DISABILITY SUPPORT ADVISORY COMMITTEE

Agenda

Thursday 21 February 2019 10.00am-12 Noon

Board Room, Level 6 Gardens Block Timaru Hospital Campus

Queen Street, Timaru AGENDA

Meeting: DISABILITY SUPPORT ADVISORY COMMITTEE Date: THURSDAY 21 FEBRUARY 2019 Time: 10.00am-12noon Venue: BOARD ROOM, LEVEL 6, GARDENS BLOCK, TIMARU HOSPITAL

Item Action

KARAKIA

1. APOLOGIES Receive

2. DECLARATIONS OF INTEREST Note Attached

3. CONFIRMATION OF MINUTES OF PREVIOUS MEETING Resolution Attached

4. MATTERS ARISING FROM THE MINUTES Receive Items not covered elsewhere in agenda

5. ACTION LIST Receive Attached

6. INTERAI HOME CARE TOOL Receive Presentation – Kate Lea, Needs Assessor NASC

7. HEALTH OF OLDER PERSONS UPDATE Receive Attached – Lee Cordell-Smith

8. MONITORING REPORTS Receive Attached

9. NEWSLETTERS Receive Disability Support Newsletter Newsletter No. 71 November 2018

10. PUBLIC EXCLUDED RESOLUTION Receive Attached

PUBLIC EXCLUDED

11. ELLOUGHTON GARDENS UPDATE Receive Attached OIA 1982 S. 9 (2) (i) Commercial NZPHD Sch. 3 cl. 32 (a)

12. RESUME PUBLIC SESSION RESOLUTION Receive Attached

INFORMATION Glossary of terms

KARAKIA Disability Support Advisory Committee Member Interest Register 21 February 2019

Board Members

Peter Binns • Elected member South Canterbury , member of DSAC, Community and Public Health Advisory Committee (CPHAC) and MHAC • MB, BChir, FRCS • Retired medical practitioner • Timaru Greypower – Committee Member • Line Trust SC – Trustee

Rene Crawford • Elected member South Canterbury District Health Board, member of CPHAC & DSAC • Employed by SCDHB as Associate Director of Allied Health, Scientific & Technical • Brother employed by SCDHB as a Consultant Orthopaedic Surgeon • Physiotherapy – South Canterbury and Canterbury Branch Member • NZ Physiotherapy Board - Professional Conduct Committee member • Health and Disability Commissioner – Physiotherapy Expert Advisor • Temford Family Trust – Trustee • Board of Trustees Member – Craighead Diocesan School

Terry Kennedy • Elected member South Canterbury District Health Board, Deputy Chairperson of DSAC • Elected Member • Stroke Club – Member

Ronal (Ron) Luxton • Elected member South Canterbury District Health Board, Chairperson of SCDHB, ex officio member of CPHAC, DSAC, HAC, MHAC, Audit & Assurance Committee • Aoraki MRI Charitable Trust – Chair • Justice of the Peace • Green-gables Trust – Trustee • Temuka Lions Club – Member • Ward Family Trust – Trustee • New Zealand Health Partnerships Ltd – Director • South Canterbury Eye Clinic – Director

Edie Moke • Appointed member South Canterbury District Health Board, Chairperson of DSAC, Deputy Chairperson of Māori Health Advisory Committee (MHAC) • West Coast District Health Board – Board member • Nga Taonga Sound and Vision – Elected Member

Mark Rogers • Appointed member South Canterbury District Health Board • Director, International Airport • Chairman, Aoraki Developments & Promotions Ltd • Shareholder & Director, MVHB Holdings Ltd • Director, ourGroupIT Ltd • Treasurer, Kingsdown–Salisbury Hall • Chairman, Advisory Board of Chris Broadhead Construction Group • Committee Member, Institute of Directors – Canterbury Branch • Advisory Board Chairman, Men at Work Group

Disability Support Advisory Committee 21 February 2019 Item 2 - 1

Community Members

Suzanne Harrex • Director of Harrex Properties Holdings Ltd • Director of J A Harrex Mechanical Ltd • Director of Athletic Construction Ltd • Director of Jevol NZ Ltd (non-active) • Member of Timaru Senior Citizens Association Board • Member Experience Group of CBD Group • Member of CBD Society Executive Group • Coordinator of the Friendship Centre of the Senior Citizens Association • Member of Taiko Women’s Institute

Suzanne Hollick • Friend of Dunedin School of Medicine – University of Otago • Volunteer – Sue Harexs Friday Club

John Keenan • Chair/Club Coordinator – Special Olympics South Canterbury • Employee of the NZ Transport Agency • Son enrolled in Water-Based Exercise Programme

Vania Pirini • Member Māori Health Advisory Committee – Te Rūnanga o Arowhenua representative • MHAC representative on Disability Support Advisory Committee (DSAC) • Arowhenua Whānau Services Board – Executive Committee • Mover the Māori Nation Funding Panel – National Te Puni Kokiri Office • Arowhenua Rūnaka Incorporated Society – Chairperson • Pegasus/Burwood City Council Small Funds Committee – Community Board Member • Ngā Hau E Whā Marae National Marae – Community member • Canterbury Earthquake Recovery Authority & TKOPT Canterbury Clinical Network – Member • Ki-O-Rahi National Body / Maori Sports Festival - Secretary • Canterbury Maori & Pacific Health Forum Active Canterbury Network Committee – Board Member

Committee members are reminded that they are responsible for notifying the Committee Chair through the Committee Secretary of any changes in interests, as soon as any changes occur. The disclosure must provide adequate information to enable a determination of the extent of the nature of the interest and to assess actions that may need to be taken to manage any conflicts that arise.

Disability Support Advisory Committee 21 February 2019 Item 2 - 2

MINUTES

MINUTES OF A MEETING OF THE DISABILITY SUPPORT ADVISORY COMMITTEE HELD ON THURSDAY, 29 NOVEMBER 2018 IN THE BOARD ROOM, LEVEL 6, GARDENS BLOCK, TIMARU HOSPITAL AT 9.55AM

PRESENT Ms E Moke (Chair), Board Member, Mr T Kennedy, Board Member, Mr P Binns, Board Member, Mr M Rogers, Board Member, Mr R Luxton, Chair of SCDHB Board, Ms S Hollick, Community Member, Mr J Keenan, Community Member, Ms S Harrex, Community Member, Ms V Pirini, MHAC Representative (apology for lateness).

IN ATTENDANCE Ms R Templeton, Acting Director Primary Health Partnerships and Allied Health, Mr J Power, Director Corporate Service, Mr Nigel Trainor, Chief Executive Officer, Ms Jenny Ryan, Quality and Risk, Ms K Berry, Secretary.

WELCOME – KARAKIA The Chair welcomed everybody to the meeting.

1 APOLOGIES No apologies noted.

2 DECLARATIONS OF INTEREST Mr Mark Rogers advised, he is no longer the Chairman of the Advisory Board of Chris Broadhead Construction Group.

