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Integrated governance

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For the goals of health reform to be realised primary and secondary care must work together to achieve co-ordinated and integrated healthcare services. The process of transformation led policy has been underway for a number of years with the most recent being the COAG announcement in April 2016. Specifically in Schedule 2, “Bilateral agreements will be signed off to provide flexibility for each jurisdiction to determine the best model of care”, and the “Commonwealth will establish any enabling infrastructure, governance arrangements, or systems to support a pilot of a Health Care Homes model of primary health care, consistent with the advice provided by the Primary Health Care Advisory Group”. The implications for this work are that it provides a tool to inform the development of such governance arrangements that can be used nationally and tailored locally.

  • State of Queensland (Queensland Health). (2017). Queensland Clinical Senate - Connecting clinicians to improve care. At https://www.health.qld.gov.au/__data/assets/pdf_file/0025/632860/qcs-meeting-report-201611.pdf (accessed 8/5/17).
  • Nicholson C, Jackson C, Marley J. 2014. Best practice integrated health care governance- applying evidence to Australia’s health reform agenda. MJA 201(3): S64-66.  doi:10.5694/mja14.00310
  • Nicholson C, Jackson C, Marley J. 2013. A governance model for integrated primary/secondary care for the health-reforming first world – results of a systematic review. BMC Health Services Research 13:528.  doi:  10.1186/1472-6963-13-528
  • Nicholson C, Jackson CL, Marley JE, Wells B. 2012. The Australian Experiment: How Primary Health Care Organisations supported the evolution of a primary health care system. JABFM 25:S18-26.  DOI: 10.3122/jabfm.2012.02.110219
  • Jackson, CL, Nicholson C, McAteer EP. 2010.  ‘Fit for the Future – a regional governance structure for a new age’. MJA 192(8); 284-287. https://www.mja.com.au/system/files/issues/192_05_010310/jac10846_fm.pdf
  • Jackson CL, Nicholson C.  2008.  ‘Making integrated health care delivery happen – a framework for success’ Asia Pacific Journal of Health Management 3(2): 19-24. https://search.informit.com.au/fullText;dn=426397895886669;res=IELAPA
  • Jackson, CL, Nicholson C, Doust, J, Cheung, L, O’Donnell, J.  2008.  ‘Seriously working together: integrated governance models to achieve sustainable partnerships between health care organisations’.  MJA 188(8): S57-S60.  https://www.mja.com.au/system/files/issues/188_08_210408/jac11093_fm.pdf
  • Jackson, CL, Nicholson C, Doust, J, O’Donnell, J, Cheung, L.  2006 ‘Integration, co-ordination and multidisciplinary care in Australia: Growth via optimal governance arrangements’. At http://www.anu.edu.au/aphcri/Domain/MultidisciplinaryTeams/index.php (accessed 24/9/07).
Balanced Scorecard for integrated primary/secondary health care governance
Figure 1: Balanced Scorecard for integrated primary/secondary health care governance © Nicholson et al 2015