Tēnā koutou katoa

 

Nau mai, haere mai, welcome to this week’s Clinical Director Update. I was at the RNZCGP Conference a couple of weekends ago, and it was a real pleasure to see our Otago and Southland colleagues being recognised at the awards ceremony. Dr Verne Smith from Ranfurly was awarded the Community Service Medal, for outstanding contribution to general practice through work within his community. Prof Tim Stokes from the Department of General Practice and Rural Health at Otago Uni, and Servants Medical Centre, was awarded the President’s Service Medal for outstanding contribution to the College. And Dr Lily Fraser, Kāi Tahu, Kāti Māmoe, Waitaha, from Te Kāika, was awarded the College’s premier award, Distinguished Fellowship, recognising outstanding service to the College. In addition, three of our colleagues were awarded their Fellowship into the College and now can use the title Specialist General Practitioner – Dr Ahmad Abdul-Rahman, from Musselburgh Medical Centre, Dr Jeremy Maarschalk from Gore Medical Centre and Dr Natasha Sharp of Kurow Medical Centre. Congratulations to you all for your hard work and dedication to our communities, we are proud of you. 

And thinking about our workforce, there are several updates regarding opportunities to develop our workforce locally today, please have a look at them in the ‘Workforce Corner’.

 

Key points today:

  • National and local health partners visit WellSouth

  • Diabetes Annual Review (DAR) Uplift for Māori and Pasifika patients 

  • New Thalamus Diabetes Dashboard – Empagliflozin & Dulaglutide 

  • New referral pathway for adult haematuria – Primary Care Information

  • Te Whatu Ora – Southern Department of Gastroenterology under new leadership, Professor Michael Shultz

  • Student nurse placements

  • Training and supervision regulations RNZCGP

  • Newly graduated nurses seeking positions in general practice commencing January 2024

  • Postgraduate Nursing Education Health workforce Directorate (HWD) funding

  • ACC Primary Acute Care Expert Advisory Group – Call for expressions of interest

  • Southern Nurses Conference – Registrations now open!

  • Nurse Practitioner Training programme (NPTP) Information Session

  • GPNZ Political Panel – register now

  • Increasing awareness of funded flu vaccines for tamariki 6 months to 12 years

  • More immunisations at Dunedin Immunisation Centre (DIC)

  • Southern Numbers

 

 

What’s new

 

National and local health partners visit WellSouth

We were privileged to host our national and local health partners in our WellSouth Dunedin office this week, including Dame Karen Poutasi, new Chair of Te Whatu Ora | Health New Zealand, Chiquita Hansen, the Regional Wayfinder for Te Wai Pounamu, and Bryan Betty, Chair of GPNZ. Thank you to everyone who joined us in this gathering – further strengthening our connections through collective success.

Photo op (L to R) Carol Atmore, Aroha Metcalf, Doug Hill, Dame Karen Poutasi, Bryan Betty, Chiquita Hansen, Paulien Leijnes, Maura Thompson, Andrew Swanson-Dobbs

 

 

 

Diabetes Annual Review (DAR) Uplift for Māori and Pasifika patients 

As part of our refresh of the long-term conditions programme, we have uplifted the rates for Diabetes Annual Reviews for eligible Māori and Pasifika patients from $40 + GST, to $50 + GST. Māori and Pacific patients in our region are less likely to have had their HbA1c recorded, or a DAR, in the last 12 months than those who are non-Māori and non-Pasifika. Macroalbuminuria, eGFR < 30, and high risk/active foot disease as a result of diabetes complications rates are all between 1.5 times and 3 times worse for Māori and Pacific patients compared to non-Māori, non-Pacific patients in our region. Therefore, through uplifting the remuneration we hope to improve the clinical management of diabetes for Māori and Pacific patients through the diabetes annual review process - and reduce the downstream complications. 

 

New Thalamus Diabetes Dashboard – Empagliflozin & Dulaglutide 

General practices in the Southern region can now identify patients who qualify for diabetes medicines more easily with the Thalamus Diabetes Dashboard. The information can help GPs determine which patients are eligible for empagliflozin, dulaglutide, and liraglutide and who can be transitioned to these life-changing medications, including and importantly all Maori and Pacific patients with HbA1c of 54 or above. https://southern.communityhealthpathways.org/24232.htm

 

Here is a snapshot of the Diabetes dashboard. You can now review your dashboard to analyse your own prescribing. Click on the tab below called New Diabetes Medication to find the information about your empagliflozin, dulaglutide, and liraglutide prescribing.

Talk to your patients about the medications and benefits of these, if you haven’t had the opportunity to already. And for Māori and Pacific patients you might like to encourage whānau/aiga to join them for those first important conversations to support this change. 

Please contact our population health pharmacists if you have any questions or would like some help – sandy.so@wellsouth.org.nz or brendon.mcintosh@wellsouth.org.nz.