The Declarations of Interest were noted.

3 CONFIRMATION OF MINUTES OF PREVIOUS MEETING The minutes of the meeting held on 30 August 2018 were confirmed as a true and accurate record.

4 MATTERS ARISING There were no matters arising from the minutes dated 30 August 2018.

5 ACTION LIST 1. Provide update on development of audit tool re disabled person’s friendly services (in conjunction with Consumer Council): This has been deferred to the meeting on 29 November 2018 with a presentation to be given at that time. Closed out 29 November 2018.

2. Put any links to newsletters at the end of August on the agenda. To be removed from the action list as this is an ongoing action.

6 AUDIT TOOL – DISABILITY STOCKTAKE RECOMMENDATIONS & ACTIONS The Chair will provide a summary of the Disability Stocktake Recommendations and Actions to the SCDHB Board. A copy of the report to be circulated to the SCDHB Board members.

The Committee received the presentation.

Disability Support Advisory Committee 21 February 2019 Item 3 - 1

7 NATIONAL FUNDING REVIEW OF AGED RELATED RESIDENTIAL CARE Mr Jason Power, Director Corporate Services presented a brief overview on the aged residential care funding review. The current funding model is no longer fit for purpose. Ernst and Young are currently gathering information from the sector. Jason Power will provide an update on the aged residential care funding review in the May 2019 Disability Support Advisory Committee meeting.

The Committee received the presentation.

8 HEALTH OF OLDER PERSONS UPDATE Report were taken as read. Discussion around not having full access to the NASC electronic system which is causing anxiety and stress to the staff. The Committee notes those concerns. An NASC update and the issues the staff are facing will be discussed at the SCDHB Board Meeting on the 7th December 2018.

The Committee received the reports.

9 MONITORING REPORTS Reports were taken as read. (a) ‘Characteristics of older people in the South Canterbury DHB July to September 2018’ and (b) ‘Characteristics of older people in the Region July to September 2018’.

Discussion took place regarding the Number of people out of town – Rest Home Dementia graph. If there were 7 people transferred out of town in September and 4 returned should it not leave 3 out of town when it says 0. Lee Cordell-Smith will clarify this in the February 2019 Disability Support Advisory Committee meeting.

The Committee received the reports.

10 NEWSLETTERS The Disability Support Services e-newsletter No. 70 dated August 2018 was taken as read and received.

CLOSING – KARAKIA There being no General Business matters, the Chair thanked everyone for attending the meeting today. All present participated in a closing karakia.

The meeting closed at 11.55AM

Signed: ...……………………………………………… Date: 21 February 2019

Disability Support Advisory Committee 21 February 2019 Item 3 - 2 DSAC ACTION LIST

21 FEBRUARY 2019

Action Responsible Date Added Due Date Status / Completed 1. Share a copy of the Disability Stocktake Recommendations & Karen Berry 29 November 2018 24 January 2019 Completed Actions with the SCDHB Board members. 2. Provide an update on the National Funding Review of Aged Related Care and the National Home and Community Sector Jason Power 29 November 2018 30 May 2019 Framework.

Disability Support Advisory Committee 21 February 2019 Item 5 - 1 INTERRAI IN NEW ZEALAND

New Zealand has a royalty free licence with interRAI International through the Director- General of Health. interRAI Services is the national provider of services to support interRAI in New Zealand and is a business group within TAS – a health shared services agency. Visit the TAS website at www.tas.health.nz

The Ministry of Health provides annual funding to cover the delivery of four business functions:

• education and support services • reporting and analytics • governance and • software services.

The Ministry of Health holds a contract with Momentum Healthware as the provider of interRAI software in New Zealand and services are provided according to a Service Level Agreement.

A WORLD-FIRST IN NEW ZEALAND

New Zealand is the first country in the world where interRAI assessments are used nationwide in the home and community setting, as well as in aged residential care and the only country where all assessments are conducted in a single software platform.

The vision for interRAI in New Zealand is:

‘To continuously improve health outcomes for New Zealanders as they age, and the effectiveness and efficiency of our health system by guiding and leading the use of interRAI instruments and the dissemination and use of interRAI information.’

Disability Support Advisory Committee 21 February 2019 Item 6 - 1

KEY OBJECTIVES OF INTERRAI NEW ZEALAND

• Consumers are receiving equitable access to and benefits from interRAI assessment regardless of their location in New Zealand • Health outcomes are improved and health inequalities reduced for all those assessed through interRAI • interRAI is effective in its use of funding and resources • Promote the use by Government agencies of interRAI data as evidence in policy development where appropriate • Promote the use of interRAI data and information to shape services and support best outcomes and continued service improvements • interRAI data and information is accessible for research purposes • Access to interRAI data is maximised whilst ensuring the privacy of consumers is safeguarded at all times • New Zealand contributes to the international development of interRAI tools • The interRAI suite is successfully and consistently implemented and supported in all relevant settings in New Zealand.

INTERRAI ASSESSMENTS • The primary purpose of interRAI assessments is to accurately determine the characteristics of a person in order to fully understand their needs, ranging from clinical to social support and prepare a care plan. The information provided by interRAI assessment supports the decisions made by a healthcare professional. • Each assessment has items specific to the assessment, for example, palliative items for the Palliative Care assessment instrument, as well as a set of core items that are shared across assessments. • A person’s responses to the assessment and the outcome measures produced may be tracked over time and across a continuum of care. • The interRAI suite consists of over 20 assessment instruments covering different areas of healthcare. See www.interrai.org

Disability Support Advisory Committee 21 February 2019 Item 6 - 2 ASSESSMENTS CURRENTLY USED IN NEW ZEALAND

• Name of • Description assessment

• interRAI Contact • A basic screening assessment that provides clinical information to Assessment (CA) support decision making about the need and urgency for a comprehensive assessment, support and specialised rehabilitation services. It is used for continuing evaluation of those with non-complex needs living in the community at home.

• interRAI • The Community Health assessment and its accompanying Community Health supplements is a modular approach to comprehensive clinical Assessment (CHA) assessment. • Everyone is assessed using the core assessment, then only those older adults with specific problem areas receive one or more of the additional assessments:

• Functional Supplement: Mental Health • Deaf-Blind and • Assisted Living. • The Community Health assessment together with the functional supplement has all the same items and clinical outcome scales as the Home Care assessment.

• interRAI Home Care • A comprehensive clinical assessment that informs and guides the Assessment (HC) planning of care and services in community-based settings. It focuses on the person’s functioning and quality of life and helps support clinical decision-making when considering aged residential care.

• interRAI Palliative • A comprehensive assessment of the strengths, preferences and Care Assessment needs of community-based older adults where a palliative care (PC) focus is required.

• interRAI Long Term • A comprehensive assessment for evaluating the needs, strengths Care Facilities and preferences of those in aged residential care. The Assessment (LTCF) assessment enables a health care provider to assess key issues that will help with individualised care planning.

