What will it take for a system that is truly patient-centred?

clinician talking to patient

This blog by the new CEO of the Consumers Health Forum, Leanne Wells, was recently published on Croakey at http://blogs.crikey.com.au/croakey/2015/04/19/what-are-the-challenges-and-priorities-facing-the-new-primary-health-networks/

The latest Commonwealth plan to reboot Australia’s primary care system offers the potential for consumers to have a greater say over how their local health services should work. We hope.

“Patient-centred care” is the vogue buzz word in the modern health arena.

But will the idea of the patient being the focus of the new Primary Health Networks go the way of a joke told at a recent workshop on PHNs: Patient-centred care?  That’s where you, the patient, sits in the centre and we, the clinicians and officials, tell you what to do.

Health Minister Sussan Ley has put some emphasis on seeking out the consumer view.  On paper, the Federal Government’s approach to PHNs appears to place less emphasis on giving consumers/patients a say in the governance and priorities for PHNs than clinicians.

The growing evidence from around the world is that health services that empower consumers tend to yield better outcomes for everybody concerned.

The announcement of the preferred tenderers to oversee 28 of the 31 Primary Health Networks so far indicates that we will now see a range of different interests in the consortiums including GPs, allied health providers, universities, private health insurers and several former Medicare Locals.

CHF welcomes the Minister’s statement that the PHNs are charged with fixing fragmented care, and we hope, to being accountable for the services they commission.  Too often there are patients who fail to get the right care at the right place at the right time.

We argue that if PHNs are to work to best advantage for consumers in areas like the growing challenge of chronic illness, then they will perform best by ensuring consumers have an influential say in governance, in the priorities for local health systems and in the design and delivery of services.

The Minister’s announcement of the PHN’s six priority areas of focus: mental health, Aboriginal and Torres Strait Islander health, population health, health workforce, eHealth and aged care is an important indicator of intent.

Perhaps more challenging is the aspiration for a system that can provides effective, integrated and accountable care for everybody with chronic illness and multiple co-morbidities. To achieve this, PHNs must have the right levels of flexible funding and the right leadership mix if they are to succeed.

The real drivers of health system improvement are patients and clinicians working together regionally: PHNs must have sophisticated, evidence-based programs to ensure that the consumer voice and experience of care is centrally involved in planning and decision making about health solutions.

If they are guided by the patient experience of the system and consumer-led ideas for health system improvement, PHNs have the potential to be the catalysts of real change and innovation.

This means so much more than PHNs setting up Community Advisory Committees. It means PHNs must systematically involve communities and patients involved in all stages of the PHN commissioning cycle – not just their governance.

It requires PHNS to work with communities to identify needs and aspirations; work with the public to plan and transform services; work with patients and carers to improve quality and safety; and work with the patients and the public to procure and monitor services.

But most importantly it means PHNs embracing and realising the benefits that can be realised from the different levels and purposes of involvement.

The ‘Seven Benefits’ framework that appeared in futurepatientblog.com is one of many that describes the value of patient-led healthcare – richer insight, potential solutions, strengthened relationships, individual benefits, better quality decisions and benefits beyond the project being among the gains that can be achieved from patients as partners for change.

Here’s hoping we can exploit the novel status of the PHNs to develop a truly patient-centred approach.

 

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