Primary Health Networks – National Psychosocial Support measure

2018-2019 Activity Work Plan and Indicative Budget

Brisbane North PHN

When submitting the National Psychosocial Support measure Activity Work Plan 2018-2019 to the Department of Health, the PHN must ensure that all internal clearances have been obtained and has been

endorsed by the CEO.

The National Psychosocial Support measure Activity Work Plan must be lodged via email to PHN_Domainmanager@health.gov.au within four (4) weeks of execution of the Psychosocial

Support Schedule, and subsequently updated, on an annual basis.

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IntroductionOverview

The key objectives of Primary Health Networks (PHN) are: increasing the efficiency and effectiveness of medical services for patients, particularly those at

risk of poor health outcomes; improving coordination of care to ensure patients receive the right care in the right place at the

right time.

The purpose of the National Psychosocial Support (NPS) measure is to provide psychosocial support services to assist people with severe mental illness resulting in reduced psychosocial functional capacity who are not more appropriately supported through the National Disability Insurance Scheme (NDIS). These services, in partnership with families and carers (as appropriate), will provide a range of non-clinical community based support to these individuals to achieve their recovery goals. The NPS measure is being implemented through purpose specific funding to Primary Health Networks (PHNs) to commission these new services.

The objectives of the measure are to: support people with severe mental illness and associated psychosocial functional impairment

who are not more appropriately supported through the NDIS; improve access to psychosocial support services, mental health outcomes and equity in service

availability for the target cohort (only relevant to PHNs based in Queensland); reduce the avoidable need for more intense and acute health services and enhance

appropriate/optimal use of the health system.

These objectives will be achieved through: providing for a regional approach that would target psychosocial support services to individual

needs, creating flexible, efficient service delivery. Service types may include individual and group support and rehabilitation and peer work.

improving service coordination for individuals with severe mental illness and associated psychosocial functional impairment, while taking into account supports available across levels of governments, the community and relevant sectors.

being consistent with the priorities and objectives of the Fifth National Mental Health and Suicide Prevention Plan.

being focused on psychosocial support services with the aim of contributing to improvements over time in:

o identification of, and provision of services and outcomes for, people with a severe mental illness and associated psychosocial functional impairment, including those with complex needs, who are not more appropriately funded through the NDIS;

o more seamless, high quality and earlier psychosocial supports;o the efficiency and effectiveness of psychosocial support services across care settings.

As part of this measure, the Commonwealth has bilateral agreements with each jurisdiction regarding their continuing or enhanced investment in psychosocial services. The PHN commissioned services will need to be implemented in a flexible way to complement the State and Territory funded psychosocial support. Further, PHNs will need to consider the services that are currently provided locally by Local Health Networks, ensuring that the PHN commissioned services complement or enhance these existing services and consider how these services can meet the need of their region.

PHNs are required to outline planned activities, milestones and outcomes to provide the Australian Government with visibility as to the activities expected to be undertaken by PHNs. The Activity Work Plan must:

detail the establishment and implementation phases of the NPS measure in your region. demonstrate to the Australian Government what the PHN is going to achieve and how the PHN

plans to achieve this. be developed in consultation with State/Territory agencies, Non-Government Organisations,

Local Health Networks, the Mental Health Commission, mental health consumers and carers and other stakeholders, as appropriate.

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Further informationThe following may assist in the preparation of your Activity Work Plan:

The activity details specified under Item B of your Psychosocial Support Schedule; The Implementation Plan under Schedule A of the National Psychosocial Support Bilateral

Agreement between the Commonwealth and relevant State/Territory, provided in-confidence to support State and Territory collaboration.

The PHN Psychosocial Support Guidance material.

Please adhere to the word limit specified in the template.

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1. Planned activities funded under the Activity – National Psychosocial Support measure

PHNs must use the table below to outline the activities proposed to be undertaken in 2018-2019. These activities will be funded under the National Psychosocial Support measure under the Schedule – Psychosocial Support.

Instructions: please delete instructions (in blue font) within the ‘Description’ column before submitting to the Department, but do not delete or remove any text (in black font) in the Activity Work Plan template. Text in black font indicates information that has been pre-populated and must be retained in the Activity Work Plan. Also, do not alter the structure of the table (i.e. do not add/delete columns/rows, or insert tables/graphs), unless specifically instructed.

