Access and Equity
Framework
Adelaide Primary Health Network
(Adelaide PHN)
December 2024
Total population of Adelaide PHN region
1,321,481 (id profile 2023)
Over half of the Aboriginal and Torres Strait Islander population in the region is under the age of 24 years (PHIDU 2019)
25% or 262,656 residents in the Adelaide region were born overseas, predominantly from non-English speaking countries (MC NA 2024)
People in the Greater Adelaide area who identify as Aboriginal and Torres Strait Islander, comprising 1.7% of the population compared to 2.4% in South Australia and 3.2% in Australia (id profiles 2021)
The Adelaide metropolitan region is comprised of 17 Local Government Areas (id profiles 2023)
The Kaurna People are the Traditional Custodians of the Adelaide metropolitan region
The 10 birthplaces of people from non-English speaking countries were: India, China, Italy, Vietnam, Philippines, Greece, Germany, Malaysia, Afghanistan and Poland (ABS 2017)
44,334 (3.5%) people in the Adelaide PHN region who spoke a language other than English at home reported difficulty with speaking English (id community 2021).
To enable us to effectively engage with communities and co-create aligned solutions, we are guided by the Quintuple Aims in our commissioning cycle.
Commissioning Framework
Partnering together
The focus on Quintuple Aims of patient experience, population health, reducing costs, care team wellbeing and health equity means that APHN alone cannot achieve equity of access to primary care services – we know it will take a whole community and take an ecosystem approach
To do this, we use the following key community engagement strategies.
1
Listen first
We create spaces for community members to share their experiences, challenges and ideas.
3
Build local capacity
2
Co-design solutions
We work alongside community members to design interventions that truly meet their needs.
4
Celebrate success
We recognise and amplify communityled achievements, fostering a sense of ownership and pride
The Adelaide PHN Partnering Framework 2024 guides us in developing purposeful and sustainable relationships critical to achieving long-term equity outcomes. It provides a shared understanding of why we partner, what we mean by partnering and how we approach partnering with others.
The types of partnerships we aim to cultivate
Cross-sector collaborations
Linking health services with education, housing, employment and social services
Academic partnerships Leveraging research to inform evidencebased practices and evaluate our impact
We use an ecosystem approach, connecting partners with community and community with partners to achieve the Quintuple Aim.
Government collaborations Working with local and state governments to align policies and resources for health equity
Business alliances Engaging local businesses in creating healthier work environments and communities. Health partnerships Working with LHNs and other health service providers to join up and connect points of access for more equitable health pathways.
By focusing on and addressing all five dimensions of the Quintuple Aim patient experience, population health, reducing costs, care team wellbeing and health equity we can create a more resilient and equitable healthcare system that better serves our community's long-term needs.
We invest in training and resources that empower communities to lead their own health initiatives
Ensure that funded providers are equitable, accessible, inclusive, culturally responsive and linguistically appropriate.
Ensure commissioned services can respond to diverse whole-of-health needs as aligned to the Quintuple Aims
Build inclusive and culturally responsive and linguistically appropriate tools/criteria that focus on being person-centred and relationship-driven into procurement, selection and contracts with commissioned providers.
Build diverse representation within the organisation across governance, leadership, working, and expert advisory groups.
Build partnerships with communities experiencing health inequities and engage with them using a placebased approach underpinned by principles of codesign.
Develop more inclusive strategies to meaningfully engage community leaders and people with lived experience expertise.
Increase access while improving the experience of disadvantaged populations in primary health care services by developing local pathways with other services.
Ensure Community Council members are well connected to groups experiencing disadvantage.
Ensure diverse experts are part of working groups and expert advisory groups Facilitate knowledge sharing among working groups and advisory groups, leveraging both expert insights and lived experiences to identify and utilise individual and community strengths
Ensure community, people with lived experience and stakeholders are engaged in all stages of our commissioning process
Develop place-based co-designed solutions through partnerships with the local community, people with lived experience, organisations and other stakeholders
Strengthen partnerships with different sectors, peaks, and representative bodies to better connect local health pathways between services and industries Participate in a localised place-based multisectoral representative working group with partners to ensure ongoing pathways maintenance in addressing barriers to access and issues of inequity.
Create channels for open information, feedback and experience sharing to inform services and shape broader system thinking at a state and federal level Embed mechanisms that support meaningful storytelling and sharing of those rich insights to more widely support innovations in improving access and equity as an ecosystem.
Develop and implement data dashboards/snapshots to report impact, changes and outcomes back to the communities, partners and providers.
Ensure equity and diversity-focused tools and resources are embedded into the commissioning process to ensure increased service access to vulnerable people.
All new funding contracts include measures aligned to the Quintuple Aims
Develop and apply a health equity lens to strategic documents, planning, commissioning, reporting and quality improvement processes.
Incorporate a health equity lens and aligned tools into strategic documents, planning, design, commissioning, reporting and quality improvement processes.
