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.

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.

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
Compass Health

8 July 2015

Population Health Strategy

The board discussed and commented on key elements of a population health strategy being developed. This will be circulated more widely once in a presentable form.

General Practice New Zealand in attendance

Shelley Frost (chair) and Fiona Thomson (CEO) from General Practice New Zealand presented briefly on their strategies to support the role of primary care networks in New Zealand.

100% of practices to be accredited

The board acknowledged that 100% of Compass practices have now signed up for either Cornerstone (90%) or for Foundation standards accreditation by the end of this year. We believe this is the best showing of any major PHO, and a tangible demonstration of a commitment to quality among our practices.

Wellington offices to move

The board approved a proposal that the Wellington staff move to a new location in September, to allow colocation on one floor.

Other business

  • All but one Compass practice has implemented the free under 13 fees policy.
  • The Board agreed to a management recommendation, based on benchmarking, to increase committee and board fees for the first time in three years.
  • The board agreed to continue to provide management services (mainly business intelligence and reporting) at cost to Central PHO for a further two years.
  • The board reviewed correspondence from the Minster of Health commenting on health target performance.

15 June 2015

Annual plan

The board reviewed the draft annual plan and approved a break even budget focusing on three themes:

  • Empowering patients and whanau;
  • Implementing the Health Care Home concept; and
  • Being a high performing network and PHO.

A series of projects will be undertaken to deliver on these three priorities. More detail will be provided at the next GP forum. As always, capitated first level funding is passed directly on to practices.

Contract Changes

The DHB have confirmed a number of changes. Compass will take over the National Immunisation Register and immunisation coordination role for CCDHB, and Ora Toa/Well Health will pick up all immunisation outreach. Funding for sexual health will be reduced by over 50% resulting in a reduced eligibility age - further information on this is attached.

Infrastructure as a service (PMS remote hosting) preferred provider

The Compass Finance and Audit Committee approved Primary Technology as a preferred provider of infrastructure as a services (a.k.a. remote hosting of patient management systems). Further information on the service is attached. Compass practices will receive a 10% discount on the remote hosting fee.

Other business

  • The Hora Te Pai trust deed will be changed to make the entity independent of Compass Health;
  • An application for a new practice in Lambton quay has been received and will be reviewed;
  • We have agreed to form a Health Care Home collaborative with the three other large primary care networks, to promote shared learning and evaluation.

23 April 2015

Strategic Planning session

The board heard a report back from those who attended the study trip to Group Health in Seattle and the Patient Centred Medical Home conference in Philadelphia hosted by Midlands Health Network. There is considerable interest in adapting some of the model of care innovations for a New Zealand context, while recognising that we are already well advanced in many aspects of primary care. Particular items of interest included:

  • the trend toward patient centred models of care
  • the use of Lean process techniques in health care
  • the ability to make gains from managing acute demand better

We will develop a plan to support role out locally of the Health Care Home concept.

Contract reductions

The board was disappointed to hear that the DHB are reviewing the sexual health contract and outreach immunisation, with a view to reducing funding substantially in both these areas.

National Policy Reviews

The Government have commissioned three reviews of significance to primary care:

  • A refresh of the NZ Health Strategy
  • A Health sector capacity and Capability review
  • A review of Health funding

The board agreed that we need to make representations on each of these matters, and particularly the funding review, and financial tend to over-ride policy and strategy plans in the longer term.

Other business

  • Due diligence on Third Age has not yet been completed, hence we have no back to back contract with them at this point
  • Four practices have had HealthPac enrolment audits, with claw-backs of up to $1,175. Further audits are occurring, and practices are advised to pay attention to patients travelling overseas for longer than 6 months, as clawbacks can be considerable.

20 March 2015

Health Care Home Business Case

The board endorsed the business case being developed by the larger primary care networks for Government investment in enhanced general practice services. The concept is that we should accredit practices meeting certain standards as Health Care Homes, with additional funding to support more comprehensive and proactive services. The ideas will be discussed in more detail in GP forums and practice visits during the year.

