Forum Powerpoint_030822

Provider Forum 3 August 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

Session

Phil Back, General Manager, Network Services, WBOP PHO Emma Green, Allied Health Community Strategic Lead, Hauora a Toi Bay of Plenty Sarah Nash, Programme Manager, Hauora a Toi Bay of Plenty Judith Guccione, Community Allied Health Service Lead, Hauora a Toi Bay of Plenty Dr Claire Isham, Clinical Director, WBOP PHO Dr James Peckett, Clinical Advisor, WBOP PHO

PHO Update 7 to 7.20 PM

Dr Ruth Teh, Senior Lecturer and Senior Research Fellow, University of Auckland Christin Fuchs & Kirsten Van Dommelen, Research Assistants Kim Blair, Project Lead CHIRP, Hauora a Toi Bay of Plenty Anja Theron, Transformation Lead, Child Wellbeing, Hauora a Toi Bay of Plenty

AWESSoM Study on The LifeCurve App 7.55 to 8.10 PM

Rehabilitation programmes in the community 7.20 to 7.40 PM

PHO Clinical Update 7.40 to 7.55 PM

Child Health Integrated Response Pathway (CHIRP). The Bay of Plenty’s solution to children with neurodevelopmental, mental health or behavioural problems falling through the gaps 8.10 to 8.30 PM

PHO Update Phil Back

General Manager, Network Services Western Bay of Plenty Primary Health Organisation

Health Reforms etc! Ø Emphasis on regional structure development. Likely to be interim until end of year. Ø Arms of both Te Whatu Ora and Te Aka Whai Ora will have strong regional presence. Ø Iwi- Māori Partnership Boards a key vehicle to support and inform local and regional commissioning. Ø Focus on national consistency with regional / local implementation. Ø Clinical networks for specialties/sub-specialities nationally led as opposed to local determination.

Ø Locality development. Continue to show connectedness and unity locally. Ø Lack of national guidance on locality development – creating our own reality within the vacuum. Ø Window to progress this through to June 2024 but may need to jump through some hoops on the way.

Heath Reforms cont.: Ø Planned care national working group – sole primary care voice. Ø Enhancing care closer to home – primary and community service delivery. Ø Strong message around any shift must be adequately resourced – funding and training/credentialling. Ø Devolution does not require every Practice to undertake more work. Enhancing GPSI approach. Ø National work underway around Planned Care – Primary Options (POAC). Ø Consistency in service provision but will also have standardised approach. Ø National range of services and funding attached to specific services.

Ø Health System Indicators framework (SLMs retired 30 June 2022). No clear implementation plans. Ø $28M committed nationally to SLMs has been retained. Waiting for clarity around expectation.

Heath Reforms cont.: Ø Annual Fees process to have nationally consistent approach through regionalised consideration. Ø All notifications above allowable percentage referred for regional consideration. Ø Regional decision required within 30 days from receipt of notification. 11 August is current cut-off. Ø Potential that all will be referred to Regional Fees Review Committee. Ø Will potentially create additional work for Practices and delays in outcomes being advised.

Ø Independent consultant StayWell Ltd has agreed to progress Afterhours Service Review. Ø Providers Inc. and Afterhours Committee to review proposal and we will seek endorsement. Ø Work will commence in coming weeks with 2-3 month timeframe for delivery of initial report. Ø Strong national interest in strengthening local response to sustainable afterhours service provision.

Integrated Rehabilitation Services Sharing service developments from Keeping Me Well 3/08/2022

Keeping Me Well Aim; Introduce a community enablement approach to; • Enable, engage, empower, and enhance a person to remain well or get well within their own home.

• Provide a more joined-up, seamless approach which is easy to navigate for people and their family/whānau to access.

• Improve current state of the system by removing barriers that exist to reduce inequalities and improve health and wellbeing outcomes.

Keeping Me Well Concepts •

Home Based delivery – to challenge ourselves to move services in to the home setting

•

Integrated - health services that are well coordinated across disciplines, services and care settings as their needs change.

