bay of plenty district health board 2016 … · 2 bay of plenty district health board contents...

A ANNUAL PLAN 2016/17www.bopdhb.govt.nz

2016 -17ANNUAL PLAN

BAY OF PLENTY DISTRICT HEALTH BOARD

E79

Incorporating the Statement of Intent and Statement of Performance Expectations

221,000Serves a population of

are under 25 years of age32.4%

25%identify as having

Māori ethnicity

are aged 65 or over18%

2,533 Babies delivered in hospital

facilities

people who smoke have been seen by a

GP and provided with advice to quit smoking

21,841 3.4 mil

lion

Bay of plentydistrict health board

in the life of the

A year

community pharmacy prescriptions

944,995hours of home support

services for over 65s

73,623attendances at the

Emergency Departments

with health care providers for health services to the Bay of Plenty community

laboratory tests have been undertaken

1,325,307community

district nurse visits

86,898

School dental services to an enrolled population of

38,545

of people are seen within 21 days for alcohol and drug services80%

enrolled in the Well Child Tamariki Ora service

6,905 CHILDREN

413 Contracts

I BAY OF PLENTY DISTRICT HEALTH BOARD

II ANNUAL PLAN 2016/17

III BAY OF PLENTY DISTRICT HEALTH BOARD

1 ANNUAL PLAN 2016/17

2016 -17ANNUAL PLAN

BAY OF PLENTY DISTRICT HEALTH BOARD

Published 16 September 2016 by theBay of Plenty District Health Board

P O Box 12024, Tauranga, 3143

ISSN: 2230-4371 (Print)ISSN: 2230-438X (Online)

This document is available on the Bay of Plenty District Health Board website:

www.bopdhb.govt.nz

Crown copyright ©. This copyright work is licensed under the Creative Commons Attribution 4.0 International licence. In essence, you are free to copy, distribute and adapt the work, as long as you attribute the work to the New Zealand Government and abide by the other licence terms. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Please note that neither the New Zealand Government emblem nor the New Zealand Government logo may be used in any way which infringes any provision of the Flags, Emblems, and Names Protection Act 1981 or would infringe such provision if the relevant use occurred within New Zealand. Attribution to the New Zealand Government should be in written form and not by reproduction of any emblem or the New Zealand Government logo.

2 BAY OF PLENTY DISTRICT HEALTH BOARD

Contents

Module One: Introduction and Strategic Intentions 4

1.1 Message from the Chair of the Bay of Plenty District Health Board 4

1.2 Message from the Chair of Te Rūnanga Hauora Māori ō Te Moana ā Toi 6

1.3 Message from the Chief Executive Officer 8

1.4 Executive Summary 9

1.5 Signatory Page 12

1.6 Context 13

1.7 Strategic Intentions 17

Module 2A: Implementation of the New Zealand Health Strategy 27

2A.1 Context 27

2A.2 Themes from the New Zealand Health Strategy 29

Module 2B: Delivering on Priorities and Targets 31

2B.1 Priorities and Targets 31

2B.1.1 Implementing Government Priorities 31

2B.1.2 Integrated Healthcare 33

2B.1.3 Child and Youth Health 44

2B.1.4 Long Term Conditions – Prevention, Identification and Management 70

2B.1.6 Living Within Our Means 107

2B.1.7 Other 108

Module Three: Statement of Performance Expectations 117

3.1 Statement of Performance Expectations (SPE) 117

3.2 Healthy Individuals – Mauri Ora 120

3.3 Healthy Families – Whānau Ora 123

3.4 Healthy Environments – Wai Ora 127

3 ANNUAL PLAN 2016/17

Module Four: Financial Performance 133

4.1 Financial Performance 133

4.2 Prospective Statement of Financial Position 141

4.3 Asset Management 142

4.4 Prospective Detailed Financial Statements 153

Module Five: Stewardship 158

5.1 Managing our Business 158

5.2 Building Capability 162

5.3 Workforce 166

5.4 Organisational Health 167

Module Six: Service Configuration 169

6.1 Service Coverage 169

6.2 Service Change 170

Module Seven: Performance Measures 171

7.1 Monitoring Framework Performance Measures 171

Module Eight: Glossary of Terms 179

4 MODULE ONE: INTRODUCTION AND STRATEGIC INTENTIONS

1.1 Message from the Chair of the Bay of Plenty District Health Board

More and more in today’s health system we are being asked to find new and different ways to provide care to our population that keeps pace with new technologies and innovation, involves a wider range of healthcare professionals as part of the care team and is provided in a way that is more centred on the needs of the patient and their family/whānau. This is an important focus for us, as with our growing population and increased co-morbidity, we realise there is a strong imperative to provide services differently.

This approach has been strengthened through the Ministry of Health’s refresh of the New Zealand Health Strategy (NZHS) which has set a vision that All New Zealanders live well, stay well, get well which strongly aligns to the Bay of Plenty District Health’s Board vision of Healthy, Thriving Communities. The NZHS is structured around 5 key strategic themes – people powered, closer to home, value and high performance, one team and smart system. This provides DHBs, other parts of the health system, and other Government agencies, the opportunity to challenge the status quo and to think about new and different ways of providing more integrated health care for the New Zealand population.

The world of technology is advancing very fast. New technologies will play a significant role in the health system in terms of what, how, where and when services are provided and who provides them. This is considered in the NZHS refresh under Smart System and the BOPDHB will be looking at opportunities for how it can advance new technologies that will enhance how it provides excellent patient care.

The NZHS considers throughout – What great might look like in 10 years. The Board and Runanga have been actively involved in planning for 2016/17 and have considered the same statement themselves - What great might look like for the BOPDHB in 10 years. This exercise, called A Postcard From the Future, asked Board and Runanga members how they would see the health system in 5-10 years. Key themes emerged – focus on health and wellness not illness, children living well, community involved in co-creating health services, one system, leadership across boundaries, health in the widest sense, health and social care, creating a Pae Ora future, systems designed to fit the users.

postcard from thefutureBay of plenty health 2020Healthy, Thriving Communities - Kia Momoho Te Hāpori Ōranga

Sally WebbChair Bay of Plenty DHB

Executive Leadership

Module One: Introduction and Strategic Intentions

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ANNUAL PLAN 2016/17

These aspirations from the Board and Runanga are captured below:

These themes are very important to the BOPDHB as we move into the 2016/17 year and think about what commitments we will make towards improving health services for the Bay of Plenty.

In 2016/17 we will continue to apply our Integrated Healthcare Strategy (IHS) to seek opportunities to work in a ‘whole of health system way’ by continuing to look at how health information can be shared safely across a wider range of health professionals, to seek opportunities for more services to be provided closer to home, to work as a health system collaboratively with other agencies and Councils to consider the wider determinants of health, and that we always put the patient / whānau at the centre of what we do.

We are committed to using our best endeavours to achieve the priorities set out in the Minister’s Letter of Expectations which, for next year, include a continued strong focus on Working Across Government and advancing the range of initiatives such as Children’s Teams and Healthy Housing Initiatives that we already have in place in the Bay of Plenty. Working towards achieving the current and new Health Targets, further seeking opportunities to integrate health services and supporting new Government initiatives such as Raising Healthy Kids and Reducing Teenage Pregnancies will also be areas of focus.

Most important to us as a District Health Board is that you receive excellent care when you or your family or whānau come into contact with the health system. Our CARE values (Compassion, Attitude, Responsiveness and Excellence) are paramount to our success both within our organisation and with our range of health providers.

We will do our best to meet the challenges and make the most of the opportunities that 2016/17 will bring as we work as a Board to continue to achieve our vision for the Bay of Plenty population of Healthy Thriving Communities – Kia Momoho Te Hāpori Oranga.

runsocial

People-poweredMeasureIncubate

Self-manageSelf-navigate

Multi-purposeuse

Self-determineSocial leadership

ConnectionactionPassion

ScaleEasysuccess

MobiliseResponsive

digitalMulti-mode

strengthFlexible

Sally WebbChair Bay of Plenty DHB

Date: September 2016

Ron ScottDeputy ChairBay of Plenty DHB


The Honourable Jonathan ColemanMinister of Health

Date: October 2016


1.2 Message from the Chair of Te Rūnanga Hauora Māori ō Te Moana ā Toi

E ngā iwi, e ngā mana, e ngā karangatanga maha o te rohe o te Hauora a Toi, ka huri ngā mihi ki a koutou. Tēnā koutou, tēnā koutou, tēnā tātou katoa

“Toi Ora – Optimum Wellbeing” is our overall goal in improving health for our population, in particular Māori. There are many synergies with the national aspiration of Pae Ora – Healthy Futures. To better support our communities the Runanga and the BOPDHB Board see greater multi-agency collaboration occuring over the coming year to help address the social determinants of health. This will be illustrated through directing funding to achieve desired outcomes; ongoing collaboration through the Children’s Team and a more targeted focus on long term high need populations.

Key threads in creating Pae Ora – Healthy Futures will be through Mauri Ora – Flourishing Individuals; Whānau Ora – Healthy Families; and Wai Ora – Healthy Environments. This will be achieved by improving family/whānau knowledge, addressing the causes of illness, commissioning for Māori health and ensuring Māori models of wellness and safety. The aspirations and dreams of our people will be met by our ongoing commitment, leadership and collaborative efforts and our cognisance of the financially constrained environment within which we operate. The health system will continue to ensure that the health needs are person and family/whānau centred. At the core of this is an ongoing drive about empowering families/whānau and individuals to take control of their future to be self-determining.

Over the past year, we have seen some great achievements and activities to help close the disparity gap between Māori and non-Māori, in particular:

• Māori Health Plan web-based tool – www.trendly.co.nz The launch of the web-based tool for Māori Health Plan performance

monitoring, which was developed in 2014/15, has been implemented over 2015/16. This innovative tool gives all 20 District Health Boards an instant, mobile way of tracking equity, performance, and improvements in Māori health. This initiative was sponsored by Tumu Whakarae, the national Māori General Managers Group, and endorsed by the national CEO group for implementation across the sector. The initial prototype was funded by Bay of Plenty, Hawkes Bay, and Capital and Coast DHBs.

• Kaupapa Māori Nurse Practitioners There has been a continuing focus on building the capacity of the Māori

nursing workforce by supporting and developing pathways for six kaupapa Māori nurses to attain nurse practitioners status. It has been a delight to see that this initiative is being adopted in areas of high isolation and need. There have been three kaupapa nurses that have attained nurse practitioner status over the past year.

Punohu McCauslandChairTe Rūnanga Hauora Māori ō te Moana ā Toi

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ANNUAL PLAN 2016/17

• Māori Health Excellence Seminars The BOPDHB, in partnership with the Midland

DHBs, was funded by the Ministry of Health, via the Māori Provider Development Scheme, to deliver a series of health excellence seminars. These seminars feature some of the best performing organisations in the country, enabling providers within the BOPDHB to learn effective service delivery models and to improve health outcomes for Māori and other New Zealanders. Four seminars were delivered on the topics of reducing avoidable hospitalisations, reducing tobacco use, improving cardiovascular risk assessment rates and improving childhood immunisations. The seminars and the web based monitoring tool have been integrated and the seminar presentations and supporting material have been archived and can be accessed and viewed by users in Trendly.

• Ministry of Business Innovation and Employment (MBIE) contracting framework

The BOPDHB is the demonstration site for rolling out the Ministry of Business Innovation and Employment (MBIE) contracting framework focusing on Adult Mental Health’s services with four providers - two Kaupapa Māori and two mainstream providers. The performance measures were co-designed with the relevant providers using the Results Based Accountability (RBA) methodology.

Notwithstanding these great achievements, there is still much work to be done. It is a pleasure to see the Whānau Ora Leadership Group, comprising Cabinet Ministers and Iwi Leaders, taking strides to improve the oral health of our children; reducing the prevalence of obesity; and reducing smoking rates of pregnant women. The Māori Health Runanga, along with the Board, will continue to support these initiatives as they will help our communities achieve Toi Ora.

Punohu McCauslandChairTe Rūnanga Hauora Māori ō te Moana ā Toi



1.3 Message from the Chief Executive Officer

I am pleased to present to you our 2016/17 Annual Plan.

As the new Chief Executive of the Bay of Plenty District Health Board, I couldn’t ask for a better foundation than the one we have. It’s an honour and a privilege for me to be in this role, working with the Bay of Plenty community to provide high quality health services.

Over the last few months, we’ve all been reflecting on and acknowledging the work that Phil Cammish, our previous Chief Executive, led over the last ten years, transforming our DHB in many ways. We now have the clinical schools, radiation therapy available locally, great hospital buildings in Tauranga and Whakatane. We have a strong leadership model, where our doctors and nurses work together with business leaders to shape the services our communities receive. We have strong providers of health care in our hospitals and in our communities, through primary health organisations, Māori health services, pharmacy, aged care services, mental health services, non-governmental organisation providers, the list goes on.

We have a unique opportunity to build on this solid foundation together and to always be thinking about what we can do to improve the health of our communities. To do that well, we need to really understand what matters to our patients, to their families, and to our communities, through delivering person and family centred care. Not to be asking them what’s the matter with you, but understanding what matters to them.

The refreshed NZHS gives us a way to help our communities go from languishing to flourishing. To start well, live well, stay well, and get well. For us to support our communities to be truly healthy and thriving, we welcome the opportunity of working with a whole range of agencies, local authorities, education, justice and looking for new ways to collaborate.

We have a strong Board and Runanga which work closely together to ensure we’re improving Māori Health, a dedicated leadership team, thousands of dedicated staff (doctors, nurses, allied health, administration, orderlies, and cleaners) in our hospitals and across all our community providers. Each and every one of us plays an important role in supporting our communities.

I feel a deep responsibility for ensuring our communities achieve the best health they can and believe that this year’s Annual Plan will continue to build on our solid foundation as we work together to achieve Healthy Thriving Communities across the Bay of Plenty.

Helen MasonChief Executive OfficerBay of Plenty District Health Board

Helen MasonChief Executive OfficerBay of Plenty District Health Board


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ANNUAL PLAN 2016/17

1.4 Executive Summary The health sector is changing, presenting challenges and pressures to the way we approach our work. Challenges include an ageing population, substantial inequalities in health status, more people living longer and more with multiple and long-term conditions and health system workforce shortages. The challenges that affect us all are global, national and local.

With challenges, however, come opportunities and this plan details many of the opportunities and interventions we can make to have positive impacts on the health status of our population. Opportunities to collaborate with other agencies, communities and individuals, to build trust and establish partnerships.

The burden of disease is unfairly distributed in our society; long-term conditions and risk factors such as obesity, smoking, and diabetes contribute to serious health disparity. The health of Māori remains an area in which we must do better, and more detail as to how we plan to do this is set out in this Annual Plan and the Te Māhere Māori o Te Hauora a Toi - Māori Health Plan.

New Zealand Health Strategy (NZHS)

The Ministry of Health has given the NZHS a refresh. The updated Strategy proposes a clear view of the future for the health system over the next 10 years, to ensure all New Zealanders live well, stay well, get well. The strategic direction set out in this Plan for the BOPDHB is aligned to this vision and the five strategic themes contained within the Strategy.

Integrated Healthcare Strategy 2020 (IHS)

Our response to the challenges facing us requires us to work together in partnership with people and our community, as one system. This year’s Annual Plan continues to build on the foundations created since the adoption of the IHS and reflects our commitment to fulfilling the promises we have made in the IHS. In particular, to work together with our primary care partners, through our Bay of Plenty Alliance Leadership Team, to make changes to the health system, for the benefit of our population.


BOPDHB’s Population Priorities

The Board continues to support four key strategic population priorities for the coming year: (i) Child and youth; (ii) Health of older people; (iii) Māori health – Achieving equity; and (iv) Long-term conditions.

For each population priority, the Board has identified why each strategic priority is important for the Bay of Plenty population and what they want to achieve. The way we work together is important in meeting the expectations of our community and the Minister.

1. Child and Youth

Healthier children and youth lead to healthier adults. Through the implementation of our Child and Youth Strategy (CYS) and other initiatives targeted at child and youth, we should be able to fulfil our vision. The CYS is a positive example of multi agencies such as the BOPDHB, Ministry of Health, Ministry of Social Development and Ministry of Education working together and more cohesively to improve the health outcomes of our children and youth. We continue to be proactive participants and will implement the actions derived from the Children’s Team.

2. Health of Older People

The Bay of Plenty has a significant ageing demographic that is set to increase in size and change in profile over time. The Bay of Plenty’s Health of Older People Strategy has an emphasis on wellness, encouraging healthy, independent living with access to quality services. We are continuing to support more people to live in their own homes through maintaining our investment in Home Based Support Services (HBSS) and shifting the model of care to have a greater emphasis on restorative care. This allows people to live longer in their own homes, with support rather than moving into residential care.

See section 2B.1.5.4 for key activities in these areas for 2016/17.

3. Māori Health –Achieving Equity

The long-term goal is for Māori within the Bay of Plenty to have the same level of wellness as non-Māori. Key actions in this area are listed below.

• Continue with leading He Pou Oranga, He Ritenga and the Māori Health Plan as they are important in ensuring mainstream services are responsive to meeting the needs of Māori and to address and reduce inequalities between Māori and non-Māori. DHBs across the Midland region have adopted the unique Māori tools and frameworks developed by the BOPDHB to monitor how effectively DHBs are reducing inequalities for Māori.

• Creating an equity culture through the committed leadership of the Board, Runanga and executive team.

• Continued roll out of the Māori Health Excellence series of seminars that brings together local, regional and national champions to share what works from their experience and help others learn from those experiences to improve Māori health.

• Supporting Trendly to measure the progress we are making towards closing the gap.

See Module 2B, in particular section 2B.1.5.7 Whānau Ora for key activities for 2016/17.

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ANNUAL PLAN 2016/17

4. Long Term Conditions

The BOPDHB will support services that enable people to become healthier and reduce the need for treatment. This will include reduced obesity, supporting smoking cessation, increasing immunisation rates and services that focus on improving physical health outcomes for those with mental health and addiction problems. For those people who have a long-term condition, we will:

• reduce cancer wait-times

• improve the management of stroke rehabilitation and reduce waiting times for cardiac services

• maintain and improve services for people with diabetes

• support patients to navigate their own care across multiple providers

• implement models of care that provide greater coordination of health services

• improve the physical health of people with severe mental health needs

• implement new Government initiatives to raise healthy kids including the new health target.

See Module 2B, for further information and activities on our key activities for improving and addressing long-term conditions.

Summary

This Annual Plan expresses our continued commitment to our Board’s vision of Healthy Thriving Communities – Kia Momoho Te Hāpori Oranga. It articulates our commitment to meeting the Minister’s expectations, including the Health Targets, how we will achieve them, and how we will work with our Midland DHB partners to deliver on care closer to home for our local people.

Further work on integrating care within our health system and with other sectors is paramount to delivering quality healthcare. For the coming year, we will be looking to build upon the great work we do, and implementing activities from key strategic documents such as the NZHS, He Korowai Oranga: Māori Health Strategy, and the IHS.

The BOPDHB will receive annual revenue of approximately $715 million from all sources to provide and fund a full range of health and disability support services in the most efficient and effective ways possible. To live within our means in the coming years will require innovation, integration, collaboration and reconfiguration to continue to provide a high level of service within financial constraints.

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1.5 Signatory PageA number of sections of this annual plan have been jointly developed between our organisations and the BOPDHB. We are committed to working in partnership with the BOPDHB to ensure achievement of the outcomes described in this plan and the Māori Health Plan.

Bryan Gould ChairpersonEastern Bay Primary Health Alliance


Bev FlavellChairpersonNgā Mataapuna Oranga


Dr John Gemming Co-ChairpersonWestern Bay of Plenty Primary Health Organisation


Colleen Te ArihiCo-ChairpersonWestern Bay of Plenty Primary Health Organisation


Michelle Murray Chief Executive OfficerEastern Bay Primary Health Alliance


Janice KukaChief Executive OfficerNgā Mataapuna Oranga


Roger TaylorChief Executive OfficerWestern Bay of Plenty Primary Health Organisation


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ANNUAL PLAN 2016/17

1.6 Context

1.6.1 Background information and operating environment

The Bay of Plenty District Health Board (BOPDHB) is one of 20 District Health Boards in New Zealand and has a purpose of funding and providing personal health services, public health services and disability support services for the Bay of Plenty.

The BOPDHB covers an area of 9,666 square kilometres and serves a population of 221,000. 32.4% of the population are under 25 and 25% identify as having Māori ethnicity. The area served stretches from Waihi Beach in the north-west to Whangaparaoa on the East Cape and inland to the Urewera, Kaimai and Mamaku ranges. These boundaries take in the major population centres of Tauranga, Katikati, Te Puke, Whakatane, Kawerau and Opotiki. Eighteen Iwi are located within the BOPDHB area.

Overarching system context influencing the BOPDHB:

To achieve the objectives required by section 22 of the New Zealand Public Health and Disability Act 2000 (NZPHDA), the BOPDHB must be aligned to a number of national directives including the Ministry of Health’s Statement of Intent, the updated NZHS, He Korowai Oranga: Māori Health Strategy, the UN Convention on the Rights of Persons with Disabilities, and the Treaty of Waitangi. On a regional scale, the BOPDHB is guided by the objectives set out in the Midland District Health Board’s Regional Services Plan (RSP).

The NZHS has recently undergone a refresh. The updated strategy sets out the changes required across the health system to address the substantial variations in outcomes for different populations, particularly for Māori and Pacific populations and for those living in more socioeconomically deprived areas (Statement of Intent 2015 to 2019 – Ministry of Health). The updated strategy has a particular focus on prevention and wellness, system integration, service improvement, quality and performance, and leadership and capability for change. In accordance with section 38(2) of the NZPHDA, the strategic themes of the updated strategy are reflected throughout this Plan and specific commitments of the BOPDHB to deliver on actions in line with the Strategy’s Roadmap of Actions are detailed in Module 2A.

Health Profile

To enable the BOPDHB to properly coordinate health services to meet the needs of the Bay of Plenty population, it is necessary to develop and understand the health profile of the area. This enables key issues to be identified and prioritised and work programmes established. Analysis of the health needs of the Bay of Plenty population has indicated that the following are key issues for the BOPDHB:

• the population is declining in the eastern Bay of Plenty, but increasing across the western Bay of Plenty and the Bay of Plenty as a whole. Both Māori and non-Māori populations will age over coming decades, particularly non-Māori populations

• smoking in pregnancy, with 13% of total pregnant women and 39% of Māori pregnant women being recorded as smoking two weeks after birth1

• avoidable hospitalisations

• higher prevalence of respiratory system disease, particularly in children

• poor oral health, with only 9% fluoridation in the water supply and generally poor oral health outcomes

• chronic obstructive airways disease amongst adults that is 10% higher than national rates

1 Whānau ora assessment: Te Moana ā Toi 2015-16


• acute bronchitis among infants and young children, especially Māori infants

• diabetes and chronic renal disease (including diabetes renal failure), that disproportionately affects Māori

• Māori in the Bay of Plenty face double the rates of admissions with cardiovascular system conditions, double the registration and mortality rate for cancer, three to four times the rate of hospital admission with asthma or chronic obstructive pulmonary disease, and 1.5 times the rate of hospital admission with mental health disorders compared with the non-Māori Bay of Plenty population

• 21.6% of the BOP population (7,941 youth) aged 15-24 are most at risk of poor outcomes as adults2.

Operating Environment

In 2016/17 the BOPDHB will receive approximately $715 million in funding from the Government and other District Health Boards to deliver health services to meet the needs of the Bay of Plenty community. These services include personal health services (to improve the health of individuals), mental health, Māori health and the health of older people. The amount of funding received is determined by the size of the population, demographics (age, gender, ethnicity and deprivation) and the population’s historic utilisation of health services. The Government requires that this money be spent in a financially responsible manner so health services are delivered in the most effective and efficient way possible.

The funding is allocated across all health services in the Bay of Plenty with Tauranga and Whakatane Hospitals receiving approximately half, with the balance funding those services provided in the community by Non-Government Organisations (NGOs) providing a range of mental health and personal health services, general practice, community pharmacy, aged residential care, home based support services and community laboratory services. This allocation is illustrated in Graph 1 below.

2 Using Integrated Administrative Data to Identify Youth Who Are at Risk of Poor Outcomes as Adults, The Treasury, December 2015, http://www.treasury.govt.nz/publications/research-policy/ap/2015/15-02

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ANNUAL PLAN 2016/17

In order to achieve the planned outputs, impacts and outcomes as outlined in this Annual Plan, the BOPDHB may, pursuant to section 25 of the New Zealand Public Health and Disability Act 2000, negotiate and enter into, or vary any current agreement for the provision or procurement of any health and disability support service. These agreements (or variations) may contain any terms or conditions acceptable to the BOPDHB.

The Ministry of Health also has a role in the planning and funding of some services provided by the BOPDHB. Some services are funded and contracted nationally, for example, public health services, breast and cervical screening, as well as the provision of disability support services for people aged less than 65 years.

Toi Te Ora – Public Health Service (Toi Te Ora) has a role to play in providing public health services which aim to protect, promote and improve the health of the population living in and visiting the Bay of Plenty. An important part of Toi Te Ora’s purpose is to reduce inequalities in health status, with a particular focus on Māori. As the Bay of Plenty DHB’s public health unit Toi Te Ora has a key role to play in supporting and advising the District Health Board to ensure there is public health input into their planning, and to assist with the implementation of their respective plans.

Toi Te Ora’s three strategic goals align with the BOPDHB’s goals and are to:

• Reduce childhood admissions to hospital from acute rheumatic fever, respiratory infections and skin infections, each by 2/3 in five years

• Reduce childhood obesity by 1/3 in 10 years

• Reduce the proportion of year 10 students smoking by 2/3 in five years.

Key areas of risk for the BOPDHB in delivering health services across all of our population includes reducing health inequalities particularly for the Māori population, managing growth and demand on the health system especially from our ageing population, living within our means while maintaining quality health services, achieving better outcomes for our most vulnerable populations and supporting and developing the health system workforce. To help manage these levels of risk, the BOPDHB has identified the potentially

Expenditure by Service Type

Graph 1: Proposed Spend by Service 2016/17

43%

0.4%

0.7%

13.0%

14.6%

9%

7.8%

3.4%

8.2%Hospital Based Care

Maori Health Services

General Practice

Pharmacy

Public Health

Health of Older People

Mental Health Services

Services Lab Testing

Community Care


significant gains to be made by collaborating with other agencies, inside and outside the health sector, and the community. A key focus for the BOPDHB in 2016/17 will be working across government, at both a national and local level, with a particular emphasis on vulnerable populations. Further detail around how the BOPDHB’s operating environment is changing and the challenges this presents is described in section 1.7.1.

The Tuhoe Service Management Plan (SMP) is part of the comprehensive settlement of historic Te Tiriti o Waitangi claims for Ngai Tūhoe. The commitments set out in the plan are made for the purpose of developing, implementing, expanding and renewing from time to time, a plan for the transformation of the social circumstances of the people of Ngāi Tūhoe.

In signing up to the Health Sector Chapter in the SMP, the district health boards (Bay of Plenty, Lakes and Hawkes Bay) remain mindful of Tūhoe’s desire for mana motuhake and move towards independence by raising the standards of care to Tūhoe whanau.

Ngai Tūhoe genuinely desires a collaborative relationship with the Ministry of Health and district health boards that will support the development of their health infrastructure in each of the four Tūhoe valleys (Waimana, Taneatua, Ruatahuna, and Waikaremoana).

The BOPDHB will continue to provide sound advice and support to Ngai Tūhoe through the exchange of ideas, identification of risks, capacity and capability building opportunities and meaningful health investment.

1.6.2 Nature and scope of functions/intended operations

The BOPDHB carries out the following functions:

• Plans the strategic direction for health and disability services in the Bay of Plenty, in partnership with key stakeholders and our community (i.e. clinical leaders, Iwi, Primary Health Organisations and NGOs); and in collaboration with other DHBs and the Ministry of Health

• Funds the provision of the majority of the public health and disability services in the district, through contracts with providers

• Provides hospital and specialist services primarily for its population but also for people referred from other DHBs

• Promotes, protects and improves the population’s health and wellbeing through health promotion, health protection, health education and the provision of evidence-based public health initiatives

• Owns and manages Crown assets to enable the provision of health and disability services in the Bay of Plenty, in accordance with Ministry of Health requirements. The BOPDHB’s asset management plan covers a 20 year period and provides an outline of capital affordability and shows details of the capital intentions planned in response to identified service needs.

Key Consideration – Achieving Equity

Health measures show continued disparities in the Bay of Plenty. Māori in the Bay of Plenty face double the rates of admissions with cardiovascular system conditions, double the registration and mortality rate for cancer, three to four times the rate of hospital admission with asthma or chronic obstructive pulmonary disease, and 1.5 times the rate of hospital admission with mental health disorders3 than non-Māori. The BOPDHB is committed to eliminating the effects of health disparities through, first, identifying them, and

3 Whānau ora assessment: Te Moana ā Toi 2015-16.

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ANNUAL PLAN 2016/17

second, addressing them by working collaboratively, providing programmes and/or activities and improving access to services. In 2016/17, the BOPDHB will:

• Use Pae Ora as a ‘focusing point’ to provide one, collaborative agenda for iwi, agencies, community and whānau to work from

• focus its attention on the indicators in the Bay of Plenty Māori Health Plan

• work with other social sector organisations to achieve sector goals in relation to the Whānau ora Partnership Group’s Better Public Service initiatives

• implement the Toi Te Ora – Public Health Service Plan 2016/17

• deliver services that target communities with identified health inequalities

• set equity targets by ethnicity and by high needs with explicit accountability expectations

• support kaupapa Māori services and ‘for Pacific by Pacific’ services where appropriate

• allocate resources to areas of greatest need

• increase the capability of the Māori and Pacific workforce across our district

• use an equity lens as part of decision-making and prioritisation processes

• work towards the New Zealand Triple Aim for Quality Improvement4

• provide advice to our governance bodies (iwi, Runanga, Board, Community and Public Health Advisory Committee and Disability Support Advisory Committee) to inform decision making

• engage with community health forums and expert advisory groups , including alliance mechanisms and service level alliance teams representing community/primary/DHB perspectives

• continue to support the “by Māori for Māori’ provider arrangements and complement this with an increased focus on mainstream responsiveness

• configure health service delivery in a way that takes account of the complex relationships between the key social determinants of health inequalities (e.g. housing quality and employment), while recognising that a number of public and private agencies influence health outcomes.

Further details as to how the BOPDHB intends to simultaneously improve health and equity for all populations, improve quality, safety and experience of care, and deliver best value for public health system resources are set out throughout this plan.

1.7 Strategic IntentionsThe BOPDHB’s strategic intention demonstrates how the BOPDHB intends to give effect to the NZ Public Health and Disability Act 2000 under the guidance of the refreshed NZHS and its vision of All New Zealanders live well, stay well, get well. It sets out how the BOPDHB aims to achieve its vision of Healthy, Thriving Communities - Kia Momoho Te Hapori Oranga by defining the outcomes to be achieved at the national, regional and local level, the actions necessary to achieve these outcomes, and the measures to know when success has been reached.

4 Defined by the Health Quality and Safety Commission NZ (HQSC) as “Improved quality, safety and experience of care, improved health and equity for all populations, and best value for public health system resources.”


This strategic direction is set out in the second part of this section but first it is important to recognise some significant changes facing the health sector and how the BOPDHB is responding.

1.7.1 Responding to a Changing Environment

The health sector environment is changing, presenting challenges and pressures to those who work within it but also to those who use it. These challenges include an ageing population, dealing with unprecedented demand on the health system, a changing demographic make-up of population, substantial inequalities in health status, more people living longer and more with multiple and long-term conditions. Health system workforce shortages are worsening in some areas, mixed with an ageing workforce, and public expectations are rising.

For the BOPDHB it is about acknowledging this environment and revising its approach to achieving health outcomes. It is about continuing on the integrated healthcare path but with increased emphasis on Health in All Policies and developing a more collaborative way of working with agencies and communities outside the health sector, for example housing, education and welfare, to improve New Zealanders’ health and wellbeing. It is also about family/whānau centred, co-designed, collective action that focuses on outcomes. Tackling obesity for example, means collaborating with the health sector, education, the food industry, communities and individuals to make an impact on their health and wellbeing.

As Mason Durie said at a community workshop in Tauranga on 25 November 2015, “The next 30 years will require refocusing towards the determinants of health, requiring a collective effort that transcends sectors, iwi, disciplines, and statutory authorities. This will lead to positive outcomes that are greater than any one agency could achieve.”

Further to this, it is about providing more effective social services. The New Zealand Productivity Commission produced a report in October 2015 titled “Cut to the Chase: More Effective Social Services”. The report identifies 10,000 particularly disadvantaged New Zealanders who are most in need of help and the system is not working at all well for them. The Commission believes that a new approach to service design is needed, an adaptive, client-centred approach, to support them to improve their lives.

This disadvantaged population are a priority for the BOPDHB and we will be working to identify who are most in need of the greatest support and which are the most vulnerable, to identify where to focus our efforts. Responding to this need will involve working across agencies and communities.

In addition to this collective effort, it is also about innovation and looking for opportunities to advance technologies that will enhance the way the BOPDHB accesses and shares information to work in a smarter way.

1.7.2 Strategic Direction in a National and Regional Context

This section sets out the strategic direction for the BOPDHB by identifying the national and regional visions, outcomes and priorities and then describes in more detail the local context and how the BOPDHB is committed to achieving Healthy, Thriving Communities for the Bay of Plenty population. The following framework outlines the Ministry’s current purpose and outcomes for the health system.

19


ANNUAL PLAN 2016/17

Ministry of Health’s National Outcomes Framework

Purpose and role Improve and protect the health of New Zealanders

Long-term success measures

Health expectancy improves

Life expectancy over time

Life expectancy by health spending

per capita compares well

withing the OECD

Health expectancy improves

Health system outcomes The health system is cost effective and supports a productive economy

New Zealanders live longer, healthier, more independent lives

Ministry's high-level outcomes

What will long-term success look like

1. New Zealanders are healthier and more

independent

2. High-quality health and disability services

are delivered in a timely and accessible manner

3. The future sustainability of the health and disability

system is assured

Ministry's impacts Results or actions

directly attributable to the Ministry's outputs

1. The public is supported to make informed decisions

about their own health and independence

3. The public can access quality services that meet their needs in a timely manner where

they need them

6. The health and disability system is

supported by suitable infrastructure, workforce and regulatory settings

2. Health and disability services are closely

integrated with other social services and health

hazards are minimised

4. Personalised and integrated support

services are provided for people who need them

7. Quality, efficiency and value for money

improvements are enhanced

5. Health services are clinically integrated and

better coordinated


Within this framework, the Minister of Health has set out the following Government priorities for 2016/17:

a) Refreshed NZHS – DHB’s current work programmes and new initiatives need to be aligned to the five themes in the refreshed strategy – people-powered, closer to home, value and high performance, one team and smart system.

b) Living Within our Means – DHBs need to budget and operate within allocated funding and must have detailed plans to improve year-on-year financial performance. More specifically, the Minister’s expectation is that the BOPDHB will improve its current financial position.

c) Working Across Government – DHBs are expected to continue supporting cross-agency work that delivers outcomes for children and young people, and advise the Minister and Ministry of work being undertaken with other sector agencies. Included in this work programme is reducing long-term welfare dependence and within that, the new sub-focus on reducing unintended teenage pregnancies.

d) National Health Targets – DHBs are to remain focussed on achieving and improving performance against the health targets, particularly the Faster Cancer Treatment target. The national health targets are described below.

e) Tackling Obesity – A key focus for 2016/17 is to reduce the incidence of obesity. A key part of this package is a new health target Raising Healthy Kids.

f) Shifting and Integrating Services – DHBs are to continue to move services closer to home and provide clear evidence of how they plan to do this.

g) Health IT Programme 2015-2020 – DHBs are to be part of the co-design phase of this programme to make health information systems more productive, efficient and sustainable.

21


ANNUAL PLAN 2016/17

Immunisation

IncreasedIncreased Immunisation

95% of eight months olds will have their primary course of immunisation (six weeks, three months and five months immunisation events) on time.

Faster

Cancer Treatment

Faster Cancer Treatment

85% of patients receive their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks by July 2016, increasing to 90% by June 2017.

Smokers to Quit

Better help for

Better Help for Smokers to Quit

90% of PHO enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months.

Raising Healthy Kids

By December 2017, 95% of obese children identified in the Before School Check (B4SC) programme will be offered a referral to a health professional for clinical assessment and family based nutrition, activity and lifestyle interventions.


Shorter stays in

EmergencyDepartments

Shorter stays in Shorter Stays in Emergency Departments

95% of patients will be admitted, discharged, or transferred from an Emergency Department (ED) within six hours of presentation.

Elective Surgery

Improvedaccess to Improved Access to Elective Surgery

The volume of elective surgery will be increased by an average of 4,000 discharges per year.


Regional Outcomes

The BOPDHB is one of five DHBs⁵ that make up the Midland region. The Midland DHBs have produced a Regional Services Plan (RSP) which describes the strategic intent for the Midland DHB region. The BOPDHB is committed to being an active participant in the regional planning process. The Midland DHBs have agreed to the following regional strategic vision and outcomes:

Mid

land

Visio

n

All residents of Midland District Health Boards lead longer, healthier and more independent lives

Reg

ional Service P

lan (RSP

) – Mo

dule 1

Reg

ional

Strategic

Outco

mes

To improve the health of our population To reduce or eliminate health inequalities

Reg

ional

Outco

me

Indicato

rs

To increase our average life expectancy

To reduce premature death rates

To improve our amenable mortality rate

Reg

ional

Strategic

Ob

jectives

To improve Māori Health

outcomes

Integrate across the continuum

of care

To improve quality across agreed regional services

To improve clinical

information systems

To build the workforce

Efficiently allocate public health system

resources

By focusing on these objectives, we will be able to drive change that enables us to live within our means.

Further detail is provided in the Midland DHBs RSP 2016/17.

5 Waikato, Lakes, Tairawhiti, Taranaki and Bay of Plenty

23


ANNUAL PLAN 2016/17

1.7.3 Strategic Direction in a Local Context

In the context of the national and regional outcomes and priorities outlined above, this section illustrates how the BOPDHB is focussing on being locally based and responsive to meet the health and wellness needs of the Bay of Plenty population. It sets out the vision and mission of the BOPDHB, its priority populations, why the BOPDHB is focussing on integration and collaboration, what specific local outcomes it is aiming to achieve and how it plans to achieve them (see the work programme set out in Module 2B of this Plan).

1.7.3.1 Our Vision - Tā Mātou Moemoea

Healthy, thriving communities – Kia Momoho Te Hāpori Oranga

1.7.3.2 Our Mission - Tā Mātou Matakite

Enabling communities to achieve good health, independence and access to quality services

1.7.3.3 Our Values - Ā Mātou Uara

CARE - Compassion Attitude Responsiveness Excellence

Our CARE values underpin the way we work together to provide a better-connected health system that is patient and family/whānau centred.

1.7.3.4 Our Priority Populations

• Child and Youth

• Health of Older People

• Māori Health –Achieving Equity

• Long-term Conditions


1.7.3.5 Our Strategic Direction

The following diagram illustrates the BOPDHB’s strategic direction.

Why is the BOPDHB focussing on Integration and Collaboration?

The BOPDHB is guided by a number of national and local strategies and directives to which it must be aligned as it works towards achieving its vision of Healthy, Thriving Communities – Kia Momoho Te Hāpori Oranga. Those of particular significance include the Ministry of Health’s Statement of Intent, the updated NZHS, He Korowai Oranga: Māori Health Strategy and Pae Ora, the IHS, and the BOPDHB’s accountabilities to the Minister of Health to provide and fund health services, personal health services, public health services and disability support services for the Bay of Plenty. The DHB accountabilities to the Minister are set out in his Letter of Expectations which, for 2016/17, include a continued strong focus on Working Across Government and advancing the range of initiatives such as Children’s Teams and Healthy Housing Initiatives working towards achieving the current and new Health Targets⁶, further seeking opportunities to integrate health services and supporting new Government initiatives such as Raising Healthy Kids and Reducing Unintended Teenage Pregnancies.

Integration and Collaboration in the Bay of Plenty

Why

Healthy Thriving

Communities

Kia Momoho Te Hāpori Oranga

Pae Ora

DHB Accountabilities

Bay of Plenty Integrated Healthcare Strategy 2014 – 2020

Languishing to Flourishing

Palliative to Population Health

New Zealand Health Strategy Get Well, Stay Well, Live Well

What Local

Outcomes

Healthy Individuals - Mauri Ora

1. All people live healthily with a good quality of life

2. All children have the best start in life

3. People die in their place of choice

Healthy Families - Whānau Ora

1. Family/whānau live well with long-term conditions

2. People are safe, well and healthy in their own homes and communities

Healthy Environments - Wai Ora

1. All people live, learn, work and play in an environment that supports and sustains a healthy life

2. Our population is enabled to self-manage

3. All people receive timely, seamless and appropriate care

LeadershipPromoting Whānau Ora

Fostering equity and quality improvement

Leading by example

CollaborationCo-design

Alliancing

Influencing health in all policies

CommunicationUse common language

Mobilise through technology

Curate and share knowledge

How

Values: Compassion, Attitude, Responsiveness, Excellence

6 For details of the six health targets refer to Section 2B.1.1.2

25


ANNUAL PLAN 2016/17

What is the BOPDHB trying to achieve?

The BOPDHB, together with its PHO an NGO partners, will give effect to the directives noted above more specifically through accelerating the implementation of the IHS and the identification of local outcomes. The IHS is helping us to re-orientate our system so that by 2020 Bay of Plenty health services will be centred on the needs of people, their families and whānau. People will be able to easily access services when required and healthcare workers will be able to seamlessly transfer care between settings when needed. People will be empowered to manage their own health and to share in decision making.

The BOPDHB has identified local outcomes that focus on its population priorities, Child and Youth, Health of Older People, Māori Health – Achieving Equity and Long-term Conditions, and support the achievement of regional and national health outcomes. The local outcomes are based on the Pae Ora framework and identify what the BOPDHB wants to achieve in terms of healthy individuals (Mauri Ora), healthy families (Whānau Ora) and healthy environment (Wai Ora).

How is the BOPDHB trying to achieve these outcomes?

The BOPDHB will strive to achieve these outcomes through leadership, collaboration and communication, while remaining committed to its CARE values. The BOPDHB will demonstrate Leadership by bringing community leaders together in order to address health issues, focussing on quality improvement with every staff member being an ‘improver’, and acknowledging that “it starts with us”.

The determinants of health, such as education, employment status, housing quality, sport and recreation, and public transportation, all have an impact on the health and wellness of individuals and their families, however, responsibility for them sits across multiple sectors, industries and agencies. Collaboration and collective impact is greater than individual agencies working in isolation and the BOPDHB is committed to building partnerships and working together, to co-design, to provide one, collaborative agenda that uses a common language for Iwi, agencies, community and family/whānau to work from. A particular focus for the BOPDHB is working with local government to further influence Health in all Policies. Examples of cross-sector work already underway are Whānau Ora, Children’s Teams, and the Prime Minister’s Youth Mental Health Project. The BOPDHB is committed to advancing these initiatives.

Good Communication is key to the BOPDHB. The BOPDHB wants to see ‘healthspeak’ transformed into common language so people can make informed and appropriate health decisions and are better equipped to manage their own health. This leads to better patient outcomes and more effective use of health resources. Technology can help us communicate with each other, share information between healthcare providers to make the patient journey smoother, and enables the access of data so progress can be tracked and work programmes altered accordingly.

Our CARE and He Pou Oranga values and principles (Compassion, Attitude, Responsiveness and Excellence) underpin the way we work together within our organisation and with our range of health providers to provide a better-connected health system that is patient and family/whānau centred. They provide us with the cultural foundation for how we integrate, lead and collaborate.

The BOPDHB’s Local Outcomes

The BOPDHB has identified local outcomes to focus on for 2016/17. In addition to contributing towards achieving outcomes at a national and regional level, they identify matters of particular significance to the health needs of the Bay of Plenty population. There is strong alignment between Pae Ora, the refreshed NZHS, the Minister of Health’s priorities for 2016/17⁷ and regional and local priorities. The table below sets out these outcomes and the indicators and measures that will be used to determine success.