Third Age request for a back to back contract

The board accepted a recommendation to enter into due diligence to determine whether Third age meets the criteria for a back to back agreement with Compass Health. If they do then the board considers they will need to grant the provider a contract. The board noted that the age residential care homes involved have already contracted with Third Age as their supplier of GP services, which poses continuity of care issues for the patients, who remain enrolled with local GP practices, but who are having most of their care provided by Third Age clinicians.

Laboratory Services

The board discussed the tender of laboratory services and noted that we have three experienced GPs involved in the tender assessment: Lynn McBain, Tony Becker, and Hans Snoek. The board would not support a reduction in quality of service, but do not object in principle to the integration of community and hospital laboratory services, which works well in the Wairarapa.

Other business

  • The board agreed to enter into a contract with the DHB to manage the shared care record for the Greater Wellington region. We will be able to provide Health Care Online free of charge to practices until at least June 2017.
  • The processes around Foundation standards are becoming clearer. All practices will need to meet or exceed these standards by June 2016.

17 February 2015

Health Care Home Business Case

The board endorsed the business case being developed by the larger primary care networks for Government investment in enhanced general practice services. The concept is that we should accredit practices meeting certain standards as Health Care Homes, with additional funding to support more comprehensive and proactive services. The ideas will be discussed in more detail in GP forums and practice visits during the year.

Third Age request for a back to back contract

The board accepted a recommendation to enter into due diligence to determine whether Third age meets the criteria for a back to back agreement with Compass Health. If they do then the board considers they will need to grant the provider a contract. The board noted that the age residential care homes involved have already contracted with Third Age as their supplier of GP services, which poses continuity of care issues for the patients, who remain enrolled with local GP practices, but who are having most of their care provided by Third Age clinicians.

Laboratory Services

The board discussed the tender of laboratory services and noted that we have three experienced GPs involved in the tender assessment: Lynn McBain, Tony Becker, and Hans Snoek. The board would not support a reduction in quality of service, but do not object in principle to the integration of community and hospital laboratory services, which works well in the Wairarapa.

Other business

  • The board agreed to enter into a contract with the DHB to manage the shared care record for the Greater Wellington region. We will be able to provide Health Care Online free of charge to practices until at least June 2017.
  • The processes around Foundation standards are becoming clearer. All practices will need to meet or exceed these standards by June 2016.

18 December 2014

Larry Jordan appointed as chair

The Board elected Dr Larry Jordan as Chair, and Dr Lynn McBain as Deputy Chair.

GM Community Health

Chris Kerr introduced the Pacific Navigation Team, who support Pacific patients through health education, connection to social services, and reconnection to general practice. The Pacific avoidable hospitalisation rate is falling for the first time in years. Chris also noted that the DHB are currently reviewing a number of contracts, including outreach immunisation, Pacific navigation, Care Coordination Centre and sexual health. The outcomes will be known in the new year.

Briefing for the incoming Minister

Compass Health worked with Pegasus, Procare and Pinnacle to prepare a briefing to the new Health Minister Jonathon Coleman. The briefing focuses on the idea of general practice as the Health Care Home, and the opportunities to invest in general practice to ensure sustainability, and to improve overall health system outcomes.

More Practices using Healthcare online

The Board saw the regular practice performance report showing that six practices are now using ManageMyHealth to provide online access for patients to their healthcare records and to make appointments, view lab results, and request repeat scripts.

Primary Technology

The Board approved a resolution to sell the 25% Compass stake in Primary Technology. Compass Health considers that Pritech provide an excellent service, and wish to be able to recommend it to practices and PHOs without having an apparent conflict of interest.

Other business

  • Congratulations to Compass practices and teams for winning 7 DHB quality awards
  • Wellington office is looking at new accommodation options
  • Compass is developing policies to support practices to comply with the Vulnerable Children’s Act.

