A Regional Health and Wellbeing Implementation Strategy for

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					A Regional Health and Wellbeing Implementation
Strategy for Melbourne’s North and West
Metropolitan Region: Harnessing the capability
of the Regional Management Forum




Dr Iain Butterworth
Manager, Public Health NWMR
WHO Healthy Cities Model (Hancock, 1993)
                           Preliminary potential pathways of
                             social determinants of health
                                                          Car dependency –




                                                                                Overweight and
                                                           increased VMT




                                                                                   obesity
                                 Reduced access to
 Low density housing in        amenity, community                                                Chronic disease (CVD,
                                                              Inactivity
 new areas on the fringe        services and public                                                Diabetes, Cancer)
                                     transport
                                                            Sedentariness


                                                            Reduced use of
                                                          community services




                                                           Drug and alcohol




                                                                               isolation
                                                             dependence                          Chronic disease (Mental




                                                                                Stress,
                                                                                 social
                             Affordability of living on                                              health, CVD)
Affordability of housing
                                      fringe
                                                           Family violence


                                  Increased VMT
                                                          Domestic violence
Lack of local employment                                                                             Slide source:
      opportunities                                                                                  Prof Billie
                               High unemployment                                                     Giles-Corti
                                                            Youth violence
Population Health


“concerned with improving the health of
whole populations or specific
populations, particularly to reduce
health inequities, through policies,
programmes, research and
interventions designed to protect and
enhance health”

  Victorian Healthcare Association, www.vha.org.au/page/1111.html
                                                                                                                                                                                                                                                                    We are “Population Health
                                                                       Operating Model
                                                                                                                                                                                                            • Public health and wellbeing
                                                                       Health and Aged Care                                                                                                                  is promoted and protected




                                                                                                                                                                                                                                                                          Developers”
         North and West Metropolitan Region                                                                                                                                                    GOAL A:
                                                                                                                                                                                              Improved
                                                                       Department of Health                                                                                                  health and • Independence and health
                                                                                                                                                                                             wellbeing of   for longer
                                                                                                                                                                                              all people
                                                                                                                                                                                              within our
                                                                                                                                                                                                region    • Reduced harm and impact
                                                                                                                                                                                                             from substance use,
                                                                                                                                                                                                             mental illness and health
                                                                                                                                                                                                             conditions




                                                                                                                                                                                                                                                                                                              We are “System Integrators”
                                                                                                                                                                                                                                                                                                              We are “System Integrators”
                                                                                                                                                                                                                                   AGED SERVICES
                                                                                                                                                                                               GOAL B:
                                                                                                                                                                                              Improved
                                                                       GOAL D:                                                                                                              health equity
                                                                   Building our own                                                                                                        for those most




                                                                                                                                                                                                                                                   progression to
                                                                                                                                                                                                                                                    established
                                                                                                                                                                                                                                                    established
                                                                 workforce and system                                                                                                       vulnerable /




                                                                                                                                                                                                                                                     condition

                                                                                                                                                                                                                                                      Prevent
                                                                 capacity to influence                                                                                                     disadvantaged
                                                                        change




                                                                                                                                                                                                                                                                            We are “Health System Managers”
                               Policy interpretation and development




                                                                                                                                                                                                               • The health system
                                                                                                                                                                                                                 operates with raised
                                                                                                                                                                                     INW                         efficiency to meet rising
Service system integration




                                                                                                                                                                                                                 expectation and demand
                                                                         Program implementation


                                                                                                  Resource & Performance




                                                                                                                                                                                               GOAL C:
                                                                                                                                                                                              Integrated
                                                                                                                                                              Evidence translation
                                                                                                                                        Regional operations




                                                                                                                                                                                                 health        • The health system
                                                                                                                                                                                      N      system that         anticipates and responds
                                                                                                                                                                                            is responsive        to independence needs
                                                                                                                           Regulation




                                                                                                                                                                                              to people’s
                                                                                                                                                                                                 needs         • Stakeholders inside  &
                                                                                                                                                                                     W                           outside the health sector
                                                                                                                                                                                                                 make health and wellbeing
                                                                                                                                                                                                                 part of their core business


                             Key functions of H&AC Teams
Victorian Health Priorities Framework
2012 - 2022
Victorian Public Health and Wellbeing Plan
2011-2015
                             Municipal Public Health Plans
                             Local governance structures


                              Primary Care Partnerships
               Primary Care and Population Health Advisory Committees
                    Community and Women’s Health IHP networks
                Growth Areas Authority Infrastructure Working Groups
                   Regional Development Australia (Western Region)
                                   Divisions of GP
                           DH NWMR area-based approach

                             Regional Management Forum
                               DH NWMR Strategic Plan
                          Regional Health and Wellbeing Plan
                   North Western Metropolitan Regional Team DPCD
                        Melbourne 2030/ Melbourne @ 5 Million
                          Metropolitan Health Plan 2012 - 2022
               Other regional governance networks, e.g. Closing the Gap

