SCDHB

South Canterbury District Health Board members will decide on a new primary care structure at a meeting this Friday. The meeting is open to the public.

The board will vote on the recommendation “that primary care becomes an integrated operating unit within South Canterbury DHB and not an external organisation”. If the vote is yes, South Canterbury will become the first area in New Zealand with primary health integrated with a district health board. This will enhance clinical leadership and provide opportunities to improve health services for the people of South Canterbury.

What Will Happen if the Board Approves the Recommendation?

The first step will be to work with the Ministry of Health to implement the recommendations. This will include the current PHO in South Canterbury, Aoraki PHO, being disestablished on April 30 with services transferred to a new division of the District Health Board called “Primary and Community Services”.

Over the next two years, “Primary and Community Services” will take responsibility for a group of community-based health services that together receive $35-40 million a year of taxpayer funding. Only a portion of these services will originate from Aoraki PHO, with others coming from a planned restructure within the DHB.

Primary and Community Services will have responsibility for all GPs and pharmacies in South Canterbury – at present about $18 million goes towards providing prescription medicines, and about $9 million is spent supporting patient health care through general practices.

Some Aoraki PHO services will shift to Primary and Community Services while they are reviewed by clinical leaders to identify any areas where improvement can be made. This category includes a service to improve youth access to sexual health services, CarePlus (an initiative for people with high health needs), the Diabetes Get Checked programme, and Green Prescriptions.

Another six PHO contracts, that are presently under-used or have finished their work programme, will be suspended until they are reviewed by clinical leaders. Three of these six contracts are for pilot programmes or fixed -term contracts that finish by April 30. The other three are:
• a fund for health promotion in primary care that has not been widely used and will have further clinical input before it can continue,
• funding for a diabetes steering group that was suspended by the DHB and PHO. This funding has been returned to the DHB,
• breastfeeding health promotion support. A local health sector breastfeeding group is already in place to support services.

Some services performed or funded directly by the DHB will also join the new “Primary and Community Services” when the structure is in place. They include Public Health Nursing, District Nursing, Sexual health services and Maori health services, which are funded by the DHB and will continue to be delivered by a contracted provider.

New primary care clinical leadership positions will be created. These leaders will design services to improve people’s health and contribute to the achievement of national health targets.

Changes will also be made at a governance level to ensure primary and community health is given a high priority. The Community and Public Health Advisory Committee will be restructured with new members and more frequent meetings, and will be asked to provide advice to board members on community health matters. This committee will consist of three board representatives, three health professionals, three community members and two Iwi representatives.

All these changes together will provide a wider range of health services that are more responsive to the needs of the community.

The following documents will be considered by board members at the meeting on Friday. They are available on the SCDHB website:

1. Introduction and Recommendations to the Board
2. Full Report – Primary and Community Health Care in South Canterbury, from the Primary Health Establishment Board
3. Draft new terms of reference for the Community and Public Health Advisory Committee

Please attribute this information to SCDHB Chief Executive Chris Fleming.


Background

Primary Health Organisations (PHOs) are funded on a capitation basis by the New Zealand Government via district health boards. They are usually set up as not-for-profit trusts and have as their goal the improvement of their population's health. Aoraki Primary Health Organisation is the only PHO operating in South Canterbury.

Last March, South Canterbury DHB received an application from South Link Health to establish a new primary health organisation in this district. Three months later a number of general practitioners wrote to SCDHB expressing a loss of confidence in Aoraki PHO.

In August, SCDHB board members decided to decline the proposal from South Link Health and get a group of experts together (the Establishment Board) to design a new primary health environment in South Canterbury. An exit notice was issued to Aoraki PHO with an exit date of April 30, 2010.

The members of the primary health establishment board are:
• Chairman Tony Shaw, from Timpany Walton Lawyers in Timaru
• Professor Murray Tilyard, a GP and now Professor of General Practice
• Dr Bruce Small, Timaru GP
• Paul Townend, Waimate Pharmacist
• Sam Powell, Director of Nursing, Midwifery and Allied Health at SCDHB
The recommendations of the establishment board were presented to SCDHB board members and to general practitioners. A public meeting was held and feedback given.
The final report and recommendations have been presented to the board for a decision at the March 26 meeting.

For more information contact:

Arlene Goss
Communications Advisor
South Canterbury District Health Board
Private Bag 911, Timaru
Ph: 03 684 1395
Fax: 03 688 0238
Mobile: 027 276 4259