Tēnā koutou katoa

 

Well winter has really hit town this week, frost and ice and beautiful days. This is my last day of being acting CEO and we have all survived the experience! Andrew Swanson-Dobbs is back at the helm on Monday and I am looking forward to his return – but don’t tell him :) 

In today’s newsletter, Ruth Zienert provides an update on the general practice workforce survey. We are going to re-start reporting your responses every month, to get a sense of how things are going across the district. If your practice doesnt’ regularly contribute, please think about whether you might be able to. Many thanks.

 

Thinking about workforce, I recall making comment a couple of months ago about encouraging us all to look after ourselves this winter, as it is going to be busy. So I’m trying to be outside  (in the sun if its there!) for 10 minutes each day to stave off my seasonal affective tendencies, to keep going to the gym three times a week and keep in contact with my mates (described affectionately by one of their adult daughters as the ‘girl gang’). What’s your winter plan?

 

Key points today:

  • GP Leaders Forum response Te Whatu ora-HealthNZ regarding prescription for Capitation rates/proposed uplift

  • Winter Wellness Check Claiming Form Live

  • Winter Wellness Check Q+A webinar recording

  • Long Term Conditions Management Programme and CLIC beyond 1 July

  • General Practice Workforce Survey

  • COVID-19 additional booster vaccination messaging to PMS systems

  • National Guideline: Imaging after Knee Arthroplasty

  • New HealthPathway – Prescribing Antibiotics in Primary Care

  • Update from Te Whatu Ora Southern community continence service

  • Southern Primary Care Research Network (SPCRN) Newsletter

  • Gynaecology Education Sessions – Survey to gauge interest in Dunedin

  • Respiratory Study Day for Register Nurses – Survey

  • The Canterbury Initiative – Funny turns: Syncope and POTS

  • Covid numbers

 

 

What’s new

 

GP Leaders Forum response Te Whatu ora-HealthNZ regarding prescription for Capitation rates/proposed uplift

All our general practices would have received the message below and linked letter yesterday. GPNZ also issued this joint news release yesterday. WellSouth continues to work closely with GPNZ and other primary care agencies to secure better funding packages and uplift to capitation, and to address other critical pressures facing general practice and primary care providers.

We will provide further updates on this process.
                                                

Important message from the GP Leaders’ Forum; please share across your organisations:

Kia ora -

General practice organisations have joined forces to reject the Government’s proposed 5 per cent increase in general practice funding from July 1, saying that an increase of at least 14 per cent is needed to keep services going.

General Practice New Zealand (GPNZ) led a coordinated response involving GenPro, Hauora Taiwhenua, The Royal New Zealand College of General Practitioners (RNZCGP), the Practice Managers Association (PMAANZ) and College of Primary Care Nurses. Collectively the organisations have provided Te Whatu Ora with a comprehensive counterproposal that includes workforce solutions as well as additional funding. Please see attached letter.

The counterproposal has been shared with officials across Te Whatu Ora, Te Aka Whai Ora and Manatū Hauora, along with Ministers and politicians.

A joint media release will be issued this morning. If your practice is contacted by the media on this matter please feel free to direct them to Moira Finn at WellSouth moira.finn@wellsouth.org.nz 021 854 734 or Marie Simpson, GPNZ Head of Communication and Engagement, marie.simpson@gpnz.org.nz or 021 157 5204.

We will keep you up to date with further developments. Please feel free to reach out to me or WellSouth representatives at any time if you have questions or feedback.

Noho ora mai

Maura

 



Maura Thompson
Chief Executive Officer
General Practice New Zealand
Mobile: +64 21 02579859

www.gpnz.org.nz

 

Winter Wellness Check Claiming Form Live

The Winter Wellness Check claiming form is live and can be accessed through the WellSouth Portal. Here’s a helpful guide for the Winter Wellness Claiming form, please review this document for the steps to submit a claim.

All information relating to the WWC can be found on our Winter Wellness Plans webpage. The Winter Wellness Check Programme Sheet has been added, alongside a recording of the Q+A webinar held on 25 May 2023.

Please contact your Primary Care Relationship manager if you have any questions.

 

Winter Wellness Check Q+A Webinar Recording

We held a brief Q+A webinar on the 25 May, as an overview of the Winter Wellness Check and to answer questions from practices.

The recording is now available to view here.

At yesterday’s final Q and A session, one of the practices shared how they have set up a hot key “.ww”. This populates into the patient record the prompts that we have circulated, so all the relevant questions are covered during the consultation – great tip, credit to Mornington Health Centre for the idea!

 

Long Term Conditions Management Programme and CLIC beyond 1 July

The Long Term Conditions programme refresh which is currently underway is progressing well.  There is a working group meeting fortnightly to support the WellSouth team in determining the future direction of Long Term Conditions management. This group is made up of practice representatives, community providers including Māori providers, & consumer representatives. There are clinical and non clinical people so discussions are always rich and valuable to our work. The new programme will be focused on equity, more flexible, simpler to use and supported by the WellSouth team. We look forward to sharing further details of the changes in our upcoming updates.

