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Framework for Development of Primary Health Care Organisations in Australia Australian General Practice Network Boundary Modelling Project

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Framework for Development of Primary Health Care Organisations in Australia Australian General Practice Network Boundary Modelling Project Framework for development of Primary Health Care Organisations in Australia Australian General Practice Network Boundary Modelling Project. Parts 1 and 2: Introduction and State and Territory Modelling Prepared by Carla Cranny and Dr Gary Eckstein Carla Cranny & Associates Pty Ltd May, 2010 1 PHCO Boundary Modelling Project Contents Contents ...........................................................................................................................................................i 1 Introduction ............................................................................................................................................1 1.1 Purpose and scope of the PHCO modelling project........................................................................2 1.2 Modelling project methodology .....................................................................................................3 1.2.1 Policy analysis and design criteria...........................................................................................3 1.2.2 Technical modelling ................................................................................................................3 1.2.3 Limitations...............................................................................................................................4 1.3 Report format .................................................................................................................................4 2 Part 1: PHCO modelling and design criteria............................................................................................5 2.1 Policy Context .................................................................................................................................5 2.1.1 Need for national health system reform ................................................................................5 2.1.2 International trends and the role of primary health care.......................................................5 2.2 Primary Health Care Organisations in Australia - definitions and policy settings ..........................6 2.2.1 National Health and Hospitals Reform Commission...............................................................6 2.2.2 National Primary Health Care Strategy...................................................................................7 2.2.3 Nation Health and Hospitals Network Reform Directions ......................................................8 2.2.4 COAG National Health and Hospitals Agreement...................................................................8 2.3 PHCO Planning Principles and Design Criteria ..............................................................................10 2.3.1 Planning principles and assumptions underpinning the modelling......................................10 2.3.2 Planning Principle 1: Form should follow function...............................................................10 2.3.3 Planning principle 2: PHCO Participants, Local Primary Care Networks and Partners ........11 2.3.4 Planning Principle 3: Plan for communities using population planning principles...............13 2.4 Design Criteria...............................................................................................................................14 2.4.1 Design Criteria 1: Align PHCOs with Local Government Areas .............................................14 2.4.2 Design Criteria 2: Align PHCOs with state and territory borders..........................................15 2.4.3 Design Criteria 3: Alignment with State Health Services and Hospital Networks.................17 i PHCO Boundary Modelling Project 2010 2.4.4 Design Criteria 4: Primary Health Care Service Delivery Environments ...............................19 2.4.5 Design Criteria 5: Capability and critical mass ......................................................................21 2.4.6 Local Primary Health Care Service Provider Networks and Branch Offices..........................22 2.4.7 Teaching and training implications .......................................................................................22 2.5 Results of the National Modelling Project ....................................................................................23 2.5.1 Preferred Options .................................................................................................................23 2.5.2 Implementation issues and fine tuning ................................................................................24 3 New South Wales..................................................................................................................................26 3.1 Overview .......................................................................................................................................26 3.2 Demographic Features..................................................................................................................26 3.2.1 Current population................................................................................................................26 3.2.2 Indigenous population ..........................................................................................................26 3.2.3 Projected population and patterns of growth ......................................................................27 3.3 Structure of Health Services..........................................................................................................27 3.3.1 General Practice....................................................................................................................27 3.3.2 Workforce and GP distribution .............................................................................................30 3.3.3 Area Health Services .............................................................................................................30 3.3.4 Aboriginal community controlled health services ................................................................32 3.4 PHCO Design Issues in NSW ..........................................................................................................32 3.4.1 Size and scale ........................................................................................................................33 3.4.2 Cross border flows and communities of interest..................................................................33 3.5 Configuration Options for PHCOs in NSW.....................................................................................33 3.5.1 Option 1: 15 PHCOS with 8 metropolitan, Hunter and Illawarra major regional, 5 rural and flows from south west NSW to Victoria................................................................................................33 3.5.2 Cross border flows to Victoria...............................................................................................40 3.5.3 Strengths and weaknesses....................................................................................................41 ii PHCO Boundary Modelling Project [Year]2010 3.5.4 Option 2: 16 PHCOS with 9 metropolitan, 2 regional, 5 rural and flows from south west NSW to Victoria.....................................................................................................................................42 3.5.5 Strengths and weaknesses....................................................................................................42 3.5.6 Option 3: Cross border flows to Queensland, the ACT and Victoria.....................................43 3.5.7 NSW/ACT Cross Border Options ...........................................................................................43 3.5.8 Option 3a: Cross border PHCO with contiguous NSW LGAs flowing to ACT.........................44 3.5.9 Strengths and weaknesses....................................................................................................44 3.5.10 Option 3b: 14 NSW PHCOs with all of Southern NSW in the ACT PHCO ..............................45 3.5.11 Strengths and weaknesses....................................................................................................46 3.5.12 Suggested approach..............................................................................................................47 3.5.13 NSW/Queensland Cross Border Option................................................................................47 3.5.14 Strengths and weaknesses....................................................................................................48 3.5.15 Suggested approach..............................................................................................................48 3.5.16 Other cross border options considered and rejected...........................................................48 3.5.17 Variations in the number and size of rural PHCOs in NSW...................................................49 3.5.18 Option 4: 15 PHCOS with 9 metropolitan, 2 major regional, 4 rural plus flows to ACT, Victoria and Queensland.......................................................................................................................49 3.5.19 Strengths and weaknesses of 4 rural PHCOs ........................................................................52 3.5.20 Option 5:16 PHCOS 9 metropolitan, 2 major regional and 5 rural .......................................53 3.5.21 Option 6: 17 PHCOS with 9 metropolitan, 2 major regional and 6 rural PHCOs ..................54 3.5.22
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