出版社：Utrecht University, Maastricht University, Groningen University
摘要：Sydney North Primary Health Network (SNPHN) has developed an innovative framework for strengthening the role of primary health care providers in supporting the patient journey through the complex health system, whilst bringing services closer to patient’s homes. We are excited to be working with General Practices and wider primary care to establish six Local Coordinated Networks (LCNs) that cover the span of the Northern Sydney metropolitan region. Reflecting a ‘Medical Neighbourhood’ model, a LCN is a grouping of general practices within a locality, with multidisciplinary teams and services working in collaboration with general practice so that together, they can provide services which best meet the needs of their local population. The establishment of LCNs provides a significant opportunity for SNPHN to work in partnership with the Local Health District, private hospitals, private health insurers and local government councils to align services and co-design and co-commission local solutions relevant to each Local Coordinated Network. During the last 12 months, SNPHN has worked closely with general practices from each LCN, with consumers and other key stakeholders, to better understand the needs of both the local population and service providers to identify areas for service improvements. This has resulted in identification of areas that have been addressed in enabling a more accessible primary care system to positively impact patient experience of care, improve patient outcomes and ultimately improve population health. Based on key issues pertinent to individual LCNs, as identified through co-design sessions and needs assessment data, SNHPN has provided funding to support and enhance local service delivery and commission services in the following areas: aged care social work services, aged care services for people with dementia, chronic and complex care coordination, falls prevention and support for members of the community experiencing severe and complex mental illness. Additional benefits of the SNPHN LCN model: Primary health care services commissioned to address local need for greater impact Reaffirming general practice as having a key role within the health system Better understanding of local population health needs / priorities Care provided closer to the patient’s medical home Improved use of data to measure the impact on patients including health outcomes Further opportunities for SNPHN LCN activity: Opportunity to test new ways of working Networking with General Practice, Community providers and Local Health District GP involvement in commissioning of community based services based on identified need within their network e.g. social work, allied health, mental health Closer working relationship with acute services to agree priority areas and investment, providing specialist outreach support services, care coordination, co-commissioning Further development of localised care pathways – simplifying access to and navigation of the local system (including Health Pathways) Working with local government councils to explore opportunities for collaboration, co-commissioning and systems approach to meeting local needs Alignment of commissioning funds to LCNs to ensure best use of resources for local needs SNPHN is working closely with general practice in the development of our LCN framework to promote GP ownership and support of enhanced integrated services in Northern Sydney.
关键词：primary health care ; commissioning ; innovation
