Better Health Plan for the WestPartnership Framework 2017 – 2021

2 BETTER HEALTH PLAN FOR THE WEST – FRAMEWORK 2017-2021

Local Government Authorities

Partners

Hospital and integrated health services

Primary and community health services

Regional and representative organisations

BETTER HEALTH PLAN FOR THE WEST – FRAMEWORK 2017-202 3

1 Introduction and Foreword

We are excited to present the Better Health Plan for the West (BHP4W) Partnership Framework (2017-2021). This framework presents a high-level overview of how we are working in partnership to collectively achieve improvements in the health and wellbeing of people living in Melbourne’s west.

BackgroundThe Better Health Plan for the West (BHP4W) partnership was first established in 2011. It builds on the strong culture of dialogue and collaboration among health and community service providers in the west of Melbourne, and creates an opportunity for the west to be a leader among regional health partnerships in Victoria. The involvement of local government is recognised as a strength of the BHP4W, connecting health-focused organisations and community-focused local government authorities.

BHP4W has provided a collective platform for advocacy and generated significant profile as a flagship alliance. It has given individual organisations a common point of reference and facilitated regional projects. Following recent changes to the health policy landscape and a review of the BHP4W, this new framework has been developed to guide the future work of the BHP4W partnership.

About the FrameworkThe Partnership Framework articulates how we will harness the combined capability and influence of multiple partner organisations to deliver the greatest collective impact.

It provides the overarching context, principles and structures for the revitalised BHP4W partnership, which is shaping the way local health organisations respond to the needs of one of Australia’s fastest growing and most diverse regions.

The Partnership Framework is supported by two key documents which guide the implementation of the BHP4W:

• The BHP4W Memorandum of Understanding (MOU) –articulates the partnership arrangements that enable BHP4W to fulfil its mission, and foster a culture of shared accountability, excellence and agility.

• BHP4W Partnership Work Plan (the Work Plan) – will be developed to articulate the activities that the BHP4W partners will undertake to achieve our mission and vision. The Work Plan will incorporate a performance and evaluation framework to enable us to monitor how we are progressing over time.

This suite of documents replaces the BHP4W document released in July 2012.

BHP4W Stakeholders

Partners

BHP4W partners include hospitals and integrated health services, primary and community health services and regional and representative organisations, as well as local government authorities.

Governing partners are members of the recently established BHP4W Governance Group which is responsible for:

• enabling and maintaining accountability for the implementation of BHP4W; and

• identifying and pursuing strategic activities and alliances that support achievement of the BHP4W vision and mission.

Together, the governing partners provide backbone support to the BHP4W and are committed to a shared investment in high leverage activities. They do this by establishing and actively participating in the governance structure more broadly and by developing shared capabilities that are essential to supporting the work of the BHP4W.

Supporting partners are individuals or organisations, outside the governing partners, that actively engage with BHP4W via a range of mechanisms including information sharing, consultation, or collaboration. These partners may be represented on steering and working groups, and provide input, guidance and advice to broader BHP4W operational activities.

Supporting partners include providers of health or social services, general practice or other primary care providers, local government authorities, other regional alliances and consumers and carers.

Other Stakeholders

Other Stakeholders include any other individual or organisation that influences, or is impacted or interested in the work of the BHP4W partnership.

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Better Health Plan for the West

Vision

Purpose

Better health and improved wellbeing for people in Melbourne’s west

A partnership between health and government organisations focussed on delivering better health and improved wellbeing with people and communities in Melbourne’s west.

MissionTo build a strong health system in Melbourne’s west

Principles We seek collective impact

We focus on vulnerable groups

We adopt a place-based approach

We use evidence to inform action

The BHP4W provides a basis for partners to achieve more together than they can alone. While each BHP4W partner has their own organisational priorities, our efforts under the BHP4W are specifically focused on advocacy and activities that harness the expertise, capability and influence of multiple partners to deliver the greatest impact.

Across Melbourne’s west, there are significant variations in the built and natural environment, population health and demography, and the topology of the service system. By placing emphasis on place-based advocacy and activity, we prioritise understanding the strengths and challenges present in different contexts, and avoid a ‘one-size-fits-all’ approach.

