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Health Care Home programme expanding in Southern

Wednesday 23 September 2020

Equity focus of next stage of implementation

The Health Care Home programme is again expanding in the Southern region.

The model of general practice improves patient experience and access to care while also supporting the sustainability of general practice.

WellSouth Primary Health Network is calling for interest among general practices to join the Health Care Home programme, with as many as 10 additional practices commencing the programme in November.

There are already 14 HCH practices in Southern, representing 115,000 enrolled patients. With the next stage, practices with higher numbers of Māori and Pasifika patients and those living in lower income suburbs will be prioritised. Health Care Home continues to be patient and whānau-centred and focused on balancing four-key aspects of general practices: urgent and unplanned care, proactive care, routine and preventative care and sustainability.

“Health Care Home updates the traditional general practice approach that’s based on a 15-minute GP consultation. Face-to-face appointments are still available – in fact, they’re more readily available for those who most need them. But there are more options for accessing care, including greater use of online patient portals, telephone consultations and seeing other health professionals like a nurse or health coach,” says Stuart Barson, Health Care Home Lead with WellSouth. 

“The benefits for patients are more convenient access to care, better long-term condition support, shorter waiting times, and increased access to their clinician of choice – so better continuity of care.”

For general practices, the HCH model is a more effective and efficient way of working and promotes long-term sustainability, Barson says.

Based on the experience of practices already in the HCH programme, some revisions have been made to the next stage starting from November, including reducing the implementation timeline from three years to two, allowing for more flexibility in when and how practices introduce key elements of the HCH programme, and more focus on equity and outcomes for Māori. 

“The Health Care Home programme has been a cornerstone of the Primary and Community Care Strategy and Action Plan for the Southern health system,” says Southern DHB Executive Director Strategy, Primary and Commmunity Lisa Gestro.

“It is a key part of reshaping the health system to support more care to be provided closer to home. This in turn allows us to effectively design the New Dunedin Hospital to support the health system for the future.

“We’ve seen that Health Care Homes are making a difference and it is exciting to continue this progress.”Mornington Health Centre GP Dr Taatske Rijken says the HCH programme has been a catalyst in helping practices improve services and patient care.

"GP triage streamlines the on-the-day demand for appointments and we are experiencing a 60 percent resolution rate through telephone triage and arranging pre-work prior to a face-to-face appointments at a later convenient time. This is a win-win for the patient and the GP."

WellSouth CEO Andrew Swanson Dobbs says the HCH model of general practice is a good fit for Otago and Southland, with a mix of rural and urban areas across a large geographical area: “The needs of our population, patient expectations and workforce availability, all this is changing. Health Care Home supports positive changes in general practice, so we can ensure access to care and help general practice teams to support patients and whānau into the future.”

HCH core to Southern’s Primary and Community Care Strategy

The Health Care Home programme was introduced in 2018 as part of the Southern Primary and Community Care Strategy. The strategy is a blueprint for improving health care services across the Southern district by increasing capacity and capability in primary and community care, providing care closer to people’s homes, and promoting more equal access to services for better health outcomes.

Four practices, Amity Health Centre, Gore Health, Gore Medical Centre and Queenstown Medical Centre, were the original HCH practices in Southern beginning in July 2018.
Wanaka Medical Centre and Aspiring Medical Centre in Wanaka, Broadway Medical Centre in Dunedin, and Junction Health in Cromwell joined in November 2018, with Mornington Health Centre and Te Kāika in Dunedin, Clutha Health First in Balclutha, Health Central in Alexandra, North End in Oamaru and Invercargill Medical Centre joining in mid-2019.

Adding new practices to the HCH programme over the next 12 months will mean around 80% of the enrolled population in Southern will be with a Health Care home practice.

A recent University of Otago review of the implementation experiences of HCH in the Southern region indicate the programme was working for practices and for patients.  

“As a result of implementing the HCH model, practices increased efficiency, improved working life for staff and increased patient experience,” says study author Prof Tim Stokes, Dept of General Practice and Rural Medicine, Otago Medical School.

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