Forum Powerpoint_15092021

Provider Forum 15 September 2021

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 PHO Update. Lindsey Webber, CEO – WBoP PHO Mana Orite – Ngāti Ranginui Iwi. Profiling the Iwi Ora model.

Mel Tata, CEO – Ngāti Ranginui PHO Clinical Update. Dr Claire Isham, Clinical Director – WBoP PHO Profile of Ngāi Te Rangi Iwi services. Emily Gudsell, Contracts Manager, Ngāi Te Rangi Atawhai – Making it safe to talk about family violence in health care. Dr Anna Rolleston & Dr Claire Gear, Co-Investigators

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

Te Rūnanga o Ngāti Ranginui

1. 29th April 1864 Battle of Pukehinahina 50,000 Hectares of Land Confiscated Ngāti Ranginui Iwi Loses identity 2. 21 June 1864 Battle of Te Ranga 3. Bush Campaign Introduction to Govt Policy Scorched Earth Act 4. 1956 Opening of Tamatea at Huria Marae by King Koroki, Ngati Ranginui is acknowledged by Māori chiefs from around the motu 5. 1990 – Iwi Authorities Act 6. 21 June 2012 – Apology and Commitment from the NZ GOVT

NRI Strategic Priorities 2018 - 2038 Guiding the Business

1.

2.

3.

4.

5.

Shared Vision, Three Entities, One Iwi Kotahitanga - Mātauranga Māori Revitalisation Health & Social Service - Mauri Ora, Whanau Ora Education - Training and Life Long Learning Economic Development and Social Enterprise

6. Environmental Sustainability 7. Housing Innovation

Mana Whenua

Mana Moana

Mana Tangata

Te Rūnanga Mātauranga Māori Whakapapa Local History Marae, Hapū Teachers Clinicians Researchers Accountant Taiao + Kāhui Kaumātua Addition of External Reps

Examples of Joint Venture Agreements and Partnerships in practice Te Tūāpapa Auaha WBOPPHO 50% Iwi Owned

Te Whakareia

Iwi MOU APL

Iwi

Central & Local GOVT

MSD Ministry of Health

Vocational Services for People with Disabilities (Te Whironui) Under 65 years Disabilities Support Long Term Support - Chronic Health Conditions - Home Based Support Services

Ministry of Health

COVID 19 Testing Teams / Vaccination Teams

Bay of Plenty DHB

Over 65 years Home based support

Bay of Plenty DHB

Kaupapa Maori Healthy Lifestyles for Rangatahi and Tamariki 0 - 18years

Western Bay of Plenty PHO

Mauri Ora 2020

Western Bay of Plenty PHO

Te Ahunga Whanau

Oranga Tamariki

Cultural Advisor

Oranga Tamariki

Shared Care

Oranga Tamariki

Tamariki Ora and Whanau Support

Oranga Tamariki

Youth Mentoring Funding

Oranga Tamariki

Nga Peka Titoki

Oranga Tamariki

Mental Health Nursing Services dedicated to Youth residence

MOJ / Dep of Corrections

Non Violence Programmes for Perpetrators of Family Violence

MOJ Western Bay of Plenty PHO

Physiotherapist Contracted RN’s Kaiāwhina level 2 - 4 Service Coordinator Training assessor Data and Performance Analyst Personal trainer Dietitian Programme facilitators RN and Kaiāwhina Huikakahu Kawe Registered Social Workers Youth mentors Programme facilitators Community worker – Social Science RN

Non violence facilitators Contract for the provision of Non-Violence Programmes, Safety Programmes Tamariki/Rangatahi Counsellor and strengthening Safety Service.

AOD counsellor Mataora Trauma counsellor Peer Coach

MOE

Partnering with Iwi to accelerate Maori Educational Achievement

MOE

Te Tai Whanake / Localised Curriculum

Registered Teacher Register Teacher, Kaumatua

Finance Manager/Accountant

Child protection

Iwi Ora

HCSS, support or employment

Youth Justice

Referral: Govt, Community, Whanau, Self

Integrated Services

Healthy lifestyles Dietician

Hui a whanau

Whanau Kaumatua Awhi Whanau

Cultural competency

Programmes Education

Men, Woman, Children, Rangatahi

AOD Counselling Mental Health

Disabilities vocation

Ngā Peka Titoki Te Ara Taiohi

Whanau: - Placement - Emergency - Transitional - Permanent - Access

Rangatiratanga: - Awhi Whanau - Hui a whanau - Future pathways

Timeframes:

Emergency

What are my goals?

Referral, OT

Matauranga: - Ko wai au - NPT Kaiawhina - School

Whanau

Hinengaro: - Wairua - Mana Tamaiti - Resilience

Hauora: - GP - Services

Transitional

Ngati Ranginui Iwi Mana Moana

Mana Whenua

Mana Tangata

• A unique organisational structure allowing various govt agencies to integrate resource • A structure that allows a political voice for Whānau, Hapū, Iwi • A structure that enables connected sector conversations • A structure that can collate multiple sector data • A structure that is resilient to change and has the DNA to maintain a generational presence • A structure that connects locally, regionally and nationally • A structure that drives equitable outcomes for Māori inclusive of its people.