Continue to invest in the capability of staff to identify and undertake quality improvement in processes, approaches, documents or projects that do not align with the APHN approach and philosophy to improving access and equity.
Review reporting mechanisms to incorporate outcomes-focused data that articulates the impact of activities and how APHN and partnerships are improving access and equity
Develop aligned measures (based on the Quintuple Aim) to be used with all commissioning contracts
Embed health equity and understanding of place-based, co-design and social determinants of health as key competencies for Adelaide PHN staff.
Provide staff with the opportunity to improve their understanding of access, inequity, place-based, co-design and social determinants of health. Enhance staff capacity to address regional inequities through targeted learning opportunities, and provide role-specific guidance to support the practical application of equity principles in daily work
Incorporate an equity agenda item in team meetings for ongoing staff input into identifying and improving existing inequity in processes and activities
Incorporate open and purposeful forums/meetings that create space for staff to engage with partners and community members to consider the complex intersectionality of barriers within and between community groups
Support primary care, funded providers and other services to ensure that services are equitable and accessible.
Improve the data collection system and reporting requirements to better capture data related to inequity, including the intersectionality of social determinants of health.
Provide opportunities for primary care providers and funded providers to improve their understanding of health equity, place-based thinking and social determinants of health
Identify support needs of funded providers and general practice teams to apply a health equity lens to existing practices and undertake quality improvement
Support regular training on health equity, social determinants of health, and a place-based approach, as well as other capacity-building activities for general practice teams and funded providers.
Inform general practice teams and funded providers about place-based approaches in their region and what they mean for them as primary care providers
Support general practice teams and funded providers in understanding new referral pathways to intersectoral services to ensure equity of access
Provide and contribute to resources on adopting a strengths-based approach in service delivery and community engagement
Incorporate key lines of enquiry regarding equity and disadvantaged groups into the Health Needs Assessment.
Develop and implement clear and measurable indicators to identify priority populations.
Use evidence-informed and best-practice approaches when developing interventions to address inequity.
Improve monitoring and population health assessment data through enhanced partnerships or relationships with agencies in domains such as housing, education, social and economic development and planning information.
Use quantitative data to identify disadvantaged groups and qualitative data (kitchen tables, focus groups, interviews, etc ) to gain a more in-depth understanding of the core issues to inform solutions
4.0
Governance, implementation and evaluation
4.1 Governance
An Adelaide PHN Access and Equity Integrated Steering Group will oversee the implementation of the objectives, activities and actions identified in the framework. The Access and Equity Integrated Steering Group will report directly to Adelaide PHN Executive Leadership.
The Access and Equity Integrated Steering Group will work closely with staff across the organisation to develop and implement a 12-month Access and Equity Action Plan The Plan will identify:
Tasks to be implemented
Completion milestones
4.2 Reporting and evaluation
Who will be responsible for the implementation of the task(s)
Effective reporting and evaluation are crucial to the success of our Access and Equity Framework. By regularly assessing our progress and impact, we can ensure that our efforts are making a tangible difference in our communities and identify areas for improvement.
Our approach to reporting and evaluation is designed to be transparent, inclusive and action-oriented, involving stakeholders at all levels of our organisation and the broader community This process not only helps us track our achievements but also fosters a culture of continuous learning and adaptation, enabling us to respond effectively to the evolving health equity needs in our region
Reporting guidelines
Implementation of the Framework will be monitored and reported to the Board, Executive and staff regularly
The implementation status of the Framework activities and actions will be reviewed at the end of 12 months, in accordance with the 12-month Action Plan, to measure progress and inform quality improvement
Access and equity performance measures will also be developed and used to establish how well Adelaide PHN improves health equity outcomes in the community
Progress in implementing the Framework, including key equity achievements, will be included in the Annual report
Queensland Government (QLD Gov), Department of Housing, Local Government, Planning and Public Works. 'What is place-based approaches?' 2024. Available at: https://www-qcoss-orgau webpkgcache com/doc/-/s/www qcoss org au/wp-content/uploads/2019/06/Place-Based-Guide-Toolkit-FINALprinciples-of-place-based-approaches-1 docx [Accessed May 2024]
Strategic Momentum Group (SMG). 'Exploring place-based as an approach at APHN Workshop.' Adelaide PHN, 2024. Available at: https://strategicmomentumgroup com [Accessed May 2024]
World Health Organisation (WHO). 'Health Inequities and Their Causes.' World Health Organization, 2018. Available at: https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes [Accessed 14 November 2024]
World Health Organisation (WHO). 'WHO Health Equity.' Geneva, Switzerland, 2024. Available at: https://www.who.int/health-topics/health-equity#tab=tab 1 [Accessed May 2024]
World Health Organisation (WHO). 'Social determinants of health ' WHO, 2024 Available at: https://www.who.int/health-topics/social-determinants-of-health#tab=tab 1 [Accessed 14 November 2024]