•

Continuity of care – response is interconnected, seamless and coherent with other healthcare services experienced by the person.

•

Targeted approach - identifying those at high risk of becoming unwell within their home.

•

Community In-reach mechanism - proactively identify and “pull” people from within the hospital and support them to get home sooner.

•

Integrated team - that comes together as one, based in the community, and is flexible to expand or contract as a person’s needs change.

•

Inter-professional - utilises registered and non-registered healthcare professionals from diverse fields combining their expertise and resources to work in a coordinated fashion toward a common goal defined by the person.

•

Flexible approach - flexible in response to the needs as they arise.

•

No door’s the wrong door - no barriers to requesting access and information to community services.

•

Single point of access and information (CCC) - utilise a “request for assistance” model where request can be made to a central point to proactively find solutions for community assistance requests.

What has changed?

Community allied health services in the Western bay now provide; •

Rehabilitation programmes from home and from hospital which focus on ‘what matters to the person’

•

Rapid response – same day response to urgent cases from hospital or the community.

•

Transitional care – ARC based rehabilitation for those that need 24 hour care in a rehab environment.

•

Poipoia te pā Harakeke - allied health resource

•

All of these pathways can be accessed via CCC

embedded in primary health team and practice – Te Puke

What else is in the pipeline?

Keeping Me Well Stage 2 which includes: • Expansion of rapid response to include other Te Whatu Ora services • Expansion of community allied health rehab services to cover weekends and tasks that are required to support people to live at home. i.e., rehabilitation support services.

• Exploration of transitional care both in the home and within ARC (very dependent on bed availability) • Expansion of Poipoia te Pā Harakeke • Services instated across the Bay of Plenty.

By June 2023

Any questions?

PHO Clinical Update Dr Claire Isham, Clinical Director, WBOP PHO Dr James Peckett, Clinical Advisor, WBOP PHO

Covid Updates Advance Prescriptions for Oral COVID-19 Antiviral Medicines This document provides initial guidance to support safe and timely access to oral therapeutics for COVID-19 to reduce the risk of hospitalisation and poor outcomes.

Funding is available for these consults ($60 consult, no script & $120 consult + script). The Halcyon claim form will go live on Friday.

For more info, please see below useful guidance and links: PHARMAC advice including eligibility information Covid medication interaction checker (University of Liverpool) Midland health pathways > Covid -19 Case management in adults > Case Management > Covid19 Specific Therapies. Username: midlanduser - Password: midlandpassword Click here for Health Navigator information for patients.

AstraZeneca From 4 September 2022, the AstraZeneca COVID-19 vaccine will no longer be available. New Zealand has no further accesses to doses of AstraZeneca.

The Ministry will contact people who either haven't completed their course or who are yet to receive a booster, to give them the opportunity to make a booking before 4 September.

AstraZeneca vaccine | Covid-19 Response (rnzcgp.org.nz)

ECG Services Discontinued from Friday 19 August • Due to workforce capacity constraints and the need to prioritise competing work demands, it is regrettable to advise that the Outreach Nursing Service is no longer able to provide this non-urgent ECG Service.

• Referrals received after this time will be referred back to referees for follow up.

• We are in the process of working with ARC Services to ensure ongoing access to ECG Services for their population beyond this date.

Pharmac’s decision to widen access to antiretrovirals and nitrofurantoin • Decision to widen access to antiretrovirals and nitrofurantoin - Pharmac | New Zealand Government

• Essentially any prescriber can now prescribe the whole course of PEP. The secondary services Sexual Health Service welcomes referrals for PEP F/U as in STIC and other tests at the completion of the 28-day course.

An additional September ACC GP MRI training The August training is booked out but places are still available for the 28 September Training, 6 to 8.30 PM. Info and registration via this link: BOP Training Session Invitation 280922 by WBOP PHO - Issuu

Midland HealthPathways Update New pathways for GPs on HealthPathways The following pathways are now live on the HealthPathways site for you to use: •

Family Violence

•

Suicide Prevention in Young People

•

Acute Asthma in Adults

•

Diabetes Screening and Diagnosis

•

Kidney Disease in Diabetes

•

Deliberate Self-harm

Username: midlanduser - Password: midlandpassword

Western Bay of Plenty Palliative Care Services – a clinician guide • The Palliative Care Services Guide for the WBOP, developed by Hauora a Toi Bay of Plenty is now available via Bay Navigator.

