Better Sooner More Convenient Primary Care - New Zealand Doctor

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appointment of GM/PHO CEO to oversee the changes establishment of project office and commencement of detailed project planning agreement on year one Annual Health Services Plan (including funding, reporting, etc). 10.5 Objectives, key activities and workplans The tables below map the objectives, key activities and associated workplans to each of the eight major goals for Better Sooner More Convenient health care in the West Coast. This provides an overall implementation roadmap for the interlinked series of projects. Goal 1. Partnership with the community Objectives Key activities Associated work plans Community focus on wellness and prevention More self care skills leading to decreased acute demand Information campaign about after hours arrangements Information campaign about how to access care at your general practice – role of nurses etc Collaborative approach to health promotion Focus on smokefree, immunisation and health living More health promotion in the workplace Health promoters based in IFHCs Enhanced screening programmes Community education about self care for common conditions Access to web based information Coaching for frequent flyers Self management support for those with long term conditions Core general practice redesign Acute Care Keeping people healthy Mental health Long term conditions Core general practice redesign Keeping people healthy Long term conditions Mental health Frail older people Goal 2 Sooner for patients: improving access to primary care Objectives Key activities Associated projects More flexible appointment systems in general practices Expanded nurse roles Facilitated workshops with practices to develop more flexible appointment systems eg. triage of appointments, phone appointments, email appointments, varying appointment length, extended hours clinics Nurse triage Nurses as first contact Implementation of standing orders Core general practice redesign Core general practice redesign Acute care Business case EoI V38 AC 25Feb10 Page 66
Expanded pharmacy roles Improving access for Māori Improved after hours care Nurse LTC clinics After hours care Development of team based partnership model of care Treatment of minor ailments Medication utilisation reviews Pharmacy facilitation Māori nurse roles Kaiawhina support Lay navigators HML Triage Shared nurse and GP rosters ED sends Triage 5 to GP Work more closely with St John Long term conditions Workforce Core general practice redesign Long term conditions Workforce Referred services Core general practice redesign Long term conditions Workforce Acute care Goal 3. Better for patients: improving continuity of primary care Objectives Key activities Associated projects Patient usually sees same nurse and GP Facilitated workshops with practices to develop systems to enhance continuity Core general practice redesign Increase number of permanent GPs on the Coast and decrease number of short term locums Increase retention of staff Coast wide system for recruiting GPs and locums for all practices Rural academic training centre Support programmes for staff and families of health providers Workforce Workforce Goal 4. Better: Improving consistency of care Objectives Key activities Associated projects GPs and nurses support each other to provide consistent care Provide consistent care for those with LTCs Care provided is consistent across primary and secondary care Processes established in each practice for dedicated time to discuss care of individual patients Expansion of LTC programme Canterbury Health pathways adapted for local situation and implemented Dual staff appointments Core general practice redesign Long term conditions Health pathways Business case EoI V38 AC 25Feb10 Page 67
Page 1 and 2:
Business Case Better, Sooner, More
Page 3 and 4:
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
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 and 54: 7 Governance, Ownership & Managemen
Page 55 and 56: Option D: PHO/DHB jointly owned Pri
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: 10.4 Key milestones The table below
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
Page 109 and 110: The Community Health System Deliver
Page 111 and 112: Clinical care Practice self managem
Page 113 and 114: and increases in the numbers of pat
Page 115 and 116: 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
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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
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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
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11 Organisational accountabilities
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There are often vacancies for allie
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6 Deliverables / activities Program
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Professional development: Provide
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Mainstream arguments are concerned
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Appendix Thirteen: IFHCs - Faciliti
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A key possibility is that land at t
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This option is effectively a Greenf
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7 Westland IFHC Facilities options
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Year two Substantive-IFHC in Greymo
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12 Costs Capital costs Greymouth IF
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utilize MedTech, but via their own
Page 203 and 204:
4 Objectives: To implement c
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Security An individual‟s health i
Page 207 and 208:
8 Effect on inequalities The increa
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Appendix Fifteen: Project advisory
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Better Sooner More Convenient Primary Care - New Zealand Doctor

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