15 November 2014

Proposal to establish virtual practices specialising in age care facility residents

Enliven and Third Age have separately proposed establishing ‘virtual general practices’ with registers based on enrolees from specific age residential care facilities. This was a major topic of discussion at the AGM, with many GPs expressing a view that the current arrangements work well and provide good clinical continuity of care for patients and families. Others noted that the newer GPs are less keen on residential care work and that Compass would need to be careful not to breach Commerce Commission rules. Third Age have already recently gained age residential care GP support contracts in the Horowhenua and Kapiti areas, without having a back-to-back contract with Compass Health.

Compass website features Healthcare Online and Annual Report

The Compass Health website has two recently added links: one to Healthcare Online (aka patient portal) resources and set up guide; the other to the Compass Annual Report. The Annual Report for the first time includes information on quality activities and reportable events for the year. One aim is to normalise reporting of adverse events so that more can be done to prevent them.

Richard Medlicott and Kerry Prendergast are new board members

This was Richard Tyler’s last Board meeting as he is stepping down, and Richard Medlicott was elected by majority vote as the new provider representative. Kerry Prendergast has been appointed by the Board to Chair the Community Council, and to be a community rep on the Compass Health Board.

Draft MOU with the Medical Council

The Board reviewed a draft national Memorandum of Understanding between PHOs and the Medical Council, and emphasised that any MOU would need to clearly show that the PHO is there to support GPs, not to regulate them.

15 October 2014

Proposal to establish virtual practices specialising in age care facility residents

Enliven and Third Age have separately proposed establishing ‘virtual general practices’ with registers based on enrolees from specific age residential care facilities. Board members noted that the population aged over 65 is due to increase by 50,000 in the period to 2031, and that younger GPs were often not as willing to cover the on-call requirements of rest homes. However, they also recognised the importance on choice of provider, and of clinical continuity of care. They asked that the proposal be included in the agenda at the AGM, and sent out to member practices, so that views form general practice teams could be considered before any decision is taken.

Clinical Pathways

The board noted that there are now 41 clinical pathways published on the localised Clinical pathways site, and that the DHB are considering funding minor gynaecological procedures in general practice as part of the gynae pathways.

Foundation Standards

A paper authored by Dr Chris Fawcett proposed that Compass Health staff could accredit practices against the new Foundations standards. The standards, which will be compulsory from June 2016, are available on the College website. Dr Fawcett also proposed that Compass could coordinate places in practices for PGY1s and PGY2s, who will, in future need to spend 12% of their time in community settings. The board supported the direction proposed, but asked for more information on the likely costs, and asked that we also consider nursing students.

Other updates

The Board received other updates including:

  • A summary of each practice’s performance on a range of measures
  • A presentation from Dr Don Simmers on cardiovascular risk assessment, and of the importance of shifting the average risk (the whole population) not just targeting those with a high risk.

13 September 2014

Strategic discussion items

We had a forward looking discussion about the extent to which Compass should aim to be a community health services provider, and whether if we focus on that function we detract from our core primary care network support activity. At the next meeting the board will be considering the question of whether age residential care providers could, in partnership with specialist providers such as Third Age, become contracted general practice providers for their residents.

3DHB Laboratory Project

The Board noted that the three DHBs are jointly seeking proposals for a single laboratory service provider covering hospital and community laboratory services. They were reassured by the fact that there are three GPs on assessment panel, but also want to ensure that the Compass network has input to performance standards elements such as turn-around time and access to phlebotomy. The DHBs are considering either full outsourcing, or a community lab/DHB joint venture.

Primary options for acute care

The Board noted that Compass is working with the Hutt PHO on a joint proposal for access to funding in general practice for more extensive packages of care to keep people out of hospital. This will build on the cellulitis and DVT management funding that practices have started accessing.

Radiology co-payments

The Board agreed in principle to reinstate co-payments for non-cardholders accessing community radiology.

Other updates

The Board received other updates including:

  • An improved careplus/long term conditions formula
  • Access to the shared care record in hospital is now at around 25% of records in the Wairarapa and 12% in CCDHB.

25 August 2014

Porirua Social Sector Trial

The Board received a presentation on the first 12 months of the novel Porirua Social Sector Trial initiative. For the first time we have Education, Health, Social welfare and Housing around the table jointly planning initiatives to improve wellbeing. The report of the first year can be accessed here.