                       Victorian Public Health & Wellbeing Act 2008
                                  DH Strategic Directions
                   Victorian Public Health & Wellbeing Plan 2011 – 2015
                     Victorian Population Health Advisory Committee
Other state-level health strategies, e.g. Women's and Men’s health & wellbeing strategies



                              National Prevention Agenda
                National Partnership Agreement on Preventative Health
                                         COAG
NWM Regional Management Forum

                                    DBI

                       VicRoads


                                                                   CFA
   14 Local Councils                NWM Regional
                                     Management
                                       Forum                        VicPol


     DTF                           Chair: Jim Betts,                 GAA
                                    DoT Secretary
      DoJ
                                  Regional Directors
                                                                   DoT
                                  Local Council CEOs
      DHS


             DH                                              RDA
                         DPCD
                                                       DSE
                                          DEECD
NWMR Health and Wellbeing Implementation
Strategy


1. Promote Integrated Planning
• Interpret the overarching goals of the Victorian Public
  Health & Wellbeing Plan 2011-2015
• Secure and support decisive inter-sectoral
  collaboration, led by the NWM Regional Management
  Forum, to promote population health;
• Support the RMF to develop achievable strategies for
  leading and stimulating integrated, coordinated
  investment for local government
NWMR Health and Wellbeing Implementation
Strategy


2. Provide Tools

• Provide the RMF with useful, practical tools for building on
  current regional and local efforts

• Generate the evidence base to document the efficacy of this
  intersectoral approach and the lead role played by the RMF.

• Show how the RMF can add value to existing work across
  the region

• Assist the Region to build its research capability and develop
  an integrated data platform by linking the RMF to the existing
  Partnership between the Department of Health NWMR,
  Department of Human Services NWMR and Melbourne
  University
NWMR Health and Wellbeing Implementation
Strategy


3. Support Existing Policies across NWMR


• Provide an overarching operating framework for
  population health to be applied and demonstrated
  across Dept Health portfolios, between government
  agencies and other stakeholders;
The NWM Regional Management Forum




                                 DBI

                    VicRoads


                                                                 CFA
14 Local Councils                NWM Regional
                                  Management
                                    Forum                         VicPol


  DTF                           Chair: Jim Betts,                  GAA
                                 DoT Secretary
   DoJ
                                Regional Directors
                                                                 DoT
                               Local Council CEOs
   DHS


         DH                                                RDA
                      DPCD
                                                     DSE
                                       DEECD
How the NWM RMF and Victorian Prevention and
Population Health Advisory Board can influence each other

                                                                           Victorian Prevention and
                                                                           Population Health Advisory
                                                                           Board

                                                                           Secretaries of
                                 DBI                                       •DH
                                                                           •DoT
                    VicRoads                                               •DEECD
                                                                           •DPCD
                                                                 CFA       •DSE
14 Local Councils                NWM Regional
                                                                           •DoJ
                                  Management                               •DHS
                                    Forum                         VicPol   •DPC

  DTF                           Chair: Jim Betts,                          •EPA
                                                                   GAA
                                 DoT Secretary                             •VACCHO
                                                                           •VicHealth
   DoJ                                                                     •MAV
                                Regional Directors                         •Cancer Council
                                                                 DoT
                               Local Council CEOs                          •National Heart Foundation
   DHS                                                                     •School of Population Health,
                                                                           University of Melbourne
         DH                                                RDA
                      DPCD
                                                     DSE
                                       DEECD
How the NWM RMF and Victorian Prevention and
Population Health Advisory Board can influence urban form

                                                                           Victorian Population an
                        Melbourne Metropolitan Strategy:                   Prevention and Health Advisory
                        Interdepartmental Governance Group                 Board

                                                                           Secretaries of
                                 DBI                                       •DH
                                                                           •DoT
                    VicRoads                                               •DEECD
                                                                           •DPCD
                                                                 CFA       •DSE
14 Local Councils                NWM Regional
                                                                           •DoJ
                                  Management                               •DHS
                                    Forum                         VicPol   •DPC

  DTF                           Chair: Jim Betts,                          •EPA
                                                                   GAA
                                 DoT Secretary                             •VACCHO
                                                                           •VicHealth
   DoJ                                                                     •MAV
                                Regional Directors                         •Cancer Council
                                                                 DoT
                               Local Council CEOs                          •National Heart Foundation
   DHS                                                                     •School of Population Health,
                                                                           University of Melbourne
         DH                                                RDA
                      DPCD
                                                     DSE
                                       DEECD
WHO Healthy Cities Governance framework
(WHO, 1997)
Diagram: Regional ‘strategy’ will link State- and local-level activity
                Victorian Public Health & Wellbeing Plan 2011-2015

