met.
During 2010-11, the department commenced implementation arrangements for the Improved Access to Primary Health Care Services for Older Australians Program. Program guidelines are being drafted and will be finalised in consultation with key stakeholders, including Medicare Locals as they are established.
Quantitative Deliverable:		Number of additional incentive payments made to GPs under the Improved Access to Primary Health Care Services for Older Australians initiative.
2010-11 Target:		1,200	2010-11 Actual:	264
Result: Deliverable not met.
The department has increased GP incentive payments under the Improved Access to Primary Health Care Services for Older Australians initiative. The increased incentive payments were introduced in July 2010. There has been a lower than expected take-up in 2010-11. The number of incentive payments is reliant on general practitioners providing a pre-determined minimum number of services in residential aged care facilities. The department will continue to promote the Aged Care Access Incentive through the quarterly newsletter provided to general practices.
Qualitative KPI:	Effective and timely consultation on, and development of, flexible funding arrangements for the Improved Access to Primary Health Care Services for Older Australians initiative.
2010-11 Reference Point:	Key consultations undertaken on development of flexible funding arrangements for implementation.
Result: Indicator met.
The flexible funding component of the Improved Access to Primary Health Care Services for Older Australians Program will commence in July 2012. This program will provide flexible funding for Medicare Locals to address gaps in primary health care for older Australians in their local communities in ways best suited to meet the needs and priorities. During 2010-11, the department considered implementation arrangements for the measure and this work will continue during 2011-12. The department will consult with Medicare Locals as they are established from July 2011.
Quantitative KPI:	Estimated number of additional GPs qualifying for incentive payments under the Aged Care Access initiative.
2010-11 Target:	800		2010-11 Actual:	170
Result: Indicator not met.
Increased GP incentive payments under the Improved Access to Primary Health Care Services for Older Australians initiative were introduced in July 2010. There has been a lower than expected take-up in 2010-11. The uptake is reliant on general practitioners providing a pre-determined minimum number of services in residential aged care.

Whole of Program Performance Information

Qualitative Deliverable:	Stakeholders participate in program development through a range of avenues.
2010-11 Reference Point:	Stakeholders participated in program development through avenues such as regular consultative committees, conferences, stakeholder engagement forums, surveys, submissions on departmental discussion papers and meetings.
Result: Deliverable met.
During 2010-11, the department actively sought stakeholder participation in the development of a number of key programs, including Medicare Locals, Practice Nurse Incentive Program and After Hours Primary Care. This participation included community meetings, submissions from the public on discussion papers and direct consultation with key stakeholders through the establishment of Technical Working Groups. Medicare Locals In 2010-11, The department received in excess of 220 submissions from the public in response to a public discussion paper on Medicare Local governance and functions, and approximately 190 submissions on Medicare Local catchment area boundaries. Practice Nurse Incentive Program In 2010-11, the department conducted four meetings with the Technical Working Group to discuss implementation arrangements and communication activities for the Practice Nurse Incentive Program. The Technical Working Group assisted the department with the development of a number of key documents including the Practice Nurse Incentive Program Guidelines and the ready reckoner calculator. After Hours Primary Care The department worked with an After Hours Primary Care Technical Working Group74 to assist it in the development of the after hours primary care reforms. The working group met four times with the department in 2010-11.
GP Super Clinics In October 2010, the Minister announced the roll out of 28 additional GP Super Clinics. In 2010-11, as part of this roll out, the department held 12 community consultation meetings to enable each region an opportunity to provide input to tailor the new GP Super Clinic to meet the needs of each community.
Qualitative Deliverable:	Produce timely and effective funding arrangements for the Australian Government’s health reform.
2010-11 Reference Point:	Funding agreements finalised with relevant organisations in a timely manner.
Result: Deliverable met.
In 2010-11, the department executed funding agreements for ten GP Super Clinics and 137 Primary Care Infrastructure Grants. The department also finalised funding arrangements with the first 19 Medicare Locals for establishment activities.
Quantitative Deliverable:		Percentage of variance between actual and budgeted expenses
2010-11 Target:		≤0.5%	2010-11 Actual:	0.3%
Result: Deliverable met.
The administered expenses for Program 5.2 were 0.3% greater than planned budgeted expenses.

Program 5.3: Primary Care Policy, Innovation and Research

Promote Innovation and Research in the Primary Health Care Sector

Strengthen and Support the Evidence Base for Primary Health Care Reform

Primary health care research under the Primary Health Care Research, Evaluation and Development Strategy is currently focussed on four key health priority areas: improving access; better management of chronic conditions; prevention; and improving quality and governance. The findings from this research will influence policy and practice to improve patient outcomes.

