Right care, right place, right time: improving the timeliness of health care in New South Wales through a public–private hospital partnershipCarla Saunders A C and David J. Carter B
A Centre for Health Services Management, Faculty of Health, University of Technology, Jones Street, Ultimo (PO Box 222), Sydney, NSW 2007, Australia.
B Faculty of Law, University of Technology Sydney, Quay Street, Ultimo (PO BOX 123), Sydney, NSW 2007, Australia. Email: email@example.com
C Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH16075
Submitted: 3 April 2016 Accepted: 2 August 2016 Published online: 23 September 2016
Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public–private hospital partnership.
Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals.
Results In 2014–15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27 400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames.
Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care.
What is known about the topic? There are very few studies available to inform public–private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships.
What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public–private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner.
What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts have the potential to realise a key objective, namely to deliver the ‘right care, in the right place, at the right time’, through the core value of collaboration, using available infrastructure.
Additional keywords: integrated service delivery, quality of care, rehabilitation services.
References Steering Committee for the Review of Government Service Provision. Report on Government Services 2016. Canberra: Productivity Commission; 2016.
 New South Wales Ministry of Health. The NSW state health plan: towards 2021. Sydney: NSW Ministry of Health; 2014.
 Kohn LT, Corrigan JM, Donaldson MS. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Committee on Quality of Health Care in America, Institute of Medicine; 2001.
 Weissman JS, Stern R, Fielding SL, Epstein AM. Delayed access to health care: risk factors, reasons, and consequences. Ann Intern Med 1991; 114 325–31.
| Delayed access to health care: risk factors, reasons, and consequences.CrossRef | 1:STN:280:DyaK3M7gtlCmtQ%3D%3D&md5=be46510df7e32d8adffacdd79472a88eCAS | 1899012PubMed |
 Australian Commission on Safety and Quality in HealthCare (ACSQHC). Australian safety and quality framework for health care putting the framework into action: getting started. Sydney: ACSQHC; 2010.
 Clinical Excellence Commission. Patient based care challenge Available at: http://www.cec.health.nsw.gov.au/programs/partnering-with-patients/patient-based-care-challenge-pwp#pbcm [verified 24 March 2016].
 Berry LL, Seiders K, Wilder SS. Innovations in access to care: a patient-centered approach. Ann Intern Med 2003; 139 568–74.
| Innovations in access to care: a patient-centered approach.CrossRef | 14530228PubMed |
 Levy AR, Sobolev BG, Hayden R, Kiely M, FitzGerald M, Schechter MT. Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991–2000. BMC Health Serv Res 2005; 5 22
| Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991–2000.CrossRef | 15766381PubMed |
 Pacifico MD, Pearl RA, Grover R. The UK Government two-week rule and its impact on melanoma prognosis: an evidence-based study. Ann R Coll Surg Engl 2007; 89 609–15.
| The UK Government two-week rule and its impact on melanoma prognosis: an evidence-based study.CrossRef | 1:STN:280:DC%2BD1c%2FkvV2ltQ%3D%3D&md5=e40dc4a8221dbd423bd8c7860f2ea522CAS | 18201477PubMed |
 Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ. Influence of delay on survival in patients with breast cancer: a systematic review. Lancet 1999; 353 1119–26.
| Influence of delay on survival in patients with breast cancer: a systematic review.CrossRef | 1:STN:280:DyaK1M3isVKrsg%3D%3D&md5=d550b1db04425ae8c36795b855cfdb95CAS | 10209974PubMed |
 Audit Office of NSW. Volume ten health. 5. Service delivery. 2015. Available at: https://www.audit.nsw.gov.au/publications/latest-reports/financial/volume-ten-2015-health/service-delivery/5-service-delivery [verified 24 March 2016].
 Australian Commission on Safety and Quality in HealthCare (ACSQHC). Accreditation and the NSQHS Standards. Sydney: ACSQHC; 2010.
 Emergency Care Institute NSW. National emergency access target. Available at: http://www.ecinsw.com.au/neat [verified 24 March 2016].
 Infrastructure NSW. State infrastructure strategy 2012–2032. 2014. Available at: http://www.infrastructure.nsw.gov.au/pdfs/SIS_Report_Complete_Print.pdf [verified 24 March 2016].
 Productivity Commission. Efficiency in Health, Commission Research Paper. JEL codes: I10, I18. Canberra: Commonwealth of Australia; 2015.
 Productivity Commission. Public and private hospitals: research report. Canberra: Productivity Commission; 2009.
 Catholic Health Australia. 100% surgery target achievable, with non-government support. Media Release 147893. Catholic Health Australia Website. Available at: http://www.cha.org.au/ [verified 24 March 2016].
 Australian Institute of Health and Welfare (AIHW). Admitted patient care 2013–14: Australian hospital statistics. Health Services Series no. 60. Catalogue no. HSE 156. Canberra: AIHW; 2015.
 Department of Health. Guidelines for recognition of private hospital-based rehabilitation services. 2013. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-phicirculars2013-32a [verified 24 March 2016].
 World Health Organization (WHO). Everybody’s business: strengthening health systems to improve health outcomes. WHO’s framework for action. Geneva: WHO; 2007.
 National Health and Hospitals Reform Commission. Principles to shape Australia’s health system. A healthier future for all Australians: final report. Canberra: Commonwealth of Australia; 2009.
