Evaluation of the GP Super Clinics Program 2007-2008

7.4.5 Differences in Organisational Models

Page last updated: 2012

Organisational models in primary care have been demonstrated to impact on performance.76 Criteria to assess performance included those related to patient experience, access, population coverage, response to vulnerable clients and a range of productivity measures.76 Models of primary care which had population-based responsibility, strong integration into health network activities, a broad range of services and access through walk-in clinics or by appointment performed better against all criteria than other models.

All GP Super Clinics participating in this aspect of the evaluation provided multi-disciplinary care despite differences in the organisational and business models. Variations in structure, ownership and business models were noted. The GP Super Clinics National Program Guide 2008 was deliberately flexible in describing the requirements for the organisational, business and service delivery models. This has proved critical in attracting a variety of applicants, who have demonstrated both a commitment to the models of care, and the adoption of business models to ensure a sustainable approach to enhanced primary care in the local communities.

The organisational model which appeared to have the most difficulties was where there was a third party contract arrangement. This occurred where a state health service was the successful applicant for the GP Super Clinic but sub-contracted that arrangement to a third party or where the funding recipient split asset holding and operational entities to mitigate risks to ownership of the property asset should financial viability be an issue. As in any third party contractual arrangement, this model has inherent risks which need to be identified and managed, particularly in instances where the contractor’s objectives and those of the GP Super Clinics Program may not totally align. This was further complicated by the indirect, third party communication and reporting arrangements between the GP Super Clinic and the Department of Health and Ageing, which in the opinion of the evaluation team was ineffective and inefficient.