Better Sooner More Convenient Primary Care - New Zealand Doctor

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8 Deliverables / activities Implementation plan: to June 30 Proto-IFHC in Greymouth Plan and build primary care academic practice on Grey Base Hospital site incorporates teaching component to support rural workforce retention & development co-located with Grey Base Hospital, with GP registrars doing work in both facilities contribution to resolving after hours cover issues Substantive-IFHC in Greymouth Plan primary and community care components of Grey IFHC relationship map completed by Feb '10 understand links to and implications (both ways) of possible link with Grey Hospital site & business case by Mar '10 explore site options by Apr '10 explore financing options by May '10 concept design by June 2010 Westport Review plans for Westport assess fit with revised model of care; adapt & revise designs as necessary Year one: Proto-IFHC in Greymouth Academic practice on Grey Base Hospital site opens 1 Jul '10 Substantive-IFHC in Greymouth Build substantial primary/community care facility (on Grey Base Hospital site?) preliminary design by August 2010 capital funding in place by end Aug '10 developed design by October 2010 resource consents received by end Oct '10 detailed plans completed by Feb 2011 building consents received by Mar 2011 building commences April 2011 Westport revise designs, timelines, decanting etc by end Dec '10 finalise plans and submit resource & building consent applications by end Mar '11 capital funding in place by Mar '11 Reefton Explore and document Reefton's facility requirements Business case appendices V12 AC 25Feb2010 Page 126
Year two Substantive-IFHC in Greymouth Substantial primary/community care facility on Grey Base Hospital site in operation building completed Feb 2012 building opens 1 March 2012 various tenants move in during Mar '12 building fully operational from 1 Apr '12 Westport first stage of building commences 1 Apr '12 Reefton progress options developed Year three Westport all stages of building completed 30 Sep '12 Changes to current staffing: Well configured facilities will assist in achieving optimised, efficient staffing levels. 9 Risk analysis Risk Probability Impact Contingency plan Capital costs of, and therefore operating High High Revise plans to be reduce capital costs /be affordable costs in, new facilities too high Connection of Grey IFHC with Grey Hospital rebuild High High Explore options for Grey IFHC to not be dependent on Grey Hospital obtaining Crown funding for its rebuild causes delays and/or derails project Co-location does not lead to integration of services High Medium Develop Charter to sit alongside leases (Charter commits tenants to integrated way of working) PHO provides facilitation/overall management function to drive integration Community opposition to Buller IFHC, if seen as a downgrade for/of Buller Hospital High Medium Engage community leaders early Engage with community re service delivery options for Buller, and facilities implications Articulate reasons for service & facility options once chosen Business case appendices V12 AC 25Feb2010 Page 127
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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
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Appendix Eight: Improved access to
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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 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: 7 Westland IFHC Facilities options
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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