• This guide and other Palliative Care resources can also be found under P on the Guide to Programme and Funding for Patient Services page.

BOP Spirometry Workshop – 1 and 2 September 2022 Attendees will gain the confidence to perform spirometry accurately and safely with patients, allowing practices to care for patients with a greater level of diagnostic certainty. This course is presented by Tauranga Hospital Respiratory Physiologists and follows the Australian and NZ Society of Respiratory Science guidelines for spirometry training.

This course can be taken as part of the PHO scholarship funding.

Click here for more information on this course and to register.

Hepatitis C National Campaign The new national website Getting tested for hepatitis C » Hep C Awareness (stickittohepc.co.nz) supports the launch of a national awareness campaign ‘Stick it to hep C.’ Launched on World Hepatitis Day the campaign is aimed at raising awareness and encouraging Kiwis to get an easy, finger-prick test to detect the virus.

The Te Manawa Taki Community Hepatitis C service team are keen to work with WBOP PHO practices to help identify any of their population with Hep C, or support patients on the treatment pathway. Examples are adding a Hep C antibody test to a CVRA, providing opportunistic Hep C point of care testing at the practice.

If practices have people identified with Hep C they may be eligible for the WBOP PHO funded Hepatitis C Treatment Initiative: https://portal.wboppho.org.nz/images/documents/28._Hepatitis_C.pdf If they require a Fibroscan this can be accessed via BPAC eReferral to “Community hepatitis C services – Fibroscan.”

Patients with complex needs should be referred to the Gastroenterology team for secondary care management.

Contact details: Jo de Lisle | m: 027 549 2122 e: Jo.DeLisle@healthshare.co.nz Te Manawa Taki Community Hepatitis C Service | 0800 195 115

Body In Motion Physio & Rehab The provider of the In Home Strength and Balance Programme funded by the Bay of Plenty DHB. This is a falls prevention programme for clients over the age of 75 (Maori and Pacifica 65+).

It includes a home hazard check and in-home exercises to improve strength and balance and monitors the client for 6 months. This is ideal for clients who have a history of falls or at risk of falls at home.

The services provided in this programme are available to those clients who are: ● Over 75 years of age (over 65 years for Māori) ● Live within the BOP DHB area ● Living in the community but not in residential rest home level care ● Unable to attend a community falls prevention programme (Keep On Your Feet- Sports BOP) You can refer your eligible patients to this service by electronic referral to BOP DHB District Nursing, via Community Care Co-ordination (CCC), they will screen the referral and send it to Body In Motion. Simply use the BPAC eReferral BOP DHB District Nursing referral form and clearly state the reason for referral is In-Home Falls prevention.

AWESSoM Study (ageing well through eating, sleeping, socialising and mobility) WBOP PHO Provider Forum, 3 August 2022

Introduce the team ´ Professor Ngaire Kerse, Joyce Cook Chair in Ageing and Principal Investigator ´ Dr Ruth Teh, Senior Lecturer and Co-investigator ´ Karen Campbell, project manager ´ Local research team: ´ Christin Fuchs, Research Assistant ´ Jo Parsons, Research Assistant ´ Kirsten van Dommelen, Research Assistant

Brief overview of AWESSoM ´ Older people are the fastest growing age group. ´ Maintaining quality of life and function is highly valued ´ Living well means being independent with activities of daily living and participating in whānau and family life. ´ Five projects under AWESSoM: ´ Pacific Grandparents – three studies – podiatry, health assessment questionnaire and LifeCurve™ App ´ Māori - Ngā Pou o Rongo - to implement and evaluate an existing whānau-based lifestyle management strategy ´ Care Home – oral health, sleep health, cognitive stimulation therapy ´ Multi-morbidity – discern patterns of multimorbidity associated with a trajectory of dependence and high health services utilisation using primary care practice data (COMPASS Health) and interRAI

