Introduction

Policy makers consider strengthening primary health care as fundamental to reducing inequity and increasing the sustainability of health systems. Medicare Locals (ML) are a network of independent primary care organisations established to action the National Primary Health Care Strategy reforms around access and coordination. Working with regional health authorities and primary care providers, MLs design and deliver integrated, coordinated and responsive services at the local level. A consistent concern is the provision of services after hours. All MLs have been tasked with the evaluation, and subsequent fostering of evidence informed improvements, of the delivery of after hours services in their region.

Method

We will present a pragmatic mixed-methods protocol for evaluating a multi-faceted after-hours primary care delivery pilot for the South Eastern Melbourne ML. Our evaluation will follow a natural experiment design that captures a) routinely collected health services administrative data (ED, locum, ambulance caseload) b) practice administrative data (from billing software/clinical databases, audited medical records c) pre and post appointment patient surveys and c) qualitative data (from in-depth key informant interviews, non-participant direct observations of practice sites and clinician patient interactions). The evaluation is structured into four stages: researchers will build a detailed profile of 1) study region, 2) the pilot sites and 3) patients attending pilot sites and finally 4) the pilot will be evaluated against measures of success.

Results

We will reflect on the practical challenges and priority contentions in designing the evaluation. We will outline how we intend to evaluate the after hours pilot against measurable indicators for access, acceptability and effectiveness.

Conclusion