We are now entering into a transition phase away from the current programme and preparing for the new direction. With the end of the financial year just around the corner (30 June), many practices are asking about CLIC allocations from 1 July.

We have therefore made the decision to cease comprehensive health assessments (CHA’s) after 30 June. Your patients who were assessed as Level 2 or 3 before 30 June, will continue to generate monthly payments into the practice for the remainder of their time on the programme, or until 31 December 2023 – whichever comes first. If your patient has their CHA in June 2023, their monthly payments will cease in December.

We realise there may be patients who you would want to be supported by the LTC programme during the transition. The Quick CLIC programme is continuing unchanged and this option is available during the transition period. The new programme will be available in November 2023.

Over coming weeks we will be working on Thalamus reports to support you through this transition away from CHAs.  Quick CLIC allocations are being calculated at present and we will communicate these with practices in the final week of June.

We are also exploring the synergies that may be present between Long Term Conditions Management programme that Community Pharmacy provides and the General Practice programme, as well as linking in with other community providers. Watch this space!

 

General Practice Workforce Survey

Message from Ruth Zeinert, WellSouth Primary Care Relationship Director:

In February 2022 we began surveying practices weekly in order to get a snapshot of staffing and stress levels; while we knew the COVID-related pressure on general practice was still high, we had also started hearing an increasing number of comments about issues such as staff burnout and poor patient behaviour which we wanted to keep track of.  The survey was deliberately designed to be only five questions so as to provide useful information without being a burden on practice managers:

  1. How busy is your practice currently? (scale 0 – 10)

  2. For this coming week, do you expect to have sufficient staff to manage BAU during normal business hours? (Yes/No answer, broken down to GP/nurse/reception admin)

  3. For this coming week, do you expect to have sufficient staff to manage your COVID positive patients who are isolating at home? (Yes/No answer, broken down to GP/nurse/reception admin)

  4. The overall mood at the practice is... (1-5 rating)

  5. Is there anything else you think WellSouth should know? (text box)

 

In September, as COVID-related pressures decreased, we changed the survey frequency to monthly. We have also recently changed question 3 to reflect winter illness rather than COVID-related pressure.

We currently get around 30 responses each month, a number which has stayed stable for some time. Comments from the May survey included:

  • We have staff off for a number of reasons, we will adjust our routine appointments to manage this. With doing Covid and Flu vax clinics our nurses are stretched.

  • I think there is a general mood that staff are fairly tired. Question 3 asks if we have enough GPs - I ticked yes, but in reality we could always do with more. The demands on the practice means we can generally deal with the day to day activities, using careful planning and management of resources but, it leaves little left to deal with proactive care - the recalls and follow ups. We don't have the ability or the funding streams to try new innovations.

  • We are struggling to recruit a Dr, any help would be appreciated.

  • We have staff illness and nursing vacancies.

  • Struggling to hire reception staff due to pay rates.

  • Short staffed - risk of staff burnout.

The following graph shows the percentage of responding practices who indicated they have enough GP (blue line), nurse (yellow line) and reception/admin (grey line) staff to manage BAU during normal business hours.

 

Many thanks to the practices who are taking a few minutes each month to complete this survey, it continues to provides useful information and we do follow up on those specific comments that we can provide support for. If you have any questions about the survey please contact your Relationship Manager.

 

Ngā mihi nui ǀ Kind regards

Ruth Zeinert

Primary Care Relationship Director / Kaiuruki Maimoataka Matua

 

COVID-19 additional booster vaccination messaging to PMS systems

Notifications for enrolled patients who previously received a COVID-19 additional booster vaccination will become available throughout the month of June.

MedTech practices notifications will be enabled by the end of June (date pending).  All other practice management systems will have notifications enabled from the evening of Thursday 8 June 2023.

The backlog of notifications will be sent in batches – for non-MedTech practices,  starting on the evening of Thursday 8 June and continuing again from Monday evening 12 June until Thursday evening 15 June. For MedTech practices this will happen at the end of the month, date to be confirmed.

 

National Guideline: Imaging after Knee Arthroplasty

Te Whatu Ora have consulted with the New Zealand Orthopaedic Association (NZOA), who have issued a new national guideline on “Follow-up imaging after Knee Arthroplasty”.

The new guideline states an initial, high quality, standing knee x-ray series, acceptable to an orthopaedic surgeon, is required within a year of index surgery as a minimum.

Subsequent knee x-rays should be on clinical grounds and not requested as “routine”.  The guideline also confirms that X-rays for knee pain post joint replacement are clinically indicated so will be accepted into the hospital system.

Memo – National Guideline on Follow-up Imaging after Knee Arthroplasty

 

New HealthPathway – Prescribing Antibiotics in Primary Care

A new pathway has just gone live on HealthPathways -
Prescribing Antibiotics in Primary Care - Community HealthPathways Southern

 

Update from Te Whatu Ora Southern community continence service

The Community Continence service continue to receive a significant number of referrals from primary care that are requesting products only, or referrals we are unable to triage due to a lack of clinical information and/or assessment.

