Executive Summary

Country SA PHN covers rural and remote South Australia. Our mission is to bridge the gap of health inequality and access in rural South Australia by building a collaborative and responsive country South Australian health care system.

Summary

The Country SA PHN Needs Assessment 2022-2025 builds on previous Needs Assessments. It further investigates the health needs of country South Australian communities, the corresponding required services and identifies populations and communities which may be particularly disadvantaged.

Using an iterative approach, information is gained between submissions, including emerging needs to be incorporated to refresh analysis and triangulation for action. Over time, it is expected that large parts of the documentation will remain static. This reflects the incremental shifts in population demographics, health risk behaviour, disease prevalence and improvements in health outcomes in response to implemented initiatives or other factors. Country SA PHN incorporates various organisational processes to facilitate Needs Assessment activity, including internal governance to oversee development and continuous improvement.

Integrating data available publicly or obtained confidentially from the Australian Department of Health and key partners such as SA Health and the six South Australian regional Local Health Networks, Country SA PHN also utilises evidence obtained through stakeholder consultation.

A triangulation matrix approach bringing together information and data sourced from various agencies was applied to synthesise and triangulate the finding of the health and service needs analysis and identify key issues and themes. The analysis affirmed Country SA PHN priorities have not shifted from the previous Needs Assessment and remain current. Naming conventions were adjusted to support improved clarity in communication of priorities and identified needs.

A range of indicators associated with these priorities can be measured to assess both absolute and relative levels of health and service needs in the many Country SA PHN communities. These indicators include demographic, health status and risks, and service statistics. These indicators provide information about the issues and the locations where Country SA PHN can contribute to improving health outcomes through strategic commissioning activities, leadership, and collaboration in the coordination and integration of services.

Stakeholder and community views serve to complement and contextualise information gathered from regional health and health service statistics. As such, they represent an essential element of both the needs assessment process and ongoing activity planning and implementation. Country SA PHN developed a stakeholder consultation strategy (20202022) to improve our knowledge and understanding of regional characteristics and community needs, and effectively inform the Needs Assessment. Consultation activity relative to priority health and service needs is embedded within Country SA PHN business through a collection of mechanisms including forums, workshops, meetings, online surveys and other opportunities for input and feedback. Consultation represents a wide coverage of stakeholders including; SA Health, Wellbeing SA, six regional Local Health Networks, Country SA PHN Clinical Council, Country SA PHN 11 Local Health Clusters, state and regional network groups, service providers and health professionals in the region, and community members.

Consultation information is incorporated in this report within overall health and service needs analysis, and at times highlighted in Community Voice.

As part of a continuous improvement approach, an evaluation of the Needs Assessment process will be completed following submission of the report. The result of which will inform the process going forward including; planning and operational approach, data and analysis approach, systems and resources.

Additional Data Needs and Gaps

The needs assessment process highlights the importance of investigating chronic conditions and their risk factors, including resultant progression to multimorbidity, to fully realise opportunities for primary and secondary prevention in future Country SA PHN work. Commonly identified examples include; type 2 diabetes, cardiovascular disease, chronic kidney disease, as well as chronic pain, which can relate to a wide range of other chronic conditions including the afore mentioned, arthritis, cancer and depression or pain resulting from another unresolved issues or injury.

However, the magnitude of these disease burdens and service needs are likely to be underestimated owing in part to the difficulty of timely diagnosis along with the difficulty in obtaining accurate statistics, especially at the small area level.

Moreover, the interrelated nature of socioeconomic determinants, risk factors, and health status, suggests that acting on any one of the principal needs identified in this report will positively impact on other needs, stated or unstated. In addition, missing a key need relevant to service access, even where the actual need is located further upstream and not necessarily within the purview of Country SA PHN, risks diminishing the success of programs designed to increase service availability and appropriateness

The data illustrates that remote regions within our catchment are predominantly home to higher concentrations of disadvantaged populations with less equitable access to services than the rest of South Australia and indeed, Australia. There is a continuing need to investigate and advocate for services that enable access to services in rural and remote regions that are critical to improving health and wellbeing but are not within the remit of PHNs. The issue of transport availability as a determinant of access to service is raised consistently across the region as an important issue impacting on health service access and utilisation. Continuation of activities in a local setting, supplemented with or totally replaced with innovative solutions, palatable to consumers and providers, needs further investigation

Data collection and analysis is an ongoing process that represents an integral part of systematic stakeholder engagement and collaboration in Country SA PHN’s commissioning cycle. As pointed out above, there continues to be gaps in the data currently available to Country SA PHN, some of which will be addressed through continual service mapping. This includes data on private providers in the allied health, aged care and disability spaces for which assessment of the actual level of care and operating hours, including afterhours, are made available by providers.

Stakeholder consultations have been integrated into the agreed mission of both Clinical Councils and the Local Health Clusters (Community Advisory Committees). These permanent structures provide a springboard for periodic consultations with the wider community to obtain a broad and localised perspective, including the views of hard-toreach consumers. Meaningful engagement and consultation with consumers, carers, local councils, and localised service providers are essential to provide context and add affirmation to data and priorities obtained through more traditional research and needs analysis modalities. In addition, the translation of the results from the needs assessment into service design and commissioning depends on an accurate understanding of existing local context

Country SA PHN continues to work with key partners in undertaking the continuous consultation and engagement needed for joint planning with the newly formed regional Local Health Networks. The continuation of efforts will be crucial to ensuring effective and informed commissioning not only in general and mental health, but in all priority areas

Requirements for further developmental work relate predominantly to (1) continuing comprehensive, in-depth service mapping; (2) obtaining and analysing quality practice data from a range of general practices throughout the region, and (3) building and refining stakeholder engagement structures that enable ongoing consultation. These three requirements will form the foundations of ongoing Country SA PHN activities.