Integrated Family Health Services and the Health Care Home – enhancing primary care capacity for full integration
The Health Care Home is a national initiative, developed in partnership with Compass Health, Midlands Health Network and ProCare. Led by primary care clinicians and supported by expert facilitators it is built on the philosophy of providing patients with the right services, at the right place and by the right professionals.
Here in Canterbury, we have for several years been working on the Integrated Family Health Services (IFHS) programme that is part of the Canterbury Clinical Network and hosted by Pegasus Health. The IFHS has seen some real improvements in access to care and the patient experience, as well as efficiency gains and time benefits for practice teams.
As described by Pegasus Health CEO Vince Barry, “The Health Care Home is a developing NZ model for building primary capacity and capability to contribute to the full integration of services that Canterbury aspires to deliver via its IFHS model." As the Health Care Home is a national initiative and to ensure consistency of language, you will hear us refer to Health Care Home, however, in Canterbury, we will still strive via our IFHS comprehensive programme to support the integration of our whole system.
The Health Care Home concept, to have one place that connects people with the broader health and social system through their General Practice, delivers the key benefits as follows:
- Enables people to self-manage and have more involvement in their own care
- Provides a focus on people in greatest need and ensures they receive health care and support when and where they need it
- Integrates health and social services around people
- Maintains the continuity that people value
- Releases general practice resources to be available to those in most need
- Ensures the integration of previously siloed health professionals
- Releases secondary care based specialist resources to be responsive to episodic events and provide support to primary care.
It builds on the principle that the point of continuity for care for most people is their general practice, and by coordinating care from the Health Care Home, we strengthen this principle.
Part of the Health Care Home programme will support general practice to redesign the way they deliver services. This involves reorganising resources including clinical and business processes to improve health services; making better use of public and private funding; and rebalancing acute care with proactive and preventative care in the community. And there is support and guidance to achieve that.
Pegasus Health, under the IFHS programme, and Midlands Health, under their Models of care redesign programme have already started to introduce Health Care Home at a local level. ProCare and Compass Health are also now underway, with the total coverage being 450 general practices and 1.9 million New Zealanders.
Another part of the programme will be to accredit practices against standards and ultimately this will ensure sustainable and effective general practice for patients and professionals.
Vince says, “Health Care Home will make General Practices more effective, sustainable and beneficial for patients.”
In a Health Care Home, patients will be able, for example, to get a same-day appointment if needed (acute care); access services online (proactive care); and receive support to stay well (preventative care).
As a result of reorganising the models of care the expectation is that we will create up to a further 30 per cent capacity. This will mean that extra services can be delivered to those who need it the most.
Health Care Home is not about buildings. What we have learned through the IFHS process is that the improvements and changes are based on how things are done and the relationships across providers rather than bricks and mortar.
Pegasus Health IFHS project managers Jan Edwards and Mark Henare say the need for a model such as Health Care Home comes from the enormous challenges facing the New Zealand health system – “challenges that have become more and more significant over the last decade, and are quickly becoming acute".
They say, “a growing and ageing population, combined with workforce and financial pressures in the health system, along with people wanting to be more involved in managing their health, means that a fundamental shift is needed for primary health care to be sustainable.”