• Visit www.interRAI.org for more about available assessments Disability Support Advisory Committee 21 February 2019 Item 6 - 3

Memo To: Disability Support Advisory Committee

From: Lee Cordell-Smith, Portfolio Manager, Community Services

Date: 14.2.2019

Re: Health of Older People Update

Integrated Community Assessment Treatment Team (ICATT) Clinical Coordinator, Tracey Foster commenced her new role in December, orientation and meetings held to update her regarding the implementation of the Single Point of Entry (SPOE)process for Community Services. Implementation plan being created for the collocation of District Nursing Service, Community Allied Health and the Needs Assessment Service, to Talbot Park. Trial of pulling referrals through to the community services from the inpatient areas commenced in Quarter 3 with designated liaison people from the single point of entry team (SPOE) being allocated to the three key wards, AT&R, Surgical and Medical. Recruitment is underway for 0.6 FTE Physiotherapist to assist with the management of referrals and delivery of components of the falls contract. Meetings to be held in quarter three to confirm IT process and documentation to be used to work towards a single patient electronic record. A New Clinical Leader for Occupational Therapy commenced in December whose role will incorporate the triaging of community referrals, on behalf of Allied Health as part of SPOE.

Falls An audit was undertaken identifying the people who had received an interRAI in the first six months of the year that the falls CAP had been activated as high risk of falls. The NASC electronic record was also reviewed to see what interventions had been offered as a result of this notification. 110 assessments were completed and 38 people were identified as at high risk of falls, at 34.5%. Findings indicate inconsistent referral practice across assessors and documentation of treatment recommendations. The auditor had to go to three places to see what had been recommended. There were a number of individuals who had cognitive impairment, or were to be transferred to a facility. Meeting held with NASC Assessors to discuss improvements. NASC to receive update from Sonya Veale regarding the strength and balance programmes she has been delivering to the staff of Home Based Providers, to improve their care planning and the frequency that people are offered appropriate falls interventions. Resources regarding Falls created locally and nationally is to be included in the Assessors orientation package on induction. Encourage Needs Assessors to complete the on line training resource on Falls which is on Healthlearn. New research shows people with dementia would still benefit from exercising if they are able to follow along with the support of their carer, Needs assessors to consider this when exploring options on the care plan.

Approved Exercise Providers A total of 17 exercise providers have been signed off as delivering ACC approved strength and balance classes. This covers providers in both town and rural areas. The aim in quarter three is to promote programme enrolment and to work with the local DHB Communications Manager to advertise the programmes within the communities and GP’s. We are also implementing the single point of entry process in Quarter 3 where all falls referrals will be triaged

Disability Support Advisory Committee 21 February 2019 Item 7 - 1 with daily screening of ED presentations for injuries as a result of a fall which will result in follow-up by the Duty work team to ensure they have received appropriate options in relation to future interventions. Home based providers will be offered further training for their staff on strength and balance exercises in Quarter 3 to promote programmes and ensure consistency of approach across the system.

Advance Care Planning (ACP) See update from the South Island Advance Care Planning Steering Group. Currently we are in the process of localising the ACP HealthPathway which we received in February to accommodate the regional changes. The Electronic ACP Template which is available on HCS will be launched following this. The first national public-facing advance care planning campaign is to be announced on 19 February 2019 in Wellington by Hon. Dr David Clark, Minister of Health. There is a be a national media campaign with a key focus each week of an aspect of ACP leading up to advance care planning day on 5 April 2019. Plans are away to support this campaign within South Canterbury.

Calderdale Framework Three District Nurses have attended the Calderdale Framework Training and embarking on projects to increase skill sharing and delegation. The project includes creation and implementation of the following training packages to to enable the support workers and HCA’s to be competent to carry out bowel care for those people living in the community, deliver non complex wound care and provide the administration of eye drops. This is to allow more time for the RN’s to be able to engage in more complex assessments and an intervention which is required due to the increasing complexity in the ageing population as those are living longer.

ATR Non Acute Rehabilitation Contract This contract was signed this quarter, introducing the community rehabilitation funding option. This option allows for people to be discharged earlier and receive rehabilitation in the home rather than on the AT&R ward. The hope is that this new component will reduce the length of stay of people in hospital and provide better and faster rehabilitation outcomes for those with an injury. Meetings were held with ACC and the provider arm to identify any risks and changes that will be required to the current service delivery model. Further work to occur in this area to embed this process and will be incorporated with the implementation of the Integrated Community Assessment Treatment Team (ICATT)

Bridges Programme Bridges Programme which was piloted in AT&R and is in the process of being evaluated. Two staff are invited to become a trained Bridges Facilitator and have been approved. Training is to take place in March 19. There has been a positive response from staff and patients who have engaged in this process.

Recommendation

That the Committee

• Receives this report.

Disability Support Advisory Committee 21 February 2019 Item 7 - 2 South Island Advance Care Planning Steering Group Update

11 December 2018 DecemberSouth Island2017 ACP Steering Group Meetings 2018 is fast drawing to a close and with a number of items on the agenda for the ACP Steering Group to discuss - we are planning a meeting 28 January 2019. Meanwhile here is an Update – so we keep our threads together. South Island Electronic ACP As soon as the SI ACP HealthPathway is available in each DHB – electronic ACPs will ‘go live’ this should be any day now – an email will be circulated in your DHB. The small virtual team - South Island Regional quality Verification (SIRV) Team are ready to complete the quality review of all newly written electronic ACPs in the South Island.

ACP National Team – Update of Key Activities a.2 May 2019 National Team ACP workshop SI Outline of the agenda (tbc): This is what National ACP Team are thinking at this stage: • Update on national work underway across the five national ACP workstreams • Opportunity to hear from the DHBs in the region (sharing opportunity) • Present the proposed programme for 2020, call for SI/DHB feedback • Work with your region to understand what is working and what is not from a national support and local implementation perspective. • Discuss what SI DHBs still need for successful ACP implementation. • We will use the output from these sessions to inform the review in June 2019 and our national funding request for beyond Dec 2019 (when current joint DHB funding ends). b.ACP DHB train-the-trainer programme – update Clinicians in DHBs around the country are being trained to deliver the ACP one-day L1A workshop. This is termed Train the Trainer (TtT). Forty-one DHB trainers have attended TtT training to date. In order to be accredited, trainees are required to co-facilitate two workshops following their TtT training days. This has been challenging for some DHBs to facilitate, especially if they do not have dedicated FTE to support ACP and ACP training. Train-the- trainer workshops are planned for the third quarters of 2019 in the South Island. Now is the time to start thinking of who your DHB will train and how they will support the TtT to meet their training and delivery requirements to embed their skills post training and gain accreditation. c.The ACP programme’s stance on the End of Life Choices Bill is being finalised and will be shared soon. Link to the bill - https://www.parliament.nz/en/pb/bills-and-laws/bills-proposed-laws/document/BILL_74307/end-of- life-choice-bill d.Māori review of ACP: A summary report has been developed by Anton Blank, Māori communications consultant from Oranui, to share across all ACP networks (report attached to this email) e.ACP Resources - Project Charter draft - to guide the continued development of ACP resources/tools that are integrated and seemless for use by consumers, community and health care workers. This work has resulted from the report in 3d above. We need your feedback – ACP Resources - Project Charter draft will be shared in January 2019 for your critique. f.Digital ACP scoping project: Jim Brown (Health IT specialist) is providing a report to identify what digital platforms exist nationally and recommend ways forward to enable ACP to have nationally consistent IT. Report is overdue. g.National NHI Alert: The national ACP team has asked for an ACP alert to be added to NHI numbers. Submissions have closed and are still under consideration. h.Central resource ordering - Discussions are happening between the Commission and a provider to set up an online stock control and ordering system for ACP resources. Watch this space.

