1. Sandy Austin Director Health and Aged Care North and Western Metropolitan Region NWMR Health & Wellbeing Implementation Strategy …the implications are clear. Without change, our health system will not be able to meet our future needs. Victorian Health Priorities Framework 2012-2022

2. Wicked Problems for Health and Wellbeing The Victorian Health Priorities Framework 2012-2022 states that the implications are clear. Without change, our health system will not be able to meet our future needs. Health and wellbeing issues confronting society include – increasing obesity rates – increasing trends in chronic health conditions e.g. diabetes – ageing populations – rapid population growth – spiralling health care costs Source: Australian Public Services Commission (2007) Tackling Wicked Problems A Public Policy Perspective, Commonwealth of Australia, Canberra, ACT.

3. Fifth Wave FIRST WAVE Water/Sanitation SECOND WAVE Scientific breakthroughs THIRD WAVE Social security/Medicare FOURTH WAVE Risk factors and lifestyle FIFTH WAVE Complex adaptive system thinking Source: Hanlon et al (2011) Making the Case for a Fifth wave in public health 1830 - 19001890 - 1950 1940 - 1960 1960 - 2000 2011 +

4. Fifth Wave Aspects of this fifth wave include 1.Complex adaptive systems 2.Reframe our thinking 3.Rebalance our models 4.Rebalance our orientation 5.Iterate and scale up Source: Hanlon et al (2011) Making the Case for a Fifth wave in public health

5. Victorian Health System reform Primary Health Care Planning – in partnership with the Commonwealth Mental Health System – recovery focus Alcohol and Other Drugs – Whole of Govt Strategy and AOD Treatment System Reform Aged Services – Healthy ageing and Active Service Model State Health and Wellbeing Plan – Prevention Community Model

6. Victorian Public Health and Wellbeing Plan 2011- 2015

7. The goal of the Plan Improve the health and wellbeing of all Victorians by engaging communities in prevention, and by strengthening systems for health protection, health promotion and preventive health care across all sectors and levels of government.

8. Achieving our goals Two main achievements of the Health and Aged Care NWM Regional Office: 1.Reoriented ourselves and how we interface with our stakeholders 2.Broadened and enhanced the authorising environments

9. 1. We reoriented ourselves and how we interface with our stakeholders Well Population At Risk Prevent movement to at risk group Prevent progression to established condition Established Conditions Prevent/delay progression to complications Complex Conditions NWMR Regional Operating Model

10. Area based approach to system management and population health planning Improve ability of Health and Aged Care (H&AC) to identify priorities and address service gaps and inequities in local communities. Build capacity within H&AC programs and NWMR funded agencies through organisational and workforce development. Increase efficient and effective work practices in H&AC by streamlining communication with funded agencies i.e. Lead PASA role.

11. Place A place or area usually ranges from a neighbourhood to a local government area which differs considerably in size and population density. Thus, place-based interventions may use varying definitions or size boundaries for place. VicHealth (2008) People, Places, Processes Reducing health inequalities through balanced health promotion approaches, Victorian Health Promotion Foundation, Carlton.

12. Key functions of H&AC Teams We are Population Health Developers We are Health System Managers We are System Integrators ACUTE GOAL D: Building our own workforce and system capacity to influence change Public health and wellbeing is promoted and protected Reduced harm and impact from substance use, mental illness and health conditions Independence and health for longer Service system integration The health system anticipates and responds to independence needs The health system operates with raised efficiency to meet rising expectation and demand Stakeholders inside & outside the health sector make health and wellbeing part of their core business GOAL B: Improved health equity for those most vulnerable / disadvantaged GOAL A: Improved health and wellbeing of all people within our region GOAL C: Integrated health system that is responsive to peoples needs Well Population At Risk Established Conditions Complex Conditions Prevent movement to at risk group Prevent progression to established condition Prevent/delay progression to complications AGED SERVICES Regulation Regional operations Evidence translation Program implementation Resource & Performance Policy interpretation and development INW N W Operating Model Health and Aged Care North and West Metropolitan Region Department of Health

13. We are System Managers Organisational Structure Northern Area Manager Team Leader Lead PASA Manager Team Leader Lead PASA Manager Team Leader Lead PASA Inner North West Area Western Area

14. National State Regional Sub-regional Local Local Government Round Table meetings Support to individual Councils and organisations Support for integrated local area/catchment planning HACC rolling consultations Active Ageing in Place - HACC Population Health Short Course MPHP Evaluation – University of Melbourne Engaging RMF members to tackle employment, transport, education, secure housing 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 Support Implementation of Victorian Public Health and Wellbeing Plan Support Melbourne Metropolitan Strategy Australian Urban Research Infrastructure Network 2. We broadened and enhanced the authorising environments

15. NWM Regional Management Forum NWM Regional Management Forum Chair: Jim Betts, DoT Secretary Regional Directors Local Council CEOs DHS DH DPCD DEECD RDA DoT DoJ 14 Local Councils GAA DSE DBI DTF VicRoads VicPol CFA

16. WHO Healthy Cities Governance framework (WHO, 1997)

17. Regional Management Forum – Key Outcomes 1. Identification and commitment to key priorities –Creation of local jobs –Public transport –Education –Secure housing (DoJ priority) 2. Integrated Data Working Group – AURIN/ANDS Demonstration Projects 3. Integrated Planning Forums

18. Alignment of State and municipal public health and wellbeing planning 2011201220132014201520162017 October 2012 Local government elections June 2013 Council plans October 2013 MPHWPs October 2016 Local government elections October 2017 MPHWPs June 2017 Council plans November 2010 Victorian government election September 2015 Victorian Public Health and Wellbeing Plan November 2014 Victorian government election September 2011 Victorian Public Health and Wellbeing Plan 2018

19. Special mention: Dr. Iain Butterworth for his expert and engaging leadership