Expertise for a healthier New Zealand

PHOcus on Health specialises in supporting the primary health care sector to improve the health of New Zealanders - in ways that are both equitable and demonstrable.

PHOcus on Health works with and for primary health organisations (PHOs), primary care organisations, Maori and community providers and medical centres, providing governance, management & clinical support.  The team also works with District Health Boards (DHBs) providing assistance in developing, delivering and evaluating primary care initiatives.

The PHOcus on Health team has particular interest and expertise in long term conditions management (LTCM).  We design, develop, implement and evaluate LTCM programmes.  We are exploring methods of combining physical activity, nutrition and weight loss components alongside structured primary care.

Mental health & wellbeing website for West Coast youth

PHOcus on Health has been project managing the design and development of an on-line mental health & wellbeing resource for young people on the West Coast. The site is called simply 'Youth West Coast' and it can be accessed here:

 

Weight loss programme graduate wins "Healthy Lifestyle Ambassador" award

Jareth McKay (right), an early winner from the West Coast PHO's new weight loss service in Westport, pictured with Buller District mayor, Pat McManus (centre) and then WCPHO CEO, Anthony Cooke (left).  The occasion was the awarding of the 2012 Buller District "Health Lifestyle Ambassador" award to Jareth

Jareth McKay (right), an early winner from the West Coast PHO's new weight loss service in Westport, pictured with Buller District mayor, Pat McManus (centre) and former WCPHO CEO, Anthony Cooke (left).  The occasion was the awarding of the WCPHO's 2012 Buller District "Health Lifestyle Ambassador" award to Jareth.

 

New weight loss and diabetes prevention programme

The PHOcus on Health team has been working with West Coast PHO to develop an evidence based approach to weight loss, particurlary for those who are on a path to becoming diabetic.

A recent British Medical Journal article (BMJ, 2011, 343) reported on a randomised control trial comparing the effectiveness (and cost-effectiveness) of a range of commercial and primary care led weight reduction programmes.  All the commercial programmes were effective to some degree.  General practice teams themselves were more expensive and less effective at achieving sustained weight loss than were some of the commercial providers.

So, the PHO worked with available providers in the town chosen as the pilot site (Westport).  Contracts were developed with a local life coach for group weight loss sessions and with the local Council run recreation centre for a group-based physical activity programme.

A media release about the new initiative is here.

 

Health needs assessment in the Eastern Bay of Plenty

Eastern Bay Primary Health Alliance (EBPHA) commissioned PHOcus on Health to analyse the health needs of Eastern Bay of Plenty residents. 

EBPHA is now using the results to determine service delivery and programme priorities.

More information about the Eastern Bay Primary Health Alliance's services can be found on their website:

http://www.ebpha.org.nz/

 

 

 

 

CVD & diabetes prevention: what works in the real world?

PHOcus on Health has recently completed a review for Counties Manukau DHB, examining the translational research related to diabetes and CVD prevention.  Translational research seeks to take initiatives that have been shown to be effective in clinical trial situations and translate them into real world contexts.

Conclusion?  It isn't easy, but here's some of the evidence that is beginning to emerge from around the world about those elements that go to make up a successful, real world prevention programe.

Our thanks to the DHB for making the report publicly available.

 

West Coast Business Case: 'better, sooner, more convenient primary care'

PHOcus on Health played the lead role in the development and writing of the West Coast PHO's business case.  The 200 pg business case has been approved for implementation by the Ministry of Health.  Left to right below are: Grey District Mayor, Tony Kokshoorn; (then) Tasman West Coast MP, Chris Auchinvole; Minister of Health, Hon. Tony Ryall (holding the business case document) and (then) WCPHO chief executive, Anthony Cooke.

 

Evaluation: Interpreters in Primary Healthcare

PHOcus on Health completed a two and a half year evaluation of the Northern DHB Support Agency's pilot of the use of interpreters in primary health care.

The evaluation demonstrates the value to both clinicians and patients of having professional interpreters as part of the healthcare consultation.

