Abstract
ALICE is a new model of care that has been co-designed with residents to support the health and social care needs of all community-dwelling older people aged over 65 (or aged 50+ for Aboriginal and Torres Strait Islander community) living in priority Central Coast communities in New South Wales, Australia.
The ALICE Program is an initiative of the Hunter New England and the Central Coast Primary Health Network (HNECCPHN), Central Coast Local Health District (CCLHD), Central Coast Council and the Department of Regional New South Wales.
The ALICE model comprises three elements: a ‘Health Kiosk’ (community hub) that provides a local, physical focal point for information, wellness support and health promotional events; a Link Worker service that provides relational continuity to high-needs older people; and a commitment to Healthy Place-Making, which seeks to enable a built and natural environment that supports older people to live active, healthy lifestyles in their local community.
This presentation will be provided as a case study in 'how to' systematically build a costed value case to support a complex integrated care innovation such as ALICE. It will describe and assess the establishment of ALICE as a translational research program during the participatory co-design period between July 2022 and May 2024 including reflections on the partnership and implementation process that ran from the initial concept of the ALICE program as a means to meet the needs of older people on the Central Coast, to the delivery of a costed value case and implementation plan.
Specifically, the case study paper will describe how ALICE used the "Implementation Model for Integrated Care" [1] and drew upon ""Complex Adaptive System"" thinking to design a stepped process in the building of its value case. This will include:
- the development of the initial concept for ALICE and the formulation of a guiding coalition for change;
- outcomes from a joint needs assessment process, a first of its kind process undertaken in Australia, to identify local communities in need of programs such as ALICE;
- evidence from an international scoping review to support the potential impact of ALICE on care experiences, outcomes and costs of care;
- assessment of the ongoing co-design process with Central Coast residents and other local stakeholders;
- a data audit to examine the additional capacity required to support older people in the community;
- results of a cost-benefit analysis to demonstrate the estimated long-term impact of ALICE; and
- details of a phased and costed implementation plan to pilot and roll-out ALICE across the Central Coast over the next 5 years.
The presentation will reflect on the use and usefulness of the implementation model for integrated care, and of complex adaptive thinking, during the development of the ALICE value case. It will reflect on the challenges faced in building the business case for ALICE, including the effectiveness of its co-design methodology. It will conclude with a look ahead to the future development of ALICE as a ongoing program of care innovation on the Coast.