7 As set out in his Letter of Expectations to DHBs dated 22 December 2015


Healthy, Thriving Communities - Kia Momoho Te Hāpori OrangaHealthy Futures - Pae Ora

Po

pul

atio

n P

rio

riti

es




Strategic D

irection M

od

ule 1

Bay of Plenty Population Accountabilities (Local Outcomes):1. All people have healthy lifestyles

with a good quality of life


3. People die in comfort in their place of choice

Bay of Plenty Population Accountabilities (Local Outcomes):1. Family/whānau live well with long-

term conditions


Bay of Plenty Population Accountabilities (Local Outcomes):1. All people live, learn, work and play

in an environment¹ that supports and sustains a healthy life

2. Our population is enabled to self- manage


Population Indicators:Fewer people smoke

Reduction in vaccine preventable diseases

Improving healthy behaviours

People can access their health information

Fewer children and adolescents have decayed missing filled teeth

People with a terminal illness or life limiting chronic disease die in their place of choice

Population Indicators:Fewer people are admitted to hospital for avoidable conditions

Long-term conditions are detected early and managed well

People maintain functional independence

Families and whānau are at the centre of their healthcare

Population Indicators:Providing healthier homes

Connecting with agencies to meet community needs

Appropriate access to services

People receive prompt and appropriate acute and arranger care

Services provided or funded by the BOPDHB contribute to the transfer of knowledge and skills to family/whānau to enable self-management

Mo

dules 1, 2 and

3

Population Measures:How much did we do?# referrals of adults to the Green Prescription programme

# general practices offering patient portals

# enrolled patients² with a patient portal

# of future care plans that are shared with health professionals

Population Measures:How much did we do?# of whānau ora referrals/promotional activities undertaken

% eligible population who have their cardiovascular disease (CVD) risk assessed completed in the last 5 years

Population Measures:How much did we do?A BOP Healthy Housing Improvement Plan in place

# governance group meetings held for co-designed multi-agency initiatives

# governance group meetings attended for Healthy Families initiatives

# people supported by specialist palliative care

# registered users of CHIP client health information portal

Statement o

f Perfo

rmance E

xpectatio

ns M

od

ule 3

How well did we do?% of people received smoking cessation advice

% pregnant women who identify as smokers

% children fully immunised at eight months

% population over 65 years who have had influenza immunisation

% infants receiving any breastfeeding at six months

% children age 5 caries-free

How well did we do?Reduced ASH rates

% of population enrolled with a Primary Health Organisation

% eligible women (45-69) have breast screen examination every three years

% eligible women (20-69) have a cervical cancer screen every three years

# presentations to Emergency Department - Triage Level 4 and 5 as a percentage of the total population

How well did we do?Number of inpatient surgical discharges under elective initiative

Percentage of patients admitted, discharged or transferred from an ED within six hours

Standardised Intervention Rates meet national expectations

% improvement in access to mental health services

improved wait times for diagnostic services

% patients to receive their first cancer treatment within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks

% patients reporting better understanding of their health journey

Is anyone better off?% obese children identified in the B4SC programme will be offered a referral to a health professional

% patients receiving specialist palliative care die in their place of choice

Is anyone better off?Average age of entry into aged residential care

Hospitalisation rates per 100,000 for acute rheumatic fever

Is anyone better off?Hospitalisation rates per 100,000 for acute rheumatic fever

% of long-term condition clients reporting an improved quality of life

ResourcesWorkforce, performance management, risk management, quality improvement, information communications technology,

capital investment partnerships, collaboration, innovation

Steward

ship

Mo

dule 5

Mao

ri H

ealt

h -

Ach

eivi

ng E

qui

tyH

ealt

h o

f O

lder

Peo

ple

Chi

ld a

nd Y

out

hLo

ng-t

erm

Co

ndit

ions

¹ Environment includes social, econmic, natural and cultural attributes.² Enrolled in a Primary Health Organisation

27

Module 2A: Implementation of the New Zealand Health Strategy

ANNUAL PLAN 2016/17

2A.1 ContextIn accordance with section 38(2)(d) of the NZPHDA, DHB’s Annual Plans must reflect the draft refreshed NZHS’s direction and detail each DHB’s commitment to delivering appropriate actions in line with the Strategy’s Roadmap.

The refreshed NZHS has two parts: (i) Future Direction and (ii) Roadmap of Actions. The Future Direction outlines a high-level direction for New Zealand’s health and disability system over the next 10 years. The Roadmap of Actions identifies 20 work areas for the next five years to put the Strategy in place. Figure 1 on the right illustrates the components of the Strategy.

Figure 2 illustrates how the Strategy fits with other existing government strategies and priorities. It has been informed by the Government’s four high level priorities and will support the health system’s contribution to a range of cross-government strategies.


NEW ZEALAND HEALTH STRATEGY: FUTURE DIRECTION 3

Figure 1:Components of the New Zealand Health Strategy

New Zealand’s health system performs well

In 2014, 90 percent of New Zealanders reported they are in good, very good or excellent health, the highest percentage reported by any country in the Organisation for Economic Co-operation and Development (OECD); for those aged over 75 years, the figure is 87 percent.

80 percent of adults reported they are satisfied with the care they receive from their usual medical centre and 83 percent of people rate their care in emergency department services as good or very good.

95 percent of New Zealanders are enrolled with a primary health organisation.

New Zealanders are more likely to report being able to get a doctor’s appointment on the same or next day than people in the United Kingdom or Australia.

Waits for emergency department care are the shortest of 11 countries surveyed by the Commonwealth Fund.

Life expectancy for New Zealanders is 79.5 years for males and 83.2 years for females, both above the OECD average.

Our health system supports: 12.6 million daytime visits to general practitioners (GPs) per year (and 2.8 million visits to general practice nurses); the dispensing of 65 million pharmaceutical items; 24 million laboratory tests; and 1 million emergency department visits per year.

Sources: Ministry of Health. 2015. Health and Independence Report. Ministry of Health 2013. Patient Experience 2011/12: Key Findings of the New Zealand Health Survey. Commonwealth Fund. 2012. Commonwealth Fund International Survey of Primary Care Physicians. Commonwealth Fund. 2013. Commonwealth Fund International Health Policy Survey in eleven countries. Also unpublished Ministry data.

live wellAll New Zealanders stay well get well

Roadmap of Actions

Future Direction

Challenges and

opportunities

Page 8

The future

we want

Page 13

Five strategic themes

Page 15

Five-year signposts

Annual focus

New Zealand Health Strategy

NEW ZEALAND HEALTH STRATEGY: FUTURE DIRECTION 7

Figure 3:The New Zealand Health Strategy in its government context

Government prioritiesDelivering better public services

Responsibly managing the Government’s finances

Rebuilding Christchurch

Building a more competitive and productive economy

Population and other health strategies, eg,

He Korowai Oranga – Māori Health Strategy

‘Ala Mo’ui – Pathways to Pacific Health and Wellbeing

Health of Older People Strategy

Primary Health Care Strategy

Rising to the Challenge: Mental Health and Addiction Service Development Plan

Living Well with Diabetes: A Plan for People at High Risk or Living with Diabetes

Cross-government work 2016, eg,

Social Sector Trials

Whānau Ora

Children’s Action Plan

Action Plan on Household Crowding to Reduce Rheumatic Fever

Prime Minister’s Youth Mental Health Project

New Zealand Disability Strategy

New Zealand Health Strategy

Figure 1

Figure 2

28 MODULE 2A: IMPLEMENTATION OF THE NEW ZEALAND HEALTH STRATEGY

The refreshed NZHS focuses on health but is set within the wider context of the interconnections between health and other aspects of people’s lives. The Government is focused on improving the lives and wellbeing of New Zealanders. Its priorities include working across agencies to tackle the complex and long-term problems that some New Zealand families face. Examples include providing healthier homes to reduce the risk of illnesses like rheumatic fever and respiratory conditions, putting families and whānau at the centre of service delivery through Whānau Ora, and reducing assaults on children by working closely with the Police, Courts and Justice sector partners and providing mental health addiction and treatment. These health links with the wider environment are shown below.

Education • Housing • Social support

Workplaces • Transport Recreation

FamilyWhānau

Community

Individual Health

Environment Economy

Health influences all of life

Many factors contribute to health

Appropriate commitments and actions are referenced in this module to ensure that implementation of the Strategy can begin in 2016/17. They are structured around the five strategic themes identified in the strategy as illustrated below:

People- powered

Closer to home

Value and high performanceOne team

Smart system All New Zealanders live well, stay well, get well

3

2

1

5

4

In order to reduce duplication, where there is an obvious cross over with our DHB and/or regional activities identified under existing priority areas, we have captured these in the below table that references where the detailed actions can be found elsewhere in this plan.

29


ANNUAL PLAN 2016/17

2A.2 Themes from the New Zealand Health StrategyNote references in bold relate to activity being undertaken in areas of focus as identified in the Ministry’s Annual Planning guidance for 2016/17: raising healthy kids, long term conditions, service configuration including shifting services and information technology.

People Powered Reference

Developing understanding of users of health services

2B.1.3.3 Supporting Vulnerable Children

Encouraging and empowering people to be more involved in their health

2B.1.2.1 IHS Implementation: Theme 3 Access to Patient Information


2B.1.4.3 Living Well with Diabetes

Partnering with people to design services to meet their needs

2B.1.2.2 Shifting Services

Supporting people’s navigation of the health system


Care Closer to Home Reference

Providing health services closer to home



2B.1.4.4 Cardiovascular Disease

More integrated health services, including better connection with wider public services

2B.1.2.1 IHS Implementation

An investment early in life 2B.1.3.1 Reducing Unintended Teenage Pregnancy


2B.1.3.5 Reduced Incidence of First Episode Rheumatic Fever

2B.1.3.7 Maternal and Child Health

2B.1.4.1 Healthy Families NZ

2B.1.4.5 Better Help for Smokers to Quit

A focus on the prevention and management of chronic and long-term conditions

2B.1.4 Long Term Conditions – Prevention, Identification and Management

2B.1.4.2 Raising Healthy Kids

Value and High Performance Reference

The transparent use of information 1.7.3.5 Our Strategic Direction

An outcome-based approach 1.7.3.5 Our Strategic Direction

Strong performance measurement and a culture of improvement

1.7.3.5 Our Strategic Direction

An integrated operating model providing clarity of roles



The use of investment approaches to address complex health and social issues



2B.1.4.3 Living Well with Diabetes

2B.1.4.4 Cardiovascular Disease

30 MODULE 2A: IMPLEMENTATION OF THE NEW ZEALAND HEALTH STRATEGY

One Team Reference

Operating as a team in a high-trust system

2B.1.3.2 Immunisation

The best and flexible use of our health and disability workforce

5.3 Workforce

Leadership and management training 5.2 Building Capability

Strengthening the role for people, families and whānau and communities to support health

2B.1.5.2 Stroke Services

More collaboration with researchers 5.2 Building Capability

Smart Systems Reference

The increased use of analytics and systems to improve management reporting, planning and service delivery and clinical audit

5.2.1 Information Communications Technology

5.2.2 Clinical Technology

The health system as a learning system, that continuously monitors and evaluates what it is doing, and shares it

5.2 Building Capability

The availability – at the point of care – of reliable and accurate information including on-line electronic health records

2B.1.7.1 National Entity Priority Initiatives

2B.1.2.1 IHS Implementation: Theme 3 Access to Patient Information

31

Module 2B: Delivering on Priorities and Targets

ANNUAL PLAN 2016/17

2B.1 Priorities and Targets

2B.1.1 Implementing Government Priorities

This section presents the actions the BOPDHB is planning to deliver in 2016/17. Implementation of the actions outlined in this plan is expected to enable us to positively contribute to local, regional and national outcomes as well as the goal of All New Zealanders Live Well, Stay Well, Get Well, including Better Public Services. The actions and measures presented in this section show:

• How we are implementing Government priorities

• How we are implementing local priorities

• How we are contributing to the activities in the Midland Region Service Plan, Toi Te Ora – Public Health Service Annual Plan, and the Māori Health Plan

• How we plan to improve performance in terms of our local priorities.

This section has been developed in collaboration with key stakeholders, both internal and external to the health sector.

2B.1.1.1 Policy Drivers:

• NZHS – The newly refreshed NZHS is intended to guide change in the health system. The five strategic themes: people-powered, closer to home, value and high performance, one team and smart system, will guide us forward and provide a focus for change.

• Better Public Services (BPS) – creating an environment where services are encouraged to work together to deliver health care in a coordinated and cooperative manner. The aim of this policy is to support people to be kept healthier within their communities through the delivery of more services, and to ensure they wait less time for services. Aligned to this policy direction is a set of health targets that provide performance measures for the health sector to improve health outcomes and service quality at local and national levels.

• Regional Collaboration – DHBs working together more effectively regionally and locally.

• Integrated Care – clinical and service integration to bring organisations and clinical professionals together, to improve outcomes for patients and service users through the delivery of integrated care. Integration is a key component of placing patients at the centre of the system, increasing the focus on prevention avoidance of unplanned acute care and redesigning services closer to home.

• Value for Money – within the current fiscal environment there is a need for health services to work more efficiently and effectively to achieve priority goals and targets and for DHBs to live within their means.


32 MODULE 2B: DELIVERING ON PRIORITIES AND TARGETS

Integrated Healthcare

• IHS Implementation (Local Priority)• Service Configuration including Shifting Services

Child and Youth Health

• Reducing Unintended Teenage Pregnancy (BPS target) • Increased Immunisation (Health Target and BPS target) • Children’s Action Plan (BPS target)• Social Sector Trials• Rheumatic Fever (BPS target)• Prime Minister’s Youth Mental Health Project• Maternal and Child Health (Local Priority)

Long Term Conditions – Prevention, Identification and Management

• Healthy Families NZ• Raising Healthy Kids (Health Target)• Living Well With Diabetes• Cardiovascular Disease• Better Help for Smokers to Quit (Health Target) • Rising to the Challenge

System Integration

• Faster Cancer Treatment (Health Target) • Stroke Services• Cardiac Services• Health of Older People• System Level Outcome Measures• Shorter Stays in Emergency Departments (Health target) • Whānau ora• Improved Access to Diagnostics• Improved Access to Elective Surgery (Health Target)

Living within our Means

• Living within our Means• National Entity Priority Initiatives• NZ Health Partnerships Limited

Other

• Improving Quality • Spinal Cord Impairment Action Plan• Actions to support delivery of Regional Priorities

Immunisation

Increased

Faster

Cancer Treatment

Smokers to Quit

Better help for


Shorter stays in

EmergencyDepartments

Shorter stays in

Elective Surgery

Improvedaccess to

2B.1.1.2 Actions to deliver on Annual Plan Priorities

This section is clustered into five broad categories reflecting Government planning priorities. The categories and the specific priorities are outlined below. The BOPDHB’s regional and local actions to deliver on RSPs and the BOPDHB’s local priorities are also included in this section.

The categories and priorities are not exclusive, for example there are a number of priorities which will impact long term conditions which are not included in the long term conditions column.

33


ANNUAL PLAN 2016/17

2B.1.2 Integrated Healthcare

Over the last two years we have been building the foundations for developing integrated healthcare systematically throughout the Bay of Plenty through the implementation of the BOP Integrated Healthcare Strategy 2020 (the ‘IHS’), and we will continue to build on this foundation during 2016/17. The IHS and associated action plan has an implementation horizon to 2020. It encompasses 7 interlinked themes aimed at enabling systematic and consistent quality improvement.

Critical to our success is creating an environment that builds trust through collaboration and strengthens people, family and whanau. We have reviewed governance and management structures to align with a whole-of-system approach, and more and more we are working across traditional boundaries and building relationships with local authorities and other agencies to influence healthy environments and policies that promote health. We are building a workplace culture that engages staff to embrace quality improvement and to think and act consistently in a way that puts the patient at the centre of all decisions. Changes which are enabling delivery of this mission include:

• Fostering a collaborative, whole-of-system approach to the way we work through the development of partnerships and alliances. The Bay of Plenty Alliance Leadership Team (BOPALT) who has responsibility for monitoring and overseeing implementation of the IHS and a number of service improvement initiatives within its work programme. These include the development of an integrated model of care for Community Nursing; Opotiki Locality Planning and the Acute Demand Management programme, all of which are progressing well and within expected time frames and deliverables. (See more on the BOPALT work programme under Module 2B.1.2.2)

• Bay Navigator, which to date has focussed on developing clinical pathways, has undergone a review and is now the ‘brand’ for clinical quality improvement, and the central communication tool for system-wide improvement projects. A node on the Bay Navigator website called ‘Get Involved’ leads to information about improvement projects and how people can get involved.


• The Service Improvement Unit, and the Planning and Funding and Quality and Risk teams now work collaboratively on organisational projects and improvement initiatives that support whole of system changes.

• The Whānau Ora approach underpins and informs service improvements. Development of the Whānau Ora pathway is underway and will seek to further systematically embed Whānau Ora principles and practice into service delivery.

• We are seeking to enable an integrated healthcare environment through the way we purchase services. We are shifting our contracting system with NGO providers from price/volume based towards commissioning for outcomes. Using the Results Based Accountability methodology and by working collaboratively with providers to develop service agreements based on meaningful outcomes. We are working with the Ministry of Business, Innovation and Employment and Sector Services as a demonstration site for DHBs to implement the Streamlined Contracting Framework for NGOs.

• The BOP Information Systems Group which has a key role in delivering on the shared information requirements underpinned by a sound governance framework that will enable achievement of the major goals of the IHS. The Group advises and reports to BOPALT. See more under Module 5, Building Capability and the BOPALT work programme.

• Inter-agency initiatives, such as the Children’s Team, are ways that we are working together to streamline care and services for people with high health and social care needs. The Board has approved a Health in All Policies position statement and governance to governance engagement plan, putting in place a platform for meaningful partnerships with local authorities and other agencies to realise our vision of Pae Ora – healthy individuals, healthy whānau and healthy environments.

Section 2B.1.2.1 below sets out how the BOPDHB is implementing the IHS in 2016/17.

35


ANNUAL PLAN 2016/17

2B.1

.2.1

IHS

Imp

lem

enta

tio

n

Link

ages

Loca

l out

com

es t

able

, oth

er k

ey s

ecti

ons

of

2B, T

oi T

e O

ra’s

Ann

ual P

lan

2016

/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Them

e 1:

Pat

ient

and

Fa

mily

Cen

tred

C

are/

Whā

nau

Ora

The

BO

PD

HB

will

:

• C

ont

inue

wit

h th

e d

evel

op

men

t an

d im

ple

men

tati

on

of

the

Whā

nau

Ora

Pat

hway

. [L

ead

Māo

ri H

ealt

h P

lann

ing

and

Fun

din

g]

• S

upp

ort

DH

B le

ader

ship

and

tho

se in

volv

ed in

ser

vice

dev

elo

pm

ent

wo

rk t

o u

nder

take

W

hāna

u Tu

Whā

nau

Ora

tra

inin

g. [

Lead

: Māo

ri H

ealt

h P

lann

ing

and

Fun

din

g w

ith

Ng

a M

ataa

pun

a O

rang

a P

HO

]

• W

ork

co

llab

ora

tive

ly w

ith

cons

umer

s to

dev

elo

p e

ffec

tive

par

tner

ship

s an

d

com

mun

icat

ion

pat

hway

s w

here

it is

ag

reed

tha

t a

cons

umer

per

spec

tive

wo

uld

ad

d v

alue

to

dec

isio

n m

akin

g. W

e w

ill t

est

and

tri

al r

eco

mm

end

ed w

ays

of

eng

agin

g

pat

ient

s to

pro

vid

e in

put

to

pro

ject

s id

enti

fied

in t

he B

OPA

LT w

ork

pla

n an

d k

ey

serv

ice

imp

rove

men

t p

roje

cts

and

eva

luat

e th

e eff

ecti

vene

ss o

f o

ur a

pp

roac

h [L

ead

: Q

ualit

y an

d P

atie

nt S

afet

y. [

Lead

: Ser

vice

Imp

rove

men

t U

nit]

(se

e al

so M

od

ule

2B.1.

7.3

Imp

rovi

ng Q

ualit

y)

• D

evel

op

to

ols

and

res

our

ces

to s

upp

ort

SLA

Ts a

nd p

roje

ct t

eam

s [L

ead

: Qua

lity

and

P

atie

nt S

afet

y]

• C

ond

uct

anal

ysis

of

resu

lts

fro

m t

he P

atie

nt E

xper

ienc

e S

urve

y to

info

rm s

ervi

ce

imp

rove

men

ts in

ho

spit

al s

ervi

ces;

[Le

ad: Q

ualit

y an

d P

atie

nt S

afet

y]

• C

ont

inue

to

sup

po

rt a

nd e

nab

le t

he V

olu

ntee

r P

atie

nt A

dvi

sory

Gro

up t

o p

rovi

de

mea

ning

ful i

nput

to

ser

vice

imp

rove

men

t d

esig

n. [

Lead

: Qua

lity

and

Pat

ient

Saf

ety]

Pat

hway

dev

elo

ped

and

do

cum

ente

d

by

June

20

17.

All

Exe

c an

d S

LAT

mem

ber

s ha

ve

com

ple

ted

Whā

nau

Tu W

hāna

u O

ra

trai

ning

by

end

Jun

e 20

17.

Rep

ort

s to

BO

PALT

on

pro

ject

act

ivit

y w

ill in

clud

e ho

w c

ons

umer

and

co

mm

unit

y en

gag

emen

t ha

s b

een

und

erta

ken

and

ho

w a

ny f

eed

bac

k ha

s b

een

cons

ider

ed w

here

ap

pro

pri

ate.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Them

e 2:

Hea

lth

Lite

racy

The

BO

PD

HB

will

:

• P

rep

are

the

wo

rkfo

rce

and

gov

erna

nce

of

the

DH

B t

o b

uild

kno

wle

dg

e an

d s

kills

ar

oun

d t

he im

po

rtan

ce o

f he

alth

lite

racy

thr

oug

h id

enti

fyin

g a

nd im

ple

men

ting

hea

lth

liter

acy

awar

enes

s tr

aini

ng.

Init

ial f

ocu

s w

ill b

e o

n in

ter-

agen

cy r

elat

ions

hip

s an

d

how

to

infl

uenc

e he

alth

in a

ll p

olic

ies

thro

ugh

effec

tive

co

mm

unic

atio

n. [

Lead

: Te

Teo

H

eren

ga

Wak

a]

• E

valu

ate

the

ED

tri

al o

f th

e P

atie

nt E

duc

atio

n R

eso

urce

Cen

tre

to in

form

our

nex

t st

eps

wit

h th

e C

entr

e.[L

ead

: Ser

vice

Imp

rove

men

t]

• In

crea

se t

he k

now

led

ge

of

com

mun

ity

heal

thca

re w

ork

ers

wit

h re

spec

t to

Chi

ldho

od

O

bes

ity.

[Le

ad: N

ga

Mat

aap

una

Ora

nga

PH

O]

• P

rep

are

the

wo

rkfo

rce

of

DH

B t

o b

uild

a h

ealt

h lit

erac

y kn

ow

led

ge

bas

e th

roug

h d

evel

op

men

t o

f tr

aini

ng m

od

ules

, to

ols

and

res

our

ces.

[To

i Te

Ora

-Pub

lic H

ealt

h]

• P

rep

are

the

wo

rkfo

rce

of

pri

mar

y ca

re t

o b

uild

a h

ealt

h lit

erac

y kn

ow

led

ge

bas

e th

roug

h su

pp

ort

ing

PH

Os

to t

rain

the

tra

iner

. [Le

ad: T

oi T

e O

ra-P

ublic

Hea

lth]

• A

ll p

atie

nt in

form

atio

n p

rep

ared

by

the

DH

B w

ill u

se c

om

mo

n la

ngua

ge

and

hav

e a

heal

th li

tera

cy r

evie

w. [

Lead

: Co

mm

unic

atio

ns T

eam

]

Bo

ard

cha

mp

ions

and

sta

ff in

volv

ed

in in

ter-

agen

cy in

itia

tive

s w

ill h

ave

the

skill

s, k

now

led

ge

and

to

ols

to

sup

po

rt

heal

th in

all

po

licie

s b

y Ju

ne 2

017

.

Dec

isio

n o

n th

e fu

ture

of

fund

ing

and

im

ple

men

tati

on

of

Pat

ient

Ed

ucat

ion

Res

our

ce C

entr

e w

ill b

e m

ade

by

Dec

emb

er 2

016

.

Chi

ldho

od

Ob

esit

y H

ealt

h Li

tera

cy

Wan

ang

a un

der

take

n an

d e

valu

atio

n co

mp

lete

by

Sep

tem

ber

20

16.

Pat

ient

bo

okl

ets

and

info

rmat

ion

will

su

pp

ort

pat

ient

s an

d f

amily

/whā

nau

to

self

-man

age

- o

ngo

ing

.

Them

e 3:

Acc

ess

to P

atie

nt

Info

rmat

ion

The

BO

PD

HB

will

co

ntin

ue t

o p

rog

ress

dat

a sh

arin

g in

itia

tive

s to

sup

po

rt a

chie

vem

ent

of

the

maj

or

go

als

of

the

IHS

. In

par

ticu

lar

we

will

pro

gre

ss:

• th

e up

take

of

CH

IP4

GP

s b

y re

gis

tere

d c

om

mun

ity-

bas

ed h

ealt

hcar

e p

rofe

ssio

nals

;

• th

e up

take

of

BO

P M

edch

eck

by

com

mun

ity

pha

rmac

ists

;

• th

e d

evel

op

men

t an

d im

ple

men

tati

on

of

the

Pri

mar

y C

are

Dat

a S

et;

• su

pp

ort

the

up

take

of

pat

ient

po

rtal

s;

• th

e es

tab

lishm

ent

of

a so

und

dat

a g

over

nanc

e fr

amew

ork

thr

oug

h B

OP

Info

rmat

ion

Sys

tem

s G

roup

.

[Lea

d: B

OPA

LT/B

OP

Info

rmat

ion

Sys

tem

s G

roup

]

See

als

o M

od

ule

5 fo

r m

ore

info

rmat

ion

on

bui

ldin

g c

apab

ility

.

A c

ore

set

of

pat

ient

info

rmat

ion

sto

red

in g

ener

al p

ract

ice

pat

ient

m

anag

emen

t sy

stem

s w

ill b

e ag

reed

an

d s

hare

d b

etw

een

the

hosp

ital

and

th

e co

mm

unit

y b

y S

epte

mb

er 2

016

.

37


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Them

e 4

:

Co

-ord

inat

ed

Car

e

The

BO

PD

HB

will

:

• C

ont

inue

to

wo

rk a

s o

ne s

yste

m t

o p

rog

ress

des

ign

and

imp

lem

enta

tio

n o

f im

pro

vem

ents

in t

he f

ollo

win

g p

rio

rity

pro

ject

s w

ithi

n th

e B

OPA

LT w

ork

pro

gra

mm

e.

The

aim

s in

clud

e to

imp

rove

tra

nsit

ions

and

pro

vid

e se

amle

ss c

are

for

peo

ple

wit

h lo

ng t

erm

and

co

mp

lex

heal

th c

ond

itio

ns:

-C

om

mun

ity

Nur

sing

Inte

gra

tio

n p

roje

ct –

see

sec

tio

n 2B

.1.2.

2

-A

cute

Dem

and

Man

agem

ent

– se

e se

ctio

n 2B

.1.5.

6

-O

po

tiki

Lo

calit

y P

lann

ing

[Lea

d: B

OPA

LT]

• U

sing

the

rec

om

men

dat

ions

in t

he P

rod

ucti

vity

Co

mm

issi

one

r’s

rep

ort

on

Mo

re

Eff

ecti

ve S

oci

al S

ervi

ces,

we

will

und

erta

ke a

lite

ratu

re r

evie

w o

f b

est

pra

ctic

e m

etho

ds

to id

enti

fy h

igh

need

and

hig

h co

st a

t ri

sk in

div

idua

ls a

nd t

rial

the

use

of

a se

lect

ion

of

spec

ified

cri

teri

a an

d m

etho

do

log

y us

ing

exi

stin

g d

ata

sets

. Thi

s w

ill

info

rm o

ur p

lann

ing

and

imp

lem

enta

tio

n o

f eff

ort

s to

co

llab

ora

te w

ith

oth

ers

and

co

-o

rdin

ate

care

fo

r th

ose

mo

st in

nee

d.

Dat

a id

enti

fica

tio

n w

ill b

e ap

plie

d w

ith

resp

ect

to t

he a

bov

e p

roje

cts.

[Le

ad: P

lann

ing

and

Fun

din

g]

See

BO

PALT

wo

rk p

lan

for

mo

re d

etai

l.

Cri

teri

a id

enti

fied

and

dat

a co

llect

ion

met

hod

olo

gy

esta

blis

hed

and

tri

aled

b

y D

ecem

ber

20

16.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Them

e 5:

Cre

atin

g a

n E

nvir

onm

ent

for

Inte

gra

tio

n

The

BO

PD

HB

will

:

• C

ont

inue

our

pla

n to

fo

ster

a q

ualit

y im

pro

vem

ent

cult

ure

by

imp

rovi

ng t

he s

kills

an

d e

xper

ienc

e o

f th

e w

ork

forc

e an

d in

crea

sing

our

cap

acit

y to

und

erta

ke q

ualit

y im

pro

vem

ents

and

sup

po

rtin

g c

apac

ity

for

imp

rove

men

t. W

e w

ill s

upp

ort

ho

spit

al

staff

and

co

mm

unit

y he

alth

care

wo

rker

s to

und

erta

ke q

ualit

y im

pro

vem

ent

trai

ning

an

d in

crea

se t

he n

umb

er o

f p

eop

le w

ho h

ave

com

ple

ted

the

IHI O

pen

Sch

oo

l Mo

del

fo

r Im

pro

vem

ent;

[Le

ad: S

ervi

ce Im

pro

vem

ent

Uni

t]

• C

ont

inue

to

dev

elo

p q

ualit

y im

pro

vem

ent

cap

acit

y an

d c

apab

ility

wit

h a

focu

s o

n us

ing

our

Qua

lity

Imp

rove

men

t re

sid

ency

ap

pro

ach

to e

qui

p e

mer

gin

g le

ader

s in

our

ju

nio

r d

oct

ors

, nur

sing

alli

ed h

ealt

h an

d a

dm

in s

taff

wo

rkfo

rce

gro

ups.

[Le

ad: M

edic

al

Dir

ecto

r/D

irec

tor

of

Nur

sing

/Dir

ecto

r o

f A

llied

Hea

lth/

Ser

vice

Imp

rove

men

t U

nit]

• C

ont

inue

to

bui

ld t

rust

thr

oug

h co

llab

ora

tio

n b

y al

l BO

PALT

and

Bay

Nav

igat

or

acti

vity

usi

ng a

who

le-o

f-sy

stem

ap

pro

ach;

[Le

ad: B

OPA

LT]

• C

ont

inue

to

dev

elo

p c

linic

al le

ader

ship

thr

oug

h th

e es

tab

lishm

ent

of

a C

linic

al

Dir

ecto

r, Im

pro

vem

ent

and

Inno

vati

on

and

a G

P li

aiso

n st

ruct

ure

to s

upp

ort

inte

gra

ted

ca

re in

itia

tive

s; [

Lead

: Pro

vid

er A

rm, M

edic

al D

irec

tor]

• C

ont

inue

to

co

llab

ora

te w

ith

oth

er a

gen

cies

, in

par

ticu

lar

the

Bay

of

Ple

nty

Alli

ance

Le

ader

ship

Tea

m a

nd a

sso

ciat

ed S

LATs

, the

Chi

ldre

n’s

Team

and

the

Chi

ld a

nd Y

out

h S

trat

egic

Alli

ance

• D

evel

op

rel

atio

nshi

ps

at g

over

nanc

e le

vel w

ith

loca

l aut

hori

ties

to

infl

uenc

e he

alth

in

all p

olic

ies.

[Le

ad: B

oar

d a

nd R

unan

ga]

Incr

ease

d n

umb

er o

f D

HB

sta

ff a

nd

com

mun

ity

heal

thca

re w

ork

ers

have

co

mp

lete

d IH

I Op

en S

cho

ol M

od

el f

or

Imp

rove

men

t.

All

SLA

Ts h

ave

bro

ad c

om

mun

ity

mem

ber

ship

.

Clin

ical

Dir

ecto

r an

d G

ener

al P

ract

ice

Liai

son

team

est

ablis

hed

by

Sep

tem

ber

20

16.

Inte

r-ag

ency

par

tner

ship

s es

tab

lishe

d

and

join

t g

oal

s id

enti

fied

by

June

20

17.

Them

e 6

:

Co

ntra

ctin

g f

or

Out

com

es

The

BO

PD

HB

will

:

• C

om

ple

te a

nd e

valu

ate

the

tria

l of

Out

com

es A

gre

emen

ts u

sing

the

MB

IE S

trea

mlin

ed

Co

ntra

ctin

g f

or

NG

Os

Fra

mew

ork

wit

h A

dul

t M

enta

l Hea

lth

pro

vid

ers

[Lea

d: M

āori

H

ealt

h P

lann

ing

and

Fun

din

g];

• D

epen

din

g o

n th

e o

utco

me

of

the

eval

uati

on,

sp

read

the

imp

lem

enta

tio

n o

f th

e F

ram

ewo

rk a

cro

ss P

lann

ing

and

Fun

din

g c

ont

ract

s w

ith

NG

Os;

[Le

ad: T

e Te

o H

eren

ga

Wak

a]

• D

evel

op

and

sp

read

exp

erti

se w

ithi

n th

e w

ork

forc

e in

fac

ilita

ting

out

com

es b

ased

ag

reem

ents

wit

h N

GO

pro

vid

ers

usin

g R

esul

ts B

ased

Acc

oun

tab

ility

met

hod

olo

gy;

• D

evel

op

a li

bra

ry o

f o

utco

me

mea

sure

s fo

r lo

cal u

se a

nd t

o s

upp

ort

nat

iona

l co

nsis

tenc

y.

Tria

l co

mp

lete

d a

nd e

valu

ated

by

Sep

tem

ber

20

16.

Bro

ader

imp

lem

enta

tio

n ac

ross

NG

O

pro

vid

er c

ont

ract

s in

sta

ged

pro

cess

un

der

way

by

June

20

17.

39


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Them

e 7:

Hea

lth

in A

ll P

olic

ies

The

BO

PD

HB

will

:

• C

olla

bo

rate

at

gov

erna

nce

leve

l wit

h lo

cal a

utho

riti

es t

o s

hare

our

vis

ion

of

Pae

Ora

an

d in

flue

nce

heal

th in

all

po

licie

s. [

Lead

: Bo

ard

and

Run

ang

a]

• D

evel

op

a g

over

nanc

e to

gov

erna

nce

eng

agem

ent

pla

n an

d s

upp

ort

ing

to

ols

, tra

inin

g

and

res

our

ces

to s

upp

ort

inte

r-ag

ency

co

llab

ora

tio

n.[L

ead

: Te

Teo

Her

eng

a W

aka]

• C

ont

inue

to

wo

rk o

n im

ple

men

ting

act

ions

in t

he S

mar

tGro

wth

Str

ateg

y w

here

the

D

HB

and

TTO

are

iden

tifi

ed a

s le

ad o

r su

pp

ort

ag

enci

es. [

Lead

: To

i Te

Ora

/Te

Teo

H

eren

ga

Wak

a].

• S

upp

ort

the

Bay

of

Ple

nty

Reg

iona

l Co

unci

l’s E

aste

rn B

ay S

pat

ial P

lan.

Join

t g

oal

s es

tab

lishe

d w

ith

loca

l au

tho

riti

es.

Co

unci

l po

licie

s an

d p

lans

pro

mo

te

heal

th o

utco

mes

.


2B.1

.2.2

Ser

vice

Co

nfig

urat

ion

incl

udin

g S

hift

ing

Ser

vice

s

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Serv

ice

Co

nfig

urat

ion

incl

udin

g

Shif

ting

Ser

vice

s

Our

str

ateg

ic a

pp

roac

h to

ser

vice

co

nfig

urat

ion

and

shi

ftin

g s

ervi

ces

is a

rtic

ulat

ed in

, an

d u

nder

pin

ned

by,

the

IHS

. htt

p://

ww

w.b

op

dhb

.gov

t.nz/

med

ia/5

7858

/bo

p-i

nteg

rate

d-

heal

thca

re-s

trat

egy-

2020

-fina

l-p

ublis

hed

-ver

sio

n.p

df

BO

PALT

mai

ntai

ns k

ey r

esp

ons

ibili

ty fo

r m

oni

tori

ng im

ple

men

tati

on

of

the

annu

al p

lan

pri

ori

ties

for

the

IHS

.

The

Chi

ld a

nd Y

out

h St

rate

gic

Alli

ance

has

lead

res

po

nsib

ility

for

over

seei

ng im

ple

men

tati

on

of

inte

gra

ted

hea

lthc

are

pri

ori

ties

for

child

ren

and

yo

ung

peo

ple

.

Pri

ori

ties

for

BO

PALT

for

2016

/17

are

liste

d b

elow

. F

urth

er d

etai

l of

thes

e p

rio

riti

es a

re s

et

out

in t

he fo

llow

ing

sec

tio

n an

d a

lso

in t

he B

OPA

LT 2

016

/17

wo

rk p

rog

ram

me

whi

ch c

an b

e vi

ewed

onl

ine

on

Bay

Nav

igat

or:

1. A

cute

Dem

and

Man

agem

ent

2.

Co

mm

unit

y N

ursi

ng

3.

Op

oti

ki L

oca

lity

Pla

nnin

g

4.

Rur

al S

ervi

ces

5.

Pha

rmac

y S

ervi

ces

Inte

gra

tio

n

Syst

em le

vel e

nab

lers

to

sup

po

rt t

he w

ork

pro

gra

mm

e an

d b

uild

ing

cap

acit

y ar

e ar

ticu

late

d

in t

he IH

S.

Syst

em e

nab

ler

pri

ori

ties

for

BO

PALT

for

2016

/17

are

det

aile

d a

bov

e in

sec

tio

n 2B

.1.2.

1 and

incl

ude:

6.

Cre

atin

g a

n en

viro

nmen

t fo

r in

teg

rati

on

7.

Acc

ess

to P

atie

nt In

form

atio

n

8.

Hea

lth

Lite

racy

9.

Inte

gra

ted

Per

form

ance

and

Ince

ntiv

e P

rog

ram

me.

Oth

er p

rog

ram

mes

and

pro

ject

s o

f re

leva

nce

to B

OPA

LT in

clud

e:

10.

Hea

lthy

pre

gna

ncy

– se

e se

ctio

n 2B

.1.3.

7

11.

Rai

sing

Hea

lthy

Kid

s –

see

sect

ion

2B.1.

4.2

12.

Pri

mar

y/C

om

mun

ity

Men

tal H

ealt

h in

teg

rati

on

– se

e se

ctio

n 2B

.1.4

.6

13.

Whā

nau

Ora

Pat

hway

– s

ee s

ecti

on

2B.1.

5.7

14.

Co

mm

unit

y R

efer

red

Rad

iolo

gy

-– s

ee s

ecti

on

2B.1.

5.8

Als

o r

efer

to

Mo

dul

e 5:

Bui

ldin

g C

apac

ity

PP

22: I

mp

rovi

ng s

yste

m in

teg

rati

on

- R

epo

rt o

n d

eliv

ery

of

the

acti

ons

an

d m

ilest

one

s id

enti

fied

in t

he

Ann

ual P

lan.

The

BO

PD

HB

will

pro

vid

e na

rrat

ive

rep

ort

ing

on

the

IHS

whe

n re

qui

red

.

41


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Acu

te D

eman

d

Man

agem

ent

(AD

M)

• B

OPA

LT w

ill e

nco

urag

e ap

pro

pri

ate

use

of

Em

erg

ency

Dep

artm

ent

(ED

) fo

r ac

ute

and

em

erg

ency

car

e b

y:

-R

educ

ing

vo

lum

e o

f Tr

iag

e 4

and

5 E

D a

tten

dan

ces

-E

stab

lishi

ng w

hole

of

syst

em m

anag

emen

t p

lan

for

pea

k an

d h

olid

ay p

erio

ds

-E

nhan

cing

cap

acit

y in

gen

eral

pra

ctic

e.

Qua

rter

s 1

and

2

•Dev

elo

p a

co

llab

ora

tive

mo

del

thr

oug

h th

e A

cute

Dem

and

Man

agem

ent

Clin

ical

N

etw

ork

(A

DM

Clin

ical

Net

wo

rk)

wit

h ag

reed

Ter

ms

of

Ref

eren

ce a

nd r

egul

ar

rep

ort

ing

to

sta

keho

lder

s. T

his

gro

up w

ill g

uid

e, m

oni

tor

and

pri

ori

tise

ob

ject

ives

to

ad

dre

ss A

cute

Dem

and

Man

agem

ent

acro

ss t

he B

ay o

f P

lent

y sy

stem

. R

egul

ar

syst

em m

easu

res

will

be

dev

elo

ped

and

tri

alle

d t

hro

ugh

this

gro

up t

o g

uid

e p

rio

riti

sati

on

and

init

iati

ve d

evel

op

men

t. T

his

gro

up w

ill a

lso

sup

po

rt w

here

ab

le,

the

furt

her

dev

elo

pm

ent

of

pat

ient

info

rmat

ion

acro

ss t

he s

yste

m.

• E

nhan

ce c

urre

nt A

cute

Dem

and

Man

agem

ent

Co

mm

unit

y P

rim

ary

Op

tio

ns

(CP

O)

to e

nsur

e th

at p

atie

nts

rece

ive

cons

iste

nt a

cces

s an

d A

SH

co

ndit

ions

are

m

ore

effi

cien

tly

and

eff

ecti

vely

man

aged

thr

oug

h ta

rget

ed p

rog

ram

mes

e.g

. ce

llulit

is.

• E

xplo

re a

fter

-ho

urs

tele

pho

ne t

riag

e p

rovi

sio

n ac

ross

the

Bay

of

Ple

nty

incl

udin

g d

evel

op

ing

a c

om

mun

ity

com

mun

icat

ion

pla

n to

ens

ure

clea

r m

essa

gin

g

and

max

imis

e up

take

of

this

ser

vice

, sp

ecifi

c m

easu

res

to b

e se

t e.

g. u

tilis

atio

n in

clud

ing

vo

lum

e b

y p

ract

ice,

eth

nici

ty, t

ime

of

day

, dia

gno

sis,

and

out

com

e.

Imp

lem

enta

tio

n w

ithi

n th

is p

erio

d is

dep

end

ent

on

tim

ing

of

any

dec

isio

n.

• E

xplo

re c

olla

bo

rati

on

bet

wee

n E

D a

nd p

rim

ary

care

nur

sing

in r

elat

ion

to

com

bin

ed e

duc

atio

n w

here

ap

pro

pri

ate.

• Te

st a

co

mm

unit

y b

ased

and

nur

se le

d p

acka

ge

of

care

at

the

Taur

ang

a H

osp

ital

E

mer

gen

cy D

epar

tmen

t fo

r p

atie

nts

who

can

be

safe

ly c

ared

fo

r at

ho

me

and

w

oul

d o

ther

wis

e ha

ve b

een

adm

itte

d t

o h

osp

ital

.

Qua

rter

3

• Lo

ok

at s

yste

m m

easu

res

dev

elo

ped

by

the

AD

M C

linic

al N

etw

ork

bei

ng v

isib

le

and

uti

lised

by

all s

take

hold

ers

to in

form

ong

oin

g p

lann

ing

wo

rk.

• R

evie

w C

PO

uti

lisat

ion

and

mea

sure

s.

• B

egin

rev

iew

of

afte

rho

urs

tele

pho

ne t

riag

e to

sup

po

rt f

urth

er d

evel

op

men

t w

ith

GP

Pra

ctic

es a

nd p

ublic

co

mm

unic

atio

ns a

s ap

pro

pri

ate.

Qua

rter

4

• E

valu

atio

n o

f al

l ini

tiat

ives

.

Hea

lth

Targ

et: 9

5% o

f p

atie

nts

will

be

adm

itte

d, d

isch

arg

ed, o

r tr

ansf

erre

d

fro

m a

n E

mer

gen

cy D

epar

tmen

t w

ithi

n si

x ho

urs

of

pre

sent

atio

n.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Co

mm

unit

y N

ursi

ng

• B

OPA

LT w

ill im

ple

men

t th

e in

teg

rate

d m

od

el o

f ca

re f

or

com

mun

ity

nurs

ing

as

follo

ws:

Q

uart

er 1

: C

om

ple

ting

tes

ts o

f ch

ang

e fo

r ea

ch p

art

of

the

mo

del

of

care

. Te

sts

of

chan

ge

eval

uate

d.

Imp

lem

enta

tio

n p

lan

for

com

ple

x ch

roni

c ca

re c

om

ple

ted

. W

ork

forc

e p

ract

ice

chan

ge

det

ails

co

mp

lete

d. I

nfo

rmat

ion

tech

nolo

gy

sup

po

rt r

equi

rem

ents

co

mp

lete

d.

Q

uart

er 2

: B

usin

ess

case

pre

sent

ed a

nd p

refe

rred

op

tio

ns f

or

imp

lem

enta

tio

n co

nfirm

ed.

Fun

din

g r

equi

rem

ents

and

mec

hani

sms

com

ple

ted

. Mo

nito

ring

fra

mew

ork

co

mp

lete

d.

Refi

ned

mo

del

of

care

fina

lised

. Im

ple

men

tati

on

pro

ject

co

nclu

ded

and

less

ons

lear

nt

do

cum

ente

d.

Q

uart

er 3

: Im

ple

men

tati

on

acti

viti

es c

om

men

ce.

Q

uart

er 4

: Im

ple

men

tati

on

acti

viti

es c

ont

inue

.

Inte

gra

ted

mo

del

of

care

fo

r co

mm

unit

y nu

rsin

g im

ple

men

ted

by

31

Dec

emb

er 2

016

.

Op

oti

ki L

oca

lity

Pla

nnin

g

• B

OPA

LT w

ill im

ple

men

t th

e m

od

el o

f ca

re s

upp

ort

ing

inte

gra

ted

hea

lth

serv

ices

to

d

evel

op

as

follo

ws:

Q

uart

er 1

: G

over

nanc

e G

roup

est

ablis

hed

incl

udin

g p

rim

ary

care

bus

ines

s o

wne

rs, p

rovi

der

ar

m, O

PIN

s, S

t Jo

hns,

pha

rmac

y, C

oun

cils

, DH

B a

nd P

HO

. T

he B

OP

DH

B h

as in

vest

ed

in a

pro

ject

man

ager

fo

r 18

mo

nths

to

imp

lem

ent

chan

ges

to

the

mo

del

of

care

. F

urth

er in

vest

men

t o

r re

allo

cati

on

of

exis

ting

res

our

ces

may

occ

ur a

s p

art

of

this

w

ork

.

