Primary Health Networks (PHNs) have been established nationally to increase the efficiency and effectiveness of medical services for patients and to improve coordination of care. PHNs work with their communities to identify the health and service needs of their region and how best to improve the effectiveness of services, including mental health and drug treatment services.
PHNs are commissioners of health services for their regions. Commissioning is a fundamental shift in thinking and a more strategic approach to the procurement of health services, which involves data analysis, population planning, stakeholder consultation, design and procuring services, monitoring and evaluation. PHNs are funded to undertake commissioning to ensure that resources are best directed to addressing local primary health needs to advance positive health outcomes for the community.
As commissioners, PHNs have autonomy and flexibility to decide which services or health care interventions should be provided, who should provide them and how they should be paid for. PHNs are ensuring that services are coordinated around community need, integrated with other elements of the health system and are not ad hoc or provider centric.
On 20 December 2016, the Tasmania PHN announced the outcomes of its commissioning process for the continuation of rural primary health services in Tasmania. The five successful service providers (Diabetes Tasmania, Royal Flying Doctor Service Tasmania, Rural Health Tasmania, Huon Regional Care and Corumbene Care) are delivering face-to-face services to people across 21 local government areas from January this year. They are working closely with local GPs and other health professionals to provide coordinated care to people and support them to reduce instances of avoidable hospital admissions.
The Tasmania PHN developed transitional arrangements and then showed further flexibility by adjusting transition timeframes to 31 March 2017 for patients with critical service requirements. The PHN worked with existing providers, on a case-by-case basis, to identify any critical clinical services or at risk clients that may require continued support while new service providers are being established.
The Tasmania PHN has acknowledged and identified some service gaps in high needs areas which were not covered by suitable tenders. Following discussions with newly commissioned service providers and the Kentish community, the Tasmania PHN announced on 11 January 2017, that Rural Health Tasmania will expand on its newly commissioned service delivery arrangements in other regional areas, to also include the Kentish community. Services commenced in Kentish in January 2017, alongside the community’s existing medical services and other newly commissioned service providers for the region. In addition, a pre-existing community transport service was transferred to Community Transport Services Tasmania Inc from 10 January 2017.
Following further discussions with the Glamorgan Spring Bay community, the Tasmania PHN announced on 19 January 2017 that the Royal Flying Doctor Service Tasmania would expand its delivery arrangements to include Glamorgan Spring Bay.
There are also other commissioning processes that the Tasmania PHN has underway. Tenders recently closed for services for Aboriginal people with chronic health conditions, for young people with complex and severe mental illness, and for alcohol and other drug services for Aboriginal people and for the general population. All of these services are scheduled to commence in the first quarter of 2017. The Tasmania PHN has also scheduled a range of other commissioning processes for mental health and refugee health services to commence in the first quarter of 2017. Information on these processes can be found on the Tasmania PHN website.
Individual members of the community and interested community organisations are encouraged to continue to engage with the Tasmania PHN and to participate in future planning processes for primary health and other services across the state.
The Tasmania PHN advises that providers were informed in February 2016 of the intended commissioning process for rural primary health services. Further, the Tasmania PHN consulted widely in order to raise awareness and inform the commissioning process. Consultations included meetings with representatives from general practice, other health and community providers, local council representatives and consumers in seven locations across the state including Queenstown, Burnie, Launceston, Bicheno, Brighton and on Flinders and King Islands.
A range of communication methods was used to publicise these arrangements. These include an email invitation to these meetings to all relevant Councils on 20 June 2016, and a wider invitation to attend through a Tasmania PHN media release on 23 June 2016. Feedback from the consultations is available on theTasmania PHN website.