The Prospects for Integrated Care in Australia – Reflections from the 22nd International Conference on Integrated Care (23-25 May 2022).
CCRI Director, Professor Nicholas Goodwin, reflects on his experiences at the 22nd International Conference on Integrated Care in Odense, Denmark, 23-25 May 2022
As co-Founder of the International Foundation for Integrated Care (IFIC) it was a great experience to be back in Europe for the 22nd edition of its annual conference and to have the opportunity to meet-up with friends old and new.
During the event I was able to represent the research team at CCRI and its ongoing work on our evidence review on models of care supporting people with dementia at the end of life, as well as reflect on the findings and implications from our report on New Care Models: How Insurers Can Rise to the Challenge of Older and Sicker Societies delivered in partnership with the Geneva Association.
A key element to the conference was a celebration of 20 years of the International Journal for Integrated Care and its recent special issue examining the progress that different countries around the world have made in implementing integrated care in policy and practice. A common observation was the significant progress that appears to have been made in the adoption of integrated care as a policy objective in most parts of the world, yet the significant challenges then encountered in overcoming existing barriers and challenges towards effective implementation.
Australia is no different in this regard. During a plenary presentation on Day 3 I was able to debate Australia’s progress towards integrated care over the past decade with Professor Anne Hendry (Scotland), Professor Robin Miller (England) and Professor Mirella Minkman (Netherlands). It was fascinating to hear the different journeys these countries have taken, and interesting to note just how embedded integrated care has become at a population health-level – for example, through the statutory creation of 31 Health and Social Care Partnerships in Scotland (since 2014) and 42 Integrated Care Systems in England (since 2022).
By comparison, and despite integrated care increasingly becoming core to the policy landscape at both federal and state levels, the Australian system remains a highly fragmented one. One key reason for this is that whilst other countries have reformed their financial reimbursement systems to embrace pooled-budgets for chronic diseases and capitated-based models to support joint health and social care provision, the Australian reimbursement model through Medicare has remained largely unchanged whilst bringing together health and aged care budgets limited to small-scale pilots. As a consequence, the ability to provide integrated services through community-based multi-speciality teams and networks – a hallmark of the reforms in other countries – has not significantly progressed.
The financial barriers are a well-known problem here in Australia, yet it seems policy-making to address key concerns (e.g. aged care, mental health, complex chronic illness, rural health and Aboriginal health) has been incremental and siloed rather than transformative. It remains to be seen what the next decade will bring, but the solutions needed will undoubtedly require a more integrated approach. The heartening thing is that this is recognised, especially here on the Central Coast, and why the CCRI can play a significant part in leading research and innovation to support the uptake of new models of integrated care to the benefit of our communities.
Prof Nicholas Goodwin, May 2022