                   Regional Health & Wellbeing Implementation Strategy

     Potential
   Ginger Group                     Regional Management Forum                         Melbourne
   NGOs, NWMR                          Local Council CEOs,                             University
     community                           Regional Directors                           Partnership
    leaders and
       thinkers
                                   Project Steering Group

                    Regional Health & Wellbeing Strategy Project Team

                     Western                Inner NW                  Northern
                     Area-                  Area-                     Area-
                     based                  based                     based
                     Group                  Group                     Group

   Integrated sub-regional engagement of: Municipal Public Health Planning, Primary Care Partnerships,
  Medicare Locals, Integrated Health Promotion, Community Health, Primary Care and Population Health
 Advisory Committees, Active Service Model, transport, housing, employment, economic development, food
       security, alcohol and drugs, spatial planning, infrastructure planning, Closing the Health Gap …
Regional Management Forum Consultations



• Prof Billie Giles-Corti, Executive Director, McCaughey
  Centre
• Stephanie David, DH NWMR




• Five Regional departments
• Growth Areas Authority
• Five Councils
  Priorities: what would have most impact on health
  and wellbeing issues in north and west region?

Local Government                                                  State Government

Family violence                                                   Increase employment opportunities for
                                                                  youth/families
addressing social determinants of family violence as well as
services (e.g., pilots across region)                                    Regional workforce training
Mental health                                                     Affordable housing with access to health
                                                                  services, PT and schools
address social determinants i.e., lack of local jobs, no public
transport, as well as services
                                                                  Managing population growth in well planned
New service models for delivery of health and                     communities with social infrastructure
mental health services (serviced by public
transport)                                                                Increasing access to public transport and encouraging
                                                                  active transport
Affordable living                                                         Increasing access to health and community services
                                                                                 •     Preventive and reactive
Healthy walkable communities                                              Increasing local access
POS, school, roads                                                Whole of government approach to one issue and
Access to public transport                                        all work on that e.g., the creation of jobs in
Local jobs – particularly for youth                               region

Access to education to up-skill residents                         Create sub-groups on work on priorities

Food – food security, food-related illnesses, food                Practical solutions with focus on deliverables
production
                                                                  Community engagement, but management of
                                                                  expectations
         Slide source: Prof Billie Giles-Corti
    Enablers


Local government
                                                  State government
Economic model/mechanism for development
and delivery of infrastructure                    A different approach to planning with a focus on
                                                  transport infrastructure
RMF
                                                  Re-prioritising the way resources are used
Role clarification – what can it achieve?
Develop a practical deliverable plan              Well targeted
Bring people together – driven by a coordinator
                                                  Could focus on hot spots – most disadvantaged communities - in region
                                                  Practical with deliverables and seen to be so by
Data – base strategy on needs                     people around the table

State government support and relevant             Reduce size of RMF?
Ministers and local members
                                                  Break off into North and West and inner
                                                  Growth areas (including those in established areas0 and established
Change poly-centric nature of Melbourne
                                                  Gaining support of government/ministers
Commitment and relationships
                                                  Non-government advocacy for action
Work out how to overcome barriers
                                                  Vision – focusing on changing behaviour

    Slide source: Prof Billie Giles-Corti         Incentivize to build things differently
Key opportunities for RMF


1. Creation of local jobs
2. Public transport
3. Education
4. Secure housing (DoJ priority)
Key opportunities for RMF


1. Creation of local jobs:
Business development incentives for local businesses /
         industries that suit local skills and import $ into region
Increase access to local community, health and mental health
         services
Innovative service delivery models
Infrastructure required to house new services




Slide source: Prof Billie Giles-Corti
Key opportunities for RMF


2. Public transport
Linked to local services
Local public transport – alternative services models required?




Slide source: Prof Billie Giles-Corti
Key opportunities for RMF


3. Education


Educational opportunities
Up-skills local residents
Keep trained people in the area




Slide source: Prof Billie Giles-Corti
Key opportunities for RMF


4. Secure housing (DoJ priority)
Regional Issues identified at Health and
Aged Care rolling consultations May 2011

Participants at the May rolling     Issues identified by Regional
engagement process identified       Management Forum:
six main areas for future service
delivery:

• Workforce                         • Educational Opportunities

• Client Complexity                 • Creation of local jobs

• Service System & Demand           • Public transport
  Management                        • Secure Housing
• Ageing Population

• Transport – Community & Public

• Growth
Regional Health & Wellbeing Implementation
Strategy: Next Steps

•   Multi-pronged approach to tackle employment,
    transport, education, secure housing
•   Supports Melbourne Metropolitan Strategy
•   Support for integrated catchment planning
•   Integrated Planning Conference December 7-8
•   DH NWMR Regional engagement
•   RMF Regional Directors’ working group to support
    local government
•   RMF Integrated Data Working Group
•   Melbourne University Research 2011-2014: Planning
    Liveable and Sustainable communities in growth
    corridors
Thank you




      iain.butterworth@health.vic.gov.au

				
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