FAQs for Extended Primary Care  

How does the funding work? 

Te Whatu Ora has funded WellSouth for Extended Primary Care (EPC) for this financial year, with a contractual obligation to not exceed the funding. As we anticipate demand for this programme may exceed the available funding, we are allocating funds at a practice level. Each practice’s initial allocation is based on enrolled population, augmented by weighting for priority patient groups (Māori, Pacific, Community Service Card holders) under 14s and over 65s, and weighting for rural and very rural practices. Every practice has been allocated more funding than they have claimed through the existing acute care POAC services last financial year. 

Funding is allocated for four periods to 30 June 2025. You will not be able to claim more in each period than you have been allocated (a balance for the quarter is shown in the claiming portal): please note WellSouth is contractually obligated to pay no more than your allocation. As this is a new programme, with inherent uncertainty in demand and in practice ability to provide EPC services, we will review trends in use and may rebalance the allocation after the second period.

Each practice will be able to decide which patients in which situations they want to use the funding for.  

Patient eligibility criteria 

You can claim for any patient, whether or not the patient is enrolled in your practice, at another WellSouth practice or even outside of the WellSouth region, as long as they are eligible for NZ funded healthcare. The portal form will have a drop down to select the relevant enrolment status of the patient.  

Patients resident in ARC are eligible.

Please note that offering the programme to patients not enrolled at your practice is at your own discretion. There is no clawback available and no additional allocation for practices with higher numbers of visitors to their area. We encourage you to discuss with your local practices any local arrangements you might want to make: for example how a large practice with staff and facilities could support acute care access for smaller practice’s patients. 

Practices may charge an initial consult fee as normal. A practice can still charge a casual rate for an initial consult for those not enrolled with the practice. 

The EPC package of care post initial consult is to be provided at no cost to the patient. 

What about costs for consumables? 

Consumables costs are built into the payment rates. Two exceptions can be claimed for separately: 

No. Allocations will not be topped up in any period.  

Yes, however you cannot part-charge the patient for any difference.  

Practices may provide this service after-hours but there will be no additional amount paid for after-hours service delivery.  

If you claim after hours service for another practice’s patient, there is no clawback, and the claim is taken from your allocation. 

We are required to report on the primary presenting concern. In the event that there is more than one presenting concern, please choose the best option as the primary one. You can note the second issue in the free-text clinical notes box. 

You can still make multiple selections for the interventions you do.

This assists us to understand who you are providing packages of care to, and it will ensure we can advocate for changes in future.  

Yes, the summary page will be written back to the PMS. 

Yes, you can.  Please make a comment in the claim form explaining what happened, and select the option of “ED” or “Hospital Admission” in the outcome of treatment drop-down box 

Acute Care is to manage unwell people in the community, thereby avoiding hospitalisation. 

Rural Stabilisation (claimable by rural practices only) reflects the work required to keep a patient safe where hospital transfer is inevitable e.g. while awaiting ambulance or helicopter transfer. 

The key difference between POAC and EPC is that POAC claims were for providing an intervention and a predetermined fee was subsequently paid. EPC recognises time spent with the patient, and therefore the payment will differ depending on the package of care delivered.  

Extended Primary Care will offer practices the opportunity to manage a wider range of acute conditions than is currently available via our POAC programmes, as the inclusion criteria is broad. Once we transition to this programme the following current claiming options will be removed from the portal: 

Two existing POAC programmes will remain in the portal under a new heading of “Other”: 

An EPC presentation and programme guide are at https://wellsouth.nz/provider-access/clinical-resources/funded-programmes/extended-primary-care.