Embedding and strengthening prevention in the Queensland public health system
Project title: Making prevention a health system priority – systems analysis project
Start date: June 2021
Estimated end date: June 2022
What is the issue?
Queenslanders are living longer, yet many people experience more years of poor health due to preventable chronic diseases. Almost one in two people in Queensland have one or more chronic diseases.1
As the population ages, the high burden of chronic disease will continue to grow, reducing people’s wellbeing and quality of life, and increasing pressure on the health system. With healthcare spending projected to rise to over 40% of the state budget by 2050,2 it is critical that the Queensland public health system delivers care differently.
Effective chronic disease prevention improves quality of care, reduces health inequity, and delays or prevents people moving into higher-risk categories for disease. It also supports improved health system efficiency, creating capacity to meet increasing service demands.
There are many unseen and unknown opportunities to strengthen and integrate prevention as part of routine clinical care in the Queensland public health system. Thousands of Queenslanders connect with the healthcare system every day, providing many opportunities for enhanced prevention, such as screening and referral to appropriate support services. (Figure 1 shows the spectrum of prevention activities and key organisations in Queensland.)
In the context of this project, prevention largely refers to efforts to prevent the progression of cardiovascular diseases, type 2 diabetes, some cancers, chronic kidney disease and chronic respiratory diseases.
This project, predominantly funded by the Commonwealth Government, aligns with national long-term health reforms that recognise the importance of prevention to reduce the burden of chronic conditions and build sustainability in the health system.
Figure 1: Spectrum of prevention interventions and key organisations in Queensland
How is the project addressing the issue?
Queensland Health’s Prevention Division is leading a comprehensive systems analysis to identify the successes, gaps and opportunities in chronic disease prevention across the Queensland public health system.
The Prevention Partnership Centre is providing system science expertise to guide the analysis.
Using a co-design approach with stakeholders across the Queensland Health system, the project aims to:
- Gather information about current prevention activities
- Understand prevention gaps, opportunities and barriers
- Build a shared understanding of prevention
- Identify existing best practice prevention activities
- Identify feasible mechanisms to better embed, integrate and target prevention efforts across healthcare pathways.
The co-design approach will help to determine solutions that allow for greater flexibility at the local level.
The team will use a variety of methods to engage with stakeholders, including broad communication with the Queensland Health workforce, surveys, participatory workshops and in-depth interviews.
The project is using systems thinking methods to identify prevention opportunities and solutions that might otherwise remain invisible or unnoticed.
It will focus on how prevention efforts reach those with the greatest need, including Aboriginal and Torres Strait Islander people and rural and remote Queenslanders.
Relevance for policy and practice
The project’s findings will be used to identify implementation options for potential system redesign and determine how prevention could be better supported and integrated with treatment services and care delivered across Queensland.
What are the expected outcomes?
The key outcome of the project is to identify high-value opportunities to expand and sustainably embed chronic disease prevention as a core function of quality clinical care in the Queensland public health system.
The project will also:
- Create stewardship and support for prevention
- Build capacity to use systems methods
- Begin to generate change in the system.
For more information, email the Queensland Health team leading the project.
1. Australian Bureau of Statistics. National Health Survey: First Results, 2017-18. Canberra: ABS; 2018. Catalogue No. 4364.0.55.001. Available from: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Overweight%20and%20obesity~90.
2. Deloitte Access Economics, An IGR for the States: health and aged care expenditure Final Report, 23 January 2012 in State Infrastructure Plan Part A: Strategy, Department of Infrastructure, Local Government and Planning, Queensland Government. March 2016. https://www.dsdmip.qld.gov.au/__data/assets/pdf_file/0020/31727/sip-part-a.pdf
Dr Vicki Gedge, Queensland Health
Dr Jo Mitchell, Prevention Centre
Mark West, Queensland Health
Simone Braithwaite, Queensland Health
Rosalind Martin, Queensland Health
Jane Sanders, Queensland Health
Kirsty Tinsley, Queensland Health
Deanne Wooden, Queensland Health
Professor Andrew Wilson, Prevention
Professor Lucie Rychetnik, Prevention Centre
Professor Penny Hawe, University of Sydney
Dr Elly Howse, Prevention Centre
Dr Ray Maher, University of Queensland
Dr Melanie Pescud, Prevention Centre
The project is funded by the Commonwealth Government’s Health Innovation Fund and Queensland Health.