Australia is set to trial a new model of primary health care based on the successful “Health Care Homes” programs in Canada and the United States. Australia’s version of the Health Care Homes scheme was proposed in broad terms in December 2015 by the Primary Health Care Advisory Group, in its Better Outcomes for People with Chronic and Complex Health Conditions report. Key elements of the proposed scheme included:
- The establishment of centralised ‘home-bases’ to co-ordinate patients’ ongoing care, with an emphasis on putting patients at the centre of the healthcare system. Critically, a patient’s preferred clinician takes primary responsibility for co-ordinating care provided by hospitals, specialists, allied health providers and pharmacists.
- Greater accessibility of medical care through increased use of videoconferencing, email and phone calls, as well as the increased availability of after-hours care.
- An emphasis on integrating and coordinating patient care across the healthcare system.
- Improved data accessibility by improved information sharing between health care professionals, as well as providing online access of health records to patients.
The Australian Government’s 2016-17 budget announced funding to roll-out a trial first stage of Health Care Homes. The scheme’s initial focus will be on patients with chronic and complex conditions, as these patients are particularly affected by the existing fragmented and uncoordinated health system.
On 29 July, recently re-appointed Health Minister, Sussan Ley, gave a speech to the Pharmaceutical Society of Australia identifying key issues in the Health portfolio in the coming year. Chief amongst these was the establishment of Health Care Homes. The Minister explained the necessity of the program’s introduction, given that 20% of Australians have multiple chronic conditions, and many of these patients are visiting up to 5 different GPs each year, putting unnecessary strain on the health system. The Minister flagged the possibility of pharmacists co-locating with GPs and trialling other service delivery methods as part of the Health Care Homes roll-out.
On 1 August 2016 the Consumers Health Forum of Australia (which has as its members the Royal Australian College of General Practitioners, universities and health policy institutions), released its Patient-Centred Healthcare Homes in Australia: Towards Successful Implementation paper. The paper discusses 25 principles for implementation, including expanding the program to all patients (not just those with chronic conditions). The paper also identifies key challenges that will need to be overcome for the program to succeed, such as the successful implementation of new funding models to complement the program, the consolidation of vastly different patient management systems, the extension of the program to GP practices in remote communities and shifts in patients’ attitudes.
The Health Care Home policy has been welcomed by the Royal Australian College of General Practitioners, which believes it will have “life-changing benefits to patients”. The Australian Medical Association is also supportive of the policy, but has called for around $100 million of additional funding in order for the program to be successfully rolled-out.
The first phase of Health Care Homes is due to commence in July 2017.