Focus: Review of needs and foundational infrastructure:

• Ensure that research ethics have been obtained for relevant processes within the LIP’s local context:
  • early evaluation of need will determine who is invited to subsequent deliberations;
  • recruitment and contact details (e.g., language requirements).
• Establish foundational structure:
  • establish LIP Core Team: ensure adequate representation of decision makers, researchers, clinicians, and members of the vulnerable communities;
  • establish a LIP Management Committee (if required);
  • connect to the larger LIP community, including engaging local champions around access to comprehensive primary health care for vulnerable populations;
  • establish structures for ongoing dialogue between decision makers, researchers, clinicians, and members of the vulnerable communities in each LIP.
• Identify access-related needs, context assets, and existing organisational innovations:
  • guide and facilitate interaction with the broad network of stakeholders in the geographic area with the long term goal of developing a broader regional network;
  • document access-related needs, assets, and existing organisational innovations for vulnerable populations in the region and analyse the reasons for their poor access to primary health care:
    • collate and interpret relevant data;
    • establish approaches to data collection^[1] and record keeping (see Appendix D for meeting notes template).

• • prioritise access-related issues through stakeholder consultation and (likely) deliberative processes:
    • work with a facilitator to coordinate a series of deliberative conversations (which may include a large deliberative forum) involving decision makers, researchers, clinicians, and members of the vulnerable communities as well as representatives from local government, housing, transport, education, and other human services, as appropriate. These conversations will act to identify access goals, unmet needs, and principal perceived barriers to access for vulnerable populations in each region
    • ideally, one or more people within the local context may have already or will through the activities within the LIP be able to develop facilitation skills related to deliberative processes and will continue to support deliberative processes.

Focus: Design and implementation of organisational innovations to address needs^[2]:

• Use deliberative processes to support achievement of the program goals related to selection, design, and implementation of organisational innovations;
• LIP Core Team will:
  • continue to develop the deliberative approach/processes
  • disseminate findings of scoping reviews and deliberate on the results
  • build links and collaborative relationships within and between partners
• Start implementation
• Develop a plan to evaluate the organisational innovation

Focus: Evaluate organisational innovations that have been implemented:

• assist in testing and refining organisational innovations (and their relevance to the local context) and evaluation indicators and measures;
• engage in adapting and piloting a CBPHC instrument to assess access-to-care (first contact, organisational first contact, economic, geographic), quality of care (continuity, preventive coverage, medical errors), outcomes such as patient activation, health literacy and confidence in self-management;
• coordinate dissemination of questionnaires to patients and health practitioners;
• work in close collaboration with LIP stakeholders to evaluate the organisational innovations identified to address each region’s priority access gap for its vulnerable communities.