Challenges and Solutions in NSW Integrated Healthcare Strategy

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NSW faces increasing pressures on its healthcare system due to factors like an aging population, rising chronic diseases, and growing demands for care. The current episodic and fragmented system is not equipped to handle these challenges efficiently. Integrated care is crucial to address these issues and ensure better health outcomes for the population.


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  1. Integrated Care in NSW Presentation to NSW Rural Health & Research Congress Dubbo, 9 September 2014 Katherine Burchfield Director, Integrated Care Branch NSW Ministry of Health

  2. Content Why Integrated Care? What does it mean? The NSW Integrated Care Strategy 1

  3. Various drivers are placing increasing pressure on our health system Growing and ageing population Increased number of people living with chronic diseases Reduction in length of stay and productivity targets Increased demands from people with complex needs Increasing specialisation in medicine and nursing Increasing demands on the health system Rising consumer expectations Societal changes 2

  4. The current system is episodic and fragmented, focused on patient outcomes by exception Health promotion Planned care at home Outpatient care close to home Residential aged care Planned inpatient care Unplanned hospital care Systems designed to treat occasional episodes of care for normally healthy people are being used to deliver care for people who have complex and long term conditions. The result is that they are passed from silo to silo without the system having the ability to co-ordinate different providers S Dorrell, NHS Health Service Journal, 2011 Current system tends to supports short term episodic care rather than long term health and functionality 3

  5. Why NSW needs integrated care The NSW population is expected to grow by about 1% per annum Over 65s will represent ~20% of the population in 2030 compared to 14% in 2006 Healthcare expenditure for over 65s is two to three times higher than under 65s Ageing population Increase in chronic disease Prevalence of chronic disease expected to increase by 15-20% in 2030 Total number of chronic diseases to increase by ~1M (+33%) in 2030 Length of stay has decreased but hospital separations have increased, resulting in an increase in bed days between 2006 and 2011 Number of bed days to increase by 51% to 9.7m in 2030 Number of GP visits to increase by 64% to 56m in 2030 Increase in hospitalisations and GP visits Health workforce required to grow by 30-100% by 2030 36% more nurses 97% more physicians 30% more allied health professionals Increase in need for health workforce Increase in need for hospitals An additional 10,000 beds or ~114 hospitals will be required in 2030 4

  6. Better integration of care will help to achieve a more sustainable health system Today Tomorrow Fragmented Episodic Inefficient Unsustainable ? Integration of care Integrated, sustainable health system 5

  7. Content Why Integrated Care? What does it mean? The NSW Integrated Care Strategy 6

  8. What is integrated care? Integrated Care meets a person s needs by providing seamless, effective and efficient care, organised for, by and with the person, from prevention through to end of life. Care is person centred Care is a seamless continuum Care is effective Care is efficient Care is organised for, by and with the person by bringing care to the person s community or home rather than the person to the care Care is organised across spectrum of care ranging from social and preventative, to primary and acute, through to aged and end-of-life care Care results in the outcomes that are desired by the patient and reflect achieved health status, recovery process and sustainability of health Care makes efficient use of both financial and human resources Value-based healthcare 7

  9. Content Why Integrated Care? What does it mean? The NSW Integrated Care Strategy 8

  10. NSW State Health Plan NSW State Health Plan launched in June 2014. Three clear directions for the future delivery of healthcare in NSW Direction One: Keeping People Healthy Direction Two: Providing World Class Clinical Care Direction Three: Delivering Truly Integrated Care 9

  11. Announcement Minister for Medical Research Jillian Skinner MP Minister for Health MEDIA RELEASE Thursday 20 March 2014 NSW GOVERNMENT COMMITS $120 MILLION TO INTEGRATED HEALTH CARE The NSW Government will spend $120 million over four years to provide seamless care to people in an integrated way - from care in the community to acute care in hospital. Health Minister Jillian Skinner was joined at Parliament House today by community providers including general practitioners (GPs) and non-Government organisations (NGOs) as well as representatives of the primary care sector including pharmacies and private hospitals as she launched the Integrated Care in NSW strategy. Mrs Skinner described the NSW Government s new focus on integrated care as a transformative step for health care in this state . 10

  12. The NSW Integrated Care Strategy has three components Indicative % funding Description Goal Focused on information technology infrastructure, outcomes measurement and patient feedback, capacity building and evaluation. Establish key enablers of integrated care benefiting all LHDs and stakeholders Statewide enablers 27% $120M investment over 4 years Investment in individual initiatives and planning at the local level, including extension of successful integrated care approaches from the Demonstrators. Planning and Innovation Fund Support local planning, collaboration and innovation initiatives 31% LHD-led Demonstrators in Western NSW, Central Coast and Western Sydney focused on large-scale transformation of integrated local health systems and testing initiatives prior to extension across the State. Develop system-wide integrated care approaches in three LHDs that are transferrable and scaleable Integrated Care Demonstrators 42% Implementation will involve partnerships with primary care organisations, NGOs and private providers 11

  13. The Strategy seeks to build and link on existing initiatives 12

  14. Expected benefits Easier navigation of the system Reduced waiting times Increased satisfaction Better patient experience Better patient reported outcomes Improved long term health outcomes Improved outcomes Fewer avoidable hospitalisations and ED attendances Less duplication of services/tests Less waste 13

  15. Opportunities in rural NSW Regional planning for health services and wider determinants of health Move beyond consultation & coordination to true partnerships with primary care, aged care providers, and Aboriginal Community Controlled Health Services (ACCHS) New funding and business models particularly for community-based health services - that optimise workforce and funding streams Improve IT infrastructure and information flow, including outcomes monitoring and feedback Leverage MPS and service co-location hubs Further embed telehealth and m-health Greater use of telephonic solutions eg. HealthDirect Explore the most cost effective pathways for supporting health of remote populations Promote prevention and early intervention Consumer/community engagement, health literacy and self management 14

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