North Coast NSW
North Coast Primary Health Network and North Coast Local Health District
- Providing Right Type of Care
- Making it local
North Coast Primary Health Network (PHN) initiated a project to explore a collective approach to mental health service delivery across services and where possible pool resources in the North and Mid North Coast areas to better address the need of people living with mental health issues and or distress in the region. North Coast PHN is the lead agency in partnership with North Coast Local Health District (LHD).
Through a collaborative approach to service delivery across the region the North Coast Collective (the Collective) aims to better address the mental health support needs of the North Coast community. This approach has looked at ways to improve navigation, cross service handover and a partnership-based approach to care. The pooling of financial resources is being trialed with the aim of increasing support to people with mental health issues. The Collective aims to reduce duplication and improve overall mental health care in the North Coast region.
Ensuring that mental health care is accessible to everyone can often be a challenge. Funding for mental health is spread across a range of services with varying models of care. This includes PHN’s, LHD’s and the community managed (CMO) sector along with, for those eligible, support through the nationally funded NDIS program. The variation of funding and service delivery approaches can lead to duplication of ‘like’ services and poor communication and handover between services.
Funding for mental health care is provided through a mix of national and state-based funding with public health services usually receiving ongoing operating funding to provide hospital-based care and clinical community mental health where the focus is acute and or crisis care along with supporting people with severe and persistent mental illness. The CMO sector is heavily contract dependent and service delivery is usually based on a psychosocial rehabilitation approach delivered in the community. Due to the variation in services, navigation can be difficult for both health professionals and people with lived experience.
To find a more effective solution North Coast PHN and LHD contracted Deloitte to evaluate current funding models for health services and an analysis on the population to provide an indication on the return on investment of current funding models to detemine if funding adequately supports the needs of the region. The report identified that effective mental health care is currently only supporting 5% of the population in the region with the focus concentrated on supporting people in an acute or crisis state and people who live with severe and persistent mental illness. The report highlighted that care was often fragmented, with some duplication and provides minimal support to people who are experiencing mental health issues and or distress who are not in need of acute care.
The North Coast Collective aims to break down the silo approach to service delivery by providing a greater opportunity for collaboration, resource pooling and reducing duplication of services. The collective is made up of 30 organisational members across the region including representative from the following areas;
- People with lived experience of mental health issues and or caring
- Public Health
- Primary Health Networks
- Local Government
- First responders
- Drug and Alcohol services
- volunteer organisations
The Collective provides a whole of community approach to mental health support to better address the community need and provide the right type of support at the right time and in the right place for people experiencing mental health issues and or distress. The approach uses a targeted funding approach through the pooling of resources to break traditional and invisible lines across mental health services, improve integration across mental health services and reduce service duplication. Through open sharing and collaboration, the goal is to optimize mental health support to ensure people in the region living with mental health issues and or distress receive the best possible care.
The evaluation of the North Coast Collective will take a co-design approach across the community in partnership with all members including members with lived experience of mental health issues and or caring. The Collective will develop and define measures through evaluation processes that represent the diverse needs of the community. The evaluation will review improvements in treatment along with exploring innovative way to provide the best type of care. Return on investment will also be reviewed to assist in identifying per-capita costs of mental health and alcohol and other drugs care. The evaluation will utilize the Quadruple AIM methodology which is an internationally recognized approach to evaluate effectiveness of heath service development and service delivery.
During the first two-years the Collective is focused on improving the collaboration between mental health and drug and alcohol services with a future goal to look more broadly across health and community. The pilot period will provide an opportunity to evaluate the Collective approach to mental health care in the North Coast and if successful provide an opportunity to develop a business case for the Collective mental health funding model. It is hoped that other areas will be able to learn from the North Coast Collective experience to find a funding model that works best for their region.
Sikka, R., Morath, J.M. and Leape, L., 2015. The Quadruple Aim: care, health, cost and meaning in work. BJM Quality& safety, Vol 24, 10.