Sandy Austin Director Health and Aged Care North and Western Metropolitan Region NWMR Health & Wellbeing Implementation Strategy …the implications are.

Sandy Austin

Director Health and Aged Care North and Western Metropolitan Region

NWMR Health & Wellbeing Implementation Strategy

“…the implications are clear. Without change, our health system will not be able to meet our future needs”.

Victorian Health Priorities Framework 2012-2022

Wicked Problems for Health and Wellbeing

The Victorian Health Priorities Framework 2012-2022 states that “the implications are clear. Without change, our health system will not be able to meet our future needs”.

Health and wellbeing issues confronting society include

– increasing obesity rates– increasing trends in chronic health

conditions e.g. diabetes– ageing populations– rapid population growth– spiralling health care costs

Source: Australian Public Services Commission (2007) Tackling Wicked Problems A Public Policy Perspective, Commonwealth of Australia, Canberra, ACT.

Fifth Wave

FIRST WAVE

Water/Sanitation

SECOND WAVE

Scientific breakthroughs

THIRD WAVE

Social security/Medicare

FOURTH WAVE

Risk factors and lifestyle

FIFTH WAVE

Complex adaptive systemthinking

Source: Hanlon et al (2011) Making the Case for a ‘Fifth wave’ in public health

1830 - 1900 1890 - 1950 1940 - 1960 1960 - 2000 2011 +

Fifth Wave

Aspects of this ‘fifth wave’ include

1. Complex adaptive systems 2. Reframe our thinking 3. Rebalance our models 4. Rebalance our orientation 5. Iterate and scale up

Source: Hanlon et al (2011) Making the Case for a ‘Fifth wave’ in public health

Victorian Health System reform

• Primary Health Care Planning – in partnership with the Commonwealth

• Mental Health System – recovery focus

• Alcohol and Other Drugs – Whole of Govt Strategy and AOD Treatment System Reform

• Aged Services – Healthy ageing and Active Service Model

• State Health and Wellbeing Plan – Prevention Community Model

Victorian Public Health and Wellbeing Plan 2011-2015

The goal of the Plan

“Improve the health and wellbeing of all Victorians by engaging communities in prevention, and by strengthening systems for health protection, health promotion and preventive health care across all sectors and levels of government”.

Achieving our goals

Two main achievements of the Health and Aged Care NWM Regional Office:

1. Reoriented ourselves and how we interface with our stakeholders

2. Broadened and enhanced the authorising environments

1. We reoriented ourselves and how we interface with our stakeholders

Well P

opula

tion

At Risk

Preve

nt

move

ment t

o

‘at risk

’ gro

up

Prevent progression to

established condition

Established Conditions

Prevent/delay

progression to

complications

Com

ple

x

Conditio

ns

NWMR Regional Operating Model

Area based approach to system management and population health planning

Improve ability of Health and Aged Care (H&AC) to identify priorities and address service gaps and inequities in local communities.

Build capacity within H&AC programs and NWMR funded agencies through organisational and workforce development.

Increase efficient and effective work practices in H&AC by streamlining communication with funded agencies i.e. Lead PASA role.

Place

A place or area usually ranges from a neighbourhood to a local government area which differs considerably in size and population density. Thus, place-based interventions may use varying definitions or size boundaries for place.

VicHealth (2008) People, Places, Processes Reducing health inequalities through balanced

health promotion approaches, Victorian Health Promotion Foundation, Carlton.

Key functions of H&AC Teams

We a

re “P

op

ula

tion

Health

D

evelo

pers”

We a

re “H

ealth

Syste

m M

an

ag

ers”

We a

re “S

yste

m In

teg

rato

rs”

ACUTE

GOAL D:Building our own

workforce and system capacity to influence

change

• Public health and wellbeing is promoted and protected

• Reduced harm and impact from substance use, mental illness and health conditions

• Independence and health for longer

Serv

ice s

yst

em

in

teg

rati

on

• The health system anticipates and responds to independence needs

• The health system operates with raised efficiency to meet rising expectation and demand

• Stakeholders inside & outside the health sector make health and wellbeing part of their core business

GOAL B:Improved

health equity for those most

vulnerable / disadvantaged

GOAL A:Improved health and

wellbeing of all people within our

region

GOAL C:Integrated

health system that is responsive to people’s

needs

Well Population

At R

iskEstab

lished

Conditio

ns

Complex

Conditions

Prevent

movem

ent to

‘at risk’ group

Pre

vent

pro

gre

ssion

to

esta

blish

ed

co

nd

ition

Prevent/delay

progression to

complications

AG

ED

SER

VIC

ES

Regu

lati

on

Regio

nal op

era

tions

Evid

en

ce t

ran

slati

on

Pro

gra

m im

ple

men

tati

on

Reso

urc

e &

Perf

orm

an

ce

Polic

y in

terp

reta

tion a

nd d

eve

lopm

en

t

INW

N

W

Operating Model

Health and Aged Care

North and West Metropolitan Region

Department of Health

We a

re “S

yste

m M

an

ag

ers”

Organisational Structure

Northern Area

Manager

Team Leader

Team Leader

Lead PASA

Lead PASA

Manager

Team Leader

Team Leader

Lead PASA

Lead PASA

Manager

Team Leader

Team Leader

Lead PASA

Lead PASA

Inner North West Area Western Area

National

State

Regional

Sub-regional

Local• Local Government Round Table meetings•Support to individual Councils and organisations

•Support for integrated local area/catchment planning•HACC rolling consultations•Active Ageing in Place - HACC

•Population Health Short Course•MPHP Evaluation – University of Melbourne•Engaging RMF members to tackle employment, transport, education, secure housing•RMF Regional Directors’ working group to support local government•RMF Integrated Data Working Group•Melbourne University Research 2011-2014: Planning Liveable and Sustainable communities in growth corridors

•Support Implementation of Victorian Public Health and Wellbeing Plan•Support Melbourne Metropolitan Strategy

•Australian Urban Research Infrastructure Network

2. We broadened and enhanced the authorising environments

NWM Regional Management Forum

NWM Regional Management

Forum

Chair: Jim Betts, DoT Secretary

Regional DirectorsLocal Council CEOs

DHS

DH

DPCD

DEECD

RDA

DoT

DoJ

14 Local Councils

GAA

DSE

DBI

DTF

VicRoads

VicPol

CFA

WHO Healthy Cities Governance framework (WHO, 1997)

Regional Management Forum – Key Outcomes

1. Identification and commitment to key priorities

– Creation of local jobs– Public transport– Education– Secure housing (DoJ priority)

2. Integrated Data Working Group – AURIN/ANDS Demonstration Projects

3. Integrated Planning Forums

Alignment of State and municipal public health and Alignment of State and municipal public health and wellbeing planningwellbeing planning

2011 2012 2013 2014 2015 2016 2017

October 2012

Local government elections

June 2013

Council plans

October 2013

MPHWPs

October 2016

Local government elections

October 2017

MPHWPs

June 2017

Council plans

November 2010

Victorian government election

September 2015

Victorian Public Health and Wellbeing Plan

November 2014

Victorian government election

September 2011

Victorian Public Health and Wellbeing Plan

2018

Special mention:

Dr. Iain Butterworth for his expert and engaging leadership