HealthOne Newsletter 2 July 2007

The NSW Minister for Health, the Hon Reba Meagher MP, announced a further $12.2 million funding for the HealthOne NSW program in the 2007-08 Budget. This injection of funding will be made available over the next four years, commencing with $2.3 million in 2007-08 to increase the number of community health staff to work alongside GPs as members of integrated multidisciplinary teams. This funding announcement builds on the $40 million already made available for the HealthOne NSW program.

• EOI 1 sites = Wave 1
• EOI 2 Stream 1 sites = Wave 2
• EOI 2 Stream 2 sites = Wave 3 

A second Expression of Interest was released in November 2006. It was a competitive field with over 40  submissions received. Of these, eight were recommended by the assessment panel for progression as Wave 2 and eleven as Wave 3 HealthOne NSW projects. This brings the number of potential HealthOne NSW services to 26.Staff from the Department of Health are currently visiting each of the Wave 2 locations, meeting project partners and discussing the next steps for each proposed service. This round of site visits will be completed by early August.

The seven Wave 1 HealthOne NSW services are developing their models of care and some have a major capital works program to manage. All vary in the approach they are taking to meet the challenges of operating under a HealthOne NSW model of care. Below is a snapshot of what is happening at six of these sites as they continue their journey towards integration. Common areas of work include community consultation on the redesign of the services, progressing capital works and mapping patient journeys through an integrated primary health and community care service.

The service procurement plan and project definition plan is well underway for the community health component. Lease agreements have been signed by the GPs and some private allied health staff who will be part of the HealthOne NSW service.The proximity of the service to Cootamundra Hospital and the town's residential aged care facilities will enable the development of a defined health precinct in the community. Separate negotiations are underway by project partners to establish nearby accommodation for GP registrars, locums and medical  students. This project will support sustainable growth of the medical workforce for Cootamundra.The broader community has been involved in project planning through community forums. There are plans to distribute a flyer next month containing Frequently Asked Questions about HealthOne NSW in Cootamundra.

For more information contact:

Richard Kingsford

HealthOne NSW Project Officer, GSAHS

Tel: (02) 4472 0643

Corowa HealthOne NSW will see the extension of the existing Corowa Medical Centre on the grounds of Corowa Hospital and refurbishment of a hospital wing. The development will co-locate general practice staff and community health staff in one facility and once complete will provide a one-stop-shop for service delivery. The required planning processes for this exciting new facility are well underway. Corowa HealthOne NSW project partners have established working parties to begin the challenging task of considering patient journeys and developing the service model. The early work has focused on the following areas: wound care; chronic and complex care - chronic obstructive pulmonary disease; aged and extended care - particularly transitional aged care community packages and falls prevention; mental health and drug and alcohol services; and child and family health.Supporting staff development and learning is important to the process. Staff from both Corowa and Cootamundra had the opportunity to attend a workshop entitled "Managing Change in a Health Environment", facilitated by Professor Claire Jackson (Professor in General Practice and Primary Health Care at the University of Queensland and Director of the Mater Centre for Integrated Health Care and General Practice). Staff are keen to learn more about chronic and complex care and aged care to support implementation of integrated  models of care in both Corowa and Cootamundra HealthOne NSW services.

For more information contact:

Richard Kingsford

HealthOne NSW Project Officer, GSAHS

Tel: (02) 4472 0643

The Manilla HealthOne NSW service will be the first stage of a new Multi Purpose Service (MPS). Planning is progressing well and the project team has been working hard to better define how the building will be used. This process has required a close look at the service development model for the new HealthOne NSW facility, how the facility will work for patients, and how it will functionally and physically connect to the MPS.Departmental representatives visited the site and met with key stakeholders in April and June. Departmental representatives also regularly attend the planning and development meetings by teleconference.

For more information contact:

Delys Brady

Director Integration and Partnerships, HNEAHS

Tel: (02) 4985 5908

The Molong HealthOne NSW project is proceeding well with recent milestones including:

• Completion of a schedule of accommodation

• Architectural consultants engaged

• Draft concept plan completed

• Service plan completed

• Service redesign framework being trialled with the Rylstone HealthOne NSW project

• Governance models being explored

There is significant community interest in the project. An information evening held in mid-April and chaired by the Mayor of Cabonne Shire Council, Mr John Farr, was well attended by community members.

The HealthOne NSW project at Molong has also seen the development of a valued partnership between Cabonne Shire Council, Greater Western Area Health Service and the Central West Division of General Practice. These organisations are working together to ensure that a variety of primary health care services, including GP services, community health and social services are located in the one facility to deliver integrated care to the community.

Representatives from the Department conducted a site visit to Molong in June 2007 and met with members of the Molong HealthOne NSW Project Planning Team and Planning and Implementation Committee.

For more information contact:

John Rae

Senior Planner, GWAHS

Tel: (02) 6339 5631

The Rylstone HealthOne NSW project has reached the planning and design stage, with a schedule of accommodation now completed.

Architectural consultants and sub-consultants (engineers etc) have been engaged. A planning day was held with the consultants in May 2007. Attendees included the architect, electrical, structural, mechanical and hydraulic engineers, as well as the Rylstone HealthOne NSW project planning team.

Mid Western Regional Council has been very supportive of the development and has confirmed its contribution to the service in the form of a car park.

Representatives from NSW Department of Health conducted a site visit to Rylstone in June and enjoyed a tour of the proposed site. They were able to provide positive feedback on the planning and development of the project to a joint meeting of the Rylstone HealthOne NSW Project Planning Team and Planning and Implementation Committee.