Initially, uptake of the pilot was slower than anticipated, and the evaluation looks at the various barriers and enabling factors to the rollout and take-up of the programme.

The Primary Health Interpreter Pilot has now become the Primary Health Interpreter Service, a routine and growing part of healthcare delivery in the primary sector across the Auckland region.

More information about Interpreter Services can be found here.

 

The evidence for what works ...

Supporting people to self-manage their diabetes/chronic condition and/or to lose weight are seen as two difficult, complicated areas of primary care work.

Counties Manukau DHB commissioned PHOcus on Health to examine the evidence for what works in these areas:

 

Fiona joins the PHOcus on Health team

  

Fiona Doolan-Noble joined the PHOcus on Health team in December 2010.

Fiona's background is in nursing.  She holds the following qualifications: MPHC, PGDipPH, RGN. Fiona has significant experience of working in the secondary, primary health care and NGO sectors and in clinical project management. Her experience includes chronic disease management, health promotion, strategic planning, development of new clinical projects and services, qualitative research, and project evaluation.

Fiona is based out of Hokitika in the South Island.

 

Golden Bay calls Dr Jocelyn Tracey

Dr Jocelyn Tracey

Jocelyn Tracey is taking up a rural general practice role at the Golden Bay Medical Centre in 2011.  She will be relinquishing her role as Clinical Director with PHOcus on Health, and aims to spend much more time at home with her husband, John.

As a result, PHOcus on Health is interested in hearing from medical practitioners who would like to be involved in consulting and project work in the New Zealand primary care sector.

 

West Coast work

 

Work continues on implementing key elements of the proposed re-design of primary and community health care on the West Coast, as detailed in the region's business case to deliver 'better, sooner, more convenient primary care'

PHOcus on Health has been contracted to provide key staff to the West Coast PHO during this refinement & implementation phase.

 

Interpreters in primary care

 

The three Auckland DHBs are piloting the use of telephone interpreters in general practice and other primary care settings.  This arose from the Auckland Regional Settlement Strategy's Health Action plan.

PHOcus on Health was contracted to evaluate the pilot.  Data has been collected since the pilot's inception in mid 2008, and the evaluation was written and submitted late 2010.  Watch this space for its public release in 2011.

 

Working on the West Coast again

 

PHOcus on Health is again playing a major role with the West Coast PHO. 

The PHO had submitted an "Expression of Interest" (EoI) in providing 'better, sooner, more convenient primary care', in response to the Ministry of Health's (MoH's) call for the same, during 2009.  The PHO was one of nine successful respondents from a field of some 70 plus applicants.

The PHO was then required to develop its "business case".  This document was submitted at the end of Feb 2010, and notification that it had been accepted was received in mid-April.  The PHO has subsequently been working with the West Coast DHB to develop a first year implementation plan.  This in turn was submitted to the MoH late May.

Work continues on implementing key elements of the proposed re-design of primary and community health care on the West Coast.

PHOcus on Health has been contracted to provide Dr Jocelyn Tracey and Anthony Cooke as Clinical Director and Chief Executive of the West Coast PHO during this refinement & implementation phase.

 

Interpreters in primary care

 

 

The three Auckland DHBs are piloting the use of telephone interpreters in general practice and other primary care settings.  This has arisen out of the Auckland Regional Settlement Strategy's Health Action Plan.

PHOcus on Health has been contracted to evaluate the interpreter pilot.  Data has been collected since the pilot's inception back in mid 2008.  The evaluation is currently being written and is due for completion by Dec 2010.  Watch this space for its release.

 

Recent PHO CEOs Forum

 

The most recent South Island PHO CEOs' Forum was held in Christchurch at the Sudima Hotel on Friday 27th Nov 2009.  The Canterbuy and West Coast representatives talked about their successful "Expression of Interest" proposals.  CEOs from South Canterbury, Otago and Southland updated their colleagues on PHO developments in their respective districts.  Carolyn Gullery, General Manager, Planning and Funding, Canterbury DHB, addressed the group on likely future directions in health services delivery and contracting models, given the EoI process.

