The support of the WA Department of Health
The Western Australian public health system, referred to as WA Health, covers approximately one third of continental Australia, with almost 80% of the 2.5 million population concentrated in the capital city, Perth, with the rest distributed mainly in the south west region, and very sparsely over the mid and northern regions.
WA Health has long had a strong focus on research, research translation, and evidence-based clinical care. The excellence of the outputs from this focus has been nationally and internationally recognised through the awarding of prestigious prizes and awards to WA researchers, such as the Nobel Prize and Australians and Western Australians of the Year.
Leadership in this area is well demonstrated by the establishment in 1995 of the leading WA Data Linkage System (DLS). WA Health has had a pivotal role in developing and maintaining this system in conjunction with the academic research sector. The DLS links various sources of health-related information for the WA population, and has fostered strong collaborative translational relationships across the WA research sector.
In 2005 WA Health established the State Health Research Advisory Council (SHRAC), to advise the Department of Health and the Minister for Health on strategic directions and policies for health and medical research at a state wide level. Its overall vision was to facilitate an efficient, productive and sustainable health and medical research sector in WA, with the capacity to drive the future health, social and economic development of the State.
In recognition of the various research stakeholders, SHRAC members included representatives from the university, research institute, corporate and consumer sectors, as well as WA Health. A key leadership focus for SHRAC was on research of relevance to WA Health, which led to the establishment, in 2007, of the SHRAC-Research Translation Projects (RTP) program 1. This competitive research program is in its tenth annual round in 2016, and aims to demonstrate, through research, improved cost effectiveness and/or efficiencies that can be delivered to WA Health while maintaining or improving patient outcomes. Being a policy-driven research program, but investigator initiated for projects, this program has been transformative in its impact within WA Health, with many front-line clinicians across professional disciplines undertaking research relevant to health services, in conjunction with academic colleagues.
In 2013, the WA Government, based on significant input from SHRAC, announced the FutureHealth WA (FHWA) initiative, whereby an additional $30 million was allocated to health and medical research in WA over the period 2013/14 to 2016/17. This new funding supplements the existing $58 million core WA Health research funding over the same period.
The advent of new FHWA funding enabled a transition from the previous advisory role of SHRAC to a new structure that could better align research endeavours in the State to common goals and which could pursue agreed research priorities determined by the State health system and the research industry. This has since been formalised through the establishment of the network, now called the WA Health Translation Network (WAHTN), as a consortium of key partners in the health and medical research effort in WA, and includes, amongst others, WA Health, the five WA universities and the major WA medical research institutes. The initial funding for the WAHTN has been in large part from WA Health, with the other participants also providing funding and in-kind support in critical areas of activity.
The WAHTN is able to consolidate and expand cooperative research relationships between the key WA research stakeholders, and gives effect to the desire to further develop the WA research sector in a more active and coordinated manner, with a greater translation focus.
As the WAHTN concept was being developed, WA Health was preparing for a substantial system-wide reform process. The Government’s reform program to support the vision to deliver a safe, high quality, sustainable health system for all Western Australians has seen the enactment of the Health Services Act 2016 from 1 July 2016. This provides a new legal framework and a devolved model of governance to enable decision-making closer to service delivery and patient care.
Under this Act, WA Health comprises the Department of Health, Health Service Providers, and relevant contracted health entities. The Department of Health, led by the Director General (Chief Executive Officer) is the System Manager responsible for the overall management, strategic direction and stewardship of the WA health system.
The Health Service Providers 2 are board-governed statutory authorities, legally responsible and accountable for the delivery of health services for their local areas and communities.
As detailed in WA Health Reform Program 2015-2012, WA Health aims to create a culture of continuous improvement and clinical excellence through research and innovation. The new structure for the WA public health system presented an opportunity to explicitly embed research as a fundamental component of health service delivery. As part of these reforms, an overarching, legally binding Research Policy Framework has been implemented across WA Health, which recognises research as a core function of the WA Health system.3
Since the last National Health and Medical Research Council (NHMRC) call for submissions for recognition as an Advanced Health and Research Translation Centre, the WAHTN has refined its mandate and aims, which now dovetail into the principles that underpin the WA Health Research Policy Framework.
Funding and in-kind support from WAHTN partners, predominantly from the WA Department of Health, has enabled a number of initiatives to be commenced, with a number of others approved and ready for implementation. These initiatives, formulated and enacted through WAHTN partner input, demonstrate that pre-existing research relationships in WA have been catalysed to greater action by the formalisation of the WAHTN.
2 The health service providers include the North Metropolitan Health Service (NMHS), South Metropolitan Health Service (SMHS), East Metropolitan Health Service (EMHS), Child and Adolescent Health Service (CAHS), and WA Country Health Service (WACHS).
3 A series of key principles underpin this Research Policy Framework, including: collaboration between internal and external stakeholders; taking a consumer-centred approach; making research ‘core business’; ensuring research conducted in WA Health is of the highest ethical and scientific standard; research should be relevant to patient outcomes and healthcare productivity; research activities should be managed in a sustainable manner; and the research culture will attract and retain high calibre health professionals.