1. A Research Perspective 2014 NSW HEALTH SYMPOSIUM 19 June 2014 James Gillespie SESSION 3: Integrated Care and Health System Sustainability Associate Professor James Gillespie Director, Menzies Centre for Health Policy

2. A Research Perspective 2014 NSW HEALTH SYMPOSIUM 19 June 2014 James Gillespie

3. CF/KF 7 Nation Study Te Whiringa Ora (TWO) Bay of Plenty NZ Geriant, Noord Holland province, Netherlands Torbay and Southern Devon Health and Care Trust, UK The Norrtalje Model, Sweden The Massachusetts General Care Management Program The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA), Quebec, Canada HealthOne Mount Druitt, Sydney.

4. Findings High touch vs high tech Top-down v bottom up Engagement of primary care The role of ‘system spanners’

5. Conclusion Most required some ‘central’ stimulus to get going. Successful integration was initiated and led from the ‘bottom up’, with active involvement and leadership from the clinicians providing the care. Each successful local initiative had to overcome funding and other barriers to sustainability from the broader health system.

6. References Anne-marie Boxall and James A Gillespie, Making Medicare: the politics of universal health care in Australia, UNSW Press 2013 Nick Goodwin et al, Providing integrated care for older people with complex needs: Key insights and lessons from seven cross national case studies, King’s Fund/Commonwealth Fund/Health System Performance Review Network, October 2013 www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/providing-integrated-care-for-older- people-with-complex-needs-kingsfund-jan14.pdf www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/providing-integrated-care-for-older- people-with-complex-needs-kingsfund-jan14.pdf J. McNab, K Mallit and JA Gillespie (2013), Evaluation of HealthOne Mount Druitt, Menzies Centre for Health Policy, University of Sydney, available at http://ses.library.usyd.edu.au//bitstream/2123/8988/4/HOMDevaloct13.pdf Ellen Nolte, Emma Pitchforth (2014), What is the evidence on the economic impacts of integrated care? European Observatory on Health Systems and Policies. Policy Summary 11.