Liang Zhanming, Martin Amanda, Turner Catherine Louise
College of Business, Law and Governance, James Cook University, Townsville, QLD, Australia.
The Hunter New England and Central Coast Primary HealthNetwork, Broadmeadow, NSW, Australia.
J Healthc Leadersh. 2025 Jun 3;17:241-258. doi: 10.2147/JHL.S511151. eCollection 2025.
Primary care has strategic importance in Australia's complex health system, attracting one-third of the country's health budget. Primary Health Networks (PHNs), established in 2015 to act as commissioners for non-hospital health and social care across Australia, enable a more comprehensive health planning approach to identify and prioritise service gaps and commission appropriate health services. Hence, building PHNs' capability in health commissioning is critical to maximising health outcomes of the Australian population.
This study was conducted to identify the skill development needs of PHNs employees to lead and manage commissioning, and strategies to build commissioning capabilities across PHNs.
A multiphase mixed-method approach was used, including an anonymous online survey and two focus group discussions.
The health commissioning practices of PHNs directly affect PHN staff's confidence (Pearson's r=0.484, p<0.001) and self-perceived competence in their commissioning practices (Pearson's r=0.335, p<0.001). This study confirms that systematic upskilling commissioning among PHN employees, focusing on the commissioning cycle, complex healthcare environments, and data management, is required to improve their capabilities. This highlights the importance of organisational support in strengthening the six key factors for effective commissioning.
The enhancement of PHNs' capability in health commissioning should be centered around employees' capability building guided by the proposed PHN health commissioning capability building model. Organisation investment in performance monitoring and enhancement, organisations' multi-strategy approach towards internal support and development, and external learning and development opportunities are the three key pillars.
Enhancing robust commissioning processes and strengthening leadership capabilities in health commissioning are essential for PHNs to meet the evolving healthcare needs of the population. Effective commissioning requires skilled and confident teams, systematic upskilling, organisational support, and strategic approaches to address challenges, deliver high-quality primary care, and improve population health outcomes. Building PHNs' commissioning capability requires a systematic and progressive skill development approach that prioritises a staff-centred model.
初级医疗保健在澳大利亚复杂的卫生系统中具有战略重要性，吸引了该国三分之一的卫生预算。初级卫生保健网络（PHNs）于2015年成立，作为澳大利亚非医院卫生和社会护理的委托机构，采用更全面的卫生规划方法来识别和优先处理服务差距，并委托提供适当的卫生服务。因此，提升初级卫生保健网络在卫生委托方面的能力对于最大化澳大利亚人口的健康成果至关重要。
本研究旨在确定初级卫生保健网络员工在领导和管理委托方面的技能发展需求，以及在初级卫生保健网络中建立委托能力的策略。
采用多阶段混合方法，包括匿名在线调查和两次焦点小组讨论。
初级卫生保健网络的卫生委托实践直接影响初级卫生保健网络工作人员的信心（皮尔逊相关系数r = 0.484，p < 0.001）以及他们在委托实践中的自我感知能力（皮尔逊相关系数r = 0.335，p < 0.001）。本研究证实，需要对初级卫生保健网络员工进行系统的委托技能提升培训，重点关注委托周期、复杂的医疗环境和数据管理，以提高他们的能力。这凸显了组织支持在强化有效委托的六个关键因素方面的重要性。
提升初级卫生保健网络在卫生委托方面的能力应以员工能力建设为中心，遵循提议的初级卫生保健网络卫生委托能力建设模型。组织在绩效监测和提升方面的投资、组织对内部支持和发展的多策略方法以及外部学习和发展机会是三个关键支柱。
加强稳健的委托流程并强化卫生委托方面的领导能力对于初级卫生保健网络满足民众不断变化的医疗需求至关重要。有效的委托需要熟练且自信的团队、系统的技能提升、组织支持以及应对挑战、提供高质量初级医疗保健和改善民众健康成果的战略方法。建立初级卫生保健网络的委托能力需要一种系统且渐进的技能发展方法，该方法优先考虑以员工为中心的模式。
