Progress by Design: Change Readiness and Breakthrough Innovation in Primary Care
Summary
The Australian Government has made a long-term commitment to reforming the Australian
primary healthcare system. This recognises that existing fee-for-service models that place
the general practitioner almost solely at the centre of readily reimbursable care are not
suitable in many contexts. This is most apparent for patients with chronic health conditions.
The focus of the reforms is to move toward multidisciplinary, integrated, team-based
primary care in which primary care providers are charged with co-ordinating team-based
approaches in the pro-active management of chronic conditions and disease risks.
The importance of transitioning to team-based care is well recognised. Historically,
numerous initiatives to reform primary care along these lines have been trialled with limited
success, outside of Aboriginal Community-Controlled Health Organisations (ACCHOs).
Logistical, cultural and financial challenges in shifting individual practices to these new
models of care have proven difficult to surmount, scale and sustain. There are valuable
lessons from the small number of pioneering organisations, including ACCHOs, that have in
different ways transitioned to team-based care.
Against this background, a consultation process across primary care stakeholders was
initiated, beginning with the ‘Progress by Design: A Roundtable on Change Readiness
and Breakthrough Innovation in Primary Care’ on 5 December 2025 at The George
Institute for Global Health, Health Translation Hub University of New South Wales.
The Roundtable brought together clinicians and practitioners from across Australia who
have been pioneering team-based care alongside ACCHOs, consumers, policymakers,
and researchers. In advance of the Roundtable, a stimulus package was circulated to
participants that included a summary of policy and literature on team-based care and
change management in general practice settings. The task for participants was to identify
strategies for individual practices to manage the changes needed to transition to more
comprehensive team-based care, as well as determine the support they need along the way.
This report is a synthesis of discussions held at that meeting and subsequent follow-up of
key individuals and organisations.
Consultations revealed a high degree of consensus on a core principle: Australia’s primary
care system holds the capability to deliver modern, team-based care. What is missing is
the system architecture and leadership to support it. Participants repeatedly emphasised
that the main challenge is not lack of will, but lack of targeted funding and support to enable
the transition to integrated, team-based primary care – providing the “right care, right person,
right place, right time”.
Transforming primary care requires sector-wide changes in government policy and funding,
individual practices, Primary Health Networks (PHNs), peak bodies, colleges, provider
organisations, and corporate groups. Key enablers for change were identified as:
- 1. Adapt to a sustainable investment approach
- 2. Rework clinical governance to optimise multidisciplinary approaches
- 3. Build digital and data infrastructure and quality improvement capability
- 4. Formalise support for change management in primary care
- 5. Promote structural and cultural change towards a sustainable and integrated workforce
