WellInformed May 2019 From the Chief Executive As I continue to travel the region, I am impressed with the desire of motivated people in primary care to deliver high quality care and be involved in new and improved models of service delivery. There is no better example than the rollout and implementation of the Health Care Home program in the Southern region which is showing very promising outcomes for practices and patients. Of note: • Three practices (16,475 patients) have opened doctors’ notes to patients. • 1,485 additional patients have been registered on portals in first tranche practices . • 35% of same day appointment requests have been resolved by phone, saving the patient from coming to the practice and giving the practice increased capacity. • Over 4,500 patients have had CLIC comprehensive health assessments. • A practice in Gore has successfully begun multi-disciplinary team meetings on Palliative and Level 3 CLIC patients. One of the key roles of an organisation such as WellSouth is to advocate for primary care and ensure that general practice has access to funding to support their enrolled patients. Primary Options for Acute Care (POAC) is one such example where funding has been found for the extended care that practices are able to undertake to keep their patients out of hospital. We will be working with practices to better understand what other services can be added to the list of POAC pathways. Again thank you to those that have invited me to their place of work. I have really enjoyed the visits and have learnt a lot. Keep the invites coming so I get to better understand how the system here works! Andrew Swanson-Dobbs, CEO [email protected] WellSouth Primary Health Network [email protected] Hauora Matua Ki Te Tonga www.wellsouth.org.nz 1 Contents From the Chief Executive 1 Clinical Updates 3 Alliance South Chair Update 4 IT Helpdesk 5 Advance Care Planning Day: Southerners encouraged to think about what matters to them 6 Certificate of Advanced Dermatoscopy 8 Health Promotion 9 Whakaaro of the week 9 World Smokefree Day 31 May 9 Health Conversation Skills -Southland 11 Workforce Development 12 Upcoming Education and Training Opportunities 12 Winton Wonder Strikes Again 13 Introducing Laura Lagan – Paediatric Educator - Southland 13 South Island Māori and Pasifika women’s experiences of breastfeeding 14 Notices 16 Police Vetting 16 WellSouth Reception Email Changes 16 News Tips 16 Smoking Was Like Breathing 17 Bowel screening resources for Asian residents 18 Chinese community session well-received 18 Updates on Southern HealthPathways 19 New Clinical Editor appointed 19 4 pathways went live in March 19 Pathway Reviews 19 The 10 most frequently viewed pathways for the month of March 19 The 10 most frequently visited pathways not yet localised for the month of March 19 What to look out for 19 Green Prescriptions 20 Update to Primary Care from the NCSP May 2019 21 Teddy Bear Hospital 23 WellSouth Primary Health Network [email protected] Hauora Matua Ki Te Tonga www.wellsouth.org.nz 2 Clinical Updates Clinical Update by Dr Stephen Graham Dear Primary Care Workforce, I’ve been thinking about this a lot. Of course, it isn’t just blind luck. I see the lessons of risk mitigation In rural areas primary care also includes here. Prepare for what you can prepare for. In this emergency and afterhours medical case preparation involves appropriate training and cover. So, over the holiday period, equipment (like immersion suits), and repeated Easter and Anzac Day, rural areas practice for adverse scenarios. This has included are still involved with medical care. practicing escaping from a helicopter in water with In rural areas GPs and nurses often a blind fold on. Don’t assume the worst and take all work with the extended services in actions to remedy the situation. In this case the Search the community. Often ambulance, medical and other and Rescue has been done as professionally and services are effectively part of the same team. promptly as it can be done (I would have expected no less). This all reduces the risk of an adverse outcome. I guess this is good health and safety in action. Really, I’m just putting this background here because I want to talk about the recent helicopter crash on Auckland Island on 22 April 2019. The survival of There will be no families and community deprived of the 3 crew of the Te Anau helicopter team on the valued and loved members. That is the main thing. I Auckland Islands, pilot Andrew Hefford, winchman do suspect that there is a significant effect upon the Lester Stevens and medic John Lambeth appears to crew, teams, families and others despite all that, but have been a miraculous event. As I’m sure most are survivor’s guilt happily is not one