Arguments for primary health care reform in Australia rightly call for structural, financial and workforce changes as part of re-shaping Australia’s primary care system. In the short-term, federal and budget commitments include new models of care, selective increases to Medicare rebates, and expanding team-based care — as steps towards a more accessible and sustainable healthcare landscape.
Local design
Fostering innovative models of primary care in rural and remote communities where we have been seeing market failure for some time is absolutely critical, if we are serious about addressing rural inequities. This requires:
- Putting consumers and communities at the centre of primary care service model design and delivery
- Designing local, fit-for-purpose models supported by state or federal infrastructure, funding and workforce
- Allowing space for innovation to address local challenges.
As rural community leaders often say — rural communities are resourceful, and know what works locally. Community health leaders and research consultants can help join the dots between local thinking and national/state funding and policy frameworks.
21st century design thinking
A future-focused primary health care system needs to be fit for the 21st century.
What does this mean?
Firstly, we have populations that are ageing and presenting with more chronic care needs as well as mental illness. Multidisciplinary teams working well together are critical. Secondly, whether by design or poor planning, many clinicians are becoming scarce in numbers related to need (e.g. nurses, medical practitioners, speech therapists…). We need to help clinicians to work to the top of their scope of practice and provide the support they need including technologies and assistants. Thirdly, we need new funding models that work and are easy to utilise.
Yet reformers rightly admit that the primary care sector, given the current financial and workforce pressures (we have recently written about burnout), needs funding and active change management support to drive innovation. Services often do not have the staffing capacity to undertake service redesign or quality improvement activities (outside accreditation processes) alongside service delivery. Indeed, Larter is actively working with two clients right now assisting in the complexities of change management.
Investing in rural and remote healthcare innovation
As Australia sets its sights on this bold blueprint for healthcare, the Primary Care Rural Innovative Multidisciplinary Models (PRIMM) program emerges as a driver of innovation for rural and remote communities.
PRIMM funds communities to develop ‘trial-ready’ models of multidisciplinary primary care that address health needs or health workforce shortages in a community or a sub-region. Grant funding can cover:
- service design
- community consultations
- data analysis
- financial model design.
Acknowledging the diversity of healthcare needs across regions, PRIMM offers a direct platform for the development of community-driven solutions. By actively engaging communities in the design of healthcare strategies tailored to their distinct requirements, the program facilitates collaborative efforts between local communities and healthcare providers and acts as a bridge between the visionary goals of the 10-year national primary health reform plan and the localised needs of under-served areas.
Elevating healthcare design: PRIMM in action
To date, PRIMM has funded six organisations with grants of up to $400,000 each. This financial support is dedicated to fostering dialogue and problem-solving within communities, facilitated by healthcare experts. The resulting healthcare models serve as case studies in efficient, community-responsive care. This table provides an overview of the organisations funded and their respective innovations projects.
The power of codesign and placed-based approaches
Principles of codesign and a place-based approach are pivotal to the initiative’s success and serve as the driving force behind its impact.
Codesign recognises that a one-size-fits-all approach falls short in a diverse landscape like Australia. Different locations present distinct problems, different stakeholders, and different opportunities. PRIMM adopts a flexible codesign approach to innovations, fostering partnerships at local, regional, state, and national levels. This results in heightened health service planning, improved coordination and governance, and a deepened understanding of local priorities.
At the heart of this process is community engagement — a vital component in identifying ideas, service gaps, and underutilised resources — identifying community-led solutions that resonate with the unique needs of each region. Especially in the context of rural and remote areas, community engagement becomes the compass guiding the design of effective healthcare solutions.
A PRIMM community of practice also allows leads from different projects to exchange experiences and learn collectively, fuelling continuous improvement and innovation.
A future anchored in collaboration
We watch with interest to learn from the progress of these, and other, efforts to develop innovative models of primary care in rural and remote communities. In the innovations codesign work we do, the role of partnerships, team-based care, workforce sustainability, blended funding models, incentivisation, and outcomes measurements continue to be big topics, among others.
We continue to learn from both international and local best practice, and contribute our evaluation expertise to identify success factors, models of high value primary care excellence, and share findings more broadly to help commissioners and communities learn from successful, locally designed models.
For further insights into Australia’s healthcare transformation, or the codesign or evaluation of community-led solutions, we invite you to contact us for a conversation on 1800 527 837 or reach out at larter@larter.com.au
