As a regional commissioning platform, the North Coast Collective has adopted a shared investment strategy, which demonstrates significant alignment to major policy reforms including:
- the National Health Reform Agreement, which requires Primary Health Networks (PHNs) and Local Health Districts (LHDs) to develop collaborative and joint ways of working into the future
- the NSW Joint Statement and subsequent working groups
- recommendations of the Productivity Commission into Mental Health, that comprehensive regional approaches are a priority to improve outcomes
- the finding of the Productivity Commission into Chronic Conditions, that implementing innovative interventions on a larger scale depends on effective diffusion mechanisms and funding reform, such as blended payment models and pooled funding.
United Kingdom
The UK have embarked on a large reform agenda, the NHS Long Term Plan, with devolution playing a key role. This reform is centred around integrating health and social care, shifting care out of the hospital and into the community, and better prevention of ill-health.
Devolution aligns the responsibility, powers and funding for all areas of health care, social care and other public services, under one local regional body. This in turn allows local leaders to pool budgets and integrate commissioning functions to drive integration.
Quilter-Pinner & Antink from the UK’s Institute for Public Policy Research, have developed a program logic on how devolution is expected to work.
Decentralisation of commissioning of budgets within the NHS (alongside transformation funding) directly or indirectly drives the pooling of budgets and the integration of commissioning functions within the NHS and between the NHS and other public services at the location level.
Pooling of budgets and integration of commissioning functions helps move care into the community, joins up with care within and between the NHS and other services, and leads to more or better prevention initiatives within and outside of the NHS.
These changes drive improvements in patient outcomes, a reduction in inequalities, and a reduction of costs.
DevoConnect published a collection of essays in 2019, Is devolution the future of health and social care?, highlighting national, local, sector and political perspectives. This paper presents interesting ideas and suggestions that we could learn from on our journey: