Collaborative Commissioning: regional funding models to support value‐based care in New South Wales

Koff, Elizabeth; Pearce, Susan; Peiris, David

doi:10.5694/mja2.51243

Cited by 6 publications

(8 citation statements)

References 9 publications

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“…While the findings relating to the transaction costs of commissioning with other parties are likely to resonate with other commissioning agencies, the findings reflect the maturity of the PHN and the maturity of its relationships with commissioning partners—as well as their broader understanding and experience of implementing commissioning processes (Meurk et al., 2018). While co‐commissioning has progressed since the data were collected, with further examples of co‐commissioning and collaborative commissioning by PHNs and other funders (Koff et al., 2021), the insights provided in this paper provide useful insights to inform and strengthen co‐commissioning practice by providing an understanding of the organisational and operational considerations when co‐commissioning services—not just for PHNs, but also for other commissioning agencies. Future research may consider whether co‐commissioning is able to reduce fragmentation, improve service co‐ordination, provide efficiencies for services, and improve outcomes for service users.…”

Section: Discussionmentioning

confidence: 91%

“…Further, co‐commissioning has been encouraged through different initiatives—for example by the NSW Government in terms of encouraging partnerships between PHNs and LHDs in 2019 and then later through collaborative commissioning of value‐based health care ( CasePHN ; Koff et al., 2021) and by the DoH through the PHN Program. Within the Program, each PHN was required to develop a joint Regional Mental Health Plan and establish associated governance and collaborative mechanisms with key partners ( Regional MH Plan ; CasePHN ).…”

Section: Resultsmentioning

confidence: 99%

“…One practice paper produced by PwC and Commissioning NSW describes ‘joint commissioning’ occurring on a spectrum from seeking consistency to coordination to collaboration, involving ‘skin in the game… whether that be co‐funding arrangements, shared risks or other in‐kind contributions; shared accountability and decision‐making; and formalised partnership arrangements’ (PwC and Commissioning NSW, 2020, p. 5). Others use the term co‐commissioning to describe the engagement of citizens in the commissioning process (Loeffler & Bovaird, 2019)—rather than co‐funding—more akin to collaborative commissioning described elsewhere (Koff et al., 2021). 2 Others acknowledge the terms co‐commissioning and joint‐commissioning are used interchangeably (DoH, 2016).…”

Section: Conceptual Framingmentioning

confidence: 99%

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Understanding the costs of co‐commissioning: Early experiences with co‐commissioning in Australia

Bates,

Harris‐Roxas,

Wright

2023

Aust J Public Adm

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Public services, such as health and other human services, are increasingly being delivered by third‐party providers (providers) under contract to public sector organisations (PSOs). While often advantageous to PSOs, this creates a fragmented service context which is difficult for consumers to navigate. Further, providers often deliver services under multiple contracts to multiple funders, with high reporting requirements, high administrative costs, and low operational sustainability. Policymakers have encouraged co‐commissioning—where PSOs come together to jointly commission services—to increase the efficiency and effectiveness of outsourcing. This article seeks to understand the costs of co‐commissioning in Australia, and consequently the enablers and barriers to co‐commissioning. This qualitative study is based on the early experiences of co‐commissioning by one of 31 Primary Health Networks (PHNs). Using transaction cost economics (TCE) theory, the study explains how the PHN started co‐commissioning services with other PHNs, before co‐commissioning with other types of organisations. The PHN also co‐commissioned relatively simple activities first, before moving on to more complex services. The insights provided using TCE theory help explain why co‐commissioning is initially complicated (and costly), requiring time to understand both the services to be commissioned and the governance requirements of each party involved. While initial transaction costs may be high when co‐commissioning, this may reflect organisational learning and capacity development costs ‐ therefore, costs are expected to reduce over time.Points for practitioners Fragmentation in policy and funding also leads to fragmentation of human services and high costs to service providers. Co‐commissioning is where multiple funders pool funds and strategically commission services together. Co‐commissioning offers a way to reduce fragmentation and reduce costs to service providers, potentially offering better public value. Co‐commissioning can initially take time and resources to establish. Over time, as organisations learn, the cost of co‐commissioning reduces potentially offering benefits to funders, providers, and service users.

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Section: Discussionmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Conceptual Framingmentioning

confidence: 99%

See 1 more Smart Citation

Understanding the costs of co‐commissioning: Early experiences with co‐commissioning in Australia

Bates,

Harris‐Roxas,

Wright

2023

Aust J Public Adm

View full text Add to dashboard Cite

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“…(20) However, new funding models such as "value-based' care have been proposed that appear to have underlying principles of exibility and community engagement in their descriptions. (21) People with end of life COPD, their support people and health professionals recommended the development of a National Respiratory Strategy aligned with Te Tiriti O Waitangi (Treaty of Waitangi)…”

Section: Discussionmentioning

confidence: 99%

Policy, system and service design influence on healthcare inequities for people with end-of-life chronic obstructive airways disease, their support people and health professionals.

