News from the HCA team

HCA a part of Irish health system reform

As the pace of public hospital funding reform in Australia, towards the more transparent model of activity based funding, seemingly is becoming less focused and certainly having a reduced profile, the Irish Government is pushing determinedly ahead to introduce a funding model based on activity (‘Money Follows the Patient’) to 38 of its largest hospitals. The Government’s intentions are best summarised in their document Activity-Based Funding Programme: Implementation Plan 2015 – 2017. The Plan can be downloaded here.


HCA’s Principal, Lee Ridoutt, leading a key workshop with Irish coders

In the last two years a transition has been occurring, and of course some hospitals are better prepared than others to adapt to the new funding approach. As a whole, the change is most at risk from poor quality of data on activity, especially episodes of care not being coded accurately and in a way which appropriately reflects their complexity, and therefore cost.
HCA has been supporting one of its key consultancy partners, Pavilion Health, who has a large contract with the Irish Healthcare Pricing Office (HPO), to improve the data quality. The project, commenced in June 2015 and due to be completed in May 2016, has several elements aimed at identifying the magnitude and nature of any data quality deficiencies, including a traditional auditing approach of the coding of a sample of episodes of care from a sample of hospitals, and broader statistical analysis of the entire 2014 data set. HCA’s contribution is to study the way coding services are managed in a selection of Irish hospitals (benchmarked against a theoretical ‘best practice’) and to identify interventions at both a hospital and systems level to improve management. As well, HCA is working with Professor Beth Reid to evaluate the HPO capacity to develop and support competent clinical coders and advise on the best workforce development approaches and required infrastructure.

As the project nears completion, some very valuable advice is being formulated to improve HPO’s workforce development infrastructure. In the area of coding services management, important research has ben completed in a space that is poorly covered in the academic literature, and it is hoped HCA’s research work, with Pavilion Health and HPO, will be converted post project into published articles.

Information about the project and especially HCA’s contribution is best obtained from HCA’s most involved staff members Lee Ridoutt and Victoria Hirst.

HCA’s most senior consultant undertaking a PhD

HCA’s Victoria Hirst, the longest serving member of the core staff group (apart from the Principal), has been accepted into a PhD program in 2015 at the University of Newcastle.

While this might limit to some extent in the short term the time Victoria can continue to contribute to HCA projects, the long term benefits to the company are appreciable. Apart from accelerating Victoria’s knowledge base and competence in an area of HCA work where she has begun to specialise, mental health services workforce, it will bring more academic contacts to HCA, adding to the already long list of HCA’s academic relationships to institutions and individual associates.

Victoria’s PhD research aims to investigate the benefits and possibility of including carers of people with mental health issues within the mental health workforce in a more structured way. Thus, some embryonic thinking within HCA about the inefficient way in which carer resources are currently utilised in mental health (and too aged care and disability) and how this could be addressed by adopting a human resources management approach will be explored. Of course, as with all PhD endeavours in the early days, Victoria’s research direction is ever evolving. We will keep you up to date with her research output later in the year, but for those with a keen interest in the area and perhaps already researching this space, don’t hesitate to contact Victoria about her studies.

New associate – Judy Harwood

HCA is pleased to welcome Judy Harwood as an associate. Judy brings a welcome expertise in disability to boost HCA’s capacity to understand and respond to workforce issues arising from NDIS implementation. This will supplement HCA’s own growing expertise from an NDIS workforce project with MHCC.

Judy has seventeen years of senior experience with government in program administration, policy, reform, and business strategies. As well as extensive experience in disability program and sector reform. She has also managed the Home and Community Care Program for NSW.

For more information about Judy’s experience and qualifications please go to our Associates page.

HCA mental health workforce report published

In late 2014 HCA was contracted to provide advice to the National Mental Health Commission as part of their development of a National Review of Mental Health Programmes and Services, a seminal report on the future of mental health services for the Federal Minster of Health. The advice was primarily in regard to the workforce implications of the visionary new form the Commission wanted to take mental health services. HCA’s advice took the form of numerous meetings with the Commission’s officers and the CEO David Butt, but more particularly was provided in a just under 100 page report. The HCA report, along with other reports commissioned by NMHC were published on the 16th April, 2015, and can be downloaded here.

If you want to see also the Commission’s report to Government, it can be found here.

HCA’s growing specialisation: Mental Health Workforce

Over the last 3-4 years HCA has been incrementally accumulating a high level of expertise in mental healh workforce.

HCA is currently applying it’s mental health workforce expertise in a number of new projects including:

• The Centre for Rural and Remote Mental Health (CRRMH) to undertook an assessment of basic mental health education required by staff employed by non-governmental organisations (NGOs) in rural and remote NSW service providers.

• Scoping the Australian community managed mental health sector’s workforce development needs in relation to the delivery of psychosocial disability support/services with the new NDIS funding framework, HCA will make recommendations about next steps and priorities to address these in the context of the national implementation of the NDIS.

• Undertaking an external evaluation of the Rural Adversity and Mental Health Program’s (RAMHP), in particular the program’s linkages and connections to mental health and community stakeholders. This process includes interviewing and surveying several stakeholder groups such as community mental health services, rural support/resilience workers, and the managers of public sector mental health services in rural Local Health Districts (LHDs).

• Providing the National Mental Health Commission (NMHC) expert advice on the workforce requirements to support the commission’s vision and service plans for the future, presented to the Federal Minister for Health in the National Review of Mental Health Programmes and Services. HCA’s report has just been published and can be downloaded here.

• In conjunction with the Centre for Rural and Remote Mental Health (CRRMH), HCA completed a literature review of service models for mental health services for the Mid North Coast (MNC) Local Health District, identifying possible best practice service structures, resource distribution and new and innovative ways of service governance that support integrated service behaviours.

New core staff member

HCA welcomes a new member into its core staff team Debbie Stanford. Debbie has been an associate with HCA for over a year, but will now take on a more structured role in the core team, taking specific client relationship responsibility for all Canberra based clients and will play a role, most often project management, in all of HCA’s Federal Government consultancy assignments. Given that HCA has recently been contracted as a member of the Families and Children Expert Panel (click here for information on the panel) in addition to its membership in other Commonwealth expert panels, Debbie’s expertise will be a great asset.

Debbie has worked in Commonwealth Government agencies for many years in particular the Department of Health, at a senior level. Apart from understanding the content intricacies of many portfolios of health policy and service activity, she has a particularly keen insight more broadly into how government agencies actually work, and as a consultant what approaches and mechanisms you need to adopt to be successful. For more on Debbie’s background go to Our People page.