It’s only day 12 in the CEO chair at one of Australia's most important health coordinating bodies and Julie Sturgess is understandably cautious to predict how the North Coast Primary Health Network will evolve under her stewardship.
This is not to say she is unfamiliar with what the Commonwealth-funded PHNs, totalling 31 in Australia, are intended to achieve. In short, to quote the department, the PHNs are aimed at “increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time.”
The simplicity of the aim belies the complexity of the delivery, a point Ms Sturgess hardly needs reminding of, having come here from Townsville where she headed Northern Australia Primary Health Limited, a comparable organisation charged with providing primary health care services to much of northern Queensland, including the Torres Strait islands.
The PHNs were set up in 2015 after a largely critical review of their forerunners, the Medicare Locals, bodies whose very name confused the public. Many thought it was where you took your bills to get the Medicare refund. Today’s PHNs have considerably less profile: Julie Sturgess is often asked what the organisation she runs actually does.
The answer is a lot, working behind the scenes to improve primary health care, and create seamless journeys for patients between the community and acute care providers, notably the State-funded Local Health Districts - two of them in this PHN’s footprint, Tweed to Port Macquarie - and private hospitals.
The collaborative aim is to deliver a safer and smoother ‘patient journey’ through our often-complex health system, reducing duplication and unnecessary calls on the precious health dollar. Despite contrasting geography and seemingly different demographics Ms Sturgess sees “more similarities than differences” between northern NSW and northern Queensland, not least of which is the challenges presented by the need to close the gap in life expectancy for Aboriginal groups within the community.
“Both areas have many small remote locations that create problems for stand-alone services, on top of which is the complexity of delivering effective mainstream as well as community controlled services,” she said.
In addition, “Both have pockets of significant advantage and great disadvantage.” Conscious that health services do not operate in a social vacuum, Ms Sturgess commented on the high cost of local housing, both for purchase and rent, and how this can stress all aspects of people’s lives, including lifestyles and health care.
A new report shows that six of regional NSW’s seven least affordable LGAs are on the North Coast. These include Ballina, Byron Bay and Tweed.
Perhaps drawing on her previous life with Telstra Health and as Director for Digital Governance for eHealth Queensland, she raised the importance of using technologies to support local providers in developing viable services. She has not opted out of My Health Record and trusts that the current review will enhance privacy protection as well as encouraging patients and clinicians to recognise the scheme’s benefits, and to make use of it.
Ms Sturgess regards the PHN’s relationship with general practice as “pivotal”, again raising the benefits of technology in a “catchment that has a strong focus on the patient-centred medical home.” “Building strong community patient health care is our remit and GPs are at the centre… it’s vital that we incorporate their knowledge and experience.”
Noting that while the PHN’s focus is to commission and coordinate services, support providers and advocate for primary care, Ms Sturgess said the organisation also engages with the broader community (through public consultations) regarding needs assessment. Do people see service gaps? Undue complexity? Unreasonable costs? These community feedback sessions contribute to the future planning of primary health services to be delivered.
It also seeks to promote healthy lifestyles, hence its ‘Healthy North Coast’ branding, and to enable all residents to actively manage their own health, make informed decisions about their healthcare needs, and get the type of healthcare they need, where and when they need it.
The goals may be easy to define, but the challenge is in the delivery. It is a task that Julie Sturgess, qualified nurse and former practising RN, both recognises and looks forward to tackling.