Tēnā koutou katoa

Greetings! I am up at the RNZCGP Conference so looking forward to some stimulating presentations and conversations.

There is a focus on diabetes in this week’s update.  Diabetes care is an area where we have inequitable outcomes across our area, and we hope that providing some tools to help will help you in providing care for your patients.


Key points today:

  • Thalamus to update diabetes data

  • Update to Diabetes Dashboard – No Recalls 

  • New Thalamus Dashboard – Empagliflozin and Dulaglutide 

  • POAC Payment for IV Zoledronate (“Aclasta”)

  • Ability to see CLIC patients who need Care Planning completed 

  • Te Whatu Ora – Key information about Vancomycin-resistant Enterococci for Primary Care providers

  • Community Pharmacy-Additional National Immunisation Schedule

  • Concussion Management Pathway update

  • Working with our Hospital Colleagues Webinar Wed 26th July 18.00-19.00

  • Skin cancer in the elderly – online course

  • New Resource for Paracetamol Recommendation for Meningococcal B (Bexsero) for children Under 2 years

  • Covid numbers

  • Referral pathway for COVID-19 vaccination home visits 


What’s new


Thalamus to update diabetes data

The Thalamus team has been working hard on improving the accuracy of the programme to capture all your patients who have diabetes. The patients who have had their latest 2 x HbA1c over 50 who do not have a diabetes code in the PMS are a particular group we are concerned about because they may be missing out on appropriate interventions, such as clinical review, retinal screening and foot checks. These patients may have had testing done away from their usual practice but need to be picked up by General Practice and will be eligible for WellSouth funded diabetes reviews.

We have now added a bar to the Diabetes screen in Thalamus, called “Uncoded diabetics”. Looking at the data, we can see that many practices have zero patients in this category (well done!), but others have a significant number, meaning there are over 300 in Otago-Southland.

Please see the linked instructions on how to find the relevant bar, and the list of patients.

If you have questions or would like help, please email Susie.lawless@wellsouth.org.nz or Glen.knol@wellsouth.org.nz


Update to Diabetes Dashboard – No Recalls 

An update to the Diabetes Dashboard in Thalamus now means practices can identify all patients who have diabetes, who do not have a recall set in the PMS. This can support practices to identify patients at risk of “falling through the cracks” and their diabetes potentially deteriorating.  
There are currently 3545 patients who have diabetes wo do not have a recall set in our region, out of a population of 15,026 diabetics. 
If you would like more information on this, or to discuss the diabetes dashboard more generally, please contact Glen Knol on glen.knol@wellsouth.org.nz  


New Thalamus Dashboard – Empagliflozin and Dulaglutide 

The new diabetes medications - Empagliflozin and Dulaglutide - became fully funded in February 2021. 
2,830 patients in our takiwā have been transitioned onto the new medications, while 1263 (31%) have not been transitioned to the new medications, despite meeting special authority criteria. This may be due to the medication not being clinically appropriate, or it could be that the medication review with the patient has yet to happen.  
The new thalamus dashboard supports practices to identify patients who have yet to be transitioned onto the new medications. 
So please have a look at this and connect with your patients who are eligible for the medications, but who you haven’t yet had the conversation. These new drugs are game changes for people with diabetes, and save kidneys and hearts and lives.


POAC Payment for IV Zoledronate (“Aclasta”)

The WellSouth Clinical Quality Committee has championed the funding of IV zoledronate infusion for the treatment of Osteoporosis and Paget’s disease to Māori, Pasifika, Quintile 5 and CSC holders.

The programme which funds IV infusion of this medication for eligible patients will be covered by a POAC payment, claimed through the WellSouth portal, of $125+GST and available from Monday  24th July 2023.

This payment is designed to ensure equitable access to the appropriate treatment of osteoporosis and supports the work of the Fracture Liaison Service (FLS) as it seeks to reduce the burden of fragility fractures throughout the Southern region. The FLS is happy to respond to all enquiries about fragility fracture care and osteoporosis management and can be contacted through their clinical lead richard.macharg@wellsouth.org.nz. 

Please see attached programme information sheet for detailed criteria, and service codes which need to be set up in the practice PMS prior to first claims being made. 


Ability to see CLIC patients who need Care Planning completed 

In the last Clinical Director update, we informed practices that in switching off the ability to complete CHAs from within the WellSouth portal, we inadvertently removed the ability for practices to identify patients who have not had care planning completed.  

We are happy to say that this has now been updated in the WellSouth portal, and you should now be able to complete and view care planning for patients who are currently still enrolled on the CLIC programme. 

We hope to provide a more general update on the direction of the new LTC programme in the next Clinical Director update. 


Te Whatu Ora – Key information about Vancomycin-resistant Enterococci for Primary Care providers

Message on behalf of Te Whatu Ora:

This email is to inform you that Te Whatu Ora is aware of a number of cases of Vancomycin-resistant Enterococci (VRE) in hospital patients across the Te Manawa Taki region.

Attached you will find national key messages to provide you and your colleagues with the following:

  1. background information on VRE;

  2. details of the local response in Te Manawa Taki; and

  3. specific guidance for Primary Care providers.