During 2010-11, the Primary Health Care Research and Information Service and the Australian Primary Health Care Research Institute exchanged and disseminated primary health care research amongst the primary health care sector and to the department. The sector includes policy makers, consumer groups, primary health care oganisations and health care service providers. The department hosted 14 knowledge exchange events attended by health care experts, policy makers and researchers. The Primary Health Care Research and Information Service continued its role to facilitate primary health care research and knowledge sharing.

The department created a Primary Health Care Research Evaluation and Development Strategy Liaison Officer position to actively broker knowledge exchange in primary health care research. This position is based in the Australian Primary Health Care Research Institute and filled by a departmental policy staff member on secondment. When primary health care is informed by the best research evidence there can be significant benefits for the health and wellbeing of a community and wider population.

Quantitative Deliverable:		Number of knowledge exchange opportunities organised between researchers and the department.
2010-11 Target:		10		2010-11 Actual:		14
Result: Deliverable met.
The department organised 14 knowledge exchange opportunities between primary health care experts and researchers on policy relevant topics.
Quantitative KPI:	Number of research projects completed with a focus on the four key priority areas identified in the National Primary Health Care Strategy.
2010-11 Target:	15		2010-11 Actual:		18
Result: Indicator met.
All completed primary health care research projects were aligned to the four key health priority areas of the National Primary Health Care Strategy.

As part of the Strategy, the department funded the Australian Primary Health Care Research Institute to create three networks of centres of research excellence in primary health care research. These centres of research excellence form collaborations with institutions across Australia, including some international participation.

The research focus for these centres of excellence are: research in building quality, governance, performance and sustainability in primary health care; Indigenous primary care intervention research in chronic disease; and research in accessible and equitable primary health service provision in rural and remote Australia. The research is closely aligned with the Australian Government’s health reform agenda. These centres have also helped form closer links with the researchers, primary health care sector and policy makers.

Quantitative Deliverable:		Number of collaborations and partnerships funded to undertake primary health care research.
2010-11 Target:		6	2010-11 Actual:	5
Result: Deliverable substantially met.
The department funded the Australian Primary Health Care Research Institute and the Primary Health Care Research and Information Service. These organisations have networks of collaborations and partnerships in place to facilitate their research obligations. The Australian Primary Health Care Research Institute also funded three centres of research excellence each of which has a lead university. In the 2012 academic year, the department will work to establish up to six new centres of research excellence to generate evidence and research to inform health care policy and practice. The department aims to meet the future targets through establishment of the additional new centres.
Qualitative KPI:	Increase access to relevant primary health care research for policy makers.
2010-11 Reference Point:	Increased use of primary health care research by policy makers.
Result: Indicator met.
The department continued to facilitate a high number of knowledge exchange opportunities organised for policy makers. These knowledge exchange opportunities were evaluated on each occasion as being of significant value by researchers. The commencement of centres of research excellence has provided a new avenue for policy makers to interact with primary health care researchers. This has been facilitated by the creation of a Primary Health Care Research Evaluation and Development Strategy Liaison Officer role who provides a key point of contact for researchers and policy makers.

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Support Maternity Services Reform

The department commenced work with the Australian Institute of Health and Welfare to develop a comprehensive, nationally consistent maternal and perinatal mortality and morbidity data collection. This data collection will become a national asset, building the evidence-base for maternity and perinatal service delivery.

The department has also commenced work on a comprehensive evaluation to assess the appropriateness, effectiveness and efficiency of the Improving Maternity Services Budget Package (2009-10). The evaluation will be completed by 30 June 2013 and will identify opportunities and recommendations to assist future maternity services policy development.

In 2010-11, the department worked closely with the National Health Call Centre Network to successfully implement the Pregnancy, Birth and Baby Helpline, a 24‑hour national pregnancy and perinatal support helpline.⁷⁷ The helpline provides women, their partners and families, seeking assistance during a pregnancy or within the first 12 months of the birth of their child, with access to a broad range of information, advice and referral services. Where appropriate, callers to the helpline are directed to other local or national services, such as the Australian Breastfeeding Association’s 24-hour national helpline, or the National Health Call Centre Network for advice from a registered nurse. To complement the helpline, the department worked with the National Health Call Centre Network to establish a web portal⁷⁸, providing access to a comprehensive range of resources relating to pregnancy and perinatal care. The department launched this web portal on 1 November 2010.

During 2010-11, the department worked in consultation with state and territory governments, and consulted with maternity care professionals to develop the National Maternity Services Plan (the Plan). The Plan was endorsed by all Australian Health Ministers on 12 November 2010 and provides a strategic national framework for the Australian, state and territory governments for five years (2010-2015). With the release of the Plan, the department and its state and territory counterparts commenced implementation of action items under the Plan. The department, in collaboration with the state and territory governments, will support the Australian Health Ministers Advisory Council in providing a progress report on the first year of the Plan’s implementation to Australian Health Ministers in November 2011.

