Better Sooner More Convenient Primary Care - New Zealand Doctor

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Option B: DHB takes over current PHO functions DHB Board & CEO DHB funder DHB secondary services Shared corporate services GM primary & community Region-wide services IFHCs Under this option the DHB cancels the PHO contract and takes full responsibility for delivery of integrated primary and community services. Option C - PHO assumes responsibility for current DHB <strong>Primary</strong> & Community services DHB Board & CEO PHO Board DHB funder DHB secondary services Shared corporate services GM primary & community Region-wide services IFHCs Under this option the DHB devolves to the PHO responsibility for delivery of integrated primary and community services. The makeup of the PHO board, and its associated trust deed, would need to adapt to this expanded role. Business case EoI V38 AC 25Feb10 Page 54
Option D: PHO/DHB jointly owned <strong>Primary</strong> & Community services entity DHB Board / CEO PHO Board DHB funder P & C Trust or alliance contract DHB secondary services Shared corporate services GM primary & community Region-wide services IFHCs Under this option the DHB and PHO Boards form an alliance either using contractual arrangements or a joint venture entity, to achieve integrated management of primary and community services. Over time, the continued need for the parent bodies could be assessed. 7.2 Assessing the options In any of options B, C and D, a West Coast based entity assumes responsibility for the operation of the community based, non hospital services, currently operated by the DHB, including primary care services, and the current functions of the PHO. The option of the PHO disappearing, and the DHB assuming responsibility for the entirety of primary and community services (Option B) is not attractive to either the existing PHO or to private providers. This option is also unlikely to assist the sector in managing within available funding. It could also lead to less local influence and orientation, should the West Coast DHB's understandable moves to work more closely with Canterbury DHB, lead eventually to its own disappearance as an independent entity. Therefore, most thinking has been focused on developing Options C and D. Both of these come with some possibilities for interim steps and a staged approach. For example, it may be that the DHB might continue to employ and remunerate staff, and the focus of effort in the first year be on integrating actual service delivery (rather than on changing organisational structures). The PHO and DHB boards have established a joint management and clinical working party to consider the costs and benefits of the organisational options and to come up with firm recommendations to their respective boards by 30 April 2010. Business case EoI V38 AC 25Feb10 Page 55
Page 1 and 2:
Business Case Better, Sooner, More
Page 3 and 4: 1 Caveats/status This business case
Page 5 and 6: Current situation By three years Wa
Page 7 and 8: staffed on a capacity model - in wh
Page 9 and 10: support from DHBs, specialist clini
Page 11 and 12: 10.4 Key milestones................
Page 13 and 14: Annual government health funding pe
Page 15 and 16: Ambulatory Sensitive Hospitalisatio
Page 17 and 18: The base populations of the three d
Page 19 and 20: Māori/Pacific Not Māori/Pacific D
Page 21 and 22: 4.7 West Coast region service deliv
Page 23 and 24: 5 Future model of care 5.1 The desi
Page 25 and 26: support them. Help with understandi
Page 27 and 28: LEVERS VISION Better, sooner, more
Page 29 and 30: providing the majority of care). Th
Page 31 and 32: The Community Health System Deliver
Page 33 and 34: To better integrate the support pro
Page 35 and 36: 5.5 Enablers A key aspect of this b
Page 37 and 38: Two rounds of meetings with front l
Page 39 and 40: While doctor-nurse substitution has
Page 41 and 42: Nick Goodwin, Kings Fund 14 , in hi
Page 43 and 44: Quality domains Each new initiative
Page 45 and 46: Preventative Acute LTC management R
Page 47 and 48: Preventative Acute LTC management R
Page 49 and 50: The core services are provided or p
Page 51 and 52: Total required FTEs for the Grey IF
Page 53: 7 Governance, Ownership & Managemen
Page 57 and 58: The IFHS will need the ability to b
Page 59 and 60: Of note, a large proportion of the
Page 61 and 62: The DHB delegates decision making o
Page 63 and 64: Limited integration of community se
Page 65 and 66: 10.4 Key milestones The table below
Page 67 and 68: Expanded pharmacy roles Improving a
Page 69 and 70: Devolved community based services w
Page 71 and 72: Appendices Appendix One: Health Equ
Page 73 and 74: ongoing GP shortage creating an env
Page 75 and 76: 10. What are the unintended consequ
Page 77 and 78: It is common for people with an acu
Page 79 and 80: Outcome measures Indicator Baseline
Page 81 and 82: determine ratio of nurses and GPs t
Page 83 and 84: C. Extended role for pharmacists:
Page 85 and 86: 11 Engagement Working group who dev
Page 87 and 88: Appendix B: Acutely unwell adult pa
Page 89 and 90: 4 Objectives to implement nur
Page 91 and 92: Review Buller after hours arrangeme
Page 93 and 94: Year three Community education camp
Page 95 and 96: 13 Costs Budget considerations:
Page 97 and 98: established. This group now oversee
Page 99 and 100: Output measures Tobacco control / s
Page 101 and 102: Improving immunisation coverage - h
Page 103 and 104: Year three Continued joint plan
Page 105 and 106:
extending health promotion activiti
Page 107 and 108:
Immunisation Coverage Funder Provid
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The Community Health System Deliver
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Clinical care Practice self managem
Page 113 and 114:
and increases in the numbers of pat
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Ambulatory Sensitive Hospitalisatio
Page 117 and 118:
% CVD on lipid lowering drugs, beta
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Health navigators/ kaiawhina: chan
Page 121 and 122:
Committee‟s objectives 41 of prov
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- lack of consistency of care betwe
Page 125 and 126:
qualifications and skills. Where ca
Page 127 and 128:
6 Deliverables / activities Impleme
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“With an aging population and an
Page 131 and 132:
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
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Year One - July 2010 to June 2011 T
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LECG 50 evaluated whether “the im
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Appendix Nine: Referred services 1.
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them by technical errors or lack of
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Identify patients that would benefi
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• Provision of patient specific m
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12 Organisational accountabilities
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emain under the care and management
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Service user pathways in an optimal
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Model for shared care pathways deve
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Implementation plan: to June 30 Dev
Page 167 and 168:
Year two Review progress, outcome m
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10 Risk analysis Risk Probability I
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Appendix Eleven: Frail older people
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ehab and treatment programmes that
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Year one: Maintain and continue the
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Māori have a higher incidence of m
Page 179 and 180:
11 Organisational accountabilities
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There are often vacancies for allie
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6 Deliverables / activities Program
Page 185 and 186:
Professional development: Provide
Page 187 and 188:
Mainstream arguments are concerned
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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
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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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