Better Sooner More Convenient Primary Care - New Zealand Doctor

Each provides support and education to clinicians within primary and secondary settings, as well
as education and self management support to patients within the hospital and home settings,
some examples are:
Breathe easy groups have been happening sporadically according to staff resourcing cardiac
rehabilitation have two formal programmes:
phase 2 cardiac rehabilitation, a six week outpatient programme based at the DHB
physio gym in Greymouth and a modified programme at Buller hospitals
Heart Guide Aotearoa, a home based programme designed to improve access to
rehabilitation for West Coasters.
Allied health comprises physiotherapy, occupational therapy, social work, dietician, speech
language therapy, all with work components crossing secondary and primary care. These
services are utilized within all levels of care as required, preferably sooner than later within the
patient journey, this will ensure patient and family supports are put in place earlier before crisis
point is hit.
Pharmacist support
This is related to levels of care, people would tend to move to more „intensive‟ care over time.
Patients managing well – prescription dispensing, brief counseling/education as medicines
added or adjusted, eg. take with food, side effects to watch for, inhaler/spacer
technique, self care cards, adherence support, referral onto other team members as
required.
Supporting self management – as above but likely to be seen more often as receiving
more medicines and more presentations to pharmacy, increased likelihood of
medicines-related problems, medication reviews, compliance aid provision as necessary.
Integration – as above, likely weekly compliance packaging – picked up or delivered to
home or sometimes district nursing, reminders to visit GP for 3 monthly prescription,
liaison with hospital and GP practice at discharge, follow-up if (blister-packed)
medications not collected. Scope for comprehensive medication review at this level.
General support – pharmacists are involved with various support groups, eg. cardiac and
respiratory as speakers and are accessible to those with questions, presenting for Over
The Counter (OTC) products or wanting their weight or blood pressure measured.
Smoking cessation services are offered. People are referred as necessary, eg. to
diabetes nurse specialist or general practice team.
Ambulatory sensitive hospitalisations for those aged 45–64 are helpful in indicating whether
LTC management is keeping people out of hospital. 39
39 Included are angina, MI, CHF, pneumonia, asthma, diabetes, stroke, epilepsy
Business case appendices V12 AC 25Feb2010 Page 44