 

Government decisions re the Horn report

 

The Minister of Health, Hon. Tony Ryall, has announced the first raft of what is likely to be a series of decisions in response to the recommendations of the Ministerial Reference Group (Horn report).

The various cabinet papers associated with this decision can be found on the Beehive website.

 

9 PHOs to be replaced by 1 in the South

  

The Otago and Southland District Health Boards (DHBs) have both decided to issue notice of termination of contract to the nine existing PHOs in their districts, and to set-up a single replacement PHO across both districts.  The DHBs had originally decided to move from nine to two PHOs - one for each district (see press release).  However, this decision has been superceded by a decision to move to a single large PHO across both districts - the board paper that led to this decision is here.

 

Ministry Requests Expressions of Interest


Sainsbury interviews Minister Ryall

 

Did you miss Mark Sainsbury's interview with Health Minister Tony Ryall on Sunday 16th Aug?  Here's a link to the relevant video on the TVNZ website ...

http://tvnz.co.nz/politics-news/government-determined-maximise-health-dollar-2919404/video

 

Ministerial Reference Group (Horn) report released


Changes in the primary care landscape

 

Huge potential changes are afoot in the primary care sector. Here’s a sampler of documents from multiple sources that gives an overview of the kind of things that are up for discussion:

 

PHO CEO Forums

 

PHOcus on Health facilitated two forums for PHO managers, one in Christchurch on 17th June 2009, followed by one in Wellington the next day. 

These fora are all about peer support, shared learning, professional development and networking for the managers of PHOs.

One of the important things managers discussed was the Minister of Health's recent speech to the PHO Alliance - important because this speech was substantially written by the Minister himself, not his officials, so very much reveals the Minister's own thinking and desires.  It's worth some study for that reason alone.

 

Re. "There's something slightly strange in primary health"

 

Is IRD doing a more thorough job of monitoring the not-for-profit status of PHOs than are DHBs?

This is the question one might ask, based on a recent article by Dr Carolyn Cordery, in the Chartered Accountants Journal, February 2009.  Carolyn lectures at Victoria University, Wellington.  The article notes that some PHOs are being made to pay tax, because the PHOs' for-profit owners effectively control them.  We ask, how does this fit with the government's primary health care strategy?

Article posted with permission of the publisher.

 

Next PHO CEO Forums

 

PHOcus on Health's next scheduled forums for PHO managers are as follows:

  • South Island, Wednesday 17th June 2009, and
  • North Island, Friday 19th June 2009.

These forums are all about peer support, shared learning, professional development and networking.

For more information, contact Anthony - you'll find his e-mail address and phone numbers on this page.

 

Turangi Community Health Centre opens

 

In August 2004 PHOcus on Health prepared a feasibility study cum business plan for the Lakes DHB, concerning the establishment of a 'one stop shop' health facility in Turangi, on the southern shores of Lake Taupo.

On 28th Oct 2008, PHOcus on Health had the privilege of attending the official opening of the resulting facililty, the Turangi Community Health Centre.

A 900+ square metre facility, the centre's tenants include a general practice, medical laboratory, Maori health provider (Tuwharetoa Health Services), physio, public health nurses and naturopath.  The centre is the culmination of a lot of significant work by the local Turangi and southern Lake Taupo community and by Lake Taupo PHO and Lakes DHB personnel.  Our congratulations to those who were involved in bringing the project to fruition.

 

Lower Nth Island PHO CEOs' Forum

 

Following a series of successful forums for the CEOs/General Managers of PHOs in the South Island, PHOcus on Health organised & facilitated a similar get-together in the lower North Island, in collaboration with the PHO Alliance.  The purpose was shared learning, peer support and networking.