Landers

Pitama

Palmer

et al. 2023

Preprint

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Background: People with end-of-life chronic obstructive pulmonary disease (COPD) experience debilitating physical limitations, with a high mortality rate. Our research has shown health system design and delivery leads to inequitable outcomes. Enabling people with end-of-life COPD, their support people, and health professionals to partner in setting the agenda for resource allocation may inform health service improvement. Design: Qualitative methodology utilising focus groups including patients, family, friends, informal support people, health care workers and professionals. Methods: The analysis, utilising critical theory and Actor-Network theory, positioned people with severe COPD, their support people and health professionals as experts in end-of-life care. Analyses triangulated these perspectives, and were reviewed by the research investigators and an expert reference group. Results: Participants (n=74) in seven focus groups reported their experiences of inequity within the healthcare system. Equity was an overarching phenomenon identified by participants, with three specific themes being described: policy design, system design, and service design. Conclusion: Experiences of patients, their support people and health professionals as experts in end-of-life COPD care can inform health systems and health service design to address current inequities in funding and delivery of care for end-of-life COPD.

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“…The implementation of HealthPathways in the Hunter New England area of New South Wales is an example of an initiative identified in this study involving successful partnerships and shared governance between the Hunter New England Central Coast PHN and the Hunter New England Local Health District (Gray et al 2018). Co-commissioning has the potential to promote efficiency, overcome fragmentation and foster a more integrated primary healthcare system (Swerissen et al 2018;Freeman et al 2021;Koff et al 2021); however, resources and support to PHNs are needed to encourage collaborative mechanisms (Freeman et al 2021). The Ministry of Health, New South Wales state government, has recently developed a program to support co-commissioning between PHNs and Local Hospital Districts called patient-centred co-commissioning groups (PCCGs), jointly responsible for improving care for their communities, with the potential expansion of the program to include payers and providers from public, private, and nongovernment sectors to facilitate whole-of system integration (Koff et al 2021).…”

Section: Initiatives For Aboriginal and Torres Strait Islander People...mentioning

confidence: 99%

Health and service needs, priorities and initiatives of primary health networks related to chronic pain

Morgan

Walker

Blyth

et al. 2022

Aust. J. Prim. Health

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Background. Chronic pain is a major and growing public health issue. Multidisciplinary tertiary pain services cannot meet patient demand and greater involvement of primary care is needed. The aims of this study were to understand the needs and priorities of Australian primary health networks (PHNs) related to the management and secondary prevention of chronic pain; map current PHN chronic pain initiatives and identify gaps; highlight key enablers to implementation; and highlight solutions identified by PHNs to increase capacity to commission initiatives. Methods. Mixed methods were used, including: a review of PHN needs assessments; and consultation with PHN executive-level staff and program managers from 27 out of the 28 PHNs, and the WA Primary Health Alliance (WAPHAa state alliance between three Western Australian PHNs) via telephone interviews, online surveys, a workshop, a deliberative dialogue and email consultation. Results. Chronic pain was identified as a health and/or service need by approximately half of PHNs. Barriers for PHNs to identifying chronic pain as a need or priority are highlighted. Gaps identified by the mapping included: initiatives related to the secondary prevention of chronic pain (post-surgery or post-injury), digitally enabled consumer and health professional chronic pain initiatives, and chronic pain initiatives for specific populations groups such as Aboriginal and Torres Strait Islander people. Among existing PHN practice, two exemplar evidence-based initiatives suitable for scale-up across PHNs in Australia were identified: multidisciplinary community-based pain programs, and an online health professional capacity-building initiative, Project ECHO (chronic pain). Solutions identified by PHNs to increase capacity to commission initiatives included: co-funding initiatives across different PHN funding streams, collaborative initiatives between PHNs, and co-commissioning with government and non-government partners. Conclusions. Chronic pain has been classified as a disease in itself through the World Health Organization. PHNs recognising chronic pain as a distinct condition in PHN needs analysis and data collection would lead to more dedicated funding. PHNs could do more to improve the secondary prevention and management of chronic pain. A self-identified need for greater collaboration across PHNs and co-commissioning with local and state governments and non-government partners would help to build PHN capacity.

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Collaborative Commissioning: regional funding models to support value‐based care in New South Wales

Cited by 6 publications

References 9 publications

Understanding the costs of co‐commissioning: Early experiences with co‐commissioning in Australia

Understanding the costs of co‐commissioning: Early experiences with co‐commissioning in Australia

Policy, system and service design influence on healthcare inequities for people with end-of-life chronic obstructive airways disease, their support people and health professionals.

Health and service needs, priorities and initiatives of primary health networks related to chronic pain

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