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METHODS article

Front. Public Health
Sec. Public Health Policy
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1405034

An effective approach to tackling complex health policy challenges. Using a clinical microsystems approach and rethinking codesign

Provisionally accepted
Maria Duggan Maria Duggan 1Rosemary V. Calder Rosemary V. Calder 2*Mark A. Morgan Mark A. Morgan 3Maximilian P. de Courten Maximilian P. de Courten 4Kevin P. Mc Namara Kevin P. Mc Namara 5James A. Dunbar James A. Dunbar 2,5
  • 1 Mitchell Institute, Victoria University, Melbourne, Australia
  • 2 Australian Health Policy Collaboration, Victoria University, Melbourne, Australia
  • 3 Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
  • 4 Victoria University, Australia, Melbourne, Australia
  • 5 Deakin University, Geelong, Australia

The final, formatted version of the article will be published soon.

    That people with serious mental illness have poor physical health and face a significant life expectancy gap compared with the general population is well known. Despite considerable policy focus in some countries, the gap in life expectancy remains. Tackling complex and persistent health problems such as this requires a systems-based approach, recognising the complexity of interacting components and their effects on the problem and on each other and applying collaborative analysis, design and implementation by those with knowledge of and expertise in the problem and the context. This paper describes the methods used to develop the Australian Being Equally Well National Policy Roadmap for better physical health care and longer lives for people with severe mental illness. Whilst recognising that high rates of physical health comorbidities are caused by many factors including lifestyle, access to high-quality healthcare and medication side effects, the work was focused on what could be done within Australian primary care to improve the physical health of this cohort.A Clinical Microsystem Approach was applied to synthesise clinical evidence with professional and lived experience, and an innovative policy development process was established, creating trust across all system levels. Participants with different kinds of knowledge and experience worked in discrete groups according to their professional or expert role whilst also being supported to participate in an intensive cross-collaboration.The potential value of this methodology for tackling other complex problems in health policy is discussed.

    Keywords: Health Policy, Clinical Microsystem, Mental Health, physical health, Integrated healthcare, Healthcare Disparities, systems approach, Lived experience

    Received: 22 Mar 2024; Accepted: 03 Oct 2024.

    Copyright: © 2024 Duggan, Calder, Morgan, de Courten, Mc Namara and Dunbar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Rosemary V. Calder, Australian Health Policy Collaboration, Victoria University, Melbourne, Australia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.