PHNs are local, independent organisations set up by the Australian Government to collaborate with GPs and other health professionals to ensure that primary health care is accessible, efficient and effective. Times of natural disasters such as bushfires, cyclones and floods, and the current COVID-19 pandemic, present an array of challenges to consumers accessing their usual primary health care and, in the case of COVID-19, accessing extraordinary care such as an emerging need for mental health services, telehealth and COVID-19 testing. PHNs have had key roles during the COVID-19 response at a Commonwealth, State, Territory and jurisdictional level, as well as a local community level.
At a Commonwealth level, PHNs have had the logistical responsibility for the distribution of personal protective equipment to general practice, the establishment of GP-led Respiratory Clinics Australia-wide, and Victorian PHNs are leading the establishment of new federally funded mental health hubs. Central Queensland Wide Bay Sunshine Coast PHN supported the development of the first GP-led Respiratory Clinic in Australia, opening in Emerald, Queensland, within one week of the Australian Government’s March announcement that it would fund private practice respiratory clinics nationally. Within a few months, PHNs across the country had supported the establishment of over 100 GP-led respiratory clinics, demonstrating the agility of PHNs and their strong on-the-ground relationships with general practitioners. Victorian PHNs are currently playing a significant leadership role in establishing 15 new mental health hubs in recognition of the impact of the COVID-19 pandemic on the mental health of Victorians. Victorian PHNs worked collaboratively to rapidly design and implement the new hubs, known as HeadtoHelp, in just four weeks.
The pathway, informed by the experience of residents of Victoria’s public housing towers…
At State, Territory and jurisdictional levels PHNs have been key contributors to local health emergency management structures through coordinated multiagency responses that include hospital and health service districts, residential aged care services, public health units, and ambulance services. Hunter New England and Central Coast PHN has led a regional, multiagency working group utilising a risk management approach to implement activities designed to support 195 residential aged care facilities in the event of an COVID outbreak. Strong advocacy by North Western Melbourne PHN, local GPs and The Royal Melbourne Hospital also drove a collaboration with the Victorian Department of Health and Human Services to develop and pilot an integrated model of care for COVID-19 positive patients. The pathway, informed by the experience of residents of Victoria’s public housing towers, was stood up in a matter of weeks. Critical to the pathway was clinical leadership, agreed clinical and social risk stratification, and associated stepped care and social supports across primary and acute services. This ensured people could safely self-isolate, enabled early identification of deterioration and provided GPs with the support needed to confidently manage low risk patients in the community.
At a local community level, PHNs across Australia have had a role as trusted sources of comprehensive localised COVID-19 information and resources for GPs; providing updates, clinical education opportunities, business continuity supports and other resources to support their clinical practice. PHNs have been also been extremely nimble in responding to the COVID-19 outbreak, using local knowledge and coordination expertise to quickly mobilise and coordinate primary health care services and community supports to provide much needed care while reducing the burden on local hospitals. For example, South Western Sydney PHN produced consumer resources for use by general practice, using simple text in six community languages, outlining testing options and other information. North Western Melbourne PHN created a suite of videos in 18 languages in less than a month by working with the community. South East New South Wales PHN worked with a young community filmmaker to create videos specifically for social media platforms encouraging young people to get tested.
PHNs have also led from the front with support for telehealth and online platforms…
PHNs have also led from the front with support for telehealth and online platforms that can maintain consumers’ engagement with their usual health care provider. Nationally PHNs supported general practices to link with the healthdirect Video Call platform to enable health care providers to offer their services to consumers via video. WA Primary Health Alliance, the operator of Western Australia’s three PHNs, collaborated with ConnectGroups, the State’s peak body for support groups, and supported an increase in the uptake of telehealth by consumers with chronic disease through education and awareness aimed at building confidence and trust in these services. South East New South Wales PHN collaborated with a locally based exercise physiologist and psychologist to adapt a face to face multidisciplinary pain program to an online platform. Central and Eastern Sydney PHN transitioned programs supporting CALD communities to a virtual service delivery model to support greater community resilience.
The primary health care sector is the cornerstone of Australia’s health care system, and equal to the hospital sector in terms of total annual health expenditure. Primary care providers offer a ready-made workforce that can provide appropriate and timely care during an emergency. Diverting primary care consumers to more suitable care providers reduces pressure on acute care services, allowing hospitals to focus on acute care needs. PHNs have demonstrated their unique insights and skills to coordinate an integrated response from local health care providers for their communities and have had, and continue to have, a highly positive influence on outcomes for consumers as part of the Australian COVID-19 response.
About the author
Susi Wise BPsych(Hons) is the Executive Officer for the PHN CEO Cooperative, the collective of 31 Primary Health Networks across Australia. Susi works closely with the PHN CEOs to support strategic activities that respond to, and influence, specific PHN and national health priorities. These help to collectively demonstrate the PHN Program’s value to Primary Health Care Reform and health system integration. Before joining the PHN CEO Cooperative, Susi was a Senior Executive with Northern Territory PHN managing their Rural Workforce Agency and Medical Outreach in Chronic Disease portfolio. She has lived in Alice Springs and Charleville in Western Queensland and has lived experience of the importance of accesses to effective and integrated primary health care.