Better, Connected Care: integrated services reform in Victoria, Australia

Abstract

Better, Connected Care is a whole of government reform currently underway in the Australian state of Victoria. It is focussed on improving service delivery for people with multiple and complex needs who need support from multiple service systems. Better, Connected Care (BCC) is about joining up services, putting the person at the centre and considering their needs across all stages of their life.
 The reform vision is: better connected care and services for people with multiple needs, supported by stronger partnerships and earlier intervention, to achieve improved client outcomes and reduce demand on acute services.
 The problem that Better, Connected Care seeks to address:
 Over the past decade, pressure on the provision social services has increased. There is a growing number of Victorians who have been in contact with multiple services funded or provided by a variety of Victorian government departments, including human services, housing, health and justice. Demand across the service system has soared, as evidenced by a 26% increase in child protection placements and a 25% increase in family violence incidents since 2016. In the same period, there has been a 13% increase in people accessing homelessness services, with a 21% increase in mental health related presentations to emergency departments since 2015 and a 25% increase in incarceration rates since 2011.
 Accessing multiple services can be difficult for people, particularly those with multiple needs. This service system fragmentation can cause frustration for the person as they are often required to undertake multiple assessments, re-tell their story, leave services due to age requirements and sever relationships with trusted workers, and be required to fit into existing service models. From a person-centred perspective, BCC aims to address the barriers many people experience as they navigate access to multiple services across a range of programs and organisations.
 From a system perspective, the boundaries between services can cause service delays or prevent people from accessing the services they need. In the absence of an integrated joined up approach, people with multiple needs may not be adequately supported, which can result in increasingly complex needs, making it harder to achieve positive outcomes. In addition, service models can be narrow and are sometimes not able to provide the range of services a person or their family might need, such as housing, mental health and drug and alcohol service support. A more joined-up service system that can respond to people earlier and more holistically can help overcome these challenges.
 
 The Better, Connected Care approach:
 BCC is building on the successes of joined up care for specific cohorts, such as the Multiple and Complex Needs Initiative and the Orange Door services for Family Violence, and expanding these to the whole service system for health, justice and social services. BCC activities will address a range of system barriers that exist between services – like improving information sharing practices, considering more flexible and portable funding approaches, building capacity and capability in joined up responses, streamlining assessments and trialling service delivery models with increased levels of integration."