Critical Success Factors for Intersectoral Collaboration: Homelessness and COVID-19 &ndash; Case Studies and Learnings from an Australian City

Stephanie Macfarlane; Fiona Haigh; Lisa Woodland; Brendan Goodger; Matthew Larkin; Erin Miller; Lisa Parcsi; Phillip Read; Lisa Wood

doi:10.5334/ijic.7653

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Intersectoral Homelessness Health Strategy (IHHS) partner agencies and their responsibilities.

Table 1

Overview of Case Studies.

OVERVIEW OF CASE STUDIES
CASE STUDY	CONTEXT & MECHANISMS	BARRIERS & CHALLENGES
Inner Sydney Rough Sleeper Taskforce/COVID-19 Accommodation Pathway	Context	Managing the changing demand and the availability of the Special Health Accommodation Inconsistent messaging between agencies around roles and responsibilities, particularly in the early days with rapidly evolving information Changing public policy settings and public health orders prevented regular consistent messaging, external partner agencies were often confused and seeking regular clarification Managing the demands and expectations of the non-health partner agencies in accessing the accommodation
	Collaborative leadership Authorising environment Executive level endorsement Urgency Special Health Accommodation was funded
	Mechanisms
	Co-designed pathway Communication mechanisms Taskforce as a coordinating mechanism and advocacy opportunity
Mobile Primary Care Clinic	Context	Managing the demand from the general population while prioritising target population Managing government approval processes in a time pressured, urgent environment Managing public concern that pop up testing was encouraging people with COVID to travel to the clinics Responding to, and communicating changing testing criteria to people with poor health literacy Engaging people for long enough for transport to pick them up and take them to specialist accommodation for people unable to isolate at home; known as Special Health Accommodation (SHA) Reduction in delivery of broader healthcare to people experiencing homelessness when testing demand was very high Communicating with partner organisations about people who were required to isolate, whilst respecting patient privacy
	Urgency Shared imperative Existing relationships and trust with client group Media interest Funded initiative
	Mechanisms
	Tailored location based response Effective deployment of finite resources Agile collaboration Specialist clinical teams
Boarding House Outbreak Management Response	Context	Regularly adapting outbreak management responses to align with rapidly evolving public health advice and in the context of the boarding house setting Difficulty standardising processes and responses given the varying standards and environment of boarding houses Gaining the support of boarding house managers to respond to outbreaks Managing the mental health and substance use of tenants who had limited resources to cope with isolation Some tenants did not want other tenants to know of their COVID positive status which required sensitive management in an environment that often inhibits privacy
	Urgency Shared imperative Existing relationships and trust with client group Authorising environment
	Mechanisms
	Agile collaboration Tailored location based response Specialist clinical teams Shared existing governance structures
Outreach Vaccination Clinic	Context	Developing a communication strategy that reached the target population and clearly articulated eligibility for the service; required regular refining Asking partner services to commit to the delivery of the clinic without any additional resources Meeting the demand and expectations for vaccination with limited resources in an evolving landscape The flow and delivery of the clinic had to be rapidly re-designed to comply with changing COVID policy settings Vaccine availability was limited in the early weeks, which increased the demand on services by both the target population and the general public Without an existing model to guide a COVID-19 vaccine clinic for homeless populations, the model had to be continually revised and refined
	Urgency Shared imperative Existing relationships and implied trust (between agencies and with client group) Media interest Unfunded (in-kind) initiative
	Mechanisms
	Pooling of resources Agile collaboration Delivery of vaccine by one key agency Weekly planning meetings attended by key stakeholders Communication materials; marketing to key populations Specialist clinical teams
Swab Squad	Context	High level relationships established via IHHS; operational relationship/trust was built and strengthened through this process Dealing with stakeholders outside the primary service system (corporate hotel accommodating rough sleepers) was often challenging; difficult to align vision and purpose During peak of the outbreak the demand for the Swab Squad was very high and resulted in a reduction in the delivery of broader healthcare provided by both services Swab Squad not always able to provide a rapid response due to workforce issues Communicating with partner organisations about people who were residing in these accommodation services whilst respecting patient privacy
	Urgency Shared imperative Shared values Unfunded in-kind initiative
	Mechanisms
	Pooling of resources Established communication mechanisms Agile collaboration Tailored location based response Specialist clinical teams

Critical Success Factors for Intersectoral Collaboration.

ACRONYMS
CESPHN	Central and Eastern Sydney Primary Health Network
CoS	City Of Sydney
DCJ SSESNS	Department of Communities and Justice Sydney South East Sydney and Northern Sydney
IHHS	Intersectoral Homelessness Health Strategy
SCA	Senior Collaborative Alliance
SESLHD	South Eastern Sydney Local Health District
SHA	Special Health Accommodation
SLHD	Sydney Local Health District
SVHS	St Vincent’s Hospital Sydney

Critical Success Factors for Intersectoral Collaboration: Homelessness and COVID-19 – Case Studies and Learnings from an Australian City

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