Approving non-medical casual GMS claimers

The Board agreed to delegate approval of practice nurses working within usual general practice settings as GMS casual claimers to the Compass Medical Director: Chris Fawcett. Approval of any other claimants will require board agreement.

Supporting smoking cessation

The Board endorsed an approach of building smoking conversations into general practice as the most evidence based way to meet the smoking cessation health target, and agreed to put most of the at risk quality payment funding into this target in 2014/15.

Other updates

The Board received other updates including:

  • A plan to support very low cost access practices
  • Compass finished the year slightly better than budget, with both income and expenditure for the year at around $62 million.
  • The mental health initiative involving the provision of therapists in practices has been evaluated and will now roll out.
  • The Medical Council has decided that PGY1 and PGY2 doctors will be requiredto spend 12.5% of their time in primary care – Chris Fawcett is working on how we resource this.

10 July 2014

Clinical Pathways and casual GMS claiming

Dr Chris Fawcett, Compass Health Medical Director, introduced the board to the 3DHB clinical pathways website, which has gone live for practices to allow them to view clinical pathways pertaining to Wellington, Hutt and Wairarapa. It also provides access to the Canterbury clinical pathways. Instructions on how to download the Medtech icon to allow 1-click access to the pathways are on the Compass Health Provider Portal.

Dr Fawcett also discussed the extension of casual GMS claiming to nonmedical staff. Compass Health now has authority to approve extensions of casual claiming to nurses and other health professionals. The board agreed that Chris should come back to the board with a set of principles to guide decision making.

Quality Plan

The board reviewed a draft Compass quality and performance framework, which would measure general practice quality on a variety of dimensions, replacing the old PPP targets, and getting ready for the Integrated Performance Incentive Framework which is under development nationally. The framework will be sent out to GP teams for comment and may take some months to finalise.

Community Council

Kerry Prendergast has agreed to chair the newly created Compass Health Community Council. The Council will have members from each locality and will, among other things) advise on community needs and the best use of health promotion funding.

Fee reviews

Some 18 practices have now been supported through a fees review process. The board agreed that we will continue to support fee reviews for those with fees 10% or more below the median fee level, who have not already had a fee review. There are currently 6 practices in this category. Exceptional circumstances will continue to be catered for on a case by case basis.

Satisfaction survey – network level summary

The first report generated from the standardised patient satisfaction survey was reviewed. Based on 1421 responses from 16 practices, the following were highlighted:

  • 87% of patients were satisfied or very satisfied with their practice
  • 91% were satisfied with the doctors caring and concern
  • 66% saw a nurse during the visit
  • 97% rated the quality of nursing care good to excellent
  • Only 62% were satisfied with waiting times at the practice
  • Only 63% were satisfied with phoning through to their GP
  • Only 18% of patients said that they usually can get to see their particular doctor on the same day – versus the national benchmark of 40%.

Other updates

The board received other updates including:

  • The shared care record is being viewed in about 10% of ED/outpatient consultations (some 1400 views per month) in CCDHB and in 22% of consults in the Wairarapa
  • 52/60 practices are now Cornerstone accredited or on the pathway
  • Dr Larry Jordan has merged with Whitby practice
  • 50/60 practices have moved to the bulk funding for LTC, or have agreed a start date for the move.
  • The Wellington Free Ambulance urgent care service will be closing overnight in Kapiti, to allow it to open during the daytime in Porirua.

13 June 2014

Māori health Cornerstone resources

The Board had a presentation from Tricia Keelan and the Māori Health team showcasing the new resources they have developed to support practices to meet the Māori health and cultural responsiveness elements of Cornerstone Accreditation. The resources include a plan template, local iwi information, health profiles and other useful resources. The kit will be available to practices from July.

PHO Service Agreement Amendments

We noted that national negotiations have culminated in agreement that casual GMS claiming by nonmedical professionals will be allowed subject to:

  • PHOs authorising additional claimants individually
  • Reporting to PHOs to identify claimants
  • A stop loss clause that caps the net clawback risk for practices at 0.5% of capitation.

