Commissioning for health and community sector reform: perspectives on change from Victoria

Commissioning health and community services is a complex task involving planning, purchasing and monitoring services for a population. It is particularly difficult when attempting system-level reform, and many barriers to effective commissioning have been documented. In Victoria, the state governmen...

Full description

Saved in:
Bibliographic Details
Published in:Australian journal of primary health 2020-01, Vol.26 (4), p.332
Main Authors: Silburn, Kate, Lewis, Virginia
Format: Article
Language:English
Subjects:
Accountability
Alcohol
Commissioning
Community health
Community health care
Community mental health services
Community services
Community support
Complex tasks
Disruption
Drug abuse
Drugs
Funding
Government agencies
Interviews
Medical treatment
Mental health
Mental health services
Performance management
Planning
Reforms
Rural areas
State government
Substance abuse
Substance abuse treatment
Supporters
Tendering
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Commissioning health and community services is a complex task involving planning, purchasing and monitoring services for a population. It is particularly difficult when attempting system-level reform, and many barriers to effective commissioning have been documented. In Victoria, the state government has operated as a commissioner of many services, including mental health community support and alcohol and other drug treatment services. This study investigated the perceived consequences of a reform process in these two sectors after recommissioning was used as a mechanism to achieve sector-wide redesign. Semi-structured interviews were conducted with 23 senior staff from community health, mental health and drug and alcohol services 6 months after implementation. The process was affected by restructuring in the commissioning department resulting in truncation of preparatory planning and technical work required for system design. Consequently, reform implementation was reportedly chaotic, costly to agencies and staff, and resulted in disillusionment of enthusiastic reform supporters. Negative service system impacts were produced, such as disruption of collaborative and/or comprehensive models of care and strategies for reaching marginalised groups. Without careful planning and development commissioning processes can become over-reliant on competitive tendering to produce results, create significant costs to service providers and engender system-level issues with the potential to disrupt innovative models focused on meeting client needs.
ISSN:1448-7527
1836-7399
DOI:10.1071/PY20011