Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor
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Underdevelopment of support for carers – local voluntary agencies are barely<br />
sustainable as the Coast population is not large enough to support services that would be<br />
available in bigger centres, (eg. age concern befriending, continence education, dementia<br />
support). <strong>Care</strong>r burnout contributes to the relatively high rate of rest home entry.<br />
Many health and support workers and many clients still hold to a traditional dependency<br />
and entitlement model for rest home and home support services and there is limited<br />
implementation of a restorative model as yet.<br />
Very limited availability of allied health staff for community based work, (eg. supervising<br />
home carers in home based rehabilitation programmes, responding to GP referrals),<br />
reflected in high rate of inpatient admission to AT&R ward.<br />
Residential aged care facilities (in Greymouth) have had limited access to general<br />
practitioner services, reflected in a relatively high rate of referrals to the acute<br />
services. <strong>Primary</strong> health care received by residential care residents is sometimes suboptimal<br />
and would benefit from greater input from medical staff with specialist<br />
knowledge of older peoples health, including dementia.<br />
A number of residential aged care facilities have had a continued shortage of registered<br />
nurses, which has repeatedly compromised quality of care.<br />
3 OBJECTIVES<br />
Set up a clear pathway for accessing primary and community services. This would include:<br />
A hub of shared client information available to all health and support services – GPs,<br />
practice nurses, district nurses, <strong>Care</strong> Link, ward staff, allied health, residential care,<br />
home care agencies etc. This includes InterRAI and other assessments.<br />
A triage function for logging all cases and sending simple routine cases directly to the<br />
appropriate service while ensuring complex cases receive multidisciplinary assessment,<br />
case management through Chronic Conditions Programme and/or <strong>Care</strong> Link, and/or<br />
referral to specialist services<br />
Clear, agreed protocols for accessing services<br />
Co-locate <strong>Care</strong> Link with the Integrated Family Health Centres (IFHC), and link staff to<br />
specific primary health teams, thereby giving those teams easy access to expert assessment<br />
(InterRAI), community-based support packages and a case management function for people with<br />
long-term disabling conditions.<br />
Set up a restorative home-based support service based on need, accessed through <strong>Care</strong> Link and<br />
closely linked to primary and community health services:<br />
Home care workers having close connection to primary health services, community<br />
nursing and allied health, in some cases working under supervision to help clients do the<br />
Business case appendices V12 AC 25Feb2010 Page 102