Home' Australian Ageing Agenda : AAA May-Jun 2014 Contents part of this process and we will be working
As such, Shipway was part of a forum
on integrated healthcare organised by Aged
and Community Services NSW & ACT in late
February. ACS NSW chief executive Illana
Halliday says the forum showcased effective
collaborations between aged services and
other elements of the health system.
Halliday believes that with the move
of ageing to DSS at the federal level, it is
crucially important that stakeholders at
the regional level maintain their efforts
and ensure the work around integrated
healthcare is not lost.
Burchfield, meanwhile, is under no
illusions about the scale of the challenge
facing her and those involved in the state's
integrated care strategy. "Getting to the
point where we have a more integrated
health system is a 10 to 20-year-journey.
We're starting to invest now but with no
expectation that in a couple of years' time
everything will be perfect," she says.
For Yates, the issue of integrated
healthcare needs to be championed from
the top, in order for real strides to be
made. "It ought to be in the KPIs of the
CEOs of every health system in Australia.
It ought to be a high priority for federal
Health Minister Peter Dutton."
And, Yates believes, there should
be financial incentives built in to the
Commonwealth-State health relationship
for both sides to share in the subsequent
savings. He says this might help, finally,
to bring about real progress in this long-
standing area. n
PLAN FOR ACTION
To help progress integrated healthcare
across NSW, and in response to the State
Government's whole-of-government ageing
strategy, the ACI in March released a
strategic framework, based on extensive
consultation with stakeholders.
Shipway says the framework outlines
a series of guiding principles, rather than
specific directions. "You can't be too
prescriptive; people need to work out
what will work locally and what will build
effective relationships," he says.
The need to involve older people
at every step of their health journey
is one such principle, which Shipway
acknowledges is "enormously challenging."
The use of technology is another guiding
principle. It offers enormous opportunities,
particularly in rural areas where distance
is a barrier, often confounded by a lack of
transport, Shipway says.
MAKING IT HAPPEN
Those behind the NSW framework are
determined to see it implemented; for
the promise of its lofty principles to be
realised in local settings across the state.
To that end, the ACI is about to begin
presenting the framework to the chief
executives of MLs and LHDs, as well as
"aggressively promoting it and creating
opportunities for training and planning,
service redesign and collaboration,"
"I would expect residential facilities
to be part of that mix as well. Certainly I
see aged care peak bodies as being a key
whether that involved hospital treatment
or community-based primary healthcare,"
she tells AAA.
Skinner says the challenge of integrated
healthcare is an international one and she
had travelled overseas to discuss strategies.
Katherine Burchfield, the director of
the Integrated Care Branch within NSW
Health, says the strategy seeks to strike
an important balance between facilitating
projects that are local but which also have
sufficient impact and scale.
"It's about recognising that it's not
very helpful for us to sit in an ivory tower
and say 'Thou shalt integrate care in the
following ways'. But, we also need to
get away from the small individual pilot
that hasn't advanced us far enough. This
approach is a compromise," she says.
A key component is to foster greater
relationships between Medicare Locals
(ML) and Local Health Districts (LHD).
Together, MLs and LHDs would act as
the primary pillars in a region, drawing
together the various other players such as
GPs, aged care and allied health.
"It's a level that makes sense because
you are getting some economies of scale,
but you are still local," Burchfield says.
The concept of a LHD and ML
collaboration underpinning integrated
healthcare at the regional level is one
supported by Chris Shipway, director
of primary care at the NSW Agency for
Clinical Innovation (ACI).
Shipway says aged care providers
should be partners in these collaborations
and suggests a shared governance
committee, comprised of representatives
from the LHD, ML, residential and
community care providers, which would
agree on a vision for integrated healthcare
in their region.
"There has been some promising work
between LHDs and residential facilities,
and MLs are getting in on this as well, in
providing training to the residential care
workforce around dealing with acute
situations, for example," Shipway says.
From the consumer perspective, Ian
Yates, chief executive of the Council on
the Ageing (COTA) Australia, agrees that
greater collaboration at the regional level
could advance integrated healthcare.
Yates says MLs could also take the lead
in areas such as demographic profiling
and implementing programs that respond
to local needs.
But he stresses this should be
addressed from a wellness, rather than
an illness perspective. "You can't have
integrated health and aged care if you
don't have a much greater investment in
health promotion and illness prevention."
He says the funders of health services
-- government, and increasingly private
health funds -- have realised their interests
are served by ensuring there are sufficient
preventative health services. "They can
see that demographic shift impacting on
their viability. Governments just need to
look at who the people coming down the
front drives of their hospitals are."
VICTORIAN AGED CARE provider Benetas last
year partnered with Bayside Medicare Local
to pilot a better approach to supporting older
people as they move between their homes,
hospital, rehabilitation and aged care.
Dr Amee Morgans, head of research at
Benetas, says the partnership began with
months of information gathering to determine the barriers to integrated healthcare.
That informed the six projects that will run this year as part of the partnership. These
focus on the residential aged care workforce; transition care; communication among
stakeholders via a health advisory council; transport; and the relationship between
residential facilities and their local GPs, says Morgans.
Dr Elizabeth Deveny, CEO of the Bayside Medicare Local, says her organisation is well
placed to connect the various stakeholders.
"Because we're local players, we know the issues," she tells Australian Ageing Agenda.
"I can tell you we have 700 GPs in our area, almost 200 practices, almost 100 residential
aged care facilities. We know the GPs who are interested in aged care, the ones that
visit nursing homes. So we provide that kind of local knowledge to assist Benetas in
connecting aged care to local primary healthcare."
Communication is crucial in facilitating integrated healthcare, Deveny says. "If you have
a lot of small businesses, which is effectively what most primary care is, you have to get
them to communicate with each other before they can better coordinate their services."
Deveny says she is hopeful the project will identify models for working together, as well as
a greater appreciation among stakeholders of each other's roles and responsibilities. "And to
learn what it is we can do to support better care for older people, and people in aged care."
The project runs until March 2015.
Dr Elizabeth Deveny Dr Amee Morgans
www.australianageingagenda.com.au | 37
Links Archive AAA Jul-Aug 2014 AAA Jan-Feb 2014 Navigation Previous Page Next Page