Better Sooner More Convenient Primary Care - New Zealand Doctor

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12 Organisational accountabilities Organisational accountability lies with the PHO for the first year, and with the IFHS thereafter. 13 Costs Draft budget Income Recruitment and retention fund - 30% 75,000 Payment from practices to recruitment agency 80,000 Professional development (PHO contract) 65,000 PHO Performance programme 120,000 Expenditure Total 340,000 Project management 40,000 GP registrar scholarships 15,000 <strong>New</strong> grad nurse scholarships 12,000 Teaching - funded by CTA 0 Recruitment agency 100,000 Recruitment agency advertising costs 80,000 Peer mentoring 1,000 Professional development activities 25000 Health pathways editors 5,000 Course/ conference leave support 35,000 Support for Cornerstone and practice quality activities 10,000 PHO Performance programme facilitation 24,000 Support for Practice QI teams 20,000 Pharmacy support for PPP 4,000 Practice PPP incentive payments 50,000 Total expenditure 421,000 Surplus/deficit ($91,000) The deficit in this budget has been included in the „Implementing Service Strategies‟ aspect of the Investing in Change budget, Section 11.1 in the Business Case. Business case appendices V12 AC 25Feb2010 Page 118
Appendix Thirteen: IFHCs - Facilities 1. Aspirational statement: Facilities are renovated and/or created that best progress and support the new models of care, so as to improve the health of West Coasters. 2 Problem definition <strong>Primary</strong> care facilities across the Coast vary enormously. In Greymouth and Westport, in particular, the location and/or nature of the buildings that house the primary services and workforce are problematic for delivering the desired model of care. In Greymouth, the three medical centres and other private providers including pharmacies are in different parts of town (and none is connected to the hospital). No medical centres have on-site or adjacent diagnostics or pharmacy. In Westport, the medical centre is located in old hospital buildings, with other community based services on the same campus, but widely separated by long corridors - the layout/location of services is a barrier to communication between services. Some individual centres are cramped for space. A number of facilties are old and don't comply with seismic regulations (Westport in particular). 3 Objectives: To integrate a variety of services alongside traditional general practice service, in line with the revised model of care and other workstreams To adapt facilities to best fit with the new ways of working, where this is feasible To purpose-build future-proofed facilities optimised for the new model of care where this is the best option and/or necessary 4 Benefits and gains Output measures Indicator Baseline Target – Yr 1 Year 2 Year 3 No. of IFHCs 0 Embryonic 1 2 Business case appendices V12 AC 25Feb2010 Page 119
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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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extending health promotion activiti
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Immunisation Coverage Funder Provid
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The Community Health System Deliver
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Clinical care Practice self managem
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and increases in the numbers of pat
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Ambulatory Sensitive Hospitalisatio
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% CVD on lipid lowering drugs, beta
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Health navigators/ kaiawhina: chan
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Committee‟s objectives 41 of prov
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- lack of consistency of care betwe
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qualifications and skills. Where ca
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6 Deliverables / activities Impleme
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“With an aging population and an
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Differences between revenue generat
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Appendix Seven: Integration - Healt
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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 and 156: • Provision of patient specific m
Page 157 and 158: 12 Organisational accountabilities
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: Mainstream arguments are concerned
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
Page 207 and 208: 8 Effect on inequalities The increa
Page 209: Appendix Fifteen: Project advisory
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Better Sooner More Convenient Primary Care - New Zealand Doctor

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