In May 2013, the Council of Social Service of NSW (NCOSS) undertook a survey of not-for-profit community sector organisations’ engagement with NSW Medicare Locals. NCOSS sought a more comprehensive evidence base about Medicare Locals collaboration and engagement with the sector, after members’ raised concerns at roundtables earlier this year.
Medicare Locals need to develop effective working relationships with community sector organisations in order to improve primary care coordination and integration at the local level. Effective engagement has the potential to improve the planning, development, and delivery of service to benefit community health and well-being.
The NCOSS survey was completed by 323 respondents from a range of sectors and geographic locations. The results show considerable variation in the extent and quality of engagement between community sector organisations and Medicare Locals across the State (see boxed text below).
Some organisations reported positive experiences resulting in beneficial outcomes. They cited regular communication, active relationship building, and genuine partnerships with their Medicare Local. This resulted in networking opportunities, information exchange, increased referrals, funding and partnership opportunities, better local services, and improved client and community outcomes.
However, some organisations reported less successful experiences. Respondents frequently said there had been no on-going engagement beyond one-off or ad-hoc consultation. Others said they had tried to initiate contact but had no response from the Medicare Local. In some instances neither party had attempted to make contact.
The main challenges and barriers to engagement identified by the survey respondents were Medicare Locals lack of understanding about the community sectors, a lack of information about Medicare Locals, a lack of time and resources to engage, infrequent/poor communication, and Medicare Locals’ focus on clinical health priorities.
Respondents generally acknowledged it is still early days in Medicare Locals’ establishment. Many were optimistic about the future and the potential to build stronger relationships. While a few respondents saw no value in Medicare Locals, a greater number reserved judgement saying they would ‘wait and see’ how they evolve over time.
There was broad consensus about how engagement could be improved. First and foremost, respondents said there needed to be more information and communication about Medicare Locals. This includes their role, the services they provide, and how to engage with them. Many also suggested the same information and education for Medicare Locals about the community sector. Performance measures and reporting on community sector engagement was also suggested.
At the local level, respondents’ primarily identified the need for regular communication and on-going forms of engagement to sustain the relationship long-term. Suggestions included Medicare Local community newsletters, email updates, interagency meetings, and regular regional forums.
In addition to more information and regular communication, clarifying ambiguous aspects of the Medicare Locals role would improve the foundations for building relationships. The Commonwealth Government needs to provide clearer guidance about the scope of Medicare Locals role in relation to the broader primary health and social care systems. It also needs to clearly position Medicare Locals role as systems planners and coordinators based on a partnership approach, rather than as direct competitors with existing services.
Key survey results
- Mixed levels of understanding of Medicare Locals role and purpose – 40% good/very good, 31% fair, 28% poor or very poor understanding
- Wide variations in frequency of contact: around half (52%) in regular contact (monthly or more) but just under half (42%) only had one-off or ad-hoc contact.
- Most common type of engagement: consultation events (28%), one-on-one meetings (27%), and collaborative initiatives (19%)
- Type of engagement most commonly wanted: organisational membership of Medicare Local (20%), collaborative initiatives (17%), and formal partnership agreement (15%).
- Value of engagement: Over one third (37%) said extremely or very worthwhile, nearly half (46%) said somewhat worthwhile, and 17% not worthwhile.
- Main reason for not engaging (non-engaged respondents): unsure how to initiate contact (25%), didn’t know they existed (20%), lack of time/resources (15%), and Medicare Local didn’t respond to contact (15%).
- Vast majority were either definitely (68%) or possibly (28%) interested in engaging with Medicare Locals in the future.