Responding to the needs of people who are most at risk of poor health outcomes is a priority for governments and communities across Australia. While definitions vary, there is widespread agreement in the literature that the commissioning of health services is more than traditional planning, funding and procurement. It is the process for deciding how to use the total health resources available in order to improve outcomes in the most efficient, effective, equitable and sustainable way. This issues brief sets out the rationale for developing and implementing a clinical governance framework for Primary Health Networks (PHNs) in commissioning the provision of primary health services that are safe and effective. It provides principles that inform clinical governance policy including recommendations on how clinical governance should be supported in commissioning undertaken by PHNs for contract development, management, auditing and compliance. PHNs also have a role in influencing the uptake of quality improvement activities in general practice including the interface between primary care and community services.
The critical areas in ensuring clinical governance are:
- Consumers having opportunities to manage their own health and also participate in innovation and value creation through co-design processes.
- Clinician-led workforce that enables PHNs to make informed decisions about commissioning health services with providers who have the appropriate capacity and expertise to deliver safe care.
- Delivery of safe quality care through identifying areas for practice improvement and those practices that may put consumers at risk of harm,and making recommendations to prevent or control those risks.
- Clinical risk management to ensure that service providers have the capacity to meet legislative requirements and national and jurisdictional standards when designing best practice for their service.