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Compass Blog July 2017 – Martin Hefford

Media Releases

Latest News and Media Releases

Board Update

Monthly updates from the Compass Health Board

New Provider Portal

Information on the new Provider Portal: 8 June 2016

Patients receive faster care, closer to home

Media Release: 16 November 2015

Network enabling safer patient care

Media Release: 16 November 2015

Your VOICE our VISION

Media Release: 1 October 2015

Compass Health Wellington Office Relocation

2 September 2015

Compass Health Chair to stand down

Media Release: 17 October 2014

Community Council to support community wellbeing

Media Release: 28 July 2014

Hauora Cornerstone Support Programme Launch

Media Release: 24 July 2014

New online health record a big step forward

Media Release: 4 April 2014

Partners with communities for better wellbeing

Media Release: 21 March 2014

Minister of Health launches Social Sector Trial

Media Release: 12 December 2013

Continuing Professional Development Booking System

5 November 2013

Outstanding response to CVRA campaign

Media Release: 5 July 2013

Primary Healthcare Long Term Conditions Symposium

Media Release: 14 May 2013

Campaign to reduce heart attacks and strokes

Media Release: 13 May 2013

Pandemic Preparedness Bolstered

Media Release: 2 May 2013

Patients to Benefit from New Online Health Record

Media Release: 30 April 2013

Compass Health Trust Boards merge

Media Release: 9 October 2012

Compass Health Appoints New CEO

Media Release: 4 October 2012

Compass CEO Takes On Ministry Role

Media Release: 27 June 2012

Dr Matt Handley Presentation

Media Release: 12 March 2012

Compass Blog July 2017 - Martin Hefford

18 July 2017

Compass Health Blog 1: This blog is entirely the opinion of the author and does not represent the position of the Compass Health Board.

If I were Minister of Health: A Policy Prescription for Primary Health Care

Ten weeks to the election and the public-sector policy wonks are being told to put down their pens on any matter that might be seen to be party political; but they can use the intervening time to work on briefings for the incoming Minister.  Not being public servants, we can still say what we like.   I was very disappointed in the lack of support for primary care in the last budget.  Rather than complain, I have decided to use this first Compass blog to outline what I think primary care friendly health policy would look like.   I’m not greedy, my list includes only 3 items…

1.     Immediately support affordable general practice for those with low incomes

Most of us spend more on our hairdresser than we do on our GP.  It’s true, a recent survey[i] showed that the average kiwi spends $71 per hairdresser visit and visits 4 times per year, whereas they visit their GP about 3.8 times a year, and spend less than $50 per visit.  But we also know that for over 530,000 low income NZers[ii] the cost of GP services is a barrier to accessing care – and not going to your GP when you have a health need is considerably more important than putting up with split ends.  Good access to general practice improves equity, health outcomes, and overall health system value for money[iii]

A new government could, by July 2018, offer practices an extra subsidy for their enrolled patients who have a community services card, or who are living in the most deprived areas, in return for lower copayments for this group.  Such a policy need not impact on VLCA practices – that bulk arrangement could stay in place (and be strengthened) for those with high concentrations of very high need patients. 

Such a subsidy will not help practices financially; it is purely a patient benefit, since the practice gains extra capitation, but loses co-payment revenue.  So, we also need to …

2.     Invest in sustainable general practice

Capitation rates were set some 15 years ago.  They need to be reviewed to better reflect patient need and complexity.  Some adjustments I would like to see:

  • move to single year age bands to recognise more exactly the way that average use changes by age – an 82-year-old is different to a 66-year-old and should be funded accordingly;
  • recognise ethnicity and deprivation in the capitation rate as a proxy for complexity – Maori and pacific people suffer from long term conditions such as diabetes and heart failure on average considerably younger than Pākehā, and have more socioeconomic complications. An adjustment would help struggling VLCA practices, and also those non-VLCA practices with many high needs patients (Titahi Bay and Featherston come to mind); 
  • open up more registrar and nursing-entry-to-practice places to ensure we have enough new GPs and practice nurses being trained to cope with the ageing population and expected retirements.   

3.     Invest in Comprehensive, Patient-centred Primary Health Care

It’s time we got serious about creating comprehensive primary health care teams including GPs, nurses, physiotherapists, clinical pharmacists, health care assistants, midwives, social work, district nursing, mental health therapists, coordination services and so on. One way to enable this would be for a set of ‘modular’ add-ons to the PHO agreement, whereby practices that met certain criteria could opt to provide, for instance, physiotherapy, podiatry, maternity, mental health, well child, etc, with support from their PHO.  The amount for each service could be negotiated nationally.  The wider team would then become part of the PHO network.

This would also require investment in changes to the model of care in general practice, to offer better use of new technology, a focus on patient convenience, and use of lean processes (along the lines of the Health Care Home model).   A funding arrangement that split the cost of providing patient centred services 50:50 nationally and locally would help get PHO and DHB buy in to the changes needed.  It would also recognise the foresight of DHBs such as Capital and Coast that trying to invest in the future while struggling to pays today’s bills.

What would it cost nationally? Affordable access might cost $70 million, sustainable general practice and comprehensive health care perhaps another $200 million a year.  It seems a lot – though it is less than 2% of the current health budget.  Perhaps a better question is: what will it cost if we don’t do it?  What is the impact if primary health providers can’t cope with the silver tsunami or the mental health epidemic?  Just in the Wellington region alone we will need another 200 or so hospital beds by 2031 to cope with the aging population if we don’t actively pursue these changes now.

Martin Hefford
CEO
Compass Health

Foe A Te Vaka providing improved Primary Care health solutions for Pacific Peoples

Press Release: from Compass Health PHO

Release date: 29/05/17

Foe_A_Te_Vaka2

Compass Health provided a warm Pacific welcome to distinguished guests, health leaders and community providers last night during the Foe A Te Vaka Pacific Health Action Plan launch.

The launch celebrated a Pacific Health Action Plan to provide local Pacific communities with a better Primary Care health system response in the Wellington region.

Foe A Te Vaka was launched by Minister for Pacific Peoples Hon Alfred Ngaro this week with members of the local Pacific community and Pacific providers.

‘Foe A Te Vaka signifies a collaborative effort between Wellington’s Pacific community and Compass Health,’ says Dr Larry Jordan Chair – Compass Health, ‘and was the culmination of extensive research and consultation within the Pacific communities and health providers.’

The health status of Pacific people lags behind that of non-Pacific. Compass Health is responsible for over 13,500 Pacific people in its enrolled population and is charged with addressing the health needs of all people to reduce health disparities. The plan focuses on five priority areas:

Compass Health Action Plan priorities:
  1. To Improve and Sustain Child and Youth Health (0-24 years)
  2. Empowering Pacific families to make positive changes for improved health and wellness.
  3. Ensure quality primary health care is available, accessible, affordable and is family-centred
  4. Best practice is supported through Provider and Workforce Development
  5. Pacific Health research and effective use of data

‘This plan is an important guide for Compass Health and the wider health sector’ says Tofa Suafole-Gush - Chair of the Compass Health Pacific Committee. ‘It links our local health planning with wider government policies and strategies.’

‘Foe A Te Vaka is a valuable action plan for Pacific peoples,’ says Dr Jordan, ‘providing clear milestones for future health service development in the wider Wellington region that both the health sector and Pacific people can support.’

Foe A Te Vaka Brochure


More information:

Compass Health is a Primary Health Organisation (PHO) that provides a wide range of primary care services through 60 General Practice Teams and a number of other health care providers throughout the Wellington, Porirua, Kapiti and Wairarapa regions.

Susan Fullerton-Smith
Communications Advisor
Susan.fullerton-smith@compasshealth.org.nz
022 638 0578
www.compasshealth.org.nz
Twitter: @compasshealthnz

Health Promotion at Victoria University
Barbara Vardey Compass Health with Eleni Mason, Tovila Fomai, Kitiona Tauira Pacific Health Services Porirua
Health Promotion at Victoria University
Martin Hefford CEO Compass Health and Dr Larry Jordan Compass Chair welcome Taima Fagaloa Director Pacific Health CCDHB, Adri Isbister CEO Wairarapa DHB, Debbie Chin CEO CCDHB and Hon Alfred Ngaro Minister for Pacific Peoples to the Foe A Te Vaka launch.
Health Promotion at Victoria University
Hon. Alfred Ngaro launches Foe A Te Vaka – Pacific Health Action Plan at Compass offices

New Compass Health Provider Portal

8 June 2016

The new provider portal is live! Access it here:
Compass Health Provider Portal

This means you can:

  • login directly through Medtech32
  • access faster, more convenient information as it happens in a safe on-line environment
  • update key practice and staff details without paper forms
  • access IPIF targets, CPDs and important updates
  • move away from the legacy platform Silverlight to make it accessible across all browsers

Here is a quick one page reference, a full user guide and an introduction video to help navigate the new Provider Portal:


Board Update

11 February 2016

Compass Health Board Meeting update February 2016

This letter provides a brief summary of the important points from the most recent Board meetings.

Pacific Trustee appointment

Tofa Suafole Gush has been appointed as chair of the Pacific Health Advisory Committee and board representative. Tofa serves on the Te Awakairangi Health Network Board as a Pacific representative, and is the Pacific Advisor at Hutt Valley and Wairarapa DHB. She is Samoan, and has had various roles in government and private sectors.

Healthlink charges

The board noted that Healthlink have again increased their charges considerably. Compass Have been in collective PHO negotiations with Healthlink for over 18 months, and have been carrying the increased charges (at a cost of over $100,000) during that time. However, we have no funding source for this, and will be passing the cost on to practices from 1 July. Letters will be sent to every practice over the next week with estimated costs.

Other business

  • The board agreed to offer to purchase a practice in Porirua, if they are unable to agree terms with other purchasers.
  • Melissa Simpson will be retiring from the board in the next few months as she is now a Compass Health staff member; the nurses committee will be asked to nominate an alternate until the AGM this year.
  • The board discussed recent tragic events in Masterton with the loss of two young lives, and noted that Compass is involved in the relevant high school and medical centre to help ensure youth friendly services in the area.

Board Update

26 November 2015

Compass Health Board Meeting update November 2015

This letter provides a brief summary of the important points from the last Board meeting and the AGM.

2015 AGM and Trustee reappointments

The Compass Health AGM was well attended, as was the social function to open the new Wellington offices. Dr Don Simmers was re-elected as a Trustee, and Dr Nick Crozier was elected as GP representative for the Wairarapa. We took the opportunity to launch the funding for low income individuals for minor gynaecology procedures, the Drug Seeker Network, and the Managemyhealth patient portal smartphone APP. The annual report is available on the Compass Website, and will be sent to every practice.

New back to back agreement policy

The board agreed to revisions to our policy for granting new back to back agreements. The revised policy no longer focuses entirely on practice size, but instead seeks to balance a number of factors including:

  • Patient choice and ability to meet cultural expectations
  • Practice financial sustainability and risk
  • Quality of service
  • The requirements of the Commerce Act
  • Ability to meet contractual obligations
  • Support for health service integration.

Other business

  • The national working party considering GP funding has completed a round of workshops across the country and has made recommendations proposing that Very Low Cost Access funding be revised to target individuals rather than practices.
  • The MOH have announced that the more heart and diabetes checks health target will be retired at the end of June 2016.
  • The Government have indicated that the Social Sector Trials will finish up at the end of June, and may or may not be replaced with an alternate arrangement.

Patients receive faster care, closer to home through new joint DHB/PHO funding initiative

Media Release: 16 November 2015

Women needing medical help to investigate and relieve some menstrual problems and pelvic organ prolapse can now receive faster care, closer to home through a local GP practice. Patients with a community services card or those living in some areas (deprivation quintile 5) may be eligible for fully funded procedures. GPs not able to provide these services can now refer patients to their colleagues who have the skills for these procedures.

This means “there will be no need to wait for a specialist hospital assessment before procedures such as Mirena insertion, Pipelle biopsy and Ring pessaries are undertaken in the Wellington, Hutt, Wairarapa and Kapiti areas’’ says Chris Kerr, Clinical Director Compass Health PHO.

The initiative comes from a three DHB Health Pathways initiative working with PHOs, hospital specialists and GP’s in the greater Wellington area, aiming to make gynaecology procedures more available in Primary Care.

“It is hoped that increased scope of GP gynaecology will reduce pressure on hospital gynaecology clinic waiting lists and also improve access for women with more complex gynaecology needs to the hospital specialists,” says Jackie Hawley - Clinical Leader Gynaecology CCDHB.”

Naenae Medical Centre GP (Hutt Valley) Dr Kolitha DeSilva says that “although I already offer some of these procedures, making it free for patients that can’t afford to pay will enable more patients to get treated at their local health practice, rather than having to go to hospital.”

“I support this development and we will be working to establish a number of these options in our practice over the coming months.”

The RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) have recently provided training to refresh and up skill GPs as part of the World of Women’s Health conference 2015. More training is planned for the next year.

Subsidies for qualifying patients are available now in participating practices. Patients warranting gynaecology care for these conditions but not eligible for funding, may still be referred for treatment through their local hospital.


Network enabling safer patient care

Media Release: 16 November 2015

Compass Health PHO is encouraging Wellington, Porirua, Kapiti and Wairarapa healthcare providers to join a network helping health professionals share information about patients who may be abusing or seeking drugs.

The Drug Seeker Network is made up of GPs, Nurses, Pharmacists, After hours clinics and Emergency Departments. Participating clinics display clear signage in waiting areas to inform patients about the network in compliance with the Health Privacy Act. This then gives staff the opportunity to discuss possible patient drug seeking behaviour and critical prescribing information with health professionals from other services, where this is in the best interests of the patient.

“The network enables safer patient care through respectful management of personal health information where drug seeking behaviour is identified. It’s also a way our local health community can work together more closely." says Chris Kerr, Compass Health Clinical Director.

“The ultimate aim is to identify patients at risk and to get them the help they need," says Kerr.

Poster and link to current list of participants available publically on the Compass Health website here.