´ Community at Risk - establish the impact of using the App on social wellbeing (Age Concern social connector), sedentary behaviour (accelerometer), physical and mental wellbeing

Community At Risk ´ Rationale: There are multiple factors that identify risk of functional decline: poor oral health, poor sleep, sedentary behaviour, complex comorbidities and social isolation. ´ The Community at Risk study focusses on improving health and wellbeing for older people including oral and sleep health, socialisation and mobility. ´ Assessments before and after use of the LifeCurve™ App, baseline and 6 months follow-up ´ Two assessments completing using a health-based questionnaire, the study will evaluate the LifeCurve™ App outcomes with a before and after introduction of the App study; and establish the role of other factors: social isolation, sleep and oral health in impacting decline in ADL functions.

´ We are fortunate to have Age Concern connected with our study, both nationally and regionally in Tauranga and Auckland as a community resource. For those engaged in the study they will provide a social connector role operating in the community to combat social isolation.

LifeCurve ™ App ´ Activities of daily living (ADLs) and Instruments of Daily Living (IDLs)) have been conceptualised as a list of basic functions which allow individuals to maintain independence within their own home, or extended functions towards independence in the community. Research showed decline or loss in our ADLs and IDLs in a specific order in a hierarchy of functional levels. ´ The LifeCurve™ has been operationalised into an App to link personal ADL status to local community social and health services and/or to utilise level specific exercises, goals and aspirations which may help to maintain/improve current level or slow functional decline. The App aims to engage individuals, families and whānau. ´ The answers to 17 questions indicate a person’s LifeCurve™ status.

Compression of functional decline

Eligibility

Study duration

´ Living in Tauranga or Auckland.

´ Recruitment: July – Dec 2022

´ Living independently in the community or a retirement village.

´ Follow-up: Jan – June 2023

´ Māori and Pacific aged 60+. ´ Non-Māori aged 75+ (all other ethnicities).

´ N=300 (both sites)

How you may be able to support us to recruit participants…. ´ Looking for support in the community ´ Distribution of leaflets or ability to place on noticeboards ´ Invite to attend events in person or zoom to talk about the study

What is in for your patients…. ´ Introduction to LifeCurve App ´ SPPB assessments ´ Enter into draws to win a food/petrol voucher

Questions…

• Toll free phone 0800 222 848 (to leave a voicemail) • Email: awessom.research@auckland.ac.nz with contact details • Scan this QR Code and enter contact details

Child Health Integrated Response Pathway

For all Tamariki and their whānau, who are experiencing behavioural, neuro-developmental or mental health concerns to experience timely, responsive and integrated care that matters to them.

Child Health Integrated Response Pathways (CHIRP) Child Health Integrated Response Pathways (CHIRP) is Hauora a Toi’ answer to children bouncing between services and falling between gaps. To the left, CHIRP is visualised as a model for Child Development Services, Child Mental Health, and Paediatrics but this is just a starting point. The model recognizes the unique contribution each team makes to the care of children and whānau. The model also recognizes spaces where services can work together to address complex needs, as well as where services could reconfigure to address needs which more than one team could manage on their own.

Currently there are children under the age of 12 with different developmental needs being referred to Child Development Services, Child Mental Health, and Paediatrics. For example a school may refer a child with possible ASD to Child Development Services, Paediatrics, and Child Mental Health at the same time as different services respond to different needs. The coordination of care becomes very complex with children often left waiting in multiple queues.

The CHIRP vision would be to create a child at the centre model. This will mean that young people will be assessed by a team of professionals consisting of members from the different child facing services and that their needs would be addressed by the best clinician rather than the best department. This will mean a significant reduction in waiting time, more efficient care and coordination by reducing overlap and debate, and improved access to services that can’t be provided in silos, for example a child accessing CDS won’t require another referral to access Mental Health.