Have a Peaceful Christmas and New Year - Hopefully you have a break. For clarification of any point or item suggestions - contact Jane Large, Facilitator South Island Alliance: [email protected]

Disability Support Advisory Committee 21 February 2019 Item 7 - 3 Māori Resource Review and a Māori Strategy for Advance Care Planning

Anton Blank, Māori communications consultant from Oranui, was commissioned to conduct a review of the Māori resource He Waka Kakarauri developed by Northland DHB to see how it could contribute to a national resource for Māori. Anton provided:

• A literature review of international and local research relevant to Māori ACP (with assistance from Ricki Smith) • A review of the Northland resource He Waka Kakarauri • Interviews with Māori stakeholders • Summary of the above with recommendations for the future

In the study End-of-Life Care and Māori Whānau Resilience some Māori caregivers providing palliative care felt isolated, unsupported and inadequately prepared to deal with the health system, including hospices (Moeke- Maxwwell, Nikora and Te Awekotuku 2014). By contrast, caregivers with engaged support from the extended whānau were more resilient and evidenced the practical application of the Māori values of rangatiratanga, aroha, manaakitanga, kotahitanga, kaitiakitanga and wairuatanga.

He Waka Kakarauri reflects the generic ACP resource by getting whānau to consider the critical ACP issues. It also reflects Māori values and metaphor. The waka is used as a visual device in the resource and represents the journey into the spiritual realm. Dr Mason Durie’s Māori health model Te Whare Tapa Whā provides whānau with a framework for decision making in He Waka Kakarauri. The resource articulates the values described by Moeke-Maxwell.

He Waka Kakarauri is anchored by tikanga Māori. In terms of the Māori diversity continuum described in the literature review, those Māori less engaged with Māori culture may not identify with the metaphor and narrative. Whangarei Base Hospital is littered with health promotion material. Notices boards and hallways are covered in posters and pamphlets. Some of the messaging is very unclear and a range of health promotion campaigns compete for attention.

The Māori ACP Working Group who created He Waka Kakarauri found the korero and process of creating the resource rewarding, but in reality, they use the principles discussed rather than the resource itself in daily work. In summary: • He Waka Kakarauri is philosophically sound and steeped in tikanga Māori; • The resource emerged out of local needs and narratives – it is specific to the area; • Workers are not using the hard-copy pamphlet regularly although the principles are put into practice in each conversation with patients/whānau; • It would not be appropriate or necessary to roll the resource out nationally at this stage • Mobile devices are being used extensively across rural networks, so tools that can be accessed on phone or IPADs can be shared more easily in communities Recommendations: • A generic ACP resource that can be integrated into IT systems and/or mobile devices would be more appropriate for Māori • A co-design process to create a simplified ACP resource will be instigated by the ACP team to incorporate Māori, Pacific and diverse community voices. This will provide a resource that can be easily uploaded to all IT systems and also to be made available on mobile devices. (A co-design action plan will be developed by the team) • A national Māori strategy is recommended across the ACP five-year programme to ensure • Te Ao Māori perspective across the five streams of work in the ACP strategy. (for further discussion).

Contacts:

Anton Blank, Oranui , Writer, www.oranui.co.nz Mobile: 021406031 Clare O’Leary, ACP Promotions Coordinator [email protected] Mobile: 021554529

Disability Support Advisory Committee 21 February 2019 Item 7 - 4

Memo To: Disability Support Advisory Committee

From: Lee Cordell-Smith, Manager, Health of Older Persons and Long Term Conditions

Date: 12 February 2019

Re: Monitoring Reports

COMPARISON OF THE CHARACTERISTICS OF OLDER PEOPLE WITHIN THE SOUTH ISLAND AND SCDHB

The attached document shows data under the following headings:

• Number of people out of town – Rest Home Data • Number of people out of town – Hospital Level Dementia (D6) • Number of people receiving Home Based Support Services • Number of Respite Care Bed Days • Primary Care accessing Cognitive Impairment Pathway • Expenditure per Month • Number of People Supported in the Community with Dementia

Explanations are provided beside each of these graphs. I am happy to answer any queries relating to these.

Recommendation

That the Disability Support Advisory Committee: • Receives these reports

Disability Support Advisory Committee 21 February 2019 Item 8 - 1

Number of people out of town- Rest Home Dementia

10 Comment 9 People requiring Dementia Resthome Level of Care that have transferring out of area due to unavailability of D3 beds locally or due 8 7 7 7 to needing to be near family has occurred again this quarter. Currently two people out of area wish to return to Timaru, there are 6 two patients in the community with families choosing for them to 5 remain at home until a place becomes available in SCDHB. One of 4 3 whom have requested a specific facility. The longest has been waiting st 3 2 2 2 since 21 of December 18. 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Occupancy Resthome Dementia Units across SCDHB: 0 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 2017/18 2017/18 2017/18 2017/18 2018/19 2018/19 Q1 Q2 Q3 Q4 Q1 Q2 90% 100% 100% 93% 96 NA

Out of Town Returned during Month

Number of people out of town - Hospital Level Dementia (D6) 10 9 Comment Occupancy level for Talbot Park with 25 beds available. 8

7 2017/18 2017/18 2017/18 2017/18 2018/19 2018/19 6 Q1 Q2 Q3 Q4 Q1 Q2 5 88% 84% 92% 0% 76 81 4 3 Talbot is currently occupied with 21 people residing in the facility. 2 1 1 In the event that more people require this level of care the challenge 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 for the DHB is to obtain staffing to increase beds beyond 21. We 0 would require an HCA for (4 hours in the am and 4 hours in the pm)

Out of Town Returned during Month

Disability Support Advisory Committee 21 February 2019 Item 8 - 2 Number of people receiving Home Based Support Servcies

1400 Comment

1200 There is an increasing trend when comparing previous quarters in the numbers of non complex patients. 1000

755 752 749 749 758 751 740 743 751 Average numbers per quarter complex 721 730 740 742 800 Quarter 2017/18 2017/18 2018/19 2018/19 600 Q3 Q4 Q1 Q2 Complex 495 506 507 519 400 Non 730 752 753 742 complex 489 497 500 505 504 508 511 501 509 501 523 532 521 200

