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Delivering Better, Sooner, More Convenient Primary Health Care

Delivering Better, Sooner, More Convenient Primary Health Care. Dr Paul McCormack 2 December 2010. Government’s Objectives:. Improved patient experience – better, sooner, more convenient

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Delivering Better, Sooner, More Convenient Primary Health Care

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  1. Delivering Better, Sooner, More Convenient Primary Health Care Dr Paul McCormack 2 December 2010

  2. Government’s Objectives: • Improved patient experience – better, sooner, more convenient • Shifting services from hospital settings to primary care, delivering more care within existing resources • Reducing demand for hospital capital investment

  3. Policy Settings:Alliance Processes • Clinical leaders, key managers, DHB P+Fs, and other relevant sector experts • Jointly agree on how to: • Prioritise service development • Monitor progress towards achieving jointly-agreed targets • Collectively manage risks and share benefits

  4. What this means • Government (through MoH and DHBs) still decides “what” [Health Strategy] and “how much” [Health Budget] • Alliance Leadership team decides where service delivery and performance change is sought – establish Service Alliance • Alliance Teams – clinical leaders, key managers and DHBs decide the “how”

  5. Alliance Process Process intended to deliver Clinically led service change “Whole of system” approach “Working together” Not about structures, but about functionality - how people work together and make joint decisions Not a new structure –same people, different roles, new team

  6. Policy Settings:Flexible Funding Pool • Intent: to signal a new environment for doctors, nurses and pharmacists • High trust, high quality, high performance, high accountability and low bureaucracy. • High-level objectives set nationally – health promotion, disease management, address access, and delivery of business cases

  7. Policy Settings:Monitoring Framework • Framework designed to: • Focus sector on achievement of shared system-level outcomes • Provide stakeholders with information to assess impact of BSMC • Assess progress on business case implementation

  8. BSMC Approach • Integration - ‘single system’ approach focused on patients • Ability to evolve – a ‘transformation platform’ • Reset engagement from ‘master – servant’ to “working with …. “

  9. The Next 18 Months • Clinically led service development • Patient focused • Supported and informed by community • Supported and informed by iwi • Continuing focus on inequalities • Continuing focus on keeping people healthy

  10. The Next 18 Months • Services devolved from hospitals into community • Extended urgent care programmes [POAC+] safe care in community as alternative to hospital admissions • Improved care of people with long term conditions, of older people • New primary mental health services, devolved from hospitals

  11. The Next 18 Months • Where appropriate, fewer PHOs – larger primary care infrastructure • Consolidation of general practices supported to achieve sustainability & scale • Extended hours • New demonstration sites e.g. mental health, nursing roles, walk in clinics

  12. Integrated Family Health Centre [IFHCs] • Large community based facility with co-location of doctors and nurses with enrolled patients, working with pharmacists and other allied health professionals, sharing a health record and often with on site radiological or laboratory diagnostics • Walk in clinics • Extended hours • Some social services

  13. Integrated Family [Community] Health Hub (IFHH): • Co-location of doctors and nurses, without enrolled patients, with pharmacists and other allied health professionals, sharing a health record and often with on site radiological or laboratory diagnostics – • Likely to be a hub and spoke arrangement working closely with a local integrated network of general practices, pharmacies and nursing services, and a site for urgent care, more complex care, community physicians and paediatricians and perhaps after hours care

  14. What is in this for DHBs? • Integration across health system • Shifting services and demand from hospitals into community • New workforce models • Health resources are used in the most productive way • Ability to plan future hospitals that are right sized and more affordable

  15. What does this BSMC environment mean for us? • MoH / DHBs need to walk-the-walk in new alliancing process • Replaces master-servant relationship with “working with…” • MoH / DHBs need to implement Govt policy of creating new (positive) relationships with health professionals • Close off old policy levers and focus on elevating / accelerating the new

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