From 1 July there will be a simplified PHO Performance Program/Integrated Performance Incentive Framework hybrid, with the following measures and targets:

  • Immunisation (at 8 months and at 2 years) target 95%
  • Cervical screening – target 80%
  • CVDRA - target 90%
  • Brief advice to quit smoking – target 90%

Each item will attract 25% of the total funding of $5.33 per capita. Results more than 10% away from the target will attract no funding. PHOs will be required to pass at least 50% of the funding on to practices.

DHB District Annual Plans & Compass Annual Plan

The Board approved the draft Compass budget and annual plan for the year, and endorsed the DHB District Annual Plan. Some highlights include:

  • Inclusion of a budget of $500,000 to fund additional services in primary care through Primary Options for Acute Care
  • Agreement to provide access for GPs to Concerto (hospital records), and to facilitate uptake of the patient portal
  • Inclusion of a section on integration of community health services with general practice with the following key words “Community Health GP Multi-disciplinary teams: alignment of district nursing, allied health and care coordination roles to create multidisciplinary teams working together with general practices in local clusters serving enrolled populations." The DHB has reserved around $500k to support this work
  • Agreement for subregion non-melanoma skin cancer service – details to be finalised.

Conflict of Interest guidelines

The Board considered feedback and approved the draft Practice ownership Conflict of Interest Guidelines with some revisions. The guidelines will be placed on the Compass provider portal for practices to view.

Satisfaction survey and special interest areas

An analysis of General practice team answers to the recent survey was reviewed. Generally feedback was positive, but some areas of improvement were noted. The report will be made available to practices on the Compass provider portal.

Other items

The Board noted that Larry Jordan’s practice is merging with Whitby from 1 July.

We discussed ensuring that the shared care record is well utilised, and management reported that the shared care record has been accessed by hospital clinicians 2,200 times at CCDHB in the period from April to the middle of May.

13 May 2014

Integrated care: DVT & Cellulitis pathways

The board noted that the DVT and cellulitis pathways, which allow payment to GP teams for services more usually performed in hospital settings, such as IV antibiotics, will go live in May. These are the precursor to more substantive increases to the scope of what can be provided in general practice.

Outreach nursing – subcontracted to larger practices

A review of outreach nurse has established ‘fair shares’ of nursing time for each practice, and the larger practices have been given the option of providing the outreach nursing service themselves, with funding from Compass Health.

Cardiovascular risk assessment and smoking advice outcomes

The board noted information from the Ministry of Health showing that acute MI admissions have reduced significantly over the past 3 years. The reduction in CCDHB has been in the order of 20%, and 50% in the Wairarapa. It may well be the case that some of the reduction is due to better management of cardiovascular risk, associated with the CVRA campaign.

Enrolment audit clawback

An external audit of three practices has resulted in a clawback of $4,800 based on incomplete or erroneous enrolment forms. Practices can access Compass resources for a friendly audit at any time, and this is recommended.

Clinical research – patient finding service

The board deferred a decision on a proposed clinical research patient finding service. The proposal would have us working with clinical trial research to identify and offer patients the opportunity to be part of clinical trials. The board will revisit the issue in 3 months.

The board also had presented learnings from a GPNZ masterclass tour in Europe. A report on this will be circulated to practices directly.

22 April 2014

Information and communications technology

Ken Biswell, Compass Chief Information Officer, presented on strategies for information sharing and practice development, including the proposal that Compass support the development of practice websites and facilitate access to the patient portal.

The Board also approved a policy paper on information governance outlining when staff can pull data and for what purpose. The policy is available on the Compass Health provider portal.

Mental health therapists in practices

The Board endorsed a pilot whereby primary mental health therapists are based in a practice several days a week (depending on practice demand), and clinicians can book the patients in to be seen at the practice, rather than referring them. The aims are:

  1. to reduce waiting times for patients; and
  2. to avoid the ‘double handling’ that goes with the current brokerage role played by Compass mental health clinicians – which will also
  3. reduce costs and allow access to more people within the budget.

