Tēnā koutou katoa

So, it had to happen, my household finally succumbed to Covid last week, and its certainly the gift that keeps on giving. I’m looking forward to not needing an afternoon nap!

Last week we held our AGM, and the WellSouth Annual Report was tabled. It is a good read and it showcases the work we are all doing to keep our communities healthy and well.  If you would like us to send a hard copy of the report, please email communications@wellsouth.org.nz with Annual Report Order in the subject line.

And we have just been notified that there is a case of Pertussis in Dunedin, as below – please, keep your eye out for more.


Key points today:

  • Pertussis case confirmed in Dunedin

  • WellSouth General Practice Workforce Information

  • WellSouth introduces new Pasifika and Māori scholarship for medical students

  • Oamaru Pacific Island Community Group (OPICG) Pink Day

  • AIR Cutover DELAY – Change of date to 2 December

  • Toitū Takata – LTC programme

  • Diabetes Annual Reviews

  • Cryptosporidium funding continues in Queenstown/Central Lakes

  • Seeking a General Practitioner to be a member of WellSouth’s Clinical Governance Group

  • CME Session – Cellulitis: Flucloxacillin with Breakfast never tasted so good

  • CPR Immediate Life Support Workshops – Level 2 and Level 4 Update Workshops

  • Te Whatu Ora – IV Cannulation and Venipuncture Workshops

  • Awanui Labs Annual Infection Prevention and Control (IPC) Seminar

  • The GPNZ Inbox Management Webinar series viewable now

  • Southern Covid deaths, vaccine status and ARC residents

 

 

What’s new

 

Pertussis case confirmed in Dunedin

The National Public Health Service, Southern has been notified of a confirmed pertussis case in an educational setting in Dunedin. The case had not travelled during their incubation period, suggesting that pertussis is circulating undetected in the community. Please have a low index of suspicion for pertussis, and isolate, treat and urgently notify the case to public health when you suspect pertussis, rather than waiting for a confirmed lab result. Here is the link ot the HealthPathways information: Pertussis (Whooping Cough) - Community HealthPathways Southern

 

WellSouth General Practice Workforce Information

Our team at WellSouth has been collating general practice workforce data, focusing first on general practitioners and primary care nurses, and we are pleased to present a summary of this below.

Primary health care has a number of challenges, and, like anything, we need to understand how and why this is happening – at a broad level.

We work alongside general practices to understand their needs and pressures first hand, but we are also collecting data to help identify trends, to be responsive, to spearhead initiatives, to advocate for change and to design and introduce new technologies and programmes. 

A critical aspect of this planning and research involves workforce analysis. Information such as work hour (FTE or part-time), ethnicity and age all help build a picture. 

For example, in November, a new set of data was collected through the practices and compared with 2021. Key insights from the data has shown the increase in nurses across the southern region and the decrease in GP numbers across the region. What was also evident was the low number of nurses under the age of 30. As a result, we recognise the need to concentrate efforts on attracting recently graduated nurses to the region.

The data also enables us to assess the region's progress relative to other areas in the country and benchmark against national averages.

Information collected is not about individual identification, but about seeing how our Southern primary health care system is faring, and how we at WellSouth can better support challenges and demands in an efficient, appropriate and relevant way.

As well as workforce data, we capture similar information from our Southern community, together developing a picture of the demands and provision of primary health care in Southland and Otago.

 

  •  54 GPs across the southern region work in multiple practices.

 

GP Numbers by location


  • Decreases in GP numbers are visible across the region except for Southland.

  • A number of practices included their GP’s age brackets. The reported ages ranged from 27 to 85 years old.  Of the 212 GPs with age data provided, 34% were aged 55 and older. This compares to the national picture where 44% were aged 55 and older in 2022 (see the RNZCGP_Workforce_Survey_Time_Series_Report_3.pdf)

 

 

 

 

Ratio – GP numbers per enrolled population

We note that the GP headcount, rather than GP FTE figures, are included in the GP to patient ratios below:

 

 Primary Care Nurses:

 

 

Nursing Council of New Zealand* has outlined that there are 641 nurses registered in the southern region and 582 in the Primary Health Care/Community Service (non-Te Whatu Ora).  

The majority of nurses scope of practice is Registered Nurse, and we now have 32 Nurse Practitioners in the district.

 

We plan to expand the team members on who we report this information in the future. We are most grateful to our general practices for providing us with this information.

 

WellSouth introduces new Pasifika and Māori scholarship for medical students

To support our growing Māori and Pasifika workforce, WellSouth has introduced a scholarship for top-achieving Pasifika and Māori final year medical students in General Practice.

The annual WellSouth Primary Care General Practice Award 2023, is worth $2,000, and given to University of Otago Bachelor of Medicine and Bachelor of Surgery (MBChB) Māori and Pasifika final year medical students who are based in Dunedin.

