This paper focuses on what can be learnt from the experiences of Primary Care Organisations (PCOs) in England, Scotland and New Zealand about the potential role of Divisions of General Practice (DGPs) and Primary Health Care Networks/Partnerships (PCN/Ps) in Australia, in addressing the challenges of ensuring access to a comprehensive range of primary health care services that are well coordinated and address population health needs. Responsibility for contracting and commissioning gives PCOs considerable leverage to influence the availability and range of primary health care services. A capitation-based funding system and associated patient enrolment enables a population focus and care over time, while aligned regional and local planning boundaries between PCOs and other health service planning boundaries also help with more coordinated approaches to planning, service development and service delivery. These elements are largely absent in the Australian health care system and set significant limitations on the role of DGPs and PCN/Ps. While DGPs can contribute to improving general practice quality and access to multidisciplinary care, and PCN/Ps can improve coordination, their scope of responsibilities and authority will need to be significantly strengthened to enable them to take a comprehensive approach to ensuring access to primary health care, service coordination and addressing population health needs.
Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey
