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Implementing the Primary Health Care Strategy, 2006 - 2010

Outline . Initial DHB/MoH thinkingWhat's been achieved since 2001?A new way of working" Major themesProposed workstreams Programme structureQuestions ? future engagement. The work so far??... Aim to engage sector in a proposed work programme Joint project led by Stephen McKernan (DHB CEO)

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Implementing the Primary Health Care Strategy, 2006 - 2010

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    1. Implementing the Primary Health Care Strategy, 2006 - 2010 March 2006 Win Bennett (DHBs) & Jim Primrose (Ministry) on behalf of the Joint PHCS Implementation Steering Group

    2. Outline Initial DHB/MoH thinking What’s been achieved since 2001 “A new way of working” Major themes Proposed workstreams Programme structure Questions – future engagement

    3. The work so far…….. Aim to engage sector in a proposed work programme Joint project led by Stephen McKernan (DHB CEO) & Dr Colin Feek (DDG Ministry of Health) Steering group included: DHBs: Kevin Hague, Win Bennett, Chris Mules, Julian Inch MoH: Jim Primrose, Sarah Turner Initial sector engagement late 2005

    4. What’s been achieved since 2001 Primary Health Care Strategy launched 2001 First PHOs established 2002 Now, 81 PHOs with >3.9m New Zealanders enrolled or registered capitation funding in place improved access - substantially lower fees for GP services and pharmaceuticals - for most New Zealanders new and innovative services growing community involvement PHO performance management programme has commenced ………….it’s time now to re-focus on the aims of the Strategy

    5. Primary Health Care Strategy Better health for all Reduced health inequalities More emphasis on population health Better access to primary health care services Co-ordination, continuity, collaboration Community participation Primary health care fully involved in health system The aims of the Strategy are outlined on this overhead – it includes the key themes we’ve already discussed ………………….and these aims will be achieved through new organisations - called Primary Health Organisations The aims of the Strategy are outlined on this overhead – it includes the key themes we’ve already discussed ………………….and these aims will be achieved through new organisations - called Primary Health Organisations

    7. “A New Way of Working” This next phase is challenging, substantive and complex, requiring a different change management approach, i.e. Change needs to be led from the sector, with: PHOs taking a greater population focus Local DHB/PHO/community relationships central DHBs responsible for local implementation decisions The Ministry focussed on policy, strategic direction, monitoring of DHBs, and acting as the Minister’s agent ………an approach consistent with the sector’s devolved model

    8. Fundamentals of this next phase PHO development that focuses on engaging communities reducing health inequalities improving the prevention and management of chronic conditions Improving the health of local populations through a population approach addressing determinants improved access - sustained over time continued service development

    9. Themes of the Work Programme Active & Informed Communities Communities & PHOs will be engaged & interact at multiple levels – governance, service design, delivery and monitoring Primary Health Care Actively Working Towards Reducing Inequalities High need populations participate in local decisions PHOs apply equity tools in their planning Low cost environment maintained More innovative services Increased support for PHOs with low fees Enhanced Delivery – population focus Prevention & management of chronic conditions Health promotion activities - determinants

    10. Capability Development “High Performing” PHOs Broader range & diversity of providers & care teams Co-ordination / integration Workforce training & development - with greater diversity Information Management Shared Approach – a single system Accountability A knowledge environment with shared learning & feedback the norm ..............underpinned by a culture aligned with the values of the Primary Health Care Strategy

    11. Primary Health Care Strategy IMPLEMENTATION WORK PROGRAMME

    12. Funding & Accountability Realignment of DHB / MoH activity Planned transition of functions to DHBs Funding arrangements Review of funding formula Transfer of PHCS $$ into PBFF Universal low fees Increased funding for PHOs (?practices) with low fees

    13. Service Development High Performing PHOs Assessment criteria Additional opportunities Delivery Models PHO structure – governance/management Models of care – team work, NGO relationships Population Health Approach Prevention and management of chronic conditions Health outcomes for enrolled populations Health promotion Determinants of health

    14. Infrastructure & Sector Development Workforce Capacity / Capability Incorporating current activities Supporting key groups – GPs, nurses, pharmacists, allied health etc Information Systems Establish IS work programme Enable PHOs and DHBs access to national systems

    15. Change Management Programme Change Strategies Shared Learning Environment Shared Accountability – with a greater focus on outcomes

    16. Structure of the Work Programme

    17. Sector involvement Participation in the Implementation Group Existing Advisory Groups continue New Expert Advisory Groups for specific workstreams/projects

    18. Questions Do you see different workstreams? Prioritisation what’s important? what should be done first? PHCS Implementation Group PHO engagement Maori engagement Community engagement Contacts: Local DHB – PHO programme manager Rana Wong – RWong@cmdhb.org.nz

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