Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor
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and laboratory testing<br />
and pharmacies<br />
Identify potential areas of saving<br />
Implement programmes to align<br />
clinical and financial drivers<br />
10.6 Work in progress items<br />
While this entire business case is a work in progress, we note that the following, in particular<br />
require further work and consideration:<br />
The linkages between Reefton and Buller /Greymouth based services.<br />
<br />
<br />
<br />
<br />
<br />
The linkages between South Westland and Hokitika / Greymouth based services.<br />
The nature of the future assessment and care co-ordination role/function at each IFHC<br />
relative to LTC management, frail elderly service co-ordination and mental health.<br />
The size and timing of service related savings.<br />
The organisational structure and governance arrangements.<br />
The activity based FTE model.<br />
10.7 Risks and Mitigations<br />
The following risks and mitigations strategies have been identified.<br />
Risk description<br />
Mitigation<br />
Service continuity<br />
If clinical staff do not support the proposed<br />
changes then they may move elsewhere,<br />
jeopardizing service continuity.<br />
Keep staff informed and apply best practice<br />
change management techniques. Programme<br />
adequate funding and time to achieve shifts in<br />
models of care.<br />
Workforce<br />
Workforce may be unprepared to take on new<br />
clinical tasks or to work in new ways.<br />
Invest in workforce competency development.<br />
Decreased integration between<br />
primary/community and secondary care<br />
Devolution of community services to a primary<br />
care organisation may result in decreased<br />
integration with secondary care.<br />
DHB Financial impact<br />
DHB may retain fixed costs in the form of<br />
overheads and facilities and corporate<br />
services, but with reducing revenue.<br />
PHO Financial impact<br />
PHO may inherit services that run at large<br />
deficit, without ability to manage costs down.<br />
Invest in purposeful development of clinical<br />
pathways across primary and secondary care<br />
using an engagement approach. Contract<br />
SMOs to visit IFHCs and to deliver outpatient<br />
services from IFHCs.<br />
Allocate overhead costs to community services<br />
and require PHO to purchase back from the<br />
DHB those services for the initial 3 year<br />
period.<br />
Ensure change programme agreed prior to<br />
transfer. Agree transitional funds to cover<br />
deficit for the first 3 years.<br />
Business case EoI V38 AC 25Feb10 Page 70