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HealthOne NSW

HealthOne NSW | Why HealthOne NSW? | What makes HealthOne NSW different? | Model of Care | Governance | Information Management & Technology

HealthOne NSW

HealthOne NSW is a NSW Government initiative to integrate primary health care and community health to better meet the health needs of people in NSW.
 
HealthOne NSW services are bringing together GPs and community health and other health care providers in 'one stop shops'.
 
HealthOne NSW services will focus on keeping people well and out of hospital through prevention of disease and ill health, early intervention strategies and continuing care for people with chronic illness as well as providing GP and community health services.
 
The NSW Government has committed $40 million for planning, construction and establishing HealthOne NSW services across NSW. This sizeable investment reflects the importance the Government attaches to this initiative.
 
HealthOne NSW services are central to the NSW State Health Plan and the NSW Integrated Primary and Community Health Policy 2007-2012.
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Why HealthOne NSW?

NSW has a growing and ageing population. By 2026, people aged 65 years and older will account for 20% of the estimated population of 8 million people. By the 2020s chronic disease is expected to account for 80% or more of the burden of disease in Australia.
 
The NSW Government now spends over to 28% of the total NSW budget on health, up from 23% in 1994-95. These increases in health expenditure cannot be sustained indefinitely. All developed countries are facing similar problems of increasing demand and rising costs.
 
We need to explore and implement new models of health care to promote health and wellbeing, and provide health services in the most efficient and effective way possible. Rather than continuing to supply additional hospital services we can reduce the need for hospital services by providing better primary health care. This can be acheived through:
  • an increased focus on health promotion and disease prevention strategies ("wellness")
  • earlier diagnosis and management to avoid or delay the development of chronic illnesses and
  • better management of chronic conditions in the community.
There is evidence to show that integrated primary health and community care services can offer the most cost-effective, accessible first-line response to health care needs, and can reduce the need for expensive and invasive hospital care. We also know that people with chronic conditions often prefer to be cared for at home, in a familiar environment.
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What makes HealthOne NSW different?

The HealthOne NSW service model recognises the challenge of moving from a health system where health professionals usually work in isolation to one where they work together in multidisciplinary teams. Health professionals working in HealthOne NSW services understand that working as multidisciplinary teams is both professionally rewarding and provides the best and most appropriate care for patients.

The service model requires major changes to the way we plan for and deliver health services. For example:

  • HealthOne NSW services will provide prevention and early intervention services, as well as episodic and continuing care for people who are unwell.

  • HealthOne NSW services will engage communities and plan for population needs, as well as continue to meet the needs of individuals.

  • Information usually held and recorded separately will need to be shared.

  • Clinical and corporate governance arrangements to support integration will need to be in place.

  • Financial arrangements between all the stakeholders need to be considered.

  • Some HealthOne NSW services are moving beyond traditional health services to form partnerships with local government, community services and the charitable sector to provide a suite of health and community services in one location.

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Model of Care

Integration underpins the model of care. Integration can mean different things to different people, but for HealthOne NSW services it means, at a very practical level, integration of the following:

  • The efforts of individuals and communities as active participants in staying well and optimally managing any disease process, in collaboration with the HealthOne NSW health professionals.
  • The care delivered by all the health care professionals in the HealthOne NSW service working as a multidisciplinary team.
  • The care delivered by members of the HealthOne NSW team with the care provided by hospitals and other services such as NGOs, private health care providers and Aboriginal Community Controlled Health Organisations.

  • Patient/client records documenting the diagnosis, advice, plans and treatment offered by health professionals working in all the above settings (integration of clinical information).

  • The financial resources made available by both state and federal governments.

  • Operational aspects and governance arrangements of the HealthOne NSW service across private and public services.

  • Clinical service provision and record keeping with monitoring, evaluation and research activities.

The importance of integration across the primary health and community care services, and across primary health care and acute services, is well understood and supported by good evidence. The challenge is making it happen.

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Governance

Underpinning the model of care are governance arrangements that allow primary health and community care professionals to work together as a multidisciplinary team.
  • HealthOne NSW services must comply with section 19(2) of the Commonwealth Health Insurance Act 1973 and provide an efficient and effective structure with manageable business compliance costs and acceptable staff employment and contracting options.
  • HealthOne NSW services may choose different governance arrangements, but all arrangements are expected to support the concept of team-based care and the integration of services.
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Information Management & Technology

Shared information systems to support multidisciplinary care are critical to the success of HealthOne NSW services. Sharing of information will support services to:

  • coordinate care
  • manage the business
  • coordinate appointments
  • monitor and evaluate the service
  • contribute to the evaluation of the HealthOne NSW program
 
NSW Health will support HealthOne NSW services to identify and implement the most appropriate local arrangements to integrate information systems. The first step is to identify ways in which community health staff, GPs and practice nurses can share information, using their existing information systems.
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