Better Sooner More Convenient Primary Care - New Zealand Doctor

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Physical Activity and Nutrition Indicator Baseline Target – Yr 1 Year 2 Year 3 Full and exclusive breastfeeding at 75% 75% 76% 77% 6 weeks – total (Plunket) Full and exclusive breastfeeding at 66% 68% 70% 72% 6 weeks – Māori (Plunket) Full and exclusive breastfeeding at 6 months – total (Plunket) 35% 35% 36% 37% Full and exclusive breastfeeding at 6 months – Māori (Plunket) 25% 27% 29% 31% * figures are adjusted for WCDHB „eligible‟ population as Gloriavale Christian Community does not immunise. 6 Deliverables / activities Implementation phase Alignment of the three organisations planning processes and joint planning in three priority areas (tobacco control/smokefree, immunisation, physical activity and nutrition). Year one Tobacco control/Smokefree: Implementing the ABC strategy –joint implementation of the ABC strategy to ensure patients across community, primary and secondary care are provided with advice and support to quit. Smoking cessation services – including training of primary and secondary staff on brief advice (additional training will be provided to mental health workers, Māori providers, midwives and those working with youth), utilization of NRT and referrals onto specialist cessation services, a media campaign to promote smokefree lifestyles and cessation services and provision of a range of cessation services (including Coast Quit, ABC & NRT dispensing, Aukati kai Paipa, WCDHB Specialist Smoking Cessation Services, Quitline). Smokefree pregnancy – smoking cessation training will be provided to midwives throughout the district. A joint plan will be established to provide services specifically for this key target group (including a key focus on Aukati kai Paipa for Māori women). Māori Smokefree Initiatives – implementation of smokefree initiatives and health promotion through Aukati kai Paipa and Rata Te Awhina Trust. This will include other health promotion activities. Māori smokefree health promotion roopu continues to work together to reduce unacceptable Māori smoking rates on Tai Poutini. Reducing smoking initiation – joint health promotion initiatives will focus on increasing the percentage of year 10 students living in a smokefree home. The HPS programme will continue to support smokefree environments and strategies in West Coast schools. Smokefree Policies - training and support will be offered to WCDHB providers and selected workplaces. Business case appendices V12 AC 25Feb2010 Page 30
Improving immunisation coverage – health promotion strategies: Co-ordination of the Immunisation Advisory Group - continue to co-ordinate an Immunisation Advisory Group (includes Māori representation) to work strategically to increase immunisation coverage and work collaboratively to achieve this outcome. Seasonal Influenza – facilitation of a range of seasonal influenza health promotion activities such as primary care clinics, promotions in practices, promotional campaigns targeting the chronically ill and those aged 65 years and over, supermarket promotions and linking into the national campaign through radio advertisement, aquatic centre promotion and pharmacy flu bug themed promotions. Staff Seasonal Influenza Vaccination Programme – facilitation of the WCDHB and WCPHO staff seasonal influenza promotion (encouraging and educating staff on getting immunised). Supporting workplace staff to become immunised throughout the West Coast (for larger organisations such as Pike River Coal). Childhood Immunisations (including HPV): Improvement of the practice process for immunisation, particularly relating to providing timely recall information (using the long term conditions model of engagement and collaboration) and offering flexibility around clinic times. Ongoing promotion and implementation of the HPV programme in schools throughout the West Coast with a focus on promotion and uptake for Māori girls. Provision of immunisation education in antenatal classes. Health promoting schools framework used to promote immunisation services. Outreach Immunisation Services – continued provision of Outreach Immunisation Services with a focus on reducing inequalities in coverage for tamariki Māori and children in NZ Dep 9 and 10 areas (including by use of Māori staff). Training & Education – the ongoing provision of practice nurse training by the Immunisation Co-ordinator. Increase physical activity and improve nutrition: Breastfeeding Action - implement the Breastfeeding Action Plan (focus on implementation of the Mum4Mum Peer Support programme, education of primary care and social service providers, antenatal education, creating and maintaining environments that support breastfeeding and professional development for maternity and well child staff). Māori Community Action - implement the Māori Community Action Plan that focuses on Māori communities being supported and assisted to devise and implement programmes that improve nutrition, increase physical activity and reduce chronic disease. Healthy Ageing Programme - this programme targets adults aged 65 years and over (and Māori aged 55 years and over) and focuses on improving nutrition, increasing physical activity and decreasing falls. Building Community Capability – implement programmes such as the Cooking Skills to Life Skills, Senior Chef, workplace wellness interventions and relevant physical activity programmes that use a skill-based model to build capability of community volunteers and at risk populations. Business case appendices V12 AC 25Feb2010 Page 31
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Business Case Better, Sooner, More
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1 Caveats/status This business case
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Current situation By three years Wa
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staffed on a capacity model - in wh
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support from DHBs, specialist clini
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10.4 Key milestones................