 

New referral pathway for adult haematuria – Primary Care Information

A new referral pathway for adult haematuria went live on 24 July 2023. The pathway changes are to improve patient care, reduce unnecessary invasive procedures (the number of cystoscopies is expected to reduce by 50%) and reduce burden on secondary care services, therefore freeing up more time to see those patients who do require access to the Urology service. This pathway includes the use of Cxbladder rather than urine cytology in the process, as well as GP referral for renal ultrasound or CT-haematuria. Investigations following this pathway are very sensitive for detecting urothelial cancer. Patients with normal investigations have an extremely low risk of malignancy, and urological referral for cystoscopy is no longer required. This new pathway is a positive development for our patients and has  been developed with WellSouth clinical advisors, and I’m pleased to be able to present it here.

 

You can read further information about the new pathway below.

Haematuria in Adults Health Pathway

Primary Care Information – New haematuria pathway

 

You can also watch an introductory educational video by Dr Mike Stotzer (Urology Consultant) and Pacific Edge (the company behind CX Bladder) here: Educational Video | CX Bladder Triage - YouTube

 

Te Whatu Ora – Southern Department of Gastroenterology under new leadership, Professor Michael Shultz

Message on behalf of Professor Michael Shultz:

Let me please introduce myself as the new Clinical Director for the Department of Gastroenterology at Te Whatu Ora - Southern. Together with Dr Kyle Hendry as the Endoscopy Lead Otago and Mr Paul Manuel as the Endoscopy Lead Southland we have taken over from Dr Hill who remains the Director for the National Bowel Screening Program. I came to New Zealand in 2005 and took a position as a joint clinician with the University of Otago and the then Otago District Health Board. After stints as the President of the New Zealand Society of Gastroenterology and as Head of the Department of Medicine at the University I am looking forward to this new challenge.

Kyle has been a registrar for many years at Dunedin Hospital before embarking on specialist training in gastroenterology in the North Island. He joined our team four years ago as a Consultant Gastroenterologist with a special focus on endoscopies. Paul, originally from Canada is a General Surgeon at Kew hospital with an interest in endoscopy.

The aim of the new leadership team is to work together with all stakeholders and build bridges to achieve the best outcome for our patients.

 

Workforce Corner

Student nurse placements

Our local tertiary nursing education providers need our help in providing quality clinical placements for our future nursing workforce. Offering student placements in general practice is one way of attracting nurses to work in primary health care and offers employers an opportunity to play a role in growing future team members.

Otago Polytechnic have a group of Enrolled Nursing students requiring primary health care clinical placements from 23/10/2023 until 26/11/2023 in the Otago region.

SIT have a group of Enrolled Nursing students requiring primary health care placements from 24/10/23 – 17/11/23 in Southland.

SIT is also seeking a placement for a nurse in the Competence assessment programme (CAP). The CAP enables NZ qualified nurses who have been out of the workforce for some time or internationally qualified nurses an opportunity to apply for registration in NZ.

If you are interested in offering a placement to any of these students or you would like to know more, please contact Kate Norris (Professional Nurse Advisor) - kate.norris@wellsouth.org.nz or phone 0225604176.

 

Training and supervision regulations RNZCGP

Message on behalf of Lead Medical Educators for Southern GPEP1 RNZCGP:

Kia Ora All,

We wanted to get in touch to communicate and clarify some training and supervision regulations from RNZCGP for GPEP2/3+ trainees.
https://www.rnzcgp.org.nz/documents/230/GPEP_Fellowship_Pathway_Regulations_2023.pdf

As stated in section 3.7.1 (g)

If a registrar has been unsuccessful with their written and/or clinical examinations, they are required to always have a Fellow of the college on-site to provide clinical oversight when they are practicing.

The GPEP1 year is 12 months long in total and this time can not be extended.

Please don’t hesitate to contact any of us for any further queries.

Thanks

Ngā Mihi Nui

Lead Medical Educators for Southern GPEP1 RNZCGP

Taatske Rijken-Dunedin Region

Keith Abbott-Central Otago Region

Aisha Paulose-Southland Region

 

Newly graduated nurses seeking positions in general practice commencing January 2024

The Te Whatu Ora Nurse Entry to Practice (NETP) and Enrolled Nurse Support in Practice (ENSIPP) teams are calling for expressions of interest from practices who are keen to employ a new graduate Registered Nurse (RN) or Enrolled Nurse (EN), commencing in January 2024.

Further information about the NETP and ENSIPP can be found here.

If you are interested in employing a new graduate nurse or would like to know more about the program, please contact Kate Norris, Wellsouth Professional Nurse Advisor - kate.norris@wellsouth.org.nz or phone 0225604176.

 

Postgraduate Nursing Education Health workforce Directorate (HWD) funding

The HWD is a funding agency of the Ministry of Health that provides funding for workforce development. Funding is available for study leading to postgraduate nursing qualifications including (but not limited to) RN prescribing (in primary health and specialty teams) and masters qualifications (leading to the Nurse Practitioner scope of practice).

Applications for 2024 open on 1st September 2023 and close on 1st October 2023.