0 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19

Non Complex Complex

Number of Respite Care Bed Days

290 Comment 4 270 Continual fluctuation in the use of respite this past quarter which is 250 42 230 based on client demand. In January families often go on holiday 210 34 hence the increase in the number of rest home bed days. We are in 190 11 the process of remarketing the use of Respite and designing a 170 0 0 0 24 5 0 150 42 35 0 0 40 leaflet to ensure that people and their carers are aware of how to 49 36 34 130 26 27 25 access and their roles and responsibilities in terms of organising 28 0 21 33 110 10 22 14 15 201 18 19 0 medication, special equipment etc In recognition of the increase in 90 15 21 21 161 70 14 111 demand for dementia respite rest home beds we have agreed to 50 101 100 102 101 99 106 98 68 77 80 increase the funding of the bed days to 365 per year. 30 10 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19

Emergency Respite Hospital Rest Home Dementia Rest Home

Disability Support Advisory Committee 21 February 2019 Item 8 - 3 Primary Care accessing Cognitive Impairment Pathway

60 Comment Dr Mathew Croucher is visiting South Island DHBs this year to 50 discuss ways to improve local dementia services and help integrate ‘Dementia is Everybody’s Business’ – a shared South 40 Island model of care guide. He is in Timaru on the 18th of 30 February 2019 to meet key stakeholder groups, DHB planning and funding, aged residential care and PHOs – anyone who is 20 interested in how services for people with dementia can be improved. . He is particularly wishing to focus on early 10 diagnosis and primary care. 0 “Part of my leadership brief is to share good ideas from other DHBs that might work for them locally, and to encourage consistency across the South Island by supporting person- Primary Care accessing Cognitive Impairment Pathway centred care and helping them to work more in line with the

shared model of care for dementia document.” Expenditure per Month

1,000,000 Comment 900,000 Increase in home based support is due to a timing issue with Pay 800,000 Equity and is offset by the additional revenue received by the 700,000 Ministry of Health in January which is not shown on this graph. Overall we are under on the resthome budget which offsets the 600,000 overspend in Home Based which means we are keeping people in 500,000 their homes rather than in residential care. 400,000

300,000 YTS there is however a 181K overspend in Homebased which 200,000 equates to 1% of the overall budget in DSS Cost Centre. An audit is 100,000 being undertaken on the allocation of household management for - those that is less than 2 hours to identify need and reason for Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 allocation.

Hospital Level Rest Home Home Based Support

Disability Support Advisory Committee 21 February 2019 Item 8 - 4 Number of people support in the community with Dementia

Comment 100 Slight increase in the number of people diagnosed with dementia 90 being supported in the community with complex needs when 80 31 compared to Q 1. 70 28 29 0 0 0 60 21 Meeting to be held with PSS regarding community first to look at 18 50 14 15 how we can market this service more as this service is not being 15 14 14 40 used to its full capacity. 65 65 65 62 30 57 58 46 44 45 20 40 41 39 43 10 0 Jul-18 Jan-18 Jan-19 Jun-18 Oct-18 Apr-18 Feb-18 Sep-18 Dec-18 Aug-18 Nov-18 Mar-18 May-18 High and Complex Complex

Disability Support Advisory Committee 21 February 2019 Item 8 - 5 Disability Support Services e-newsletter

No. 71 November 2018 ISSN 2253-1386

From Mathew Parr Contents Acting Deputy Page 2 Director-General, Disability Ministry of Kia ora Health new I have been acting in Toni’s role for a couple structure of months now, and in this short time I continue to be blown away by the amazing work done on a daily basis to Enabling Good make a positive difference in the lives of individuals and families across the disability sector. Lives 2

Here at the Ministry we have been implementing the new structure, Page 4 which includes raising the profile of disability to the Ministry of Health Executive Team. The new Disability Directorate provides an exciting Mana Whaikaha4 opportunity to make a greater difference for disabled people across Page 5 our Health and Disability System. The new Directorate comprises all disability-related services, including Disability Support Services, DSS updates 5 System Transformation, Disability Policy, contracting and procurement support. Page 6

We’ve been celebrating the success of the new system launched News from our on 1 October in MidCentral District Health Board, with excellent providers7 uptake in people accessing connectors. We’re also looking forward to implementing I Choose, the replacement for the Carer Support Subsidy 9 in the new year.

On 27 September, the Government announced its intention to make changes to the Funded Family Care (FFC) policy and legislation, which has been in place since 2013, and is considering options and timing for these changes. The Disability policy team will be coordinating the development of these options and advice for the Government, including targeted stakeholder engagement. Issues being considered include eligibility, pay rates for carers, the employment relationship, and the type of care covered.

Disability Support Advisory Committee 21 February 2019 Item 9 - 1 Ministry of Health new structure

On 1 October 2018 Director-General of Health, Dr , outlined his changes to the Ministry’s second-tier structure. This followed a three-week consultation period with Ministry staff.

The Ministry needs to deliver on its core functions, its sector leadership and stewardship roles, and on the Government’s priorities for health care, disability support, health improvement and equity.

The new structure, along with the changes to the way the Ministry works, will provide a clearer focus on the key areas that require Ministry leadership and improve the oversight and leadership of Ministry corporate functions.

Both the structure and the operating model will ensure that the Ministry’s work programme is well led and governed.

The new structure came into effect from 15 October 2018. For more details and a copy of the organisation chart please see: health.govt.nz/about-ministry/leadership- ministry/executive-leadership-team/changes-ministrys-second-tier- structureNABLING GOOD LIVES

Enabling Good Lives

Christchurch

Hannah Perry, Enabling Good Lives Lead, Ministry of Health

Kia ora koutou

It is already Term Four and students in Christchurch are preparing to leave school with plans in place to study, travel, work, move out of home, gain skills, maintain social lives, get fit and have fun!

Some of the key messages we hear about young people developing and living their good life have been around thinking differently about how they do things, how funding is used and how support is considered. Being creative about respite is one example of how the Enabling Good Lives (EGL) approach can result in person centred supports and better lives.

Young people and their families often don’t use the word respite but they do talk about the importance of having a break from each other. For some families this means having someone to hang out at home with the young person while family members go away for the weekend, or perhaps the young person going on a camping trip with their mates and some supporters. A number of different providers have started to offer fun, youth-led, creative opportunities for young people, which means that families don’t have to do all of the organising and coordinating for the young person to have a weekend (or a week!) away.

Disability Support Advisory Committee 21 February 2019 Item 9 - 2 DSS e-newsletter 2 November 2018 People continue to enjoy the flexibility of their EGL personal budgets, and purchasing technology has made it much easier for young people to live the lives they wish to. For some people, having access to the right device and equipment has reduced their need for a paid support worker; one young person is catching the bus by themselves (with the support of the bus driver and a GPS enabled phone), another school leaver is learning to go to the local gym alone, assisted by some sessions with a personal trainer, as well as photographs of themselves using the exercise equipment safely.