 Government of South Australia. Transforming health discussion paper. 2014. Available at: http://transforminghealth.sa.gov.au/wp/wp-content/uploads/2014/12/14096.9-A4-Discussion-Paper_WEB-Secure.pdf [verified 24 March 2016].
 Boxall A, Tobin P, Gillespie J. Public problems: private solutions? Short term contracting of inpatient hospital care. Deeble Institute Issues Brief. 2014.
 Foley M. A mixed public–private system for 2020. A paper commissioned by the Australian Health and Hospitals Reform Commission. Canberra: National Health and Hospitals Reform Commission; 2008.
 Sturgess GL. Contestability in public services: an alternative to outsourcing. ANZSOG Research Monograph. Melbourne: ANZSOG; 2015.
 Skinner J. The future of private sector and NGO partnerships in healthcare delivery. Speech delivered at the American Chamber of Commerce, Sydney 7 March 2014. Available at: http://www.health.nsw.gov.au/ministers/Documents/skinner-speech-20140307-acc.pdf [verified 24 March 2016].
 Petrich ML, Ramamurthy V, Hendrie D, Robinson S. Challenges and opportunities for integration in health systems: an Australian perspective. J Integr Care 2013; 21 347–59.
| Challenges and opportunities for integration in health systems: an Australian perspective.CrossRef |
 Australian Institute of Health and Welfare (AIHW). Australian hospital statistics 2011–12. Health Services Series no. 50. Catalogue no. HSE 134. Canberra: AIHW; 2013.
 Forbes M, Harslett P, Mastoris I, Risse L. Measuring the technical efficiency of public and private hospitals in Australia. Presented at the Australian Conference of Economists, 27–29 September 2010, Sydney. Available at: http://www.pc.gov.au/research/supporting/hospital-technical-efficiency [verified 24 March 2016].
 National Health and Medical Research Council (NHMRC). National guidance on collaborative maternity care. Canberra: NHMRC; 2010.
 Victorian Government. Victorian health priorities framework 2012–2022: metropolitan health plan. Melbourne: Victorian Government; 2011.
 Queensland Department of Health. Surgery connect program Queensland State Government. Brisbane: Surgery Connect, Contracting and Performance Management Branch, Queensland Department of Health; 2007.
 NSW Health. Advice for referring and treating doctors: waiting time and elective surgery policy. NSW Health Policy IB2012_004. Sydney: NSW Ministry of Health; 2012.
 Australian Institute of Health and Welfare (AIHW). Elective surgery waiting times 2014–15: Australian hospital statistics. Health Services Series no. 64. Catalogue no. HSE 166. Canberra: AIHW; 2015.
 Australian Institute of Health and Welfare (AIHW). Australian hospital statistics 2012–13. Health Services Series no. 54. Catalogue no. HSE 145. Canberra: AIHW; 2014.
 Australian Bureau of Statistics (ABS). Private hospitals, Australia 2013–14. Catalogue no. 4390.0. Canberra: ABS; 2015.
 Australian Private Hospitals Association. Capital works projects. Available at: http://www.apha.org.au/capital-works-projects/ [verified 24 March 2016].
 Mason C. Public–private health care delivery becoming the norm in Sweden. CMAJ 2008; 179 129–31.
| Public–private health care delivery becoming the norm in Sweden.CrossRef | 18625979PubMed |
 Kreindler SA. Policy strategies to reduce waits for elective care: a synthesis of international evidence. Br Med Bull 2010; 95 7–32.
| Policy strategies to reduce waits for elective care: a synthesis of international evidence.CrossRef | 20457662PubMed |
 Appleby J, Boyle S, Devlin N, Harley M, Harrison A, Locock L, Thorlby R. Sustaining reductions in waiting times: identifying successful strategies. Final report to the Department of Health. London: Kings Fund; 2005.
 Harrison A, Appleby J. Reducing waiting times for hospital treatment: lessons from the English NHS. J Health Serv Res Policy 2009; 14 168–73.
| Reducing waiting times for hospital treatment: lessons from the English NHS.CrossRef | 19541876PubMed |
 Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. Measuring and reducing waiting times: a cross-national comparison of strategies. Health Aff 2007; 26 1078–87.
| Measuring and reducing waiting times: a cross-national comparison of strategies.CrossRef |
 Health SA. Public private partnership and the Royal Adelaide Hospital. 2011. Available at: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+reform/the+new+royal+adelaide+hospital/public+private+partnership+and+the+new+royal+adelaide+hospital [verified 24 March 2016].
 Duckett SJ. Private care and public waiting. Aust Health Rev 2005; 29 87–93.
| Private care and public waiting.CrossRef | 15683360PubMed |
 Schofield DJ, Earnest A. Demographic change and the future demand for public hospital care in Australia, 2005 to 2050. Aust Health Rev 2006; 30 507–15.
| Demographic change and the future demand for public hospital care in Australia, 2005 to 2050.CrossRef | 17073546PubMed |
 46 Private health sector seeks stable relationship. Australian Financial Review April 30 2014. Available at: http://www.afr.com/news/policy/budget/private-health-sector-seeks-stable-relationship-20140429-iwuva [verified 24 March 2016].
 Taylor L. Radical changes to hospital funding on the table to settle GST debate. The Guardian 2 February 2016. Available at: http://www.theguardian.com/australia-news/2016/feb/02/radical-changes-to-hospital-funding-on-the-table-to-settle-gst-debate [verified 24 March 2016].
 Millman ML. Access to health care in America. Washington, DC: Institute of Medicine, National Academy Press; 1993.