Big impact in a short time: New report shows Tōku Oranga-Access + Choice programme making a difference, service is equitable

Tuesday 02 May 2023

Meaningful and measurable benefits for patients is how a new report describes the impact of a WellSouth mental health and well-being service delivered through general practices across Southern.

The Evaluation of the Tōku-Oranga-Access and Choice Programme report finds there is ‘evidence of the programme’s effectiveness’, including ‘significant improvements in mental, physical and social health for patients.’

As for areas of improvement, consulting group Synergia suggests more people need to know about the service -- and know they can self-refer to access support.

Supporting future direction

Jodie Black, WellSouth Clinical Services Manager for Primary Mental Health Services, says the findings are a strong endorsement of the service and, along with the achievable improvements noted, will continue to benefit patients, communities and health providers for the future.

“The report confirms what we have been hearing and what our clinicians and practices experience: the Tōku-Oranga-Access and Choice service has a tangible impact on people’s lives, making preventative care more readily available,” she says. “We agree there is more work to do in making people aware of the service, how it can help and that it can be accessed directly from reception, without seeing a doctor or nurse first.”

Some of the feedback gathered in consumer interviews is particularly powerful, Jodie notes, with clients describing their experiences as life-changing or live-saving and one consumer saying they were ‘screaming from the balconies’ in support of the programme.

The review supports that the programme is on the right track, ensuring the programme is available where it is needed, providing preventative early intervention, and is improving the lives of more people.

About Tōku Oranga Access and Choice Programme

Tōku Oranga is the name gifted to WellSouth for the Access and Choice programme. The service was launched through seven general practices in Southern in September 2020 and has grown steadily across the district since.

Tōku Oranga Access and Choice is available in 48 general practices, accessible to 239,000 patients - approximately 74% of the Southern population.

The well-being teams are comprised of three complementary roles – Health Improvement Practitioners, Health Coaches, and Support Workers which are based in general practices and integrated with practice teams. They provide mental health and well-being support for mild to moderate issues including depression and anxiety, sleep problems, drug, and alcohol use.

The teams also help patients and whānau with self-management of long-term conditions and can also support people to access other social and community services.

Hallmarks of the service are that support is free and immediate and there is no wrong referral – meaning there is no charge for practices’ enrolled patients, appointments are often available same or next day, and can be booked directly, without referral from a GP or practice nurse.

In addition to favourable outcomes, the research indicated that the model of care responds to a broader range of needs and is more flexible and practical than traditional counselling and consumers had faster access to support.

“The service is values based, focused on what’s important to the patient, and the care delivered in practice or provider where they’re used to receiving care, it is more immediate and feels more normal,” says Jodie. “This is a radical shift from usual delivery of mental health and wellbeing programmes and as the research confirms it’s really working, helping more people and filling a gap in the system.”

Synergia Report

WellSouth commissioned the research to determine whether the programme is meeting the needs of the community and to identify how it could improve.

With an emphasis on the perspective of patients/consumers and impact of Tōku Oranga-Access and Choice on other psychological supports, the work was carried out between September and November 2022. The report is based on interviews with 12 consumers and analysis of a year’s worth of programme data from a sample 13 practices representing 116,084 individuals who had at least one contact with the programme in the 12-month period.

While Tōku Oranga-Access and Choice programmes operate elsewhere in Aotearoa and overseas, WellSouth CEO Andrew Swanson-Dobbs says support from general practices and community partners, resourcing, ongoing training, and communications has ensured the service is well-implemented and scaled-up in this region.

The Synergia report will provide helpful perspective as the Tōku Oranga-Access and Choice programme becomes a more embedded service in the primary and community health services space, Andrew says.

“Synergia says the achievements of this programme are to be celebrated and its impact on people’s lives is huge – and I couldn’t agree more.

“The Tōku Oranga-Access and Choice leadership team and staff are passionate; they’ve learned along the way and are always responding to the needs of people, practices, and our communities.

“The dedication of general practices and providers has also been a significant success factor. They’ve embraced the programme and WellSouth Tōku Oranga-Access and Choice staff with the aim of ensuring that their patients have access to more care.

“The most important result, of course, is that the programme has been proven to help thousands of people in Southern and this work will continue.”

Other services could benefit from the success and learnings of the Tōku Oranga-Access and Choice programme, Andrew adds, as providers working together, delivering more integrated, more accessible and immediate health care services, are among the goals of health services reforms.

Tōku Oranga-Access and Choice is delivered by WellSouth in partnership with health providers in the region: Active Southland, Corstorphine Baptist Community Trust, Ngā Kete Mātauranga Pounamu Charitable Trust, Pact Group, Sport Otago, Te Hau o Te Ora, Te Kāika and Arai Te Uru Whare Hauora.