Proposed Activities - copy and complete the table as many times as necessary to report on each activityProposed Activities DescriptionActivity Title Commissioning non clinical psychosocial supports in the Brisbane North and Moreton Bay region.Description of Activity This activity involves the establishment of the National Psychosocial Support (NPS) Measure. This activity will be commissioned

in line with Brisbane North PHN’s Commissioning Framework (see attachment 1). Specific activities are described below.

Needs assessment

The PHN intends to undertake a needs assessment of the psychosocial support needs of people with severe mental illness in the region, and use this to support an informed co-design process. The needs assessment will consist of a rapid appraisal of existing data, learnings and the service landscape in the Brisbane North PHN region.

Information regarding the psychosocial support needs for the region will be collated and presented in an accessible way to support robust co-design.

Co-design

The PHN will lead an appropriate person-centred co-design process. The Commonwealth’s ‘PHN Psychosocial Support Guidance’ document will inform and provide necessary parameters for the co-design phase.

At the completion of the co-design phase, the PHN will incorporate any new qualitative data and learnings into the needs assessment, for inclusion in the Establishment Report.

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Implementation and delivery of psychosocial supports

Brisbane North PHN then procure psychosocial support services in line with departmental guidelines and the findings of our Needs Assessment and co-design processes. The procurement method and approach to market will be informed by the outcomes of the needs assessment and co-design process. Once a service model and the organisation/s who will deliver it are identified, the PHN will establish a contract to support effective and efficient implementation.

The PHN intends to engage broadly, discovering insights from the sector, service users, family/carers, service providers, local Hospital and Health Service, practitioners and other stakeholders. Following the discovery phase, the intention is to define the challenge to be addressed, and co-design solutions to meet the challenge. Testing possible scenarios and solutions with the sector will ensure the service best meets the needs of those it will impact the most. Once a solution has been determined, new partnerships may need to be established to support the development and ultimate delivery of the service.

Monitoring, evaluation and reporting

The PHN will incorporate the development of indicators into the co-design process outlined above. This will ensure that the data that is tracked and monitored gives a meaningful indication of performance against agreed domains. The PHN’s approach to monitoring and evaluating contracted services varies depending on the size of the contract and the operational funds available. Program staff meet regularly with funded agencies, and our client relationship management system provides funded agencies with reminders of deliverables due. Regular contact with funded agencies is consistent with a relationship management strategy of which contract management is a part.

Our Contract Management Module tracks payments and achievement of milestones, raising red flags when deliverables are not produced on time.

Measuring Outcomes/Data Collection and Storage

The Co-design process outlined above will be underpinned by the need for the NPS Measure to achieve the following objectives:

Support people with a severe mental illness and associated psychosocial functional impairment who are not more appropriately supported through the NDIS; and

Reduce the avoidable need for more intense and acute health services and enhance appropriate/optimal use of the health system.

The outcomes that will be expected to occur as a result of the NPS Measure (such as improved ability to manage daily living needs; or increased social and/or family connections) will be determined as part of the co-design process.

Once the outcomes are determined, the PHN will work with relevant stakeholders to determine key measures that will give the best indication of performance.

The PHN is supportive of the collection of the PMHC-MDS, and will make adjustments to its local system to ensure potential

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new providers have access to the system, and that new and/or amended data items are accommodated.

Consultation/ Collaboration/ Communication

The Co-design process outlined above provides an overview of the range of stakeholders that will be engaged in the establishment of the NPS Measure in the region.

Stakeholders from the sector will in invited to contribute to the co-design process, ensuring the voices of consumers, carers, service providers, practitioners, the HHS, relevant Qld Government Departments as well as relevant peak bodies, such as Qld Alliance for mental health, Qld Network of Alcohol and other Drug Agencies, Qld Mental Health Commission, are all heard and honoured.

The PHN will ensure that the Qld Government matched funding for the NPS Measure is clearly understood, and taken into consideration when determining the PHN NPS Measure, including the timing of various announcement and procurement processes.

The PHN will utilise ‘Collaboration in Mind’ – an existing group of strategic stakeholders who have worked collaboratively over the past few years supporting implementation of Partners in Recovery, to provide initial advice and guidance regarding the co-design process. These governance arrangements will be reviewed once implementation is underway.

