The Experience of New South Wales Primary Health Networks During the 2021 COVID-19 Outbreak: Challenges and Learnings

The NSW PHNs contracted the Western Sydney University (WSU) in December 2021 to conduct research to explore and document the experience and role of NSW PHNs in the novel coronavirus disease (COVID-19) outbreak between June and November in 2021. The exponentially rising case numbers and low vaccination rates that underlined the outbreak during that period resulted in the lockdown of greater Sydney from 26th June 2021. Rural and regional NSW had shorter lockdowns to contain smaller outbreaks. NSW was officially declared to be 'out of lockdown' on 11th October 2021, with progressive lifting of restrictions on social gatherings and mask mandates continued through into 2022. The five to six months over the period of the 2021 COVID-19 outbreak in NSW was a time of rapid evolution of change in healthcare delivery, public health activities and community support. Primary health care, including general practice and the PHNs were at the forefront of many of these changes. This research aimed to: describe the expectations and roles of NSW PHNs including expectations of primary health care (PHC) during this pandemic outbreak; document barriers and facilitators for PHNs and Primary healthcare providers (HCPs) in meeting the expectations; recommend improved processes for working with PHNs and HCPs in for future emergency responses. The WSU team used multiple sources of data collection and methods of analysis to address the research aims. Review of the PHN documents provided a detailed understanding of the required roles of the PHNs during the outbreak period, and a context for the other strands of the research. The interviews with PHN strategic and operational staff were an 'insider' exploration of what happened on the ground for the PHN and the barriers and facilitators to providing services and support to PHC. The HCP survey responses provided an 'outsider' perspective of perception and expectations that PHC has of the PHNs. The focus group with the PHN CEOs then tied together the other three strands of this research, providing an opportunity to reflect on the findings and moving the focus to recommendations for future emergency responses.