Being able to choose who supports the young person, and what they do together can mean a better life for the whole Using his EGL personal budget to buy a tandem family. For example, having a swimming buddy, a fellow bike, means that Sam and his family can enjoy each other’s company while doing something muso, sports fan, job coach or a mentor who is the same they all enjoy. age and gender as the young person can be mana enhancing for all involved and helps the young person to build relationships with the wider community. One young person is working at the local early childhood centre that she attended as a child! She currently has a support worker to assist her, but their aim is to do themselves out of a job, to intentionally connect the young woman with her colleagues, and for her to develop the skills she needs to work with the children and the staff each day.

Two of our EGL independent facilitator contractors have secured full-time employment. While we are sorry to farewell them from our team, we are thrilled that they will take the EGL approach to supporting disabled persons to live great lives, into their new workplaces. Over the next few months we will be advertising for more EGL independent facilitator contractors, and look forward to starting 2019 with a full team that reflects the diversity of the young people and families that we are working with.

Ka kite anō.

Waikato

Kate Cosgriff, Director, Enabling Good Lives Waikato

There are currently 393 disabled people, families and whānau participating in Enabling Good Lives (EGL) Waikato, 32 percent of whom are Māori and 35 percent aged under 15 years.

We continue to see people achieving great outcomes. Now in our third year, the work has become more in-depth with some participants, and the team are also enjoying getting to know the 70 disabled people and families who have recently joined.

Many families and young disabled people are choosing to employ mentors, rather than support workers, as part of their plan. In the current system this is rarely an option. By recruiting mentors there is a totally different focus to the relationship and the purpose of the time together. A critical feature is the match between the child or young person and their mentor. Over time, EGL is seeing remarkable outcomes from this small regular investment in mentoring.

Disability Support Advisory Committee 21 February 2019 Item 9 - 3 DSS e-newsletter 3 November 2018 The decision to close the Waikato waiting list has been difficult for some of the local community, especially those who continue to seek our assistance. The team is doing their best to manage this and, over the next 18 months, hope to engage with many of the 120 disabled people, families and whānau who have been waiting for 6–12 months.

The Māori Tūhono had several hui with Louise Were, who helped them describe their approach to working with whānau. The report, Exploring the practice and support of Tūhono Māori, covers tikanga or principles of practice as Tūhono Māori, outlines what things support success and describes some of the challenges that impact the success of Tūhono Māori.

EGL Waikato continues to contribute to system transformation work by sharing information, resources and experiences. It was good to recently spend a day with the new teams in , sharing experiences and learnings. It will be exciting to watch the development of the prototype in action.

Mana Whaikaha

Sacha O’Dea, Programme Lead, Ministry of Health

After 18 months of hard work by many people, the prototype of the new disability support system, Mana Whaikaha, is now underway in MidCentral.

It was launched on 1 October, with close to 200 disabled people, whānau, providers, officials and Mana Whaikaha staff marking its opening. It was humbling to be at the launch with so many people determined to make a difference. The director of the Kaitūhono/Connector team, Lorna Sullivan, says there was a ‘deep sense of investment and ownership by disabled people and whānau in the new system and this must be honoured in all aspects of our work’.

By the end of the first week, there were 175 disabled people and whānau who were wanting to work with connectors. Connectors will walk alongside disabled people and whānau to help them identify what they want in their lives, and the range of supports available to live that life.

One of the first people Mana Whaikaha had the opportunity of working with has, with the assistance of her connector, made big changes and moved out of a rest home into her own unit with the supports she needs. To successfully achieve a move of this type in such a short time tested the way the system would work. All those involved, such as the service provider, the government agencies and the wider community, came together to make this move happen. The rest home provided encouragement and support for the move, while individual staff gifted household items to ensure the house was homely and welcoming. A member of the Lions Club used his business to shift the furniture at no cost, while officials worked together with the Ministry of Social Development, enabling Mana Whaikaha to work flexibly to set up everything in a short time.

Lorna says, ‘when members of the community so generously step up to support in this way, we can be confident that good lives for people will be achieved. This is such a wonderful demonstration that a good life is not just about services but about belonging and being accepted by people in the community’.

Even small changes can make a real difference in people’s lives. For example, one family that has struggled to have a break for some time, has caring, extended family members who are happy to

Disability Support Advisory Committee 21 February 2019 Item 9 - 4 DSS e-newsletter 4 November 2018 help out but who need to cover their travel costs. They now have petrol vouchers to recompense those costs and can provide that break. Another man wants to join his local petanque club, which will cost $6 a week, and for that he will have membership, exercise, companionship, and friendship with others of like interest, a socially-valued role in his community, and be able to pursue his interest.

In the first month of the teams’ work, the focus has been on enabling disabled people and whānau to access the system and to begin supporting people to ‘imagine better’ for their lives, but we are also focused on system transformation. This means changing the way systems and services work cooperatively to advance the wellbeing of disabled people.

A relationship is being built with the local hospital’s ‘Star’ ward, so that people who have strokes can begin to engage with a connector very early in their recovery period. This means the services and supports they need will be in place so they can regain their independence as quickly as possible. Work has also begun on building a provider alliance to ensure people will have a choice of provider, but also to have providers working cooperatively to address gaps in services for people living with the impact of strokes across the region.

There are now more than 300 people who have asked to work with a connector and this is beginning to stretch the capacity of the team. This is a prototype, with a ‘try, learn and adjust’ approach, and we are continuing to take in these requests while balancing them with ensuring connectors have time to do the work required to achieve the changes we are seeking.

DSS updates Funded Family Care

Christine Petch, Contract Relationship Manager, Ministry of Health

On 27 September, the Government announced its intention to change the Funded Family Care (FFC) policy and legislation, which has been in place since 2013.

This includes the intent to repeal Part 4A of the New Zealand Public Health and Disability Act 2000.

We have undertaken targeted stakeholder engagement to inform and support change and Government decision-making, including an online survey that attracted over 900 responses.

The Government will be considering first phase options for change and the timing of changes later this year. Engagement will continue into December and further opportunities will be explored in 2019. Issues being considered include eligibility, pay rates for carers, the employment relationship, and the type of care covered, and how the policy can best work for Māori and Pacific peoples and wider communities.

Disability Support Advisory Committee 21 February 2019 Item 9 - 5 DSS e-newsletter 5 November 2018 Transforming respite

Deborah Mills, Development Manager, Ministry of Health I Choose Māku e Kōwhiri Flexible respite budgets have been branded as I Choose and will replace the Carer Support Subsidy.

During 2019, most of the 19,000 people who receive Carer Support will move to I Choose at the time of their annual review or reassessment.