There are significant disparities in health access and health outcomes for specific groups within the west. We invest our effort on marginalised and vulnerable populations who experience the most acute levels of disadvantage.

In a context where resource constraints mean choices need to be made about how they are allocated, we recognise the importance of using evidence to inform action. We use the best-available data and information to inform our work, and seek to build on and strengthen the available evidence base.

Primary Prevention Stream

Effective prevention and health promotion

Service Integration Stream

An equitable, accessible, integrated and high quality service system

How we carry out our mission

Appropriate health infrustructure workforce planning

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2 Context

Regional ProfileThe west of Melbourne is characterised by high population growth and is marked by significant pockets of disadvantage. This is reflected by:

• socio-economic disadvantage, including a number of areas with extremely low SEIFA scores compared to the Victorian and national averages;

• health disadvantage, including higher burden of disease; and

• limited access to health services and infrastructure.1

The region has a younger average population than the state, and a higher proportion of children aged 0 to 14 years, reflecting the presence of young families.2 More than 30% of the population is born outside of Australia, with at least 110 different languages spoken and about 8% of the population having poor or no English proficiency, compared to the national average of 2.6%.3

1 Urbis, Better Health Plan for the West: Final Report of the Urbis Review, 2016.

2 North Western Melbourne PHN, Regional Health Needs Assessment: August 2016, 2016.

3 Western Health, Strategic Plan: 2015-2020, 2015.

Significantly higher rates of health concerns and health risk factors are experienced by the region’s population when compared to the Victorian average, for conditions including, but not limited to, psychological stress, obesity, type II diabetes, heart disease, cancer and smoking rates.4,5

Policy LandscapeThe health and community services policy landscape within Australia is dynamic and rapidly evolving, with high-level reform at all layers of government.

A strength of the BHP4W partnership is that our collective intelligence – both of the opportunities and challenges of such reform – enables us to consider implications and develop responses across various parts of the system.

The range of key policies, frameworks, strategies and reports produced by governments and other organisations across Australia will inform the solutions and actions of the BHP4W partnership. In addition, the BHP4W will provide a platform for regional, place-based interpretation and implementation of these policies.

4 North Western Melbourne PHN, 2016.5 Western Melbourne Regional Development Australia Committee,

Regional Plan: 2016-2019, 2016.

MooneeValley

Maribyrnong

Hobsons Bay

Wyndham

Brimbank

Moorabool

BacchusMarsh

Sunbury

Melton

Hume

The BHP4W catchment area (Melbourne’s west) is defined as the local government areas of Brimbank, Hobsons Bay, Maribyrnong, Melton, Moonee Valley and Wyndham, and towns of Sunbury and Bacchus Marsh.

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3 Approach

The partners of BHP4W recognise that to achieve the vision of better health and wellbeing for people in Melbourne’s west within a complex health, social and community service system, the sum of our combined effort is greater than the parts.

Across various industries, organisations are looking for new models of change as a result of limited financial resources and the challenge of complex adaptive problems that do not respond to merely technical solutions.

Within healthcare, partnerships and consortia are being promoted and implemented across Australia to ensure the effectiveness of patient-focused solutions.6,7,8 In many advanced health systems, there is a move towards health organisations working together as a system to tackle problems from a place-based, population health perspective.9,10

The alternative to effective collaboration involves individual organisations implementing change in isolation, competing for limited resources, having potentially opposing effects on the system as a whole, and having limited impact on a population even when effective solutions have been discovered.