Qualitative Deliverable:	Establish a pregnancy and perinatal support helpline.
2010-11 Reference Point:	Support helpline established in 2010-11.
Result: Deliverable met.
The Pregnancy, Birth and Baby Helpline commenced taking calls on 1 July 2010 and handled 24,499 calls over the period to 30 June 2011.
Quantitative KPI:	Number of calls responded to through the pregnancy and perinatal support helpline.
2010-11 Target:	30,000	2010-11 Actual:	24,499
Result: Indicator substantially met.
The pregnancy and perinatal support helpline is a demand driven program. While the program did not reach the target of 30,000 per annum it is on track to meet future targets. The volume of calls handled continues to increase each month as awareness of the helpline grows from 761 calls handled in the first month of operation, July 2010, to 3,531 calls handled in June 2011.

Quantitative Deliverable:	Number of Maternity Services Advisory Group meetings in the financial year to support implementation of the Improving Maternity Services Program.
2010-11 Target:	3	2010-11 Actual:	1
Result: Deliverable not met.
During 2010-11, the Maternity Services Advisory Group met once to provide advice on issues relating to the implementation of maternity reforms. Further meetings were not required following the commencement of implementation for this program.

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Support Quality Improvement in Primary Care

The department funded and conducted an external review of the program in 2010-11. The review found that the objectives of the program had been met and improvements in clinical outcomes were evident. The department will continue to fund the program in 2011-12. The department will work with the Improvement Foundation to embed a culture of quality improvement across primary care, including working with Medicare Locals as they are established.

Qualitative Deliverable:	Provide funding to the national implementation organisation to deliver the Australian Primary Care Collaboratives Program.
2010-11 Reference Point:	Timely payment and accountability for funds provided.
Result: Deliverable met.
In 2010-11, the department funded the Improvement Foundation (Australia) to deliver the Australian Primary Care Collaboratives Program. Payments were made on acceptance of deliverables, including quarterly progress reports on the delivery of continuous quality improvement training for primary care providers.
Quantitative Deliverable:		Number of general practices participating in the Australian Primary Care Collaboratives Program.
2010-11 Target:		600	2010-11 Actual:	688
Result: Deliverable met.
The target for the number of practices participating in the Australian Primary Care Collaboratives Program has been exceeded. Work has been undertaken in the areas of diabetes, coronary heart disease, chronic disease prevention and self-management, chronic obstructive pulmonary disease and access to GP services.

Qualitative KPI:	Impact of program delivery activities under the Australian Primary Care Collaboratives Program.
2010-11 Reference Point:	A review will inform appropriateness and effectiveness of the program.
Result: Indicator met.
The Australian Primary Care Collaboratives Program supports general practice to improve clinical outcomes, reduce lifestyle risk factors, help maintain good health for those with chronic and complex conditions and improve access to Australian general practice. This is achieved by promoting a culture of quality improvement in primary health care through training, peer support and shared learning. In 2010-11, the department conducted an external review of the program. The review found that the objectives of the program had been met and improvements in clinical outcomes were evident.
Quantitative KPI:	Percentage of practices participating in the Australian Primary Care Collaboratives Program reporting improvements in patient care.
2010-11 Target:	90%	2010-11 Actual:	100%
Result: Indicator met.
All practices participating in the Program have reported improvements to patient care. Improvements are demonstrated in both clinical measures and process measures such as development of patient registers.

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Whole of Program Performance Information

Program 5.4: Primary Care Practice Incentives

Support General Practices to Deliver High Quality Primary Health Care

Practice Incentives Program – eHealth Incentive

In 2010-11, the department, through the Practice Incentives Program eHealth Incentive continued to increase participation rates in the program. In 2010-11, 84% (4,278 practices) of practices participating in the Practice Incentives Program received an eHealth incentive, compared with 78% (3,871 practices) in 2009-10. In 2010-11, the department worked closely with the medical profession and the National E-Health Transition Authority to develop new eHealth requirements to encourage uptake and the use of eHealth technologies in general practice.

In 2011-12, the department will continue to monitor participation in the Practice Incentives Program eHealth Incentive. The department will also continue consultations with the National E-Health Transition Authority, the medical profession and Medicare Australia to finalise and implement the new requirements for the Practice Incentives Program eHealth Incentive.

Quantitative KPI:	Number of Practice Incentives Program practices participating in the eHealth Incentive.
2010-11 Target:	4,300	2010-11 Actual:	4,278
Result: Indicator substantially met.
Participation in the Practice Incentives Program eHealth Incentive increased significantly in 2010-11, with 84% (4,278 practices) of practices participating in the Practice Incentives Program receiving an eHealth incentive payment, compared with 78% (3,871 practices) in 2009-10. The eHealth Incentive is a demand driven program.