I Choose will make it easier for carers to have a break from their caring responsibilities. Disabled people and their whānau will have access to funding that they can use to buy the respite supports and services that suit them best.

More information is available on the Ministry’s website www.health.govt.nz/ichoose

News from our providers

Geneva Healthcare – Dancing with Our Stars Spring Ball

This year’s Dancing With Our Stars themed Ball was the biggest yet, as hundreds of persons with disabilities from all over New Zealand became the dancing stars in a crowd of over 300 at Eden Park, .

It was a night of glitz and glamour as Dancing With The Stars celebrity contestant, , and Miss International Oceania, Michelle Isemonger, officially opened the event after a karakia and opening ceremony by the members of the Ngāti Whātua Orākei and a welcome speech by Associate Minister for Social Development, Hon Peeni Henare.

‘I really would have brought down the tone of the event with my inability to dance with any glamour or coordination’, Prime Minister joked in her surprise video message on the big screens, as wide-eyed guests listened in awe.

‘The Geneva Spring Ball is a real opportunity to bring people together to create an inclusive environment’, says Hon Carmel Sepuloni, Minister for Social

Disability Support Advisory Committee 21 February 2019 Item 9 - 6 DSS e-newsletter 6 November 2018 Development and Disability Issues. And while Hon jokingly warned everyone about not stepping on anybody’s toes as they dance, Suzy Cato got the crowd singing along to her classic song, ‘It’s Our Time’.

The event was a celebration of life and hope and great partnership between Geneva and the other organisations who worked together to make it possible – Cerebral Palsy Society of New Zealand, BNZ, SecureCom, Ray White, Cactus Lab, Trademe, Fashion Uniforms and PB Tech.

Contact Disability Support Services Email: [email protected] Phone: 0800 DSD MOH (0800 373 664)

Web: www.health.govt.nz/disability

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Disability Support Advisory Committee 21 February 2019 Item 9 - 7 DSS e-newsletter 7 November 2018 RESOLUTION EXCLUDING PUBLIC

The Committee resolves that in accordance with the provisions of clause 32 of the 3rd schedule of the New Zealand Public Health and Disability Act 2000 (“the Act”) that the public be excluded from the following part of this meeting in order that the Committee may consider:

1. Elloughton Gardens Update is that the public conduct of this part of the meeting would be likely to result in the disclosure of information for which good reason for withholding exists under the Official Information Act 1982, being -

(a) Information that would enable the Committee to carry out, without prejudice or disadvantage, commercial activities (S. 9 (2) (i) Official Information Act 1982)

The reason for passing this resolution in relation to

a) Elloughton Gardens Update is that the public conduct of this part of the meeting would be likely to result in the disclosure of:

(a) Information that relates to the privacy of natural persons (S. 9 (2) (a) Official Information Act 1982)

Disability Support Advisory Committee 21 February 2019 Item 10 RESOLUTION TO RESUME OPEN MEETING

The Committee resolves to resume in open meeting and actions taken with the public excluded are confirmed by the Committee.

