DoHAC releases PHN Strategy 2023–24 following audit

The Department of Health and Aged Care (DoHAC) has released the (primary health network) PHN Strategy (2023–24) outlining the crucial role the networks play in supporting health reform.

The document clarifies the purpose, objective and key functions of the PHNs, highlighting how they drive local innovation to meet specific local health needs and supporting consistent local delivery of national and co-commissioned programs.

PHN audit report and recommendations

The release follows the Australian National Audit Office’s (ANAO’s) audit into the Effectiveness of the Department of Health and Aged Care’s Performance Management of Primary Health Networks, aimed at assessing the effectiveness of the department’s performance management of PHNs.

PHNs were established as a delivery model for primary health care in 2015, replacing Medicare Locals. There are 29 PHN providers across Australia responsible for 31 PHN regions, with populations ranging from 64,000 to 1.7 million people. Since the establishment of PHNs, the DoHAC has committed grant funding worth $11.6bn to support these networks.

The ANAO audit found that while the PHN delivery model was established in 2015, there was no assurance framework until 2021. Although specific guidance and tools to support assurance activity have been in place since 2016, an assurance strategy and schedule were established in 2022 and a risk management plan in 2023, the ANAO said in the audit report.

The report further said that the DoHAC’s performance measurement and reporting arrangements for PHNs and the PHN delivery model are partly fit for purpose but the department has not demonstrated that the delivery model is achieving its objectives.

The report made eight recommendations relating to: ensuring PHN compliance with grant agreement requirements; improved PHN performance measures; PHN data assurance; improved PHN performance reporting; IT systems for PHN monitoring and reporting; and evaluation of the PHN delivery model. The DoHAC has agreed to seven recommendations and agreed in principle to one recommendation (implement a fit-for-purpose IT system for administering PHNs).

PHN Strategy 2023–24 — core functions and priorities

In the recently released PHN Strategy document, the DoHAC notes: “In-line with the quintuple aim of successful health reform, PHNs deliver three core functions — coordinate and integrate local health care services in collaboration with Local Hospital Networks (LHN) to improve quality of care, people’s experience and efficient use of resources; commission primary care and mental health services to address population health needs and gaps in service delivery and to improve access and equity; and capacity-build and provide practice support to primary care and mental health providers to support quality care delivery.”

The Department provides funding support to the PHNs for overhead corporate governance and non-administrative health system improvement activities and program to deliver specific activities across 11 areas of scope. While delivering on their ongoing role, the PHNs have specific policy priorities each year. The priorities starting or continuing in 2023–24, according to the DoHAC, are:

• Population health
  • After hours program reform — Refocus after hours commissioning on new program guidelines; commission multicultural access services for culturally and linguistically diverse (CALD) communities; commission primary care access services for homeless people.
  • Frequent hospital users — Contribute to co-design work with Department, S&T departments, LHNs and others to finalise program design of the new MyMedicare incentive.
     
• Practice support
  • MyMedicare implementation — Support general practices with MyMedicare registration; support more practices to become accredited; prioritise practices and solo providers servicing residential aged care homes.
  • Allied health, nursing and midwifery — Extend PHN practice support functions where practicable to allied health, nurse practitioner and midwifery-led practices.
     
• Digital health
  • PIP Quality Improvement incentive — Continue to engage and support practices on data sharing and quality improvement.
  • Data security: Renew focus on data security.
  • Data linkage and analytics — Engage with LHNs, S&T governments, AIHW and Department on data linkage and analytics initiatives.
  • My Health Record — Engage with allied health and ADHA on My Health Record-compliant software development.
     
• Emergency preparedness
  • Primary care in emergency preparedness — Facilitate primary care and mental health integration into emergency preparedness and response efforts.
  • Prepare for mobilisation — Maintain capacity to mobilise primary care and mental health in disaster scenarios.
     
• Mental health and suicide prevention
  • Primary mental health services — Continue to coordinate and commission mental health services across the 8 mental health priority areas.
  • Headspace centres — Continue to commission Headspace centres to improve health outcomes for young people.
  • Bilateral schedules — Continue to participate in activities specified in the bilateral schedules such as joint regional planning and commissioning.
     
• Alcohol and other drugs
  • Treatment and workforce — Continue to increase access to Alcohol and Other Drugs (AOD) treatment services and build capacity within AOD sector.
     
• Health services in aged care
  • General practice in aged care incentive — Work with Residential Aged Care Homes (RACHs) to identify residents with no usual GP; match these residents with a usual practice and GP; commission GPs to provide regular services in RACHs where gaps exist; work with RACHs to make simpler arrangements for GP visits.
  • Increased care access for aged care residents — Enhance after hours support and increase availability and use of telehealth for aged care residents.
  • Care Finders for older Australians — Establish and maintain the Care Finders network; help people connect with relevant support.
     
• Aboriginal and Torres Strait Islander health
  • Integrated team care — Improve health outcomes for Aboriginal and Torres Strait Islander people with chronic conditions through better access to care coordination and multidisciplinary care, support self-mgmt. and improve access to culturally appropriate mainstream care services; work with Department on transition to direct funding.
     
• Workforce
  • Workforce Incentive Program: Practice Stream — Contribute to the development of data collection arrangements on use of nursing and allied health in general practice.
  • Allied health commissioning — Commission allied health and nursing services targeted to areas of need with focus on supporting MDT care for small general practices.
  • Single employer model — Engage with single employer model (SEM) trials program for GP registrars in areas of need.
  • GP Incentive Fund — Leverage expanded PHN GP Incentive Fund to address GP workforce shortages in areas of need.
     
• Emergency response
  • Primary care emergency response — In emergency settings, operationalise and implement primary care response as required in regions.
     
• Medicare Urgent CareClinics (UCCs)
  • Support the establishment of 58 Medicare UCCs across the country and support local integration, data collection, communications and clinic operations.

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