Where to from here: Mana Whenua

Mana Moana

Mana Tangata Referral,

OT, YJ, NRI

Treaty Partnership Agreement

Strategic outcome agreement

Bespoke Contracts

PHO Clinical Updates

Topics 1 Health Pathways Guidance on Superficial Thrombophlebitis 2 COPD 3 Care Plus reminder 4 Iron Infusions 5 Vitamin B12

Superficial venous thrombosis (thrombophlebitis) • Superficial venous thrombosis has previously been regarded as a benign, self-limiting condition, however 5% of patients presenting with superficial venous thrombosis will also have a DVT. For the remainder, there is a 10% risk of extension to the deep veins in the next 10 days.

• Clinical findings will usually make the diagnosis, e.g. tenderness, induration, pain, or erythema along the course of a superficial vein.

A co-existing DVT is: o

less likely with superficial venous thrombosis at the site of an existing varicose vein.

o

more likely if the superficial venous thrombosis involves the main trunk of a saphenous vein (rather than its branches), particularly the proximal great saphenous vein if adjacent to the sapheno-femoral junction.

Superficial venous thrombosis investigations 1. D-dimer is not considered sensitive or specific enough to predict DVT in superficial venous thrombosis.

2. Arrange an ultrasound to exclude DVT if: a. there is an involved segment of vein of 5 cm or more, b. either the great or the small saphenous vein is involved, or c. there is asymmetrical leg swelling.

The ultrasound can be arranged through Acute Demand – please give all details as above

COPD

Updates on use • High Trust Model • Focus on getting every practice with one COPD champion • GPs invited to attend the next educational session on Wed 3rd November at Education centre - 25 places – invites coming soon • To access funding for the program there is a requirement to attend PHO training in last 18 months and fulfill eligibility criteria • Planning on refresher training early next year also • New Claiming form from 1st October

Care Plus • Relaunch going well • Risk stratification data on Thalamus • Care Plus lead / champion • Flexible funding 2-8 sessions • Good uptake of additional sessions

Iron Infusions • Just a reminder that iron infusions can be initiated in primary care for those patients with an Iron Deficiency anaemia • The funding is per infusion:

The funding includes all the work for the infusion e.g. weight, script generation and all blood test ordering and analysis

• Some requests will be coming from secondary care e.g. Renal team, Haematology and Gynaecology.

• There is a special authority form that allows: • "Application only from a internal medicine physician, obstetrician etc..... OR medical practitioner (i.e GP) on the recommendation of a internal medicine physician etc" • In Medtech the special authority form does not state this only • Application only from a internal medicine physician, obstetrician etc • Please be aware of this and use the paper version – you may find some of the renal physicians have done the SA for you

Vit B12 outreach • Although the outreach service is available for a lot of care, we would encourage GPs to use their high needs funds for patients in whom the barrier to accessing vit b12 injections is cost.

• We are trying to encourage the relationship between patients and GPs

End Of Life Choice Resources are coming (Nov 7 is 53 days away)…

MoH website

https://www.health.govt.nz/our-work/regulation-health-and-disability-system/end-life-choice-act-implementation

WBoP PHO website

https://www.wboppho.org.nz

Practice Managers Meetings Practice News Peer Group resources via RNZCGP Waikato/BOP Faculty Local Working Groups (Primary and Secondary) Practice support and education from PHO team.

Profile of Ngāi Te Rangi Iwi services Emily Gudsell Contracts Manager Ngāi Te Rangi

MAKING IT SAFE TO TALK ABOUT FAMILY VIOLENCE IN HEALTH CARE Dr Claire Gear, Centre for Interdisciplinary Trauma Research, AUT University Dr Anna Rolleston, Centre for Health, Tauranga

Mauao, Tauranga Moana

Atawhai research team

Professor Jane Koziol-McLain AUT University

Dr Claire Gear AUT University

Dr Anna Rolleston Centre for Health

Dr Clare Healy Hazel Hape Professor Kelsey Hegarty Tauranga Women’s Refuge General Practitioner University of Melbourne

Ngareta Timutimu, MNZM Ngāi te Rangi

Dr Elizabeth Eppel Victoria University of Wellington

Dr Claire Isham Ngāti Kahu Hauora WBOP PHO

Stacey Mareroa Ignite Your Gift Reon Tuanau Ngāi te Rangi

Lisa Mullions AUT University

Te Tiriti o Waitangi partnership • Partnership reflected across our research team, methodologies and participants • Workshops open space for Māori to develop a response based on Māori knowledge and strengths • Enhance equitable responsiveness across Māori and general population health • Support tauiwi research team with te reo and tikanga

• High rates of family violence are well known in New Zealand • Family violence is a key determinant of ill-health not well recognised by health policy or practice • Internationally, primary care is considered a priority setting for training and service delivery • Limited support and resources to help NZ primary care professionals to respond (Fanslow et al., 2010; 2021; NZ Family Violence Death Review Committee 2016; WHO 2013; Garcia-Moreno et al 2015; Gear et al 2018)

• Raises visibility of family violence as a key determinant of ill-health for policy and practice • Developed and led by primary care professionals via a series of workshops • Identifies and strengthens a range of system pathways and tools for diverse scenarios and settings • Inclusive of general practice, hauora, and health and social service providers • Research period October 2020 – September 2023; Current phase: Data collection

The Triple R Pathway

Gear et al 2019

Join with us and find out more:

Website: www.atawhaitia.co.nz Email: kiaora@atawhaitia.co.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

Fifth 2021 PHO Provider Forum

Thank you for joining us!