Partnerships and collaborative advantage in primary care reform

Increasingly, partnerships and collaborations are becoming more common, and they will continue to do so because they provide for a strategic approach to the development of common agendas and pooled resourcing, to improve health outcomes. The Peninsula Model for Primary Health Planning is a good example of this approach, using the Commonwealth’s commissioned logic model, while the Inner-North Melbourne partnership is also a response to the desire of local organisations to improve systems and health care delivery. Partnerships and collaboration need to be deliberate, with planned actions based on a logic model and theory of change. With deliberative processes rather than ad hoc approaches, partnerships can change the way organisations and individuals work, but they require incentives and mechanisms of support to enable involvement over the period of time necessary to achieve change. Private industry primary care providers are unlikely to make a long-term commitment to broad collaborations driven by public sector agencies focused on social-health change, so mechanisms to engage them, where appropriate, need to be built into the partnership’s framework. Increasing research capacity to measure collaborative advantage will reduce the nature of inconclusive evidence and is likely to improve the practice of partnerships, coalitions and joint working in health and human services. Similarly, the evidence on consumer participation in primary care partnerships is promising in hospital quality—particularly in reductions to adverse events. In relation to primary care systems and primary care reforms, benefits to consumers from primary care reform are yet to be shown. Yet there are promising practices in consumer engagement that will inform Australia’s Primary Health Networks. Structured approaches should include monitoring and accountability for benefits to consumers, and over time, of outcomes from consumer input to the reforms, particularly those that affect safety and quality. Partnerships and collaboration are about creating new value together rather than mere exchange. They are about obtaining a desired result or return on investment (such as, achieving better population health outcomes or maximising procedural efficiencies) for the amount of time, funding and effort an organisation invests in the process. For private industry providers to become involved in partnerships, the common agenda and desired outcomes need to be carefully worked-out and agreed upon in advance. This ensures that all partners share a common purpose and commitment to the partnership and its goals throughout the time required to achieve these outcomes. This means that the partnership needs to carefully orchestrate a collaborative culture and purposefully facilitate collaborative action to achieve collaborative advantage. Policymakers, researchers and practitioners need only look to Australian best practices, such as The Peninsula Model and the Inner-North Collaborative Framework among others, for models on how to develop effective partnerships and collaborative advantage to accelerate primary care reform. These models are showing improvements in many aspects of professional and organisational functioning from their partnership work. The work they are doing in the development of strategies for streamlined care, embedding of efficiencies, and reductions in avoidable hospitalisations, is just being realised. Continuing financial and policy support for them is likely to bring tangible economic, consumer, and health system quality benefits to primary care reforms