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Sector voices concerns about Health Care Homes stage one

Health sector bodies have welcomed Prime Minister Malcolm Turnbull’s announcement of stage one of the Health Care Homes (HCH) model, but not without caveats.

The government announced the 10 regions that will participate in stage one of the model. They include: Western Sydney, Hunter New England and Central Coast, and Nepean-Blue Mountains in New South Wales; Perth North in Western Australia; Brisbane North in Queensland; South Eastern Melbourne in Victoria; Adelaide and Country South Australia in South Australia; as well as the Northern Territory and Tasmania.

The Australian Healthcare & Hospitals Association (AHHA) gave its support to the reform but urged the government to ensure the HCH trial is provided with the funding and resources needed to succeed in delivering transformational change to the primary care system.

AHHA chief executive Alison Verhoeven said: “The establishment of Health Care Homes is a step in the right direction to resolving fragmented primary and acute care services for people with chronic conditions, but it will be important to get the funding balance right so that incentives promote value, not volume of services.”

Verhoeven said the investment proposed for the trial looks set to fall substantially short of requirements.

“Evidence from a number of sources suggests that funding of between $1300 and $2500 a person per annum would be required to truly deliver reform via a Health Care Home,” she said.

The AHHA head also urged the government to avoid a one-size-fits-all approach to the HCH package.

“Chronic care reforms must be flexible, patient-centred and integrated with other reforms throughout the broader health sector, including the acute sector, and designed in partnership with the states and territories,” she argued. “Such initiatives have been shown to be most effective when primary care-based population approaches are taken.”

Consumers Health Forum of Australia (CHF) chief executive Leanne Wells agreed that the model would need to be focused on the individual needs of patients and that funding increases would be an important part of its success.

Wells said: "HCH has the potential to transform the way people with chronic diseases receive care, but only if it is adequately resourced and supported."

She added a commitment to substantially more money is needed, as is a truly comprehensive national approach.

“At the moment, we are seeing a somewhat scattered approach, with some federally financed pilot programs while some Primary Health Networks are separately commissioning joined-up care services,” Wells explained. “The stage one plan is to attract 65,000 patients in 200 GP clinics. Both patients and doctors will need to be convinced there is more support being offered to focus on the overall needs of chronic patient care.”

Wells added CHF wants to see Health Care Homes as part of an integrated approach and not as a separate silo that does not have strong connections to the rest of the system.

Palliative Care Australia would like end-of-life planning and care to be part of the equation.

The group stated that 4 out of 5 deaths in Australia are from chronic disease and the HCH model provides the opportunity for co-ordinated care and early referral to palliative care when needed.

PCA chief executive Liz Callaghan said: “It is important that Primary Health Networks work with palliative care services in their areas to ensure impeccable care is delivered to their population groups.”

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