Q

uart

er 2

: W

ork

pro

gra

mm

e ag

reed

. Im

ple

men

tati

on

of

agre

ed m

od

el o

f ca

re.

Q

uart

ers

3 an

d 4

: F

acili

ty o

pti

ons

det

erm

ined

. Tr

ansi

tio

n to

ag

reed

mo

del

of

care

. D

HB

s an

d p

rim

ary

care

ser

vice

s re

confi

gur

ed t

o s

upp

ort

mo

del

of

care

.

Mo

del

of

care

fo

r O

po

tiki

hea

lth

serv

ices

imp

lem

ente

d b

y 30

Jun

e 20

17.

43


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Rur

al S

ervi

ces

• T

he R

ural

Ser

vice

Lev

el A

llian

ce T

eam

(R

SLA

T)

will

act

as

an e

xper

t ad

viso

ry g

roup

to

BO

PALT

as

follo

ws:

-D

evel

op

a c

olla

bo

rati

ve s

yste

m-w

ide

app

roac

h to

the

use

of

Rur

al

Sus

tain

abili

ty F

und

ing

;

-Im

pro

ve c

om

mun

icat

ion

and

und

erst

and

ing

aro

und

rur

al p

rim

ary

heal

th

issu

es a

nd a

sso

ciat

ed f

und

ing

so

luti

ons

.

Q

uart

ers

1 an

d 2

: Im

ple

men

tati

on

of

a re

vise

d R

ural

Pha

rmac

y Is

ola

tio

n an

d S

usta

inab

ility

ser

vice

.

C

om

ple

te w

ork

forc

e su

stai

nab

ility

rev

iew

, und

erta

king

a p

ract

ice

surv

ey.

C

om

ple

te a

gap

ana

lysi

s o

f ex

isti

ng s

ervi

ce a

cces

s.

R

evie

w t

erm

s o

f re

fere

nce

and

fun

ctio

n o

f th

e R

ural

SLA

T.

Q

uart

ers

3 an

d 4

: R

esp

ond

to

the

wo

rkfo

rce

and

gap

s an

alys

is w

ith

an a

gre

ed w

ork

pla

n.

Wo

rk p

lan

for

rura

l hea

lth

serv

ices

is

imp

lem

ente

d b

y 30

Jun

e 20

17.

Pha

rmac

y Se

rvic

es

Inte

gra

tio

n:

(i)

Inte

gra

tio

n -

Dev

elo

p a

nd

imp

lem

ent

med

icin

es

adhe

renc

e an

d

op

tim

isat

ion

serv

ices

of

hig

h q

ualit

y th

at

incl

ude

targ

eted

vo

lum

es f

or

each

se

rvic

e by

yea

r en

d

• F

urth

er d

evel

op

men

t o

f th

e p

harm

acy

Long

Ter

m C

ond

itio

ns s

ervi

ce t

o a

lign

wit

h th

e ne

w s

ervi

ce m

od

el

• O

ffer

tra

inin

g t

o p

harm

acis

ts a

nd t

echn

icia

ns in

co

unse

lling

pat

ient

s to

eff

ecti

vely

se

lf-m

anag

e th

eir

med

icin

es a

nd im

pro

ve t

heir

hea

lth

liter

acy

• C

ons

ult

and

wo

rk w

ith

the

BO

P C

om

mun

ity

Pha

rmac

y G

roup

fo

r lo

cal i

nnov

atio

ns

• R

evie

w n

atio

nal p

rovi

sio

n o

f M

edic

ine

The

rap

y A

sses

smen

ts (

MTA

s)

• R

evie

w t

he d

eliv

ery

serv

ices

tha

t o

pti

mis

e sp

ecifi

c m

edic

ines

eg

. CPA

MS

ens

urin

g

alig

nmen

t to

the

new

ser

vice

mo

del

Spec

ific

mile

sto

nes

incl

ude:

Qua

rter

1

• P

erfo

rman

ce r

epo

rtin

g f

or

curr

ent

init

iati

ves

com

ple

ted

fo

r B

OPA

LT/S

LAT

fo

r b

asel

ine

revi

ew a

nd s

tock

take

Qua

rter

2

• O

pti

mis

atio

n an

d a

dhe

renc

e/ M

TA s

ervi

ce in

itia

tive

s o

pti

ons

iden

tifi

ed in

clud

ing

p

ote

ntia

l ser

vice

mea

sure

s.

Qua

rter

3

• P

erfo

rman

ce r

epo

rts

revi

ewed

Qua

rter

4

• E

ngag

emen

t ac

ross

oth

er p

rim

ary

care

ser

vice

s.

• M

oni

tori

ng r

epo

rt o

n LT

C

reg

istr

atio

n vo

lum

es

• In

crea

sed

num

ber

of

pat

ient

s re

ceiv

e th

e LT

C S

ervi

ce f

rom

the

ir

pha

rmac

y

• R

epre

sent

atio

n w

ithi

n B

OP

A

llian

ce S

LAT

• S

tock

take

of

loca

l pro

visi

on

of

MTA

s

• R

eco

mm

end

atio

ns r

epo

rt o

n M

TAs

• M

oni

tori

ng r

epo

rt o

n C

PAM

S

• R

eco

mm

end

atio

ns r

epo

rt o

n re

view


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

(ii)

BO

PALT

w

ill e

stab

lish

a P

harm

acy

Serv

ice

Leve

l A

llian

ce T

eam

(S

LAT)

• A

SLA

T w

ork

pla

n fo

r 20

16/1

7 is

ag

reed

.

• S

upp

ort

loca

l im

ple

men

tati

on

of

the

Dra

ft P

harm

acy

Act

ion

Pla

n 20

15-2

020

wit

h a

focu

s o

n m

edic

ine

man

agem

ent.

Spec

ific

mile

sto

nes

incl

ude:

Qua

rter

1

• S

LAT

wo

rk p

lan

dev

elo

ped

and

init

iati

ves

for

revi

ew/d

evel

op

men

t ag

reed

.

Qua

rter

2

• S

ervi

ce d

evel

op

men

t im

ple

men

ted

thr

oug

h ap

pro

pri

ate

cont

ract

pro

cess

es; o

ther

se

rvic

e en

gag

ed f

or

who

le o

f sy

stem

ap

pro

ach.

Qua

rter

3

• P

erfo

rman

ce o

f se

rvic

es r

epo

rted

to

BO

PALT

Qua

rter

4

• R

evie

w s

ervi

ce o

utco

mes

, rea

sses

s S

LAT

wo

rk p

lan

and

ad

just

as

need

ed.

• W

ork

pla

n co

mp

lete

d

45


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

(iii)

Pat

ient

s re

ceiv

e co

-o

rdin

ated

se

rvic

es c

lose

r to

ho

me

and

p

rovi

ded

wit

hin

one

tea

m

The

BO

PD

HB

will

:

• C

om

ple

te E

xpre

ssio

n o

f In

tere

st (

EO

I), i

f re

qui

red

, fo

r ex

isti

ng m

edic

ines

m

anag

emen

t se

rvic

es w

ith

a g

reat

er e

mp

hasi

s o

n vu

lner

able

po

pul

atio

ns a

nd

inte

gra

tio

n in

to a

Gen

eral

Pra

ctic

e o

r o

ther

hea

lth

sett

ing

e.g

. Ag

ed R

esid

enti

al C

are.

• S

upp

ort

wo

rk b

eing

do

ne n

atio

nally

to

dev

elo

p a

Nat

iona

l Fra

mew

ork

fo

r P

harm

acis

t S

ervi

ces

in t

he c

om

mun

ity

and

imp

lem

ent

serv

ices

out

lined

in t

he

fram

ewo

rk t

o m

eet

the

need

s o

f th

e B

OP

po

pul

atio

n.

Spec

ific

mile

sto

nes

incl

ude:

Qua

rter

2

• A

ged

Res

iden

tial

Car

e an

d p

rim

ary

care

ser

vice

are

as a

re e

ngag

ed in

SLA

T w

ork

p

lan

for

pla

nnin

g a

nd t

rial

of

new

ser

vice

op

tio

ns in

the

co

mm

unit

y

Qua

rter

3

• P

erfo

rman

ce m

easu

res

revi

ewed

and

up

dat

ed a

s re

qui

red

fo

r sy

stem

wid

e eff

ect.

• E

OI c

om

ple

ted

(if

req

uire

d)

• N

ew /

rev

ised

loca

l Med

icin

es

Man

agem

ent

Pha

rmac

y se

rvic

e ag

reem

ents

off

ered

(iv)

Dev

elo

p

and

imp

lem

ent

an e

ffici

ent

med

icin

es s

upp

ly

chai

n

The

BO

PD

HB

will

:

Imp

lem

ent

an in

teri

m s

olu

tio

n to

pha

rmac

euti

cal m

arg

ins

• F

urth

er o

pp

ort

unit

ies

to r

educ

e co

sts

and

was

te in

sup

ply

of

med

icin

es id

enti

fied

an

d p

ursu

ed

• D

evel

op

and

imp

lem

ent

a su

stai

nab

le s

olu

tio

n to

the

pha

rmac

euti

cal m

arg

in a

nd

oth

er s

upp

ly c

hain

issu

es c

ons

iste

nt w

ith

refe

rral

ad

vice

.

Spec

ific

mile

sto

nes

incl

ude:

Qua

rter

1

• C

PS

A n

atio

nal p

rog

ram

me

init

iati

ves

for

sup

ply

cha

in im

pro

vem

ent

are

pla

nned

fo

r lo

cal i

mp

lem

enta

tio

n

Qua

rter

2

• E

ngag

emen

t w

ith

com

mun

ity

pha

rmac

ists

ab

le t

o le

ad a

nd d

eliv

er s

upp

ly c

hain

im

pro

vem

ents

.

• M

edic

ines

sup

ply

effi

cien

cies

st

atus

up

dat

e re

po

rt p

ublis

hed

• R

epo

rt o

n o

pti

ons

rel

ease

d f

or

feed

bac

k fr

om

the

sec

tor.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

(v)

Co

mm

issi

on

serv

ices

to

b

est

mee

t th

e id

enti

fied

d

eman

d w

ithi

n th

e C

om

mun

ity

Pha

rmac

y en

viro

nmen

t.

The

BO

PD

HB

will

:

• P

arti

cip

ate

in a

nat

iona

l pro

cess

to

pla

n th

e o

ngo

ing

co

mm

issi

oni

ng o

f p

harm

acis

t se

rvic

es in

the

co

mm

unit

y.

• D

evel

op

new

pha

rmac

ist

serv

ices

and

fun

din

g m

od

els

to s

upp

ort

mo

re c

o-o

rdin

ated

p

atie

nt-c

entr

ed p

rim

ary

care

fo

r o

ur p

op

ulat

ion.

• S

trat

ifica

tio

n o

f p

atie

nt-c

entr

ic s

ervi

ces.

• S

upp

ort

wo

rk b

eing

do

ne n

atio

nally

to

dev

elo

p a

Nat

iona

l Fra

mew

ork

fo

r P

harm

acis

t S

ervi

ces

in t

he c

om

mun

ity

and

imp

lem

ent

serv

ices

out

lined

in t

he

fram

ewo

rk t

o m

eet

the

need

s o

f th

e B

OP

po

pul

atio

n.

Spec

ific

mile

sto

nes

incl

ude:

Qua

rter

2

• N

ew s

ervi

ces

and

cur

rent

ser

vice

init

iati

ves

com

mis

sio

ned

as

par

t o

f th

e na

tio

nal

wo

rk.

• A

ged

Res

iden

tial

Car

e an

d p

rim

ary

care

ser

vice

are

as a

re e

ngag

ed in

SLA

T w

ork

p

lan

for

pla

nnin

g a

nd t

rial

of

new

ser

vice

op

tio

ns in

the

co

mm

unit

y

Qua

rter

3

• P

erfo

rman

ce m

easu

res

revi

ewed

and

up

dat

ed a

s re

qui

red

fo

r sy

stem

wid

e eff

ect

• A

new

co

ntra

ct (

or

cont

ract

s)

in p

lace

fo

r th

e in

teg

rati

on

of

pha

rmac

ists

ser

vice

s in

the

co

mm

unit

y

• C

om

mo

n, c

ore

and

div

erg

ent

cont

ract

s in

pla

ce

• P

harm

acy

serv

ices

into

diff

eren

t he

alth

care

set

ting

s e.

g. H

om

e B

ased

Ser

vice

s, A

ged

Res

iden

tial

C

are.

47


ANNUAL PLAN 2016/17

2B.1

.3 C

hild

and

Yo

uth

Hea

lth

A k

ey f

ocu

s o

f th

e G

over

nmen

t is

vul

nera

ble

fam

ilies

. S

oci

al s

ecto

r ag

enci

es n

eed

to

be

inno

vati

ve, r

esp

ons

ive

and

wo

rk t

og

ethe

r in

ord

er

to p

rovi

de

serv

ices

tha

t b

est

mee

t th

e ne

eds

of

pri

ori

ty p

op

ulat

ions

. T

his

sect

ion

sets

out

ho

w t

he B

OP

DH

B is

sup

po

rtin

g c

ross

-ag

ency

w

ork

to

del

iver

po

siti

ve h

ealt

h o

utco

mes

fo

r ch

ildre

n an

d y

oun

g p

eop

le.

2B.1

.3.1

Red

ucin

g U

nint

end

ed T

eena

ge

Pre

gna

ncy

The

Min

iste

r’s

Lett

er o

f E

xpec

tati

ons

fo

r 20

16/1

7 no

tes

that

red

ucin

g u

nint

end

ed t

eena

ge

pre

gna

ncy

is p

art

of

the

Bet

ter

Pub

lic S

ervi

ce

Res

ult

One

: Red

ucin

g lo

ng-t

erm

wel

fare

dep

end

ence

. T

he p

rop

ose

d s

trat

egy

is t

o e

nab

le y

oun

g p

eop

le t

o t

ake

char

ge

of

thei

r se

xual

and

re

pro

duc

tive

hea

lth.

The

BO

PD

HB

is s

upp

ort

ing

thi

s g

oal

by

pro

vid

ing

eas

y ac

cess

to

aff

ord

able

yo

uth

frie

ndly

sex

ual a

nd r

epro

duc

tive

he

alth

ser

vice

s as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Red

ucin

g

Uni

nten

ded

Te

enag

e P

reg

nanc

y

The

BO

PD

HB

will

co

ntin

ue t

o s

how

lead

ersh

ip o

n R

educ

ing

Uni

nten

ded

Tee

nag

e P

reg

nanc

y as

a p

rio

rity

thr

oug

h th

e fo

llow

ing

:

• T

he C

hild

Yo

uth

Str

ateg

ic A

llian

ce (

CY

SA

) in

clud

es R

educ

ing

Uni

nten

ded

Te

enag

e P

reg

nanc

y w

ithi

n it

s im

ple

men

tati

on

role

fo

r th

e B

OP

Chi

ld a

nd Y

out

h H

ealt

h an

d W

ellb

eing

Str

ateg

y (2

014

-19

) an

d w

ill in

clud

e it

in t

he w

ork

pla

n fo

r 20

16/1

7 w

ith

the

follo

win

g m

ilest

one

s:

• Q

uart

er o

ne: C

YS

A H

ealt

hy P

reg

nanc

ies

pro

ject

wo

rk g

roup

pla

n id

enti

fies

m

ater

nity

mo

del

of

care

op

tio

ns

• Q

uart

er t

wo

: Lo

calit

y en

gag

emen

t o

n a

pre

ferr

ed m

od

el f

or

tria

l ap

plic

atio

n as

te

st o

f ch

ang

e co

mp

lete

• Q

uart

er f

our

: Wo

rkin

g G

roup

rev

iew

and

eva

luat

ion

of

tria

l

• E

nsur

e ac

cess

to

fre

e lo

ng t

erm

co

ntra

cep

tio

n th

roug

h a

vari

ety

of

loca

l ser

vice

s su

ch a

s yo

uth

heal

th, p

rim

ary

care

, pha

rmac

ies,

mat

erni

ty a

nd s

cho

ol b

ased

hea

lth.

• E

nsur

e na

tio

nal p

olic

y, p

lann

ing

and

loca

l ser

vice

s, s

uch

as t

he s

exua

l and

re

pro

duc

tive

hea

lth

acti

on

pla

n, a

re p

rovi

ded

wit

hin

a sh

ared

info

rmat

ion

foru

m

that

pro

mo

tes

an in

teg

rate

d s

ervi

ce a

pp

roac

h ac

ross

alli

ance

sec

tor

par

tner

s an

d w

ithi

n he

alth

ser

vice

s (f

urth

er d

etai

ls b

elo

w).

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.

Wo

rkfo

rce

dev

elo

pm

ent

• T

he B

OP

DH

B w

ill e

nsur

e th

at p

rim

ary

care

(in

clud

ing

GP

s, m

idw

ives

, nur

ses)

an

d t

he r

elev

ant

tert

iary

car

e w

ork

forc

e ha

ve r

ecen

t p

rofe

ssio

nal t

rain

ing

in

yout

h-fr

iend

ly, c

ultu

rally

-co

mp

eten

t, c

ont

race

pti

ve c

hoic

e d

iscu

ssio

ns (

incl

udin

g

long

act

ing

rev

ersi

ble

co

ntra

cep

tio

n (L

AR

Cs)

as

a p

osi

tive

cho

ice

wit

hin

60

m

inut

es).

• T

he B

OP

DH

B w

ill e

nsur

e th

at s

uffici

ent

pri

mar

y ca

re (

incl

udin

g G

Ps,

mid

wiv

es,

nurs

es)

and

ter

tiar

y ca

re w

ork

forc

e ha

ve r

ecen

t tr

aini

ng in

inse

rtio

n o

f LA

RC

s to

p

rovi

de

a lo

cally

ava

ilab

le s

ervi

ce in

urb

an a

nd r

ural

to

wns

.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Scho

ol b

ased

he

alth

ser

vice

(S

BH

S) c

ont

ract

s

The

BO

PD

HB

will

ens

ure

that

SB

HS

co

ntra

cts

neg

oti

ated

wit

h sc

hoo

ls in

clud

e ex

plic

it

agre

emen

t fo

r:

• nu

rses

to

pro

vid

e co

ntra

cep

tio

n ch

oic

e eg

, dis

cuss

ion,

ref

erra

l, p

resc

rip

tio

ns o

r p

rovi

sio

n an

d h

ave

suffi

cien

t ac

cess

to

co

ntra

cep

tive

sup

plie

s

• nu

rses

to

hav

e E

CP

end

ors

emen

t an

d u

se s

tand

ing

ord

ers

• nu

rses

to

get

ap

pro

pri

ate

pro

fess

iona

l sup

po

rt/s

uper

visi

on

and

rem

uner

atio

n e.

g. 1.

atte

nd w

ork

forc

e d

evel

op

men

t in

rel

evan

t yo

uth

heal

th a

nd s

exua

l and

re

pro

duc

tive

hea

lth

issu

es

2.

acce

ss t

rain

ing

fro

m D

HB

nur

sing

pro

fess

iona

l dev

elo

pm

ent

unit

s

3.

atte

nd r

egio

nal n

etw

ork

s o

f o

ther

sch

oo

l nur

ses

and

/or

yout

h he

alth

p

rofe

ssio

nals

4.

be

able

to

acc

ess

clin

ical

sup

ervi

sio

n/su

pp

ort

fro

m a

pp

rop

riat

e he

alth

p

rofe

ssio

nals

eg

, GP

s.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.

Acc

ess

to

cont

race

pti

ves

and

ter

min

atio

n o

f p

reg

nanc

y

• T

he B

OP

DH

B p

rovi

des

acc

ess

to a

ll w

om

en in

clud

ing

yo

uth

to s

afe

term

inat

ion

of

pre

gna

ncy

incl

udin

g e

arly

med

ical

ab

ort

ion.

Co

ntra

cep

tive

co

unse

lling

is

pro

vid

ed t

o a

ll vu

lner

able

yo

ung

wo

men

/tee

nag

ers

in p

rim

ary

care

, wit

h E

aste

rn

Bay

Pri

mar

y H

ealt

h A

llian

ce p

rovi

din

g f

ree

sexu

al a

nd r

epro

duc

tive

hea

lth

care

to

all

und

er 2

5s.

• T

he B

OP

DH

B w

ill w

ork

wit

h P

HO

s an

d r

elev

ant

Hau

ora

pro

vid

ers

to e

xten

d t

he

acce

ss t

o a

ffo

rdab

le (

low

co

st, n

o c

ost

), lo

cally

ava

ilab

le, c

ultu

rally

co

mp

eten

t,

yout

h fr

iend

ly, p

rim

ary

care

sex

ual h

ealt

h an

d c

ont

race

pti

ve c

ons

ulta

tio

ns

(inc

lud

ing

the

inse

rtio

n o

f LA

RC

s) in

urb

an a

nd r

ural

to

wns

acr

oss

the

BO

P.

• T

he e

mer

gen

cy c

ont

race

pti

ve p

rog

ram

me

del

iver

ed f

rom

sel

ecte

d p

harm

acie

s ac

ross

the

BO

P r

egio

n w

ill c

ont

inue

to

ens

ure

com

mun

ity

acce

ssib

ility

as

need

ed.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.

49


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Alig

nmen

t w

ith

Min

istr

y o

f H

ealt

h’s

Sexu

al a

nd

Rep

rod

ucti

ve

Hea

lth

Act

ion

Pla

n

• T

he B

OP

DH

B w

ill a

lign

its

wo

rk w

ith

the

nati

ona

l Sex

ual a

nd R

epro

duc

tive

H

ealt

h A

ctio

n P

lan

onc

e it

is r

elea

sed

. The

DH

B e

xpec

ts t

hat

this

alig

nmen

t w

ork

w

ill n

eed

to

occ

ur o

ver

a lo

nger

tim

e p

erio

d t

han

2016

/17,

so

act

ivit

ies

will

be

pha

sed

and

pri

ori

tise

d.

Key

mile

sto

nes

for

sexu

al h

ealt

h an

d c

ont

race

pti

on

acti

vity

pla

nned

:

Qua

rter

2

• S

tock

take

co

mp

lete

d f

or

pro

vid

er c

apac

ity

and

co

mp

eten

cy t

o p

rovi

de

long

act

ing

re

vers

ible

co

ntra

cep

tio

n (L

AR

Cs)

ser

vice

Qua

rter

3

• S

ervi

ce p

rop

osa

l co

mp

lete

d f

or

bud

get

fun

din

g o

f LA

RC

ser

vice

incl

udin

g t

rain

ing

as

iden

tifi

ed f

or

imp

lem

enta

tio

n; a

nd c

om

ple

te e

ngag

emen

t w

ith

PH

Os

and

rel

evan

t H

auo

ra p

rovi

der

s fo

r yo

uth

and

co

mm

unit

y le

vel r

esp

ons

e

Qua

rter

4

• P

erfo

rman

ce r

epo

rts

revi

ewed

fo

r al

ignm

ent

to g

uid

elin

es o

f th

e na

tio

nal S

exua

l H

ealt

h A

ctio

n P

lan.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.

Clin

ical

Le

ader

ship

CY

SA

has

clin

ical

rep

rese

ntat

ion

that

will

pro

vid

e le

ader

ship

and

ove

rsig

ht f

or

pro

gra

mm

es t

hat

are

yout

h re

late

d, t

o e

nsur

e eq

uity

of

acce

ss a

nd q

ualit

y im

pro

vem

ent

pro

cess

es a

re d

evel

op

ed s

uch

as f

or

the

Sch

oo

l Bas

ed H

ealt

h S

ervi

ce a

nd K

aup

apa

pro

vid

ers

in t

he c

om

mun

ity.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.


2B.1

.3.2

Incr

ease

d Im

mun

isat

ion

In a

cco

rdan

ce w

ith

nati

ona

l im

mun

isat

ion

init

iati

ves,

the

BO

PD

HB

will

tak

e ac

tio

ns t

o s

upp

ort

rea

chin

g a

nd m

aint

aini

ng

targ

et c

over

age

rate

s fo

r al

l im

mun

isat

ions

, sp

ecifi

cally

chi

ldho

od

(8

mo

nths

, 24

mo

nths

, 5 y

ears

and

11/

12 y

ears

) as

fo

llow

s.

Link

ages

Hea

lth

Targ

et

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Mai

ntai

ning

in

fant

im

mun

isat

ion

rate

s (s

ix w

eeks

, th

ree

mo

nths

an

d fi

ve m

ont

hs

imm

unis

atio

n ev

ents

) at

95%

un

til 2

017

• T

he B

OP

Imm

unis

atio

n A

dvi

sory

Gro

up, a

bro

ad s

ecto

r g

roup

, will

co

ntin

ue t

o m

eet

bi-

mo

nthl

y to

dri

ve t

arg

et p

erfo

rman

ce a

chie

vem

ent

and

ad

dre

ss a

ll im

mun

isat

ion

issu

es a

t a

stra

teg

ic a

nd o

per

atio

nal l

evel

.

• A

fo

cus

gro

up (

that

incl

udes

rep

rese

ntat

ives

fro

m t

he M

inis

try

of

Hea

lth,

PH

Os

and

D

HB

) ha

s b

een

conv

ened

to

exa

min

e ta

rget

per

form

ance

at

eig

ht m

ont

hs; e

stab

lish

linka

ges

reg

iona

lly w

ith

Mid

land

ear

ly e

nro

lmen

t ac

tivi

ty, a

nd in

vest

igat

e g

ener

al

pra

ctic

e p

roce

sses

incl

udin

g:

-re

ferr

al t

o O

utre

ach

Imm

unis

atio

n S

ervi

ces

-re

duc

ing

dec

lines

, and

-m

oni

tori

ng P

HO

and

pra

ctic

e p

erfo

rman

ce.

• E

xam

ine

and

rep

ort

on

the

imm

unis

atio

n st

atus

fo

r in

fant

s an

d c

hild

ren

atte

ndin

g

hosp

ital

ser

vice

s, a

nd w

here

nec

essa

ry o

ngo

ing

ref

erra

l to

gen

eral

pra

ctic

e fo

r fo

llow

-up

and

whe

re a

pp

rop

riat

e un

der

take

op

po

rtun

isti

c va

ccin

atio

ns.

• T

he B

OP

DH

B h

as r

eque

sted

tha

t ea

ch P

HO

set

up

mul

ti-d

isci

plin

ary

mee

ting

s (M

DM

) w

ith

the

rem

it t

o im

pro

ve t

he e

ight

-mo

nth

old

imm

unis

atio

n ta

rget

thr

oug

h im

pro

ved

inte

r-d

isci

plin

ary

com

mun

icat

ion.

The

Mul

ti-D

isci

plin

ary

Team

s (M

DT

) w

ill b

e es

tab

lishe

d b

y th

e en

d o

f Q

uart

er 1

and

will

incl

ude

the

DH

B (

Pla

nnin

g a

nd

Fun

din

g, P

ublic

Hea

lth

Nur

ses,

NIR

) P

HO

s, t

he O

ral H

ealt

h S

ervi

ce, W

ell C

hild

/Ta

mar

iki O

ra, M

idw

ives

, Plu

nket

and

Gen

eral

Pra

ctic

e Im

mun

isat

ion

Cha

mp

ions

. T

he M

DT

will

mee

t m

ont

hly

unti

l the

tar

get

of

95%

is r

each

ed, t

hen

two

mo

nthl

y to

mai

ntai

n co

mp

lianc

e. T

he M

DT

will

sha

re in

form

atio

n re

gar

din

g h

ard

to

rea

ch

fam

ilies

, and

fo

rthc

om

ing

chi

ldre

n tu

rnin

g e

ight

mo

nths

. T

he M

DT

will

ens

ure

the

mo

st r

elev

ant

reso

urce

s ar

e us

ed t

o w

ork

wit

h fa

mili

es w

ho a

re h

esit

ant

or

refu

sing

va

ccin

atio

ns.

The

MD

T w

ill r

epo

rt m

ont

hly

to t

he M

inis

try

of

Hea

lth.

Eac

h P

HO

will

en

sure

tha

t lis

ts o

f m

isse

d b

abie

s an

d t

hose

co

min

g u

p t

o e

ight

mo

nths

old

will

be

pro

vid

ed t

o t

he M

DT

wit

h st

atus

and

act

ions

.

Hea

lth

targ

et: 9

5% o

f ei

ght

-mo

nth-

old

s w

ill h

ave

thei

r p

rim

ary

cour

se

of

imm

unis

atio

n (s

ix w

eeks

, thr

ee

mo

nths

and

five

mo

nths

imm

unis

atio

n ev

ents

) o

n ti

me.

Imm

unis

atio

n

Incr

ease

d

51


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Incr

easi

ng

child

ren’

s im

mun

isat

ion

rate

s (f

or

two

ye

ars

and

five

ye

ars)

to

95%

• T

he B

OP

DH

B w

ill c

ons

ider

a c

ross

-ag

ency

ap

pro

ach

to d

esig

n an

d im

ple

men

t ch

ang

es a

imed

at

incr

easi

ng t

arg

et p

erfo

rman

ce a

chie

vem

ent

for

two

and

five

ye

ar o

lds.

All

BO

PD

HB

ag

reem

ents

rel

ated

to

chi

ldho

od

imm

unis

atio

ns a

re b

eing

re

view

ed p

rio

r to

1 J

uly

2016

to

bet

ter

alig

n fu

nded

act

ivit

y w

ith

targ

ets.

Thi

s w

ill

cons

ider

the

co

-lo

cati

on

of

rele

vant

ser

vice

s w

here

ap

pro

pri

ate,

or

faili

ng t

hat,

m

ore

inte

gra

ted

wo

rkin

g p

ract

ices

bet

wee

n N

IR, O

utre

ach

Imm

unis

atio

n S

ervi

ces,

D

HB

Imm

unis

atio

n F

acili

tato

r an

d P

HO

Imm

unis

atio

n C

oo

rdin

ato

r se

rvic

es a

s o

ne

team

. In

the

Wes

tern

BO

P, a

mul

ti-d

isci

plin

ary

team

will

mee

t w

eekl

y to

allo

cate

re

spo

nsib

ility

fo

r fo

llow

ing

up

all

child

ren

who

are

ove

rdue

the

ir v

acci

nati

on

at e

vent

ag

es t

o e

nsur

e im

mun

isat

ion

is c

om

ple

ted

by

targ

et a

ges

.

• A

ll ch

ildre

n w

ho r

ecei

ve t

he B

4S

C a

nd a

re n

ot

fully

imm

unis

ed a

re r

efer

red

bac

k to

the

ir G

P. O

verd

ue im

mun

isat

ion

lists

will

be

used

to

init

iate

fo

llow

-up

act

ion

by

a no

min

ated

Out

reac

h o

r W

ell C

hild

Tam

arik

i Ora

ser

vice

pro

vid

er t

o e

nsur

e th

at

vacc

inat

ions

are

car

ried

out

pri

or

to 5

yea

rs o

f ag

e.

95%

of

two

yea

r o

lds

are

fully

im

mun

ised

.

95%

of

five

yea

r o

lds

are

fully

im

mun

ised

by

age

5 b

y Ju

ne 2

017

.

Incr

easi

ng H

PV

(1

2-ye

ar-o

ld)

imm

unis

atio

n ra

tes

• T

he B

OP

DH

B w

ill c

ont

inue

to

imp

lem

ent

its

Act

ion

Pla

n to

incr

ease

HP

V v

acci

nati

on

cove

rag

e ra

tes.

Thi

s in

clud

es t

wo

BO

PD

HB

HP

V C

om

mun

icat

ion

Pla

ns:

1. A

sho

rt-t

erm

pla

n to

sup

po

rt M

oH

co

mm

unic

atio

ns w

ith

loca

l act

ivit

y to

en

cour

age

par

ents

to

ret

urn

cons

ent

form

s at

the

beg

inni

ng o

f th

e sc

hoo

l ye

ar; a

nd

2.

A m

ediu

m-t

erm

pla

n to

fo

cus

on

key

mes

sag

es t

o p

aren

ts a

nd o

lder

tee

nag

e g

irls

, vac

cine

saf

ety,

link

ages

acr

oss

the

hea

lth

sect

or,

and

op

tim

um u

se o

f he

alth

ed

ucat

ion

reso

urce

s.

The

Act

ion

Pla

n al

so in

clud

es e

ffici

enci

es in

the

sch

oo

l-b

ased

pro

gra

mm

e, in

crea

sed

ti

me

for

pub

lic h

ealt

h nu

rses

to

eng

age

wit

h va

ccin

e-he

sita

nt p

aren

ts, a

gre

ed

refe

rral

pro

cess

es t

o g

ener

al p

ract

ice

thro

ugh

NIR

, and

act

ions

to

incr

ease

up

take

by

old

er t

eena

ge

gir

ls w

ho c

an c

ons

ent

them

selv

es.

At

leas

t 70

% o

f al

l 12-

year

-old

gir

ls w

ill

have

co

mp

lete

d a

ll d

ose

s o

f th

eir

HP

V

vacc

ine

(fo

r 20

16/1

7 it

is t

he 2

00

3 b

irth

co

hort

mea

sure

d a

t 30

Jun

e in

20

17).


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

H

ealt

h P

lan)

Per

cent

age

of

infa

nts

fully

im

mun

ised

by

eig

ht m

ont

hs o

f ag

e

The

BO

PD

HB

will

hav

e m

et w

ith

at le

ast

50%

of

Lead

Mat

erni

ty C

arer

s (L

MC

s) in

th

e B

ay o

f P

lent

y b

y 30

Jun

e 20

17 a

nd a

gre

e a

way

fo

rwar

d t

o r

efer

all

exp

ecta

nt

Mo

ther

’s in

form

atio

n to

the

ir r

esp

ecti

ve G

P a

t an

ear

lier

stag

e (w

hen

ante

nata

l b

loo

ds

avai

lab

le)

so t

he p

ract

ice

can

set

up im

mun

isat

ion

noti

fica

tio

ns.

The

BO

PD

HB

will

rep

ort

pro

gre

ss o

n th

is in

itia

tive

to

the

Māo

ri H

ealt

h P

lan

Ste

erin

g

Gro

up o

n th

e fo

llow

ing

fo

ur d

ates

: 1)

30 S

epte

mb

er 2

016

, 2)

31 D

ecem

ber

20

16, 3

) 31

M

arch

20

17, a

nd 4

) 30

Jun

e 20

17.

The

BO

PD

HB

will

co

nduc

t a

revi

ew o

f th

e o

utre

ach

imm

unis

atio

n se

rvic

es (

OIS

) co

ntra

cts

wit

h P

HO

s to

ens

ure

the

diff

eren

t m

od

els

curr

entl

y us

ed a

re m

eeti

ng t

he

95%

tar

get

by

31 J

uly

2016

.

The

BO

PD

HB

will

exp

lore

wit

h P

HO

s th

e p

ote

ntia

l ben

efits

fo

r th

e co

-lo

cati

on

of

imm

unis

atio

n o

utre

ach

staff

and

cus

tom

ise

our

ap

pro

ache

s in

ord

er t

o r

each

10

0%

o

f no

n-im

mun

ised

bab

ies

by

30 S

epte

mb

er 2

016

.

The

BO

PD

HB

will

rep

ort

to

the

Māo

ri H

ealt

h P

lan

Ste

erin

g G

roup

on

inte

rven

tio

ns

that

will

incr

ease

inte

gra

tio

n b

etw

een

the

OIS

, im

mun

isat

ion

faci

litat

ors

at

the

DH

B

and

PH

Os,

and

the

NIR

.

The

BO

PD

HB

will

rep

ort

on

the

com

ple

tio

n o

f th

ese

init

iati

ves

to t

he M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up b

y 30

Sep

tem

ber

20

16.

The

BO

PD

HB

will

wo

rk c

lose

ly w

ith

our

PH

Os

to e

nsur

e th

at im

mun

isat

ion

info

rmat

ion

rela

yed

to

par

ents

, GP

s, N

urse

s an

d t

he g

ener

al p

ublic

is c

ons

iste

nt.

We

will

wo

rk c

lose

ly w

ith

ind

ivid

ual P

HO

s to

imp

lem

ent

at le

ast

3 im

mun

isat

ion

pro

mo

tio

nal a

ctiv

itie

s ea

ch b

y Ju

ne 2

017

.

The

BO

PD

HB

will

rep

ort

pro

gre

ss o

n th

is in

itia

tive

to

the

Māo

ri H

ealt

h P

lan

Ste

erin

g

Gro

up o

n th

e fo

llow

ing

thr

ee d

ates

: 1)

31 D

ecem

ber

20

16, 2

) 31

Mar

ch 2

017

, and

3)

30

June

20

17.

The

BO

PD

HB

will

mo

nito

r im

mun

isat

ion

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g a

nd F

und

ing

tea

m a

nd v

ia t

he B

OP

DH

B P

lann

ing

an

d F

und

ing

imm

unis

atio

n ch

amp

ion.

The

BO

PD

HB

will

mo

nito

r im

mun

isat

ion

per

form

ance

on

a q

uart

erly

bas

is t

hro

ugh

the

Māo

ri H

ealt

h P

lan

Ste

erin

g G

roup

.

53


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Seas

ona

l in

flue

nza

imm

unis

atio

n ra

tes

(65

year

s an

d o

ver)

Pro

mo

tio

n o

f th

e se

aso

nal i

nflue

nza

vacc

inat

ion

thro

ugh

PH

Os,

Māo

ri W

om

en’s

Wel

fare

Lea

gue

, Ko

roua

and

Kui

a he

alth

ser

vice

p

rovi

der

s, W

hāna

u O

ra p

rovi

der

s, a

nd o

ther

Hau

ora

pro

vid

ers,

usi

ng t

he lo

cally

dev

elo

ped

te

reo

res

our

ce.

N.B

. The

re is

no

nat

iona

l str

ateg

y fo

r in

crea

sing

up

take

in M

āori

, no

r an

y na

tio

nal h

ealt

h ed

ucat

ion

reso

urce

s p

rod

uced

in t

e re

o.

Pro

mo

tio

n o

f th

e se

aso

nal i

nflue

nza

vacc

inat

ion

thro

ugh

Māo

ri m

edia

suc

h as

the

Māo

riva

tio

n p

rog

ram

me

on

Mo

ana

FM

Ta

uran

ga.

Enh

ance

d r

ecal

l pro

cess

es in

gen

eral

pra

ctic

e fo

r M

āori

pat

ient

s ag

ed 6

5+. T

his

wo

uld

invo

lve

mo

re p

roac

tive

eng

agem

ent

wit

h w

hana

u fo

llow

ing

the

sta

ndar

d p

atie

nt r

ecal

l sys

tem

s.

Cov

erag

e ra

tes

are

avai

lab

le b

y P

HO

by

ethn

icit

y th

roug

h na

tio

nal d

ata

colle

ctio

ns f

or

pri

mar

y he

alth

. Thi

s d

ata

is a

vaila

ble

on

a q

uart

erly

bas

is o

nly

and

is d

eriv

ed f

rom

pra

ctic

e p

aym

ent

clai

ms.

Dat

a is

als

o a

vaila

ble

fro

m t

he N

IR f

or

vacc

inat

ions

del

iver

ed in

gen

eral

pra

ctic

e an

d p

rob

ably

by

2017

win

ter

fro

m p

harm

acie

s,

DH

B s

taff

and

per

hap

s fr

om

oth

er o

ccup

atio

nal h

ealt

h nu

rsin

g s

ervi

ces.

The

NIR

dat

a w

oul

d b

e av

aila

ble

mo

nthl

y th

roug

h d

atam

art.

Mo

nito

r im

mun

isat

ion

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g a

nd F

und

ing

tea

m a

nd v

ia

the

BO

PD

HB

Fun

din

g a

nd P

lann

ing

imm

unis

atio

n ch

amp

ion.

Mo

nito

r im

mun

isat

ion

per

form

ance

on

a q

uart

erly

bas

is t

hro

ugh

the

Māo

ri H

ealt

h P

lan

Ste

erin

g G

roup

.


2B.1

.3.3

Sup

po

rtin

g V

ulne

rab

le C

hild

ren

The

gov

ernm

ent’

s C

hild

ren’

s A

ctio

n P

lan

is c

om

mit

ted

to

hav

ing

a s

afe

and

co

mp

eten

t w

ork

forc

e su

pp

ort

ed b

y hi

gh

qua

lity

child

pro

tect

ion

po

licie

s. T

he B

OP

DH

B is

sup

po

rtin

g t

his

go

al a

nd m

eeti

ng it

s re

qui

rem

ents

und

er t

he V

ulne

rab

le C

hild

ren

Act

20

14 a

s fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

(i)

Red

ucin

g

dea

th f

rom

as

saul

t, n

egle

ct

or

mal

trea

tmen

t o

f ch

ildre

n ag

ed

0 –

14

yea

rs; a

nd

(ii)

red

ucin

g

hosp

ital

isat

ions

fo

r in

juri

es

aris

ing

fro

m t

he

assa

ult,

neg

lect

or

mal

trea

tmen

t o

f ch

ildre

n ag

ed 0

–

14 y

ears

The

BO

PD

HB

will

:

• F

ollo

w t

he in

jury

flo

w c

hart

in t

he E

mer

gen

cy D

epar

tmen

t w

hen

a ch

ild p

rese

nts

wit

h in

juri

es

• M

aint

ain

the

Chi

ld P

rote

ctio

n A

lert

Sys

tem

• C

ont

inue

to

wo

rk t

og

ethe

r in

par

tner

ship

wit

h th

e N

ew Z

eala

nd P

olic

e, C

hild

, Yo

uth

and

Fam

ily in

acc

ord

ance

wit

h th

e M

emo

rand

um o

f U

nder

stan

din

g.

• M

aint

ain

the

two

day

Fam

ily V

iole

nce

Inte

rven

tio

n P

rog

ram

me

trai

ning

fo

r B

OP

DH

B

staff

• S

cree

n al

l wo

men

ove

r th

e ag

e o

f 17

fo

r fa

mily

vio

lenc

e an

d m

en o

n su

spic

ion,

in

acco

rdan

ce w

ith

BO

PD

HB

po

licy.

• C

ont

inue

to

sup

po

rt a

nd w

ork

wit

h th

e C

hild

, Yo

uth

and

Fam

ily L

iais

on

soci

al w

ork

er

• M

aint

ain

the

hig

h st

and

ard

alr

ead

y se

t b

y th

e F

amily

Vio

lenc

e In

terv

enti

on

Pro

gra

mm

e.

• Im

ple

men

t th

e S

hake

n B

aby

Pre

vent

ion

Pro

gra

mm

e (S

BP

P).

PP

27: S

upp

ort

ing

vul

nera

ble

ch

ildre

n -

Rep

ort

on

del

iver

y o

f th

e ac

tio

ns a

nd m

ilest

one

s id

enti

fied

in

the

Ann

ual P

lan.

• D

evel

op

a S

hake

n B

aby

po

licy

for

BO

PD

HB

• %

of

BO

PD

HB

sta

ff t

rain

ed

und

er t

he S

BP

P

• N

umb

er o

f ca

reg

iver

s w

ho h

ave

rece

ived

the

SB

PP

inte

rven

tio

n in

the

last

six

mo

nths

;

• Im

ple

men

t a

reg

ular

mo

nito

ring

an

d a

udit

pro

gra

mm

e fo

r th

e S

BP

P.

• S

BP

P t

rain

ing

pro

gra

mm

es

and

res

our

ces

are

shar

ed w

ith

the

ante

nata

l and

par

enti

ng

pro

vid

ers

and

rel

evan

t co

mm

unit

y g

roup

s/in

div

idua

ls.

55


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Chi

ldre

n’s

Team

• T

he B

OP

DH

B w

ill b

uild

an

adeq

uate

ly s

ized

, and

ap

pro

pri

atel

y sk

illed

, lea

d

pra

ctit

ione

r w

ork

forc

e.

• T

he B

OP

DH

B w

ill p

rovi

de

trai

ning

to

lead

pra

ctit

ione

rs in

acc

ord

ance

wit

h th

e Lo

cal

Gov

erna

nce

Gro

up (

LGG

) tr

aini

ng p

rog

ram

me.

• T

he B

OP

DH

B w

ill e

ngag

e w

ith

the

wid

er c

hild

ren’

s ne

two

rk t

o s

upp

ort

the

d

evel

op

men

t an

d im

ple

men

tati

on

of

Chi

ldre

n’s

Team

.

• T

he B

OP

DH

B w

ill m

aint

ain

an a

ctiv

e in

volv

emen

t in

the

Chi

ldre

n’s

Act

ion

Team

’s

Pan

el.

• T

he B

OP

DH

B w

ill c

ont

inue

act

ive

par

tici

pat

ion

in t

he C

hild

ren’

s Te

am a

t th

e Lo

cal

Gov

erna

nce

leve

l.

• In

crea

sing

num

ber

s o

f fu

ll-ti

me

equi

vale

nt le

ad p

ract

itio

ners

sh

ow

ing

hea

lth’

s co

ntri

but

ion.

• Tr

aini

ng a

tten

ded

by

all l

ead

p

ract

itio

ners

.

