Forum Powerpoint_02032022

Provider Forum 2 March 2022

Whakataka te Hau Karakia Timatanga (opening) Whakataka te hau ki te uru Whakataka te hau ki te tonga Kia mākinakina ki uta Kia mātaratara ki tai E hī ake ana te atakura He tio, he huka, he hau hū Tīhei mauri ora!

Cease the winds from the west Cease the winds from the south Let the breeze blow over the land Let the breeze blow over the ocean Let the red-tipped dawn come with a sharpened air A touch of frost, a promise of a glorious day

Agenda Speaker Lindsey Webber, CEO, WBoP PHO Lindsey Webber, CEO, WBoP PHO

Session PHO Update 7 to 7.15 PM WBOP PHO Restructure: Drivers for change and reorientation to focus on our key stakeholders.

7.15 to 7.25 PM

Miriarangi Ashby, Health & Disability Coordinator – Bay of Plenty, Ministry of Social Development Dr Claire Isham, Clinical Director, WBoP PHO

Work and Income services and products relevant for general practice 7.25 to 7.35 PM PHO Clinical Update 7.35 to 7.50 PM

Jeane Rossiter, Health Care Home Project Lead, WBoP Phone Triage PHO 7.50 to 8.10 PM Naomi Malcolm, Primary Mental Health Programme Lead, WBoP PHO

Jeanette Jones, Suicide Bereavement Support Coordinator, Grief Support Services

Introduction to new Lead and Update regarding service developments 8.10 to 8.20 PM Support options for people bereaved by suicide 8.20 to 8.30 PM

PHO Update Lindsey Webber CEO, Western Bay of Plenty Primary Health Organisation

WBOPPHO Organisational Structure Refresh PHO Forum March 2022

• Health & Disability Sector reforms – challenges and opportunities

Why change?

• No longer merging with EBOPPHA • Refocus on our vision, purpose and priorities • Strengthen our capacity to innovate • Be ready to work with new partners in new ways – social agencies, NGOs and community providers • Covid response as BAU • To remain fit for purpose and sustainable

Strengthen our capacity and capability to address inequity in primary care and a focus on WBOPPHO vision Empower staff to respond to a dynamic primary care locality model

Design Principles

Enable network and community-based services to support quality integrated primary care delivery through their network Demonstrate clinical, Māori health, and information and communication technology leadership, and influence the new primary care environment Create clear role clarity and lines of accountability and consider ways to be less hierarchical Enhance innovation, research and development, and new ways of working Develop leadership capability and enable a high performing team environment Provide organisation and financial sustainability

New functional model

Network Services We continue our network services function, combining this with community services. Many of the functions stay the same and we continue to support our network of providers to deliver to their communities.

Key functions include: •

General Practice liaison

•

Iwi network liaison

•

Contract management, monitoring, performance and support

•

Network acute demand – call support service

•

Health Care Homes development

•

Service planning and development,

•

Programmes to support mental health, youth health

•

Data management capability.

Population Health and Innovation A new function for Population Health and Development aims to improve our capacity and capability to roll out new integrated care models through network providers and new partners.

With this capacity and capability, we remain agile and dynamic in responding to new opportunities and challenges.

Key functions include: •

population health data and needs analysis

•

quality improvement

•

equity programmes

•

consumer engagement and co-design

•

developing digital infrastructure,

•

clinical and psycho-social services development,

•

project management,

•

change management,

•

workforce and organisation development.

Advisory This function is about leading, influencing and growing capability across the PHO network. This is especially true for Māori health because we understand what’s good for Māori is good for everyone.

Likewise, strong clinical leadership is paramount and underpins everything we do. We have also recognised a growing need for leadership and influence in information and communication strategies, infrastructure and technology as a key enabler for the future.

Key functions include: •

Māori health and wellbeing

•

clinical leadership

•

information and communications strategy, infrastructure and technology development

Clinical Services & Covid Response This function focuses on PHO clinical services delivery and Covid response.

