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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
REVIEW (Open Access)

Systems levers for commissioning primary mental healthcare: a rapid review

Carla Meurk A B E , Meredith Harris A B , Eryn Wright A B , Nicola Reavley C , Roman Scheurer A B , Bridget Bassilios C , Caroline Salom B D and Jane Pirkis C
+ Author Affiliations
- Author Affiliations

A The University of Queensland, School of Public Health, Corner Herston Road and Wyndham Street, Herston, Qld 4006, Australia.

B Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld 4108, Australia.

C The University of Melbourne, Melbourne School of Population and Global Health, Vic. 3010, Australia.

D Institute for Social Sciences Research, The University of Queensland, Long Pocket Precinct, 80 Meiers Road, Indooroopilly, Qld 4068, Australia.

E Corresponding author. Email: c.meurk@uq.edu.au

Australian Journal of Primary Health 24(1) 29-53 https://doi.org/10.1071/PY17030
Submitted: 8 March 2017  Accepted: 23 September 2017   Published: 17 January 2018

Journal compilation © La Trobe University 2018 Open Access CC BY-NC-ND

Abstract

Primary Health Networks (PHNs) are a new institution for health systems management in the Australian healthcare system. PHNs will play a key role in mental health reform through planning and commissioning primary mental health services at a regional level, specifically adopting a stepped care approach. Selected PHNs are also trialling a healthcare homes approach. Little is known about the systems levers that could be applied by PHNs to achieve these aims. A rapid review of academic and grey literature published between 2006 and 2016 was undertaken to describe the use of systems levers in commissioning primary care services. Fifty-six documents met the inclusion criteria, including twelve specific to primary mental healthcare. Twenty-six levers were identified. Referral management, contracts and tendering processes, and health information systems were identified as useful levers for implementing stepped care approaches. Location, enrolment, capitation and health information systems were identified as useful in implementing a healthcare homes approach. Other levers were relevant to overall health system functioning. Further work is needed to develop a robust evidence-base for systems levers. PHNs can facilitate this by documenting and evaluating the levers that they deploy, and making their findings available to researchers and other commissioning bodies.


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