Is headspace making a difference to young people’s lives?

Appendix B
Use of a hub and spoke model
Rationale
Hub and spoke models are a formalised service network in which rural or remote areas which lack
service capabilities are supported by larger, better resourced, centres in regional or metropolitan
areas. While headspace does not follow this model of service delivery, a number of satellite centres
exist. headspace national office enables satellite centres to be established when the main site has
fully operationalised all components of the headspace model. A satellite centre, or spoke, is then
established in the surrounding community. These satellite centres require ongoing support from
the main site. They may offer a limited number of service components and may open on a limited
number of days only.
Implementation of a more extensive network of hub and spoke centres has the potential to provide
greater access to populations living in rural and remote areas. These populations have been
identified as having greater risks of mental health disorders and reduced access to services. In
addition, there are likely to be cost savings associated with spoke centres. This is likely to include
reduced administration costs, possibility of restricted hours resulting in lower salary costs and
reduced need for clinical staff with effective referral to hub centres where required.
The satellite centres which currently exist allow for some evaluation of the hub and spoke model.
However, the limited number of centres which follow this model, and substantial variety in the
operationalization of satellite centres, limits the generalizability of these examples.
Defining catchment areas
In the earlier rounds of the headspace program, there were varying implementations of the hub
and spoke model, but this approach is not standard hNO practice. There are two exceptions to this
which are informative under the current evaluation: a funded outpost of headspace Launceston in
Devonport which attracts additional funding and fits the profile of a full centre, and a satellite site in
Wyong which offers core services and relies on like-services within the area for operational costs.
The primary sites were established during Rounds 1 and 2. Four of the six primary sites are in nonmetropolitan
areas and therefore service SA3s. These sites vary substantially in the number of youth
for whom they provide access, with youth populations ranging between 9,215 to approximately 76,106
young people within the (SA3/ SA4) service area. The majority of primary sites have a single spoke
site. However, two primary sites have multiple satellites. Satellite sites are typically in the same SA3
or SA4, with two exceptions. However, they are typically located in different suburbs within the area
and are therefore likely to provide access to different service populations.
There is little consistency between the geographic distribution of existing parent and satellite sites.
This makes the assessment of the appropriate catchment area for hub and spoke sites challenging.
In addition, the ability of smaller centres to adequately provide the required services to youth, or
allow for efficient and effective referral to hub sites as needed, requires further consideration.
Improvements in efficiency and reductions in costs are largely dependent on the geographic
distribution of hub and spoke sites, which impacts on the number of centres required, and the ability
of smaller sites to run at a lower cost. Additional information, from service delivery models external to
headspace, is needed to inform the most efficient and effective definition of catchment areas.
Centre capacity
The use of hub and spoke centres could address capacity issues in highly populated areas. The
inclusion of smaller centres, with lower funding requirements, in areas with small populations has the
potential to reduce costs at a centre level. However, the extent to which this would impact on centre
capacity, and therefore youth access, is not known. Additional information regarding the service
capacity or smaller and part-time sites is required to inform this analysis.
Evaluation
The hub and spoke model of centre allocation is likely to be associated with cost savings if spoke
sites could operate at a lower cost than traditional centres. In addition, the use of spoke sites to
service regions with small youth populations, which cannot support a fully operational site under the
current model, may assist in overcoming barriers to help-seeking, such as travel distance, and allow
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