Organisation: Sunraysia Community Health Service 

Contact Person: Simone Heald

Contact Email Address: sheald@schs.com.au

Abstract

Sunraysia Community Health Service (SCHS) has identified a lack of preventative, multi-disciplinary care outside of the acute hospital walls, resulting in unnecessary use of acute beds. Currently, community based health service providers are directed by funding requirements rather than clients’ needs, reducing their flexibility and coordination with other agencies. SCHS propose to develop a system-wide approach to integrated care, through a general practitioner Primary Health Clinic, co-located with their broad range of allied health, mental health and other community health service providers. In partnership with a range of local collaborating agencies, it will seek to develop integrated models for consumers with chronic disease(s), including streamlined intake, assessment and referral processes, multi-disciplinary care planning and service pathways, enhanced communication systems and the engagement of patients and families in proactively managing their health. This project will incorporate best practice evidence, learnings from other jurisdictions’ integrated care projects and local stakeholder engagement to develop a local health system profile and community solution. It is anticipated the project will reduce unnecessary acute hospital use, strengthen service integration, enhance local access and facilitate service quality improvements.