Better Sooner More Convenient Primary Care - New Zealand Doctor

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Enable the optimisation of health by evaluating and addressing where possible, the medication management needs of local populations and individual patients. Enable the development of medication management services that enhance patient choice, access and convenience and provide a positive experience for patients and other providers of healthcare. Enable the provision of a range of clinically effective and cost-effective medication management services that build on the strengths of community pharmacy teams and that are provided within a multidisciplinary environment. Enable the development of an integrated approach to planning and commissioning of innovative medication management services that contribute to the development of primary health care and the optimisation of health outcomes regionally and nationally. 10 Risk analysis Risk Probability Impact Contingency plan Inability to “realise” savings made through more efficient and effective practice medium high Effective and ongoing monitoring and review to identify and attribute changes in volumes of referred services. Growth in patient need outstripping effectiveness and efficiency measures medium high See above. Linkages with other monitoring processes to determine improvement in wider health outcomes, (eg. avoidable hospital admissions). Increasing emphasis on long term condition management could lead to an increase in diagnostic testing and prescribing medium Close monitoring and evaluation of diagnostic testing and prescribing to determine the „desirability‟ of any specific increases or decreases in volumes. 11 Engagement Working group who developed this plan: Dr. Tim Bolter (GP), Dr. Jocelyn Tracey (GP, <strong>Primary</strong>/Secondary Liaison), Phil Clark (Laboratory Manager), Nick Leach (Hospital Pharmacist), Wayne Champion (Corporate Services Manager, Acting Secondary Service Manager), Peter McIntosh (Senior Planning and Funding Analyst), Kerri Miedema, July Kilkelly and Lindy Mason (Community Pharmacists), Wayne Turp (GM Planning and Funding). Business case appendices V12 AC 25Feb2010 Page 86
12 Organisational accountabilities A shared DHB, PHO steering group will oversee the implementation of this plan. 13 Costs A full cost analysis of the implementation of this workstream will be developed after phase one, year one. However $30,000 for further data analysis has been included in the Investing in Change budget, Section 11.1 in the Business Case. Business case appendices V12 AC 25Feb2010 Page 87
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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
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Total required FTEs for the Grey IF
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7 Governance, Ownership & Managemen
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Option D: PHO/DHB jointly owned Pri
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The IFHS will need the ability to b
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Of note, a large proportion of the
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The DHB delegates decision making o
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Limited integration of community se
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10.4 Key milestones The table below
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Expanded pharmacy roles Improving a
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Devolved community based services w
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Appendices Appendix One: Health Equ
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ongoing GP shortage creating an env
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10. What are the unintended consequ
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It is common for people with an acu
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Outcome measures Indicator Baseline
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determine ratio of nurses and GPs t
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C. Extended role for pharmacists:
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11 Engagement Working group who dev
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Appendix B: Acutely unwell adult pa
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4 Objectives to implement nur
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Review Buller after hours arrangeme
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Year three Community education camp
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13 Costs Budget considerations:
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established. This group now oversee
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Output measures Tobacco control / s
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Improving immunisation coverage - h
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Year three Continued joint plan
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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
Page 153 and 154: Identify patients that would benefi
Page 155: • Provision of patient specific m
Page 159 and 160: emain under the care and management
Page 161 and 162: Service user pathways in an optimal
Page 163 and 164: Model for shared care pathways deve
Page 165 and 166: Implementation plan: to June 30 Dev
Page 167 and 168: Year two Review progress, outcome m
Page 169 and 170: 10 Risk analysis Risk Probability I
Page 171 and 172: Appendix Eleven: Frail older people
Page 173 and 174: ehab and treatment programmes that
Page 175 and 176: Year one: Maintain and continue the
Page 177 and 178: Māori have a higher incidence of m
Page 179 and 180: 11 Organisational accountabilities
Page 181 and 182: There are often vacancies for allie
Page 183 and 184: 6 Deliverables / activities Program
Page 185 and 186: Professional development: Provide
Page 187 and 188: Mainstream arguments are concerned
Page 189 and 190: Appendix Thirteen: IFHCs - Faciliti
Page 191 and 192: A key possibility is that land at t
Page 193 and 194: This option is effectively a Greenf
Page 195 and 196: 7 Westland IFHC Facilities options
Page 197 and 198: Year two Substantive-IFHC in Greymo
Page 199 and 200: 12 Costs Capital costs Greymouth IF
Page 201 and 202: utilize MedTech, but via their own
Page 203 and 204: 4 Objectives: To implement c
Page 205 and 206: 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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