The Australian Government’s basis for the funding of PHNs is in response to the Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services at the policy level is from a systems perspective.

This review presents nine interconnected and concrete areas of reform with PHNs leading the planning and integration at the local level in partnership with state governments, non-government organisations and other related services and organisations.

Additionally, PHNs were funded to commission alcohol and other drug services (AOD) arising from the National ‘Ice’ Taskforce’s Final Report.[1]

PHNs are tasked with improving coordination of health care to ensure people receive the right care in the right place at the right time and have a focus on mental health as a priority.

In its position paper on mental health, WAPHA states;

“WA has a complex array of uncoordinated services that are unevenly distributed, disconnected from each other, difficult to navigate.”

In response, WAPHA will focus its investment on integrated services and collaborative models of care, building on the strengths of existing and different service systems and enhancing the role of primary care.

This approach is in line with the Western Australian Mental Health Commission’s strategic policy document: Mental Health 2020: Making it personal and everybody’s’ business as well as Better Choices, Better Lives: Western Australian Mental Health, Alcohol and Other Drug Services Plan 2015-2025 (Better Choices, Better Lives) which calls for a focus on improved service navigation, collaboration and integration. It points to a picture of lack of access and underutilisation of primary care services by Western Australians experiencing mental health issues.

Similarly, the National Ice Taskforce report highlights the need for improved coordination between existing services, improved referral pathways, the need to develop the primary care workforce and provide greater access to care through GPs.

WAPHA’s PHNs will procure services which integrate mental health, suicide prevention, alcohol and drug and social and emotional well-being within a person centred approach in primary care.

Integrated Primary Mental Health Care

High prevalence mental health conditions such as anxiety and depression are amongst the most common reasons for contact with the health care system. People with comorbid issues, including problematic alcohol and drug use, as well as severe and persistent mental health conditions are frequently in contact with General Practitioners and other support services.

Primary care practitioners who are equipped to recognise and respond to these conditions, independent of the reason for presentation, can help to improve patient experiences, reduce wait times, and reduce further demands on social and health systems.

Key areas of focus:

  • Supporting general practitioners and other primary care clinicians to recognise and respond to common mental health conditions;
  • Significantly expanding access to evidence based psychological therapy;
  • Increasing support for patients and practitioners through integrated care management and improved access to community services;
  • Improving the patient journey along the care continuum.
  • Enhancing access to low intensity interventions through development of digital and tele heath platforms;
  • Improving feedback to support adjustment of treatment to better meet the needs of patients;
  • Working collectively and meaningfully with consumers, carers, health care providers (primary, secondary and tertiary), social services and a range of civic stakeholders;
  • Enhancing provision of Comprehensive Primary Care; and
  • Continuing development of HealthPathways WA.

For further information view our Integrated Primary Mental Health Care booklet.

mental-health-cpc-image

Key Principles

  • At key points of entry, ensure those in need access care without delay to services that are most appropriate to meet their needs
  • Aligning person-centred, recovery focused care with population need.
  • Increasing access to services which provide the minimum level of intervention required to create the maximum gain for individuals and improve system efficiency. The focus is on high volume, low intensity activities that meet individual needs.
  • Enhance early intervention to increase access and improve health outcomes
  • Supporting development of a broad workforce and enhancing locally based capacity

Priority Areas for focus

  1. Support to Primary Health Care sector, with a particular focus on GPs/physicians, to provide a continuum of care for people inclusive of both low intensity activities and specialised services for people with severe and complex issues,
  2. Activities to ensure the primary health needs of priority groups are met, inclusive of:
    • Children, Youth and Families
    • Hard to reach and vulnerable groups
    • Aboriginal and Torres Strait Islander people (includes a mix of mainstream and Aboriginal and Torres Strait Islander specific services)
    • People with severe and complex issues.

Commissioning Approach

WA PHNs will commission in response to locally identified needs in order to meet place based outcomes (geographical and virtual). Approaches will build on existing knowledge and involve a broad range of relevant stakeholders.

A systems approach acknowledges the overlap between key areas of focus. Pivotal to this is the need for a genuine, joined-up approach service provision that addresses current system fragmentation and continuity of care.  Commissioned activities will be designed to meet the needs of people.

A mix of procurement mechanisms including restricted and open processes will be utilised and will be proportionate to the level of investment. A phased approach to procurement of activities will be undertaken both as funding becomes available and as refinements to the flexible funding pool are made.

Essential Requirements

  • Consultation with and inclusion of consumers and carers at all stages of design and delivery
  • Evidence of partnership to ensure joined up, holistic systems of care
  • Demonstrated integration within the service system
  • Evidenced based approaches, including innovative and empirical approaches for which there is a clear rationale
  • Local content and localised solutions that maximise regional self-sufficiency (for example: the Nuremberg Model)
  • Activities that ensure client choice across the continuum of care
  • Co-design approaches around our priority areas of focus
  • Continuous quality improvement aligning with relevant standards and guidelines

In Scope

  • Early intervention services
  • Low intensity interventions
  • Activities that improve coordination and linkages between and within primary health sector services and the broader system of care
  • Activities designed and delivered in a stepped-care framework
  • Integration of drug and alcohol, mental health and social and emotional wellbeing services
  • Innovative new approaches may be needed which are carefully balanced with current best evidence

*Further detail on inclusions and exclusions will be provided in procurement documentation.

Out of Scope

  • Duplication or replacement of existing services
  • Services which would be more appropriately delivered by tertiary health services or the NDIS
  • Activities not supported by empirical evidence base
  • Activities designed to address funding shortfalls
  • Capital expenditure

Anticipated Key Dates

17 January (closing 17 February): Visit the WAPHA website(External link) to view details of three linked EOIs released today:

  1. Integrated System of Care to address problematic alcohol and drug use and mental illness (various metropolitan regions)
  2. Integrated System of Care to support Aboriginal people with problematic alcohol and drug use and mental illness (various metropolitan regions)
  3. Improving access to primary health care for vulnerable people who currently engaged with community and social service organisations

April 2017: Scheduled trial commencement of PORTS (Practitioner Online Referral Treatment Service), with roll-out in stages across the state from June 2017.

 

Resources

Literature

Stepped care in psychological therapies:  access, effectiveness and efficiency

Stepped care for depression in primary care: what should be offered and how?

Bennett-Levy, James (2010) E-Book Collections – Oxford Guide to Low Intensity CBT Interventions

Hegerl, U, Wittenburg, L  (2009) The European Alliance Against Depression; A multilevel approach to the prevention of suicidal behaviour. Psychiatric Behaviour 2009 Volume 60 No 5

Ham C and Alderwick H (2015) Place-based systems of care: A way forward for the NHS in England the Kings Fund

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