Mihi nu iki a koe

As you read this issue of our E News, we await the DHBs’ decision about how to fairly and transparently procure ongoing after-hours provision. Our PHO is associated with six out of the 11 existing providers, all of whom have been asked to roll over their contracts to 31 October, while awaiting the procurement outcome.

Our member clinics have always had a strong commitment to access, with zero fees for under 18s and access to care up till 11pm, every day, regardless of the level of after-hours funding from DHBs. The result: Bairds Rd sees more children after-hours than Middlemore Hospital’s Kidz First and Auckland City’s Starship Children’s Hospital combined. What’s more, the Ambulatory Sensitive Hospitalisation rates for East Tamaki Healthcare’s Mangere and Otara patients are among the lowest in the area.

Total Healthcare also supports the Ministry in its endeavours to make recommendations to the minister following the Primary Care Working Group’s General Practice Sustainability Report. The report called for better options for targeting high needs funding streams in primary care. As part of a Ministry working party, I have had input into the options being modelled. I’m convinced that merely tinkering with VLCA will not address the inequities that see nearly half of those deemed “high needs” not accessing a lower fee structure in primary care. There is a realopportunity here to support both patients with high needs and providers who have a focus on supporting large numbers of patients to achieve better health outcomes by reducing the barriers to access.

Meanwhile, we've got plenty of news to share with you below. 

Nāku no anā,

Mark Vella
Executive Officer

Stroke prevention study partnership with AUT

AUT’s National Institute for Stroke and Applied Neurosciences is teaming up with Total Healthcare PHO and Nirvana Health to trial new ways of preventing strokes with Auckland patients.

Total Healthcare’s enrolled population provides a convenient snapshot of the New Zealand population, and is a great place to test out health interventions, says principal investigator Professor Valery Feigin (pictured).

“This particular PHO is very high tech, they can text message all their clients. It’s a huge advantage… They are very innovative,” he says.

PHO Executive Officer Mark Vella says because of its model, database and scale, its management service organisation, Nirvana Health in partnership with Total Healthcare is increasingly being recognised by researchers as a logical partner. Read more

Mt Roskill and Manurewa clinics extend hours

We’re pleased to announce that Mt Roskill Medical Centre and East Tamaki Healthcare Manurewa are now open seven days. This is big news for the communities these clinics serve, and for the DHBs, as it will reduce demand on the hospitals’ emergency departments.

Totally committed to reducing violence

Total Healthcare is committing funds from its flexible funding pool to Gandhi Nivas, an early intervention programme for reducing domestic violence.

Gandhi Nivas provides accommodation, counselling and referral to social services for men who have either been issued with a Police Safety Order or are otherwise involved in police matters related to family violence. This month the scheme is not only celebrating its first anniversary, but an emerging trend of reduced offending. A study by Massey University’s School of Psychology shows 93% of the 103 men to date haven’t offended following their stay at Gandhi Nivas. Read more 

NZ Police honour for Ranjna Patel

Counties Manukau Police District Commander John Tims presents Nirvana Health founder and Total Healthcare PHO trustee Ranjna Patel with a Challenge Coin.

Mrs Patel received the coin, usually reserved for police, for her commitment to reducing family violence through Gandhi Nivas (see above). The PHO is also proud to announce Mrs Patel is now a board member of Global Women and the Co.OfWomen. Mrs Patel was featured in the New Zealand Listener earlier this year, where she recalls when she met husband Dr Kantilal Patel, and how they built Nirvana Health to be the organisation it is today. Read more

Dannemora nurse aims for 1000 cervical smears

Dannemora nurse Susheela Chandra loves her job – and is aiming high.

So committed to her role, Susheela has set herself a goal to improve women’s health. This year, she is aiming to take 1000 cervical smears. Last year, she came close with 900 – making her the most prolific smear taker across all Total Healthcare’s provider clinics.

“I just say to women, if you defer the test, you may not find time to come back,” says Susheela, who has been a nurse for 30 years.

It’s persuasive and dedicated nurses, like Susheela and her colleagues, that encourage women like South Auckland mum Sandi* to have regular smears.
Being a nurse herself, Sandi knows the importance of having regular smears but, like many women, finds the testing uncomfortable and unpleasant. It was a running injury that brought her to an East Tamaki Healthcare clinic. Once there, an opportunistic nurse suggested she have a smear test – a test that Sandi (49) says saved her life.

Further testing revealed a CIN-3, or high grade cancer, and action was necessary. In March this year, Sandi had a radical hysterectomy – the removal of her uterus, cervix, fallopian tubes and lymph nodes to get rid of the cancer.

“I consider myself incredibly lucky,” she says. “The smear led to an early diagnosis and early treatment."

Sandi and Susheela are sharing their stories as part of a wider Total Healthcare campaign to encourage more women to get tested. Sandi is thankful to be alive and wants to raise awareness of cervical cancer in the hope she inspires others to have their smears regularly.
*Surname withheld.

David Codyre takes Kia Kaha to the world

David Codyre is in Sweden this month as part of a Ko Awatea, Counties Manukau Health team talking about self-management and the Kia Kaha project.

Clinical lead, mental health for East Tamaki Healthcare, Dr Codyre is presenting at the prestigious International Forum on Quality and Safety in Healthcare run by the Institute of Healthcare Improvement and the British Medical Journal.
Kia Kaha is a collaborative primary care mental health project that has reduced hospital emergency department presentations by 41% for more than 100 high needs patients over three years.
We’re especially pleased that Kia Kaha has formed the template for a broader programme teaching self-management skills, using peer support, phone and web-based support, and health coaching, that is to be rolled out district wide. Early results are promising, showing increased health literacy and self-management. Read more

Working together to improve health outcomes

Total Healthcare contracts Nirvana Health Group as its management support organisation, and Nirvana contracts medical providers to deliver the services required in the PHO/DHB contracts. The providers include East Tamaki Healthcare, West Auckland Healthcare, Mt Roskill Healthcare, Raukura practices and White Cross.  
Copyright © 2016 Total Healthcare Charitable Trust, All rights reserved.

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