Central Te Whatu Ora has established a national VRE Technical Advisory Group (TAG) to support the development of national infection prevention and control (IPC) guidance and to support Te Whatu Ora district and regional providers, Primary Care providers and aged residential care facilities nationwide. This national guidance will be distributed in due course, but in the interim please refer to this fact sheet for Core IPC strategies for managing VRE in healthcare facilities. This guidance and the key messages provided have been authored by Jane Pryer, Te Whatu Ora Clinical Principal Advisor for IPC and Carolyn Clissold, Te Whatu Ora Chief Clinical Advisor for Outbreak Response, along with contribution from the VRE TAG and the Te Whatu Ora Interim Executive Leadership Team National Director Medical.

If you have any questions, please email ipc@health.govt.nz.


Community Pharmacy-Additional National Immunisation Schedule

From 1 August 2023, vaccinating pharmacies will be able to order additional National Immunisation Schedule vaccines resulting in wider availability of vaccination sites in the community. Community pharmacy can already offer funded influenza, MMR, Tdap and COVID-19 vaccines. This exciting change sees the following vaccines added:

  • Bexsero (Meningococcal B vaccine)

  • MenQuadfi (Meningococcal ACYW vaccine) *limited access due to low volume

  • Gardasil (Human papillomavirus (HPV) vaccine)

  • Shingrix (Varicella zoster [Shingles vaccine])

To support the sector in this expansion of immunisation services in community pharmacy, an Operational Planning Guide has been developed by the National Immunisation Programme to assist in the planning for the introduction of these vaccines. The following forums are also planned:

  • The Immunisation Advisory Centre (IMAC) held a clinical refresher webinar on 6 July 2023. The webinar has been recorded and is available here.

  • The Programme will run an Operational Drop-in Q&A session via Teams from 6:30 - 7:30pm on 19 July 2023. A link to join the session is here. This will be an open forum for districts, immunisation co-ordinators and pharmacy staff to have their operational questions answered.

  • If you have any questions or comments at any stage, please reach out to the Programme at immunisation@health.govt.nz


Opportunities to be involved


Concussion Management Pathway update

WellSouth is pleased to report continued enthusiasm for enhanced diagnosis and care of concussion using the BIST (Brain Injury Screening Tool), after a well-received presentation at the Otago Faculty RNZCGP CME meeting.  Any GPs or NPs interested in coming on board with ACC’s Concussion Management Pathway pilot project are encouraged to do so.

To find out more about the programme, associated CME and access to the BIST tool please do not hesitate to contact the Clinical Lead, Dr Richard Macharg at richard.macharg@wellsouth.org.nz or concussion@wellsouth.org.nz.


Upcoming training and webinars

Working with our Hospital Colleagues Webinar Wed 26th July 18.00-19.00

We are hosting a webinar to discuss the new collaborative Transfer of Care framework between primary and secondary (the most current version of the Transfer of Care framework is attached); detail policy and standards of care when communicating between the two; and talk about GP advice clinics.


Dr Andy Shute. GP Liaison, WellSouth - Primary Care feedback of the Transfer of Care framework

Dr David Gow, Chief Medical Officer, Te Whatu Ora Southern – Current system update

Dr Jo Mitchell, Medical Director, Integrated Care, Te Whatu Ora Southern  – GP Advice clinics

The link for registrants is:


So please come along, Wed 26th July 18.00-19.00. The Teams link will be included in next Tuesday’s WellSouth update, if you haven’t registered by then, and it will be recorded and available following.


Skin cancer in the elderly – online course

Saturday 19 August, 8.30am – 12.30pm

Online course

Register: https://www.melnet.org.nz/index.php?p=news/conferences-seminars-events-1

This online course will overview skin cancer diagnosis, management and care in the elderly. Improve your recognition of suspicious lesions in elerly patients and your understanding of how best to manage and care for elderly patients diagnosed with melanoma and non-melanoma skin cancers.



Other general information

Paracetamol Recommendation for Meningococcal B (Bexsero) for children Under 2 years - New Resource

To highlight the development of the new Menigococcal B (Bexsero) paracetamol recommendation resource from the National Immunisation Programme (NIP) available on Dropbox, IMAC provide a Standing Order template for the administration of prophylactic paracetamol for use in Bexsero administration.




If you intend implementing this standing order, ensure you are adhering to the MOH Standing Order Guideline. Note the specific dosing regimen for premature babies of 10 mg/ kg instead of the 15/kg for full term babies.


Covid-19 updates


Southern Numbers

Still muddling along, still slowly going down!



Referral pathway for COVID-19 vaccination home visits 

If you know someone who is unable to access a vaccination clinic for a COVID-19 vaccination (due to disability, a mental health or addictions condition, a health condition or other reason), please support them to fill out this form or call 03 476 9977 and Te Whatu Ora will be in touch to work through a solution. 


So its wet and warm in Auckland and I’m sure to get wet on the way to the Aotea Centre.  I hope you have a good chance to have a break and recharge somewhere along the way this weekend. Go the Football Ferns!

Ngā mihi nui