HIS criteria update email for COVID

Kia ora koutou This email is to give you early notification of the following, ahead of formal communications being shared with the wider sector.

The Higher Index of Suspicion (HIS) criteria for COVID-19 will be retired on 23 May 2022. Although the criteria have proven to be a useful tool in the past, they no longer reflect New Zealand’s current COVID-19 response. The HIS criteria were implemented to help to identify symptomatic people who had a higher likelihood of exposure to COVID-19. Those people who met the HIS criteria generally had links to international travel, the border or local community outbreaks. However, within the current context of the response and COVID-19 now widespread in our communities, the HIS criteria are no longer fit for purpose. Reimbursement for clinical assessment of those meeting the criteria acknowledged the level of clinical assessment, IPC and notification processes required. The retirement date of 23 May 2022 should allow the sector sufficient time to update operational systems.

Since December 2022, COVID-19 Care in the Community funding became available which includes funding for full clinical assessments, reviews and clinical escalation. Most recently the funding for COVID-19 testing was revised to include clinical assessment and RAT for symptomatic patients. With these funding streams now in place and the HIS criteria retiring, it is envisaged that from 23 May there will no longer be claims against the old Primary Care Based COVID-19 Activity Framework, which includes the $250 claim for assessments.

Attached is a consolidated document which summarises the various funding streams that have been available to primary care for COVID-19 testing, COVID-19 vaccination and COVID-19 Care in the Community. This is a live document, and intended to help the sector understand the current funding available for the delivery of COVID-19 response activities. It supersedes the Primary Care Based COVID-19 Activity Framework , and supports a shift away from the old claiming framework.

Any follow up queries should be sent to primary.care@health.govt.nz Ngā mihi Clare Perry (she/her) Interim Director – Primary, Community & Rural Interim Health New Zealand