The first scholarships were introduced last week during the graduating doctors’ prize-giving dinner to Chekodi Fearnley-Fitzgerald – the top Māori final year medical student and Eugene Kado – top Pacific final year medical student in their general practice attachements.

We will watch their career paths with interest, and hope to see them popping up in our general practices in the future!

WellSouth is proud to support and encourage a growing workforce that is representative of our many diverse communities and who will bring their cultural perspective and experience to the primary health care sector and help break down barriers and reduce inequities within the health system.

Read the full press release here.

Dr Letava Tafuna’i, Chekodi Fearnley-Fitzgerald, Eugene Kado, Professor Jo Baxter, Andrew Swanson-Dobbs at the awards ceremony last week 

 

 

Oamaru Pacific Island Community Group (OPICG) Pink Day

Another successful Pink Day was held in Oamaru on Saturday to encourage cervical screening and to celebrate women. The Pink Day was hosted by Oamaru Pacific Island Community Group (OPICG) with thanks to other partners Te Whatu Ora Southern and Breast Screening Southern.
This was a day to acknowledge Pasifika women and their role and their work, share knowledge about screening and the new self-swab.
WellSouth is also aiming to have pharmacist and dietician clinics in OPICG in the future, so watch this space.

Check out our post on LinkedIn for more.

 

AIR Cutover – Change of date to 2 December

The cutover to the Aotearoa Immunisation Register (AIR) will move to Saturday 2 December 2023 and will not happen on Saturday 25 November as previously communicated.

A key testing milestone in the dress rehearsal found a bug that could not be resolved in time for the go/no go decision held Monday 20 November 2023. Although this could be resolved prior to the original planned date, the prudent and agreed approach was to use the contingency weekend to ensure a confident and safe transition.

What this means for you

Please continue to use the current systems and processes until the new cutover date:

  • Continue to record Covid-19 vaccinations in CIR until 1am (0100) Saturday 2 December 2023.

  • Continue to record vaccinations for adults in the AIR vaccinator portal until 1am (0100) Saturday 2 December 2023.

  • Continue to record vaccinations for children in the NIR until 1am (0100) Saturday 2 December 2023.

  • If you record vaccinations into a Patient Management System (PMS) connected directly to the NIR, please continue to do so.

All other information provided on getting ready for cutover is still valid. Your experience of cutover will still be the same, however commencing one-week later.

An updated transition plan will be sent out on Friday 24 November reflecting the new dates.

Please go to the AIR Readiness Page for everything you need to know and do for cutover.

 

Toitū Takata – LTC programme

Final practice nurse workshop for 2023

Our final Toitū Takata Practice Nurse Workshop for 2023 was held in Dunedin this week. The Workshops have been well attended and the feedback from the Nurses present has been positive. We had lots of good conversations & received lots of useful feedback which we will consider as we continue to implement Toitū Takata. We will offer the Workshop content on line in early 2024 to support the launch of Toitū Takata.

Webinar for Practice Managers

Wednesday 29 November, 11am.

Online via team: Click here to join the meeting

We will be holding a webinar for Practice Managers on Wednesday 29th November at 11am, we invite Practice Managers to join us for an introduction to Toitū Takata and discuss how the programme can be delivered in Practice. The webinar will be recorded for those who are unable to attend at this time, and further webinars can be scheduled if there is demand.

  

Diabetes Annual Reviews

It is great to see that many practices have improved their Diabetes Annual Review (DAR) rates over the past 6 months, which has direct, positive implications for patients’ health. Our recent data for all of WellSouth practices shows the substantial effort that you have all been putting in to completing Diabetes Annual Reviews for your patients. It is the first time in the data series below that the rate for Māori patients has been above 60%. Also, the rate for Pacific people has only been higher than current rates once in mid 2021. So this is fantastic progress, well done and thank you all.

 

  

Here is a message from Dr Susie Lawless, and Glen Knol, regarding our diabetes data:


When we look at the data at practice level, some practices are struggling to keep up with DARs, in particular for Māori and Pacifica patients.  For example, we can also see over 2000 patients enrolled with WellSouth who have a diagnosis of diabetes but who have never had an annual diabetic review, making it difficult for practices to find them.

If we look at the data more closely there is often quite a strong correlation between the never group and those with No Recall, so to assist we have provided a list of all those people with no recall now. (See screenshot below on how to find these people). It is also important to note that some of the people with No Recalls are uncoded diabetics or diabetes type unknown, so that might also be something else to watch out for. The take home message is the easiest way to potentially fall through the gaps if you’re a patient with diabetes, is to not have a recall.