• E

stab

lishm

ent

of

BO

PD

HB

C

ham

pio

ns G

roup

wit

h se

rvic

e re

pre

sent

atio

n an

d n

umb

er o

f m

eeti

ngs

and

tra

inin

g p

rovi

ded

• N

umb

er o

f st

akeh

old

er

mee

ting

s

• A

n in

crea

se in

num

ber

of

refe

rral

s fr

om

hea

lth

sect

or

(bo

th D

HB

and

NG

O)

• N

umb

er o

f LG

G m

eeti

ngs

atte

nded

• N

umb

er o

f B

OP

DH

B S

teer

ing

G

roup

mee

ting

s p

arti

cip

ated

in

Chi

ld P

rote

ctio

n P

olic

ies

(sec

tio

ns 1

7,

19 a

nd 2

0 o

f th

e V

ulne

rab

le

Chi

ldre

n A

ct)

The

BO

PD

HB

will

dev

elo

p a

Chi

ld P

rote

ctio

n P

olic

y co

nsis

tent

wit

h S

ecti

on

15 o

f th

e C

hild

ren,

Yo

ung

Per

sons

, and

The

ir F

amili

es A

ct 1

98

9. T

he p

olic

y w

ill in

clud

e p

roce

dur

es

for

the

iden

tifi

cati

on

and

rep

ort

ing

of

child

ab

use

and

neg

lect

.

A C

hild

Pro

tect

ion

Po

licy,

co

nsis

tent

w

ith

Sec

tio

n 15

of

the

Chi

ldre

n,

Youn

g P

erso

ns a

nd t

heir

Fam

ilies

A

ct 1

98

9, i

s d

evel

op

ed.

Chi

ldre

n’s

Wo

rker

Sa

fety

Che

ckin

g

(sec

tio

ns 2

5–39

o

f th

e V

ulne

rab

le

Chi

ldre

n A

ct)

The

BO

PD

HB

will

ens

ure

that

its

syst

ems

and

pro

cess

es m

eet

the

leg

isla

tive

re

qui

rem

ents

of

sect

ions

25–

39 o

f th

e V

ulne

rab

le C

hild

ren

Act

. H

uman

res

our

ce p

roce

dur

es a

re

revi

ewed

and

mee

t le

gis

lati

ve

req

uire

men

ts.


2B.1

.3.4

So

cial

Sec

tor

Tria

ls

The

So

cial

Sec

tor

Tria

ls (

SS

Ts)

wer

e d

esig

ned

to

imp

rove

so

cial

out

com

es in

the

ir c

om

mun

itie

s b

y b

ring

ing

to

get

her

gov

ernm

ent

and

no

n-g

over

nmen

t ag

enci

es t

o a

dd

ress

the

cau

ses

of

soci

al is

sues

wit

hin

tho

se c

om

mun

itie

s.

Giv

en t

he r

ecen

t G

over

nmen

t d

ecis

ions

and

ann

oun

cem

ents

on

So

cial

Sec

tor

Tria

ls, t

he B

OP

DH

B w

ill b

e tr

ansi

tio

ning

to

a lo

cally

-led

mo

del

fo

r K

awer

au a

nd w

ill c

om

mit

to

:

• w

ork

ing

wit

h th

e Le

ad a

nd lo

cal k

ey s

take

hold

ers

to d

evel

op

and

ag

ree

a tr

ansi

tio

n p

lan

to a

loca

lly-l

ed m

od

el b

y 31

Jul

y 20

16; a

nd

• su

pp

ort

ing

imp

lem

enta

tio

n o

f th

e tr

ansi

tio

n p

lan.

Mea

sure

: A t

rans

itio

n p

lan

will

be

dev

elo

ped

and

loca

lly a

gre

ed b

y 31

Jul

y 20

16.

57


ANNUAL PLAN 2016/17

2B.1

.3.5

Red

uced

Inci

den

ce o

f Fi

rst

Ep

iso

de

Rhe

umat

ic F

ever

One

of

the

Bet

ter

Pub

lic S

ervi

ces

go

als

is t

o r

educ

e th

e in

cid

ence

of

acut

e rh

eum

atic

fev

er b

y tw

o-t

hird

s b

y Ju

ne 2

017

. T

he B

OP

DH

B w

ill

sup

po

rt t

his

go

al t

hro

ugh

the

BO

P R

heum

atic

Fev

er P

reve

ntio

n P

lan

as f

ollo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Red

ucin

g t

he

inci

den

ce o

f Fi

rst

Ep

iso

de

Rhe

umat

ic f

ever

• Th

e B

OP

DH

B w

ill im

ple

men

t th

e re

fres

hed

BO

P R

heum

atic

Fev

er P

reve

ntio

n P

lan

(BO

P

RF

PP

) as

ap

pro

ved

by

the

Min

istr

y.

• A

ll co

nfirm

ed c

ases

of

first

ep

isod

e ac

ute

rheu

mat

ic fe

ver

will

und

erg

o a

case

rev

iew

, w

ith

any

iden

tifie

d s

yste

m fa

ilure

s ad

dre

ssed

.

• A

dra

ft f

und

ing

inve

stm

ent

stra

teg

y fo

r 20

17/1

8 an

d b

eyon

d is

incl

uded

in t

he B

OP

RF

PP.

Th

is w

ill b

e co

nfirm

ed b

y 31

Dec

emb

er 2

016

in li

ght

of

late

st n

atio

nal a

nd lo

cal e

vid

ence

of

pro

gra

mm

e eff

ecti

vene

ss a

nd c

ost

effici

ency

, and

fina

ncia

l con

stra

ints

.

• Tw

o sp

ecifi

c ar

eas

req

uire

ad

dit

iona

l pla

nnin

g a

nd im

ple

men

tati

on in

20

16/1

7 on

ce t

he

Min

istr

y ta

rget

ed f

und

ing

cea

ses:

-Im

ple

men

tati

on o

f a

sust

aina

ble

pro

gra

mm

e in

pri

mar

y an

d c

omm

unit

y ca

re

for

easy

acc

ess

for

sore

thr

oat

man

agem

ent

of p

rior

ity

pop

ulat

ions

out

sid

e of

sc

hool

-bas

ed p

rog

ram

mes

.

-P

lann

ing

and

imp

lem

enta

tion

of

a su

stai

nab

le h

ealt

hy h

ousi

ng p

rog

ram

me

acro

ss

the

BO

P in

corp

orat

ing

exi

stin

g c

omm

unit

y p

roje

cts

in W

este

rn B

OP

Dis

tric

t C

ounc

il, M

urup

ara

tow

nshi

p a

nd O

pot

iki.

Red

uce

rheu

mat

ic fe

ver

inci

den

ce t

o 1.3

p

er 10

0,0

00

tot

al p

opul

atio

n by

30

Jun

e 20

17.

Del

iver

y an

d r

epor

ting

of

end

orse

d

Rhe

umat

ic F

ever

Pre

vent

ion

Pla

n ea

ch

qua

rter

. Th

is in

clud

es a

ctio

ns t

o:

• in

crea

se a

war

enes

s of

rhe

umat

ic

feve

r, w

hat

caus

es it

and

how

to

p

reve

nt it

• p

reve

nt t

he t

rans

mis

sion

of

Gro

up

A s

trep

toco

ccal

thr

oat

infe

ctio

ns

wit

hin

hous

ehol

ds

• tr

eat

Gro

up A

str

epto

cocc

al t

hroa

t in

fect

ions

qui

ckly

and

eff

ecti

vely

• p

rovi

de

an in

vest

men

t p

lan

for

confi

rmed

fun

din

g in

vest

men

t fo

r rh

eum

atic

feve

r p

reve

ntio

n fr

om

July

20

17 in

the

Qua

rter

2 r

epor

t.

Act

ions

Fa

cilit

atin

g t

he

Eff

ecti

ve F

ollo

w-

up o

f Id

enti

fied

R

heum

atic

Fev

er

Cas

es

The

BO

PD

HB

is c

omm

itte

d t

o:

• Th

e no

tific

atio

n of

all

case

s of

acu

te a

nd r

ecur

rent

acu

te r

heum

atic

feve

r to

the

Med

ical

O

ffice

r of

Hea

lth

wit

hin

7 d

ays

of h

osp

ital

isat

ion.

Thi

s m

ay b

e in

itia

lly o

n su

spic

ion

of

acut

e rh

eum

atic

feve

r ra

ther

tha

n w

ith

com

ple

te c

ase

info

rmat

ion.

• Ti

mel

y ad

min

istr

atio

n of

pro

phy

lact

ic a

ntib

ioti

cs t

o ex

isti

ng c

ases

acc

ord

ing

to

bes

t p

ract

ice

stan

dar

ds.

An

annu

al a

udit

will

be

und

erta

ken

and

rep

orte

d u

sing

the

BO

P

Rhe

umat

ic F

ever

Reg

iste

r.

• A

dd

ress

ing

kno

wn

risk

fact

ors

and

sys

tem

failu

re p

oint

s in

cas

es o

f re

curr

ent

rheu

mat

ic

feve

r.

• Fo

llow

ing

up

any

issu

es a

risi

ng f

rom

the

20

15/1

6 au

dit

of

recu

rren

t ho

spit

alis

atio

ns o

f ac

ute

rheu

mat

ic fe

ver

and

une

xpec

ted

rhe

umat

ic h

eart

dis

ease

.

• E

nsur

e th

at in

com

ple

te n

otifi

cati

ons

to t

he M

edic

al O

ffice

r of

Hea

lth

wit

hin

7 d

ays

are

upd

ated

and

co

mp

lete

d w

ithi

n a

furt

her

28 d

ays.

• P

rovi

de

a re

por

t on

the

less

ons

lear

ned

and

act

ions

tak

en fo

llow

ing

th

e ca

se r

evie

ws

to t

he M

inis

try

each

qua

rter

.

• E

nsur

e B

OP

Hea

lthy

Hou

sing

im

pro

vem

ent

pla

n is

in p

lace

by

30

Nov

emb

er 2

016

.

• R

epor

ting

on

outp

uts

thro

ugh

confi

rmat

ion

and

exc

epti

on r

epor

t fr

om Q

uart

er 3

.

• P

rovi

de

a re

por

t on

the

out

com

es

of t

he 2

016

/17

Bic

illin

Pro

gra

mm

e au

dit

in t

he Q

4 r

epor

t.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

Pla

n)

Red

ucti

on

in

rheu

mat

ic f

ever

ra

tes

• P

lann

ing

and

imp

lem

enta

tio

n o

f a

sust

aina

ble

hea

lthy

ho

usin

g p

rog

ram

me

acro

ss

the

BO

P in

corp

ora

ting

exi

stin

g c

om

mun

ity

pro

ject

s in

Wes

tern

BO

P D

istr

ict

Co

unci

l, M

urup

ara

tow

nshi

p a

nd O

po

tiki

.

• D

evel

op

men

t o

f a

fund

ing

str

ateg

y fo

r 20

17/1

8 t

hat

will

allo

w t

he c

ont

inua

tio

n o

f ev

iden

ce-b

ased

so

re t

hro

at m

anag

emen

t p

rog

ram

mes

in s

cho

ols

, co

mm

unit

y, a

nd

gen

eral

pra

ctic

e th

at r

each

the

pri

ori

ty p

op

ulat

ions

.

• C

arry

out

sys

tem

s fa

ilure

ana

lysi

s o

f al

l new

no

tifi

cati

ons

of

acut

e rh

eum

atic

fev

er, a

nd

put

into

pla

ce a

ll re

com

men

dat

ions

ari

sing

fro

m t

hat

anal

ysis

• D

eliv

ery

of

an e

ffec

tive

, qua

lity

Bic

illin

pre

vent

ativ

e p

rog

ram

me

thro

ugh

dis

tric

t nu

rsin

g p

rim

arily

acr

oss

the

BO

P d

istr

ict.

• R

eco

ncili

atio

n o

f re

gul

ato

ry n

oti

fica

tio

ns t

o t

he M

edic

al O

ffice

r o

f H

ealt

h w

ith

adm

issi

on

reco

rds

to o

bta

in c

urre

nt n

umb

ers

of

case

s an

d r

ates

.

• O

vers

ight

of

all h

ealt

hy h

ous

ing

act

ivit

y in

the

BO

P (

and

lake

s) D

HB

dis

tric

ts b

y a

mul

tiag

ency

Hea

lthy

Ho

usin

g F

oru

m t

o b

e es

tab

lishe

d b

y 30

Sep

tem

ber

20

16.

• C

om

ple

tio

n o

f 20

15/1

6 B

icill

in p

rog

ram

me

aud

it u

sing

the

BO

P r

heum

atic

fev

er

reg

iste

r, an

d u

tilis

e th

e d

ata

to in

form

ong

oin

g q

ualit

y im

pro

vem

ents

.

• U

nder

take

a c

ase

revi

ew o

f al

l cas

es o

f fi

rst

epis

od

e ac

ute

rheu

mat

ic f

ever

, and

co

mp

lete

any

act

ions

det

erm

ined

fro

m t

hose

cas

e re

view

s.

• U

se in

form

atio

n an

d r

eco

mm

end

atio

ns f

rom

the

nat

iona

l eva

luat

ion

of

the

cost

eff

ecti

vene

ss o

f al

l sch

oo

l-b

ased

so

re t

hro

at m

anag

emen

t p

rog

ram

mes

to

det

erm

ine

the

futu

re o

f th

ese

pro

gra

mm

es.

• Im

ple

men

tati

on

of

a su

stai

nab

le p

rog

ram

me

in p

rim

ary

and

co

mm

unit

y ca

re f

or

easy

ac

cess

fo

r so

re t

hro

at m

anag

emen

t o

f p

rio

rity

po

pul

atio

ns o

utsi

de

of

scho

ol-

bas

ed

pro

gra

mm

es. P

rio

rity

po

pul

atio

ns a

re 4

-19

yea

r o

ld M

āori

and

Pac

ific

livin

g in

Qui

ntile

5

neig

hbo

urho

od

s

• M

oni

tor

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g

and

Fun

din

g t

eam

.

• M

oni

tor

scre

enin

g p

erfo

rman

ce o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up.

59


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

Pla

n)

Red

ucti

on

in

rheu

mat

ic f

ever

ra

tes

• P

lann

ing

and

imp

lem

enta

tio

n o

f a

sust

aina

ble

hea

lthy

ho

usin

g p

rog

ram

me

acro

ss

the

BO

P in

corp

ora

ting

exi

stin

g c

om

mun

ity

pro

ject

s in

Wes

tern

BO

P D

istr

ict

Co

unci

l, M

urup

ara

tow

nshi

p a

nd O

po

tiki

.

• D

evel

op

men

t o

f a

fund

ing

str

ateg

y fo

r 20

17/1

8 t

hat

will

allo

w t

he c

ont

inua

tio

n o

f ev

iden

ce-b

ased

so

re t

hro

at m

anag

emen

t p

rog

ram

mes

in s

cho

ols

, co

mm

unit

y, a

nd

gen

eral

pra

ctic

e th

at r

each

the

pri

ori

ty p

op

ulat

ions

.

• C

arry

out

sys

tem

s fa

ilure

ana

lysi

s o

f al

l new

no

tifi

cati

ons

of

acut

e rh

eum

atic

fev

er, a

nd

put

into

pla

ce a

ll re

com

men

dat

ions

ari

sing

fro

m t

hat

anal

ysis

• D

eliv

ery

of

an e

ffec

tive

, qua

lity

Bic

illin

pre

vent

ativ

e p

rog

ram

me

thro

ugh

dis

tric

t nu

rsin

g p

rim

arily

acr

oss

the

BO

P d

istr

ict.

• R

eco

ncili

atio

n o

f re

gul

ato

ry n

oti

fica

tio

ns t

o t

he M

edic

al O

ffice

r o

f H

ealt

h w

ith

adm

issi

on

reco

rds

to o

bta

in c

urre

nt n

umb

ers

of

case

s an

d r

ates

.

• O

vers

ight

of

all h

ealt

hy h

ous

ing

act

ivit

y in

the

BO

P (

and

lake

s) D

HB

dis

tric

ts b

y a

mul

tiag

ency

Hea

lthy

Ho

usin

g F

oru

m t

o b

e es

tab

lishe

d b

y 30

Sep

tem

ber

20

16.

• C

om

ple

tio

n o

f 20

15/1

6 B

icill

in p

rog

ram

me

aud

it u

sing

the

BO

P r

heum

atic

fev

er

reg

iste

r, an

d u

tilis

e th

e d

ata

to in

form

ong

oin

g q

ualit

y im

pro

vem

ents

.

• U

nder

take

a c

ase

revi

ew o

f al

l cas

es o

f fi

rst

epis

od

e ac

ute

rheu

mat

ic f

ever

, and

co

mp

lete

any

act

ions

det

erm

ined

fro

m t

hose

cas

e re

view

s.

• U

se in

form

atio

n an

d r

eco

mm

end

atio

ns f

rom

the

nat

iona

l eva

luat

ion

of

the

cost

eff

ecti

vene

ss o

f al

l sch

oo

l-b

ased

so

re t

hro

at m

anag

emen

t p

rog

ram

mes

to

det

erm

ine

the

futu

re o

f th

ese

pro

gra

mm

es.

• Im

ple

men

tati

on

of

a su

stai

nab

le p

rog

ram

me

in p

rim

ary

and

co

mm

unit

y ca

re f

or

easy

ac

cess

fo

r so

re t

hro

at m

anag

emen

t o

f p

rio

rity

po

pul

atio

ns o

utsi

de

of

scho

ol-

bas

ed

pro

gra

mm

es. P

rio

rity

po

pul

atio

ns a

re 4

-19

yea

r o

ld M

āori

and

Pac

ific

livin

g in

Qui

ntile

5

neig

hbo

urho

od

s

• M

oni

tor

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g

and

Fun

din

g t

eam

.

• M

oni

tor

scre

enin

g p

erfo

rman

ce o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up.

2B.1

.3.6

Pri

me

Min

iste

r’s

Yout

h M

enta

l Hea

lth

Pro

ject

The

Pri

me

Min

iste

r’s

Yout

h M

enta

l Hea

lth

Pro

ject

, no

w in

its

thir

d y

ear,

cont

inue

s to

bui

ld a

mo

re c

o-o

rdin

ated

web

of

sup

po

rt f

or

youn

g

peo

ple

wit

h, o

r at

ris

k o

f d

evel

op

ing

, men

tal h

ealt

h is

sues

. T

his

has

incl

uded

bui

ldin

g a

n ev

iden

ce b

ase

for

wha

t w

ork

s to

imp

rove

men

tal

heal

th, i

ncre

ased

res

ilien

ce, m

ore

sup

po

rtiv

e sc

hoo

ls, c

om

mun

itie

s an

d h

ealt

h se

rvic

es, b

ette

r ac

cess

to

info

rmat

ion,

ear

lier

iden

tifi

cati

on

of

issu

es a

nd b

ette

r ac

cess

to

tre

atm

ent.

A n

umb

er o

f in

itia

tive

s ha

ve b

een

aim

ed t

ow

ard

s lo

w d

ecile

sch

oo

ls a

s p

art

of

an e

ffo

rt t

o s

upp

ort

vu

lner

able

chi

ldre

n an

d a

chie

ve b

ette

r eq

uity

of

out

com

es f

or

rang

atah

i and

Pac

ific

youn

g p

eop

le.

The

BO

PD

HB

is s

upp

ort

ing

thi

s g

oal

as

follo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Init

iati

ve 1

: Sc

hoo

l Bas

ed

Hea

lth

Serv

ices

(S

BH

S) –

PP

25

The

BO

PD

HB

will

:

• M

aint

ain

pro

vid

er a

gre

emen

ts f

or

pri

ori

ty S

BH

S t

o d

ecile

1 –

3 s

cho

ols

, inc

lud

ing

fo

r se

cond

ary

scho

ols

, tee

n p

aren

t un

its

and

alt

erna

tive

ed

ucat

ion

faci

litie

s.

• R

egul

arly

rep

ort

on

serv

ice

pro

visi

on

for

SB

HS

.

• C

ont

inue

to

str

eng

then

cur

rent

rel

atio

nshi

ps

bet

wee

n S

BH

S a

nd y

out

h p

rim

ary

men

tal h

ealt

h p

rovi

der

s.

• E

nsur

e q

ualit

y im

pro

vem

ent

pla

ns a

re c

om

ple

ted

fo

r se

cond

ary

scho

ols

, tee

n p

aren

t un

its

and

alt

erna

tive

ed

ucat

ion

faci

litie

s b

y ea

ch S

BH

S p

rim

ary

care

pro

vid

er.

• In

corp

ora

te t

he n

ew s

ervi

ce s

pec

ifica

tio

ns in

all

SB

HS

pro

vid

er’s

ter

ms

and

co

ndit

ions

. T

he e

xpec

tati

on

fro

m t

he Y

out

h H

ealt

hcar

e in

Sec

ond

ary

Sch

oo

ls: A

fr

amew

ork

fo

r co

ntin

uous

qua

lity

imp

rove

men

t w

ill b

eco

me

par

t o

f th

e q

ualit

y im

pro

vem

ent

pla

n fr

om

eac

h S

BH

S p

rovi

der

.

• In

teg

rate

key

pri

ori

ty is

sue

cove

rag

e fo

r A

do

lesc

ent

Ora

l Hea

lth;

Red

ucti

on

of

Uni

nten

ded

Tee

nag

e P

reg

nanc

y (s

ee s

ecti

on

2B.1.

3.1)

and

Rai

sing

Hea

lthy

Kid

s (s

ee

sect

ion

2B.1.

4.2

).

PP

25: P

rovi

de

qua

rter

ly q

uant

itat

ive

rep

ort

s o

n th

e im

ple

men

tati

on

of

SB

HS

, as

per

the

tem

pla

te p

rovi

ded

.

PP

25: P

rovi

de

qua

rter

ly n

arra

tive

p

rog

ress

rep

ort

s o

n ac

tio

ns

und

erta

ken

to im

ple

men

t Yo

uth

Hea

lth

Car

e in

Sec

ond

ary

Sch

oo

ls:

A f

ram

ewo

rk f

or

cont

inuo

us q

ualit

y im

pro

vem

ent

in e

ach

scho

ol (

or

gro

up

of

scho

ols

) w

ith

SB

HS

.

Six

mo

nthl

y re

po

rts

on

the

curr

ent

cont

inuo

us q

ualit

y im

pro

vem

ent

pla

ns

for

the

elig

ible

ed

ucat

ion

faci

litie

s


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Init

iati

ve 5

: Im

pro

ve t

he

resp

ons

iven

ess

of

pri

mar

y ca

re

to y

out

h –

PP

25

-T

he B

OP

DH

B w

ill c

ont

inue

act

ive

par

tici

pat

ion

wit

hin

our

loca

l cro

ss s

ecto

r A

llian

ce, (

incl

udin

g M

SD

, MO

E, D

HB

, PH

O a

nd N

GO

pro

vid

ers)

fo

r yo

uth

heal

th im

pro

vem

ent

acti

on.

-C

YS

A w

ill c

ont

inue

to

imp

lem

ent

the

BO

P C

hild

and

Yo

uth

Hea

lth

and

Wel

l B

eing

Str

ateg

y (2

014

-19

) th

roug

h an

ann

ually

rev

iew

ed w

ork

pla

n th

at

pro

vid

es g

over

nanc

e an

d a

cco

unta

bili

ty f

or

the

pla

n, o

utco

mes

of

curr

ent

init

iati

ves

and

sel

ecte

d p

rio

rity

new

pro

ject

s. T

he r

elev

ant

key

focu

s ar

eas

are:

• Im

ple

men

t th

e B

OP

DH

B C

o-E

xist

ing

Pro

ble

ms

(CE

P)

Enh

ance

d Y

out

h A

lco

hol

and

Oth

er D

rug

s (A

OD

) m

od

el:

• S

tep

ped

car

e m

od

el a

nd B

est

Pra

ctic

e G

uid

elin

es f

orm

par

t o

f al

l co

ntra

ctin

g

fro

m 1

Jul

y 20

16

• Im

ple

men

t th

e C

EP

Enh

ance

d Y

out

h A

OD

Pro

vid

er W

ork

forc

e D

evel

op

men

t P

lan

• A

do

lesc

ent

Ora

l Hea

lth

wit

h im

pro

ved

acc

ess

to in

terv

enti

on

• R

educ

tio

n o

f U

nint

end

ed T

een

Pre

gna

ncy

(see

sec

tio

n 2B

.1.3.

1)

• R

educ

tio

n o

f A

do

lesc

ent

Ob

esit

y (s

ee s

ecti

on

2B.1.

4.2

).

• T

he ‘fi

rst

200

0 d

ays

of

lives

fro

m c

onc

epti

on’

ap

pro

ach

(pre

conc

epti

on

to fi

ve

year

s o

f ag

e) t

hro

ugh

the

com

ple

tio

n o

f th

e H

ealt

hy P

reg

nanc

y p

roje

ct.

o K

ey m

ilest

one

s fo

r th

e C

YS

A w

ork

pla

n o

n yo

uth

are:

• Q

uart

er o

ne: Y

out

h w

ork

ing

gro

up e

stab

lishe

d w

ith

wo

rk p

lan;

incl

udin

g m

enta

l he

alth

AO

D a

nd C

AM

HS

• Q

uart

er t

wo

: One

Sto

p S

hop

mo

del

s co

nsul

ted

on

wit

h id

enti

fied

co

mm

unit

y fo

r tr

ial;

serv

ice

dev

elo

pm

ent

pla

n sc

op

ed f

or

CY

SA

end

ors

emen

t

• Q

uart

er t

hree

: Bud

get

and

fun

din

g p

rop

osa

ls p

rep

ared

fo

r ap

pro

val

• Q

uart

er f

our

: Sta

rt-u

p p

lan

dra

fted

.

PP

25: P

rovi

de

qua

rter

ly n

arra

tive

p

rog

ress

rep

ort

s ag

ains

t th

e lo

cal

CY

SA

alli

ance

pla

n to

imp

lem

ent

nam

ed in

itia

tive

s/ac

tio

ns t

o im

pro

ve

pri

mar

y ca

re r

esp

ons

iven

ess

to y

out

h.

Incl

ude

pro

gre

ss o

n na

med

act

ions

, m

ilest

one

s an

d m

easu

res

in t

he p

lan.

PP

25: P

rovi

de

qua

rter

ly n

arra

tive

re

po

rts

wit

h ac

tio

ns t

he y

out

h S

LAT

ha

s un

der

take

n in

tha

t q

uart

er t

o

imp

rove

the

hea

lth

of

the

DH

B’s

yo

uth

po

pul

atio

n (f

or

the

12-1

9 y

ear

age

gro

up a

t a

min

imum

) b

y ad

dre

ssin

g

iden

tifi

ed g

aps

in r

esp

ons

iven

ess,

ac

cess

, ser

vice

pro

visi

on,

clin

ical

and

fi

nanc

ial s

usta

inab

ility

fo

r p

rim

ary

and

co

mm

unit

y se

rvic

es f

or

the

youn

g

peo

ple

, as

per

yo

ur S

LAT

(s)

wo

rk

pro

gra

mm

e.

PP

26: P

rim

ary

men

tal h

ealt

h re

po

rtin

g

(yo

uth)

100

% r

elev

ant

pro

vid

ers

have

st

epp

ed c

are

mo

del

and

bes

t p

ract

ice

gui

del

ines

wit

hin

thei

r co

ntra

cts

At

leas

t fi

ve t

rain

ing

ses

sio

ns id

enti

fied

w

ithi

n th

e W

ork

forc

e D

evel

op

men

t P

lan

are

faci

litat

ed.

Reg

ular

up

dat

e re

po

rts

on

the

imp

lem

enta

tio

n o

f al

tern

ativ

e he

alth

y p

reg

nanc

y m

od

els

of

care

fo

r th

e W

este

rn B

ay p

op

ulat

ion

of

vuln

erab

le

fam

ilies

61


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Init

iati

ve 6

: R

evie

w a

nd

imp

rove

the

fo

llow

-up

ca

re f

or

tho

se

dis

char

ged

fr

om

Chi

ld a

nd

Ad

ole

scen

t M

enta

l Hea

lth

Serv

ices

(C

AM

HS)

and

Yo

uth

Alc

oho

l an

d O

ther

Dru

g

(AO

D)

serv

ices

• T

he B

OP

DH

B w

ill m

aint

ain

curr

ent

per

form

ance

thr

oug

h co

ntin

uing

to

refi

ne

tran

siti

on

pla

nnin

g a

nd d

ata

colle

ctio

n sy

stem

s an

d e

nsur

e th

at C

AM

HS

/Yo

uth

AO

D S

ervi

ces

and

Yo

uth/

Fam

ily/W

hāna

u ar

e ap

pro

pri

atel

y lin

ked

wit

h co

mm

unit

y se

rvic

es a

s p

art

of

tran

siti

on

pla

nnin

g f

rom

CA

MH

S.

• K

ey m

ilest

one

s fo

r th

e C

YS

A w

ork

pla

n o

n yo

uth

are:

• Q

uart

er o

ne: Y

out

h w

ork

ing

gro

up e

stab

lishe

d w

ith

wo

rk p

lan;

incl

udin

g m

enta

l he

alth

AO

D a

nd C

AM

HS

• Q

uart

er t

wo

: One

Sto

p S

hop

mo

del

s co

nsul

ted

on

wit

h id

enti

fied

co

mm

unit

y fo

r tr

ial;

serv

ice

dev

elo

pm

ent

pla

n sc

op

ed f

or

CY

SA

end

ors

emen

t

• Q

uart

er t

hree

: Bud

get

and

fun

din

g p

rop

osa

ls p

rep

ared

fo

r ap

pro

val

• Q

uart

er f

our

: Sta

rt-u

p p

lan

dra

fted

.

PP

7: Im

pro

ving

men

tal h

ealt

h se

rvic

es

usin

g t

rans

itio

n (d

isch

arg

e) p

lann

ing

• Lo

ng t

erm

clie

nts

– p

rovi

de

a re

po

rt a

s sp

ecifi

ed

• C

hild

and

Yo

uth

– A

t le

ast

95%

o

f cl

ient

s d

isch

arg

ed w

ill h

ave

a tr

ansi

tio

n (d

isch

arg

e) p

lan.

Init

iati

ve 7

: Im

pro

ve a

cces

s to

CA

MH

S an

d

Yout

h A

OD

se

rvic

es t

hro

ugh

wai

t ti

mes

ta

rget

s an

d

inte

gra

ted

cas

e m

anag

emen

t

• T

he B

OP

DH

B w

ill m

aint

ain

curr

ent

per

form

ance

in P

P8

wai

t-ti

mes

fo

r 0

-19

yea

r o

lds

thro

ugh

qua

rter

ly m

oni

tori

ng a

nd f

ollo

w-u

p w

ith

pro

vid

ers

to e

nsur

e co

nsis

tent

ac

cess

.

PP

8: S

hort

er w

aits

fo

r no

n-ur

gen

t m

enta

l hea

lth

and

ad

dic

tio

n se

rvic

es

for

0-1

9 y

ear

old

s

Men

tal H

ealt

h P

rovi

der

Arm

:

• 0

-19

<=

3 w

eeks

80

%,

<=

8 w

eeks

95%

• A

dd

icti

ons

(P

rovi

der

Arm

and

N

GO

):

• 0

-19

<=

3 w

eeks

80

%,

<=

8 w

eeks

95%


2B.1

.3.7

Mat

erna

l and

Chi

ld H

ealt

h

The

BO

PD

HB

rec

og

nise

s vu

lner

able

fam

ilies

are

a p

rio

rity

po

pul

atio

n re

qui

ring

fo

cuse

d c

om

mit

men

t to

imp

rove

hea

lth

out

com

es a

nd

achi

eve

equi

ty in

mat

erna

l chi

ld a

nd f

amily

/whā

nau

heal

th.

A k

ey p

art

of

pro

vid

ing

the

bes

t p

oss

ible

out

com

es f

or

child

ren

and

yo

uth

and

ass

isti

ng v

ulne

rab

le f

amili

es is

ens

urin

g a

co

ntin

uum

of

mat

erna

l and

chi

ld h

ealt

h se

rvic

es f

rom

pre

nata

l to

18

yea

rs o

f ag

e ac

ross

co

mm

unit

y, p

rim

ary

and

sec

ond

ary

care

. T

he B

OP

DH

B is

sup

po

rtin

g m

ater

nal a

nd c

hild

hea

lth

as f

ollo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Serv

ices

fo

r p

reg

nant

w

om

en, b

abie

s,

child

ren

and

fa

mili

es d

eliv

er

bes

t p

oss

ible

o

utco

mes

and

su

pp

ort

eq

uity

of

out

com

es

• T

he B

OP

DH

B w

ill m

aint

ain

a co

mm

itm

ent

to q

ualit

y im

pro

vem

ent

thro

ugh

acti

ve

pro

gre

ss w

ithi

n th

e M

ater

nity

Qua

lity

and

Saf

ety

Pro

gra

mm

e (M

QS

P)

wit

h in

clus

ion

of

a co

nsum

er r

epre

sent

atio

n an

d d

irec

t lin

ks t

o s

ecto

r ag

enci

es t

o m

ater

nity

se

rvic

es t

hat

secu

re a

sea

mle

ss s

ervi

ce f

or

wo

men

and

fam

ilies

/whā

nau.

• T

he B

OP

DH

B w

ill s

eek

imp

rove

d o

utco

mes

thr

oug

h co

llab

ora

tio

n w

ith

Mid

land

R

egio

nal g

roup

s in

clud

ing

the

Mid

land

Mat

erni

ty A

ctio

n G

roup

and

the

Chi

ld H

ealt

h A

ctio

n G

roup

.

• C

YS

A w

ill p

rovi

de

acti

ve g

over

nanc

e, a

cco

unta

bili

ty a

nd le

ader

ship

thr

oug

h im

ple

men

tati

on

of

the

BO

P C

hild

and

Yo

uth

Hea

lth

and

Wel

lbei

ng S

trat

egy

2014

-19

.

• C

YS

A’s

wo

rk p

lan

will

be

upd

ated

fo

r 20

16/1

7 to

ens

ure

lead

ersh

ip in

pri

ori

ty a

reas

o

f he

alth

y p

reg

nanc

y, b

reas

tfee

din

g, o

bes

ity,

pri

mar

y b

irth

ing

, red

ucti

on

of

child

re

spir

ato

ry d

isea

se, c

hild

ora

l hea

lth,

and

sm

oki

ng c

essa

tio

n.

• T

he B

OP

DH

B w

ill w

ork

wit

h an

d s

upp

ort

Whā

nau

Ora

as

det

aile

d in

sec

tio

n 2B

.1.5.

7.

Six

mo

nthl

y an

d a

nnua

l rep

ort

ing

up

dat

es o

n p

rog

ress

fo

r m

ater

nal a

nd

child

ser

vice

s.

Qua

rter

ly r

epo

rtin

g w

ill u

pd

ate

pro

gre

ss o

n ke

y m

ilest

one

s fo

r C

YS

A.

Red

uced

AS

H r

ates

to

113

ad

mis

sio

ns

for

Māo

ri c

hild

ren

63


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Co

ntin

uity

o

f P

rim

ary

Mat

erni

ty C

are

Hea

lthy

Pre

gna

ncie

s P

roje

ct

• C

YS

A w

ill t

rial

an

inte

gra

ted

mat

erni

ty s

ervi

ce m

od

el t

hat

add

ress

es t

he c

hang

es

reco

mm

end

ed f

or

the

Wel

com

e B

ay c

om

mun

ity,

sup

po

rted

at

the

serv

ice

and

cl

inic

al le

vels

by

a d

edic

ated

wo

rkin

g g

roup

, whi

ch in

clud

es c

ross

sec

tori

al

mem

ber

ship

and

the

co

mm

unit

y.

• In

itia

tive

s fr

om

the

Min

istr

y o

f H

ealt

h ch

ildho

od

ob

esit

y p

acka

ge

are

par

t o

f th

e ch

ang

es r

eco

mm

end

ed f

or

the

mat

erni

ty s

ervi

ce m

od

el in

clud

ing

:

-P

rovi

din

g g

uid

ance

fo

r he

alth

y w

eig

ht g

ain

dur

ing

pre

gna

ncy;

fo

r re

duc

tio

n in

inci

den

ce o

f in

app

rop

riat

e w

eig

ht g

ain

in p

reg

nanc

y, a

dvi

ce t

o w

om

an o

n w

eig

ht m

anag

emen

t p

rio

r to

and

dur

ing

pre

gna

ncy

and

po

st-p

artu

m

-M

oni

tor

the

imp

lem

enta

tio

n o

f al

l rec

om

men

dat

ions

of

the

nati

ona

l G

esta

tio

nal D

iab

etes

gui

del

ines

fo

r sc

reen

ing

and

dia

gno

sis

in p

reg

nanc

y an

d

to im

pro

ve n

eona

tal a

nd m

ater

nal o

utco

mes

-O

ffer

ing

Lea

d M

ater

nity

Car

ers

of

wo

men

wit

h, o

r at

ris

k o

f, g

esta

tio

nal

dia

bet

es o

ngo

ing

ed

ucat

ion

to in

crea

se t

he u

pta

ke o

f re

ferr

als

to t

he G

Rx

init

iati

ve.

Red

ucin

g U

nint

end

ed T

eena

ge

Pre

gna

ncie

s

(see

sec

tio

n 2B

.1.3

.1)

• T

he B

OP

DH

B w

ill c

olla

bo

rate

on

an in

teg

rate

d a

pp

roac

h b

etw

een

seco

ndar

y an

d

pri

mar

y se

rvic

es t

o p

rovi

de

acce

ss t

o f

und

ed lo

ng t

erm

co

ntra

cep

tio

n to

tee

nag

e w

om

en

• T

he B

OP

DH

B w

ill r

evie

w c

om

mun

icat

ion

po

licie

s fo

r en

gag

emen

t w

ith

soci

al

med

ia t

o im

pro

ve c

om

mun

icat

ion

wit

h yo

ung

peo

ple

and

pro

mo

te b

ette

r ac

cess

to

ed

ucat

ion,

co

ntra

cep

tio

n an

d b

ette

r p

aren

ting

.

Pro

ject

rep

ort

s o

n p

rog

ress

ag

ains

t ac

tio

ns w

ill b

e o

n a

qua

rter

ly b

asis

.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ac

tio

ns

iden

tifi

ed in

the

pla

n.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Co

ntin

uity

o

f P

rim

ary

Mat

erni

ty C

are

Mat

erni

ty Q

ualit

y an

d S

afet

y P

rog

ram

me

(MQ

SP)

• T

he B

OP

DH

B w

ill u

pd

ate

its

loca

l MQ

SP

wo

rk p

lan

and

fee

d in

pri

ori

ty is

sues

to

th

e M

inis

try

of

Hea

lth’

s na

tio

nal p

lan,

incl

udin

g o

ngo

ing

rep

ort

ing

of

per

form

ance

m

oni

tori

ng.

• T

he M

QS

P G

over

nanc

e G

roup

will

co

ntin

ue t

o a

udit

ag

ains

t th

e N

Z M

ater

nity

Clin

ical

In

dic

ato

rs a

nd im

ple

men

t a

pla

n o

f lo

cal a

ctio

ns f

or

any

vari

ance

s id

enti

fied

.

• T

he B

OP

DH

B w

ill e

stab

lish

a re

ferr

al p

athw

ay f

or

mid

wiv

es, u

sing

the

Bay

Nav

igat

or

pla

tfo

rm, t

o im

pro

ve a

cces

s to

mat

erna

l men

tal h

ealt

h co

nsul

t an

d li

aiso

n.

• T

he B

OP

DH

B’s

Sm

oke

-fre

e M

idw

ife

will

imp

lem

ent

pro

ject

rec

om

men

dat

ions

to

re

duc

e th

e ra

te o

f p

ost

-nat

al s

mo

king

(w

ithi

n 2

wee

ks)

for

wo

men

.

• T

he B

OP

DH

B w

ill r

elea

se a

n el

ectr

oni

c co

mm

unic

atio

n ne

wsl

ette

r fo

r m

ater

nal a

nd

child

hea

lth

ever

y tw

o m

ont

hs, f

or

imp

rove

d c

om

mun

icat

ion

bet

wee

n se

rvic

es f

or

loca

l, re

gio

nal a

nd n

atio

nal m

essa

ges

.

• T

he B

OP

DH

B w

ill p

rovi

de

acti

ve c

ons

umer

ad

vice

ab

out

hav

ing

a b

aby

on

its

web

site

and

incl

ude

links

to

Bay

Nav

igat

or

and

oth

er r

elev

ant

site

s.

95%

of

pre

gna

nt w

om

en r

ecei

ve

cont

inui

ty o

f p

rim

ary

mat

erni

ty c

are

thro

ugh

a co

mm

unit

y o

r D

HB

LM

C.

Num

ber

of

refe

rral

s fr

om

mid

wiv

es a

nd

num

ber

of

pho

ne c

ons

ult

liais

ons

Six

mo

nthl

y re

po

rts

will

be

sub

mit

ted

to

Min

istr

y

Pro

gre

ss a

gai

nst

acti

ons

will

be

rep

ort

ed q

uart

erly

Full

and

exc

lusi

ve b

reas

tfee

din

g r

ates

at

6 w

eeks

, 3 m

ont

hs, a

nd 6

mo

nths

• To

ach

ieve

sus

tain

able

and

eq

uity

imp

rove

men

ts in

bre

astf

eed

ing

rat

es f

or

Māo

ri

and

no

n-M

āori

, a s

take

hold

ers

foru

m w

ill b

e es

tab

lishe

d in

the

wes

tern

Bay

of

Ple

nty.

The

fo

rum

will

dev

elo

p a

wo

rk p

lan

to a

ctio

n in

nova

tio

ns a

nd in

itia

tive

s su

ch

as t

hose

imp

lem

ente

d t

hro

ugh

the

Eas

tern

Bay

Co

alit

ion

and

dev

elo

ped

by

the

reg

iona

l act

ion

pla

ns.

• T

he B

OP

DH

B w

ill w

ork

wit

h an

d s

upp

ort

the

dev

elo

pm

ent

of

a M

idla

nd

bre

astf

eed

ing

hea

lth

need

s an

alys

is t

o in

form

fut

ure

Mid

land

Mat

erni

ty A

ctio

n G

roup

wo

rk p

lans

and

pri

ori

tisa

tio

n o

f eff

ort

s to

incr

ease

rat

es a

nd d

urat

ion

of

bre

astf

eed

ing

.

• T

he B

OP

DH

B w

ill e

xplo

re o

pp

ort

unit

ies

for

a su

stai

nab

le c

om

mun

ity

lact

atio

n se

rvic

e to

mee

t d

eman

d f

rom

wo

men

nee

din

g s

upp

ort

at

the

com

mun

ity

leve

l.

• A

lso

ref

er t

o t

he M

aori

Hea

lth

Pla

n ac

tio

ns f

or

imp

rovi

ng b

reas

tfee

din

g a

mo

ng M

āori

w

om

en.

Māo

ri in

fant

s w

ill h

ave

atta

ined

b

reas

tfee

din

g r

ates

co

nsis

tent

wit

h th

e ag

e-re

late

d t

arg

ets

set

by

the

Min

istr

y o

f H

ealt

h in

the

Wel

l Chi

ld T

amar

iki O

ra

Qua

lity

Imp

rove

men

t F

ram

ewo

rk.⁸

• 6

8% a

t 6

wee

ks (

full

or

excl

usiv

e)

• 54

% a

t 3

mo

nths

(fu

ll o

r ex

clus

ive)

• 59

% a

t 6

mo

nths

(fu

ll, e

xclu

sive

, o

r p

arti

al)

⁸ "T

he W

ell C

hild

/ T

amar

iki O

ra Q

ualit

y Im

pro

vem

ent

Fra

mew

ork

." 2

013

. 12

Mar

. 20

14 <

http

://w

ww

.hea

lth.

gov

t.nz

/pub

licat

ion/

wel

l-ch

ild-t

amar

iki-

ora

-qua

lity-

imp

rove

men

t-fr

amew

ork

>

65


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Co

ntin

uity

o

f P

rim

ary

Mat

erni

ty C

are

Hea

lthy

Pre

gna

ncy

Bay

Nav

igat

or

• To

i Te

Ora

will

pro

mo

te a

cces

s an

d u

se o

f th

e B

ay N

avig

ato

r w

ebsi

te a

s a

loca

l se

rvic

e d

irec

tory

fo

r he

alth

y p

reg

nanc

ies

and

a s

ervi

ce r

efer

ral d

irec

tory

fo

r he

alth

p

rofe

ssio

nals

.

Pri

mar

y B

irth

ing

• Th

e B

OP

DH

B w

ill c

ont

inue

to

mo

nito

r p

rim

ary

bir

thin

g s

ervi

ces

to b

ette

r un

der

stan

d

utili

sati

on

and

fut

ure

serv

ice

dem

and

, inc

lud

ing

imp

acts

on

mat

erni

ty s

ervi

ces

pro

vid

ed b

y Ta

uran

ga

Ho

spit

al.

• Th

e B

OP

DH

B w

ill s

upp

ort

pri

mar

y b

irth

ing

to

incr

ease

the

BO

PD

HB

rat

es o

f no

rmal

va

gin

al d

eliv

ery.

Imm

unis

atio

n (s

ee s

ecti

on 2

B.1.

3.2)

Safe

Sle

epin

g –

see

act

ions

in t

he M

aori

Hea

lth

Pla

n

All

pri

mar

y ca

re in

the

BO

PD

HB

is

pro

vid

ed b

y Le

ad M

ater

nity

Car

ers

(LM

C).

All

LMC

s ha

ve a

cces

s to

th

e m

ater

nity

fac

iliti

es in

Tau

rang

a,

Wha

kata

ne a

nd O

po

tiki

and

Bet

hleh

em

via

an a

cces

s ag

reem

ent.

