Integrated models or mayhem? Lessons learnt from three integrated primary health care entities in regional New South Wales.

While "integration" may be a policy imperative at present, the reality of integrating services whilst managing the business of service delivery and best patient outcomes is both challenging and unfamiliar territory for most general practitioners. Recent policy changes in general practice have challenged traditional financial and governance models. This paper reviews three integrated general practice entities, all under the auspice of the University of Newcastle, for commonalities and concerns. A model was conceptualised and key factors identified and discussed. These factors included careful selection of partners, elucidation of the level of integration and the need for a lead champion to promote the changed environment. The financial and clinical governance systems needed to be clearly delineated, including the type and priority of service delivery intended. Integration is not a blanket solution but may be useful for patients with chronic and complex health problems. Being resource-intense, it may not be available or appropriate for all. The practical realities of workforce however, and the political and funding environment are likely to dictate how GP practices in the future embrace integration.