There will always be children who only require one team’s support for their needs to be met. For CDS this may be feeding plans for school-aged children, or for Child Mental Health this may be therapy following trauma.

Nathan Toms & Anja Theron 2021

There are also children with more complex needs who require our services to weave together to give them a good start in life. Open lines of communication mean that our teams can provide the best quality of care by being fully informed of a family’s situation.

“Services should follow the child rather than being sliced and diced according to age, body parts, criteria/service. Government agencies are joined with liaison roles, peer case reviews and relationships that focus on outcomes for families” Good Start in Life

Letter from a mother December 2021 Hi Lisa I am writing this complaint as a parent of a 6 year old girl.

During the first term of last year we had a few issues with my 6 year old daughter, she struggled to settle into school, at school was at times defiant and not following tasks. At home was an absolute nightmare, where she was crying and overwhelmed as soon as she got away from school. As a result we meet with the school and they suggested we do a 3 D referral. I completed this I believe in early April (if not sooner). I was aware that there was a wait list and in the mean time got other assessment completed privately. I called and followed up in August or September after having tried sooner but with no way of getting hold of anyone. I was advised that it would go to their MDM the following month and that they would call prior to this (this never occurred – despite me having other information that may have been useful at this time). In November I received a call saying that it had gone to MDM and the recommendations.

Subsequently we have received a letter from the Paediatrician team stating, she was on the waitlist and this was a 4 month wait. (thus 1 year from when we first asked for help or close to it). Then received a letter from the Occupational Therapist stating a wait list of 9-12 months. This really concerns me that as a parent, I have asked for help for a young child and that it will basically be 2 school years before assessments are completed, forget treatment or recommendations from this.

Thankfully we are now in a much better place and are aware of the issue due to our own assessments, but this should not be the case and is not OK for our most young and vulnerable.

I am hoping that this complaint will help provide the evidence needed to enable further change and a faster more responsive system for our children and their parents.

Kind regards Julie

The problems we are trying to solve

• • • • • • • • • • • • • •

Confused pathways to access support Long waiting lists (3D/Paeds/CDS up to 18months) Duplication of service response Service gaps No clear pathway to a coordinated multi-agency response Inequity of access Inconsistent diagnostic pathways Diagnosis delays Not capturing demand/unmet need across the population No clear understanding of how this is impacting on Maori Services no longer configured to meet the growing demands of the population Fragmented and siloed approaches to service delivery Service centred rather than Tamariki/Whānau centred Acute/crisis presentations that could have been avoided with earlier proactive intervention

• • • •

What we are trying to achieve

• •

• • • •

A pathway to care and support that is easy to understand and link in with.

To deliver care that is centred around the needs of Tamariki/whānau Timely and responsive support A service model that we know is responsive to Maori To deliver preventative care and reduce the risk of acute/crisis presentations An integrated centre of excellence for all Tamariki with neuro developmental, mental, or behavioural presentations Opportunity for earlier diagnosis, assessment and intervention Equity of access Shared learning environment for staff Collaborative, positive and supportive workforce experience.

Phase 1 – Current State For children experiencing neuro developmental, behavioural, disability and mental health concerns referrals come predominately from G.P’s but can also come from a range of community, primary, education and specialist services including self-referrals. They may go direct to any of the below services, or a number of services at the same time. Referrals may bounce between services, be duplicated between services, and some will receive a multi-disciplinary response from more than one service.

Referrers

G.P / Midwife / Self / Hauora / Schools / Private / Specialist / Community / Primary Health / NGO

• 0 – 15yrs • Disability •

Neuro Developmental

CDS

3D •0 -15yrs •Behavioural •Neuro Developmental

•0 – 13yrs •Neuro Developmental •Behavioural •Mental Health

MICAMHS

Voyagers •0 – 18yrs •Neuro Developmental •Behavioural •Mental Health

•0 – 15yrs •Neuro Developmental •Behavioural •Mental Health •Phyiscal Health •Disability