Imp

lem

enti

ng

the

Chi

ld a

nd

Yout

h an

d

Stra

teg

y -

Inte

gra

tio

n

CY

SA

• C

YSA

will

set

up

an

inte

rag

ency

mec

hani

sm t

o m

oni

tor

po

licie

s an

d s

ervi

ce d

eliv

ery

mo

del

s to

ens

ure

that

the

y ar

e co

here

nt a

nd c

ont

rib

ute

to a

n in

teg

rate

d a

pp

roac

h to

su

pp

ort

ing

pre

gna

nt w

om

en, c

hild

ren

and

yo

ung

peo

ple

.

• C

YSA

will

uti

lise

its

clin

ical

and

cro

ss s

ecto

r m

emb

ersh

ip t

o e

nsur

e th

at m

od

els

of

care

are

evi

den

ce-b

ased

or

bas

ed o

n p

rom

isin

g p

ract

ices

and

are

fit-

for-

pur

po

se.

Six

mo

nth

CY

SA r

epo

rt o

n p

rog

ress

B4

Sch

oo

l C

heck

s (B

4SC

)

B4

SC s

ervi

ces

mee

t ta

rget

s p

lann

ed

• C

CY

HS

who

pro

vid

e an

d c

o-o

rdin

ate

the

B4

SC

ser

vice

will

tar

get

per

form

ance

im

pro

vem

ent

mea

sure

s to

ens

ure

child

po

pul

atio

n co

vera

ge

of

B4

SC

ser

vice

s.

• Th

e B

OP

DH

B d

istr

ict

stee

ring

gro

up f

or

child

hoo

d o

bes

ity

pre

vent

ion,

red

ucti

on

and

re

ferr

al t

o in

terv

enti

on

serv

ices

will

ass

ist

mee

ting

the

tar

get

thr

oug

h im

ple

men

tati

on

of

serv

ice

pat

hway

s, d

ata

man

agem

ent

colle

ctio

n an

d r

evie

w a

nd p

lann

ing

fo

r fu

ture

d

evel

op

men

t (s

ee a

lso

Rai

sing

Hea

lthy

Kid

s se

ctio

n 2B

.1.4

.2).

90

% o

f fo

ur-y

ear-

old

s re

ceiv

e a

B4

S

cho

ol C

heck

, inc

lud

ing

90

% o

f M

āori

an

d P

acifi

c ch

ildre

n an

d c

hild

ren

livin

g

in a

reas

of

hig

h d

epri

vati

on.

Hea

lth

targ

et: B

y D

ecem

ber

20

17,

95%

of

obes

e ch

ildre

n id

enti

fied

in

the

Bef

ore

Scho

ol C

heck

(B

4SC

) p

rog

ram

me

will

be

refe

rred

to

a he

alth

p

rofe

ssio

nal f

or c

linic

al a

sses

smen

t an

d fa

mily

bas

ed n

utri

tion

, act

ivit

y an

d li

fest

yle

inte

rven

tion

s. R

epor

ted

q

uart

erly

.

95%

of

Mao

ri c

hild

ren

iden

tifi

ed in

B

4S

C c

heck

s ar

e o

ffer

ed r

efer

ral t

o

clin

ical

ass

essm

ent

and

inte

rven

tio

ns

Qua

rter

ly t

arg

et r

epo

rts

fro

m B

4S

C

dat

abas

e


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Wel

lchi

ld/

Tam

arik

i Ora

(W

CTO

) as

sist

s co

ntin

uity

of

child

car

e

WC

TO Q

ualit

y in

dic

ato

rs/l

oca

l pro

ject

gro

up f

or

sust

aina

ble

cha

nge

• T

he B

OP

DH

B w

ill c

ont

inue

to

wo

rk w

ith

and

sup

po

rt t

he r

egio

nal M

idla

nd W

CTO

Q

ualit

y Im

pro

vem

ent

pro

ject

thr

oug

h lo

cal l

ead

ersh

ip a

nd s

upp

ort

fro

m C

YS

A

• T

he lo

cal B

OP

pro

vid

er w

ork

ing

gro

up w

ill c

ont

inue

to

mee

t an

d c

olla

bo

rate

fo

r sh

ared

imp

lem

enta

tio

n o

f su

stai

nab

le q

ualit

y im

pro

vem

ents

at

the

pro

vid

er s

ervi

ce

leve

l, as

out

lined

wit

hin

the

Acc

ess

Ind

icat

ors

iden

tifi

ed n

atio

nally

thr

oug

h th

e M

inis

try

of

Hea

lth,

(b

road

ly c

over

ing

enr

olm

ent,

imm

unis

atio

n an

d c

ore

WC

TO

chec

ks)

• T

he B

OP

DH

B w

ill w

ork

wit

h g

ener

al p

ract

itio

ner

pra

ctic

es.

Rep

ort

ing

qua

rter

ly

Ora

l hea

lth,

ch

ildre

n an

d

ado

lesc

ence

; re

duc

ed

ineq

uiti

es

bet

wee

n M

āori

an

d n

on-

Māo

ri

The

BO

PD

HB

will

wo

rk w

ith

and

sup

po

rt M

idla

nd R

egio

nal a

nd P

ublic

Hea

lth

init

iati

ves

for

imp

rove

men

t in

ora

l hea

lth

for

child

ren

and

ad

ole

scen

ts a

s fo

llow

s:

• T

hro

ugh

sup

po

rt f

or

the

Chi

ld H

ealt

h A

ctio

n G

roup

str

ateg

ic p

lan,

in p

arti

cula

r im

pro

vem

ents

to

acc

ess

and

ass

essm

ent/

exam

inat

ion

for

child

ren,

and

wo

men

d

urin

g p

reg

nanc

y

• T

hro

ugh

ong

oin

g s

upp

ort

fo

r o

ral h

ealt

h p

reve

ntio

n an

d p

rom

oti

on

of

init

iati

ves

that

red

uce

dec

ay a

nd r

emov

al o

f te

eth

for

child

ren,

incl

udin

g r

educ

ed a

vaila

bili

ty

of

sug

ar s

wee

tene

d b

ever

ages

, im

pro

ved

nut

riti

on

info

rmat

ion

and

par

tner

ship

s b

etw

een

den

tal p

rovi

der

s an

d lo

cal s

cho

ols

(S

ee T

oi T

e O

ra’s

Ann

ual P

lan

2016

/17)

• T

hro

ugh

mo

nito

ring

ser

vice

per

form

ance

and

pat

ient

out

com

es o

f th

e C

om

bin

ed

Den

tal A

gre

emen

t (C

DA

) se

rvic

e w

ith

loca

l den

tist

s to

ens

ure

cove

rag

e an

d q

ualit

y se

rvic

es f

or

ado

lesc

ents

in r

esp

ons

e to

the

nat

iona

l rev

iew

of

the

CD

A a

gre

emen

t.

Imp

rove

men

t in

pat

ient

ora

l hea

lth

stat

us o

utco

me

mea

sure

s fo

r ch

ildre

n an

d a

do

lesc

ents

.

Red

uced

den

tal c

arie

s ra

tes

amo

ng 5

ye

ar o

lds

and

yea

r 8

chi

ldre

n

67


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Red

uced

den

tal

cari

es r

ates

am

ong

5 y

ear

old

s an

d y

ear

8 ch

ildre

n

Reg

iona

l and

loca

l DH

B r

evie

w o

f O

ral H

ealt

h se

rvic

e co

vera

ge

• T

he B

OP

DH

B c

om

mun

ity

ora

l hea

lth

serv

ice

will

und

erta

ke a

rev

iew

of

serv

ice

per

form

ance

and

out

com

e m

easu

res,

incl

udin

g in

form

atio

n o

n ut

ilisa

tio

n an

d

dem

and

, fo

r th

e B

OP

DH

B p

op

ulat

ion

to p

lan

for

po

tent

ial e

ffici

ency

and

sus

tain

able

se

rvic

e co

vera

ge

of

scho

ol a

ged

chi

ldre

n.

• T

he B

OP

DH

B w

ill im

ple

men

t ch

ang

es t

o a

chie

ve t

he r

equi

red

incr

ease

in

exam

inat

ions

by

den

tal t

hera

pis

ts t

hat

also

sup

po

rt im

pro

ved

cov

erag

e o

f M

āori

ch

ildre

n w

ithi

n M

āori

Hea

lth

Pla

n ta

rget

ed a

ctio

n.

• T

he B

OP

DH

B w

ill u

se o

utco

me

mea

sure

s an

d lo

cal p

erfo

rman

ce d

ata

in t

he r

evie

w

of

alte

rnat

ive

serv

ice

mo

del

s to

mak

e it

mo

re c

onv

enie

nt f

or

fam

ilies

/whā

nau

to

acce

ss o

ral h

ealt

h se

rvic

es a

nd a

dd

ress

the

nee

ds

of

hig

h ne

eds

and

vul

nera

ble

p

op

ulat

ions

.

• T

he B

OP

DH

B w

ill im

ple

men

t o

pp

ort

unis

tic

serv

ice

inno

vati

ons

, suc

h as

flex

ible

clin

ic

hour

s, o

ut o

f no

rmal

ho

urs

incl

udin

g s

cho

ol h

olid

ay p

erio

ds,

to

cap

ture

chi

ldre

n cu

rren

tly

not

atte

ndin

g a

pp

oin

tmen

ts.

• T

he B

OP

DH

B w

ill d

evel

op

str

ong

er c

om

mun

ity

links

thr

oug

h co

llab

ora

tio

n w

ith

acti

ve f

amily

ser

vice

s su

ch a

s W

CTO

and

Whā

nau

Ora

to

rea

ch c

hild

ren

req

uiri

ng

trea

tmen

t an

d p

rom

ote

ora

l hea

lth.

The

BO

PD

HB

will

mo

nito

r d

enta

l clin

ic e

nro

lmen

t p

erfo

rman

ce o

n a

mo

nthl

y b

asis

wit

hin

the

BO

PD

HB

Māo

ri H

ealt

h P

lann

ing

and

Fun

din

g t

eam

and

via

the

BO

PD

HB

Fun

din

g a

nd

Pla

nnin

g o

ral h

ealt

h ch

amp

ion

to c

om

par

e an

d c

ont

rast

eng

agem

ent

wit

h se

rvic

es f

or

ora

l hea

lth

care

.

95%

of

Māo

ri p

resc

hoo

l chi

ldre

n w

ill b

e en

rolle

d in

a d

enta

l clin

ic.

PP

11: I

ncre

ase

in M

āori

chi

ldre

n ca

ries

fr

ee a

t 5

year

s

Pro

gre

ss a

gai

nst

acti

ons

will

be

rep

ort

ed o

n a

qua

rter

ly b

asis

Dev

elo

p a

n im

pro

vem

ent

pla

n fo

r ch

ildho

od

re

spir

ato

ry

serv

ices

The

Wai

kato

DH

B w

ill w

ork

join

tly

wit

h M

idla

nd D

HB

s an

d M

idla

nd P

HO

s to

dev

elo

p a

nd

imp

lem

ent

an I

mp

rove

men

t P

lan

for

child

hoo

d r

esp

irat

ory

co

ndit

ions

.Im

pro

vem

ent

Pla

n d

evel

op

ed w

ith

Mid

land

DH

Bs

and

PH

Os

by

31

Dec

emb

er 2

016

. Im

ple

men

tati

on

will

b

e re

po

rted

on

in J

une

2017

.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

Pla

n)

Full

and

ex

clus

ive

bre

astf

eed

ing

ra

tes

at 6

wee

ks,

3 m

ont

hs, a

nd 6

m

ont

hs

The

Bre

astf

eed

ing

Fo

rum

in t

he W

este

rn B

ay o

f P

lent

y w

ill b

e m

eeti

ng r

egul

arly

and

ha

ve a

gre

ed o

n m

akeu

p o

f at

tend

ees

and

Ter

ms

of

Ref

eren

ce. K

ey a

ctiv

itie

s o

f th

is g

roup

to

incl

ude

a st

ock

take

of

bre

astf

eed

ing

pro

mo

tio

n an

d s

upp

ort

cur

rent

ly a

vaila

ble

to

co

nsum

ers,

dis

cuss

tre

nds

whe

re d

eclin

e is

evi

den

t, a

nd s

trat

egis

e fo

r im

pro

vem

ent.

Thi

s g

roup

will

hav

e re

pre

sent

atio

n at

affi

liate

d p

roje

cts

and

gro

ups

in t

he B

OP

DH

B in

clud

ing

th

e To

i Te

Ora

ob

esit

y st

eeri

ng g

roup

and

the

Mat

erni

ty S

afet

y an

d Q

ualit

y G

over

nanc

e G

roup

.

Mo

nthl

y m

eeti

ngs

will

eva

luat

e b

reas

tfee

din

g r

ates

fo

r M

āori

and

tre

nds

occ

urri

ng.

Thi

s fo

rum

will

als

o p

rovi

de

sup

po

rt f

or

Bab

y F

rien

dly

Ho

spit

al In

itia

tive

(B

FH

I) in

B

OP

DH

B H

osp

ital

s an

d c

om

mun

ity

even

ts s

uch

as T

he B

ig L

atch

. Thi

s fo

rum

will

eva

luat

e th

e B

aby

Fri

end

ly C

om

mun

ity

Init

iati

ve f

or

rele

vanc

e to

thi

s co

mm

unit

y (B

FC

I) a

nd B

FH

I m

aint

enan

ce a

s a

univ

ersa

l act

ivit

y.

The

Bre

astf

eed

ing

Fo

rum

will

wo

rk in

co

llab

ora

tio

n w

ith

Māo

ri H

ealt

h, D

HB

, PH

O, L

MC

an

d W

CTO

pro

vid

ers

to p

rovi

de

pla

nnin

g f

or

a se

rvic

e su

itab

le f

or

Whā

nau

Acc

ess

to

rece

ive

imp

rove

d s

upp

ort

and

ed

ucat

ion

to in

crea

se b

reas

tfee

din

g r

ates

.

-

Thi

s is

env

isag

ed a

s a

targ

eted

ho

me-

visi

t se

rvic

e w

here

Mar

ae-b

ased

sup

po

rt c

oul

d

also

be

succ

essf

ul, a

s ha

s b

een

imp

lem

ente

d in

Lak

es D

HB

. Cur

rent

dat

a sh

ow

s in

equa

lity

wit

h th

e ea

rlie

r ce

ssat

ion

of

bre

astf

eed

ing

fro

m M

āori

clie

nts

at t

he 3

-mo

nth

age

ban

d

as c

om

par

ed w

ith

oth

er e

thni

citi

es. T

his

has

bee

n id

enti

fied

as

an in

crea

sing

tre

nd a

cro

ss

the

pas

t th

ree

qua

rter

s. T

ota

l po

pul

atio

n ha

s ex

ceed

ed t

he c

urre

nt t

arg

et o

f 6

0%

at

each

q

uart

er.

-

Ens

ure

pat

hway

s ar

e d

evel

op

ed f

or

heal

th p

rofe

ssio

nals

and

clie

nts

to a

cces

s ti

mel

y la

ctat

ion

serv

ices

.

-

Eva

luat

e ne

ed f

or

incr

ease

d la

ctat

ion

serv

ice

follo

win

g s

tock

take

of

curr

ent

leve

l of

serv

ice

-

If n

eed

is a

gre

ed u

po

n, p

rog

ress

to

bus

ines

s p

lann

ing

.

Wel

l chi

ld p

rovi

der

s to

bui

ld o

n ca

pac

ity

and

cap

abili

ty o

f ev

iden

ce b

ased

lact

atio

n su

pp

ort

. Ass

ess

WC

TO A

ctiv

ity

to s

upp

ort

Bre

astf

eed

ing

sup

po

rt t

hro

ugh

mea

suri

ng

per

form

ance

thr

oug

h ca

re d

eliv

ery

com

po

nent

s fr

om

ind

ivid

ual w

ell c

hild

pra

ctit

ione

rs

for

thei

r ca

selo

ad. E

valu

ate

use

of

Mam

a A

roha

tal

k ca

rds

wit

hin

WC

TO e

nvir

onm

ent,

as

sess

fo

r ne

ed o

f re

fres

her

trai

ning

and

pra

ctic

e d

evel

op

men

t.

Mo

nito

r th

e b

reas

tfee

din

g in

dic

ato

r o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up.

69


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Ora

l hea

lth

A 9

5% e

nro

lmen

t ra

te f

or

pre

scho

ol M

āori

by

31 D

ecem

ber

20

16 w

ill b

e ac

hiev

ed b

y:

• C

om

men

cing

a d

ata

mat

chin

g p

roje

ct b

etw

een

July

-Sep

tem

ber

20

16 t

o m

atch

clie

nt

dat

a b

etw

een

NIR

and

Tit

aniu

m t

hro

ugh

BO

PD

HB

Dat

a In

telli

gen

ce S

ervi

ce. T

his

will

id

enti

fy c

hild

ren

not

enro

lled

Co

mm

unit

y D

enta

l Ser

vice

s (C

DS

).

• C

DS

to

co

mm

ence

co

ntac

ting

the

se f

amili

es o

f no

n-en

rolle

d c

hild

ren

by

leve

rag

ing

an

d u

tilis

ing

the

exi

stin

g n

etw

ork

s o

f N

GO

pro

vid

ers,

Wel

lchi

ld a

nd H

auo

ra M

āori

in

the

BO

PD

HB

reg

ion

fro

m O

cto

ber

20

16.

• C

ont

inue

to

wo

rk w

ith

Māo

ri R

egio

nal H

ealt

h S

ervi

ces

to h

ave

gre

ater

rea

ch in

to

com

mun

itie

s th

roug

h th

e C

DS

Ora

l Hea

lth

Pro

mo

tio

n Te

am. T

arg

et r

egio

ns w

ill b

e th

e E

ast

Co

ast

fro

m O

po

tiki

– W

hang

apar

aoa

and

Mur

upar

a d

ue t

o r

ural

ity,

iso

lati

on

and

dep

riva

tio

n. T

he a

im w

ill b

e to

del

iver

“lif

t th

e lip

tra

inin

g”

for

the

und

er 5

yr o

lds

as a

n ea

rly

inte

rven

tio

n to

ol t

o K

aup

apa

Māo

ri O

rgan

isat

ions

, Mar

ae a

nd K

oha

nga/

Kur

a. T

he O

ral H

ealt

h p

rom

oti

on

team

will

als

o d

eliv

er h

ealt

hy c

oo

king

and

ora

l he

alth

nut

riti

on

pro

gra

mm

es w

ithi

n th

ese

sett

ing

s. T

hese

init

iati

ves

will

be

del

iver

ed

bet

wee

n Ju

ly 2

016

and

Mar

ch 2

017

.

• C

ont

inue

to

tra

ck r

efer

ral s

our

ces

for

pre

-enr

olm

ent

req

uest

s fr

om

Jul

y 20

16 a

nd t

o

revi

ew t

his

info

rmat

ion

mo

nthl

y to

det

erm

ine

whe

re a

dd

itio

nal f

ocu

s ne

eds

to o

ccur

.

The

Ora

l Hea

lth

Pro

mo

tio

n te

am is

to

dev

elo

p t

he t

rain

the

tra

in p

rog

ram

me

for

ora

l he

alth

pro

mo

tio

n to

EC

C’s

into

a r

eso

urce

fo

r K

oha

nga

Reo

tha

t is

tra

nsla

ted

into

Te

Reo

b

y S

epte

mb

er 2

016

. Thi

s re

sour

ce is

to

be

used

:

• To

tra

in K

oha

nga

Reo

Kai

ako

(Te

ache

rs)

to d

eliv

er t

his

pro

gra

mm

e to

incr

ease

aw

aren

ess

of

go

od

ora

l hea

lth

nutr

itio

n an

d p

ract

ices

fo

r th

e ch

ildre

n an

d t

heir

fa

mili

es. P

rom

oti

on

and

Tra

inin

g t

o c

om

men

ce f

rom

Oct

ob

er 2

016

.

• To

ena

ble

Te

Ko

hang

a R

eo t

o a

do

pt

furt

her

go

od

ora

l po

licie

s an

d p

ract

ices

bas

ed

on

this

pro

gra

mm

e an

d f

or

this

to

be

ong

oin

g.

• To

wo

rk c

olla

bo

rati

on

wit

h K

oha

nga

Reo

to

gai

n m

ore

par

tici

pat

ion

in W

orl

d O

ral

Hea

lth

Day

(M

arch

) an

d N

atio

nal O

ral H

ealt

h D

ay (

Nov

emb

er)

each

yea

r.

• O

ral H

ealt

h P

rom

oti

on

Team

to

mea

sure

par

tici

pat

ion

and

eff

ecti

vene

ss o

f th

is

pro

gra

mm

e b

y 30

th J

une

2017

.

Mo

nito

r d

enta

l clin

ic e

nro

lmen

t p

erfo

rman

ce o

n a

mo

nthl

y b

asis

wit

hin

the

BO

PD

HB

M

āori

Hea

lth

Pla

nnin

g a

nd F

und

ing

tea

m a

nd v

ia t

he B

OP

DH

B F

und

ing

and

Pla

nnin

g o

ral

heal

th c

ham

pio

n.

Mo

nito

r d

enta

l clin

ic e

nro

lmen

t p

erfo

rman

ce o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

H

ealt

h P

lan

Ste

erin

g G

roup

.


2B.1

.4 L

ong

Ter

m C

ond

itio

ns –

Pre

vent

ion,

Iden

tifi

cati

on

and

Man

agem

ent

Long

ter

m c

ond

itio

ns a

re o

ngo

ing

, lo

ng t

erm

or

recu

rrin

g c

ond

itio

ns.

The

pre

vale

nce

of

long

ter

m c

ond

itio

ns is

incr

easi

ng c

ausi

ng

pre

mat

ure

mo

rtal

ity

and

mo

rbid

ity.

Māo

ri a

nd P

acifi

c p

eop

le, p

eop

le li

ving

in lo

w s

oci

oec

ono

mic

cir

cum

stan

ces,

peo

ple

wit

h d

isab

iliti

es

and

peo

ple

wit

h m

enta

l hea

lth

and

ad

dic

tio

n is

sues

are

dis

pro

po

rtio

nate

ly a

ffec

ted

by

som

e lo

ng t

em c

ond

itio

ns, w

ith

a m

ore

sig

nifi

cant

im

pac

t fr

om

ill h

ealt

h an

d e

arlie

r m

ort

alit

y. T

his

sect

ion

sets

out

ho

w t

he B

OP

DH

B is

ad

apti

ng it

s se

rvic

es t

o f

ocu

s o

n w

elln

ess

and

p

reve

ntio

n, e

arly

iden

tifi

cati

on,

and

inte

gra

ting

man

agem

ent

and

tre

atm

ent

in c

om

mun

ity-

bas

ed s

ervi

ces.

It d

emo

nstr

ates

the

inte

gra

tio

n b

etw

een

the

BO

PD

HB

and

To

i Te

Ora

Pub

lic H

ealt

h S

ervi

ce o

n p

reve

ntin

g, i

den

tify

ing

and

man

agin

g lo

ng t

erm

co

ndit

ions

and

the

fo

cus

on

colla

bo

rati

on

wit

h lo

cal c

ross

sec

tor

par

tner

org

anis

atio

ns t

o s

upp

ort

the

pre

vent

ion

of

long

ter

m c

ond

itio

ns f

or

the

BO

P p

op

ulat

ion.

2B.1

.4.1

Hea

lthy

Fam

ilies

NZ

Hea

lthy

Fam

ilies

New

Zea

land

is a

flag

ship

Gov

ernm

ent

init

iati

ve t

hat

aim

s to

imp

rove

peo

ple

’s h

ealt

h w

here

the

y liv

e, le

arn,

wo

rk a

nd p

lay

in o

rder

to

pre

vent

chr

oni

c d

isea

se.

The

BO

PD

HB

is s

upp

ort

ing

thi

s g

oal

as

follo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Hea

lthy

Fam

ilies

N

Z

• T

he B

OP

DH

B w

ill c

ont

inue

on

the

Hea

lthy

Fam

ilies

Eas

t C

ape

Gov

erna

nce

Gro

up

rep

rese

ntin

g b

oth

BO

P a

nd T

aira

whi

ti D

HB

s th

roug

h it

s P

ort

folio

Man

ager

, P

lann

ing

and

Fun

din

g, P

op

ulat

ion

Hea

lth.

Thi

s w

ill p

rovi

de

linka

ges

bet

wee

n D

HB

g

over

nanc

e an

d e

xecu

tive

fun

ctio

ns a

nd t

hose

of

oth

er p

artn

ers

such

as

loca

l au

tho

riti

es,

PH

Os,

Reg

iona

l Sp

ort

s Tr

usts

, pri

vate

bus

ines

ses,

and

iwi r

unan

ga

and

ha

uora

gro

ups.

• T

he B

OP

DH

B w

ill f

acili

tate

the

inte

gra

tio

n o

f p

hysi

cal a

ctiv

ity,

nut

riti

on,

to

bac

co

cont

rol a

nd a

lco

hol m

od

erat

ion

serv

ice

pro

gra

mm

es f

und

ed o

r d

eliv

ered

by

the

BO

PD

HB

in t

he O

po

tiki

Dis

tric

t.

• T

he B

OP

DH

B w

ill li

nk in

ter-

agen

cy p

lann

ing

and

net

wo

rkin

g g

roup

s in

the

BO

P f

or

tho

se s

ervi

ce a

reas

to

the

Hea

lthy

Fam

ilies

NZ

init

iati

ve.

• To

i Te

Ora

-Pub

lic H

ealt

h S

ervi

ce w

ill in

teg

rate

its

sett

ing

-bas

ed p

rog

ram

mes

suc

h as

H

ealt

h P

rom

oti

ng S

cho

ols

, Wo

rk W

ell,

Hap

u ha

uora

, and

Bui

ldin

g B

lock

s fo

r U

nder

5’

s, a

nd it

s re

gul

ato

ry, h

ealt

hy p

ublic

po

licy,

and

co

mm

unit

y d

evel

op

men

t w

ork

wit

h b

oth

the

Hea

lthy

Fam

ilies

Eas

t C

ape

and

Hea

lthy

Fam

ilies

Ro

toru

a in

itia

tive

s.

• T

he B

OP

DH

B w

ill id

enti

fy o

pp

ort

unit

ies

to m

ake

syst

em c

hang

es t

hro

ugh

eng

agem

ent

wit

h th

e p

hila

nthr

op

ic s

ecto

r, p

riva

te b

usin

esse

s, t

he f

oo

d a

nd

ente

rtai

nmen

t in

dus

trie

s, a

nd o

ther

sec

tors

to

ad

dre

ss w

hole

po

pul

atio

ns a

t sc

ale.

Num

ber

of

Gov

erna

nce

Gro

up

mee

ting

s at

tend

ed.

A Q

uart

er 4

co

nfirm

atio

n an

d

exce

pti

on

rep

ort

ag

ains

t th

e ex

amp

les

of

par

tici

pat

ion

iden

tifi

ed.

Num

ber

of

inte

r-ag

ency

link

ages

d

evel

op

ed w

ith

Hea

lthy

Fam

ilies

Eas

t C

ape

and

rep

ort

ed in

the

Qua

rter

4

confi

rmat

ion

and

exc

epti

on

rep

ort

.

Wo

rkin

g t

ow

ard

s To

i Te

Ora

’s s

trat

egic

g

oal

s to

: a)

red

uce

child

hoo

d o

bes

ity

by

1/3

in

10 y

ears

to

20

23; a

nd

b)

red

uce

the

pro

po

rtio

n o

f ye

ar 1

0

stud

ents

sm

oki

ng b

y 2/

3 in

five

yea

rs

to 2

018

.

71


ANNUAL PLAN 2016/17

2B.1

.4.2

Rai

sing

Hea

lthy

Kid

s

A n

ew h

ealt

h ta

rget

has

bee

n in

tro

duc

ed t

o s

upp

ort

the

pac

kag

e o

f in

itia

tive

s to

ens

ure

we

are

rais

ing

hea

lthy

kid

s.

The

tar

get

was

sel

ecte

d a

s th

e B

4S

C p

rog

ram

me

focu

ses

on

inte

rven

ing

in t

he e

arly

sta

ges

to

ens

ure

po

siti

ve, s

usta

ined

eff

ects

on

heal

th. T

he t

arg

et s

igna

ls t

he im

po

rtan

ce o

f eff

ecti

ve m

anag

emen

t o

f o

bes

ity

in c

hild

ren.

The

BO

PD

HB

is

sup

po

rtin

g t

he p

reve

ntio

n an

d m

anag

emen

t o

f o

bes

ity

in c

hild

ren

and

yo

ung

peo

ple

as

follo

ws.

Link

ages

• H

ealt

h Ta

rget

• To

i Te

Ora

’s A

nnua

l Pla

n 20

16/1

7 ta

rget

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Rai

sing

Hea

lthy

K

ids

• T

he B

OP

DH

B w

ill c

ont

inue

to

sho

w le

ader

ship

, and

will

del

iver

on

the

Rai

sing

H

ealt

hy K

ids

heal

th t

arg

et, a

nd id

enti

fy o

ther

ap

pro

pri

ate

acti

viti

es t

o h

elp

red

uce

the

inci

den

ce o

f o

bes

ity.

• C

YS

A in

clud

es c

hild

hoo

d o

bes

ity

wit

hin

its

gov

erna

nce

role

fo

r th

e C

hild

Yo

uth

Hea

lth

Wel

lbei

ng S

trat

egy

and

wo

rk p

lan

for

2016

/17.

Thi

s g

over

nanc

e ro

le is

an

app

roac

h th

at w

ill m

axim

ise

clin

ical

invo

lvem

ent

and

po

tent

ial c

ont

rib

utio

n fr

om

the

cr

oss

sec

tor

foru

m p

arti

cip

atio

n o

f M

inis

try

for

So

cial

Dev

elo

pm

ent,

Chi

ld, Y

out

h an

d

Fam

ily, a

nd M

inis

try

of

Ed

ucat

ion.

• T

he B

OP

DH

B w

ill a

lso

co

llab

ora

te w

ith

reg

iona

l pro

ject

pla

ns s

uch

as t

hose

fro

m

the

Mid

land

Mat

erni

ty A

ctio

n g

roup

and

Mid

land

Chi

ld H

ealt

h A

ctio

n g

roup

tha

t ha

ve n

ote

d c

hild

hoo

d o

bes

ity

wit

hin

thei

r 20

16/1

7 w

ork

pla

ns, s

o t

hat

an in

teg

rate

d

app

roac

h is

ach

ieve

d.

• T

he B

OP

DH

B w

ill f

orm

a w

ork

ing

gro

up o

f st

akeh

old

ers

for

info

rmat

ion

shar

ing

an

d c

om

mun

icat

ion

bet

wee

n se

rvic

es.

Thi

s is

to

ens

ure

an in

teg

rate

d a

pp

roac

h fo

r re

ferr

als

to a

sses

smen

t an

d s

ervi

ce in

terv

enti

on

that

has

a p

rim

ary

care

/PH

O f

ocu

s th

at in

clud

es in

-ser

vice

tra

inin

g f

or

stak

eho

lder

/pro

vid

ers.

• T

he B

OP

DH

B w

ill r

evie

w b

ase

line

BO

PD

HB

dat

a fo

r B

4S

C p

op

ulat

ion

wit

h ke

y st

akeh

old

ers.

Hea

lth

targ

et: B

y D

ecem

ber

20

17,

95%

of

ob

ese

child

ren

iden

tifi

ed in

th

e B

efo

re S

cho

ol C

heck

(B

4SC

) p

rog

ram

me

will

be

refe

rred

to

a

heal

th p

rofe

ssio

nal f

or

clin

ical

as

sess

men

t an

d f

amily

bas

ed

nutr

itio

n, a

ctiv

ity

and

life

styl

e in

terv

enti

ons

. R

epo

rted

qua

rter

ly.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Rai

sing

Hea

lthy

K

ids

Targ

eted

Init

iati

ves:

• T

he w

ork

ing

gro

up w

ill d

evel

op

sp

ecifi

c lo

cal r

efer

ral p

athw

ays

for

Bay

Nav

igat

or

usin

g t

he e

xist

ing

Wei

ght

Man

agem

ent

Pat

hway

in P

rim

ary

Car

e as

a r

efer

ence

.

• T

he B

OP

DH

B w

ill d

evel

op

a m

oni

tori

ng t

oo

l fo

r o

ngo

ing

tra

ckin

g o

f re

ferr

als,

fo

r C

linic

al A

sses

smen

t an

d s

ervi

ce in

terv

enti

on.

(G

P/P

aed

iatr

icia

n; c

om

mun

ity

pro

vid

ers

such

as

Act

ive

fam

ilies

and

Kau

pap

a M

āori

pro

vid

er o

pti

ons

); in

clud

ing

ag

reei

ng lo

cal

out

com

es f

or

mo

nito

ring

to

ass

ist

in f

utur

e se

rvic

e d

evel

op

men

t.

• T

he B

OP

DH

B w

ill e

nsur

e a

clin

ical

ass

essm

ent

too

l is

imp

lem

ente

d w

ith

pro

toco

ls d

evel

op

ed f

or

info

rmat

ion

shar

ing

bet

wee

n re

ferr

ers,

incl

udin

g B

ay N

avig

ato

r an

d P

rim

ary

Car

e/G

P p

ract

ices

.

Incr

ease

d s

upp

ort

fo

r th

ose

at

risk

:

• T

he w

ork

ing

gro

up w

ill s

cop

e re

ferr

al p

athw

ays

to p

rovi

de

asse

ssm

ent

and

acc

ess

to n

utri

tio

n an

d p

hysi

cal a

ctiv

ity

pro

gra

mm

es

• T

he w

ork

ing

gro

up w

ill s

cop

e lo

cal d

eman

d f

or

clin

ical

ass

essm

ent

and

inte

rven

tio

n se

rvic

es, b

ased

on

the

B4

SC

dat

a; t

o

info

rm im

pro

ved

man

agem

ent

for

the

refe

rral

inte

rven

tio

n ra

te r

equi

red

to

mee

t th

e R

aisi

ng H

ealt

hy K

ids

heal

th t

arg

et.

• T

he w

ork

ing

gro

up w

ill p

rovi

de

gui

del

ines

info

rmat

ion

to f

amili

es/w

hāna

u an

d p

rovi

der

s fo

r; w

eig

ht m

anag

emen

t in

chi

ldre

n;

heal

thy

wei

ght

gai

n in

pre

gna

ncy;

Ges

tati

ona

l Dia

bet

es a

nd K

iwi s

po

rt o

pti

ons

.

73


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Rai

sing

Hea

lthy

K

ids

Bro

ad P

op

ulat

ion

Ap

pro

ache

s –

assi

stin

g h

ealt

hier

cho

ices

:

• T

he B

OP

DH

B w

ill c

ont

inue

to

ad

voca

te a

nd m

oni

tor

the

BO

PD

HB

’s S

ale

of

Fo

od

and

B

ever

ages

on

DH

B p

rem

ises

po

licy

and

wo

rk t

o in

clud

e a

pro

acti

ve p

olic

y o

n S

ugar

S

wee

tene

d B

ever

ages

in a

ll ag

reem

ents

fo

r ch

ild/y

out

h he

alth

ser

vice

s.

• T

he B

OP

DH

B w

ill w

ork

co

llab

ora

tive

ly w

ith

Toi T

e O

ra -

Pub

lic H

ealt

h S

ervi

ce t

o

sup

po

rt t

he im

ple

men

tati

on

of

thei

r ch

ildho

od

ob

esit

y p

reve

ntio

n st

rate

gy,

incl

udin

g

stra

teg

ic o

bje

ctiv

es t

o:

-im

pro

ve c

hild

ren’

s nu

trit

ion,

incl

udin

g t

he r

educ

tio

n o

f th

e co

nsum

pti

on

of

sug

ar s

wee

tene

d b

ever

ages

-im

pro

ve m

ater

nal a

nd in

fant

hea

lth,

incl

udin

g a

dd

ress

ing

mo

difi

able

ris

k fa

cto

rs f

or

child

hoo

d o

bes

ity

(thr

oug

h im

pro

ving

mat

erna

l nut

riti

on,

sm

oke

free

pre

gna

ncie

s, a

nd b

reas

tfee

din

g r

ates

)

-im

pro

ve c

hild

ren’

s p

hysi

cal a

ctiv

ity

(thr

oug

h in

crea

sing

act

ive

pla

y an

d a

ctiv

e tr

ansp

ort

, and

dec

reas

ing

scr

een

tim

e.

Key

mile

sto

nes

for

Rai

sing

Hea

lthy

Kid

s:

-Q

uart

er o

ne: S

teer

ing

gro

up e

stab

lishe

d, w

ork

pla

n co

mp

lete

d, r

evie

w o

f cu

rren

t se

rvic

es c

om

ple

ted

, dev

elo

pm

ent

of

child

hoo

d o

bes

ity

refe

rral

p

athw

ay c

om

ple

ted

, and

co

mm

unic

atio

n p

lan

dra

fted

.

-Q

uart

ers

two

and

thr

ee:

Chi

ldho

od

ob

esit

y re

ferr

al p

athw

ay is

co

mm

unic

ated

to

pro

vid

ers

to c

om

ply

wit

h re

ferr

al e

xpec

tati

ons

fo

r th

e ta

rget

and

th

e p

athw

ay is

pub

lishe

d o

n B

OP

DH

B’s

Bay

Nav

igat

or.

Ref

erra

l dat

a ac

kno

wle

dg

emen

ts a

re in

crea

sed

by

50%

by

the

end

of

qua

rter

tw

o.

A c

olle

ctio

n o

f su

cces

s m

easu

res

is d

evel

op

ed f

or

curr

ent

serv

ices

to

eva

luat

e su

cces

s o

f in

terv

enti

ons

, and

cur

rent

and

fut

ure

serv

ice

del

iver

y o

pti

ons

are

co

nso

lidat

ed.

In a

cco

rdan

ce w

ith

the

wo

rkp

lan,

pri

ori

ty p

reve

ntio

n ac

tivi

ties

im

ple

men

ted

at

the

po

pul

atio

n le

vel f

or

pub

lic h

ealt

h, t

o a

dd

ress

env

iro

nmen

t is

sues

; uti

lisin

g c

om

mun

icat

ion

stra

teg

ies.

-Q

uart

er F

our

and

20

17/1

8: I

niti

al a

ctiv

itie

s re

view

.


2B.1

.4.3

Liv

ing

Wel

l Wit

h D

iab

etes

Livi

ng W

ell w

ith

Dia

bet

es 2

015

-20

20 is

a p

lan

for

peo

ple

at

hig

h ri

sk o

f o

r liv

ing

wit

h d

iab

etes

. T

he f

ocu

s is

on

enha

ncin

g c

are

and

q

ualit

y o

f lif

e fo

r p

eop

le w

ith

dia

bet

es a

nd t

he f

oca

l po

int

of

care

rem

ains

in p

rim

ary

care

and

the

co

mm

unit

y se

ttin

g, t

his

is s

upp

ort

ed b

y in

teg

rate

d p

rim

ary

heal

th c

are

team

s an

d s

pec

ialis

t he

alth

ser

vice

s. T

he B

OP

DH

B is

imp

lem

enti

ng a

ctio

ns t

o s

upp

ort

the

del

iver

y o

f th

is

Pla

n as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Livi

ng W

ell w

ith

Dia

bet

es

Pre

vent

hig

h ri

sk p

eop

le f

rom

dev

elo

pin

g d

iab

etes

:

The

Wes

tern

Bay

of

Ple

nty

Pri

mar

y H

ealt

h O

rgan

isat

ion

(WB

OP

PH

O)

will

:

• E

nsur

e b

ette

r in

teg

rati

on

of

CV

D s

elf-

man

agem

ent

gro

ups

and

WB

OP

PH

O H

ealt

h an

d W

elln

ess

Ser

vice

. T

he C

VD

sel

f-m

anag

emen

t p

rog

ram

me

to r

educ

e th

e ri

sk o

f d

evel

op

ing

dia

bet

es.

• A

ll in

div

idua

ls w

ith

imp

aire

d g

luco

se t

ole

ranc

e w

ill b

e o

ffer

ed f

ree

of

char

ge

atte

ndan

ce a

t a

loca

l CV

D s

elf-

man

agem

ent

gro

up

• P

rom

ote

wei

ght

man

agem

ent

stra

teg

ies

in g

ener

al p

ract

ice

• D

evel

op

a m

ind

fuln

ess

eati

ng p

rog

ram

me

led

by

the

com

mun

ity

die

titi

an t

o s

upp

ort

w

eig

ht m

anag

emen

t

• P

rovi

de

educ

atio

n an

d s

upp

ort

to

Māo

ri h

ealt

h fu

nded

co

mm

unit

y w

ork

ers

so t

hey

are

bet

ter

able

to

sup

po

rt w

eig

ht m

anag

emen

t

• W

ork

wit

h sc

hoo

l hea

lth

coo

rdin

ato

rs t

o id

enti

fy c

hild

ren

who

are

ove

rwei

ght

and

p

rovi

de

trai

ning

on

the

wei

ght

man

agem

ent

too

ls t

o b

ette

r su

pp

ort

the

ir p

ract

ice.

Ena

ble

eff

ecti

ve s

elf-

man

agem

ent:

WB

OP

PH

O w

ill:

• C

ont

inue

to

pro

vid

e an

nual

in-h

ous

e se

lf-m

anag

emen

t tr

aini

ng t

o t

he s

elf-

man

agem

ent

cour

se p

rese

nter

s

• U

nder

take

ana

lysi

s o

f th

e fi

rst

and

last

par

tner

s in

hea

lth

sco

res

to d

eter

min

e th

e eff

ecti

vene

ss o

f se

lf-m

anag

emen

t

• C

ont

inue

to

sup

po

rt t

he s

elf-

man

agem

ent

stee

ring

gro

up t

o m

eet

on

a q

uart

erly

b

asis

and

to

ens

ure

that

the

re is

pat

ient

rep

rese

ntat

ion

at t

his

gro

up in

ad

dit

ion

to

the

atte

ndan

ce o

f th

e lo

cal D

iab

etes

Tau

rang

a su

pp

ort

gro

up r

epre

sent

ativ

e.

• C

ont

inue

to

wo

rk c

olla

bo

rati

vely

wit

h N

gā

Mat

aap

una

Ora

nga

(NM

O)

PH

O a

s th

e se

lf-m

anag

emen

t g

roup

s ar

e p

rovi

ded

fo

r al

l elig

ible

pat

ient

s ac

ross

WB

OP

re

gar

dle

ss o

f en

rolm

ent

Evi

den

ce d

emo

nstr

atin

g a

lignm

ent

to

the

Mo

H s

elf-

man

agem

ent

stan

dar

ds

to b

e su

bm

itte

d t

o B

OP

DH

B b

y Ju

ly

2016

PP

20: R

educ

tio

n in

pro

po

rtio

n o

f p

atie

nts

wit

h H

ba1

c ab

ove

64

, 80

and

10

0 m

mo

l/m

ol (

DH

Bs

who

can

not

rep

ort

ran

ges

sho

uld

wo

rk t

ow

ard

s th

is

as a

qua

lity

imp

rove

men

t m

easu

re.

Rep

ort

ing

on

imp

lem

enta

tio

n o

f ac

tio

ns in

the

Liv

ing

Wel

l wit

h D

iab

etes

Pla

n.

75


ANNUAL PLAN 2016/17

2B.1

.4.3

Liv

ing

Wel

l Wit

h D

iab

etes

Livi

ng W

ell w

ith

Dia

bet

es 2

015

-20

20 is

a p

lan

for

peo

ple

at

hig

h ri

sk o

f o

r liv

ing

wit

h d

iab

etes

. T

he f

ocu

s is

on

enha

ncin

g c

are

and

q

ualit

y o

f lif

e fo

r p

eop

le w

ith

dia

bet

es a

nd t

he f

oca

l po

int

of

care

rem

ains

in p

rim

ary

care

and

the

co

mm

unit

y se

ttin

g, t

his

is s

upp

ort

ed b

y in

teg

rate

d p

rim

ary

heal

th c

are

team

s an

d s

pec

ialis

t he

alth

ser

vice

s. T

he B

OP

DH

B is

imp

lem

enti

ng a

ctio

ns t

o s

upp

ort

the

del

iver

y o

f th

is

Pla

n as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Livi

ng W

ell w

ith

Dia

bet

es

Eas

tern

Bay

of

Ple

nty

Pri

mar

y H

ealt

h A

llian

ce (

EB

OP

PH

A)

will

:

• In

crea

se t

he s

elf-

man

agem

ent

cour

se f

rom

fo

ur t

o fi

ve w

eeks

fo

r th

ose

ind

ivid

uals

ta

king

insu

lin.

• M

easu

re c

linic

al in

dic

ato

rs (

cho

lest

ero

l, H

bA

1c a

nd m

icro

alb

umin

uria

) fo

r a

smal

l co

hort

of

par

tici

pan

ts o

n en

try

to s

elf-

man

agem

ent

and

at

thre

e m

ont

h fo

llow

up

.

• In

crea

se p

arti

cip

atio

n o

f M

aori

at

dia

bet

es a

nd C

VD

sel

f-m

anag

emen

t p

rog

ram

me.

Imp

rove

Qua

lity

of

Serv

ices

:

• S

elf-

man

agem

ent

gro

ups

will

co

ntin

ue t

o b

e su

pp

ort

ed in

bo

th E

BO

P a

nd W

BO

P.

The

Kau

pap

a M

āori

dia

bet

es s

elf-

man

agem

ent

gro

ups

will

als

o c

ont

inue

to

be

sup

po

rted

.

• A

lignm

ent

to t

he d

iab

etes

sel

f-m

anag

emen

t st

and

ard

s fo

r al

l dia

bet

es s

elf-

man

agem

ent

gro

ups

will

be

confi

rmed

by

July

20

16.