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Practice Incentives Program – Indigenous Health Incentive

As part of the Practice Incentives Program – Indigenous Health Incentive in 2010-11, the department funded the Royal Australian College of General Practitioners to develop a free, online Indigenous health educational package that aims to support Australian general practices to provide culturally appropriate healthcare to Aboriginal and Torres Strait Islander peoples. The department launched the new educational package on 8 April 2011.

Participation in the Practice Incentives Program – Indigenous Health Incentive continued to increase in 2010-11 with around 2,100 practices registered for the incentive by May 2011 compared with 850 practices registered in May 2010. In 2011-12, the department will continue to monitor practices participation in this incentive.

Quantitative KPI:	Number of Practice Incentives Program practices signed onto the Indigenous Health Incentive.
2010-11 Target:	4,300	2010-11 Actual:	2,100
Result: Indicator not met.
Participation in the Practice Incentives Program – Indigenous Health Incentive increased significantly in 2010-11 with 2,100 practices registered for the incentive by May 2011 compared with 850 practices registered in May 2010. The original target set for the Practice Incentives Program – Indigenous Health Incentive was estimated before the program was introduced. Since the program was introduced in May 2010, the Key Performance Indicator has been revised downward to 2,000 registered practices in 2010-11.

General Practice Immunisation Incentives Scheme

Whole of Program Performance Information

Outcome 5 – Financial Resources Summary

	(A) Budget Estimate1 2010-11 $’000	(B) Actual 2010-11 $’000	Variation (Column B minus Column A) $’000
Program 5.1: Primary Care Education and Training
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	153,463	153,115	(348)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	2,209	2,213	4
Revenues from other sources (s31)	78	69	(9)
Unfunded depreciation expense	55	73	18
Operating loss / (surplus)	-	-	-
Total for Program 5.1	155,805	155,470	(335)
Program 5.2: Primary Care Financing, Quality and Access
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	324,157	325,198	1,041
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	24,510	24,559	49
Revenues from other sources (s31)	863	767	(96)
Unfunded depreciation expense	607	808	201
Operating loss / (surplus)	-	1	1
Total for Program 5.2	350,137	351,333	1,196
Program 5.3: Primary Care Policy, Innovation and Research
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	24,413	24,062	(351)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	8,766	8,784	18
Revenues from other sources (s31)	309	274	(35)
Unfunded depreciation expense	217	289	72
Operating loss / (surplus)	-	-	-
Total for Program 5.3	33,705	33,409	(296)
Program 5.4: Primary Care Practices Incentives
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	301,351	332,484	31,133
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	1,631	1,634	3
Revenues from other sources (s31)	57	51	(6)
Unfunded depreciation expense	40	54	14
Operating loss / (surplus)	-	-	-
Total for Program 5.4	303,079	334,223	31,144
Outcome 5 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	803,384	834,859	31,475
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	37,116	37,190	74
Revenues from other sources (s31)	1,307	1,161	(146)
Unfunded depreciation expense	919	1,224	305
Operating loss / (surplus)	-	1	1
Total Expenses for Outcome 5	842,726	874,435	31,709
Average Staffing Level (Number)	267	274	7
1 Budgeted appropriations taken from the 2011-12 Health and Ageing Portfolio Budget Statements and re-aligned to the 2010-11 outcome structure.

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⁶⁹Available at: www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/medilocprofiles
⁷⁰The Queanbeyan GP Super Clinic commenced services in early August 2011, bringing the total number of clinics providing services to 12.
⁷¹Telephone on: 1800 022 222
⁷² Technical Working Group comprised of key stakeholders including: The Australian Nursing Federation; Australian Practice Nurses Association; Royal College of Nursing, Australia; Royal Australian College of General Practitioners; Australian Medical Association; Australian General Practice Network; Rural Doctors Association of Australia; National Aboriginal Community Controlled Health Organisation; National Aboriginal and Torres Strait Islander Health Worker Association; Health Care Consumers’ Association; Australian Association of Practice Managers; Medicare Australia; and The Department of Veterans’ Affairs.
⁷³ Available at: www.medicareaustralia.gov.au/provider/incentives/pnip.jsp
⁷⁴ Technical Working Group comprised of key stakeholders including: Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Consumer Health Forum of Australia, Australian Medical Association, Royal Australian College of General Practitioners, National Association for Medical Deputising, and Australian General Practice Network.
⁷⁵ Available at: www.health.gov.au/internet/main/publishing.nsf/Content/pcd-programs-phcred
⁷⁶ Available at: www.nhmrc.gov.au/publications/synopses/cp124syn.htm
⁷⁷Telephone on: 1800 88 24 36
⁷⁸ Available at: www.healthdirect.org.au/pbb
⁷⁹Available at: www.health.gov.au/internet/main/publishing.nsf/content/national+Ehealth+strategy

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