Shared Care Record

The Board noted that the shared care record is now live, with CCDHB doctors and ED nurses able to now see a summary of the GP patient record (excluding consultation notes). The awareness strategy includes six week of insertions of a notice in the local giveaway newspapers.

21 March 2014

Organisational Dashboard

Attached is the current organisational dashboard, which illustrates Compass’s performance against internal targets.

Conflict of Interest in Practice Ownership

The Board considered the draft policy on conflict of interest in practice ownership and approved it for circulation to members for comments. The draft policy is attached.

Proposal to deregister WIPA

At the February Board meeting, it was agreed to put a motion to the WIPA AGM in November to deregister WIPA. WIPA (Wellington Independent Practice Association Limited) was established in 1995. At the end of June 2008 WIPA assets and liabilities were purchased by Greater Wellington Health Trust. WIPA has not traded since that time. It had been retained as a legal entity as it held software licences that were going to be costly to transfer to another entity. This is no longer the case, as the licences have been transferred to Compass Health as they came up from renewal. WIPA does not have any assets or liabilities, as they were transferred to GWHT at close of business on 30 June 2008.

Porirua Relocation Proposal

Board approves Porirua lease to replace Tawa building - The Board have approved us leasing space in Porirua on the 3rd Floor of the Walton Leigh Ave Building in Porirua. There are a number of benefits to be gained by relocation to the proposed new premises in Porirua:

  • Accommodate larger team together: the proposed office is sufficiently large to address overcrowding of office staff in Tawa
  • Security: the building has a high quality security system in place
  • Location: the offices are in the former Housing Corporation building across the road from the North City Mall with high foot traffic and in close proximity to the Porirua central transport hub (rail and buses) and central to our General Practices
  • Earthquake safety: the building has a high seismic rated building of at least 71% and is likely to allow for continued business operations in an earthquake. The building is likely to be outside any possible CBD red zone. There is an onsite server room which will allow us to turn Porirua into a business continuity and disaster recovery site.
  • Travel: the office is closer to our core communities and reduces travel costs and time for community facing staff considerably. Our clients are also more readily able to attend appointments at our offices if they prefer.
  • Our partners: we will be closer to our partner organisations particularly Regional Public Health who have agreed to shared space on the 3rd floor
  • Data: the building has excellent cabling in place and potential for an improved server setup
  • Profile of Compass Health: the location facilitates an increased profile and presence of Compass Health in the Porirua communities.
  • Parking – currently Compass cars are either tandem parked or parked on the street. The new premises allow for more secure nearby parking.
  • Purpose designed: we have flexibility to design the layout in the office and provide a quality office space with potential to attract high quality employees. The space will include room to conduct continuing practice development sessions.

Tricia Keelan is leading the design of the new space and the transition planning.

National PSAAP negotiation

The national PSAAP negotiation to include the Integration Performance Incentive framework in the PHO Service Agreement is scheduled for 13 and 14 February. The attached schematic gives an overall picture of the proposed framework.

Practice Patient Satisfaction Survey

Compass Health is offering Practices the opportunity to implement a standardised patient satisfaction survey called the New Zealand General Practice Assessment Questionnaire (NZGPAQ). Survey information was sent out at the beginning of February and at the time of writing this report, 29/59 Practices had agreed to take up the survey and one declined. Overall support appears very good, and it is expected that uptake will be excellent once Practices have had a chance to review the information and discuss it within their teams.

Tawa Medical and Linden Surgery completed the survey in December and received their report early in January. Feedback from the practices is very positive about the survey, in particular that it was straight forward to administer, they had a good response rate and the information gathered was extremely valuable.

13 December 2013

Porirua Action Plan Launch
Ranei Wineera-Parai, SST Manager; Hon Tony Ryall; Carl Crafar, Director SST MSD

Social Sector Trials

The Social Sector Trial was officially launched last week, by Hon. Tony Ryall, Minister of Health. The Minister was very supportive of the initiative. The action plan is available here.

Canterbury Clinical pathways

Health organisations across the Wairarapa, Hutt Valley and Capital and Coast regions have agreed to collaborate on the development and publishing of care pathways. After evaluation of a number of options, the HealthPathways process and web based platform has been selected and implementation will commence early in 2014.

