Better Sooner More Convenient Primary Care - New Zealand Doctor

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Option 2 - IFHC integrated with Grey Hospital master plan The second option integrates with the staged development proposed in the Grey Hospital masterplan. It proposes a 3,385m2 gross floor area for the IFHC component, 1,395m2 of which is refurbishment to existing hospital buildings and 1,990m2 is new building. This option tightly integrates with the proposed new hospital, such that the strategic aims of both IFHC and hospital developments can be most effectively achieved. This option is the only one of the three that allows optimum integration of primary care, hospital-based care and community services in one location and fully supports an integrated, multi-disciplinary model of health service delivery in Greymouth across the primary-secondary continuum. It also makes most effective use of existing buildings, thereby reducing the amount of new building required, avoiding duplication of services and facilities. The combined cost estimate is $76.545m, with the IFHC component being $10.1m and the hospital component being $66.445m. The IFHC could be built as the first stage of this project. Option 3 - IFHC located adjacent to existing Grey Hospital The third option is also on the Grey Base Hospital site. However, it assumes that no funds are made available for the Grey Base Hospital rebuild, locates the IFHC adjacent to the existing hospital without connecting the two, and assumes that both allied health services and the office bases of the likes of community nurses and mental health services would remain in existing hospital buildings, even though their clinical contact with patients would occur within the IFHC. Business case appendices V12 AC 25Feb2010 Page 122
This option is effectively a Greenfield part-IFHC adjacent to the existing hospital and, as such, goes some way towards integrating health service delivery, but does not support fully integrated multi-disciplinary service models to the extent of option 2. The new build area of the IFHC is less than the other options because allied health and community services remain in existing hospital buildings, some distance away from primary services. The area of this smaller option is 2,863m 2 , 2,213m2 of which is new building and 650m2 is refurbishment of the existing Corporate Building. This option requires relocation of DHB Administration to another, as yet undefined location, most likely rental accommodation off site. The cost of this option is in the region of $10.785m and includes an allowance for fitout of new DHB Admin offices elsewhere, but excludes both relocation and lease costs (though these costs should be considered as part of the overall cost of option 3). The resulting site plan is as follows: Financing Private financing of the capital cost of the IFHC is being explored; initial discussions have indicated strong potential for a private funding syndicate. A key conversation has been with Development West Coast, which has expressed its interest in the project, particularly if a freehold option is chosen, and indicated that the likely scale of the project is one that is manageable for, and attractive to, them. Mawhera Incorporation is a major Maori land owner in central Greymouth, which has also expressed interest in a financing and/or development role. Business case appendices V12 AC 25Feb2010 Page 123
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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
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Year two implement the process to
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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
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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 and 188: Mainstream arguments are concerned
Page 189 and 190: Appendix Thirteen: IFHCs - Faciliti
Page 191: A key possibility is that land at t
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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