Disability Support Advisory Committee 21 February 2019 Item 12 Glossary of Terms

Ask about and document every person’s smoking status, give brief advice to stop every person who ABC smokes, and strongly encourage every person who smokes to use cessation support (a combination of behavioral support and stop-smoking medicine works best) and offer to help them access it. ABCD2 TIA assessment – age, blood pressure, clinical symptoms, diabetes and duration. ACC Accident Compensation Corporation ACP Advance Care Planning ACPP Accelerated Chest Pain Pathway ACS Acute Coronary Syndrome ADOM Alcohol and Drug Outcome Measure Aoraki HealthPathways. Pathways, for the care and management of patients within South Canterbury AHP that have been developed jointly by primary and secondary care clinicians. Ajexus Mental Health Information System Software ALOS Average Length of Stay A web-based system to support clinical quality improvement in secondary care cardiology practice and to ANZACS - QI better understand the relevant population health profile within regions and nationally. AOD Alcohol and Other Drug ARRC Age Related Residential Care The Atlas of Healthcare Variation displays easy-to-use maps, graphs, tables and commentaries that ATLAS highlight variations by geographic area in the provision and use of specific health services and health outcomes. ATR Assessment, Treatment & Rehabilitation Services AWS Arowhenua Whānau Services BadgerNet Specialist perinatal management software BFAG Breast Feeding Action Group Calderdale Framework Framework to enable the sharing of skills between healthcare professions. CAPA Choice And Partnership Approach CAPEX Capital Expenditure A national method of measuring dissimilar outputs in a common way. E.g. a hip replacement is 4.008 Caseweight case weights and an appendix removal is 1.044 case weights. I.e. a hip replacement is considered to use about four times the resources (or cost) than an appendectomy. CCDM Care Capacity Demand Management CCP Contribution to Cost Pressure CDHB Canterbury District Health Board CMO Chief Medical Officer CNC Cancer Nurse Coordinator CNM Charge Nurse Manager CNS Clinical Nurse Specialist CPAC Clinical Prioritisation Assessment Criteria CPH Community & Public Health CPHAC Community & Public Health Advisory Committee A generic term for a diverse range of entities within one of the five categories referred to in section 7(1) of the Crown Entities Act 2004, namely: statutory entities, companies, Crown entity Crown Entity subsidiaries, school boards of trustees, and tertiary education institutions. Crown entities are legally separate from the Crown and operate at arm’s length from the responsible or shareholding Minister(s); they are included in the annual financial statements of the Government. CSNZ Cancer Society New Zealand CT Computed Tomography CVD Cardiovascular Disease CWD Cost Weighted Discharge DBI Drug Burden Index DHB District Health Board DMFT Decayed, Missing, Filled Teeth DMO Debt Management Office DNA Did Not Attend 1 DPNM Director Patient, Nursing & Midwifery Services Dr Info is an electronic software programme which pulls and collates information allowing general Dr Info practice access at the point of service to real-time health information from a number of data sources. DSAC Disability Support Advisory Committee DSS Disability Support Services DXA A scan which measures bone density and is typically used to diagnose and monitor osteoporosis. ECAN Environment Canterbury ECG Electrocardiogram ED Emergency Department eMR Electronic Medicines Reconciliation An intensive 12 week programme to assist either newly diagnosed Type 2 diabetics, Type 2 diabetics starting on insulin therapy and patients who have not attended their Diabetes Annual Review and are Encounter Programme considered at high risk of complications from diabetes due to poor metabolic control, to better self- manage lifestyle and medication requirements and to allow for a better quality of life and improved metabolic control. ENT Ear, Nose and Throat ePA ePrescribing and Administration ePM ePharmacy EPOA Enduring Power of Attorney ERAS Early Recovery After Surgery ESPI Elective Services Patient Flow Indicator eSURV Electronic Shared Care Record View ERMS Electronic Referral Management System FAST Sudden signs of stroke – face dropping, arm weakness, speech difficulty – time to call 111. FCT Faster Cancer Treatment FIM Functional Interdependence Measure FSA First Specialist Assessment FST Financial Sustainable Threshold FTE Full Time Equivalent, e.g., two people each working 20 hours per week = 1 FTE. FVIP Family Violence Intervention Programme The part of the DHB that funds (purchases) services from providers of health services, including the DHB’s Funder Arm own Provider Arm. GP General Practitioner GST Goods and Services Tax HAC Hospital Advisory Committee HAI Hospital Acquired Infection HBSS Home Based Support Services HCS Health Connect South Home, Education & employment, Eating, Activities with peers, Drugs, Sexual activity, Suicide & HEEADSSS Depression, Safety. HOP Health of Older Persons HPV Human Papilloma Virus HQSC Health Quality & Safety Commission HR Human Resources HRMIS Human Resource Management Information System HWNZ Health Workforce New Zealand ICAMHS Infant, Child and Adolescent Mental Health Services ICATT Integrated Community Assessment Treatment Team IDF Inter-District Flows. Patients who live in one district receiving services in another district. Impact measures are attributed to agency (DHBs) outputs in a credible way. Impact measures represent near-term results expected from the goods and services you deliver; can often be measured soon after Impact measures delivery, promoting timely decisions; and may reveal specific ways in which managers can remedy performance shortfalls. A framework for describing the relationships between resources, activities and results. It provides a Intervention logic model common approach for integrating planning, implementation, evaluation and reporting. Intervention logic also focuses on being accountable for what matters – impacts and outcomes. 2 InterRAI Clinical assessment tool used in Older Persons Care. ISSP Information Systems Strategic Plan IS Information Services IT Information Technology KPI Key Performance Indicator “Living within our Providing the expected level of outputs within a break even budget or National Health Board (NHB) means” agreed deficit step toward break even by a specific time. LMC Lead Maternity Carer LOS Length of Stay LTC Long Term Condition Multi Condition Rehab. A 6 week long, twice weekly, rehabilitation programme for people with long MCR term conditions such as diabetes, heart and respiratory conditions. The focus of the programme is to teach people how to manage their conditions better themselves. MDMs Multi-Disciplinary Meetings MHAC Māori Health Advisory Committee MOH Ministry of Health MOSAIQ is a complete patient information management system that centralizes radiation oncology, MOSAIQ particle therapy and medical oncology patient data into a single user interface, accessible by multi- disciplinary teams across multiple locations. MOU Memorandum of Understanding MRI Magnetic Resonance Imaging NASC Needs Assessment Service Coordination NCCP National Costing Collection and Pricing Programme NGO Non-Government Organisation NIR National Immunisation Register NPWT Negative Pressure Wound Therapy NZD New Zealand Dollar NZDep New Zealand Index of Deprivation NZGAAP New Zealand Generally Accepted Accounting Practice NZIFRS New Zealand International Financial Reporting Standards NZULM New Zealand Universal List of Medicines Outcomes are the impacts on or the consequences for, the community of the outputs or activities of government. In common usage, however, the term 'outcomes' is often used more generally to mean results, regardless of whether they are produced by government action or other means. An intermediate outcome is expected to lead to an end outcome, but, in itself, is not the desired result. An end outcome is Outcome the final result desired from delivering outputs. An output may have more than one end outcome; or several outputs may contribute to a single end outcome. A state or condition of society, the economy or the environment and includes a change in that state or condition. (Public Finance Act 1989). An aggregation of outputs, or groups of similar outputs. (Public Finance Act 1989) Output classes Outputs can be grouped if they are of a similar nature. The output classes selected in your non-financial measures must also be reflected in your financial measures (s 142 (2) (b) Crown Entities Act 2004). PACS Picture Archiving and Communication System. PAS Patient Administration System PBFF Population Based Funding Formula PCI Percutaneous Coronary Intervention PCS Primary & Community Services Plan, Study, Do, Act. Using PDSA cycles enables you to test out changes before wholesale PDSA implementation and gives stakeholders the opportunity to see if the proposed change will work. Selected measures must align with the DHBs Regional Service Plan and Annual Plan. Four or five key outcomes with associated outputs for non-financial forecast service performance are considered Performance measure adequate. Appropriate measures should be selected and should consider quality, quantity, effectiveness and timeliness. PHNS Public Health Nursing Service PHO Primary Health Organisation PPIG Primary Physiotherapy Intervention Group. PPP Primary Performance Programme 3 PPS Palliative Patient Score PRIME Primary Response in Medical Emergencies (Pronounced ‘primed’) is a Ministry of Health single national mental health and addiction information PRIMHD collection of service activity and outcomes data for health consumers. Priorities Statements of medium term policy priorities. Quality Accounts A Quality Account is a report about the quality of services delivered by a healthcare provider. QIP Quality Improvement Programme Regional collaboration refers to DHBs across geographical ‘regions’ for the purposes of planning and Regional collaboration delivering services (clinical and non-clinical) together. Four regions exist. SCDHB is part of the Southern Region. Sometimes used as a synonym for 'Outcomes'; sometimes to denote the degree to which an organisation Results successfully delivers its outputs; and sometimes with both meanings at once. Ring-fence Can be used for the designated purpose only. RMO Registered Medical Officer RMS Orion Health’s Referral Management System SAC Severity Assessment Code SCDHB South Canterbury District Health Board SCN Southern Cancer Network Second level health services to which the public need referral, e.g., hospital-based services except for Secondary emergency services. SI South Island SIA South Island Alliance SIAPO South Island Alliance Programme Office SICCIS South Island Cancer Coordination Information System SIISSLA South Island Information Service, Service Level Alliance SIHSP South Island Health Service Plan SIRTH South Island Regional Training Hub SIWDH South Island Workforce Development Hub SLT Strategic Leadership Team SMO Senior Medical Officer SS Secondary Services SSCL Surgical Safety Check List SUDI Sudden Unexpected Death of an Infant Strengths Recovery A strengths approach is a specific method of working with and resolving the problems experienced by a Approach person presenting to mental health services. Strength, Wellbeing, Independence and Movement. This is a subsidised swimming programme for clients SWIM who have a long term health or disability condition(s), would benefit from water therapy and land based exercise/activity options have been explored and are not suitable. TIA Transient Ischaemic Attack TOR Terms of Reference The collectively shared principles that guide judgment about what is good and proper. The standards of integrity and conduct expected of public sector officials in concrete situations are often derived from a Values nation's core values which, in turn, tend to be drawn from social norms, democratic principles and professional ethos. The assessment of benefits relative to cost, in determining whether specific current or future Value for money investments/expenditures are the best use of available resource. WIAS Walking in Another’s Shoes – Dementia Education Programme. WAVE Wellbeing and Vitality in Education: SCDHB’s Intersectoral Child and Youth Health Project. WCTO Well Child Tamariki Ora WET Water-based Exercise Therapy WHO World Health Organisation YOT Youth Offending Team

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