Diabetes Care Project

The Diabetes Care Project (DCP)

The consortium, led by global management consultancy McKinsey and Company, has been appointed to deliver the pilot for the Department of Health and Ageing (DoHA) with Healthfirst Network™ as the lead Division of General Practice tasked to implement the pilot in South Australia.

The DCP is a 3-year pilot (delivered in 3 phases; 6 month design, 2-year implementation and 6 month evaluation) of a new model of healthcare delivery designed to improve care for people with diabetes.

The Adelaide Hills Division of General Practice will also working closely with the team across areas where the pilot will be trialled.  In its entirety, the pilot will involve up to 150 practices in 3 states, and will compare results between two intervention groups of general practices and a control group, to enable a rigorous evaluation of the outcomes. Participation will be voluntary for consumers and healthcare providers.

Diabetes is a major problem for Australia’s healthcare system.  The DCP will evaluate the impact of four changes: an integrated information and technology system, a new model of funding, the inclusion of a Care Facilitator in the care team, and an education and training program that builds capabilities related to the project and overall care management.:

Information and technology system

For patients, clinical measures, appointment dates, referrals, and other beneficial information will be available online or in hard copy. For practitioners, an IT tool will provide a means of common communication, up-to-date monitoring of outcomes, and facilitate the rapid creation of care plans.

New flexible funding model, including quality improvement support payments

A new flexible funding model that involves a lump-sum payment per patient to general practices will increase financial viability and replace General Practice Management Plans, Team Care Arrangements and their reviews. Quality improvement support payments to promote patient experience and clinical quality, and funding for training and Care Facilitators will also be introduced. This system will increase resources for primary care, allocate additional funding to those most in need, increase flexibility and reward high-quality care. It is important to note that this system will not replace MBS items for regular General Practitioner (GP) visits which will continue to be claimed on a fee-for-service basis.

The introduction of a Care Facilitator

The project will evaluate the effectiveness of a new Care Facilitator (CF) role to support GPs, AHPs and people with diabetes. CFs will collaborate closely with GPs, Practice Nurses and other healthcare professionals to promote timely, risk-based intervention for those in need, reduce the time spent on administrative tasks, and improve ways of working and communicating within care teams.

Education and training program

Participants will also be supported by in-person, online, and paper-based training and education. This will be designed to improve people’s understanding of diabetes management, from both a patient and practitioner viewpoint, and equip participants to navigate the existing landscape of resources.

Through the above key enablers, the project is designed to mutually benefit all participants, specifically:

• Consumers > will benefit from increased transparency over the management of their condition, increased empowerment to more effectively manage their diabetes and greater resources for those with greatest needs.
• General practices > will benefit from more flexibility in managing care for people with diabetes, greater visibility over the integrated care of patients and their own performance, reduced administrative burden and flexibility to leverage practice staff, and access to cross-profession training and education.
• AHPs > will benefit from greater involvement in patient care and the wider care team, increased visibility of patient information and integrated care, increased flexibility in delivery of care supported by new funding model, and access to cross-profession training and education.
• Specialists > stand to benefit from reduced unnecessary referrals, greater involvement in patient care and wider care team, and increased visibility of patient information and integrated care

At the end of the pilot implementation phase, the groups will be compared to evaluate whether these new models of care can deliver better quality healthcare outcomes, enable care to be provided in more flexible ways, improve patient and practitioner experiences, and prove economically sustainable and scalable nationally.

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Page updated 11/11