Collective ImpactCollective Impact is the operating model for BHP4W. This approach is premised on the belief that no single policy, government department, organisation or program can tackle or solve the increasingly complex social problems we face as a society. This approach calls for multiple organisations or entities from different sectors to align their efforts to advance the creation of measurable impact.11

Measurable impact has been achieved in industries including education, food manufacturing, welfare and global health, and at both international and local levels.12,13

The BHP4W operating model is based on the five conditions for Collective Impact14, which are further described below:

3.1 A common agenda

3.2 Backbone support.

3.3 Mutually reinforcing activities

3.4 Shared measurement

3.5 Continuous communication

Collective Impact

Continous communication

Engagement and participation across collective

Interfaces with stakeholders beyond collective

Backbone support

Governance structure

Shared capabilities

Mutually reinforcing activities

Partnership work plan

Collective efforts

Common agenda

Shared vision for change

Shared approach to change

Shared measurement

Commitment to monitoring

Commitment to evaluation

6 Brisbane North PHN, Steady invested strong: A Consortium and Commissioning Toolkit, 2016.

7 The Collaborative, Collaborative Framework 2016-2020: Working Together to Strengthen Health Care Outcomes of Our Communities, 2016

8 VicHealth, The Partnership Analysis Tool: A Resource for Establishing, Developing and Maintaining Partnerships for Health Promotion, 2016.

9 H. Alderwick, C. Ham and D. Buck, Population Health Systems: Going Beyond Integrated Care, London, The King’s Fund, 2015.

10 C. Ham and H. Alderwick, Place-based Systems of Care: A Way Forward for the NHS in England, London, The King’s Fund, 2015.

11 www.collaborationforimpact.com/collective-impact/

12 J. Kania and M. Kramer, ‘Collective Impact’, Stanford Social Innovation Review, 2011.

13 F. Hanleybrown, J. Kania and M. Kramer, ‘Channeling Change: Making Collective Impact Work’, Stanford Social Innovation Review, 2012.

14 J. Kania, F. Hanleybrown and J. Splansky Juster, ‘Essential Mindset Shifts for Collective impact’, Stanford Social Innovation Review, 2014.

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3.1 Common Agenda The common agenda for BHP4W partners is to collectively achieve improvements in the health and wellbeing of people living in Melbourne’s west. This is undertaken through a joint approach which recognises three complementary platforms for action, including a focus on:

• effective prevention and health promotion;

• an equitable, accessible, integrated and high quality service system; and

• appropriate health infrastructure and workforce planning.

Two streams of priority activity are driven by steering groups which together enable the elements of the BHP4W mission to be carried out:

• Western Region Primary Prevention Taskforce has a primary focus on “effective primary prevention and health promotion.”

• Service Integration Steering Group focuses on “an equitable, accessible, well-coordinated and high quality service system.”

Both streams of activity consider solutions that contribute to appropriate health infrastructure and workforce solutions and draw on the ongoing planning work through the Department of Health and Human Services (DHHS) West Division, North Western Melbourne Primary Health Network (NWMPHN) and local government.

Principle areas of focus Based on population health priorities and the current policy landscape the principle

areas of focus for BHP4W are:

Chronic disease

Mental health

Children and families

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3.2 Backbone SupportGoverning partners take accountability for providing backbone support to the BHP4W collective through:

• the establishment of an appropriate governance structure; and

• the development of key shared capabilities required to enable the work of the collective, such as monitoring and evaluation, data management, resource management and communications/marketing.

North Western Melbourne Primary Health Network, in its role as the auspice organisation for BHP4W, facilitates this work for the governing partners.

Governance Structure

The BHP4W governance structure comprises three tiers including:

• The BHP4W Governance Group;

• Steering Groups responsible for the service integration and primary prevention work streams (the Service Integration Steering Group and Western Region Primary Prevention Taskforce); and

• Working Groups (as required).

BHP4W Governance Group

• Comprised of CEOs, or senior executives from governing partners.

Responsible for:

• Promoting and advocating on behalf of the BHP4W collective.

• Pursuing strategic activities that support achievement of the BHP4W vision.

• Enabling and maintaining accountability for the collective efforts of BHP4W.

Service Integration Steering Group

• Comprised of senior managers from partner organisations.

• Focused on improving access, equity and integration across the primary care and acute services.

Western Region Primary Prevention Taskforce

• Managed under the auspice of the HealthWest Management Group.

• Formal interface via representation on the BHP4W Governance Group

• Focused on primary prevention planning, implementation and evaluation.

Working Groups

• Formed to develop and implement priority projects (as required).

• Comprised of relevant stakeholders from across and beyond the partnership.