Det

ect

dia

bet

es e

arly

and

red

uce

inci

den

ce o

f co

mp

licat

ions

:

• A

ll P

HO

s w

ill a

chie

ve t

he M

ore

Hea

rt a

nd D

iab

etes

Che

cks

Targ

et a

nd w

ill r

educ

e an

d id

eally

elim

inat

e M

āori

and

Pac

ifica

hea

lth

ineq

ualit

ies

in r

egar

ds

to a

chie

vem

ent

of

the

targ

et (

see

next

sec

tio

n)

WB

oP

PH

O w

ill:

• C

ont

inue

to

wo

rk c

lose

ly w

ith

reti

nal s

cree

ning

to

ens

ure

all n

ewly

dia

gno

sed

peo

ple

w

ith

dia

bet

es a

re a

war

e o

f an

d a

re o

ffer

ed f

ree

atte

ndan

ce a

t a

dia

bet

es s

elf-

man

agem

ent

gro

up

• P

rovi

de

spec

ialis

t co

mm

unit

y su

pp

ort

to

sup

po

rt g

ener

al p

ract

ice

to e

xten

d t

heir

sk

ills

and

co

mp

eten

cy in

dia

bet

es m

anag

emen

t

• P

rovi

de

free

of

char

ge

spec

ialis

t tr

aini

ng t

o s

upp

ort

insu

lin in

itia

tio

n in

gen

eral

p

ract

ice

• P

rovi

de

free

of

char

ge

bas

ic d

iab

etes

tra

inin

g t

o e

nsur

e nu

rses

are

ab

le t

o u

nder

take

d

iab

etes

rev

iew

acc

urat

ely

• D

evel

op

and

pro

vid

e tr

aini

ng f

or

unre

gul

ated

wo

rker

s to

sup

po

rt im

pro

ved

dia

bet

es

man

agem

ent.

Dat

a co

llect

ion

and

rep

ort

by

31

Dec

emb

er 2

016

.

% o

f M

aori

par

tici

pat

ing

in C

VD

se

lf-m

anag

emen

t p

rog

ram

me

at 3

1 D

ecem

ber

.

Red

ucti

on

in T

aura

nga

hosp

ital

d

iab

etes

ad

mis

sio

ns r

elat

ed t

o s

tero

id

ther

apy

by

Dec

20

16

Incr

ease

d v

olu

me

of

refe

rral

s to

sel

f-m

anag

emen

t fr

om

Tau

rang

a ho

spit

al

staff


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Livi

ng W

ell w

ith

Dia

bet

es

EB

PH

A w

ill:

• F

orm

a D

iab

etes

/CV

D N

GO

gro

up t

o g

aug

e w

hat

is h

app

enin

g lo

cally

. R

epre

sent

ativ

es w

ill in

clud

e Iw

i, P

acifi

c Is

land

fo

rum

, dia

bet

es s

upp

ort

gro

ups,

p

harm

acie

s, p

od

iatr

ists

, and

the

Hea

rt F

oun

dat

ion.

The

gro

up w

ill c

olle

ctiv

ely

targ

et is

sues

suc

h as

Hb

A1c

, lip

ids

etc;

and

be

led

by

the

Clin

ical

Nur

se S

pec

ialis

t in

D

iab

etes

(C

NS

D)

• T

he C

NS

D w

ill c

ont

inue

to

wo

rk w

ith

the

Pra

ctic

es/P

ract

ice

Nur

ses

to h

old

DC

IP

clin

ics

in t

hose

Pra

ctic

es w

ho c

laim

DC

IP f

und

ing

.

• E

stab

lish

qua

rter

ly m

eeti

ngs

for

a d

iab

etes

nur

se s

pec

ial i

nter

est

gro

up f

or

pra

ctic

e nu

rses

, co

mm

unit

y nu

rses

and

res

iden

tial

car

e nu

rsin

g.

NM

O P

HO

will

:

• C

ont

inue

to

fo

cus

on

its

mo

st v

ulne

rab

le p

op

ulat

ion

whe

n un

der

taki

ng C

VD

RA

.

• E

stab

lish

a cu

ltur

ally

ap

pro

pri

ate

self

-man

agem

ent

gro

up t

hat

wo

rks

alo

ngsi

de

WB

OP

PH

O

• W

ork

clo

sely

wit

h W

BO

PP

HO

to

iden

tify

Mao

ri w

ithd

raw

als/

sud

den

exi

ts f

rom

sel

f-m

anag

emen

t p

rog

ram

mes

• E

nsur

e th

ose

at

risk

of

dia

bet

es a

re h

ealt

h lit

erat

e w

hen

refe

rred

in t

o C

VD

sel

f-m

anag

emen

t g

roup

s w

ithi

n W

BO

P.

• P

rovi

de

mo

re e

duc

atio

n an

d h

ealt

h lit

erac

y to

our

co

mm

unit

ies

iden

tifi

ed a

s hi

gh

risk

po

pul

atio

ns w

ho f

all o

utsi

de

of

exis

ting

sel

f-m

anag

emen

t p

rog

ram

mes

• In

co

llab

ora

tio

n w

ith

BO

PD

HB

, ‘tr

ack

and

tra

ce’ h

igh

risk

ad

ult

mal

es 3

5 –

44

yea

rs

thro

ugh

the

dev

elo

pm

ent

of

a d

iab

etes

and

car

dia

c sp

ecifi

c W

hāna

u o

ra P

athw

ay

that

sp

ans

the

pat

ient

jour

ney

fro

m g

ener

al p

ract

ice

to s

eco

ndar

y ca

re a

nd b

ack

into

the

co

mm

unit

y

• Im

ple

men

t w

anan

ga

at lo

cal m

arae

to

incr

ease

co

mm

unit

y aw

aren

ess

of

Dia

bet

es

and

CV

DR

A

• W

ork

wit

h S

enio

r C

linic

al P

ract

itio

ner

to im

pro

ve C

VD

RA

and

Dia

bet

es C

heck

s us

ing

a

mul

ti-d

isci

plin

ary

team

ap

pro

ach,

whi

ch w

oul

d in

clud

e N

ew R

egis

trar

s, C

om

mun

ity

Nur

ses,

Pra

ctic

e N

urse

, Hea

lthc

are

Ass

ista

nce

and

Whā

nau

ora

Kai

mah

i. T

his

Mul

ti-

dis

cip

linar

y te

am a

pp

roac

h w

ill a

lso

be

pla

ce in

co

mm

unit

y se

ttin

gs

focu

sing

in h

igh

po

pul

atio

ns o

f M

aori

and

or

cult

ural

/ sp

ort

s ev

ents

.

Red

ucti

on

in d

iab

etes

rel

ated

hea

lth

ineq

ualit

ies

for

Mao

ri t

ane

aged

35

-44

year

s

Whā

nau

ora

dia

bet

es a

nd c

ard

iac

pat

hway

s es

tab

lishe

d b

y M

arch

20

17.

Imp

lem

ent

two

wan

ang

a at

loca

l m

arae

fo

cuse

d s

pec

ifica

lly o

n D

iab

etes

an

d C

VD

by

Dec

emb

er 2

016

77


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Livi

ng W

ell w

ith

Dia

bet

es

Pro

vid

e In

teg

rate

d C

are:

WB

OP

PH

O w

ill:

• W

ork

wit

h sp

ecia

list

staff

at

Taur

ang

a ho

spit

al t

o a

rran

ge

cont

inui

ng

med

ical

ed

ucat

ion

(CM

E)

and

co

ntin

uing

nur

sing

ed

ucat

ion

(CN

E)

on

the

man

agem

ent

of

dia

bet

es a

nd s

teri

od

s as

thi

s ha

s b

een

a ca

use

of

dia

bet

es

rela

ted

ad

mis

sio

ns.

• Le

ad a

Tau

rang

a ho

spit

al n

ursi

ng f

oru

m o

n se

lf-m

anag

emen

t an

d t

he

imp

ort

ance

of

refe

rrin

g p

atie

nts

wit

h d

iab

etes

.

• W

ork

co

llab

ora

tive

ly w

ith

Taur

ang

a sp

ecia

list

staff

and

the

sch

oo

l bas

ed

heal

th s

ervi

ces

to s

upp

ort

yo

uth

wit

h d

iab

etes

(b

oth

typ

e 1

dia

bet

es a

nd

typ

e 2

dia

bet

es)

• C

ont

inue

to

wo

rk c

olla

bo

rati

vely

wit

h N

MO

PH

O o

n co

ntin

uing

med

ical

an

d n

ursi

ng e

duc

atio

n.

• E

BO

P P

HA

will

co

ntin

ue t

o s

upp

ort

the

join

t p

rim

ary

seco

ndar

y ca

re

dia

bet

es n

urse

sp

ecia

list

role

in t

he E

aste

rn B

ay.

Mee

t th

e ne

eds

of

child

ren

and

ad

ults

wit

h Ty

pe

1 d

iab

etes

:

• W

BO

P P

HO

co

mm

unit

y d

iab

etes

nur

se w

ill s

pen

d t

ime

wit

h ho

spit

al

spec

ialis

t st

aff t

o g

ain

add

itio

nal s

kills

in t

he m

anag

emen

t o

f Ty

pe

1 d

iab

etes

• S

eco

ndar

y ca

re w

ill c

ont

inue

to

lead

Typ

e 1

serv

ice

pro

visi

on

and

pro

vid

e su

pp

ort

to

pri

mar

y ca

re p

rovi

der

s to

fur

ther

enh

ance

car

e p

rovi

sio

n

• S

eco

ndar

y ca

re w

ill m

aint

ain

a sp

ecia

list

nurs

e w

ard

vis

itin

g s

ervi

ce

for

inp

atie

nts

to s

upp

ort

a s

afe

envi

ronm

ent

for

tho

se in

div

idua

ls w

ith

dia

bet

es.

Co

mp

leti

on

of

CM

E a

nd C

NE

on

the

man

agem

ent

of

dia

bet

es a

nd s

teri

od

s b

y 30

Nov

emb

er 2

016

.

Co

mp

leti

on

of

Taur

ang

a ho

spit

al

nurs

ing

fo

rum

by

30 N

ovem

ber

20

16.


2B.1

.4.4

Car

dio

vasc

ular

Dis

ease

The

go

al o

f th

is p

rio

rity

is t

o m

aint

ain

the

mo

men

tum

gen

erat

ed f

rom

the

Mo

re H

eart

and

Dia

bet

es H

ealt

h ta

rget

whi

ch h

as b

een

rep

lace

d

by

the

Rai

sing

Hea

lthy

Kid

s ta

rget

. S

igni

fica

nt a

war

enes

s o

f ca

rdio

vasc

ular

dis

ease

ris

k fa

cto

rs, i

mp

rove

men

ts in

hea

lth

liter

acy

and

sel

f-m

anag

emen

t ha

s b

een

gen

erat

ed b

y th

e p

rim

ary

care

sec

tor

and

it is

exp

ecte

d t

hat

card

iova

scul

ar d

isea

se r

isk

asse

ssm

ents

will

co

ntin

ue.

The

pri

mar

y ca

re s

ecto

r in

the

Bay

of

Ple

nty

will

co

ntin

ue t

his

as f

ollo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Car

dio

vasc

ular

D

isea

se

PH

Os

will

:

Ens

ure

dat

a in

teg

rity

and

co

mp

lete

ness

and

acc

urac

y o

f d

ata

extr

act

fro

m a

ll g

ener

al

pra

ctic

e P

MS

.

Pro

vid

e fr

ee n

urse

-led

CV

DR

A o

pp

ort

unit

ies

at v

ario

us lo

cati

ons

incl

udin

g M

arae

Co

ntin

ue t

o p

rovi

de

Wo

rkp

lace

Wel

lnes

s fo

r w

ork

pla

ces

that

em

plo

y la

rge

volu

mes

o

f lo

w p

aid

Māo

ri a

nd P

acifi

ca w

ork

ers.

Dev

elo

p a

nd a

gre

e a

mem

ora

ndum

of

und

erst

and

ing

wit

h To

i Te

Ora

Pub

lic H

ealt

h S

ervi

ce t

o e

nab

le W

ork

Wel

l and

Wo

rkp

lace

W

elln

ess

to w

ork

co

llab

ora

tive

ly.

Thi

s sh

oul

d r

esul

t in

a g

reat

er n

umb

er o

f w

ork

pla

ces

rece

ivin

g W

ork

pla

ce W

elln

ess.

9

Pro

vid

e co

ntin

uous

med

ical

ed

ucat

ion

and

co

ntin

uous

nur

sing

ed

ucat

ion

op

po

rtun

itie

s fo

r C

VD

rel

ated

pro

fess

iona

l dev

elo

pm

ent

Co

ntin

ue t

o p

rovi

de

free

CV

D s

elf-

man

agem

ent

gro

ups

to a

ssis

t w

ith

risk

fac

tor

man

agem

ent.

In W

este

rn B

ay o

f P

lent

y, p

rovi

de

sup

po

rt f

or

wei

ght

red

ucti

on

thro

ugh

the

pro

visi

on

of

gro

up s

essi

ons

and

ind

ivid

ual d

iete

tic-

led

ap

po

intm

ents

. T

his

will

incl

ude

dem

and

-led

g

roup

pro

visi

on

for

min

dfu

l eat

ing

.

WB

OP

PH

O w

ill d

evel

op

fur

ther

rel

atio

nshi

ps

wit

h N

gat

i Ran

gin

ui t

oS

upp

ort

Mao

ri C

VD

ri

sk f

acto

r re

duc

tio

n b

y fi

ndin

g h

ard

to

rea

ch in

div

idua

ls w

ho a

re n

ot

eng

aged

wit

h g

ener

al p

ract

ice

and

link

ing

the

se in

div

idua

ls w

ith

Wes

tern

Bay

of

Ple

nty

Hea

lth

and

W

elln

ess

Ser

vice

s.

EB

PH

A w

ill d

evel

op

a t

rans

itio

n an

d im

ple

men

tati

on

pla

n to

mov

e fu

ndin

g f

rom

CV

D

asse

ssm

ent

to C

VD

man

agem

ent.

Co

nfirm

the

acc

urac

y an

d

com

ple

tene

ss o

f d

ata

extr

acts

fo

r d

iab

etes

and

CV

DR

A r

elat

ed t

arg

et

rela

ted

ext

ract

s b

y en

d o

f Ju

ly 2

016

.

PP

20: 9

0%

of

the

elig

ible

ad

ult

po

pul

atio

n w

ill h

ave

had

the

ir C

VD

ris

k as

sess

ed in

the

last

five

yea

rs.

Sig

ned

Mem

ora

ndum

of

Und

erst

and

ing

b

y 1

July

20

16.

PP

20: 9

0%

of

elig

ible

Māo

ri m

en in

the

P

HO

ag

ed 3

5-4

4 y

ears

who

hav

e ha

d a

C

VD

ris

k re

cord

ed w

ithi

n th

e p

ast

five

ye

ars.

Red

ucti

on

in C

VD

RA

rel

ated

Māo

ri

heal

th in

equa

litie

s fo

r M

āori

men

ag

ed

35-4

4 y

ears

.

Ach

ieve

men

t o

f C

VD

RA

tar

get

by

Aug

ust

2016

.

Num

ber

of

gro

up m

ind

ful e

atin

g

sess

ions

pro

vid

ed.

Rep

ort

on

the

del

iver

y o

f th

e ac

tio

ns

and

mile

sto

nes

iden

tifi

ed in

the

Ann

ual

Pla

n.

Dev

elo

pm

ent

of

an a

gre

ed p

lan

by

31

Dec

emb

er 2

016

.

9 W

ork

pla

ce W

elln

ess

will

sup

po

rt r

isk

fact

or

man

agem

ent

red

ucti

on

thro

ugh:

• W

ork

pla

ce s

mo

king

ces

sati

on

sup

po

rt•

Wo

rkp

lace

hea

lthy

eat

ing

and

wei

ght

red

ucti

on

sup

po

rt•

Incr

ease

d u

nder

stan

din

g o

f im

po

rtan

ce o

f ta

king

pre

scri

bed

med

icat

ion

• P

rom

oti

on

of

reg

ular

exe

rcis

e.

79


ANNUAL PLAN 2016/17

2B.1

.4.4

Car

dio

vasc

ular

Dis

ease

The

go

al o

f th

is p

rio

rity

is t

o m

aint

ain

the

mo

men

tum

gen

erat

ed f

rom

the

Mo

re H

eart

and

Dia

bet

es H

ealt

h ta

rget

whi

ch h

as b

een

rep

lace

d

by

the

Rai

sing

Hea

lthy

Kid

s ta

rget

. S

igni

fica

nt a

war

enes

s o

f ca

rdio

vasc

ular

dis

ease

ris

k fa

cto

rs, i

mp

rove

men

ts in

hea

lth

liter

acy

and

sel

f-m

anag

emen

t ha

s b

een

gen

erat

ed b

y th

e p

rim

ary

care

sec

tor

and

it is

exp

ecte

d t

hat

card

iova

scul

ar d

isea

se r

isk

asse

ssm

ents

will

co

ntin

ue.

The

pri

mar

y ca

re s

ecto

r in

the

Bay

of

Ple

nty

will

co

ntin

ue t

his

as f

ollo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Car

dio

vasc

ular

D

isea

se

PH

Os

will

:

Ens

ure

dat

a in

teg

rity

and

co

mp

lete

ness

and

acc

urac

y o

f d

ata

extr

act

fro

m a

ll g

ener

al

pra

ctic

e P

MS

.

Pro

vid

e fr

ee n

urse

-led

CV

DR

A o

pp

ort

unit

ies

at v

ario

us lo

cati

ons

incl

udin

g M

arae

Co

ntin

ue t

o p

rovi

de

Wo

rkp

lace

Wel

lnes

s fo

r w

ork

pla

ces

that

em

plo

y la

rge

volu

mes

o

f lo

w p

aid

Māo

ri a

nd P

acifi

ca w

ork

ers.

Dev

elo

p a

nd a

gre

e a

mem

ora

ndum

of

und

erst

and

ing

wit

h To

i Te

Ora

Pub

lic H

ealt

h S

ervi

ce t

o e

nab

le W

ork

Wel

l and

Wo

rkp

lace

W

elln

ess

to w

ork

co

llab

ora

tive

ly.

Thi

s sh

oul

d r

esul

t in

a g

reat

er n

umb

er o

f w

ork

pla

ces

rece

ivin

g W

ork

pla

ce W

elln

ess.

9

Pro

vid

e co

ntin

uous

med

ical

ed

ucat

ion

and

co

ntin

uous

nur

sing

ed

ucat

ion

op

po

rtun

itie

s fo

r C

VD

rel

ated

pro

fess

iona

l dev

elo

pm

ent

Co

ntin

ue t

o p

rovi

de

free

CV

D s

elf-

man

agem

ent

gro

ups

to a

ssis

t w

ith

risk

fac

tor

man

agem

ent.

In W

este

rn B

ay o

f P

lent

y, p

rovi

de

sup

po

rt f

or

wei

ght

red

ucti

on

thro

ugh

the

pro

visi

on

of

gro

up s

essi

ons

and

ind

ivid

ual d

iete

tic-

led

ap

po

intm

ents

. T

his

will

incl

ude

dem

and

-led

g

roup

pro

visi

on

for

min

dfu

l eat

ing

.

WB

OP

PH

O w

ill d

evel

op

fur

ther

rel

atio

nshi

ps

wit

h N

gat

i Ran

gin

ui t

oS

upp

ort

Mao

ri C

VD

ri

sk f

acto

r re

duc

tio

n b

y fi

ndin

g h

ard

to

rea

ch in

div

idua

ls w

ho a

re n

ot

eng

aged

wit

h g

ener

al p

ract

ice

and

link

ing

the

se in

div

idua

ls w

ith

Wes

tern

Bay

of

Ple

nty

Hea

lth

and

W

elln

ess

Ser

vice

s.

EB

PH

A w

ill d

evel

op

a t

rans

itio

n an

d im

ple

men

tati

on

pla

n to

mov

e fu

ndin

g f

rom

CV

D

asse

ssm

ent

to C

VD

man

agem

ent.

Co

nfirm

the

acc

urac

y an

d

com

ple

tene

ss o

f d

ata

extr

acts

fo

r d

iab

etes

and

CV

DR

A r

elat

ed t

arg

et

rela

ted

ext

ract

s b

y en

d o

f Ju

ly 2

016

.

PP

20: 9

0%

of

the

elig

ible

ad

ult

po

pul

atio

n w

ill h

ave

had

the

ir C

VD

ris

k as

sess

ed in

the

last

five

yea

rs.

Sig

ned

Mem

ora

ndum

of

Und

erst

and

ing

b

y 1

July

20

16.

PP

20: 9

0%

of

elig

ible

Māo

ri m

en in

the

P

HO

ag

ed 3

5-4

4 y

ears

who

hav

e ha

d a

C

VD

ris

k re

cord

ed w

ithi

n th

e p

ast

five

ye

ars.

Red

ucti

on

in C

VD

RA

rel

ated

Māo

ri

heal

th in

equa

litie

s fo

r M

āori

men

ag

ed

35-4

4 y

ears

.

Ach

ieve

men

t o

f C

VD

RA

tar

get

by

Aug

ust

2016

.

Num

ber

of

gro

up m

ind

ful e

atin

g

sess

ions

pro

vid

ed.

Rep

ort

on

the

del

iver

y o

f th

e ac

tio

ns

and

mile

sto

nes

iden

tifi

ed in

the

Ann

ual

Pla

n.

Dev

elo

pm

ent

of

an a

gre

ed p

lan

by

31

Dec

emb

er 2

016

.

9 W

ork

pla

ce W

elln

ess

will

sup

po

rt r

isk

fact

or

man

agem

ent

red

ucti

on

thro

ugh:

• W

ork

pla

ce s

mo

king

ces

sati

on

sup

po

rt•

Wo

rkp

lace

hea

lthy

eat

ing

and

wei

ght

red

ucti

on

sup

po

rt•

Incr

ease

d u

nder

stan

din

g o

f im

po

rtan

ce o

f ta

king

pre

scri

bed

med

icat

ion

• P

rom

oti

on

of

reg

ular

exe

rcis

e.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Car

dio

vasc

ular

D

isea

se

NM

O P

HO

will

:

• C

ont

inue

to

und

erta

ke C

VD

RA

and

ens

ure

tho

se a

t ri

sk o

f d

iab

etes

are

ref

erre

d in

to

C

VD

sel

f-m

anag

emen

t g

roup

s w

ithi

n W

BO

P.

• D

evel

op

men

t o

f t

he T

e M

anu

Toro

a C

NS

att

end

ing

car

dio

log

y cl

inic

s at

the

DH

B

wit

h th

e m

edic

al t

eam

s –

this

to

aid

in

the

dev

elo

pm

ent

of

the

co

ntin

uity

of

care

in

to t

he c

om

mun

ity

of

the

clie

nts

heal

th r

elat

ed jo

urne

y

• P

urch

asin

g o

f eq

uip

men

t th

at w

ill a

id in

mo

re r

apid

ass

essm

ent

of

pat

ient

CV

ris

k (a

p

oin

t o

f ca

re d

evic

e th

at d

oes

Hb

A1C

+ c

hole

ster

ol a

t th

e sa

me

tim

e).

• D

evel

op

men

t o

f p

rog

ram

mes

whe

reb

y th

is p

oin

t o

f ca

re d

evic

e ca

n b

e us

ed in

co

mm

unit

y se

ttin

gs

to s

cree

n fo

r C

VD

ris

k an

d a

pp

rop

riat

e ac

tio

n th

erea

fter

– a

ll to

re

duc

e ho

spit

al a

dm

issi

ons

• D

evel

op

men

t o

f p

rog

ram

mes

to

enc

our

age

upta

ke o

f va

rio

us h

ealt

h in

itia

tive

s

• D

evel

op

men

t o

f an

d in

stig

atin

g c

ard

iac

care

cla

sses

fo

r M

aori

wo

men

• D

evel

op

men

t an

d im

ple

men

ting

eas

y to

fo

llow

bo

okl

ets

and

tea

chin

g s

essi

ons

fo

r cl

ient

s an

d t

heir

ext

end

ed w

hana

u. T

his

to a

id a

nd a

ssis

t th

ose

wit

h he

alth

lite

racy

is

sues

.

• R

ota

ting

car

dia

c d

isp

lay

bo

ard

s fo

r p

atie

nt v

iew

ing

in t

he T

MT

Clin

ic w

aiti

ng a

rea

• D

evel

op

men

t o

f fe

edb

ack

syst

ems

fro

m c

lient

to

imp

rove

ser

vice

del

iver

y

• O

ngo

ing

ed

ucat

ion

of

nurs

ing

sta

ff a

lso

to

imp

rove

ser

vice

del

iver

y

Co

nfirm

the

acc

urac

y an

d

com

ple

tene

ss o

f d

ata

extr

acts

fo

r d

iab

etes

and

CV

DR

A r

elat

ed t

arg

et

rela

ted

ext

ract

s b

y en

d o

f Ju

ly 2

016

.

PP

20: 9

0%

of

the

elig

ible

ad

ult

po

pul

atio

n w

ill h

ave

had

the

ir C

VD

ris

k as

sess

ed in

the

last

five

yea

rs.

Sig

ned

Mem

ora

ndum

of

Und

erst

and

ing

b

y 1

July

20

16.

PP

20: 9

0%

of

elig

ible

Māo

ri m

en in

the

P

HO

ag

ed 3

5-4

4 y

ears

who

hav

e ha

d a

C

VD

ris

k re

cord

ed w

ithi

n th

e p

ast

five

ye

ars.

Red

ucti

on

in C

VD

RA

rel

ated

Māo

ri

heal

th in

equa

litie

s fo

r Māo

ri m

en a

ged

35

-44

yea

rs.

Ach

ieve

men

t o

f C

VD

RA

tar

get

by

Aug

ust

2016

.

Num

ber

of

gro

up m

ind

ful e

atin

g

sess

ions

pro

vid

ed.

Rep

ort

on

the

del

iver

y o

f th

e ac

tio

ns

and

mile

sto

nes

iden

tifi

ed in

the

Ann

ual

Pla

n.

Dev

elo

pm

ent

of

an a

gre

ed p

lan

by

31

Dec

emb

er 2

016

.

Imp

rove

men

t in

clie

nt p

athw

ays

by

31

Dec

emb

er 2

016

.

Two

pro

gra

mm

es d

evel

op

ed f

or

scre

enin

g C

VD

ris

k.

Two

car

dia

c ca

re c

lass

es d

eliv

ered

fo

r M

aori

wo

men

by

31 M

arch

20

17.


2B.1

.4.5

Bet

ter

Hel

p f

or

Smo

kers

to

Qui

t

The

Gov

ernm

ent’

s S

mo

kefr

ee g

oal

is t

hat

less

tha

n 5%

of

the

po

pul

atio

n w

ill b

e a

curr

ent

smo

ker

by

2025

. T

he B

OP

DH

B is

sup

po

rtin

g t

his

go

al t

hro

ugh

the

imp

lem

enta

tio

n o

f th

e B

OP

DH

B’s

To

bac

co C

ont

rol P

lan

as f

ollo

ws.

Link

ages

:

• H

ealt

h Ta

rget

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Smo

kefr

ee 2

025

The

BO

PD

HB

co

mm

its

to t

he G

over

nmen

t’s

Sm

oke

free

Ao

tear

oa

2025

go

al t

hro

ugh

the

imp

lem

enta

tio

n o

f th

e B

OP

DH

B T

ob

acco

Co

ntro

l Pla

n in

clud

ing

:

• P

rog

ram

mes

to

bo

th in

crea

se s

mo

king

ces

sati

on

rate

s an

d t

o p

reve

nt u

pta

ke b

y yo

ung

peo

ple

• C

ont

inue

d a

chie

vem

ent

of

the

seco

ndar

y ca

re in

dic

ato

r, p

rim

ary

care

and

mat

erni

ty

Hea

lth

Targ

ets

• P

urch

asin

g a

nd d

eliv

ery

of

tob

acco

co

ntro

l and

sm

oki

ng c

essa

tio

n se

rvic

es a

s fu

nded

by

the

Min

istr

y o

f H

ealt

h d

irec

t to

the

BO

PD

HB

. The

pur

chas

ing

of

serv

ices

fr

om

1 J

uly

2016

will

be

agre

ed w

ith

the

Min

istr

y fo

llow

ing

the

rea

lignm

ent

of

tob

acco

co

ntro

l ser

vice

s p

roce

ss

• Li

nkag

e to

the

Hea

lthy

Fam

ilies

Eas

t C

ape

and

Hea

lthy

Fam

ilies

Ro

toru

a in

itia

tive

s.

• A

lignm

ent

wit

h se

rvic

es f

und

ed d

irec

tly

by

the

Min

istr

y to

pro

vid

ers

und

er t

he

real

ignm

ent

of

tob

acco

co

ntro

l ser

vice

s p

urch

asin

g p

rog

ram

me.

PP

31: C

ont

inue

d a

chie

vem

ent

of

the

seco

ndar

y in

dic

ato

r th

at 9

5% o

f al

l sm

oki

ng in

pat

ient

s re

ceiv

e b

rief

ad

vice

an

d s

upp

ort

to

qui

t th

roug

h re

ferr

al t

o

smo

king

ces

sati

on

serv

ices

.

Toi T

e O

ra’s

str

ateg

ic g

oal

to

red

uce

the

pro

po

rtio

n o

f ye

ar 1

0 s

tud

ents

sm

oki

ng b

y 2/

3 in

five

yea

rs t

o 2

018

.

Hea

lth

Targ

et: 9

0%

of

PH

O e

nro

lled

p

atie

nts

who

sm

oke

hav

e b

een

off

ered

hel

p t

o q

uit

smo

king

by

a he

alth

car

e p

ract

itio

ner

in t

he la

st 1

5 m

ont

hs.

Red

uce

smo

king

rat

es in

New

Zea

land

to

less

tha

n 5%

by

2025

wit

h no

eth

nic

ineq

uiti

es.

Smok

ers

to Q

uit

Bet

ter

help

for

81


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Bet

ter

Hel

p f

or

Smo

kers

to

Qui

t

The

BO

PD

HB

will

wo

rk w

ith

its

PH

O p

artn

ers,

its

fund

ed p

rovi

der

s an

d t

hro

ugh

Toi

Te O

ra-P

ublic

Hea

lth

Ser

vice

to

del

iver

pro

gra

mm

es t

hat

add

ress

the

fo

llow

ing

thr

ee

pri

ori

ty g

roup

s in

ord

er t

o r

educ

e he

alth

ineq

uiti

es.

• M

āori

and

Pac

ific.

Māo

ri a

nd P

acifi

c in

the

BO

P h

ave

hig

her

smo

king

rat

es t

han

non-

Māo

ri a

nd n

on-

Pac

ific

in t

he B

OP,

and

Māo

ri in

the

BO

P h

ave

hig

her

rate

s th

an M

āori

in

NZ

. The

DH

B w

ill s

upp

ort

the

Auk

ati K

ai P

aip

a p

rog

ram

me

in t

he B

OP

fun

ded

by

the

Min

istr

y, a

nd e

nsur

e th

at m

ains

trea

m s

ervi

ces

the

BO

PD

HB

pur

chas

es t

hro

ugh

PH

Os

have

a f

ocu

s o

n M

āori

and

Pac

ific

smo

kers

.

• P

reg

nant

wo

men

. The

BO

P e

xper

ienc

es h

igh

rate

s o

f sm

oki

ng a

mo

ngst

pre

gna

nt

wo

men

and

mo

ther

s w

ith

infa

nts,

par

ticu

larl

y am

ong

st M

āori

. The

BO

PD

HB

will

en

sure

tha

t th

ere

is a

Hap

u M

ama

serv

ice

spec

ifica

lly f

or

pre

gna

nt M

āori

wo

men

, fu

nded

by

the

Min

istr

y an

d/o

r th

e D

HB

.

• Ta

ngat

a w

haio

ra -

peo

ple

wit

h m

enta

l illn

ess.

A n

ew s

ervi

ce t

o b

e es

tab

lishe

d

targ

eted

at

peo

ple

wit

h m

enta

l illn

ess

acro

ss s

eco

ndar

y, p

rim

ary

and

co

mm

unit

y se

ttin

gs.

The

Eq

ually

Wel

l dat

a sh

ow

s th

at p

eop

le w

ith

men

tal i

llnes

s ha

ve e

arlie

r m

ort

alit

y fr

om

the

ir h

ighe

r sm

oki

ng r

ates

. Sm

oki

ng a

mo

ngst

peo

ple

wit

h m

enta

l ill

ness

will

bec

om

e an

eve

n m

ore

sig

nifi

cant

pro

po

rtio

n o

f th

e re

mai

ning

sm

oke

rs a

s w

e ap

pro

ach

the

~5%

sm

oki

ng p

reva

lenc

e ta

rget

in 2

025

.

• C

ont

inue

d d

eliv

ery

of

reg

ulat

ory

wo

rk u

nder

the

Sm

oke

free

Env

iro

nmen

ts A

ct 1

99

0,

incl

udin

g c

ont

rolle

d p

urch

ase

op

erat

ions

to

lim

it t

he s

ale

of

tob

acco

pro

duc

ts t

o

und

er 1

8 y

ear

old

s.

• H

ealt

h p

rom

oti

on

wo

rk t

hro

ugh

esta

blis

hed

pro

gra

mm

es in

set

ting

s su

ch a

s H

ealt

h P

rom

oti

ng S

cho

ols

, Wo

rk W

ell,

earl

y ch

ildho

od

cen

tres

, mar

ae a

nd in

pub

lic p

lace

s in

co

njun

ctio

n w

ith

loca

l aut

hori

ties

.

Wo

rk t

ow

ard

s ac

hiev

emen

t o

f th

e G

over

nmen

t’s

go

al t

o r

educ

e M

āori

sm

oki

ng r

ates

by

half

by

2018

.

BO

P B

asel

ine

2013

cen

sus

Māo

ri

Fem

ale

35.8

%, M

ale

31.3

%

• P

acifi

c F

emal

e 25

.2%

, Mal

e 26

.6%

BO

P b

asel

ine

(las

t fo

ur q

uart

ers

mat

erni

ty d

ata

to S

ept

2015

.

• S

mo

king

pre

vale

nce

tota

l p

op

ulat

ion

21%

• S

mo

king

pre

vale

nce

Māo

ri

po

pul

atio

n 5

2%

Co

mp

leti

on

of

pla

n fo

r sm

oki

ng

cess

atio

n se

rvic

es f

or

tang

ata

wha

iora

b

y 30

Sep

tem

ber

20

16.

Imp

lem

enta

tio

n o

f p

lan

for

smo

king

ce

ssat

ion

serv

ices

fo

r ta

ngat

a w

haio

ra

by

31 D

ecem

ber

20

16.

Hea

lth

Targ

et: 9

0%

of

pre

gna

nt

wo

men

who

iden

tify

as

smo

kers

up

on

reg

istr

atio

n w

ith

a D

HB

-em

plo

yed

m

idw

ife

or

Lead

Mat

erni

ty C

arer

are

o

ffer

ed a

dvi

ce a

nd s

upp

ort

to

qui

t sm

oki

ng.

Qua

rter

ly r

epo

rts

to M

inis

try

agai

nst

BO

P T

ob

acco

Co

ntro

l Pla

n an

d f

und

ed

serv

ices

.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

)Pla

n

Smo

king

ce

ssat

ion

in

pre

gna

ncy

• E

nhan

ce r

efer

ral p

athw

ays

fro

m L

MC

s, D

HB

mid

wiv

es a

nd a

nte-

nata

l ed

ucat

ion

pro

vid

ers

to n

atio

nal a

nd lo

cal s

mo

king

ces

sati

on

pro

vid

ers,

tak

ing

into

acc

oun

t ne

w p

rovi

der

s an

d p

rog

ram

mes

fun

ded

by

the

Min

istr

y fo

llow

ing

the

Rea

lignm

ent

of

tob

acco

co

ntro

l ser

vice

s R

FP

pro

cess

.

• P

rovi

de

trai

ning

ap

pro

pri

ate

to p

rovi

der

s an

d D

HB

sta

ff o

n en

gag

ing

wit

h M

āori

p

reg

nant

wo

men

(an

d t

heir

wha

nau)

and

the

ir s

mo

king

beh

avio

urs.

Tra

inin

g w

ill

diff

er f

or

staff

dep

end

ing

on

whe

ther

the

y ar

e ca

rryi

ng o

ut A

BC

and

ref

erri

ng,

or

del

iver

ing

a r

egul

ar s

upp

ort

ive

qui

t sm

oki

ng p

rog

ram

me

for

Māo

ri s

mo

king

p

reg

nant

wo

men

.

• In

crea

se t

he p

rop

ort

ion

of

smo

king

Māo

ri p

reg

nant

wo

men

who

acc

ept

cess

atio

n su

pp

ort

fro

m 1

5.8

% (

Q2

2015

/16

res

ult)

to

40

%.

• W

ork

wit

h th

e M

oH

to

imp

rove

rep

ort

ing

on

this

ind

icat

or.

• M

oni

tori

ng o

f th

e ta

rget

at

two

wee

ks p

ost

nata

l is

not

tim

ely

wit

h a

long

lag

per

iod

fo

r re

sult

s. It

is n

ot

usef

ul t

here

fore

fo

r m

oni

tori

ng r

esul

ts c

hang

es q

uick

ly f

ollo

win

g

intr

od

ucti

on

of

new

act

ivit

ies.

• M

ater

nity

to

bac

co d

ata

colle

cted

at

reg

istr

atio

n w

ith

LMC

is r

epo

rted

qua

rter

ly b

ut

do

es n

ot

refl

ect

smo

king

sta

tus

at t

wo

wee

ks p

ost

nata

l.

• M

oni

tor

smo

king

ces

sati

on

advi

ce p

rovi

sio

n p

erfo

rman

ce o

n a

mo

nthl

y b

asis

wit

hin

the

BO

PD

HB

Māo

ri H

ealt

h P

lann

ing

and

Fun

din

g t

eam

.

• M

oni

tor

smo

king

ces

sati

on

advi

ce p

rovi

sio

n an

d s

mo

kefr

ee r

ates

at

two

wee

ks

po

stna

tal o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up.

83


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

)Pla

n

Smo

king

ce

ssat

ion

in

pre

gna

ncy

• E

nhan

ce r

efer

ral p

athw

ays

fro

m L

MC

s, D

HB

mid

wiv

es a

nd a

nte-

nata

l ed

ucat

ion

pro

vid

ers

to n

atio

nal a

nd lo

cal s

mo

king

ces

sati

on

pro

vid

ers,

tak

ing

into

acc

oun

t ne

w p

rovi

der

s an

d p

rog

ram

mes

fun

ded

by

the

Min

istr

y fo

llow

ing

the

Rea

lignm

ent

of

tob

acco

co

ntro

l ser

vice

s R

FP

pro

cess

.

• P

rovi

de

trai

ning

ap

pro

pri

ate

to p

rovi

der

s an

d D

HB

sta

ff o

n en

gag

ing

wit

h M

āori

p

reg

nant

wo

men

(an

d t

heir

wha

nau)

and

the

ir s

mo

king

beh

avio

urs.

Tra

inin

g w

ill

diff

er f

or

staff

dep

end

ing

on

whe

ther

the

y ar

e ca

rryi

ng o

ut A

BC

and

ref

erri

ng,

or

del

iver

ing

a r

egul

ar s

upp

ort

ive

qui

t sm

oki

ng p

rog

ram

me

for

Māo

ri s

mo

king

p

reg

nant

wo

men

.

• In

crea

se t

he p

rop

ort

ion

of

smo

king

Māo

ri p

reg

nant

wo

men

who

acc

ept

cess

atio

n su

pp

ort

fro

m 1

5.8

% (

Q2

2015

/16

res

ult)

to

40

%.

• W

ork

wit

h th

e M

oH

to

imp

rove

rep

ort

ing

on

this

ind

icat

or.

• M

oni

tori

ng o

f th

e ta

rget

at

two

wee

ks p

ost

nata

l is

not

tim

ely

wit

h a

long

lag

per

iod

fo

r re

sult

s. It

is n

ot

usef

ul t

here

fore

fo

r m

oni

tori

ng r

esul

ts c

hang

es q

uick

ly f

ollo

win

g

intr

od

ucti

on

of

new

act

ivit

ies.

• M

ater

nity

to

bac

co d

ata

colle

cted

at

reg

istr

atio

n w

ith

LMC

is r

epo

rted

qua

rter

ly b

ut

do

es n

ot

refl

ect

smo

king

sta

tus

at t

wo

wee

ks p

ost

nata

l.

• M

oni

tor

smo

king

ces

sati

on

advi

ce p

rovi

sio

n p

erfo

rman

ce o

n a

mo

nthl

y b

asis

wit

hin

the

BO

PD

HB

Māo

ri H

ealt

h P

lann

ing

and

Fun

din

g t

eam

.

• M

oni

tor

smo

king

ces

sati

on

advi

ce p

rovi

sio

n an

d s

mo

kefr

ee r

ates

at

two

wee

ks

po

stna

tal o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up.

2B.1

.4.6

Ris

ing

to

the

Cha

lleng

e 20

12-2

017

The

Gov

ernm

ent

has

dev

elo

ped

the

Men

tal H

ealt

h an

d A

dd

icti

on

Ser

vice

Dev

elo

pm

ent

Pla

n 20

12-2

017

.

The

BO

PD

HB

is w

ork

ing

co

llab

ora

tive

ly w

ith

oth

er G

over

nmen

t ag

enci

es, n

on-

gov

ernm

enta

l org

anis

atio

ns, p

rim

ary

care

par

tner

s an

d r

egio

nal c

olle

ague

s to

d

eliv

er o

n th

e o

utco

mes

in t

his

Pla

n as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Ris

ing

to

the

C

halle

nge

The

BO

PD

HB

will

rep

ort

on

the

stat

us o

f q

uart

erly

mile

sto

nes

in t

he M

enta

l Hea

lth

and

A

dd

icti

on

Ser

vice

Dev

elo

pm

ent

Pla

n an

d c

om

ple

te a

ll ac

tio

ns b

y 30

Jun

e 20

17.

PP

26: T

he M

enta

l Hea

lth

and

Ad

dic

tio

n S

ervi

ce D

evel

op

men

t P

lan

- R

epo

rt

on

the

stat

us o

f q

uart

erly

mile

sto

nes

for

a m

inim

um o

f ei

ght

act

ions

to

b

e co

mp

lete

d in

20

16/1

7 an

d f

or

any

acti

ons

whi

ch a

re in

pro

gre

ss/o

ngo

ing

in

20

16/1

7.

PP

8: S

hort

er w

aits

fo

r no

n-ur

gen

t m

enta

l hea

lth

and

ad

dic

tio

n se

rvic

es

for

0-1

9 y

ear

old

s

Men

tal H

ealt

h P

rovi

der

Arm

:

0-1

9 <

= 3

wee

ks 8

0%

, <

= 8

wee

ks 9

5%

Ad

dic

tio

ns (

Pro

vid

er A

rm a

nd N

GO

):

0-1

9 <

= 3

wee

ks 8

0%

, <

= 8

wee

ks 9

5%

• T

he B

OP

DH

B w

ill im

ple

men

t ac

tio

ns a

risi

ng f

rom

the

Pri

mar

y/S

eco

ndar

y In

teg

rati

on

mee

ting

s he

ld in

20

16 w

hich

will

res

ult

in a

dd

itio

nal p

sych

olo

gic

al a

nd o

ther

sup

po

rt

avai

lab

le w

ithi

n p

rim

ary

care

and

NG

O s

etti

ngs.

Incr

ease

d n

umb

ers

seen

via

PP

26

rep

ort

ing

tem

pla

te (

pri

mar

y m

enta

l he

alth

yo

uth

& a

dul

t

• T

he B

OP

DH

B w

ill im

ple

men

t es

sent

ial a

ctio

ns o

f th

e S

upp

ort

ing

Par

ents

Hea

lthy

C

hild

ren

(SP

HC

) g

uid

elin

esA

t le

ast

10 e

ssen

tial

act

ions

are

im

ple

men

ted

acr

oss

sec

ond

ary

and

N

GO

ser

vice

s as

sp

ecifi

ed in

the

SP

HC

g

uid

elin

es

• T

he B

OP

DH

B w

ill in

crea

se f

ocu

s o

n P

ae O

ra/t

he s

oci

al d

eter

min

ants

of

heal

th w

ithi

n th

e S

hare

d S

upp

ort

Pla

n p

roce

ss f

or

tho

se in

ser

vice

2 y

ears

+8

0%

of

shar

ed s

upp

ort

pla

ns c

ont

ain

acti

ons

rel

ated

to

Pae

Ora

/so

cial

d

eter

min

ants

of

heal

th.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Ris

ing

to

the

C

halle

nge

Equa

lly W

ell I

niti

ativ

es:

The

BO

PD

HB

will

:

• Id

enti

fy m

enta

l hea

lth

and

ad

dic

tio

n se

rvic

e us

ers

at r

isk

of

dev

elo

pin

g T

ype

II d

iab

etes

and

link

wit

h se

rvic

es (

see

sect

ion

2B.1.

3.3

Livi

ng W

ell w

ith

Dia

bet

es)

• Id

enti

fy m

enta

l hea

lth

and

ad

dic

tio

n se

rvic

e us

ers

- C

ard

iova

scul

ar d

isea

se r

isk

asse

ssm

ents

(C

VD

RA

s)

• W

ork

alo

ngsi

de

Sp

ort

BO

P’s

Gre

en P

resc

rip

tio

n se

rvic

e to

incr

ease

acc

ess

for

serv

ice

user

s b

y p

rovi

din

g a

pp

rop

riat

e su

pp

ort

Ser

vice

use

rs t

hat

req

uire

sup

po

rt t

o

utili

se t

he G

reen

Pre

scri

pti

on

serv

ice

will

be

iden

tifi

ed.