For more information contact:

John Rae

Senior Planner, GWAHS

Tel: (02) 6339 5631

The Mt Druitt HealthOne NSW implementation planning phase continues to progress with the focus on reviewing current communication systems between GPs and community health staff, and establishing more standardised and routine communication. The process of defining models of care and aligning clinical referral and case management arrangements is well underway. The emphasis in the first instance is on coordinated case management for vulnerable older people and people with chronic illnesses.

Defining the governance structures has proven a challenge. An independently facilitated Governance Structure Planning Workshop was recently held toexplore governance options. Representatives attended the workshop from the four GP partner organisations, Sydney West Area Health Service and NSW Department of Health. The workshop was successful, although there is still work to be done.

A second workshop will be scheduled in the coming months. The project partners have articulated the importance of establishing a strong governance structure to underpin the working arrangements of the HealthOne NSW service at Mt Druitt.

For more information contact:

Louise Cowper

Network Director, Primary Care and Community Health Network, SWAHS

Tel: (02) 9881 8727

Introducing Max Jones - HealthOne NSW Information Business Analyst

The capacity of service partners to share relevant client information is critical to the success of a HealthOne NSW service. Information systems that provide data to support a multidisciplinary care team environment are equally important. The Department recognises that this is a specialist area of work which will require support and advice across all HealthOne NSW services.

Max Jones has joined the HealthOne NSW Program Team to scope business solutions and address connectivity between multidisciplinary HealthOne NSW teams. Max brings a wealth of knowledge and experience from his  work in Australia and the United Kingdom. Max has previously held positions with Cerner and has worked on the National Programme for IT in England.

In his first month with the team, Max visited a number of HealthOne NSW services and began to scope the issues associated with the IM&T requirements. He will work closely with local service providers at each site to support local solutions.

"In most cases GPs and community health providers will be using different practice/client management systems that meet their specific business requirements. GPs and community health providers in a HealthOne NSW service are likely to retain their practice management systems, and ideally these will be integrated to support the clinical work flow within the HealthOne NSW service" Max said.

"The first step is to determine the clinical information requirements to support patient journeys across services following on from the clinical redesign, looking at any bottlenecks and disconnects. The information requirements will then be mapped to the current systems and any gaps identified. In determining a solution we will be looking to leverage work done on other projects that employ Health Information Standards.

"Max is investigating options for connecting multidisciplinary teams and looking at the issues relating to flow of data, unique patient identification, privacy, consent, and licensing arrangements. While there may not be one solution that fits all, solutions will be in line with NSW Department of Health guidelines and strategic directions, and will be designed with economies of scale in mind.

You can contact Max Jones on 02 9391 9591 or email him at max.jones@doh.health.nsw.gov.au

Professor John Dwyer is a clinical consultant to the HealthOne NSW Program. He is able to answer your questions about the HealthOne NSW Program.

John Dwyer is Professor Emeritus of Medicine at the University of NSW. He has a long-standing interest in health care reform and in 1996 founded the Australian Health Care Reform Alliance.

Dear John,

I am a busy GP but interested in the "HealthOne NSW" initiative. Could you please outline the advantages for General Practitioners who participate in the program?

Dr A.P. (Auburn)

Dear Dr A.P

Many of your colleagues are already excited by the opportunities (and challenges) of this innovative program.

The HealthOne NSW initiative has been established to demonstrate how a new delivery model for primary care with a major emphasis on maintaining "wellness" and the earlier diagnosis and treatment of disease processes can benefit individuals, health professionals and the community. As you probably know this approach is central to the health care reform efforts of many countries and there is a wealth of evidence that demonstrates the advantages.

Central to this model is the concept of primary care delivered by the multidisciplinary team. Doctors working with practice nurses, community health nurses and allied health professionals in an integrated way can provide the best outcomes for the patient.

The team approach is commonplace in our major hospitals but has been difficult to achieve in primary care. The Medicare Benefits Schedule items for Chronic Disease Management allow for GP Management Plans and team care arrangements for patients with chronic and complex care needs. While this initiative is a good start, the MBS items do not readily support appropriate integration of health services including community health clinicians to work with the general practice team. These barriers can be overcome through partnerships between community health clinicians, local GPs, Area Health Services and other partners. The NSW Government is providing $40 million to develop these  partnerships and the capital works necessary to establish HealthOne NSW services.

Overseas data tell us that team work, case management, sharing of clinical data electronically, the more efficient business practices available to larger units and, most importantly, greater patient satisfaction with better health outcomes markedly increases job satisfaction and retention rates for GPs working in both urban and rural centres. A number of these themes will be explored in more detail in future columns but I do hope this has increased your interest and understanding of what we are trying to achieve with this most important program.

If you or your colleagues have a question for Professor Dwyer please email it to healthonensw@doh.health.nsw.gov.au

HealthOne NSW Services Statewide Workshop

Mecure Hotel - Sydney Airport

Friday 31 August 2007, 9.30am to 4.00pm.

What is the workshop about?

The workshop will provide an opportunity for participants to learn more about the HealthOne NSW program and what it means to be involved in developing a HealthOne NSW service. It will also give people a chance to hear from other sites about their approaches and to share experiences.

Who should attend?

Anyone actively involved in planning for and developing HealthOne NSW services approved through the two Expressions of Interest. This may include clinical and other staff in Area Health Services, GPs and other general practice staff, other private health providers, Divisions of General Practice and local councils and other partner organisations as appropriate to your HealthOne NSW project.

How do I register?

Email to healthonensw@doh.health.nsw.gov.au .We hope to be able to accept all registrations but may have to limit participant numbers so as not to exceed the capacity of the venue. A detailed agenda will be provided when you register. The deadline for registrations is 17 August 2007.

If you would like to contribute to the next newsletteror want to get in touch with us for any other reason please send an email to: healthonensw@doh.health.nsw.gov.au

• Manilla's experience in mapping the patients' journeys.
• The case for prevention.
• Highlights from the statewide workshop.