of the issues! aware this medivac helicopter crash-landed in water at night in a truly isolated and hostile wilderness. It has The emotional roller coaster associated with something no doubt been a difficult, uncomfortable, frightening like this will affect different people in different ways. event for the crew. It has also been an emotional The “what might have been” ideas are difficult to rollercoaster for all the families, helicopter Search and avoid. For anyone who knew about this before the Rescue, ambulance and medical teams in Te Anau crew were found they will have been through all the (and a lot of the wider population I’m sure). All of this horrible scenarios mentally already. An experience like crew are well known and popular and routinely part of this tends to make some rethink their priorities also. ambulance and wider medical team in Te Anau. Many of the people in these teams know it could just as I know that debriefing and active support of all affected easily have been them in the helicopter. people will have been started and will be ongoing. I personally think right now that counting one’s blessings Overnight and in the morning the scenario looked and celebrating a good outcome are the correct very bleak, a helicopter lost at night over the Southern responses to this incident. This has been a potentially Ocean lost to all contact with wreckage found in the terrible event with a fantastic outcome. How often do water. The truth is few would expect the crew of a you get to celebrate in these circumstances? helicopter ditching in the Southern Ocean to be picked up alive the next day as ultimately happened after the crew extracted themselves from the helicopter in darkness, swam to nearby shore (and Auckland Thanks Island is extremely exposed and steep in most places) and sheltered themselves in what sounds like storm Dr Stephen Graham conditions overnight until help in the form of Search Medical Director WellSouth PHO and Rescue arrived. It really does appear to be a highly unlikely statistical event, which is why the term [email protected] miraculous is being attached to this. WellSouth Primary Health Network [email protected] Hauora Matua Ki Te Tonga www.wellsouth.org.nz 3 Alliance South Chair Update April 2019 At our Alliance Leadership Team meeting this month we considered the progress that has been made in the first year of implementing the Primary and Community Care Strategy across the Southern Health System. The spirit of working collaboratively across WellSouth Primary Health Network and general practices in the district, Southern District Health Board hospital and community based providers is evident. A key area of focus has been on implementing the Health Care Home initiative in the first group of practices, including practices in Gore, Dunedin, Invercargill and in the Central Lakes area. In the first year, practices are focused on establishing and improving processes, and in years two and three they use these improved processes to concentrate on patient outcomes. Some great new processes are in place: 16,718 patients have online access to their consult notes, and over 700 people (and increasing quickly) have benefited from GP and nurse practitioner telephone triage. The feedback from participating practices has been positive, and the sharing of ideas and solutions between practices has been a hallmark of this initiative. The CLIC programme (Client-Led Integrated Care program) is well underway, with 48 general practices using it to support people living with multiple long term conditions to live well. Primary Options in Acute Care has been expanded. The Home Team of nurses, physiotherapists, occupational therapists and rehabilitation assistants working out of Dunedin Hospital has enabled patients to return home earlier and be supported in rehabilitation at home, or not be admitted at all. This service has also recently started in Invercargill. We are finalising the composition of our first Locality Network to be based in Central Lakes. This network will advise the Alliance Leadership Team on the local health needs and priorities of local communities. Early thinking is underway on developing Community Health Hubs across the district, with initial focus on Dunedin. The opportunity to reflect on what we have achieved makes me realise that this is only possible through the effort and goodwill of all of you and your colleagues committing to work together, being gracious when needed and keeping your eye on the goal of improving the health and well-being of people in our communities. Thank you. Best wishes Nga mihi nui As-Salaam Alaikum Dr Carol Atmore [email protected] WellSouth Primary Health Network [email protected] Hauora Matua Ki Te Tonga www.wellsouth.org.nz