Further information can be found on the Te Whatu Ora Postgraduate Nursing education page- http://www.southernhealth.nz/postgradnursing

Or by contacting the Te Whatu Ora Postgraduate Nursing education office HWDfunding@southerndhb.govt.nz


 

Opportunities to be involved

 

ACC Primary Acute Care Expert Advisory Group – Call for expressions of interest

ACC are seeking people to join an expert advisory group to work with ACC to consider the future state of primary acute care services. The output of this group will contribute to the design of a new service for implementation by 1 July 2025. 

Please review the expression of interest document which outlines what the group is for, who we would like to form the group, and an application form.

We ask that interested people send their expression of interest form to PACAdvisory@acc.co.nz. By 5pm, Friday 18 August 2023. 

 

 

Upcoming conferences, training and webinars


Southern Nurses Conference – Registrations now open!

13-14 October 2023, Scenic Southern Cross Hotel, Dunedin

Click here to register.

The theme of this 2-day conference is ‘Toward positive change in primary health care’.
The health system reform offers opportunity for primary health care nurses to work in innovative and dynamic ways to best meet the needs of their diverse populations. This conference will bring primary health care nurses together, to celebrate their work and to offer opportunities for networking and professional development.

A provisional programme is being prepared; topics and speakers include:

  • Chiquita Hansen (keynote speaker) - Regional Wayfinder Te Waipounamu, Te Whatu Ora

  • Type II diabetes update

  • Supporting people with intellectual disabilities in the primary care context

  • Gender affirming primary healthcare

  • Mihimihi and foundations of Māori culture

  • Decolonising primary care

  • Gout update

  • Women’s health update

  • Long term condition management panel discussion

  • Immunisation update

  • Nurse prescribing and Nurse Practitioner scope of practice

  • Neuroscience based self-care strategies.

There is a cost of $120 (GST inclusive) to attend the conference, this includes lunch, morning and afternoon tea and a mix and mingle social evening with canapes and entertainment on the Friday evening.

Register now: https://training.wellsouth.nz/events/692-primary-health-care-nurses-conference-2023/

 

Nurse Practitioner Training programme (NPTP) Information Session

Applications for the 2024 Nurse Practitioner Training Programme intake close on Monday 4th September 2023. The University of Auckland are holding an information session next week for anyone interested in the programme, details below.

Information session:

Date and time: Thursday 10 August, 6pm

Online: Join the webinar here (passcode 934790)

Further information: https://nurseworkforce.blogs.auckland.ac.nz/nptp/nptp-info/

 

GPNZ Political Panel – register now

GPNZ is pleased to be hosting an online political panel on Wednesday 23 August, 7pm – 8.30pm.

They have made this an online, evening event to allow for maximum participation from the primary care workforce nationwide.

Register here - Capacity is set to a maximum of 1,000 and the event will be recorded and made available for those who unable to attend on the night.

Confirmed speakers so far include:

Each speaker will address the audience on their stance, policies, and priorities, then our MC will open to your questions - you can submit your questions during registration or ask on the night.

 

Other general information


Increasing awareness of funded flu vaccines for tamariki 6 months to 12 years

In response to reports of more pēpi and tamariki being admitted to hospital in recent weeks, Te Whatu Ora and Te Aka Whai Ora are urging parents, caregivers and whānau to not be complacent about the flu. Pharmac expanded the eligibility for free flu vaccines this year, to include pēpi and tamariki aged 6 months to 12 years.

Influenza B, which tends to impact tamariki the most, is circulating in New Zealand for the first time since 2019. As you know, the funded flu vaccine protects against four strains of flu, including Influenza B.

To complement the existing flu vaccine campaigns in market, Health NZ will begin digital and social media advertising aimed at parents and caregivers of children aged 6 months to 12 years, who are eligible for a free flu vaccine.

We hope this could increase the demand for flu vaccinations in the coming weeks and can confirm that there is enough stock to support a surge – please see the below update on Afluria Quad Junior. We appreciate your efforts and support to help protect pēpi and tamariki from becoming seriously unwell this winter.

 

More immunisations at Dunedin Immunisation Centre (DIC)

To utilise the Dunedin Immunisation Centre (DIC) better and to target childhood immunisations, they will be offering more opportunities for most funded vaccines to be available at the DIC. The intent is to target those unenrolled & those that may have other challenges to get vaccinated. Whilst the clinic is open Mon-Fri for all vaccinations there will be targeted clinics as per below.

They will roll out Funded Fluquadri for 6 months to 3-year-olds every Wednesday morning starting 16th of August 2023 on an appointment basis.

Clients can book an appointment through Book My Vaccine website https://bookmyvaccine.health.nz/ or call 0800 28 29 26 to make a booking over the phone.

 

 

Covid-19 update


Southern Numbers

So as winter continues, Covid reported numbers trickle along, as the data by age and ethnicity over the last month below:

 

There seems to be no particular geographical ‘hot spots’ over recent months, as the collated data since February shows below:

 

  

I am away for the week on leave in a fortnight, so if there is any information that needs to be circulated that week there may be an abridged update sent in my absence, otherwise I’ll be back in touch in 4 weeks, and aiming to have this update out mid-week going forward. And it will nearly be spring by then!

 

Stay well

Ngā mihi nui

Carol