90

% o

f th

e el

igib

le a

dul

t p

op

ulat

ion

will

ha

ve h

ad t

heir

CV

D r

isk

asse

ssed

in t

he

last

five

yea

rs.(

see

sect

ion

2B.1.

3.4

)

• Th

e B

OP

DH

B w

ill e

nsur

e vo

cati

ona

l sup

po

rt a

nd e

mp

loym

ent

spec

ialis

ts a

re a

vaila

ble

to

clin

ical

mul

tid

isci

plin

ary

team

s an

d t

o N

GO

s.

• Th

e B

OP

DH

B w

ill e

xplo

re a

lter

nati

ve m

eans

to

incr

ease

em

plo

ymen

t o

pp

ort

unit

ies

thro

ugh

So

cial

Ent

erp

rise

init

iati

ves

PP

7 –

incr

ease

d n

umb

ers

of

Ser

vice

U

sers

in t

rain

ing

, ed

ucat

iona

l p

rog

ram

mes

or

emp

loym

ent

• S

pec

ialis

t S

eco

ndar

y M

enta

l Hea

lth

Ser

vice

s w

ill r

evie

w a

cces

s to

ser

vice

via

cur

rent

A

cute

Car

e p

athw

ay a

nd im

ple

men

t re

com

men

dat

ions

or

revi

se m

od

el.

Rev

iew

co

mp

lete

d, r

eco

mm

end

atio

ns

or

revi

sed

mo

del

imp

lem

ente

d.

Leve

l of

NZ

Po

lice

sati

sfac

tio

n w

ith

cris

is r

esp

ons

e se

rvic

es.

• Th

e B

OP

DH

B w

ill r

evie

w t

he c

urre

nt R

esp

ite

Car

e se

rvic

e m

od

el in

ord

er t

o in

crea

se

acce

ss w

hile

mai

ntai

ning

the

cur

rent

Kau

pap

a M

aori

mo

del

of

resp

ite

care

.R

evie

w c

om

ple

ted

, and

acc

ess

to

resp

ite

care

incr

ease

d.

• Th

e B

OP

DH

B w

ill u

nder

take

a p

ilot

pro

ject

to

alig

n o

utco

mes

dev

elo

ped

thr

oug

h th

e tr

ial o

f th

e M

BIE

co

ntra

ctin

g f

or

out

com

es t

emp

late

wit

h th

e N

atio

nal P

op

ulat

ion

Out

com

es F

ram

ewo

rk b

eing

dev

elo

ped

.

Alig

nmen

t o

f B

OP

DH

B o

utco

mes

wit

h th

e N

atio

nal P

op

ulat

ion

Out

com

es

Fra

mew

ork

Ris

ing

to

the

C

halle

nge

• Th

BO

PD

HB

will

co

ord

inat

e B

ay o

f P

lent

y S

uici

de

Pre

vent

ion

and

Po

stve

ntio

n P

lan

(SP

P)

imp

lem

enta

tio

n th

roug

hout

the

Reg

ion.

Iden

tific

atio

n o

f S

PP

key

lead

s an

d

cham

pio

ns a

cro

ss t

he r

egio

n.

Co

-ord

inat

ion

of

SP

P t

rain

ing

acr

oss

the

re

gio

n.

Trac

king

of

SP

P IR

T p

roce

sses

acr

oss

th

e re

gio

n.

Sup

po

rtin

g fa

mily

/whā

nau

and

co

mm

unit

ies

for

des

igni

ng S

PP

clo

ser

to h

om

e.

Dis

sem

inat

ion

of

SP

P in

form

atio

n ac

ross

th

e re

gio

n.

85


ANNUAL PLAN 2016/17

2B.1

.5 S

yste

m In

teg

rati

on

A h

ealt

h sy

stem

tha

t is

wel

l int

egra

ted

pro

vid

es a

sus

tain

able

sys

tem

whe

re p

eop

le r

ecei

ve s

ervi

ces

fro

m t

he r

ight

per

son,

at

the

rig

ht t

ime

and

in t

he r

ight

pla

ce.

A o

ne-t

eam

ap

pro

ach

is u

sed

invo

lvin

g D

HB

s, P

HO

s an

d n

on-

gov

ernm

enta

l org

anis

atio

ns.

A s

usta

inab

le h

ealt

h sy

stem

into

the

fut

ure

req

uire

s o

ne t

eam

pro

vid

ing

car

e cl

ose

r to

ho

me,

ear

ly in

terv

enti

on,

ho

spit

al a

void

ance

inte

rven

tio

ns a

nd r

educ

ing

ac

ute

dem

and

. T

his

pri

ori

ty a

rea

alig

ns w

ith

the

refr

eshe

d N

ew Z

eala

nd H

ealt

h S

trat

egy.

2B.1

.5.1

Can

cer

The

BO

PD

HB

will

dev

elo

p a

nd im

ple

men

t p

lans

in a

cco

rdan

ce w

ith

nati

ona

l str

ateg

ies;

in p

arti

cula

r th

ose

tha

t su

pp

ort

th

e ac

hiev

emen

t o

f th

e fa

ster

can

cer

trea

tmen

t he

alth

tar

get

and

imp

rove

eq

uity

fo

r p

atie

nts

alo

ng t

he c

ance

r p

athw

ay,

and

the

Mid

land

Can

cer

Net

wo

rk -

Mid

land

Can

cer

Str

ateg

y P

lan

2015

-20

20.

Sp

ecifi

c ac

tio

ns f

or

2016

/17

are

as f

ollo

ws.

Link

ages

• H

ealt

h Ta

rget

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Can

cer

The

BO

PD

HB

will

:

• C

ont

inue

to

fo

cus

on

imp

rovi

ng t

he q

ualit

y o

f d

ata

and

dat

a co

llect

ion

that

incl

udes

w

ork

ing

to

war

ds

inte

gra

tio

n o

f F

CT

dat

a co

llect

ion

as b

usin

ess

as u

sual

acr

oss

all

clin

ical

tea

ms

• W

ork

wit

h p

rim

ary

care

to

iden

tify

and

imp

lem

ent

tum

our

str

eam

sp

ecifi

c e

– R

efer

rals

.

• Id

enti

fy H

igh

Sus

pic

ion

of

Can

cer

refe

rral

s to

Rad

iolo

gy.

• W

ork

wit

h ex

tern

al p

rovi

der

s (V

entu

ro a

nd K

KC

) to

ens

ure

FC

T d

ata

is p

rovi

ded

in a

ti

mel

y m

anne

r in

the

req

uire

d f

orm

at.

• C

ont

inue

to

wo

rk w

ith

the

reg

iona

l can

cer

netw

ork

to

ens

ure

rece

ipt

of

tert

iary

dat

a sp

ecif

ying

tre

atm

ent

det

ails

are

rec

eive

d in

a t

imel

y m

anne

r an

d e

nter

ed in

to t

he

reg

iona

l dat

abas

e. F

or

furt

her

info

rmat

ion

ple

ase

refe

r to

the

RS

P.

• S

upp

ort

the

imp

lem

enta

tio

n o

f th

e C

ance

r H

ealt

h In

form

atio

n S

trat

egy

whe

n it

is

fina

lised

.

• C

ont

inue

to

wo

rk a

long

sid

e th

e re

gio

nal c

ance

r ne

two

rk t

o e

nsur

e tu

mo

ur s

trea

m

anal

ysis

and

imp

lem

enta

tio

n.

• C

ont

inue

wit

h ac

tio

ns r

equi

red

to

ens

ure

the

sust

aina

bili

ty o

f th

e F

aste

r C

ance

r D

iag

nost

ic C

erta

inty

Pro

ject

out

com

es.

Hea

lth

Targ

et: 8

5% o

f p

atie

nts

rece

ive

thei

r fi

rst

canc

er t

reat

men

t (o

r o

ther

m

anag

emen

t) w

ithi

n 6

2 d

ays

of

bei

ng

refe

rred

wit

h a

hig

h su

spic

ion

of

canc

er a

nd a

nee

d t

o b

e se

en w

ithi

n tw

o w

eeks

by

July

20

16, i

ncre

asin

g t

o

90

per

cent

by

June

20

17.

PP

30: P

art

A: F

aste

r ca

ncer

tre

atm

ent

– 31

day

ind

icat

or

– 8

5% o

f p

atie

nts

rece

ive

thei

r fi

rst

canc

er t

reat

men

t (o

r o

ther

man

agem

ent)

wit

hin

31 d

ays

fro

m d

ate

of

dec

isio

n-to

-tre

at.

Par

t B

: S

hort

er w

aits

fo

r ca

ncer

tre

atm

ent

-

– r

adio

ther

apy

and

che

mo

ther

apy

- A

ll p

atie

nts

read

y-fo

r-tr

eatm

ent

rece

ive

trea

tmen

t w

ithi

n fo

ur w

eeks

fro

m

dec

isio

n-to

-tre

at.

Fast

er

Canc

er T

reat

men

t


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Can

cer

• C

ont

inue

to

wo

rk a

long

sid

e th

e re

gio

nal c

ance

r ne

two

rk t

o e

nsur

e tu

mo

ur s

trea

m

anal

ysis

and

imp

lem

enta

tio

n.

• C

ont

inue

wit

h ac

tio

ns r

equi

red

to

ens

ure

the

sust

aina

bili

ty o

f th

e F

aste

r C

ance

r D

iag

nost

ic C

erta

inty

Pro

ject

out

com

es.

• M

aint

ain

com

mit

men

t to

imp

lem

enti

ng t

he s

upp

ort

ive

care

ser

vice

s fo

r ca

ncer

p

atie

nts

as p

art

of

the

stra

teg

y o

utlin

ed in

the

Mid

land

s P

sych

olo

gic

al a

nd S

oci

al

Sup

po

rt S

ervi

ces

Pla

n 20

15-1

8.

• C

ont

inue

to

mo

nito

r an

d r

epo

rt o

n ti

mel

ines

s in

dic

ato

rs o

n a

mo

nthl

y b

asis

to

the

M

inis

try.

If

ther

e ar

e va

rian

ces,

we

will

dev

elo

p a

ctio

ns p

lans

as

app

rop

riat

e.

• W

e w

ill c

ont

inue

to

ap

ply

the

Eq

uity

of

Hea

lth

Car

e fo

r M

āori

Fra

mew

ork

.

• C

ont

inue

to

wo

rk a

s p

art

of

the

Mid

land

Can

cer

netw

ork

wit

h im

pro

ving

MD

M

acti

vity

.

• D

evel

op

an

imp

rove

men

t p

lan

for

bre

ast

canc

er s

tand

ard

s ag

ains

t th

e lo

cal s

elf-

as

sess

men

ts a

nd r

egio

nal r

eco

mm

end

atio

ns a

nd in

clud

e lo

cal s

ervi

ce im

pro

vem

ent

init

iati

ves

that

will

alig

n w

ith

reg

iona

l act

ivit

y..

87


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Can

cer

• D

evel

op a

Bay

Nav

igat

or B

reas

t C

ance

r p

athw

ay.

• D

evel

op a

n im

pro

vem

ent

pla

n fo

r Sa

rcom

a C

ance

r St

and

ard

s ag

ains

t th

e fin

din

gs

of t

he

gap

ana

lysi

s an

d in

clud

e lo

cal s

ervi

ce im

pro

vem

ent

initi

ativ

es t

hat

will

alig

n w

ith r

egio

nal

activ

ity.

• C

ontin

ue t

o su

pp

ort

the

imp

lem

enta

tion

of t

he C

ance

r N

urse

Coo

rdin

ator

Initi

ativ

e.

• Im

ple

men

t th

e M

inis

try

of H

ealth

Pro

stat

e C

ance

r M

anag

emen

t an

d R

efer

ral G

uid

ance

d

urin

g 2

016

/17.

• Im

pro

ve e

qui

ty a

t a

syst

ems

and

org

anis

atio

nal l

evel

(re

fer

to E

qui

ty o

f Hea

lth C

are

for

Māo

ri: A

fram

ewor

k re

sour

ce)

by w

orki

ng in

par

tner

ship

with

Mid

land

Can

cer

Net

wor

k to

:

-D

eliv

er o

ne K

ia O

ra E

Te

Iwi c

omm

unity

hea

lth li

tera

cy p

rog

ram

me

-im

ple

men

t th

e M

idla

nd P

atie

nt In

form

atio

n R

esou

rce

Pro

ject

20

16/1

7 –

2017

/18

-Im

ple

men

t th

e M

idla

nd P

sych

olog

ical

and

Soc

ial S

upp

ort

Serv

ices

Pla

n 20

15-2

018

-C

onsi

der

incl

udin

g c

ance

r co

mp

onen

t in

to w

hāna

u or

a /

chro

nic

cond

ition

s co

ntra

cts

-Su

pp

ort

a “

coug

h co

ugh

coug

h” e

arly

det

ectio

n lu

ng c

ance

r p

roje

ct –

clin

icia

ns

sup

por

t re

gio

nal p

roje

ct.

The

BO

PD

HB

will

:

• D

eter

min

e an

d t

est

viab

le w

ays

of im

pro

ving

the

Fas

ter

Can

cer

Trea

tmen

t Pa

thw

ay fo

r M

āori

in B

ay o

f Ple

nty:

-P

hase

1 -

und

erta

ke a

feas

ibili

ty s

tud

y by

31/

12/2

016

to

det

erm

ine

way

s to

ad

dre

ss

the

ineq

uity

gap

-P

hase

2 -T

he In

stitu

te o

f Hea

lthca

re Im

pro

vem

ent

(IH

I) m

etho

dol

ogy

(Pla

n, D

o,

Stud

y, A

ct (

PD

SA))

will

be

emp

loye

d t

o id

entif

y at

leas

t tw

o vi

able

op

por

tuni

ties

to im

pro

ve t

he c

ance

r jo

urne

y fo

r M

āori

in t

he B

OP

and

red

uce

ineq

uitie

s by

30

/06/

2017

.

• R

evie

w p

atie

nt p

athw

ays

and

iden

tify

key

bar

riers

to

targ

et a

chie

vem

ent

and

man

age

thro

ugh

the

FCT

pro

ject

man

agem

ent

team

.

• W

ork

tow

ard

s ac

hiev

emen

t of

the

FC

T he

alth

tar

get

by

imp

rovi

ng e

qui

ty a

long

the

can

cer

pat

hway

, and

:

-b

uild

org

anis

atio

nal k

now

led

ge

and

exp

lore

hea

lth e

qui

ty is

sues

for

Māo

ri w

ith

canc

er in

the

Bay

of P

lent

y

-un

der

take

eq

uity

ana

lysi

s an

d e

xplo

re t

he u

se o

f evi

den

ce b

ased

imp

rove

men

t to

ols

that

sup

por

t hi

gh-

qua

lity

heal

th c

are

and

are

res

pon

sive

to

the

need

s an

d

asp

iratio

ns o

f Māo

ri liv

ing

in t

he B

ay o

f Ple

nty

-ac

tivel

y p

artn

er w

ith p

rovi

der

s b

eyon

d t

he p

rovi

der

arm

for

imp

rove

d s

ervi

ce

inte

gra

tion,

pla

nnin

g a

nd s

upp

ort

for

whā

nau,

hap

ū, iw

i and

pro

vid

e an

op

por

tuni

ty

to t

rial s

olut

ions

to

imp

rove

acc

ess

to h

ealth

ser

vice

s fo

r th

is p

opul

atio

n.

Pha

se 1

:

• T

he f

easi

bili

ty s

tud

y p

hase

will

d

ocu

men

t th

e in

equa

litie

s in

ca

ncer

inci

den

ce, d

iag

nosi

s,

man

agem

ent

and

out

com

es f

or

Māo

ri a

nd n

on-

Māo

ri p

op

ulat

ions

in

Eas

tern

and

Wes

tern

BO

P

• C

olla

te in

form

atio

n g

athe

red

fro

m

Māo

ri h

ealt

h o

rgan

isat

ions

, hea

lth

pro

vid

ers,

Eas

tern

and

Wes

tern

B

OP

co

mm

unit

ies,

pat

ient

s an

d

fam

ily/w

hāna

u, a

nd o

ther

key

st

akeh

old

ers

e.g

. Mid

land

Can

cer

Net

wo

rk t

o id

enti

fy s

ervi

ce g

aps,

b

arri

ers

to a

cces

s o

r tr

eatm

ent,

an

d c

ultu

ral c

ons

ider

atio

ns

whi

ch r

esul

t in

ineq

uiti

es u

nder

th

e S

TE

EE

P f

ram

ewo

rk (

Saf

ety,

Ti

mel

ines

s, E

ffici

ency

, Eq

uity

, E

ffici

ency

and

Peo

ple

cen

tred

)

Pha

se 2

:

• Im

ple

men

tati

on

of

two

via

ble

o

pti

ons

.

• 6

mo

nthl

y re

po

rt o

n p

rog

ress


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Māo

ri H

ealt

h P

lan

Act

ions

(fo

r fu

rthe

r in

form

atio

n re

fer

to t

he M

āori

Hea

lth

Pla

n)

Bre

ast

scre

enin

g

rate

s (5

0-6

9

year

s)

-IS

Ps

to im

ple

men

t re

crui

tmen

t st

rate

gie

s, 3

mo

nths

pri

or

to t

he s

ched

uled

b

reas

t sc

reen

ing

mo

bile

uni

t vi

sit,

fo

r p

rio

rity

wo

men

to

acc

ess

the

bre

ast

scre

enin

g m

ob

ile u

nit

spec

ifica

lly in

the

Kat

ikat

i, W

aihi

, Te

Pun

a re

gio

n th

roug

h a

hap

u ap

pro

ach

to e

nsur

e m

axim

um u

tilis

atio

n o

f al

loca

ted

ap

po

intm

ents

, suc

h as

pro

mo

ting

the

mo

bile

scr

eeni

ng u

nit

on

the

loca

l Ta

uran

ga

Mo

ana

iwi r

adio

sta

tio

n p

rog

ram

me

(Mo

ana

AM

Māo

riva

tio

n),

wo

rkin

g w

ith

the

Run

ang

a, a

do

pti

ng M

ana

Wah

ine

Cha

mp

ions

fro

m t

he h

apu

to p

rom

ote

mo

bile

uni

t vi

sits

, w

ork

ing

wit

h lo

cal G

P P

ract

ices

.

-T

he IS

Ps

will

imp

lem

ent

the

Wai

kato

DH

B’s

Mam

mo

gra

m p

roje

ct w

hich

aim

s to

fo

cus

on

usin

g d

aug

hter

s to

enc

our

age

and

sup

po

rt t

heir

mo

ther

s to

get

a

mam

mo

gra

m, a

nd t

o b

e a

cond

uit

of

go

od

info

rmat

ion

for

thei

r m

oth

ers.

T

he a

pp

roac

h al

so a

dd

s to

the

kno

wle

dg

e yo

ung

er w

om

en h

ave

abo

ut b

reas

t sc

reen

ing

fo

r w

hen

they

rea

ch t

he 4

5+ a

ge

gro

up.

-R

evie

w t

he In

stit

ute

of

Hea

lthc

are

Imp

rove

men

t p

roje

ct t

hat

was

im

ple

men

ted

in 2

015

/16

to

und

erst

and

bo

ttle

neck

s in

the

pat

ient

jour

ney,

an

d m

ake

iter

ativ

e ch

ang

es t

o t

he in

terv

enti

on

bas

ed o

n re

sult

s fr

om

usi

ng a

p

art-

tim

e p

atie

nt n

avig

ato

r. O

nce

iter

ativ

e ch

ang

es a

re id

enti

fied

wo

rk w

ith

PH

Os

to e

nsur

e d

ata

mat

chin

g w

ith

BS

M a

nd a

pp

ly t

he s

trat

egy

to a

noth

er

GP

clin

ic w

ith

low

enr

olm

ents

of

elig

ible

Māo

ri w

om

en t

o t

he b

reas

t sc

reen

ing

p

rog

ram

me.

-IS

Ps,

Pla

nnin

g a

nd F

und

ing

, Pri

mar

y C

are

and

Co

lpo

sco

py

will

par

tici

pat

e in

th

e re

gio

nal p

lann

ing

pro

cess

wit

h B

SA

pro

vid

ers.

-M

oni

tor

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g a

nd F

und

ing

tea

m.

-M

oni

tor

scre

enin

g p

erfo

rman

ce o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

HS

G.

• In

crea

se in

the

num

ber

of

Māo

ri

wo

men

scr

eene

d w

ith

the

bre

ast

scre

enin

g m

ob

ile u

nit.

• In

crea

se in

the

res

po

nse

rate

(i

ncre

ased

num

ber

of

enq

uiri

es f

or

enro

lmen

t o

r b

oo

king

s).

• R

esul

ts (

incr

ease

d n

umb

er o

f b

oo

king

s co

nver

ted

to

co

mp

lete

d

mam

mo

gra

ms)

.

• A

war

enes

s (f

eed

bac

k an

d o

vera

ll as

sess

men

t o

f ca

mp

aig

n, p

lus

follo

w-u

p s

urve

y o

f sa

mp

le if

re

qui

red

.

• In

crea

se in

the

num

ber

of

Māo

ri

wo

men

who

enr

ol t

o t

he n

atio

nal

bre

ast

scre

enin

g p

rog

ram

me.

• P

arti

cip

atio

n in

tw

o r

egio

nal

coo

rdin

atio

n m

eeti

ngs

per

ann

um.

• S

cree

ning

per

form

ance

is

mo

nito

red

mo

nthl

y an

d

qua

rter

ly a

nd k

ey a

ctio

ns t

o li

ft

per

form

ance

are

iden

tifi

ed.

• M

āori

wo

men

rec

eive

tim

ely

colp

osc

op

y tr

eatm

ent

• N

umb

er o

f p

ract

ices

sup

po

rted

to

iden

tify

and

rec

all u

nscr

eene

d

and

und

ersc

reen

ed M

āori

wo

men

.

• N

umb

er o

f w

om

en s

cree

ned

at

the

clin

ic.

89


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Cer

vica

l sc

reen

ing

rat

es

(25-

69 y

ears

)

-IS

Ps

and

Co

lpo

sco

py

to u

nder

take

a q

ualit

y in

itia

tive

to

rev

iew

and

imp

rove

th

e re

leva

nt a

dm

inis

trat

ion

pro

cess

es s

o M

āori

wo

men

rec

eive

tim

ely

colp

osc

op

y tr

eatm

ent

-To

i Te

Ora

will

ass

ist

PH

Os

wit

h th

e us

e o

f th

e N

atio

nal S

cree

ning

Uni

t’s

mo

nthl

y el

ectr

oni

c d

ata-

mat

chin

g r

epo

rts

to id

enti

fy w

om

en w

ho h

ave

slip

ped

thr

oug

h th

e G

ener

al P

ract

ice

reca

ll sy

stem

s.

-Te

Kup

eng

a H

auo

ra o

Tau

rang

a M

oan

a w

ill e

stab

lish

reg

ular

cer

vica

l sc

reen

ing

clin

ics

at T

aura

nga

Ho

spit

al s

pec

ifica

lly t

arg

etin

g S

upp

ort

Ser

vice

s w

here

the

re a

re h

igh

elig

ible

Māo

ri w

om

en e

mp

loye

d. E

ligib

le w

om

en w

ill

also

be

enco

urag

ed t

o e

nro

l and

bo

ok

a b

reas

t sc

reen

ing

ap

po

intm

ent

at t

he

tim

e o

f sc

reen

ing

.

-T

he T

aku

Wah

ine

Pur

oto

pro

gra

mm

e (p

rovi

sio

n o

f o

utre

ach

and

aft

er h

our

s ce

rvic

al s

cree

ning

ser

vice

s fo

r el

igib

le M

āori

wo

men

) to

be

exte

nded

and

d

eliv

ered

by

Wes

tern

Bay

of

Ple

nty

PH

O, N

ga

Mat

aap

una

PH

O a

nd E

aste

rn

Bay

Pri

mar

y H

ealt

h A

llian

ce.

-S

tren

gth

en t

he c

om

mun

icat

ion

skill

s o

f P

rim

ary

Car

e P

rovi

der

sta

ff t

o e

nab

le

imp

rove

d c

ervi

cal s

cree

ning

hea

lth

liter

acy

and

imp

rove

d a

cces

s to

cer

vica

l sc

reen

ing

ser

vice

s p

arti

cula

rly

for

Māo

ri w

om

en.

-M

oni

tor

per

form

ance

on

a m

ont

hly

bas

is w

ithi

n th

e B

OP

DH

B M

āori

Hea

lth

Pla

nnin

g a

nd F

und

ing

tea

m.

-M

oni

tor

scre

enin

g p

erfo

rman

ce o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

HS

G.

• N

umb

er o

f w

om

en s

cree

ned

at

the

out

reac

h cl

inic

s.

• N

umb

er o

f tr

aini

ng s

essi

ons

d

eliv

ered

on

taki

ng a

bes

t p

ract

ice

heal

th li

tera

cy a

pp

roac

h to

ce

rvic

al s

cree

ning

.

• S

cree

ning

per

form

ance

is

mo

nito

red

mo

nthl

y an

d

qua

rter

ly a

nd k

ey a

ctio

ns t

o li

ft

per

form

ance

are

iden

tifi

ed.


2B.1

.5.2

Str

oke

Ser

vice

s

Str

oke

Ser

vice

s ar

e an

iden

tifi

ed p

rio

rity

are

a in

our

RS

P a

nd A

nnua

l Pla

n. H

ealt

hSha

re t

hro

ugh

the

Mid

land

Str

oke

Act

ion

Gro

up is

lead

ing

th

e d

evel

op

men

t an

d im

ple

men

tati

on

of

reg

iona

l act

ions

. T

he B

OP

DH

B w

ill p

rovi

de

stro

ke s

ervi

ces

in a

way

tha

t is

co

nsis

tent

wit

h th

e N

ew

Zea

land

Clin

ical

Gui

del

ines

fo

r S

tro

ke M

anag

emen

t 20

10 a

s fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Stro

ke S

ervi

ces

• T

he B

OP

DH

B w

ill c

ont

inue

to

pro

vid

e a

ded

icat

ed s

tro

ke u

nit

and

are

as f

or

man

agem

ent

of

peo

ple

wit

h st

roke

, thr

om

bo

lysi

s, a

nd t

rans

ient

isch

aem

ic a

ttac

k se

rvic

es s

upp

ort

ed b

y o

ngo

ing

ed

ucat

ion

and

tra

inin

g f

or

lead

clin

icia

ns, t

he C

linic

al

Nur

se S

pec

ialis

t an

d f

ull M

ulti

-Dis

cip

linar

y Te

am m

emb

ersh

ip. T

he B

OP

DH

B d

eliv

ers

a M

DT

str

oke

ed

ucat

ion

seri

es (

6 w

eek

pro

gra

mm

e) t

wic

e a

year

. T

his

is d

eliv

ered

ac

ross

bo

th s

ites

via

vid

eo li

nk. T

he fi

rst

pro

gra

mm

e ha

s ru

n fo

r 20

16 a

nd t

he n

ext

seri

es w

ill c

om

men

ce in

Sep

tem

ber

20

16.

In a

dd

itio

n, s

taff

em

plo

yed

wit

hin

Str

oke

ar

eas

at T

aura

nga

and

Wha

kata

ne H

osp

ital

s ar

e en

cour

aged

to

co

mp

lete

on-

line

lear

ning

pac

kag

e al

ong

wit

h o

ther

org

anis

atio

nal t

rain

ing

, e.g

. dys

pha

gia

ass

essm

ent

cert

ifica

tio

n.

• T

he B

OP

DH

B w

ill c

ont

inue

to

mo

nito

r su

stai

ned

del

iver

y ag

ains

t th

e ta

rget

w

ith

a fo

cus

on

serv

ice

imp

rove

men

t m

easu

res

such

as

do

or-

to-n

eed

le t

ime

for

thro

mb

oly

sis

as p

art

of

the

ong

oin

g p

rog

ram

me.

Mo

nito

ring

is o

ngo

ing

via

loca

l d

ata

colle

ctio

n p

roce

sses

– s

ervi

ce im

pro

vem

ents

suc

h as

Co

de

Str

oke

are

ong

oin

g

PD

SA

cyc

les

and

are

ant

icip

ated

to

co

ntin

ue w

ith

reg

ular

rev

iew

of

pro

cess

.

• A

cces

s to

24

/7 t

hro

mb

oly

sis,

e.g

. CT

acc

ess

and

ED

acu

te m

edic

al s

ervi

ce r

esp

ons

e to

str

oke

pre

sent

atio

n, is

in p

lace

wit

h o

ngo

ing

ed

ucat

ion

and

ser

vice

imp

rove

men

t en

gag

emen

t fr

om

locu

m s

tro

ke p

hysi

cian

/s. T

he n

atio

nal F

AS

T c

amp

aig

n m

ay r

esul

t in

imp

rove

men

ts t

o p

atie

nt p

rese

ntat

ion

out

of

hour

s as

thi

s is

a k

ey d

rive

r fo

r im

pro

ving

acc

ess

to e

arly

thr

om

bo

lysi

s in

elig

ible

pat

ient

s.

• A

rev

iew

will

tak

e p

lace

thi

s fi

nanc

ial y

ear

for

the

exis

ting

str

oke

fac

iliti

es a

nd

staffi

ng w

ithi

n th

e B

OP

DH

B t

o d

eter

min

e ap

pro

pri

aten

ess,

val

idat

e ex

isti

ng s

ervi

ce

pro

visi

on

and

acc

essi

bili

ty o

f st

roke

ser

vice

s. T

he s

ervi

ce w

ill d

o t

his

wo

rk in

co

njun

ctio

n w

ith

the

serv

ice

dev

elo

pm

ent

team

wit

hin

the

BO

PD

HB

. Thi

s is

unl

ikel

y to

occ

ur p

rio

r to

Qua

rter

4 d

ue t

o t

rans

itio

n o

f st

aff w

ith

the

per

man

ent

stro

ke

phy

sici

an t

akin

g u

p p

ost

ear

ly in

20

17.

• T

he B

OP

DH

B w

ill r

evie

w a

nd, i

f ne

cess

ary,

dev

elo

p c

apac

ity

to d

eliv

er c

om

mun

ity

bas

ed r

ehab

ilita

tio

n se

rvic

es f

or

stro

ke p

atie

nts

via

our

Alli

ed H

ealt

h Te

ams.

• T

he B

OP

PH

Os

will

co

ntin

ue w

ith

thei

r C

VD

ris

k as

sess

men

ts a

s an

imp

ort

ant

det

ecti

ve m

easu

re t

hat

can

lead

to

the

pre

vent

ion

of

stro

ke.

• T

he B

OP

DH

B w

ill c

ont

inue

to

att

end

and

sup

po

rt t

he M

idla

nd C

linic

al S

tro

ke

Net

wo

rk t

o im

ple

men

t ac

tio

ns t

o im

pro

ve o

utco

mes

fo

r p

eop

le w

ho h

ave

had

a

stro

ke.

We

will

als

o s

upp

ort

thr

oug

h o

ur in

volv

emen

t o

n na

tio

nal g

roup

s an

d

thro

ugh

gro

ups

such

as

the

Clin

ical

Nur

se S

pec

ialis

ts f

oru

m.

• P

P20

: 6%

or

mo

re o

f p

ote

ntia

lly

elig

ible

str

oke

pat

ient

s’

thro

mb

oly

sed

24

/7 (

see

PP

20 f

or

defi

niti

on

of

‘elig

ible

’).

• P

P20

: 80

% o

f st

roke

pat

ient

s ad

mit

ted

to

a s

tro

ke u

nit

or

org

anis

ed s

tro

ke s

ervi

ce (

see

PP

20 f

or

defi

niti

ons

).

• P

P20

: 80

% o

f p

atie

nts

adm

itte

d

wit

h ac

ute

stro

ke w

ho a

re

tran

sfer

red

to

inp

atie

nt

reha

bili

tati

on

serv

ices

are

tr

ansf

erre

d w

ithi

n 7

day

s o

f ac

ute

adm

issi

on

(als

o r

epo

rt p

erce

nt o

f ac

ute

stro

ke p

atie

nts

tran

sfer

red

to

inp

atie

nt r

ehab

ilita

tio

n).

• R

epo

rt o

n d

eliv

ery

of

the

acti

ons

an

d m

ilest

one

s id

enti

fied

in t

he

Ann

ual P

lan.

91


ANNUAL PLAN 2016/17

2B.1

.5.3

Car

dia

c Se

rvic

es

The

BO

PD

HB

will

be

cont

inui

ng t

he w

ork

reg

iona

lly t

o b

ette

r he

lp u

tilis

e re

sour

ces

and

ens

ure

that

the

dev

elo

pm

ent

of

app

rop

riat

e cl

inic

al

pat

hway

s co

ntin

ues.

We

will

co

ntin

ue t

o e

ngag

e w

ith

our

pri

mar

y ca

re p

artn

ers

in t

he p

lann

ing

and

imp

lem

enta

tio

n ac

tivi

ties

tha

t o

ccur

in

this

are

a as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Acu

te C

ard

iac

Serv

ices

• T

he B

OP

DH

B w

ill c

ont

inue

to

wo

rk r

egio

nally

to

co

ord

inat

e re

sour

ces.

T

his

incl

udes

wo

rkin

g in

co

njun

ctio

n w

ith

the

tert

iary

cen

tre

thro

ugh

op

erat

iona

l co

ord

inat

ion

and

the

Reg

iona

l Clin

ical

Net

wo

rk t

o im

pro

ve

dat

a co

llect

ion

as a

pp

rop

riat

e.

• T

he B

OP

DH

B w

ill r

evie

w a

nd im

ple

men

t A

ccel

erat

ed C

hest

Pai

n P

athw

ay c

hang

es a

s ap

pro

pri

ate

in c

onj

unct

ion

wit

h d

evel

op

men

t o

f th

e re

gio

nal/

nati

ona

l pat

hway

, and

will

aud

it t

he p

athw

ay b

y 30

Jun

e 20

17.

• T

he B

OP

DH

B w

ill c

ont

rib

ute

dat

a to

the

Car

dia

c A

NZ

AC

S-Q

I and

C

ard

iac

Sur

gic

al r

egis

ters

to

ena

ble

rep

ort

ing

mea

sure

s o

f A

cute

C

oro

nary

Syn

dro

me

(AC

S)

risk

str

atifi

cati

on

and

tim

e to

ap

pro

pri

ate

inte

rven

tio

n.

PP

20: 7

0%

of

hig

h-ri

sk p

atie

nts

will

rec

eive

an

ang

iog

ram

wit

hin

3 d

ays

of

adm

issi

on

(‘D

ay o

f A

dm

issi

on’

bei

ng ‘D

ay 0

’) r

epo

rted

by

ethn

icit

y.

Seco

ndar

y Se

rvic

es

The

BO

PD

HB

will

:

• C

ons

olid

ate

the

loca

tio

n o

f a

rang

e o

f ca

rdia

c se

rvic

es s

o t

hat

they

sh

are

a co

mm

on

phy

sica

l are

a to

ach

ieve

gre

ater

syn

erg

y an

d s

ervi

ce

coo

rdin

atio

n.

• E

nsur

e w

here

po

ssib

le t

o m

eet

the

AN

ZA

CS

-QI a

cute

tar

get

s fo

r an

gio

gra

phy

and

ang

iop

last

y. (

It is

imp

ort

ant

to n

ote

tha

t ac

ute

ang

iop

last

y is

pro

vid

ed t

hro

ugh

Wai

kato

Dis

tric

t H

ealt

h B

oar

d a

nd t

he

elec

tive

/acu

te is

arr

ang

ed t

hro

ugh

the

BO

PD

HB

Car

dio

log

y se

rvic

e.)

Mai

ntai

n E

lect

ive

Ser

vice

s P

atie

nt F

low

Ind

icat

ors

(E

SP

I) c

om

plia

nce

in

rela

tio

n to

our

wai

t-ti

me

com

mit

men

ts.

• C

ont

ract

wit

h o

ur c

ard

iac

surg

ery

pro

vid

er a

t le

vels

bas

ed o

n th

e ap

pro

pri

ate

inte

rven

tio

n ra

te f

or

our

reg

ion.

• C

ont

inue

to

end

ors

e re

gio

nally

ag

reed

pri

ori

tisa

tio

n p

roce

sses

fo

r ca

rdia

c su

rger

y.

• C

ont

inue

to

rev

iew

car

dio

log

y re

ferr

al p

atte

rns

to e

nsur

e th

at a

ctiv

ity

leve

ls s

upp

ort

the

kin

d o

f in

terv

enti

on

rate

ap

plic

able

fo

r o

ur r

egio

n.

• D

evel

op

CT

Ang

iog

rap

hy a

s ap

pro

pri

ate

(ser

vice

is a

lrea

dy

in

op

erat

ion)

• E

xplo

re w

ith

our

PH

Os

the

op

tio

n o

f a

card

iac

nurs

e sp

ecia

list

role

jo

intl

y m

anag

ed a

cro

ss p

rim

ary

and

sec

ond

ary

in s

upp

ort

of

our

eff

ort

s ar

oun

d C

VD

man

agem

ent.

• A

gre

emen

t to

and

pro

visi

on

of

a m

inim

um o

f 17

8 t

ota

l car

dia

c su

rger

y d

isch

arg

es f

or

your

lo

cal p

op

ulat

ion

• P

P29

: Im

pro

ved

acc

ess

to d

iag

nost

ics.

95%

o

f p

eop

le w

ill r

ecei

ve e

lect

ive

coro

nary

an

gio

gra

ms

wit

hin

90

day

s.

• E

lect

ive

Ser

vice

s P

atie

nt F

low

Ind

icat

ors

: p

atie

nts

wai

t no

long

er t

han

four

mo

nths

fo

r fi

rst

spec

ialis

t as

sess

men

t an

d t

reat

men

t.

• SI

4: S

tand

ard

ised

Inte

rven

tio

n R

ates

.

-C

ard

iac

surg

ery:

a t

arg

et in

terv

enti

on

rate

of

6.5

per

10

,00

0 o

f p

op

ulat

ion

will

b

e ac

hiev

ed.

DH

Bs

wit

h ra

tes

of

6.5

per

10

,00

0 o

r ab

ove

in p

revi

ous

yea

rs w

ill

be

req

uire

d t

o m

aint

ain

this

rat

e.

-P

ercu

tane

ous

rev

ascu

lari

sati

on:

a

targ

et r

ate

of

at le

ast

12.5

per

10

,00

0 o

f p

op

ulat

ion

will

be

achi

eved

.

-C

oro

nary

ang

iog

rap

hy: a

tar

get

rat

e o

f at

leas

t 34

.7 p

er 1

0,0

00

of

po

pul

atio

n w

ill b

e ac

hiev

ed.


2B.1

.5.4

Hea

lth

of

Old

er P

eop

le

The

BO

PD

HB

will

imp

lem

ent

the

new

res

po

nsiv

e m

od

el o

f ca

re f

or

hom

e an

d c

om

mun

ity

sup

po

rt s

ervi

ces.

Ini

tiat

ives

des

igne

d t

o im

pro

ve

the

qua

lity

of

care

in a

ged

res

iden

tial

car

e ar

e al

so a

hig

h p

rio

rity

and

the

se a

re b

eing

del

iver

ed t

hro

ugh

ded

icat

ed c

linic

al r

eso

urce

s. W

e w

ill c

ont

inue

to

sup

po

rt p

rim

ary

care

to

iden

tify

peo

ple

wit

h d

emen

tia

and

mak

e ea

rly

refe

rral

to

sup

po

rt, i

nfo

rmat

ion/

advi

ce t

hro

ugh

the

clin

ical

pat

hway

dev

elo

pm

ent

for

dem

enti

a th

roug

h B

ay N

avig

ato

r an

d M

ap o

f M

edic

ine.

We

will

dev

elo

p c

linic

al p

athw

ays

rela

ting

to

d

elir

ium

, fra

ctur

e lia

iso

n se

rvic

es a

nd w

oun

d c

are.

The

BO

PD

HB

is c

om

mit

ted

to

imp

lem

enti

ng a

dva

nce/

futu

re c

are

pla

nnin

g in

to b

usin

ess

as u

sual

pra

ctic

e. D

etai

ls a

re a

s fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Syst

em

Inte

gra

tio

n fo

r O

lder

Peo

ple

(P

P23

)

Ref

er t

o M

od

ule

5.2.

1, B

uild

ing

Cap

abili

ty

• Th

e B

OP

DH

B w

ill b

uild

the

cap

abili

ty o

f th

e he

alth

sys

tem

thr

oug

h p

rog

ress

ing

dat

a sh

arin

g in

itia

tive

s un

der

pin

ned

by

a so

und

dat

a g

over

nanc

e fr

amew

ork

thr

oug

h th

e B

OP

Info

rmat

ion

Syst

ems

Gro

up.

W

e w

ill c

ont

inue

to

bui

ld o

n th

e p

rog

ress

we

are

mak

ing

thr

oug

h cu

rren

t p

roje

cts

incl

udin

g t

he C

linic

al H

ealt

h In

form

atio

n P

ort

al f

or

Gen

eral

Pra

ctit

ione

rs (

CH

IP4

GP

),

BO

P M

edch

eck

and

dev

elo

pm

ent

of

a d

efine

d P

rim

ary

Car

e D

ata

Set

. Th

ese

pro

ject

s w

ill p

rog

ress

the

sha

ring

of

heal

th in

form

atio

n b

etw

een

aged

car

e p

rovi

der

s th

roug

h g

ener

al p

ract

ice.

Rep

ort

on

pro

gre

ss w

ith

CH

IP4

GP,

B

OP

Med

chec

k an

d t

he P

rim

ary

Car

e D

ata

Set

Ad

vanc

e/Fu

ture

C

are

Pla

nnin

g

• Th

e B

OP

DH

B F

utur

e C

are

Pla

nnin

g A

dvi

sory

Gro

up w

ill im

ple

men

t ac

tio

ns f

rom

the

st

rate

gic

wo

rk p

lan

to e

mb

ed F

utur

e C

are

Pla

nnin

g in

the

Bay

of

Ple

nty.

• Th

e B

OP

DH

B w

ill e

lect

roni

cally

cap

ture

sub

mit

ted

Ad

vanc

e/F

utur

e C

are

Pla

ns

exp

ort

ed f

rom

pri

mar

y ca

re t

o C

HIP

to

sup

po

rt p

atie

nt p

refe

renc

es t

o s

upp

ort

he

alth

care

pro

fess

iona

ls.

• Th

e B

OP

DH

B w

ill in

tro

duc

e C

eilin

g o

f In

terv

enti

on

form

s10 in

hea

lth

faci

litie

s11

• B

udg

et 2

015

New

Ho

spic

e In

nova

tio

n F

und

ing

– W

aip

una

Ho

spic

e an

d H

osp

ice

Eas

tern

Bay

of

Ple

nty

to p

lan

and

imp

lem

ent

app

rove

d s

ervi

ce d

evel

op

men

t p

rop

osa

ls.

• N

umb

er o

f su

bm

itte

d A

dva

nce/

Fut

ure

Car

e P

lans

sha

red

fro

m

pri

mar

y ca

re t

o s

eco

ndar

y ca

re.

• N

umb

er o

f he

alth

car

e p

rofe

ssio

nals

tra

ined

to

Ad

vanc

e C

are

Pla

nnin

g L

2 p

ract

itio

ner

leve

l.

• %

of

peo

ple

in h

ealt

h fa

cilit

ies

that

ha

ve a

do

cum

ente

d C

eilin

g o

f In

terv

enti

on

form

.

• 9

0%

of

Bay

of

Ple

nty

faci

litie

s ar

e us

ing

the

Cei

ling

of

Inte

rven

tio

n fo

rms.

• E

valu

ate

and

rep

ort

pro

gre

ss

agai

nst

the

Bud

get

20

15 N

ew

Ho

spic

e In

nova

tio

n F

und

ing

se

rvic

e d

evel

op

men

t p

rop

osa

ls

as a

pp

rove

d b

y H

osp

ice

NZ

and

M

inis

try

of

Hea

lth.

10 C

eilin

g o

f In

terv

enti

on

form

ref

ers

to a

fo

rm f

or

pat

ient

s, c

ont

aine

d w

ithi

n th

eir

Ad

vanc

e/F

utur

e C

are

Pla

n, t

hat

sets

out

gui

dan

ce f

or

clin

icia

ns a

s to

exa

ctly

wha

t le

vel o

f in

terv

enti

on

that

per

son

wan

ts r

egar

din

g t

heir

fut

ure

heal

thca

re, f

or

exam

ple

, res

usci

tate

me,

ven

tila

te m

e, k

eep

me

com

fort

able

etc

. 11 H

ealt

h fa

cilit

ies

incl

ude

aged

res

iden

tial

car

e, h

osp

ice

and

ho

spit

al f

acili

ties

.

93


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Inte

gra

ted

Fal

ls

and

Fra

ctur

e (P

P23

)

• T

he B

OP

DH

B w

ill w

ork

wit

h A

CC

to

pro

gre

ss a

co

llab

ora

tive

Fal

ls P

reve

ntio

n p

roje

ct.

The

BO

PD

HB

has

bee

n ap

pro

ache

d b

y A

CC

to

pro

gre

ss p

ote

ntia

l int

egra

ted

wo

rk

stre

ams

for

the

BO

PD

HB

Fra

ctur

e an

d F

alls

Pre

vent

ion

Ser

vice

s.

