Better Sooner More Convenient Primary Care - New Zealand Doctor

It is significant that the 9% of the 30,000+ enrolled population who attended medical centres
most frequently, accounted for 35% of the 120,000+ visits to medical centres, ie. those sickest
9% patients attended their medical centre an average 16 times during 2009.
In addition, district and rural health nurses received 2,351 referrals in 2009 and saw patients
on average 12 times, clinical nurse specialists received 782 referrals and saw patients on
average 6 times, while allied health received 4,613 referrals and saw patients on average 4
times. All in all, the community nursing and allied health workforces conducted some 50,000
patient contacts, in addition to the 120,000+ visits to medical centres.
4 Objectives
The overarching aim is to provide better co-ordinated care for patients across medical centres,
community nursing and allied health services, by including the community nursing and allied
health workforces as members of Integrated Family Health Centres (IFHC)teams. This is likely
to be of particular benefit for high complexity patients with Long Term Conditions (LTCs) and
high numbers of admissions (see also LTC Project plan).
A multi disciplinary team (MDT) approach to care (for that subset of patients who will benefit
from it), including MDT clinical review, will be developed. Patient pathways for common and
complex conditions, which integrate home based and clinic based care, and that align the
activities of health professionals providing that care will be developed (see also the LTC Project
plan and the Health Pathways Project plan).
We will therefore work towards achieving a unified management and clinical leadership
structure which respects and promotes the professional contribution of all staff within the
IFHC, and makes the most efficient use of the nursing and allied health resources available on
the West Coast. This structure will recognise the particular ownership characteristics and
needs of participating health providers in the integrated setting.
Where particular roles or professions need to contribute to more than one IFHC, we will define
how such specialist roles can best be organised across the region. It will be important to
maintain linkages between professional groups, who are working in a variety of settings, and to
review and develop professional roles so that they contain both generalist and special interest
components. Health professionals will retain their professional identity and have access to
robust professional development processes to ensure the delivery of evidence based best
practice, especially in the context of delivery of rural/remote services with practitioners often
working in isolation.
We intend to develop health assistant roles within the IFHCs and so ensure health professionals
are working to their maximum capacity in delivering care to patients commensurate with their
Business case appendices V12 AC 25Feb2010 Page 54