Health organisations across the Wairarapa, Hutt Valley and Capital and Coast regions have agreed to collaborate on the implementation of HealthPathways from early 2014. HealthPathways is the care pathway approach originally developed and implemented by the Canterbury District Health Board (CDHB) in 2007. It is a whole-of-system approach to the planning and design of health services, currently being implemented by all South Island DHBs, and 10 Australian health regions.

A HealthPathways Planning Seminar, led by a team from Canterbury, is scheduled for 20 February 2014 and is aimed at health sector clinical and management leaders. The following day a practical workshop will be held for those who are directly involved in local pathway development and implementation and is aimed at project manager, workgroup facilitators and locally appointed HealthPathways team members.

Primary Care Assistants

An opportunity exists for Practices to train Primary Care Assistants through a new programme that has been developed by Wintec in partnership with Midlands Health Network. We are seeking to gauge interest in the programme, as Compass Health has been extended the opportunity to participate in the next training intake commencing February 2014. A formal contract between Compass Health and Wintec will formalise this training arrangement. A pre-requisite for Wintec is that they require a minimum of 10 practice staff members to complete the training to ensure this is a viable option.

A fax back form for expressions of interest, and information on these roles has been sent out to practices this week to determine those who are interested in placing a staff member through this training programme.

Annual Report

The annual report is available on the Publications page of the Compass website.

Wairarapa Results

Attached is the DHB quarterly performance on the health targets. An outstanding performance by the Wairarapa has them as the best performer in the country on all three of the primary care targets.

24 October 2013

Northland Village Surgery

Compass has purchased a 50% share in Northland Village Surgery, effective 1 November 2013. Dr Ken Greer will continue to practice at Northland, and retains ownership of the other 50%.

Community Council

At the October Board meeting, the Board agreed in principle to the establishment of a Community Council. The Council is intended to:

  • Support Compass Health to better understand local health related needs
  • Support local communities and providers to coordinate efforts to improve community wellbeing, through community health fora, health service directories, social media, and the use of common healthy lifestyle messages
  • Work with regional public health to advocate for healthy public policy locally – eg: fluoridation, cycle ways, alcohol licensing, pedestrian friendly streets, crime prevention, etc.
  • Advise Compass Health on the best use of health promotion and related funding to improve community wellbeing
  • Facilitate communication between Compass Health (and its contracted providers) and the communities Compass serves
  • Advise on ways to reduce inequalities in health outcomes.

The Council is planned to commence by 31 March 2014.

Tricia Keelan, Acting Māori Health Director, is leading the work to establish the Council.

Social Sector Trials

A draft action plan has been developed for the Porirua Social Sector Trial. The Trial aims to reduce use of acute secondary services through coordinated action and by tackling some of the determinantes of Health.

Annual General Meeting

The Compass Annual General Meeting is being held on Thursday 14 November 2013 in the Seminar Room on Level 7 of Freemason House, 195-201 Willis Street. Documents have been emailed out to all individual back-to-back and corporate contract holders. If you have not received yours, please contact Steph Gartrell on 978 4394, or stephanie.gartrell@compasshealth.org.nz. Nick Goodwin is the invited speaker.

Annual Report

The annual report is in the final stages of preparation, and will again this year be online, with hard copies available on request.

22 August 2013

Compass leading the Porirua Social Sector trial

Ranei Wineera

Porirua is one of the 16 Social Sector Trials nationally, and the only one focused on health outcomes. The trial in Porirua aims to reduce ambulatory sensitive hospitalisations (ASH) and emergency department attendances among Porirua residents aged 0-75 years. We have been appointed to work across Government agencies to make a positive improvement to the health and wellbeing of our Porirua community. We will draft an Action Plan ready for inter sectorial implementation by 1 October. Give the project manager, Ranei Wineera-Parai a call if you want to know anything else or if you have any ideas for solutions for Porirua.

Also, the ICT team are working on doing a Social Sector Trial page linked on the Compass Health homepage, including a feedback mechanism.

