A number of factors were identified as impacting either positively or negatively on the implementation of the GP Super Clinics Program 2007-2008. These factors were derived from document reviews and from interviews with Department of Health and Ageing staff.
Ministerial and Departmental CommitmentIt was perceived and was obvious in documents such as Ministerial briefings and minutes that there was a high level of Ministerial commitment to the GP Super Clinics Program. This aligns with evidence cited in the document, Implementation of Program and Policy Initiatives: Making Implementation Matter, which stresses the importance of leadership and commitment.25 This commitment was demonstrated through the approval processes at different levels of governance structures and through the locality-specific consultation processes. The commitment and leadership within the Division and Branch were also cited as positively impacting on implementation.
Division and Branch CapacityThere was no allocation within the budget for program implementation, i.e. the allocation of program staff is excluded in grants budgets. To address this, staff and funds were identified from other programs in the Primary and Ambulatory Care Division within the Department of Health and Ageing. This potentially compromised the adequacy of staffing in numbers, skills and experience, addressed the necessary start-up staffing levels, but did not address identified skills gaps.
The identification and filling of skills gaps was perceived to be an important factor in program implementation. The requirements for staff managing a grants program for construction and a new model of primary care were considerable. In addition to contracting specific expertise, a staff development program was tailored to train existing staff. This training is now part of the orientation program for all new GP Super Clinic Branch staff.
The complexities of managing large construction programs have been challenging for staff. The extensive consultation processes as part of the Invitation to Apply processes have also been demanding. The complexities of corporate structures commonly found in general practice have added to these challenges. Staff burnout was recognised as an issue which had the potential to impact on GP Super Clinics Branch operations.
The structure within the GP Super Clinics Branch has progressively evolved. It now facilitates vertical and horizontal integration across the executive team within the Branch. Executives have diverse yet complementary skills for the nature of this Program. This was perceived to have positively impacted on the effectiveness of the Branch in managing the complexities of this grants program.
25Implementation of Programme and Policy Initiatives: Making Implementation Matter - Better Practice Guide. Canberra: Department of Prime Minister and Cabinet and Australian National Audit Office;2006.