MDAT/ASD

Paediatrics

Phase 3 Children experiencing neuro developmental, behavioural and mental Health concerns can be referred direct to CHIRP. CHIRP will also provide a centre of shared excellence and expertise to support Primary Care and other community services

Referrers

G.P / Midwife / Self / Hauora / Schools / Private / Specialist / Community / Primary Health / NGO

CDS/3D/MICAMHS/Voyagers/Paediatricians/Psychiatry/Psychology/MDAT

CHIRP Multi team/multi-disciplinary response

Steering group and Project team Working Group – Meet Fortnightly

Steering Group – Meet 6/8 weeks Executive Sponsor

Glenda Gillgren - Team leader Voyagers

Sarah Mitchell

Cultural Assurance / Equity Stewart Ngatai

Dr David Jones/ Dr Sarah Moll - Paediatricians for the Western BOP

Consumer representative

Beth Hughes

Dr Stephen Robinson Paediatrician for the Eastern BOP

Consumer representative

Erika Harvey

Clinical Assurance

Dianne Lees

Dr Mike Gudex – Child and Adolescent Psychiatrist for East and West BOP

Data Analyst

Nathan Toms

Chris McAlpine – Psychologist for East and West BOP

P & F representative

Rozi Pukepuke/Tim Slow

Heather Stewart – Team leader Child Development Services West BOP

SMO representative

Dr Justin Wilde/ Dr David Jones

Hayley Evemy - Team leader Child Development Services East BOP

Judie Smith – Child team leader – MICAMHS

Primary Care representative Dr Claire Isham

Vicky Collinge - 3D coordinator

Ministry of Education rep

Te Paea Muir – Social Worker – CDS (kaupapa maori Lens)

Joanne Burch Anja Theron – Project Change Manager Kim Blair – Project Manager Nicola Chadwick – Project Support

Child Health Integrated Pathway - September 2021 – December 2022

Phase 1 Sept 2021

Jan 2022

Phase 3

Phase 2

May 2022

June 2022

Jul 2022

Aug 2022

Sep 2022

Oct 2022

Referral pathway

Project set Up Planning day Set up Steering Group and Project Group

All referrals - received by MICAMHS, CDS, Voyagers, Paeds, 3D - for children with neuro development, behavioural and mental Heath needs – to be redirected to MART/CHIRP

Nov 2022

Dec 2022

Tamariki and Whanau centred model and request pathway Establish a single point of referral for Child Health and Development (Ex Physical health)

Develop project Plan and charter Design Service Integrated response – MART/CHIRP

Implement and Test Integrated response CHIRP

Establish a Single point of Triage for Child Health and Development (Ex Physical health)

Knowledge and Culture

Testing, review and development of model in practice

To deliver an integrated, timely and well coordinated response, with clearly defined pathways

Med student – learnings from Tamariki/Whanau

Introduce a Shared Care IT Platform with a parent portal

Reduction of current wait list ‘Hump’ resource and funding plan

Shared workshops to showcase the contribution of each team/disciplines and foster a collaborative cross service response

Develop Baseline data set Design Service Integrated response –

CHIRP

Integrated response to triage/ assessment/ diagnosis/Intervention

Data and IT

Key Indicator Reporting Dashboard

Centre of excellence Working with Primary care and Community providers to strengthen Primary response and support

Embed supporting Clinical applications

Integrated Triage/assessment/Diagnosis/intervention

Funding implications

One clearly defined ASD and ADHD pathway

Adaptive funding models

Explore and Build on a community Integrated response

Co-location Project – Anja Theron / Jim Robb / Nicola Chadwick CDS and Voyagers –EBOP – Explore opportunity for CDS to co-locate with Voyagers – potential for shared lease from Jan 2023 Explore Co-location opportunities for CDS, Paediatrics and Child Mental Health - WBOP Identifying a suitable co-location / submit initial business case

Develop full Business case to guide purpose built fit out

Anja and Sarah Mitchell WBOP

Commence Building - WBOP

Establish Values and Model

One Clearly defined ASD and ADHD pathway though an Integrated response Med student input - regional/national/private pathways Map existing pathways – Nicola Chadwick

Establish consistent clinical pathways in line with International, national and local guidelines

Testing ASD and ADHD pathways to inform future operating model

What have we done so far?

