133 Molesworth St Thorndon PO Box 5013 Wellington 6145 New Zealand
22 February 2022
To: DHB CEOs, PHO CEs Cc: DHB GMs Planning & Funding, General Practice, Urgent Care and Pharmacy Sector Leads
Tēnā koe
Update to pricing schedule for funding COVID-19 Care in the Community clinical services On 22 December 2021 the Ministry wrote to you regarding the initial funding arrangements to support primary and community care providers providing clinical care to COVID-19 patients in the community. The funding was approved for the purposes of supporting regional and local implementation of the Ministry’s COVID-19 Care in the Community Operational Framework (the framework).The letter also noted that there would be a pricing review in early 2022. Over the December and January holiday period, Delta case numbers were much lower than were originally predicted, and we are only at the beginning of an Omicron outbreak. As a result, there is not enough evidence to support a review of the pricing model currently. We will continue to engage with the sector to gather insights and evidence over the coming months. We anticipate that there will be greater data and insights available later in the coming months to be able to determine whether a pricing review for primary care is required. We anticipate gathering this data through to the end of March and will then undertake a review in April. With the appearance of the Omicron variant in our communities, the system must remain dynamic and the advice supporting our response and subsequent pricing structures needs to be agile. We expect most cases will be able to self-manage with support from online tools and minimal direct contact with the health system. We have shifted our health system response as a result. This shift allows us to preserve health system capacity for those at highest risk of mortality and morbidity when infected with COVID-19. These people will be under active clinical management and will have a care plan developed to provide the appropriate level of care for their circumstances. The wider needs of their whānau/household will also be taken into account. We are no longer categorising clinical care into level 1 and 2, but instead allowing clinicians providing that care to determine the frequency of review based on clinical need. It is anticipated that this flexibility gives clinicians greater ability to develop a care plan with a person and their whānau that will meet their clinical needs. It also simplifies the pricing schedule. Updated clinical guidance has been published on Health Pathways. People with COVID-19 will be able to move between self-management and active clinical management during their illness depending on need. People with COVID-19 will be advised when and how to escalate their care if they become more unwell and need active clinical care.