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Needs assessments in primary health care provide information to plan and change services, with the ultimate goal of improving the health of a population. It is the first step in health care services planning, and involves identifying and analysing a region’s health problems and potential target group. For the purposes of this report, need was defined as “the population’s ability to benefit” as this lends itself most usefully to health services planning. This report also reflects on International and Australian models that may inform approaches to needs assessments in Australia.

People with low levels of health literacy report poorer health status and experience poorer health outcomes compared to those with good health literacy. Poor health literacy is most prevalent in socio-economically disadvantaged populations, which are often in greater need of health care to manage complex conditions. In recognition of its potential positive impact on health outcomes, improving the health literacy of populations is being incorporated into policy. This RESEARCH ROUNDup reports on some recent developments in health literacy research and the role of primary health care in enhancing health literacy to improve health outcomes.

Most people, at some time in their lives, will require health care services from multiple health care providers, whether it is for short-term unexpected ill health, long-term chronic conditions or co-morbidities that cross disciplines (eg. substance-related conditions and mental health). Integration of health services is particularly important for patients with chronic and complex conditions as they must frequently negotiate a path through different health care sectors, including primary, acute and ambulatory care services, as well as the public and private health jurisdictions. Standardised pathways for the more common chronic conditions may be needed to enable seamless transitions and avoid negative outcomes that may result from delays, duplications and errors in a system that operates as multiple independent organisations.

Australia currently accepts over 13,000 refugee entrants each year. A refugee is a person who, “owing to a well founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside of the country of his nationality and is unable or owing to such fear is unwilling to avail himself of the protection of that country”. An asylum seeker is a person seeking protection as a refugee but whose claim is still being reviewed. The application process may take considerable time. Refugees are provided with the same rights to healthcare as other Australian permanent residents, however asylum seekers have complex visa conditions and not all are eligible to use Medicare funded services. This RESEARCH ROUNDup examines the health needs and associated primary health care challenges for refugees and asylum seekers in Australia.

A well coordinated health system provides a comprehensive and continuous experience for the patient, promotes teamwork between practitioners, and the coordination of service delivery organisations. Improving teamwork between General Practitioners (GPs) and Allied Health Providers (AHPs) has been an ongoing challenge for Australia due to the split responsibility for primary health care between Commonwealth and State jurisdictions leading to incompatible systems of funding and accountability. Integration of services at the regional level has been identified as a priority in Australia’s Primary Health Care Strategy. This issue of RESEARCH ROUNDup highlights Australian research and systematic reviews that have addressed the role of teamwork in system integration in primary health care.

Patient-centred care, a fundamental tenet of quality healthcare, means delivering services which respond to and are sensitive to the needs and wishes of the consumers or patients. Without systematic ways of collecting information about patients’ experience of the health care system, a vital perspective is missing from efforts to improve the quality of care. Submissions to the draft National Primary Health Care Strategy identified that consumer satisfaction, holistic care, equity of access, and obtaining feedback from users are some areas which are appropriate for performance management via indicators.

This Policy Issue Review is an overview of enrolment models relevant to Australian primary health care. A predetermined report structure was designed, reflecting the dimensions of the study questions, and searching was targeted, seeking information sources to answer specific, predetermined questions. Google, Google Scholar and Pub Med were used to locate information sources and supplemented by existing PHC RIS resources and bibliographic references.

The announcement in January 2009 of funding of $5.6 million for cancer research and a Primary Care Cooperative Cancer Clinical Trials Group to focus on prevention, detection and care of people with cancer comes after the call by a number of commentators for an expanded role for primary health care in the care of people with cancer. Some recent studies have shown that transfer of care from hospitals and specialists to general practitioners is safe and effective. However recent Australian research on service design to support cancer care in primary health care is limited, with most research focussing on the differences between care in urban and rural areas. The forthcoming evaluation of the Cancer Service Networks National Demonstration Program (CanNET) will fill a much needed gap in our research knowledge.

A number of barriers and facilitators to an expanded role for practice nurses have been identified. These include legal and funding issues related to the lack of a system-level model, poor role definition for practice nurses, lack of space available in general practices and GP attitudes. Inter-professional issues, medico-legal concerns and a poorly defined scope of practice need to be addressed while a defined educational and career pathway for practice nursing to attract nurses to general practice is needed.

This literature review was completed to inform the development of the Access to Psychiatry component of the Better Outcomes in Mental Health Care Initiative., This literature review is about general practitioners and psychiatrists working together in the interest of their patients, how it has been done over the last twenty or so years and what has been learned. What has become clear with this review is that General practitioners and psychiatrists do not work in isolation. Both are dependent on systems of remuneration, fee-for-service and Medicare in the case of GPs and private psychiatrists, Government funding from many different ‘buckets’ for the Divisions of General Practice and State Mental Health funding in the case of publicly employed psychiatrists and mental health workers. Thus working together involves the interaction of professional cultures, systems and bureaucracies, not to mention pharmaceutical companies., Better Outcomes in Mental Health Care Initiative; Access to Psychiatry Primary Mental Health Care Australian Resource Centre (PARC)

This literature review was commissioned by the Commonwealth Department of Health and Ageing to inform the development of the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative., Looks at current arrangements for peer support/supervision in Australia in a number of professions which undertake psychotherapy. .A number of different models and issues are examined. The need for peer support/supervision for GPs undertaking psychotherapy is also assessed and an argument is made for its necessity., Commonwealth Department of Health and Ageing Better Outcomes in Mental Health Care Initiative.

This literature review was commissioned by the Commonwealth Department of Health and Ageing to inform the development of the Access to Allied Health Services component of the Better Outcomes in Mental Health Care Initiative., This review looks at psychotherapy and counselling services in primary health care provided by persons from the Allied Health Professions. The report makes a number of recommendations regarding location of the service, fundholding and employment, practitioner support, reporting and confidentiality., Commonwealth Department of Health and Ageing Better Outcomes in Mental Health Care Initiative.

Part of the Primary Mental Health Care Australian Resource Centre (PARC) knowledge management strategy for the Primary Mental Health Care Network., This discussion paper describes the mental health activities of Divisions of General Practice (DGPs) operating in remote areas of Australia , and documents the knowledge of the people who work in these programs., Primary Mental Health Care Australian Resource Centre (PARC) Primary Mental Health Care Network.