Driving change through collaboration

The inaugural Primary Health Care Congress 

 

by Mia Dhillon, APNA General Manager, Health Care Solutions

Source: APNA Primary Times Summer 2024-5

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On 26 July 2024, the Primary Health Care Alliance (the Alliance) facilitated its inaugural Primary Health Care Congress (PHC Congress) at the International Convention Centre in Adelaide. The Congress was attended by more than 60 health leaders from medical, nursing, allied health and university peak bodies and professional organisations, along with representatives from the Australian Government Department of Health and Aged Care. 

Against the backdrop of significant health reform discussions in Australia, such as those stemming from the Strengthening Medicare Taskforce recommendations, the PHC Alliance recognised that clear and visible alignment from multiple stakeholders is needed for effective and timely reform of the primary health care (PHC) sector. Yet, few opportunities exist for these stakeholders to come together to understand areas of consensus. This first Alliance event aimed to change that.  

The pre-Congress survey, which was completed by 61 of the invited guests, showed that consensus already existed on the following topics: 

• Primary health care in Australia needs reform. 

• Primary health care funding needs reform. 

• Primary health care funding is not optimized.  

Significantly, only 16% of survey respondents believed their area of PHC is understood by others. 

Setting the scene 

To ensure that the day started with a focus on increasing mutual understanding of the PHC sector and reform opportunities, keynote speeches were delivered by the Hon Ged Kearney, Assistant Minister for Health and Aged Care; Senator Anne Ruston, Shadow Minister for Health and Aged Care; Professor Michael Kidd, Global Primary Care and Future Health Systems, University of NSW; and Professor Mark Cormack, Scope of Practice Review Lead, Australian National University.  

Responding to PHC reform 

The top areas requiring reform or optimisation in PHC in Australia, as rated by participants in the pre-Congress survey, were presented to the group. These areas were:  

• funding models 

• workforce capability and utilization 

• models of care 

• access to services 

• preventative health care 

• data, evaluation and research 

• digital interoperability 

• system/jurisdictional connectivity.  

A panel of speakers selected for their diverse subject matter knowledge and insights from across health economics, policy, First Nations and consumer perspectives were given the opportunity to respond to the reform priorities and stretch the thinking of the group.  

Speakers included Professor Anthony Scott, health economist and researcher, Monash University; Dr Anthony Hobbs, former Deputy Chief Medical Officer; Anita Hobson-Powell, Chief Allied Health Officer; Dr Rosemary Bryant, Australia’s first Chief Nursing and Midwifery Officer; Dr Elizabeth Deveny, CEO, Consumers Health Forum of Australia; and Dr Jason Agostino, Medical Advisor, National Aboriginal Community Controlled Health Organisation. 

Health leaders decide ways forward  

Next it was over to the health leaders in attendance to map out what change could look like. Facilitated by PHC Alliance members and APNA staff, groups of six to eight people were allocated a reform area from the above list with the objective of determining a system-level change for that area, as well as features and enablers for the change.  

Taking inspiration from Edward De Bono’s ‘six thinking hats’ concept to encourage thinking from different perspectives, each individual participant was also assigned a component of the Quintuple Aim for health care improvement to ensure that the identified change and features addressed this framework.  

Seating was arranged to ensure a diverse mix of voices were heard and to address gaps in understanding between different PHC sectors. This allowed for an expanded, collaborative approach to reform. The panel speakers also rotated between tables to contribute their unique insights, strengthening the problem-solving work of each group.  

Health leaders vote 

After much discussion – as well as laughter and general good-will – each group prepared its proposed system-level changes for presentation. In quick succession, groups delivered 90-second pitches for peer review and voting. Each table had 60 seconds to quickly decide if they, as a group, supported the proposed change. Short time frames were used to maintain momentum, build engagement and ensure all tables had an opportunity to pitch their idea.  

Speaker panellists voted based on whether the change adequately addressed the Quintuple Aim. Representatives from each table also moved about the room with enthusiasm and interest, allocating their votes.  

Consensus achieved 

A consensus was reached on four reform areas that should be prioritised for Government consideration: (1) funding, (2) digital health, (3) data and research and (4) workforce training. 

Funding 

The proposed funding reform comprised the following three system-level features: needs-based funding; flexible funding that enables multidisciplinary care across health systems; and increasing the percentage of funding to PHC to enable proactive preventative care. 

Digital health 

The proposed digital health reform addressed the interconnectivity needed between PHC and private and tertiary providers, which was recognised as essential for a future-fit approach to developing the system.  

Data and research 

The proposed data and research reform entailed a consistent national data and evaluation framework to inform health policies and interventions, along with a strategic research agenda that was viewed as essential for achieving greater efficiency, equity and stronger health outcomes.  

Workforce training 

Finally, the proposed workforce training reform included the need for PHC theory and practice (i.e., clinical placements) to be embedded into the undergraduate curriculum across all health professions. Workforce training was considered essential for growing an interdisciplinary PHC workforce, delivering stronger health outcomes and developing postgraduate pathways into PHC.  

Conclusion 

The PHC Congress provided a valuable forum to bring together health leaders from across the PHC system, some of whom had never met or worked together before. Genuine and respectful discussions prevailed, allowing individuals to listen to each other and find common ground on the system-level changes needed to create meaningful and timely reforms to the PHC sector. 

The feedback from participants was overwhelmingly positive with most participants expressing interest in attending future PHC Congress events.  

The Alliance would like to thank all speakers and participants who took the time to attend and contribute to this important inaugural event and would like to acknowledge the interest shown by organisations in the activities and work of the Alliance. 

 

 

 

 

 

 

Professor Michael Kidd addresses the PHC Congress 

 

 

 

 

 

 

Panel speakers (L–R): Dr Elizabeth Deveny, Dr Rosemary Bryant, Anita Hobson-Powell, Dr Jason Agostino Professor Anthony Scott and Dr Anthony Hobbs 

 

 

The Primary Health Care Alliance  The Alliance is a diverse group of organisations with a common interest in transforming the primary health care system to a model of multidisciplinary primary health care through collaborative efforts that support system-wide reform. It consists of the following members:  Australian Healthcare and Hospitals Association  Allied Health Professions Australia  Australian Nursing and Midwifery Federation  Australian Primary Health Care Nurses Association  Congress of Aboriginal and Torres Strait Islander Nurses and Midwives  Australasian College of Paramedicine  Pharmaceutical Society of Australia  Rural Doctors Network

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following organisations participated in the PHC Congress: 

ACT Health	Heart Foundation
Adelaide Primary Health Network	Inala Primary Care
Australasian College of Paramedicine	Monash University
Australasian Society of Lifestyle Medicine	National Aboriginal Community Controlled Health Organisation
Australian Association of Practice Management	Northern Territory Primary Health Network
Australian College of Midwives	Occupational Therapy Australia
Australian College of Nursing	OneBridge
Australian College of Nurse Practitioners	Rosemary Bryant Foundation
Australian Medical Association (SA)	Royal Australian College of General Practice
Australian Nursing & Midwifery Federation	Royal Flying Doctors Service
Australian Podiatry Association	Rural Doctors Network
Australian Primary Health Care Nurses Association	Pfizer Australia
Allied Health Professions Australia	Pharmaceutical Society of Australia
Brisbane South Primary Health Network	Private Healthcare Australia
Calvary Aged Care	Safer Care Victoria
Commonwealth Department of Health and Aged Care	South Australian Department of Health
Congress of Aboriginal and Torres Strait Islander Nurses and Midwives	Speech Pathology Australia
Consumers Health Forum	The Pharmacy Guild of Australia (TAS)
Council of Ambulance Authorities	Victorian Department of Health
CRANAplus	Western Australia Primary Health Alliance
Edith Cowan University	WentWest, Western Sydney Primary Health Network
Exercise and Sports Science Australia	Wounds Australia
Florence Nightingale Foundation
Health North Coast Primary Health Network
Health Workforce Queensland