Midland Region Primary Healthcare Forum

30 May 2014

Integration of Primary / Secondary Services within the Region

Coverage

• Healthcare structure in NZ• What/who influences health care policy and

direction• What is the role of the Midland DHB’s?• How are DHB’s structured?• What opportunities and limitations for DHB’s

in the current health care structure?

Strategies• Child Health Strategy• Health of Older People

Strategy• He Korowai Oranga: Maori

Health Strategy• NZ Disability Strategy

• NZ Health Strategy• NZ Palliative Care Strategy• Pacific Health & Disability Action

Plan• Sexual and Reproductive Health

Strategy

• Primary Health Care Strategy• Youth health: A Guide to Action• Our Health, Our Future• Inhaling Inequality

Chief Advisors• Services• Nursing• Disability Support Services• Maori Health

• Mental Health• General Practice• Child and Youth Health• Oral Health

• Medical Advisor• Pacific Health• Health Information Strategy & Policy• Media

DIRECTORATES

Corporate and Information

DHB Funding and Performance

SectorPolicy

ClinicalServices

Public Health Maori Health DisabilityServices Mental Health

Policy Frameworks• Treaty of Waitangi• Legislation

• NZ Health Strategy• NZ Disability Strategy

• Monitoring and Accountability

MoH Expectations

• Regional planning and delivery• Health Targets• HQSC – falls prevention, surgical site infections• Elective Service Performance Indicators• Stroke• Trauma• Cardiology• Oncology• Financial Performance

Regional ObjectivesSix Regional Objectives:

– To improve Maori health outcomes– Integration across continuums of care– To improve quality across all regional services– To build the workforce– To improve clinical information systems – Efficient allocation of public health system

resources

Regional MeasuresRegion to monitor progress:

– Life expectancy: life expectancy is a calculation of life expectancy at birth based on the mortality rates of the population in each age in a given year

– Premature death: early death is the rate of deaths before the age of 75 years

– Amenable mortality: are deaths that could, in theory, be averted by good healthcare

– Fewer people smoking– Reduction in vaccine preventable diseases– Improving health behaviours

The Midland Region

• Covers 56,728km2 (21% of NZ land mass)• 5 DHB’s: Lakes, Waikato, Tairawhiti, Bay of

Plenty & Taranaki• Approximately 853,725 people• Maori population: 205,590 identifying as

Maori (24% total population) – proportion much higher in Midland against the national proportion

Midland Region (continued)

• Low proportion of the population identified as Asian or Pacific peoples

• Higher number of people living in rural areas• Relatively higher proportion of people living in

areas identified as high deprivation (quintile 4&5)

Each Day within the Midland Region:

• 541 people are admitted to a Midland hospital• 837 people have a first specialist or follow up

appointment• 5,033 people have a general practice

consultation, and• 17 people die

Regional Vision

• All residents of Midland Health Boards lead longer, healthier and more self-sufficient lives

TDHB Aims

• To promote healthy lifestyles & self responsibility• To have the people & infrastructure to meet

changing health needs • To have people as healthy as they can be through

promotion, prevention, early intervention & rehabilitation

• To have services that are people centred and accessible, where the health sector lives as one

• To have a multi agency approach to health• To improve the health of Maori & groups with

poor health status• To lead & support the health & disability

sector & provide stability throughout change• To make the best use of resources available

TDHB Aims (continued)

Regional Networks & Action Groups

• Midland Cancer Network Programme• Cardiac services• Elective Services• Health of Older People• Mental Health & Addiction Network• Regional Trauma Service• Child Health action Group• Maternity Action Group• Radiology Group

Project Maunga

• Theatre Suite• Enhanced Day Stay • Endoscopy Suite• Medical Floor• Surgical Floor• Older Peoples Health Ward• Children's Ward

Taranaki health targets: quarter 1 (July–September) 2013/14 results

Shorter stays in emergency departments

Increased access to elective surgery

Shorter waits for cancer treatment (radiotherapy & chemotherapy)

Increased immunisation (8-month-olds)

Better help for smokers to quit – hospitals

Better help for smokers to quit – primary care

More heart & diabetes checks

Ranking quarter 1, 2013/14

12 6 1 13 9 10 7

Quarter 4, 2012/13 95.5% 112.1% 100.0% 89.3% 97.3% 65.2% 73.1%Quarter 1, 2013/14 94.0% 111.8% 100.0% 89.9% 96.5% 66.5% 75.6%National goal 95.0% 100.0% 100.0% 90.0% 95.0% 90.0% 90.0%

Elective Services

ESPI compliance

Ministry Policy: Elective Services

• Original policy released March 2000• Intended to ensure patients with highest

priority are treated ahead of those with a lower priority

• DHBs required to comply with the policy• Previously it was a “never ending” waiting list

Aims

• Maximum waiting time of 5 months for a first specialist assessment (moving to 4)

• All patients who have been assessed clinically as having a level of need, which can be met within resources available, receive surgery / procedure within 5 months (moving to 4)

Planning for next year• Live within our means• Maintain a Quality focus• Regional planning & delivery• Link with Regional Services plan• Link with Maori Health Plan• Implement more meaningful primary /

secondary integration

Questions?