Increase in fte.

• Temporary resource boost - We have utilised ‘under recruitment’ funds to resource and address the bottlenecks in our system – to reduce the current wait lists and waiting times. Increased fte in 3D, contracted with private psychology providers, short term contract for additional Paediatrician and psychologists.

Longest wait for first contact from CHIRP…

800 600

200

400

100

200

0

0 Jan-22 Feb-22 Mar-22 Apr-22 May-22

Days waiting for MDM

Jan-22

Feb-22 Mar-22 Apr-22 May-22

Clients waiting for Psychology in CDS Tauranga

Wait time for a psychology assessment in CDS has reduced from 18 months to 4 months.

200 150 100 50 Ap r-2 2

2

ar -2 2 M

Fe b2

22 Ja n-

21 De c-

v-2 1 No

t-2 1 Oc

Se p2

1

0

Impact on referrals Referrals into 3D/Triage 100 90 80 70 60 50 40 30 20 10 0 Jan-22

Feb-22

Mar-22

Apr-22

May-22

Jun-22

Jul-22

• CHIRP Triage team – comprehensive triage at point of referral.

• Psychologist in the CHIRP team - knowledge and experience of neuro-diverse conditions.

Changing the way we work together

• Established a weekly Multi-disciplinary meeting to bring together expertise from across our specialist services and cross- sector to discuss the needs of children who will likely need an integrated approach from these services. o MDM Membership - Developmental Psychologists, Psychiatrist, Paediatrician, Nurse, Speech and Language specialist, occupational therapist. Representation from Child Mental Health, Child Development Services, Public Health Nurses, Early Intervention Education, RTLB and Mental Health in Schools (Kahui Ako).

• Testing new pathways for ADHD and ASD assessments – to reduce overall diagnostic journey from 25 months to 7 months • Exploring opportunity for Te Pou Kokiri support in CHIRP 2023 – to deliver a service that is culturally responsive to Maori • Te Whare Waka working with Child Health Services to incorporate Toi Ora system of Care

Endpoint name (displays endpoint name) Child Health Integrated Response Pathway - CHIRP (Previously known as 3D)

BPAC 3D/CHIRP Referral

News (Section colour = Orange. Service related communication) CHIRP is a triage service for children aged 14yrs and younger with developmental, attentional and/or behavioural concerns, that are of clinical significance, impact on the child’s functioning across home and educational settings and may be due to an underlying neurodevelopmental condition including autism spectrum disorder, ADHD and/or intellectual disability.

Service detail (Brief general introduction of the service) CHIRP is a triage team made up of registered health professionals who will review referrals with a multidisciplinary and multi-service approach. CHIRP may gather further information from whānau, school/preschool and any other services involved with the child.

With representation from Child Mental Health, Child Development Service, Paediatrics and Education, the team will then identify a pathway for assessment and support that best meets the needs of the young person and their whānau. Where appropriate this may lead to an integrated response from more than one service.

The whānau and the GP will be contacted with the outcome of the referral.

Eligibility Criteria (Referral eligibility criteria) • •

Young person is 14yrs or younger Parents have consented to the referral

Exclusion Criteria (Referral exclusion criteria) Patient Must Resident in the Western Bay of Plenty Referral to include • • • •

Comprehensive information will expedite the service response. Where available please include: Medical check-up and referral from a GP Any relevant family history (including family members with ASD/ADHD/dyslexia, mental and physical welling being of family members, parental separation, loss, grief or trauma) School information (which school/preschool is attended and since when, educational concerns, academic performance) Supporting information from whānau and other involved services.

Resources and Links

Resources and links text

Te Waka Aorangi

This is just the beginning…

Thank you for listening, Please do not hesitate to contact us should you wish to discuss the project further. Anja Theron anja.theron@bopdhb.govt.nz Kim Blair kim.blair@bopdhb.govt.nz

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

Thank you for joining us!