The ICA© on the road: teaching integrated care design and implementation in rural New South Wales

In the inspiring landscape of Orange, at the Centre for Rural and Remote Mental Health of the University of Newcastle a group of integrated care enthusiasts gathered on Monday, 29 October, to start a week-long Accelerated Learning Course on “Designing and Implementing Integrated Care”. The successful intensive learning programme designed and lead by the Integrated Care Academy© of the International Foundation for Integrated Care was to be held for the first time in rural Australia. The format combines presentations on the various building blocks and key principles of integrated care by international experts with small group work sessions, in which the participating teams vet their integrated care projects according to a change management cycle. The unique opportunity to spend a week as a team discussing the ways forward and next steps of an integrated care project in the making under the aegis of Dr Nick Goodwin, Dr Viktoria Stein and colleagues from IFIC Australia interspersed with content input on so varied topics as building networks and team competencies, governance, financing and incentives or leading and managing change offered the participants a catalyst to strengthen or rethink their respective projects.

Anthony Brown from Health Consumers NSW brought home the message that “nothing should be done about us, without us” and demonstrated how varied the input of consumers can and should be as part of project development, but also management and governance of health. The intricacies of creating, managing and maintaining networks were explained by Prof Jeffrey Fuller from Flinders University, while Caroline Nicholson from the Mater Research Institute at the University of Queensland presented a governance framework applicable to any integrated care initiative. Dr Apostolos Tsiachristas from Oxford University demonstrated that the health economics of integrated care, and thinking about how to finance and incentivise it, can be very entertaining and indeed comprehensible. Finally, in a plenary discussion around rural and remote health, the difficulties of addressing the needs of one’s population were discussed with Prof David Perkins (Centre for Rural and Remote Mental Health) and Prof Peter McGeorge (IFIC Australia).

A key element for the success of this course is the fact that participants need to apply as a team and with an existing project. Throughout the week small group exercises give the teams a possibility to get to know each other, rethink their project based on expert advice, and strengthen their thinking around integrated care implementation. Even though the teams and their projects, which are put together by the respective primary health networks, local health districts and relevant other stakeholders, were at different stages of development, the course design enabled everyone to enhance their understanding of integrated care in theory and practice.

The programme was completed with a site visit to Molong Multipurpose Service and HealthOne, an excellent example of how integrated care works in practice in a rural town. We were welcomed and guided by Dr Robin Williams whose enthusiasm and energy enlivened the experience further. Based on the simple principle that many patients coming into the GP practice need more than or something different from medical services, HealthOne is a one stop shop for health and wellbeing in Molong. At the heart of the multi-professional practice is a common reception area and a shared calendar for all service providers. With collocated allied health professionals, a fitness and therapy room, and psychological support, in addition to the GPs and nurse practitioners, the centre offers an array of services to support people with chronic conditions. The link to the MPS further facilitates transition management including to the local hospital in Orange. The MPS itself is a great example of how long-term care, emergency and ambulatory care can be managed efficiently and holistically by putting the person first. This has gone so far as to provide shower and changing facilities for homeless people in the community – a simple measure with enormous impact on the health and wellbeing. Despite challenges faced by different funding streams, the difficulty of finding and retaining qualified staff members and a lack of collaboration with other service providers, we came away impressed. If you want to find out more, please visit the following links:

Quotes from participants:

I recently attended the IFIC Summer school in Orange, NSW between 29th Oct – 2nd November. I have to say I thoroughly enjoyed myself and learnt so much. The program was excellent, packed full of some really useful and effective frameworks and tools for working within the integrated care space. Each Presenter was warm, exceptionally knowledgeable and very generous with their time. The program’s collegial atmosphere was also very conducive to learning and putting into practice newfound skills and knowledge. I really couldn’t recommend the course enough to those working to better integrate care services and systems.”
Bronwyn Penny – Manager Integrated Care, Hunter New England & Central Coast PHN.

I recently attended the Accelerated Learning Program in Orange and what a fantastic opportunity it was! The content was in-depth and took my understanding of IC to another level. It was wonderful to meet the leaders in this field, bringing research to clinical practice and service design. I was able to refine my project plan and was left with some clear goals to work on. The opportunity to network with other teams from around the state was an enjoyable bonus. I would highly recommend this intensive week of learning.”
Victoria Lovecchio – Integrated Care Change Manager, Western NSW LHD

We will run two Accelerated Learning Programmes next year. From April 7th 2019, to be hosted by North Coast PHN, and in November 2019 there will be another programme in Orange at the Centre for Rural & Remote Mental Health. Watch this space for more information or contact IFIC Australia.

Viktoria Stein is Editor and Chief of the International Journal of Integrated Care (IJIC)