There will also be a focus on delivering the locality model through integrated care in our communities, outreach, partnering with others in the new health system.

Contracts that sit within this function include: •

School Based Health Services

•

Health and Wellness (Diabetes, self-management for LTCs, Outreach Nursing)

•

Covid Response – CPRT team to support the network to continue testing, vaccination and Covid community care

Corporate Services Keeping the organisation operating effectively is the key domain of back-office business services. New opportunities may arise in the locality model to provide these services to locality partners.

Key functions include: • providing information technology – hardware, software and support, • accounting and finance management, • asset and property management, • human resources operations • administration.

Thank you Questions

Helping New Zealanders What drives us

Work & Income

Miri Ashby – Health and Disability Coordinator

We help New Zealanders to be safe, strong and independent Manaaki tangata, manaaki whānau

What’s Work & Income to Me (as a GP) • The financial safety net for people who are out of work either due to the impact of a health condition or disability, or those who are currently out of a job; • The evidence supporting the Health Benefits of Good Work is compelling; • One in Eight Working-age adults (18 to 64 years) live on a Welfare Benefit; • One in Five children in NZ live in a house hold with no one in paid work.

Financial Support Jobseeker Support

• people available and looking for full-time work • temporary deferral of work-obligations due to health condition • long term/ permanent condition with capacity to work

Sole Parent Support

• sole parents with dependent children under 14 years

Supported Living Payment

• people with serious health conditions or disability unable to work 15 hours or more a week • caregivers looking after seriously ill people

Additional Financial Support

Provide: • Assistance with extra costs o Accommodation ($80 to $235 /wk) o Child care (up to $5.37/hr) o Health and disability related costs o One off costs o Costs of returning to work •

Social Housing o Assessment of needs to access Social Housing o Contracts with providers o Tenancy reviews

Work and Income Medical Certificates •

Work Capacity Medical Certificate (Available for E-lodgement

•

Supported Living Payment medical certificate for a person being cared for (Carer’s Benefit)

•

Disability Certificate (for Disability Allowance)

•

Disability Certificate – Counselling

•

Disability Allowance – Medical Alarm Assessment

•

Child Disability Allowance – Medical Certificate

•

Other Medical Certificates: Limited Service Volunteer

through HealthLink via the PMS)

Medical Council of New Zealand

Medical Council of New Zealand

Work Capacity Medical Certificates •

A Medical Certificate is a Legal Document

•

The Certificate represents your Professional assessment of the patient’s condition and situation

•

It is your signature at the bottom – not the patient’s

•

A Medical Certificate may have a greater influence on a person’s health than any prescription – do you put the same amount of care and consideration into it

•

When considering a person’s work capacity enquire into their previous work experience

•

Worklessness is not necessarily a quick fix

PHO Clinical Updates

Cancellations / Events on hold

• Cancellations/On hold • PHO fun run • CME for March • Further delay of National Bowel Screening roll out in BOP – go live date TBC • ED redirect project Paused

The Good News!

• Guide to patient services – updated at the end of last year and now online through the PHO provider portal. New folders with to full updated programme have also been distributed to practices. http://portal.wboppho.org.nz/funded-clinical-programmes/ • Radiology accepting symptomatic community referrals with negative RAT/PCR. Please annotate this on the referral form to enable the booking team to provide a smooth service to your patients.

And more good news…

• Asthma and Respiratory Centre restarted Spirometry – access maybe limited due to staff availability but please continue to refer • Sign up for Celo The GP Liaison team at BOPDHB introduced a new app-based communication platform for direct contact between hospital SMOs and GPs mid-last year. The app is called Celo Health, and the group we created is called 'GP/SMO Platform.’

Celo | Secure Messaging App for Healthcare Teams (celohealth.com)

District Nursing – Routine dressing and wound management

• all community services are currently under pressure due to reduced work force and additional time taken to deliver care.

• Please consider whether there are any adjustments that could be made – for example reduced frequency of visits or checks for a short period to enable all services to continue to function over the next few weeks.

