Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor Better Sooner More Convenient Primary Care - New Zealand Doctor
3 Table of contents 1 Caveats/status .................................................................................................................................................. 3 2 Executive summary .......................................................................................................................................... 4 2.1 Assessment criteria summary ............................................................................................................. 5 3 Table of contents ........................................................................................................................................... 10 4 Introduction .................................................................................................................................................... 12 4.1 Strategic context ................................................................................................................................. 12 4.2 Financial context ................................................................................................................................... 12 4.3 Secondary services sustainability ................................................................................................... 13 4.4 Population & health status .................................................................................................................. 14 4.5 West Coast PHO .................................................................................................................................... 17 4.6 Changes underway ................................................................................................................................ 20 4.7 West Coast region service delivery issues ................................................................................... 21 5 Future model of care ................................................................................................................................... 23 5.1 The desired patient care pathway/model of care ..................................................................... 23 5.2 Goals for better, sooner more convenient ................................................................................... 25 5.3 Reducing inequalities ........................................................................................................................... 27 5.4 Service specific model of care developments............................................................................. 28 5.5 Enablers .................................................................................................................................................. 35 5.6 Clinician engagement ........................................................................................................................... 36 5.7 Community engagement ...................................................................................................................... 37 5.8 Evidence for this model ..................................................................................................................... 38 5.9 Quality, safety and evaluation .......................................................................................................... 41 6 Business model ............................................................................................................................................... 44 6.1 Business concept .................................................................................................................................. 44 6.2 Locality Integrated Family Health Centres................................................................................. 48 6.3 Service outputs and outcomes ......................................................................................................... 49 7 Governance, Ownership & Management .................................................................................................. 53 7.1 Options .................................................................................................................................................... 53 7.2 Assessing the options ......................................................................................................................... 55 8 Contracting arrangements .......................................................................................................................... 56 8.1 Role of the IFHS ................................................................................................................................. 56 8.2 Annual health service plan ................................................................................................................. 56 8.3 Contracted providers within IFHCs. .............................................................................................. 57 9 Financial sustainability ................................................................................................................................ 58 9.1 Status quo financial situation........................................................................................................... 58 9.2 Addressing affordability ................................................................................................................... 59 9.3 Impact on the DHB .............................................................................................................................. 60 10 Implementation plan ..................................................................................................................................... 62 10.1 Project governance and management ............................................................................................. 62 10.2 Change management ............................................................................................................................ 62 10.3 Investing in change .............................................................................................................................. 64 Business case EoI V38 AC 25Feb10 Page 10
10.4 Key milestones....................................................................................................................................... 65 10.5 Objectives, key activities and workplans ..................................................................................... 66 10.6 Work in progress items ...................................................................................................................... 70 10.7 Risks and Mitigations .......................................................................................................................... 70 Business case EoI V38 AC 25Feb10 Page 11
- Page 1 and 2: Business Case Better, Sooner, More
- Page 3 and 4: 1 Caveats/status This business case
- Page 5 and 6: Current situation By three years Wa
- Page 7 and 8: staffed on a capacity model - in wh
- Page 9: support from DHBs, specialist clini
- Page 13 and 14: Annual government health funding pe
- Page 15 and 16: Ambulatory Sensitive Hospitalisatio
- Page 17 and 18: The base populations of the three d
- Page 19 and 20: Māori/Pacific Not Māori/Pacific D
- Page 21 and 22: 4.7 West Coast region service deliv
- Page 23 and 24: 5 Future model of care 5.1 The desi
- Page 25 and 26: support them. Help with understandi
- Page 27 and 28: LEVERS VISION Better, sooner, more
- Page 29 and 30: providing the majority of care). Th
- Page 31 and 32: The Community Health System Deliver
- Page 33 and 34: To better integrate the support pro
- Page 35 and 36: 5.5 Enablers A key aspect of this b
- Page 37 and 38: Two rounds of meetings with front l
- Page 39 and 40: While doctor-nurse substitution has
- Page 41 and 42: Nick Goodwin, Kings Fund 14 , in hi
- Page 43 and 44: Quality domains Each new initiative
- Page 45 and 46: Preventative Acute LTC management R
- Page 47 and 48: Preventative Acute LTC management R
- Page 49 and 50: The core services are provided or p
- Page 51 and 52: Total required FTEs for the Grey IF
- Page 53 and 54: 7 Governance, Ownership & Managemen
- Page 55 and 56: Option D: PHO/DHB jointly owned Pri
- Page 57 and 58: The IFHS will need the ability to b
- Page 59 and 60: Of note, a large proportion of the
3 Table of contents<br />
1 Caveats/status .................................................................................................................................................. 3<br />
2 Executive summary .......................................................................................................................................... 4<br />
2.1 Assessment criteria summary ............................................................................................................. 5<br />
3 Table of contents ........................................................................................................................................... 10<br />
4 Introduction .................................................................................................................................................... 12<br />
4.1 Strategic context ................................................................................................................................. 12<br />
4.2 Financial context ................................................................................................................................... 12<br />
4.3 Secondary services sustainability ................................................................................................... 13<br />
4.4 Population & health status .................................................................................................................. 14<br />
4.5 West Coast PHO .................................................................................................................................... 17<br />
4.6 Changes underway ................................................................................................................................ 20<br />
4.7 West Coast region service delivery issues ................................................................................... 21<br />
5 Future model of care ................................................................................................................................... 23<br />
5.1 The desired patient care pathway/model of care ..................................................................... 23<br />
5.2 Goals for better, sooner more convenient ................................................................................... 25<br />
5.3 Reducing inequalities ........................................................................................................................... 27<br />
5.4 Service specific model of care developments............................................................................. 28<br />
5.5 Enablers .................................................................................................................................................. 35<br />
5.6 Clinician engagement ........................................................................................................................... 36<br />
5.7 Community engagement ...................................................................................................................... 37<br />
5.8 Evidence for this model ..................................................................................................................... 38<br />
5.9 Quality, safety and evaluation .......................................................................................................... 41<br />
6 Business model ............................................................................................................................................... 44<br />
6.1 Business concept .................................................................................................................................. 44<br />
6.2 Locality Integrated Family Health Centres................................................................................. 48<br />
6.3 Service outputs and outcomes ......................................................................................................... 49<br />
7 Governance, Ownership & Management .................................................................................................. 53<br />
7.1 Options .................................................................................................................................................... 53<br />
7.2 Assessing the options ......................................................................................................................... 55<br />
8 Contracting arrangements .......................................................................................................................... 56<br />
8.1 Role of the IFHS ................................................................................................................................. 56<br />
8.2 Annual health service plan ................................................................................................................. 56<br />
8.3 Contracted providers within IFHCs. .............................................................................................. 57<br />
9 Financial sustainability ................................................................................................................................ 58<br />
9.1 Status quo financial situation........................................................................................................... 58<br />
9.2 Addressing affordability ................................................................................................................... 59<br />
9.3 Impact on the DHB .............................................................................................................................. 60<br />
10 Implementation plan ..................................................................................................................................... 62<br />
10.1 Project governance and management ............................................................................................. 62<br />
10.2 Change management ............................................................................................................................ 62<br />
10.3 Investing in change .............................................................................................................................. 64<br />
Business case EoI V38 AC 25Feb10 Page 10
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