- Systems should be more seamless. Computer and paperwork linked from home-hospital to community
- There are such varying demographics and varying community care services (non health) across the areas. Some areas seem to have great relationships with the Community care sector and others not so good. I think these need to be taken into account when deciding on what governance structure is needed. There are too many variances across areas to have a one size fits all approach -A flexible arrangement needs to be in place to account for the differences in areas.
- Community Health services should address the unique community need. While there may be state and federal priorities, each community will express the demand for services within those priorities differently
- Country and city services differ greatly in access to services and travel from patient to patient, we have a greater problem accessing specialist services and a wider area to cover.
- One model perhaps with flexibility for rural/remote areas to encompass any special needs
- Failing that, at least one model within each Area.
- I believe that the when the models are left at the discretion of the separate areas then the personal beliefs, financial issues and power plays that are operating in that area decide what happens on the ground, not what is best for the clients.
- Designed around specific population needs i.e. disease or type specific and linking population with similar needs
- Each of these has its difficulties, esp. when an area is large and diverse. If you have one for all NSW, cannot have one size fits all. If only one model in area difficult if large and diverse area. If flexible across area can create problems if each cluster manager has different ideas on what is Community Health ! Solution maybe quite distinct definition of community health with a clear understanding that it is not the provision of clinical medical/acute services. I think the development of CAPAC is great and much needed but is causing some issues in community health as some want it placed there and maybe it is the right spot but for those in executive positions with a narrow view of community health, or who see it as an extension of acute service and wish to push it into a medical model it is creating problems. The latest buzz in our cluster/area is community health will be coming under acute care streams or will be known as the "wellness" stream- making community health an acute care service, clients in community health are not "well" they are not acutely medically ill, but they often have long-term issues, health problems which affect their mental/emotion health and therefore to label them as well will be devaluing the services provided and the problems these people have!
- The notion that the same CH model will work in two totally different demographics is a fallacy - managerially convenient but out of touch with reality.
- Because of the diversity of regions, there needs to be some potential for flexible
- One model across NSW, but recognising aged care and children's health as separate, staffed by professionals experienced in these groups
- Metro and rural differences need to be accounted for.
- Models need to be tailored to the needs of the local population, so while the role and responsibilities should remain consistent across NSW, models may vary.
-
I
believe that community health services have be dismantled and unsupported by
management. community health is not just health services in the community It is
complex and spans all age groups and many areas of desired wellness. It needs
to respond to local needs. not just reinvent itself every few years by managers
who have only hospital experience eg hospital nurses who become Managers What
if Mr Garling SC makes a recommendation for a statewide child and youth health
authority which incorporates mental health and community child health services? How will this operate across the State? He is
on the public record as saying this is a model under consideration -
There are
different needs in different communities, within and across health
services. One model will not provide
adequate flexibility, will require CHC's to complete paperwork and engage in
activities not required by their communities.
This is health we are talking about and in line with a
"person-centred approach", CHC's need to determine their
priorities/treatment options/health promotion options relevant to the needs of
the community. -
something
that separates Community health from
tertiary services othrewise CH is at the bottom of the food chain in a
integrated model that privileges end of life care and marginalises preventative
practices -
This will
ensure that some AHS are not very committed to PHC/CH (such as Illawarra where
CH has effectively been dismantled and rendered invisible within the acute
sector) will have to operate an effective PH&CH service, and the CEO will have to be
accountable for it's oucomes funding
should be distributed equitably across the state using transparent and
accountable processeswithout political imperitives!!!
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