Timeline

This activity will occur throughout the whole 2018/2019 financial year. Specific timelines related to commissioning activities and deliverables are as follows:

July 2018: Completion of Activity Work Plan July – August 2018: Development of Needs Assessment August – October 2018: Community Consultation and Co-design November 2018: Completion/Submission of Establishment Report

Interim Solution (1 January 2019 – 30 June 2019)

November 2018: Varying current NGO contracts to add NPS funds to support delivery of psychosocial supports January 2019 – June 2019: Interim delivery of psychosocial supports

Longer-term Solution (1 July 2019 onwards)

November 2018: Draft procurement strategy for 2019/2020 released for comment December 2018 – January 2019: Edits/finalisation of procurement strategy for 2019/2020 January – Feb 2019: Procurement March – April 2019: Contracting May – June 2019: Establishment of new service model July 2019: Delivery

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Attachment 1

What is commissioning?Definition1

Committing limited resources to health and community care interventions with the aim of improving the health system and delivering better consumer outcomes. Commissioning relies on robust relationships and established trust at the local level.

Commissioning is a needs-led and outcome-evaluated process. Stakeholders work to identify needs and co-design solutions. The procurement of services is only one possible outcome to the commissioning process.

Commissioning underpins all areas of the PHN's work, including analysis and planning, support for GPs and other healthcare providers and purchasing health and community care interventions.

Why do we use commissioningCommissioning enables PHNs to use their limited resources to improve the health outcomes of their communities by shaping the health and community care system.

How does it workCommissioning is an on-going cyclical process. Needs are assessed through community consultation and solutions are designed in partnership with stakeholders. Transparent processes are used to promote the implementation of these solutions, including the identification of providers from whom services may be purchased. These solutions are then evaluated and the evaluation outcomes used to inform further assessment and planning.

1 Adapted from What is world class commissioning? by Michael Sobanja http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/What_is_WC_Comm.pdf

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identify desired outcomesdesign solutionsprocurement strategy selection

procurement or directinterventioncapacity buildingsector developmentmanage provider relationship

health needs assessmentcommunity and stakeholder led consultationservice mapping and market failure identification

evaluate outcomesconsumer and community feedbackfeed back into next stage of cycle

Review Assess

Co-designDeliver

Attachment 1

Commissioning principles2

Understand the needs of the community by analysing data, engaging and consulting with consumers, clinicians, carers and providers, peak bodies, community organisations and funders.Engage with potential service providers well in advance of commissioning new services.Putting outcomes for users at the heart of the strategic planning process.Adopt a whole of system approach to meeting health needs and delivering improved health outcomes.Understand the fullest practical range of providers including the contribution they could make to delivering outcomes and addressing market failure and gaps, and encourage diversity in the market.Co-design solutions; engage with stakeholders, including consumer representatives, peak bodies, community organisations, potential providers and other funders, to develop evidence-based and outcome-focused solutions. Consider investing in the capacity of providers and consumers, particularly in relation to hard-to-reach groups.Ensure procurement and contracting processes are transparent and fair, facilitating the involvement of the broadest range of suppliers, including alternative arrangements such as consortia building where appropriate.Manage through relationships; work in partnership, building connections at multiple levels of partner organisations and facilitate links between stakeholders.Develop environments high in trust through collaborative governance, shared decision-making and collective performance management. Ensure efficiency, value for money, and service enhancement.Monitor and evaluate through regular performance reports; consumer, clinician, community and provider feedback and independent evaluation.

2 Adapted from the National Audit Office (UK)

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Attachment 1

Stakeholder engagement

The extent of stakeholder involvement in the commissioning process will depend on a number of factors, including government guidelines and the amount of time and resources available.

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Attachment 1

What you can expectProviders

The PHN will:

work with you openly and honestly in a spirit of partnership engage with you as early as possible about the commissioning of new services develop an understanding of providers and the contributions they can make to delivering the desired

outcomes share population health and performance data with you consider investing in capacity building and sector development develop close relationships with you, to the greatest extent possible engage with you or your peak body, to design outcome-focused solutions ensure procurement and contracting processes are transparent and fair seek your feedback and input when evaluating services.

Health consumers

The PHN will:

engage with you or your representatives to understand your needs and the needs of your community put better health outcomes for you and your community at the centre of its planning share population health and performance data with you consider investing in capacity of consumers engage with you or your representatives, to design outcome-focused solutions seek your feedback and input when evaluating services.

Funders

The PHN will:

allocate resources to areas and populations of highest need direct funds to health and community care interventions ensure value for money provide you with open and transparent reports establish and maintain productive relationships with service providers, consumers, carers, community

organisations and other stakeholders implement a contestable approach to procurement of interventions increase the capacity of the health and community care system, including providers and consumers adopt a whole of system approach across multiple jurisdictions and levels of government.

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