When referring a patient to the Continence Service please ensure clinical information relevant to the patient’s condition is included as per the Continence Health Pathways.

Please ensure information regarding the patient’s cognition, mobility and personal representative contact details is included to assist with triaging referrals and decision-making regarding the location of assessment e.g. home vs clinic.

Product Requests

With regard to products, the continence service focuses on conservative management including information about continence products. All patients are assessed against the Ministry of Health eligibility criteria, however not all patients are eligible to receive funded products. 

We are not able to accept referrals for product requests only without any other clinical assessment information and these will be declined.

Thank you for your support. We hope that this information is helpful and saves everyone’s valuable time.

 

Southern Primary Care Research Network (SPCRN) Newsletter

Welcome to the first edition of the Southern Primary Health Care Research Network (SPCRN) newsletter. This newsletter will be published several times a year and will include important updates about Primary Care research and evaluation projects happening in our region!

Read the first edition here.

If you would like to subscribe to the newsletter, please click the following link and add your email address: https://redcap.otago.ac.nz/surveys/?s=KM3JFF4L3JFY7P7M

 

Mental Health and Wellbeing Commission – Te Hiringa Mahara 2023 Monitoring Report

The graphic below comes from the Mental Health and Wellbeing Commission’s report, available at https://www.mhwc.govt.nz/assets/Te-Huringa/Te-Huringa-2023/Summary-report/Te-Huringa-Tuarua-2023-SummaryReport.pdf

Its very concerning to see the 50% increase in prescribing for young people over the five year period. So it’s a good reminder of ‘skills before pills’ to help young people navigate this increasingly complex world.

 

 

 

 

 

Opportunities to be involved

 

Opportunity to provide GP level assistance within the Invercargill Acute Inpatient Service

Mental Health and Addiction Services in Invercargill are looking to engage a general practitioner to work in their inpatient acute service, either a short or longer term contract would be considered.  The inpatient acute service is like other health services under significant pressure at the moment and would be grateful for assistance from a general practitioner with an interest in mental health care with provision of physical health care to inpatients.

Key responsibilities:

  • Physical examinations of patients within the acute inpatient service (18 bed ward)

  • Managing physical health conditions.

    • Back up will be available from the emergency dept for urgent matters and additional support available from other hospital services for consults as required.

    • Access to senior medical senior nursing leadership will be available on a daily basis.

    • Working hours can be flexible to suit the candidate and other responsibilities, ie morning, day or evening work can be accommodated.

  • A minimum of two hours per day is required, Monday to Friday although we can be flexible with this.

  • Short term (weeks) or long term (six month) interest considered

For more information contact Adrienne Lee, service manager Adrienne.lee@southerndhb.govt.nz, 0272732291

 

Gynaecology Education Sessions – Survey to gauge interest in Dunedin

In collaboration with Dr Rebecca Brushwood and the Women’s Health Department in Dunedin, we will be hosting practical skills sessions in pessary sizing, insertion and changing, followed by options to attend OP/theatre for additional supervision and skills training in pipelles and pessaries.

We are hoping to get this up and running in the next couple of months and may deliver multiple sessions based on interest.

At this stage we are gauging interest in Dunedin only, however there will be options for other areas which we will update you on as soon as we can.

This short survey should only take one minute to complete, we really appreciate your feedback to help us gauge interest and preferences around formats and options for these sessions.

The survey will close at 5pm, Thursday 22 June 2023.

Survey Link: https://www.surveymonkey.com/r/WYR2MYV

 

Respiratory Study Day for Register Nurses - Survey

Attn: Registered Nurses

We are seeking your feedback on a Respiratory Study Day for Registered Nurses.

WellSouth are planning to run an all-day Respiratory Study Day for Registered Nurses on Saturday 4th November 2023. The day will be delivered in person and also available online. We are welcoming input and ideas from Nurses around what sort of content they would like to see, to contribute towards the planning of the session.

Please let us know what your specific learning outcomes would be via the survey link here.

 

 

Upcoming training and webinars

 

The Canterbury Initiative – Funny turns: Syncope and POTS

Wednesday 21 June, 7 – 8pm

Online via Zoom

Register here

Join Dr Jenny Butler, General Physician, Te Whatu Ora, Waitaha Canterbury for a discussion about syncope and orthostatic intolerance including POTS.

This one hour Zoom webinar is suitable for General Practitioners and Nurse Practitioners, and will include a presentation followed by a facilitated Q&A session.

The webinar will be recorded and made available on HealthPathways.

This activity has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been approved for up to 1 CME credits for Continuing Professional Development (CPD) purposes.

Full details here.

 

 

Covid-19 updates

The signals coming out of Te Whatu Ora indicate that Covid Care in the Community funding will continue as it is now until the 30th September 2023. We should have a definite answer in the next week or so and will let you know as soon as we know.

 

Southern Covid-19 Numbers

We continue to tick along, as below:

 

 

Photo of the week

As seen in Vogel St this week

 

 

So I hope you have a relaxing weekend, two weeks til Winter Solstice!

Ngā mihi nui

Carol