Introduction by Croakey: A new Primary Health Research Plan will shape $50 million in funding from the Medical Research Future Fund, with the aim of improving primary care – and health outcomes – for all Australians.
One of its key tasks will be improving access to primary care for priority groups. However, there are questions over the level of funding, and the timeframes involved.
Jason Staines writes:
The Department of Health has released a new Primary Health Research Plan that will shape $50 million in funding from the Medical Research Future Fund. Designed by an independent expert advisory panel, it aims to transform primary healthcare to support better health outcomes.
The plan will advise the Government on research projects that identify and evaluate multi-disciplinary models of primary care and enhance linkages or the use of research data.
The funding will go towards projects that work towards one of three key aims:
- Patients can access multidisciplinary team-based care,
- Integrated health services provide patient-centred care, and
- Use data to improve patient care.
“Primary healthcare is the foundation of a strong, efficient and effective healthcare system,” said Professor Jane Gunn, who chairs the MRFF’s Primary Health Research Plan Expert Advisory Panel. “When it is working well, primary healthcare keeps people healthy and out of hospital,” she said in a statement.
However, with access to primary healthcare getting more difficult for many people, including those living in rural and remote communities and First Nations Australians, the Primary Health Research Plan was designed to put “our most creative minds to think about how we put equity at the centre of primary healthcare”, said Gunn.
Under its first aim – access to multidisciplinary team-based care – the plan identifies three priority areas for investment. The first of those will look at optimal models of multidisciplinary team-based primary care at local and regional levels, and how they can be deployed in different settings to improve health outcomes. One project is expected to be funded, with up to $5.2 million available over five years, and research to begin in 2024.
The second priority area for investment under this first aim will examine the efficiency, effectiveness and acceptability of voluntary patient enrolment in improving health service access and delivery, workforce satisfaction, and patient experience and outcomes.
The intention is to support early evaluation of the initial uptake of MyMedicare which, as Jennifer Doggett reported recently, faces many implementation challenges. Research is to begin in 2024, with up to $1 million per project available over five years, and four projects are expected to be funded – two of them urban and two rural.
Optimal models
The third and final priority area under this first aim will examine optimal models of primary care. The objective is to evaluate the effectiveness and feasibility of new or existing models of integrated, multidisciplinary team-based primary care for groups who would most benefit, including First Nations Australians, people from culturally and linguistically diverse backgrounds, those with disability, children, and older populations.
Research is to begin in 2025 and three streams of funding are available based on the health service provider or geographic location of the organisation undertaking the majority of the research. Up to $2 million per project over five years will be available, with four projects — two urban, one rural and one Aboriginal Community Controlled Health Service — to be funded.
Under the second aim – integrated health services providing patient-centred care – funding of up to $2.8 million over five years will be available per project, with six projects expected to be funded; three urban and three rural. Research is to begin in 2024 and will look at improving the patient journey through the interface between primary, secondary and tertiary care, with the goal of achieving seamless transitions.
Finally, the plan expects to fund four projects – with up to $4 million per project over five years – to examine how data can be better used to improve patient care.
Research is to begin in 2024, with the aim of developing and implementing ways of using data to support collaborative team-based care to deliver better clinical practice, patient experience and health outcomes.
Raising questions
While welcoming the initiative, Adjunct Associate Professor Lesley Russell, who is also a contributing editor at Croakey, said there were some issues with the nature of the Plan, such as the level of funding, describing $50 million over four years as “not a lot of money”.
“Researchers are asked to ‘identify and evaluate new models of care’ but if you are doing this in practice and not as a paper exercise, then three to four years (the timeframe for medium length projects) is nowhere near long enough. We saw with Health Care Homes how the time frame was too short to deliver any meaningful results – have we learned nothing?” she told Croakey.
“I am also concerned that these research projects will be driven by ‘primary care clinical researchers’, and I suspect that this means that many of those with relevant expertise will be ineligible for funding. It’s also not clear how busy primary care providers at the coal face can be involved,” she added.
Meanwhile, the Chair of the RACGP Expert Committee – Research, Associate Professor Jo-Anne Manski-Nankervis, welcomed the Plan, saying it demonstrates an acknowledgement of the importance of primary care.
“However, it is important to recognise that any growth in primary health research in Australia is from a small base. General practice research in particular has not been given the priority it should have over previous decades,” Manski-Nankervis told Croakey News.
“We are asking the Federal Government to establish a framework and funding for Practice-Based Research Networks (PBRNs) to advance primary healthcare research, with associated funding to support a pipeline of GP researchers and strengthen general practice research capacity, and ongoing access to primary health care data for general practice researchers,” she added.
Manski-Nankervis said there was a significant need for health reform, especially in primary health, with relevant evidence needed to underpin and support effective policymaking and provide guidance for GPs.
“The use of GP data in this research would also be greatly supported through the establishment of a national network of PBRNs. These requests directly align with recommendations of the 10 Year Primary Care Plan,” Manski-Nankervis said.
Funding and support for general practice research would also be an important step in addressing workforce challenges, she said, particularly given the need to support the next generation of GPs.
“General practice has been seen as a low-prestige specialisation compared to those with stronger research pathways. This has reduced its attractiveness to junior doctors, only about 13 per cent of whom rank general practice as their preferred specialisation in medical school. Given we’re facing a shortage of over 11,000 GPs by 2032, we need to fix that perception,” she said.
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