Better Sooner More Convenient Primary Care - New Zealand Doctor

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Prevention & Early Intervention – co-ordination and facilitation of early intervention programmes (such as Green Prescription, Cooking Skills to Life Skills), information dissemination and education, creating social environments that support healthy eating and physical activity and provision of the Health Promoting Schools programme in West Coast schools. PHO specific deliverables – health promotion Men‟s health forums - focused on men‟s health issues including cardiovascular, mental health and urology issues. Men‟s engagement with the practices to reach „hard-to-reach‟ males is a key focus of this campaign. Whanau Ora Pai /Living Well Hui - targeted for West Coast Māori and focused on all aspects of healthy living in a culturally appropriate environment. Awareness week promotions - targeted on cervical screening, diabetes, mental health, breastfeeding, prostate cancer and men‟s health, cancer. Breastfeeding support - peer support programme, community promotions, breastfeeding friendly workplaces and cafés. As well as working on the above priority areas we also intend to: work together to reduce health inequalities operate as a virtual single entity for the three key priority areas work under a common banner for health promotion 'Healthy West Coast' produce a common community health needs assessment have transparent funding streams for public health for the three key priority areas work to develop a common approach to evaluation and review the effectiveness of different types of programme share training across all workers within the three organisations. Year two: One joint plan covering all health promotion services that each organisation implements in addition to tobacco control, immunisation coverage, physical activity and nutrition. This will further enhance the virtual single entity and ensure the needs of the West Coast community are met. Review and revise outputs and outcomes for the tobacco control/smokefree, immunisation coverage and physical activity and nutrition plans. Re-allocate funding to programmes/activities which have been shown to be more effective by appropriate evaluation. Transfer responsibility for programmes/activities to those organisation best placed to deliver them. Business case appendices V12 AC 25Feb2010 Page 32
Year three Continued joint planning by each organisation with one plan covering all health promotion services. Enhanced collaboration between the three organisations. Fully functional virtual single operating entity where each organisation WCPHO, WCDHB and CPH work together to create a “Healthy West Coast”. 7 Capability and capacity Between the three organisations, the West Coast has a small but strong health promotion workforce. This workforce is strongly supported by a range of clinicians including general practice teams, pharmacies, rural nurse specialists, practice nurses and so on. General practices and pharmacies are actively engaged in health promotion campaigns and provision of health promotion resources. West Coast PHO The West Coast PHO has a small but strong health promotion workforce with 0.5 Full Time Equivalent (FTE) Health Promoter and 1 FTE Active Communities Co-ordinator that are supported by the Clinical Manager. The Coast Quit programme is implemented by GP‟s, practice nurses, rural nurse specialists and three pharmacies. West Coast DHB Tobacco Control/Smokefree - the 1 FTE Regional Smokefree Co-ordinator is based within the Planning & Funding team and smoking cessation services and clinical training a delivered within the hospital setting by the Smoking Cessation practitioners (1 FTE total). Physical Activity and Nutrition - the Healthy Eating Healthy Action (HEHA) team is based within Planning & Funding and consists of 2.5 FTE of HEHA co-ordinators that work across the nutrition and physical activity areas and 1 FTE HEHA manager that works across the West Coast and Canterbury DHBs. Immunuisation - Outreach Immunisation co-ordinators (1 FTE total – 0.4 clinical, 0.6 Māori coordination), HPV co-ordinator (0.4 FTE), Public Health Nurses, Immunisation co-ordinator (0.6 FTE). Community & Public Health Tobacco Control/Smokefree - Aukati Kai Paipa 1.0 FTE, Māori Smoking Health Promoter 0.4 FTE, Smokefree Health Promoter 0.5 FTE, Smokefree Environment Compliance 0.2 FTE. Immunuisation - Youth Health Promoter 0.2 FTE, Health Protection Officer 0.2 FTE, Public Health Specialist 0.1 FTE. Business case appendices V12 AC 25Feb2010 Page 33
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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
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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 and 100: Output measures Tobacco control / s
Page 101: Improving immunisation coverage - h
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.
Page 151 and 152: 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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