Last year, an independent Expert Advisory Committee (EAC) was tasked with developing the Health Services Plan to put forward recommendations to improve equity and access to care for all Victorians. The impetus for this work recognised that while Victoria has a high-performing health services system, depending on where you live and who you are, people can have varied experiences of the healthcare system.
On 8 August 2024, the Victorian Government formally released the Health Services Plan, along with decisions around the 27 recommendations put forward by the EAC - 21 recommendations were accepted in full, 5 accepted in principle, and 1 not accepted - notably a decision that there be no forced consolidations or amalgamations of health services. The committee found that fragmentation and lack of coordination across the system contributes to a variety of challenges; including inequity of access; variable patient experiences and barriers to workforce attraction and retention. This has culminated in the following outcomes being recommended by the EAC and accepted by Government.
The resulting recommendations that Government accepted lean towards a strengthening partnerships model. The EAC made recommendations based on 3 pillars: Local Health Service Networks; relationships with major tertiary hospitals and a role delineation framework.
Local Health Service Networks: Victoria’s health service sites are set to be formally organised into Local Health Service Networks (LHSN) – representing discrete geographies of appropriate population scale. The LHSNs will have responsibility for clinical service planning, establishing default referral pathways for step-up and step-down care, unified clinical governance leadership, and establishing nursing, midwifery and allied workforce banks across the Network. Refer to the LHSN overview, including alternative networks for some larger geographical regions.
Relationships with major tertiary hospitals: Each network will include a major tertiary hospital which aims to formalise linkages and improve the timeliness of high complex care. This endeavors to achieve coordinated, multidisciplinary care, while enabling sharing of workforce, expertise and research efforts across specialties.
Role delineation framework: A role delineation framework will assist in clarifying the roles and responsibilities of each health service site, and guide community expectations of the care to be provided locally. Role definitions will range from Very Small to Major Tertiary sites based on clinical complexity.
The VHA acknowledges that the Health Services Plan and creation of LHSNs will be a major undertaking. This requires further consultation with stakeholders, including health service employees, consumers and clinicians. The VHA urges the government to invest in the key enablers of reform that the VHA and EAC have identified and take a measured approach to rolling out the Plan: funding; workforce, infrastructure and change management.
The VHA is pleased to see that the EAC report has acknowledged that further work is required to improve connections with primary care, community health, and across physical health, mental health and alcohol and other drug-related issues. The role of non-acute health services such as registered community health services is yet to be clarified, though the VHA understands that the department is aware that building the capacity of the non-acute system is important for the future.
While mandated amalgamations are not the model chosen, some services may still decide to voluntarily amalgamate – with funding and support understood to be available for this.
The VHA notes that reform is not a cost neutral exercise and that further funding to facilitate the establishment and operationalisation of LHSNs will also need to be provided, as we have encouraged through our recent position paper (see here).
The VHA expects further detail around implementation of the Health Services Plan, including consultation and engagement – to be detailed over the coming weeks.