AGM scheduled for November 14

The Compass Health AGM will be held in the Seminar Room on Thursday 14 November 2013. An invitation will be sent out shortly. Please accept or decline the invitation for catering purposes. The guest speaker has not yet been confirmed … watch this space …

Compass Health enters into Alliance

Compass Health has entered into an alliance agreement with Capital Coast DHB, Ora Toa, Well Health and Cosine to collaborate on system wide quality improvements. This builds on the successful integrated care collaborative.

Integrated Care Collaborative update

This is the Integrated Care Collaborative report prepared by Jon Herries of CCDHB on progress on the ICC workstreams.

Tihei Wairarapa – progress update

This report was prepared by a consultant to evaluate progress over the three years of the Better, Sooner, More Convenient business case operating in the Wairarapa region. It indicates that great progress has been made in many areas, but there is still lots to do.

30 May 2013

Justine Thorpe has been appointed to the position of Tihei Wairarapa Programme Director.

Justine Thorpe

Justine is currently CEO of Well Health PHO – a primary care organisation focused on high needs populations in Wellington and Porirua. She has been in management and governance roles in the primary healthcare sector since 2004, and, in addition to her CEO role, is currently an executive member of Health Care Aotearoa, a PHO Performance Programme Governance group representative, a mandated PSAAP facilitator, a Board trustee for the Primary Care Alliance Trust, and Chairperson of Riddiford House Trust. In addition to her primary care experience, Justine brings qualifications in business and a passion for social justice. Justine lives in the Wairarapa and has two teenage children.

Justine will take up the role formally on 12 August, but will be taking an immediate interest in the development of the Tihei programme plan for the next three years.

12 March 2013

After an 11th hour funding crisis, Creekfest – the Cannons Creek community health festival – went ahead in March with Compass Health staff winning plaudits from locals.

It’s the tenth year Creekfest has been held. Billed as family fun day, stallholders promote health messages, supported by live entertainment and sporting competitions.

Key to this year’s health messages was an inter-school sports competition run by Compass Health through workshops held in all participating schools beforehand. There was also a Compass stall that encouraged families to get throat swabs in an effort to prevent rheumatic fever in children.

Porirua resident and Compass Health General Manager, Ranei Wineera, said about 12,000 people turned up to the event, along with the Minister of Health Tony Ryall.

“It was a fantastic celebration of community diversity,” says Ranei. “Our input was especially appreciated by school teachers and others in the lead-up to the physical activities and cross-fit obstacle course inter-school competition.

“All the kids enjoyed playing the ‘knock out fizz’ game and trying vegetable juice as an alternative to soft drinks.”

26 February 2013

In 2012 the Compass Health Board agreed that all member practices should aim to become engaged in Cornerstone accreditation by 2014.

Cornerstone accreditation means that the participating practices have been audited and that they meet a wide range of best practice and quality indicators.

Meeting the Cornerstone (or similar) quality benchmark, is something the Government says it wants all General Practices in New Zealand to achieve in the near future.

19 February 2013

Compass Health will run a symposium focused on the management of Long Term Conditions over two days in May. The symposium will be held on the afternoon of Friday 10 May and will be repeated the following morning of Saturday 11 May.

Aimed at Compass Health Practice staff, the symposium will include Long Term Condition experts from both within and outside Compass Health.

The key note speaker for both sessions will be Professor Alexander Sasse, a cardiologist consulting from Wellington’s Wakefield Heart Centre in Newtown, as well as Wellington Hospital, also in Newtown. Professor Sasse will discuss Epidemics of atrial fibrillation, and valve disease or coronary diseases.

Other speakers include: Dr Ian Brooks, discussing motivational change; Dietitian Ann Gregory, speaking on diet and lifestyle; Compass Health Clinical Facilitation Team Leader, Jo Wilson, who will provide insights on e-learning tools and practical tips and tricks; and Compass Health Clinical Director, Chris Kerr, who will provide an update on the Long Term Conditions Programme, bulk funding and wrap up the symposium.

Both sessions will be held at Kenepuru Hospital Education Centre in Porirua.