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Annual government health funding pe
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Ambulatory Sensitive Hospitalisatio
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The base populations of the three d
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Māori/Pacific Not Māori/Pacific D
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4.7 West Coast region service deliv
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5 Future model of care 5.1 The desi
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support them. Help with understandi
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LEVERS VISION Better, sooner, more
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providing the majority of care). Th
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The Community Health System Deliver
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To better integrate the support pro
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5.5 Enablers A key aspect of this b
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Two rounds of meetings with front l
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While doctor-nurse substitution has
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Nick Goodwin, Kings Fund 14 , in hi
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Quality domains Each new initiative
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Preventative Acute LTC management R
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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
Page 61 and 62: The DHB delegates decision making o
Page 63 and 64: Limited integration of community se
Page 65 and 66: 10.4 Key milestones The table below
Page 67 and 68: Expanded pharmacy roles Improving a
Page 69 and 70: Devolved community based services w
Page 71 and 72: Appendices Appendix One: Health Equ
Page 73 and 74: ongoing GP shortage creating an env
Page 75 and 76: 10. What are the unintended consequ
Page 77 and 78: It is common for people with an acu
Page 79 and 80: Outcome measures Indicator Baseline
Page 81 and 82: determine ratio of nurses and GPs t
Page 83 and 84: C. Extended role for pharmacists:
Page 85 and 86: 11 Engagement Working group who dev
Page 87 and 88: Appendix B: Acutely unwell adult pa
Page 89 and 90: 4 Objectives to implement nur
Page 91 and 92: Review Buller after hours arrangeme
Page 93 and 94: Year three Community education camp
Page 95 and 96: 13 Costs Budget considerations:
Page 97 and 98: established. This group now oversee
Page 99: Output measures Tobacco control / s
Page 103 and 104: Year three Continued joint plan
Page 105 and 106: extending health promotion activiti
Page 107 and 108: Immunisation Coverage Funder Provid
Page 109 and 110: The Community Health System Deliver
Page 111 and 112: Clinical care Practice self managem
Page 113 and 114: and increases in the numbers of pat
Page 115 and 116: Ambulatory Sensitive Hospitalisatio
Page 117 and 118: % CVD on lipid lowering drugs, beta
Page 119 and 120: Health navigators/ kaiawhina: chan
Page 121 and 122: Committee‟s objectives 41 of prov
Page 123 and 124: - lack of consistency of care betwe
Page 125 and 126: qualifications and skills. Where ca
Page 127 and 128: 6 Deliverables / activities Impleme
Page 129 and 130: “With an aging population and an
Page 131 and 132: Differences between revenue generat
Page 133 and 134: Appendix Seven: Integration - Healt
Page 135 and 136: It is expected that HealthPathways
Page 137 and 138: Year two implement the process to
Page 139 and 140: Low uptake by primary and secondary
Page 141 and 142: Appendix Eight: Improved access to
Page 143 and 144: to easily access by telephone). Oth
Page 145 and 146: Year One - July 2010 to June 2011 T
Page 147 and 148: LECG 50 evaluated whether “the im
Page 149 and 150: Appendix Nine: Referred services 1.
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them by technical errors or lack of
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Identify patients that would benefi
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• Provision of patient specific m
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12 Organisational accountabilities
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emain under the care and management
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Service user pathways in an optimal
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Model for shared care pathways deve
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Implementation plan: to June 30 Dev
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Year two Review progress, outcome m
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10 Risk analysis Risk Probability I
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Appendix Eleven: Frail older people
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ehab and treatment programmes that
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Year one: Maintain and continue the
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Māori have a higher incidence of m
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11 Organisational accountabilities
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There are often vacancies for allie
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6 Deliverables / activities Program
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Professional development: Provide
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Mainstream arguments are concerned
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Appendix Thirteen: IFHCs - Faciliti
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A key possibility is that land at t
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This option is effectively a Greenf
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7 Westland IFHC Facilities options
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Year two Substantive-IFHC in Greymo
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12 Costs Capital costs Greymouth IF
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utilize MedTech, but via their own
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4 Objectives: To implement c
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Security An individual‟s health i
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8 Effect on inequalities The increa
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Appendix Fifteen: Project advisory
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