Covid Updates • Covid Alerts – if you don’t receive the Alert yet you can request to be added to the distribution list by emailing nsadmin@wboppho.org.nz • CPRT Team – Contact them for clinical care of positive patients cprt@healthbop.org.nz (07) 577 3234 • NS Team – Contact for operations guidelines, funding, etc nsadmin@wboppho.org.nz or call / email your Practice Liaison • Welfare – Contact for support with oximeter delivery, complex isolation needs (e.g accommodation) and home visits for patients whom you haven’t been able to contact and are concerned about. If a patient is isolating out of town the Community Co-ordination Hub can connect with the appropriate hub for welfare support provision.

Western Bay of Plenty welfare.referral@bopdhb.govt.nz Phone: 0800 798 729 Eastern Bay of Plenty ebopcovid@bopdhb.govt.nz Phone: 0800 633 277

Telephone Assessment & Treatment Jeane Rossiter WBOPPHO Health Care Home Project Lead Date: 2 March 2022

Opportunity for Change One of the biggest challenges currently facing General Practice across New Zealand is managing increased call volumes, including the growing number of calls from patients requesting a same day appointment (acute demand).

A Definition Telephone Assessment & Treatment (TAT) (aka GP Triage)

A systematic approach used throughout the day to assess and prioritise patients requesting a same day appointment - using a clinician who can diagnose, order investigations, refer, and prescribe at times of heaviest demand.

Equity and Continuity of Care remain a priority.

Clinical Pharmacist

General Practitioner

Nurse Practitioner

Benefits Values patient time

Provides other options for patient care

Improves efficiency, including opportunity for prework

Increases capacity to help cope with acute demand Frees up time for proactive care and care planning Enables clinicians more control over their day

TAT Resolution Flow Diagram Resolved

Clinician Triages Patient Not Resolved

Patient does not require a consultation – brief advice or non consultation service provided

Patient requires an appointment today or in the future: • Today Urgent • Today Not Urgent • Future

No future appointment required

Appointment Made • In Person • Portal • Telephone • Video

Patient Story

Implementation • Awareness. Do this with your team not to your team.

Create buy-in as all staff have a part to play.

• Desire - Be clear on your reasons for change and explain the benefits for differing roles (WIIFM - What’s In It for Me).

• Knowledge - Resources and support are available from you Network Liaison.

• Ability – Invest time in the setup phase to increase “getting it right”.

• Reinforce – Share the wins and celebrate with your team.

Change almost never fails because it’s too early, it almost always fails because it’s too late.”

Seth Godin Founder of Akimbo, The altMBA, Best Selling Author

Pō Marie

Coordinated Options Primary Mental Health Naomi Malcolm

Introduction Survey Feedback Pain Points to address : Programme Development Questions

“The level of service in no way meets the level of demand and the model for calculating a practices allocation appears to be grossly flawed”

“the ereferral is too long and time consuming, k-10 helpful but we should just put in a number rather than complete the questionnaire on the ereferral, and just include our consult notes and short referral letter instead of all the tick boxes”

“if you remove the need for the Kessler then you won't have to pay for it anyway” ”I am not a business owner; I just want what is best for my patients - the Kessler is not always required in my honest opinion.”

“These appointments often take more than 15 minutes. Why should primary care pay for lack of funding in mental health????”

“A reduced payment may be reasonable” ‘No, the consultation still takes longer, and the additional referral fee compensates for this additional time without impacting the patient’

“the accepted patients have good outcomes” “Variable as to whether/what feedback occurs”

“Would prefer modalities with good evidence base” “but not at the expense of individual counselling sessions” ‘Anything that encourages connectedness with whanau (a whanau whole approach), tools for the individual and the whanau to use, a SINGLE REFERRAL PATHWAY FOR ALL PATIENTS THAT DO NOT NEED ACUTE ASSESSMENT>>>>” “stick with what works not any touchy-feely stuff” “would just like more counselling”

“we already do”

Programme Development • Eligibility criteria • Youth Consent • Those whai ora declined as no funding is available • Referral process • Funding allocation • Documentation • Range of therapies

SUICIDE BEREAVEMENT SUPPORT SERVICES Supporting the Western Bay of Plenty NO COST SUPPORT OPTIONS Counselling

Suicide Loss Support Peers

Individual and family/whanau counselling for anyone affected by a loss to suicide or impacted by someone's suicidal behaviour.