We understand that it can be difficult to engage with the important when you are swamped with the urgent, but remember, this work is funded by WellSouth, and that this is separate from the coming Toitū Takata (LTC) funding, so there are financial avenues to support your work in this space.

Change in reporting

We would also like to draw your attention to a change in the diabetes reporting on Thalamus, where diabetics with an HbA1c between 50-53 are now separated out (see below), to enable you to easily identify those who may be eligible for new diabetes medication, such as empagloflozin or dulaglutide.

Help is available

We would like to offer our assistance in helping you engage with the Thalamus tool that can help you know who is due for a DAR. Our time is free, and we can come out to your practice as many times as you need to teach you how to use Thalamus to really improve your DAR rates. We would be happy to meet with Practice Managers, PNs or GPs, whoever is working on this material.

Please email Susie or Glen to set up a time for us to come and start this conversation with you.

Ngā mihi

Dr Susie Lawless and Glen Knol

Susie.lawless@wellsouth.org.nz and Glen.knol@wellsouth.org.nz

 

 

 

Cryptosporidium funding continues in Queenstown/Central Lakes

Please be aware that the $40 payment for nurse consultation and arranging of a stool sample for people who are symptomatic for potential cryptosporidium, but do not need a consultation, and are able to self-manage their illness, is still available for general practices in the Queenstown Lakes/Central area. This will remain in place until the boil water notice has been lifted.

 

 

Opportunities to be involved

 

We are still seeking a General Practitioner to be a member of WellSouth’s Clinical Governance Group.

As advertised last update, we are seeking a General Practitioner to join our Clinical Governance Group, to help us provide strong, transparent governance of all aspects of our clinical activities.

We meet monthly, and from next year that will be on the second Thursday of the month from 8-10 am, by Teams.  If you are interested, please contact me at carol.atmore@wellsouth.org.nz for more information.

 

 

Upcoming training and webinars

 

CME Session

Cellulitis: Flucloxacillin with Breakfast never tasted so good

Thursday 30th November

7pm – 8pm (Online)

Dr James Ussher – Clinical Microbiologist and Dr Carol Atmore – Clinical Director of WellSouth, will discuss the management of moderately severe cellulitis with oral antibiotics and the upcoming changes to the IV antibiotic claiming system (POAC programme)

Click here to register.

 

CPR Immediate Life Support Workshops

Level 2 and Level 4 Update Workshops

Invercargill

Monday 4 December, from 12pm

Spaces are still available for our upcoming CPR training in Invercargill.

Without airways ‘Level 2’ will run from 12pm – 12.45pm.

With airways ‘Level 4’ will run from 1pm – 1.45pm.

Click here to register.

 

Te Whatu Ora – IV Cannulation and Venepuncture Workshops

Frasers Building, Dunedin

Monday 4 December, 9am – 12pm or 1pm – 4pm

To register, please contact, the PDU Administrator, ext. 59552. DDI 03 474 59552 or email: PDUadmin.Otago@southerndhb.govt.nz. 

 

Awanui Labs Annual Infection Prevention and Control (IPC) Seminar

Friday 8 December, 1pm – 2pm

Online via Teams - Click here to join the meeting

About the seminar:

Join Awanui Labs for their annual IPC session with presenters Dr Juliet Elvy – Antimicrobial Resistance, and Dr Aaron Keene – Diagnostic Stewardship.

View the poster here.

 

 

Other general information

The GPNZ Inbox Management Webinar series

The GPNZ mini-series, Inbox Management, (maybe the next NetFlix phenomenon?) is now complete, and can be viewed at https://gpnz.org.nz/events/inbox-management-webinar-series/ - the last instalment from yesterday will be posted there soon. Happy watching :)

 

 

Covid-19 updates


Southern Covid deaths, vaccine status and ARC residents

In the past five weeks, Southern has recorded 30 Covid deaths (with or from Covid). Of these, 23 were ARC residents, and only 5 of whom had a booster in the past 6 months.

The Immunisation Advisory Centre has the following advice : COVID-19_Vaccine booster guidance for late 2023 - Factsheets - Immunisation Advisory Centre (immune.org.nz)

“The minimum dose interval between additional booster doses remains 6 months after COVID-19 disease or previous COVID[1]19 vaccine. Clinical discretion can be applied to spacing rules, minimum 5 months between primary and booster, 4 months between booster doses, and from 3 months after illness. Vaccine given outside this spacing will require a prescription.”

So while anecdotally, some people are ‘over’ boosters and are declining to consent, it is still worth double checking that your patients who live in ARC facilities have the opportunity to keep up to date with Covid boosters.

 

 

So that’s all folks, for today. I hope you manage to dodge the current wave of Covid as best you can, and I’ll be back in touch in a fortnight, hopefully full of renewed vigour and vim myself!

 

Ngā mihi nui

Carol