5 considerations for PHNs to go from regional planning to effective commissioning
Most of the activity of Primary Health Networks (PHNs) is aligned to organisational planning documents (e.g. regional health needs assessments and annual activity plans), developed in respect of national and state-based policy documents. PHNs often face the challenge of limited data and insight available at a regional level that leads to informed commissioning decisions. As such, PHNs frequently need to dive deeper into understanding specific health issues in their region or explore differences between individual communities before investing in a particular area.
Regional planning processes aim to build a PHN’s understanding of a particular health issue. Through targeted engagement with stakeholders, regional planning enables PHNs to prioritise activities for investment. This blog offers those working in PHNs five things to consider prior to commencing their next regional planning process. The suggestions aren’t intended to be overly negative or promote striving for mediocrity - they are crafted to take the weight off the shoulders of PHNs.
1. Be at peace with the fact that your regional plan will have unallocated priorities.
Due to the role of PHNs as system integrators and commissioners of localised health services, it is important to note that not all actions listed in a regional plan have to be owned or allocated to an organisation. If PHNs can effectively communicate that a regional plan is not a funding commitment but a roadmap for collaborative action, the expectations of partners and service providers can be managed whilst maintaining a strong signal to the market about the desired state of the system.
2. Capture all existing activity within your regional plan
A regional plan is usually co-owned by several funders including PHNs and local hospital networks (e.g. LHDs, HHSs). Capturing existing activity is necessary to identify opportunities for coordination and integration between stakeholders. Ideally, a regional plan may result in funders considering the coordination of commissioning activities or co-funding arrangements.
From another perspective, PHNs should be looking at what is already working and consider if doubling down on an investment is worthwhile. Some PHNs are constantly stuck in a cycle of 'innovate at all costs' when there are times when it may be more appropriate to scale up an existing service, either through increased funding to existing providers or adding another provider to deliver the same service in a different geography or target population.
3. PHNs don’t need to know all of the answers prior to going to market
Regional planning processes and activity planning processes may return straight forward investment options while others may require alternate approaches. PHNs are left with the choice of either entering in-depth service design processes prior to going to market or leaning on the market itself to co-design service responses. PHNs don’t need to know all of the answers prior to going to market to procure services however their co-design capability and appetite for risk may determine which route to take.
4. You will never know everything there is to know about an issue.
It is highly likely that a regional planning process will uncover a number of issues that will require further exploration. It is extremely likely that there are actions in your regional plan or annual activity plan that you could progress in a timely manner. Keep in mind that there will always be another planning cycle where you can go back to the well and get more information.
5. Strike a balance between ‘traditional service responses’ and ‘innovation’
A regional plan doesn't have to comprise of a list of genuine ‘game changers’ - they are expensive to operationalise and given the short funding horizon of PHNs unlikely to reach maturity within existing funding cycles. When considering innovation, take the time to pilot a new program or service prior to scaling. By doing so, this will give you the option to either 'fail fast' or 'scale up'.
The five points above are in no way meant to be an exhaustive regional planning guide for PHNs, but more so a list of considerations and reflections from our experience in working within the PHN environment.
As a mission-based health and social services consultancy, Beacon Strategies is committed to partnering with PHNs to better plan, design, implement, evaluate and communicate their work in delivering health outcomes for local communities. Access other insights from our recently completed PHN work.