Shared Capabilities

BHP4W Governance

Group

Service Integration

Steering Group

Western Region

Primary Prevention Taskforce

Working Groups

Appropriate Health infrastructure and workforce planning

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3.3 Mutually Reinforcing Activities

Partnership Work Plan

A partnership work plan will be developed that includes:

• activities to enable the collective efforts of BHP4W.

• high priority activities that contribute to the vision, priorities and profile of BHP4W.

Collective efforts

Partners will be involved in developing and implementing initiatives that will make up the collective efforts of BHP4W.

3.4 Shared MeasurementGoverning partners are committed to monitoring and evaluating the work of BHP4W, and the outcomes achieved for the population. Collecting data and measuring results consistently across all participants ensures efforts remain aligned and participants hold each other accountable.13

This includes a focus on shared measurement at a number of levels including:

• identification and monitoring of system level trends and indicators;

• evaluating the work of the collective towards agreed action; and

• appraising the role of the partnership.

3.5 Continuous CommunicationRegular communication

Consistent and open communication is needed across the many partners to build trust, assure mutual objectives, and create common motivation.13 Governing partners will create opportunities for ongoing dialogue and advocacy across the broader partnership and with other key stakeholders in Melbourne’s west and beyond.

Engagement

Partners and the wider group of stakeholders in Melbourne’s west will have the opportunity to engage with BHP4W via information, consultation, involvement or collaboration. BHP4W partners will maintain or create interfaces to ensure alignment of efforts and minimise duplication, for example within government, industry, community groups, academia and across existing networks.

Shared Measurement

Evaluating the partnership

The approach to the BHP4W partnership will be monitored and evaluated to measure its

effectiveness in supporting the collective and in achieving the

desired outcomes.

Evaluating system change

A long term, population health monitoring and evaluation

framework will be developed to measure change to the performance of the local

health system.

Evaluating the work of the collective

BHP4W initiatives will incorporate monitoring and evaluation plans to measure

the efficacy and effectiveness of solutions.

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Closing Remark

Our diverse and dynamic BHP4W partnership comprising of a variety of local health and government organisations is passionate about delivering better health and improved wellbeing for all people living in Melbourne’s west. By continuing to foster a culture of partnership, excellence and agility in healthcare, the BHP4W is committed to reaching its mission and full potential as an inspirational leader among regional health partnerships in Victoria. We are excited to share this next iteration of the BHP4W journey with all our diverse stakeholders and thank-you for your valued interest in the BHP4W.

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Contact Us

If you would like to provide feedback or know more information about this framework please contact bhp4w@nwmphn.org.au

Image credits

Images used in this Framework have been supplied courtesy of cohealth, Djerriwarrh Health Services, Western Health, Health West and North Western Melbourne PHN.

References

Alderwick, H., C. Ham and D. Buck, Population Health Systems: Going Beyond Integrated Care, London, The King’s Fund, 2015.

Brisbane North PHN, Steady invested strong: A Consortium and Commissioning Toolkit, 2016.

Ham, C. and H. Alderwick, Place-based Systems of Care: A Way Forward for the NHS in England, London, The King’s Fund, 2015.

Hanleybrown, F., J. Kania and M. Kramer, ‘Channeling Change: Making Collective Impact Work’, Stanford Social Innovation Review, 2012.

Kania, J. and M. Kramer, ‘Collective Impact’, Stanford Social Innovation Review, 2011.

Kania, J., F. Hanleybrown and J. Splansky Juster, ‘Essential Mindset Shifts for Collective impact’, Stanford Social Innovation Review, 2014.

The Collaborative, Collaborative Framework 2016-2020: Working Together to Strengthen Health Care Outcomes of Our Communities, 2016.

VicHealth, The Partnership Analysis Tool: A Resource for Establishing, Developing and Maintaining Partnerships for Health Promotion, 2016.

North Western Melbourne PHN, Regional Health Needs Assessment: August 2016, 2016.

Western Health, Strategic Plan: 2015-2020, 2015.

Western Melbourne Regional Development Australia Committee, Regional Plan: 2016-2019, 2016.

Urbis, Better Health Plan for the West: Final Report of the Urbis Review, 2016.