Contact Denise or Elizabeth

Trained peers with lived experience, offering informal support, mutual understanding & information.

Contact Jeanette

WAVES After Suicide Support

Training & Information

An 8-week information & support programme for ages 17+, offered 3 times per year within school terms.

Contact Jeanette or Amy

Community, workplace and organisation training and information regarding loss to suicide.

Contact Amy, Denise or Elizabeth

Suicide Bereavement Support Groups A safe space to share, find support and explore new ways to heal after the loss of someone to suicide, either recent or past. Horizons Papamoa - 2nd Tuesday of the month, 10am to 11:30am. Horizons Tauranga - 3rd Tuesday of the month, 6pm to 7:30pm. Contact Amy Riverlight Katikati – First Saturday of the month 9:30 – 11:30. Contact Karin 021 103 7404

SUICIDE BEREAVEMENT SUPPORT COORDINATORS

GRIEF SUPPORT SERVICES ADMINISTRATORS

Jeanette: 021 754 480, jeanette@griefsupport.org.nz

support@griefsupport.org.nz

Amy: 021 0903 9538, amy@griefsupport.org.nz

Denise & Elizabeth: 07 578 4480

F O R D E TA I L S & D AT E S : W W W. G R I E F S U P P O R T. O R G . N Z

An informative support group for adults 18+ who have been affected by the suicide of s o m e o n e t h e y k n o w.

T H E G R O U P O F F E R S A S A F E A N D S U P P O R T I V E S PA C E T O : • Share thoughts and feelings around what has happened • Discuss the nature of suicide • Gain information and ideas about how to care for oneself and others, including children & young people, after a suicide.

The group of 4-8 people is facilitated by trained counsellors & educators at Grief Support Services and runs over 8 weeks.

We are taking registrations for the 2022 term 2 group.

Mondays 5:30pm to 7:30pm start date for term 2 to be advised

Individual & family counselling also available

Jeanette, 021 754 480 jeanette@griefsupport.org.nz, www.griefsupport.org.nz

SUICIDE BEREAVEMENT COFFEE AND INFORMATION "Grieving doesn't make you imperfect. It makes you human."

GROUPS Sarah Dessen Please join us in this safe space to share, find support and explore new ways to heal after loss of someone to suicide, either recent or past.

Papamoa 2nd Tuesday of each month 10:00am to 11:30am Papamoa Family Services, 35e Hartford Avenue, Papamoa

Tauranga 3rd Tuesday of each month

You are not alone, there are no set expectations, sometimes being with others with a shared understanding of this form of grief and loss helps more then you may expect.

6:00pm to 7:30pm Grief Support Services, 147 Chadwick Road, Greerton

RSVP required: Amy Colonna, 021 0903 9568, amy@griefsupport.org.nz

www.griefsupport.org.nz

Contact Amy to have a chat, or link in with other forms of support such as counselling, a peer support worker or our WAVES after suicide support and education programme. All services no fees.

Grief is in two parts.

The first is loss.

The second is the remaking of life.

Anne Roiphe

SUICIDE LOSS SUPPORT PEERS

Video

office@griefsupport.org.nz for SBS mailing list enquiries

griefsupport.org.nz

KEEP IN TOUCH GriefSupportServices

SOCIAL MEDIA PLATFORMS

griefsupportservices

Grief Support Services WBOP

Kia tau Karakia whakamutunga (closing) Kia tau kia tātou katoa Te āio, te aroha me te marutau Tīhei Mauri Ora

May peace, love and safety Be upon us all Let there be life

Sixth 2021 PHO Provider Forum

Thank you for joining us!