The forum was held on Tues 21st Oct 2008, at the Miramar Golf Club in Wellington, and CEOs/Managers from fourteen PHOs across the North Island attended.  Partcipants saw value in the forum becoming a regular event.

Topics covered included:

  • PHO-DHB relations, incl.SIA/HP approvals processes, and devolution of services from DHBs to PHOs
  • Improving health outcomes, and doing so equitably
  • V18 of the national PHO contract
  • PHO business & service delivery models
  • Clinical leadership in the PHO context
 

Third South Island PHO CEOs Forum

 

The third in a series of peer support, networking and shared learning forums for the CEOs/General Managers of PHOs located in the South Island was held in Christchurch over the 17-18th Sept 08.

Topics covered included:

  • Register management options
  • Who owns patient information?
  • PHOs and public health (Dr Doone Winnard)
  • DHB-PHO contract V18. What are the important differences from V17?
  • PHOs in five years time
  • South Island PHOs working together & sharing resources
 

Interpreters in primary care

 

 

The three Auckland DHBs are piloting the use of foreign & sign language interpreters in general practices and other primary care settings.  This pilot arose out of the Auckland Regional Settlement Strategy's Health Action Plan.  The pilot focuses on telephone interpreting, but also includes face-to-face service delivery.

PHOcus on Health has been contracted to evaluate the pilot, and the evaluation report is due by the end of 2010.

 

Second South Island PHO CEOs' Forum Jun 08

 

PHOcus on Health recently organised another Forum for PHO CEOs, General Managers and Managers.  Senior managers from sixteen of the eighteen South Island PHOs gathered in Christchurch on Thursday 19th June.

Topics covered included:

  • PHO service delivery models (especially, inhouse vs contracting out)
  • clinical leadership in PHOs - why its important & how to deliver it
  • community pharmacy - an update, and discussion re its potential place in PHOs

Four CEOs presented on particular SIA projects from their PHOs - Hokonui (Gore), Mornington (Dunedin), West Coast and Aoraki (Timaru).

A third forum has been requested - and is likely to be held in September.

 

South Island Forum for PHO CEOs March 2008

The PHOcus on Health team recently had the pleasure of facilitating a day of peer support for PHO CEOs from around the South Island.  Eleven of the eighteen South Island PHOs were represented, and participants explored topics such as:

  • ensuring PHOs focus on improving health outcomes, and improving equity in those outcomes
  • the importance of good PHO-general practice relationships, and how to enhance them
  • the performance management programme
  • after hours issues

There was even the odd moment of extreme hilarity ...

Left to right: Jocelyn Tracey (PHOcus on Health), Barbara Bridger (Mornington PHO, Dunedin), Allie Shaw (Marlborough PHO), Ian Macara (Southland PHOs), Catherine Daly (Well Dunedin), Andrew Dobbs (Nelson Bays), Sandy Baines (Well Dunedin), Andrea Baker (West Coast PHO), Karen Foster (Aoraki PHO, Timaru), Kate Healey (PHOcus on Health). 

Missing: Jane Cartwright (Partnership Health Canterbury) who had to leave early.

 

Kate Healey joins the team

 

Kate Healey joined the PHOcus on Health team in Feb 2008, bringing a breadth and depth of experience in primary care and the health sector more generally. Kate has set up a primary care clinic, been a practice manager, chaired a PHO establishment committee and been on the board of a PHO. Most recently Kate worked for Waitemata DHB, with portfolio responsibility for PHOs and integration. Prior to this involvement in primary care, Kate had been engaged for twenty years in cardiac technology, community services management, and community development work.

Kate says she’s looking forward to using her wide range of skills to assist health providers to achieve positive health outcomes for their populations, and to build strong and respectful relationships within the primary health care sector. 

 

New Team Member

 

Watch this space.  PHOcus on Health has a new team member starting in early Feb 2008.  More detail to follow ...

 

Website relaunch

 

New Year. New website. As you can see we've undergone a major upgrade to our website. All the resources that were available on the old site are now combined on one page here.

 read more ...