• T

he B

OP

DH

B w

ill p

rovi

de

an o

steo

po

rosi

s m

anag

emen

t p

rog

ram

me

colla

bo

rati

vely

w

ith

pri

mar

y ca

re.

• R

epo

rt o

n ho

w o

lder

peo

ple

are

b

eing

ass

esse

d o

n th

eir

risk

of

falls

.

• R

epo

rt t

he n

umb

er o

f o

lder

p

eop

le r

efer

red

fro

m p

rim

ary

and

se

cond

ary

care

into

the

fra

ctur

e lia

iso

n se

rvic

es (

spec

ifyi

ng t

he

pro

po

rtio

n re

ferr

ed f

rom

eac

h).

• R

epo

rt t

he n

umb

er o

f o

lder

p

eop

le r

efer

red

to

a s

tren

gth

an

d b

alan

ce r

etai

ning

ser

vice

(n

umer

ato

r) a

nd s

een

by

a st

reng

th a

nd b

alan

ce r

etai

ning

se

rvic

e (d

eno

min

ato

r).

• R

epo

rt t

he n

umb

er o

f o

lder

p

eop

le r

efer

red

to

ost

eop

oro

sis

man

agem

ent

pro

gra

mm

es.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

inte

rRA

I: C

om

pre

hens

ive

Clin

ical

A

sses

smen

t in

re

sid

enti

al c

are

and

in h

om

e an

d c

om

mun

ity

sup

po

rt s

etti

ngs

(PP

23)

• 10

0%

of

old

er p

eop

le w

ill c

ont

inue

to

rec

eive

an

inte

rRA

I Ho

me

Car

e o

r C

ont

act

Ass

essm

ent

in o

rder

to

rec

eive

long

ter

m h

om

e an

d c

om

mun

ity

sup

po

rt s

ervi

ces

• 10

0%

of

peo

ple

in a

ged

res

iden

tial

car

e ar

e re

qui

red

to

hav

e an

inte

rRA

I Lo

ng-t

erm

C

are

Fac

ility

(LT

CF

) as

sess

men

t w

ithi

n 21

day

s o

f en

try

to a

n ag

ed r

esid

enti

al c

are

faci

lity.

• A

ll o

lder

peo

ple

are

req

uire

d t

o h

ave

an in

terR

AI H

om

e C

are

asse

ssm

ent

wit

hin

six

mo

nths

of

entr

y to

an

aged

res

iden

tial

car

e fa

cilit

y an

d a

lso

pri

or

to a

ny c

hang

e o

f ne

ed le

vel/

fund

ing

leve

l wit

hin

the

aged

res

iden

tial

car

e se

cto

r.

• T

he B

OP

DH

B h

as d

evel

op

ed a

n el

ectr

oni

c re

ferr

al a

nd a

lloca

tio

n d

atab

ase

usin

g t

he

nati

ona

lly a

gre

ed t

imef

ram

es f

or

asse

sso

rs t

o w

ork

to

:

-C

risi

s -

wit

hin

24-4

8 h

our

s (

hosp

ital

)

-H

igh

Ris

k -

AS

AP

but

wit

hin

1- 5

day

s fo

r as

sess

men

t, a

nd m

axim

um o

f 5

day

s to

ser

vice

co

ord

inat

ion

-M

ediu

m R

isk

- 1

- 10

day

s fo

r as

sess

men

t, a

nd m

axim

um o

f 10

day

s to

ser

vice

co

ord

inat

ion

-Lo

w R

isk

- 1

- 15

day

s fo

r as

sess

men

t, a

nd m

axim

um o

f 15

day

s to

ser

vice

co

ord

inat

ion.

• T

he B

OP

DH

B is

cur

rent

ly r

ecru

itin

g a

dd

itio

nal N

AS

C s

taff

to

sup

po

rt a

chie

vem

ent

of

thes

e ti

mef

ram

es.

• T

he B

OP

DH

B w

ill m

oni

tor

achi

evem

ent

agai

nst

thes

e ti

mef

ram

es o

n a

dai

ly b

asis

.

• W

hen

avai

lab

le, S

upp

ort

Net

will

uti

lise

dat

a fr

om

the

nat

iona

l dat

a, a

naly

sis

and

re

po

rtin

g s

ervi

ce t

o b

ench

mar

k ag

ains

t o

ther

DH

Bs.

Any

sig

nifi

cant

var

ianc

es w

ill

be

inve

stig

ated

to

ass

ess

qua

lity

of

dat

a an

d t

rain

ing

.

• P

P23

: % o

f o

lder

peo

ple

rec

eivi

ng

long

-ter

m h

om

e su

pp

ort

who

ha

ve a

co

mp

rehe

nsiv

e cl

inic

al

asse

ssm

ent

and

an

ind

ivid

ual c

are

pla

n.

• C

ont

inue

to

neg

oti

ate

at a

na

tio

nal l

evel

to

ob

tain

acc

ess

to

LTC

F d

ata

to e

nab

le t

he B

OP

DH

B

to m

oni

tor

com

plia

nce

wit

h th

e as

sess

men

t o

f ne

w r

esid

ents

w

ithi

n 21

day

s.

• P

P23

: % o

f p

eop

le in

ag

ed

resi

den

tial

car

e b

y fa

cilit

y an

d

by

DH

B w

ho h

ave

a su

bse

que

nt

inte

rRA

I LTC

F a

sses

smen

t co

mp

lete

d w

ithi

n 23

0 d

ays

of

the

pre

vio

us a

sses

smen

t.

• P

P23

: % o

f LT

CF

clie

nts

adm

itte

d

to a

n ag

ed r

esid

enti

al c

are

faci

lity

who

had

bee

n as

sess

ed u

sing

an

inte

rRA

I Ho

me

Car

e as

sess

men

t to

ol i

n th

e si

x m

ont

hs p

rio

r to

th

at fi

rst

LTC

F a

sses

smen

t.

• Ti

me

take

n fr

om

any

ref

erra

l fro

m

any

sour

ce t

o c

om

ple

te (

not

tria

ge)

an

inte

rRA

I ass

essm

ent

(ie,

Co

ntac

t, M

DS

-HC

, LT

FC

as

sess

men

t).

• U

se in

terR

AI m

easu

res

to p

rog

ress

and

co

mp

are

per

form

ance

wit

h o

ther

DH

Bs

and

DH

B r

egio

ns.

Ho

me

and

C

om

mun

ity

Sup

po

rt S

ervi

ces

for

Old

er P

eop

le

(PP

23)

• T

he B

OP

DH

B w

ill s

upp

ort

the

In B

etw

een

Set

tlem

ent

agre

emen

t o

utco

mes

as

advi

sed

and

und

erta

ke a

sso

ciat

ed a

ctio

ns t

o im

ple

men

t.

• T

he B

OP

DH

B w

ill im

ple

men

t a

new

res

po

nsiv

e M

od

el o

f C

are

for

Ho

me

and

C

om

mun

ity

Sup

po

rt S

ervi

ces

fro

m 1

Jul

y 20

16.

• In

-bet

wee

n se

ttle

men

t ag

reem

ents

and

act

ions

will

be

imp

lem

ente

d f

rom

1 J

uly

2016

.

• R

esp

ons

ive

Mo

del

of

Car

e fo

r H

om

e an

d C

om

mun

ity

Sup

po

rt

Ser

vice

s w

ill b

e im

ple

men

ted

d

urin

g 2

016

/17

and

ag

reem

ents

w

ith

pro

vid

ers

com

ple

ted

by

1 Ju

ly 2

016

.

95


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Dem

enti

a C

are

Pat

hway

s (P

P23

)

• T

he B

OP

DH

B w

ill p

arti

cip

ate

and

co

ntri

but

e re

gio

nally

to

the

Mid

land

Map

of

Med

icin

e p

athw

ays

dem

enti

a w

ork

str

eam

• T

he B

OP

DH

B w

ill d

evel

op

a s

ched

ule

of

spec

ific

area

s to

rev

iew

alig

ned

wit

h th

e re

gio

nal M

ap o

f M

edic

ine

pat

hway

.

• T

he B

OP

DH

B w

ill h

ave

cont

inue

d m

emb

ersh

ip o

f th

e M

idla

nd E

duc

ato

r G

roup

to

en

sure

a c

olla

bo

rati

ve r

egio

nal a

pp

roac

h to

sha

red

lear

ning

and

the

dev

elo

pm

ent

of

educ

atio

nal p

rog

ram

mes

.

• Im

ple

men

t th

e M

ap o

f M

edic

ine

dem

enti

a p

athw

ay w

hen

com

ple

ted

.

• W

ork

reg

iona

lly t

o:

-co

mp

lete

an

anal

ysis

o

f th

e cu

rren

t st

ate

of

educ

atio

nal p

rog

ram

mes

an

d s

upp

ort

gro

ups

that

su

pp

ort

info

rmal

car

eers

in

op

erat

ion

in t

he r

egio

n

-re

duc

e va

riab

ility

of

educ

atio

n an

d s

upp

ort

p

rog

ram

mes

ava

ilab

le t

o

sup

po

rt f

amily

/whā

nau

care

rs a

nd p

eop

le li

ving

w

ith

dem

enti

a.

• O

ngo

ing

rev

iew

s o

f th

e D

emen

tia

Car

e p

athw

ays

are

und

erta

ken

and

imp

rove

men

ts m

ade

whe

re

nece

ssar

y.

• C

ont

inue

d m

emb

ersh

ip o

f th

e M

idla

nd E

duc

ato

r G

roup

.


2B.1

.5.5

Sys

tem

Lev

el O

utco

me

Mea

sure

s

The

Min

istr

y o

f H

ealt

h ha

s b

een

wo

rkin

g c

lose

ly w

ith

the

sect

or

to c

o-d

evel

op

a s

uite

of

Sys

tem

Lev

el M

easu

res

that

pro

vid

e a

syst

em w

ide

view

of

per

form

ance

. T

here

are

fo

ur n

ew s

yste

m le

vel m

easu

res

to b

e im

ple

men

ted

fro

m 1

Jul

y 20

16, t

hey

are:

• A

mb

ulat

ory

sen

siti

ve h

osp

ital

isat

ion

rate

s p

er 1

00

,00

0 f

or

0 –

4 y

ear

old

s (i

.e. k

eep

ing

chi

ldre

n o

ut o

f th

e ho

spit

al);

• A

cute

ho

spit

al b

ed d

ays

per

cap

ita

(i.e

. usi

ng h

ealt

h re

sour

ces

effec

tive

ly);

• P

atie

nt e

xper

ienc

e o

f ca

re (

i.e. p

erso

n ce

ntre

d c

are)

;

• A

men

able

mo

rtal

ity

rate

s (i

.e. p

reve

ntio

n an

d e

arly

det

ecti

on)

.

Ad

dit

iona

lly, t

he f

ollo

win

g t

wo

sys

tem

leve

l mea

sure

s w

ill b

e d

evel

op

ed d

urin

g 2

016

/17

incl

udin

g d

efini

tio

ns a

nd id

enti

fica

tio

n o

f d

ata

sets

:

• N

umb

er o

f b

abie

s w

ho li

ve in

a s

mo

ke-f

ree

hous

eho

ld a

t si

x w

eeks

po

st-n

atal

(i.e

. hea

lthy

sta

rt);

• Yo

uth

acce

ss t

o a

nd u

tilis

atio

n o

f yo

uth

app

rop

riat

e he

alth

ser

vice

s (i

.e. t

eens

mak

e g

oo

d c

hoic

es a

bo

ut t

heir

hea

lth

and

wel

lbei

ng).

The

BO

PD

HB

, BO

PALT

, the

Wes

tern

Bay

of

Ple

nty

Pri

mar

y H

ealt

h O

rgan

isat

ion,

Eas

tern

Bay

Pri

mar

y H

ealt

h A

llian

ce a

nd N

ga

Mat

aap

una

Ora

nga

and

oth

er

app

rop

riat

e st

akeh

old

ers

will

be

invo

lved

in a

pro

cess

to

dev

elo

p a

n Im

pro

vem

ent

Pla

n. T

he Im

pro

vem

ent

Pla

n w

ill s

et o

ut h

ow

pro

cess

es a

nd p

rog

ram

mes

will

be

dev

elo

ped

and

alig

ned

to

hel

p a

chie

ve t

he m

easu

res

liste

d a

bov

e.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Syst

em L

evel

O

utco

me

Mea

sure

s

The

BO

PD

HB

will

pro

vid

e a

join

tly

dev

elo

ped

and

ag

reed

(w

ith

PH

Os

and

dis

tric

t al

lianc

es)

Imp

rove

men

t P

lan

to t

he M

inis

try

by

20 O

cto

ber

20

16.

The

Imp

rove

men

t P

lan

will

incl

ude:

• R

ealis

tic,

ap

pro

pri

ate

and

ach

ieva

ble

imp

rove

men

t m

ilest

one

s fo

r th

e S

yste

m L

evel

M

easu

res

• A

log

ical

set

of

cont

rib

uto

ry m

easu

res

that

will

co

ntri

but

e to

ach

ievi

ng t

he S

yste

m

Leve

l Mea

sure

s m

ilest

one

s. a

nd

• A

co

mm

itm

ent

fro

m a

ll p

artn

ers/

stak

eho

lder

s to

the

pla

n d

emo

nstr

ated

wit

h si

gna

ture

s.

PP

22 f

or

pro

visi

on

of

the

Imp

rove

men

t P

lan.

SI1

: Am

bul

ato

ry s

ensi

tive

(av

oid

able

) ho

spit

al a

dm

issi

ons

(0

-4 y

ears

)

SI7

: To

tal a

cute

ho

spit

al b

ed d

ays

per

ca

pit

a

SI8

: Pat

ient

Exp

erie

nce

of

Car

e

SI9

: Am

enab

le m

ort

alit

y

DV

6: Y

out

h ac

cess

to

and

uti

lisat

ion

of

yout

h ap

pro

pri

ate

heal

th s

ervi

ces

DV

7: N

umb

er o

f b

abie

s w

ho li

ve in

a

smo

ke-f

ree

hous

eho

ld a

t si

x w

eeks

p

ost

-nat

al

97


ANNUAL PLAN 2016/17

2B.1

.5.6

Sho

rter

Sta

ys in

Em

erg

ency

Dep

artm

ents

The

gro

wth

in a

cute

dem

and

in o

ur d

istr

ict

can

onl

y b

e m

anag

ed t

hro

ugh

init

iati

ves

focu

sed

acr

oss

the

who

le o

f th

e he

alth

sy

stem

, whi

ch in

clud

e:

• w

ork

ing

wit

h p

rim

ary

care

ser

vice

s to

red

uce

dem

and

fo

r un

pla

nned

car

e su

ch a

s o

ur w

ork

wit

h th

e P

rim

ary

Hea

lth

Org

anis

atio

ns o

n A

cute

Dem

and

Man

agem

ent

• in

teg

rate

d a

nd im

pro

ved

long

-ter

m h

ealt

h co

ndit

ions

car

e an

d m

anag

emen

t ac

ross

the

hea

lth

syst

em

• effi

cien

t/eff

ecti

ve u

tilis

atio

n o

f re

sour

ce t

o m

atch

dem

and

acr

oss

the

who

le h

ealt

h sy

stem

• en

suri

ng h

osp

ital

flo

w, r

educ

ing

gri

dlo

ck a

nd im

pro

ving

co

mm

unit

y b

ased

dis

char

ge

serv

ices

and

reh

abili

tati

on

for

exam

ple

, co

ntin

ued

re

view

and

dev

elo

pm

ent

of

care

pat

hway

s.

The

BO

PD

HB

will

str

ive

to a

chie

ve t

he S

hort

er S

tays

in E

mer

gen

cy D

epar

tmen

t he

alth

tar

get

and

imp

lem

ent

A Q

ualit

y F

ram

ewo

rk a

nd

Sui

te o

f Q

ualit

y M

easu

res

for

the

Em

erg

ency

Dep

artm

ent

Pha

se o

f A

cute

Pat

ient

Car

e in

New

Zea

land

as

follo

ws.

Link

ages

• H

ealt

h Ta

rget

Emer

genc

y

Dep

artm

ents

Shor

ter

stay

s in

Emer

genc

yD

epar

tmen

ts

Shor

ter

stay

s in


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Hea

lth

Targ

et

The

BO

PD

HB

will

:

• R

evie

w s

trea

min

g s

yste

ms

for

man

agin

g p

atie

nts

- Q

uart

er 1

• C

ont

inue

to

imp

lem

ent

the

Em

erg

ency

Dep

artm

ent

Qua

lity

Fra

mew

ork

fo

r em

erg

ency

ca

re d

eliv

ery.

The

BO

PD

HB

Em

erg

ency

Med

icin

e se

rvic

e ha

s al

read

y es

tab

lishe

d a

cl

inic

al g

over

nanc

e st

ruct

ure

wit

h si

te s

pec

ific

sub

-gro

ups

to e

nsur

e d

ata

colle

ctio

n is

in li

ne w

ith

the

ED

Qua

lity

Fra

mew

ork

. The

BO

PD

HB

bel

ieve

s it

has

the

ab

ility

to

co

mp

lete

all

dat

a co

llect

ion

as p

er t

he E

D Q

ualit

y F

ram

ewo

rk a

nd a

wai

ts t

he n

atio

nal

agre

emen

t o

n th

e te

mp

late

fo

r re

po

rtin

g a

nd s

hari

ng t

he d

ata

file

s.

• S

tren

gth

en n

ew li

nkag

es t

o o

ther

aft

er-h

our

s N

GO

pro

vid

ers

allo

win

g f

or

gre

ater

co

ord

inat

ion

of

the

pri

mar

y/se

cond

ary

effo

rt in

man

agin

g a

cute

dem

and

. Thi

s w

ork

in

volv

es s

hari

ng d

ata

to f

acili

tate

pat

ient

man

agem

ent

and

pat

ient

mov

emen

t at

ti

mes

of

pea

k d

eman

d –

Qua

rter

1.

• C

ont

inue

to

ref

resh

our

eff

ort

s, w

ork

ing

wit

h P

rim

ary

Car

e to

man

age

the

Top

10

0 p

rese

nter

s to

Em

erg

ency

Dep

artm

ent,

no

ting

tha

t th

is is

a fl

uid

and

evo

lvin

g

po

pul

atio

n. T

his

wo

rk w

ill in

clud

e th

e d

evel

op

men

t o

f in

div

idua

l man

agem

ent

pla

ns

wit

h G

Ps,

Acc

iden

t an

d E

mer

gen

cy (

exte

rnal

), E

D a

nd o

ther

PH

O/N

GO

gro

ups

as

req

uire

d –

Qua

rter

2.

• D

evel

op

the

fo

llow

ing

tw

o in

itia

tive

s to

imp

rove

the

flo

w o

f p

atie

nts

fro

m

Em

erg

ency

Med

icin

e in

to t

he h

osp

ital

:

• Tr

ansi

t In

– id

enti

fica

tio

n o

f a

clea

rly

defi

ned

gro

up o

f p

atie

nts

wit

h lo

wer

acu

ity

who

can

saf

ely

and

ap

pro

pri

atel

y b

e tr

ansi

ted

to

a lo

wer

ac

uity

are

a p

rio

r to

ad

mis

sio

n. T

his

will

invo

lve

the

dev

elo

pm

ent

of

stan

dar

d o

per

atin

g p

roce

dur

es f

or

tran

siti

ng p

atie

nts

to t

he t

rans

it

loun

ge

for

adm

issi

on

assi

stin

g in

pat

ient

flo

w –

Qua

rter

s 2

and

3.

• S

trea

min

g –

inte

rnat

iona

l lit

erat

ure

has

iden

tifi

ed s

trea

min

g (

ther

e ar

e m

any

defi

niti

on

and

met

hod

s) w

hich

str

eam

Em

erg

ency

Med

icin

e p

atie

nts.

Thi

s ha

s in

clud

ed S

tand

ard

Op

erat

ing

Pro

ced

ures

, ear

ly

reco

gni

tio

n to

hig

h p

rob

abili

ty o

f ad

mis

sio

n g

roup

s, a

void

ance

of

dup

licat

ion,

ear

lier

dec

isio

n to

tre

at a

nd a

lso

man

age

bed

sto

ck

app

rop

riat

ely.

The

BO

PD

HB

Em

erg

ency

Med

icin

e se

rvic

e w

ill b

e in

vest

igat

ing

and

pilo

t st

ream

ing

. Thi

s p

roje

ct w

ill b

e d

evel

op

ed a

s ap

pro

pri

ate

over

the

yea

r. T

he p

roce

ss w

ill b

e ru

n as

a f

orm

al p

roje

ct

and

will

iden

tify

po

ssib

le m

od

els.

The

se m

od

els

will

be

revi

ewed

ag

ains

t th

e si

te, r

eso

urce

s an

d f

acili

ties

the

n st

ream

ing

will

be

dev

elo

ped

thr

oug

h th

e P

DS

A c

ycle

.

• T

he B

OP

DH

B h

as a

lso

iden

tifi

ed a

num

ber

of

pat

ient

pat

hway

s to

re

view

incl

udin

g C

OP

D a

nd h

eart

fai

lure

• R

epo

rt o

n th

e he

alth

tar

get

per

form

ance

by

Mao

ri a

nd P

acifi

c et

hnic

ity.

Hea

lth

Targ

et: 9

5% o

f p

atie

nts

will

be

adm

itte

d, d

isch

arg

ed, o

r tr

ansf

erre

d

fro

m a

n E

mer

gen

cy D

epar

tmen

t w

ithi

n si

x ho

urs

of

pre

sent

atio

n.

99


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Acu

te D

eman

d

Man

agem

ent

• T

he B

OP

DH

B w

ill c

arry

out

sp

ecifi

c ac

tio

ns t

o m

anag

e ac

ute

dem

and

as

follo

ws:

Qua

rter

s 1

and

2

• D

evel

op

a c

olla

bo

rati

ve m

od

el t

hro

ugh

the

Acu

te D

eman

d M

anag

emen

t C

linic

al

Net

wo

rk (

AD

M C

linic

al N

etw

ork

) w

ith

agre

ed T

erm

s o

f R

efer

ence

and

reg

ular

re

po

rtin

g t

o s

take

hold

ers.

Thi

s g

roup

will

gui

de,

mo

nito

r an

d p

rio

riti

se o

bje

ctiv

es

to a

dd

ress

Acu

te D

eman

d M

anag

emen

t ac

ross

the

Bay

of

Ple

nty

syst

em.

Reg

ular

sy

stem

mea

sure

s w

ill b

e d

evel

op

ed a

nd t

rial

led

thr

oug

h th

is g

roup

to

gui

de

pri

ori

tisa

tio

n an

d in

itia

tive

dev

elo

pm

ent.

Thi

s g

roup

will

als

o s

upp

ort

whe

re a

ble

, th

e fu

rthe

r d

evel

op

men

t o

f p

atie

nt in

form

atio

n ac

ross

the

sys

tem

.

• E

nhan

ce c

urre

nt A

cute

Dem

and

Man

agem

ent

Co

mm

unit

y P

rim

ary

Op

tio

ns (

CP

O)

to e

nsur

e th

at p

atie

nts

rece

ive

cons

iste

nt a

cces

s an

d A

SH

co

ndit

ions

are

mo

re

effici

entl

y an

d e

ffec

tive

ly m

anag

ed t

hro

ugh

targ

eted

pro

gra

mm

es e

.g. c

ellu

litis

.

• E

xplo

re a

fter

-ho

urs

tele

pho

ne t

riag

e p

rovi

sio

n ac

ross

the

Bay

of

Ple

nty

incl

udin

g

dev

elo

pin

g a

co

mm

unit

y co

mm

unic

atio

n p

lan

to e

nsur

e cl

ear

mes

sag

ing

and

m

axim

ise

upta

ke o

f th

is s

ervi

ce, s

pec

ific

mea

sure

s to

be

set

e.g

. uti

lisat

ion

incl

udin

g

volu

me

by

pra

ctic

e, e

thni

city

, tim

e o

f d

ay, d

iag

nosi

s, a

nd o

utco

me.

Im

ple

men

tati

on

wit

hin

this

per

iod

is d

epen

den

t o

n ti

min

g o

f an

y d

ecis

ion.

• E

xplo

re c

olla

bo

rati

on

bet

wee

n E

D a

nd p

rim

ary

care

nur

sing

in r

elat

ion

to c

om

bin

ed

educ

atio

n w

here

ap

pro

pri

ate.

• Te

st a

co

mm

unit

y b

ased

and

nur

se le

d p

acka

ge

of

care

at

the

Taur

ang

a H

osp

ital

E

mer

gen

cy D

epar

tmen

t fo

r p

atie

nts

who

can

be

safe

ly c

ared

fo

r at

ho

me

and

wo

uld

o

ther

wis

e ha

ve b

een

adm

itte

d t

o h

osp

ital

.

Qua

rter

3

• Lo

ok

at s

yste

m m

easu

res

dev

elo

ped

by

the

AD

M C

linic

al N

etw

ork

bei

ng v

isib

le a

nd

utili

sed

by

all s

take

hold

ers

to in

form

ong

oin

g p

lann

ing

wo

rk.

• R

evie

w C

PO

uti

lisat

ion

and

mea

sure

s.

• B

egin

rev

iew

of

afte

rho

urs

tele

pho

ne t

riag

e to

sup

po

rt f

urth

er d

evel

op

men

t w

ith

GP

P

ract

ices

and

pub

lic c

om

mun

icat

ions

as

app

rop

riat

e

Qua

rter

4

• E

valu

atio

n o

f al

l ini

tiat

ives

.

• R

efer

als

o t

o s

ecti

on

2B.1.

2.2

Ser

vice

Co

nfig

urat

ion

incl

udin

g S

hift

ing

Ser

vice

s..


2B.1

.5.7

Whā

nau

Ora

The

BO

PD

HB

will

alig

n it

s W

hāna

u O

ra a

ctiv

ity

wit

h th

e se

t o

f in

dic

ato

rs a

gre

ed b

y th

e na

tio

nal W

hāna

u O

ra P

artn

ersh

ip G

roup

. T

his

incl

udes

the

five

key

are

as f

or

the

heal

th s

ecto

r th

at c

ont

rib

ute

to W

hāna

u O

ra (

men

tal h

ealt

h, a

sthm

a, o

ral h

ealt

h, o

bes

ity

and

to

bac

co)

achi

evem

ent

and

acc

eler

ated

pro

gre

ss t

ow

ard

hea

lth

equi

ty f

or

Māo

ri a

nd P

acifi

c, a

nd W

hāna

u O

ra in

the

nex

t fo

ur y

ears

.

As

the

sole

Whā

nau

Ora

Pro

vid

er C

olle

ctiv

e o

per

atin

g in

the

Bay

of

Ple

nty,

the

BO

PD

HB

will

co

ntin

ue t

o w

ork

clo

sely

wit

h an

d s

upp

ort

N

gā

Mat

aap

una

Ora

nga

to im

ple

men

t th

eir

colle

ctiv

e im

pac

t ac

tivi

ty a

nd g

row

the

ir c

apac

ity

and

cap

abili

ty.

Inte

r-ag

ency

rel

atio

nshi

ps

will

co

ntin

ue t

o b

e b

uilt

and

nur

ture

d w

ith

Te P

uni K

oki

ri, t

he M

inis

try

of

Hea

lth,

the

Min

istr

y o

f S

oci

al D

evel

op

men

t an

d T

e P

ou

Mat

akan

a (N

ort

h Is

land

Co

mm

issi

oni

ng A

gen

cy)

to e

nsur

e th

at W

hāna

u O

ra r

emai

ns o

n ev

eryo

ne’s

ag

end

a.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Whā

nau

Ora

The

BO

PD

HB

will

acc

eler

ate

pro

gre

ss t

ow

ard

s he

alth

eq

uity

in t

he fi

ve p

rio

rity

are

as

imp

lem

enti

ng a

nd m

oni

tori

ng t

he f

ollo

win

g a

ctiv

ity.

1. R

educ

ed r

ate

of

Māo

ri c

om

mit

ted

to

co

mp

ulso

ry t

reat

men

t re

lati

ve t

o n

on-

Māo

ri.

BO

PD

HB

Māo

ri H

ealt

h P

lan

Ind

icat

or

14: M

enta

l Hea

lth

Ap

pro

pri

ate

rate

s o

f us

e o

f S

ecti

on

29 o

f th

e M

enta

l Hea

lth

Act

(co

mm

unit

y tr

eatm

ent

ord

er).

• T

he B

OP

DH

B w

ill a

naly

se t

he d

egre

e o

f va

rian

ce b

etw

een

Māo

ri a

nd n

on-

Māo

ri

spec

ific

to c

om

mun

ity

trea

tmen

t o

rder

s w

ithi

n th

e D

HB

by

31 O

cto

ber

20

16.

• T

he B

OP

DH

B w

ill id

enti

fy a

nd im

ple

men

t ac

tivi

ty t

hat

red

uces

the

rat

e o

f co

mm

unit

y tr

eatm

ent

ord

ers

by

30 J

une

2017

.

Per

form

ance

is t

o b

e m

oni

tore

d o

n a

qua

rter

ly b

asis

thr

oug

h th

e M

āori

H

ealt

h P

lan

Ste

erin

g G

roup

12.

The

M

enta

l Hea

lth

Targ

et is

to

be

set

in

colla

bo

rati

on

wit

h th

e M

inis

try

of

Hea

lth.

2. In

crea

se in

the

num

ber

of

child

ren

who

are

car

ies

free

at

age

5

BO

PD

HB

Māo

ri H

ealt

h P

lan

Ind

icat

or

13: O

ral h

ealt

h

Imp

rove

d o

ral h

ealt

h o

utco

mes

fo

r M

āori

chi

ldre

n.

• T

he B

OP

DH

B w

ill d

evel

op

, pri

ori

tise

and

imp

lem

ent

inte

rven

tio

ns t

hat

incr

ease

Māo

ri

pre

-sch

oo

l enr

olm

ent

in a

den

tal c

linic

fro

m 6

1% t

o 8

5% b

y 31

Oct

ob

er 2

016

.

• T

he B

OP

DH

B w

ill d

evel

op

, pri

ori

tise

and

imp

lem

ent

inte

rven

tio

ns t

hat

incr

ease

Māo

ri

pre

-sch

oo

l enr

olm

ent

in a

den

tal c

linic

fro

m 8

5% t

o 9

5% b

y 30

Jun

e 20

17.

Den

tal c

linic

enr

olm

ent

per

form

ance

m

oni

tore

d q

uart

erly

thr

oug

h th

e M

āori

H

ealt

h P

lan

Ste

erin

g G

roup

.

12 T

he M

āori

Hea

lth

Pla

n S

teer

ing

Gro

up m

eets

qua

rter

ly a

nd c

om

pri

ses

rep

rese

ntat

ives

fro

m t

he v

ario

us o

rgan

isat

ions

invo

lved

in a

chie

ving

the

tar

get

s lis

ted

in t

he p

lan.

T

he g

roup

incl

udes

rep

rese

ntat

ives

fro

m p

rim

ary

care

, sec

ond

ary

care

, reg

iona

l pub

lic h

ealt

h se

rvic

es, c

om

mun

ity

pro

vid

ers,

and

the

DH

B.

101


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Whā

nau

Ora

3. 9

5% o

f al

l pre

gna

nt M

āori

wo

men

sm

oke

-fre

e at

tw

o w

eeks

po

st-n

atal

.

BO

PD

HB

Māo

ri H

ealt

h P

lan

Ind

icat

or

9: S

mo

king

ces

sati

on

in p

reg

nanc

y

Mo

re M

āori

wo

men

who

are

sm

oke

free

at

two

wee

ks p

ost

nata

l.

• T

he B

OP

DH

B w

ill in

crea

se t

he p

erce

ntag

e o

f M

āori

wo

men

off

ered

sm

oki

ng

cess

atio

n ad

vice

and

sup

po

rt a

nd w

ho a

re s

mo

kefr

ee a

t tw

o w

eeks

po

stna

tal t

o 9

5%

by

June

20

17.

• T

he B

OP

DH

B w

ill o

ffer

sm

oki

ng c

essa

tio

n ad

vice

and

sup

po

rt t

o t

he p

artn

ers

of

pre

gna

nt w

om

en a

nd o

ther

wha

nau

as w

ell.

Sm

oki

ng c

essa

tio

n ad

vice

pro

visi

on

and

sm

oke

fre

e ra

tes

at t

wo

wee

ks

po

st-n

atal

to

be

mo

nito

red

on

a q

uart

erly

bas

is t

hro

ugh

the

Māo

ri

Hea

lth

Pla

n S

teer

ing

Gro

up.

4. R

educ

ed a

sthm

a an

d w

heez

e ad

mis

sio

n ra

tes

for

Māo

ri c

hild

ren

(ASH

0-4

yea

rs)

Māo

ri t

amar

iki i

n th

e B

ay o

f P

lent

y ar

e tw

ice

as li

kely

to

be

hosp

ital

ised

fo

r as

thm

a as

no

n-M

āori

.

Red

uce

the

num

ber

of

tam

arik

i ad

mit

ted

to

ho

spit

al f

or

asth

ma.

• In

co

njun

ctio

n w

ith

Ng

a M

ataa

pun

a O

rang

a an

d t

he A

sthm

a F

oun

dat

ion,

the

B

OP

DH

B w

ill c

o-d

esig

n a

Kau

pap

a M

āori

Res

pir

ato

ry n

ursi

ng s

ervi

ce f

ocu

sing

on

tait

amar

iki w

ith

asth

ma,

and

yo

ung

par

ents

wit

h ch

ildre

n w

ith

asth

ma

by

31 A

ugus

t 20

16.

AS

H r

ates

(O

-4)

will

be

mo

nito

red

on

a q

uart

erly

bas

is t

hro

ugh

the

Māo

ri

Hea

lth

Pla

n S

teer

ing

Gro

up.

5. R

aisi

ng H

ealt

hy K

ids

• B

y 30

Jun

e 20

17, 9

5% o

f o

bes

e ch

ildre

n id

enti

fied

in t

he B

4S

C p

rog

ram

me

will

be

off

ered

a r

efer

ral t

o a

hea

lth

pro

fess

iona

l fo

r cl

inic

al a

sses

smen

t an

d f

amily

bas

ed

nutr

itio

n, a

ctiv

ity

and

life

styl

e in

terv

enti

ons

.

Mo

nito

ring

thr

oug

h th

e H

ealt

h Ta

rget

re

po

rtin

g m

echa

nism

.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Whā

nau

Ora

6. S

upp

ort

ing

our

loca

l Whā

nau

Ora

Co

llect

ive

and

Pas

ifika

Ser

vice

s

The

BO

PD

HB

will

co

ntin

ue t

o s

upp

ort

imp

rove

d o

utco

mes

fo

r M

āori

ind

ivid

uals

, and

the

ir

whā

nau.

Ng

a M

ataa

pun

a O

rang

a (N

MO

) is

the

onl

y W

hāna

u O

ra C

olle

ctiv

e o

per

atin

g

in t

he B

ay o

f P

lent

y an

d a

n ap

pro

ved

pro

vid

er o

f W

hāna

u D

irec

t an

d C

olle

ctiv

e Im

pac

t ac

tivi

ty f

or

Te P

ou

Mat

akan

a (T

PM

). W

e w

ill c

ont

inue

to

sup

po

rt t

his

colle

ctiv

e w

ith:

• O

ngo

ing

par

tici

pat

ion

on

NM

O’s

Whā

nau

Ora

Wo

rkin

g G

roup

• S

upp

ort

ing

the

ach

ieve

men

t o

f o

utco

mes

of

NM

O’s

co

llect

ive

imp

act

pro

ject

wit

h Te

P

ou

Mat

akan

a.

• C

o-d

esig

n an

d im

ple

men

tati

on

of

the

whā

nau

ora

acc

ess

pat

hway

bet

wee

n p

rim

ary

and

sec

ond

ary

care

by

Oct

ob

er 2

016

.

• E

xplo

ring

op

po

rtun

itie

s fo

r jo

int

vent

ures

, co

-fun

din

g a

nd in

vest

men

t w

ith

Ng

a M

ataa

pun

a O

rang

a an

d T

e P

ou

Mat

akan

a.

• P

acifi

c Is

land

Co

mm

unit

y (T

aura

nga)

Tru

st is

the

DH

B c

ont

ract

ed p

rovi

der

fo

r P

asifi

ka s

ervi

ces

in t

he W

este

rn B

OP,

and

are

par

t o

f a

reg

iona

l Pas

ifika

co

llect

ive

calle

d A

ere

Tai.

Aer

e Ta

i has

a f

anau

ola

co

ntra

ct w

ith

Pas

ifika

Fut

ures

, and

hav

e al

loca

ted

pro

visi

on

for

48

fan

au in

the

BO

PD

HB

dis

tric

t. O

f th

ese

48

fan

au, 4

3 ar

e in

th

e W

este

rn B

OP

and

five

in t

he E

aste

rn B

OP.

Pac

ific

Isla

nd C

om

mun

ity

(Tau

rang

a)

Trus

t ha

s w

ork

ed a

long

sid

e E

aste

rn B

ay P

HA

(w

ho h

old

a P

acifi

c nu

rsin

g f

anau

su

pp

ort

pro

gra

mm

e ag

reem

ent

wit

h th

e B

OP

DH

B),

to

iden

tify

elig

ible

fan

au in

the

E

aste

rn B

OP

fo

r fa

nau

ola

ser

vice

s an

d o

ngo

ing

sup

po

rt.

S15:

Del

iver

y o

f W

hāna

u o

ra -

Rep

ort

p

rog

ress

on

pla

nned

act

ivit

ies,

acr

oss

th

e fi

ve p

rio

rity

are

as (

men

tal h

ealt

h,

asth

ma,

ora

l hea

lth,

ob

esit

y an

d

tob

acco

), w

ith

pro

vid

ers

to im

pro

ve

serv

ice

del

iver

y an

d d

evel

op

mat

ure

pro

vid

ers.

103


ANNUAL PLAN 2016/17

2B.1

.5.8

Imp

rove

d A

cces

s to

Dia

gno

stic

s

Dia

gno

stic

s ar

e a

vita

l ste

p in

the

pat

hway

to

acc

ess

app

rop

riat

e tr

eatm

ent.

Im

pro

ving

wai

ting

tim

es f

or

dia

gno

stic

s ca

n re

duc

e d

elay

s to

a

pat

ient

’s e

pis

od

e o

f ca

re a

nd im

pro

ve D

HB

dem

and

and

cap

acit

y m

anag

emen

t. T

he B

OP

DH

B a

ims

to im

pro

ve a

cces

s to

dia

gno

stic

s as

fo

llow

s.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Imp

rove

d A

cces

s to

Dia

gno

stic

s

The

BO

PD

HB

will

:

• C

ont

inue

to

mov

e to

war

ds

100

% c

om

plia

nce

for

wai

ting

tim

e ta

rget

s th

roug

h p

lann

ed a

nd c

oo

rdin

ated

res

our

cing

and

clo

ser

PH

O m

anag

emen

t o

f re

ferr

als.

• M

anag

e th

e im

ple

men

tati

on

of

nati

ona

l gui

del

ines

whe

n re

leas

ed.

• P

rovi

de

info

rmat

ion

on

dia

gno

stic

s as

par

t o

f P

hase

3 o

f th

e N

atio

nal P

atie

nt F

low

p

roje

ct t

o m

easu

re t

he p

atie

nt jo

urne

y th

roug

h se

cond

ary

serv

ices

.

• A

gre

ed N

atio

nal P

atie

nt F

low

sy

stem

cha

nges

are

imp

lem

ente

d.

• R

epre

sent

atio

n, a

tten

dan

ce a

nd

par

tici

pat

ion

in n

atio

nal a

nd

reg

iona

l clin

ical

gro

up a

ctiv

itie

s.

• P

P29

: Im

pro

ving

wai

ting

tim

es f

or

dia

gno

stic

ser

vice

s.

• C

oro

nary

ang

iog

rap

hy –

95%

of

acce

pte

d r

efer

rals

fo

r el

ecti

ve

coro

nary

ang

iog

rap

hy w

ill r

ecei

ve

thei

r p

roce

dur

e w

ithi

n 3

mo

nths

(9

0 d

ays)

.

Rad

iolo

gy

The

BO

PD

HB

will

:

• C

ont

inue

our

pro

gra

mm

e o

f p

hase

d t

rans

itio

n o

f b

udg

et m

anag

emen

t to

PH

Os

for

com

mun

ity

refe

rred

rad

iolo

gy

serv

ices

.

• Im

ple

men

t a

syst

em t

hat

ensu

res

100

% o

f al

l co

mm

unit

y re

ferr

ed r

eque

sts

are

elec

tro

nic

by

the

end

of

the

year

.

• E

nsur

e o

ur s

urve

illan

ce o

blig

atio

ns t

o t

he r

egio

n ar

e m

et, c

lear

ing

del

ayed

act

ivit

y an

d p

utti

ng in

pla

ce s

yste

ms

to e

nsur

e th

at t

he s

urve

illan

ce n

eed

can

be

relia

bly

met

g

oin

g f

orw

ard

.

• E

nsur

e su

stai

nab

ility

of

imp

lem

ente

d im

pro

vem

ents

fro

m t

he R

adio

log

y Im

pro

vem

ent

Pro

ject

• C

T a

nd M

RI –

95%

of

acce

pte

d

refe

rral

s fo

r C

T s

cans

, and

85%

of

acce

pte

d r

efer

rals

fo

r M

RI s

cans

w

ill r

ecei

ve t

heir

sca

n w

ithi

n si

x w

eeks

(4

2 d

ays)

.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Co

lono

sco

py/

End

osc

opy

The

BO

PD

HB

will

:

• W

ork

wit

h th

e P

rovi

der

Arm

to

imp

rove

pat

ient

sur

veill

ance

rat

es b

y fu

ndin

g m

ore

co

lono

sco

pie

s.

• C

ont

inue

dev

elo

pm

ent

and

mo

nito

ring

of

the

Glo

bal

Rat

ing

Sca

le (

GR

S)

to id

enti

fy

the

key

area

s fo

r q

ualit

y im

pro

vem

ent.

• Im

ple

men

t th

e el

ectr

oni

c re

ferr

al p

athw

ay f

or

dir

ect

acce

ss c

olo

nosc

op

y -

this

is

alre

ady

und

erw

ay a

nd w

e al

read

y us

e th

e na

tio

nal c

rite

ria

for

man

ual r

efer

ral d

irec

t ac

cess

to

co

lono

sco

py.

• W

ork

wit

h th

e re

gio

nal n

etw

ork

on

(i)

esta

blis

hing

dir

ect

acce

ss c

rite

ria

for

refe

rral

an

d p

athw

ay; a

nd (

ii) s

hare

d in

itia

tive

s an

d p

lann

ing

cap

acit

y.

• D

iag

nost

ic c

olo

nosc

op

y

-8

5% o

f p

eop

le a

ccep

ted

fo

r an

urg

ent

dia

gno

stic

co

lono

sco

py

will

rec

eive

th

eir

pro

ced

ure

wit

hin

two

w

eeks

(14

cal

end

ar d

ays,

in

clus

ive)

, 10

0%

wit

hin

30

day

s

-70

% o

f p

eop

le a

ccep

ted

fo

r a

non-

urg

ent

dia

gno

stic

co

lono

sco

py

will

rec

eive

th

eir

pro

ced

ure

wit

hin

six

wee

ks (

42

day

s), 1

00

%

wit

hin

90

day

s.

• S

urve

illan

ce c

olo

nosc

op

y –

70%

o

f p

eop

le w

aiti

ng f

or

surv

eilla

nce

or

follo

w-u

p c

olo

nosc

op

y w

ill w

ait

no lo

nger

tha

n 12

wee

ks (

84

day

s)

bey

ond

the

pla

nned

dat

e, 1

00

%

wit

hin

120

day

s.

105


ANNUAL PLAN 2016/17

2B.1

.5.9

Imp

rove

d A

cces

s to

Ele

ctiv

e Su

rger

y

Man

agin

g p

atie

nt le

ngth

of

stay

is im

po

rtan

t to

the

BO

PD

HB

in s

usta

inin

g o

ur e

lect

ive

serv

ice

in t

erm

s o

f ca

pac

ity.

It

is a

lso

imp

ort

ant

for

go

od

pat

ient

hea

lth

out

com

es; h

igh

leng

th o

f st

ay is

a q

ualit

y is

sue

and

usu

ally

link

ed t

o h

igh

surg

ical

infe

ctio

n ra

tes.

Red

ucin

g le

ngth

of

stay

is c

riti

cal t

o p

rovi

din

g a

n effi

cien

t se

rvic

e an

d m

akin

g o

pti

mal

use

o

f o

ur h

ealt

h b

udg

et.

Link

ed t

o s

usta

inab

le a

nd e

ffici

ent

serv

ice

del

iver

y is

red

ucin

g d

elay

s in

del

iver

ing

dia

gno

stic

se

rvic

es, (

see

Mo

dul

e 2.

3.4

Imp

rovi

ng A

cces

s to

Dia

gno

stic

s).

The

BO

PD

HB

is w

ork

ing

reg

iona

lly w

ith

oth

er M

idla

nd

DH

Bs

to id

enti

fy o

pp

ort

unit

ies

for

gre

ater

inte

gra

tio

n o

f el

ecti

ve s

ervi

ces

and

pur

chas

ing

ap

pro

pri

ate

reg

iona

l vo

lum

es

to a

llow

fo

r su

stai

nab

le s

ervi

ce im

pro

vem

ent.

Ser

vice

imp

rove

men

t w

ill b

e fu

rthe

r su

pp

ort

ed b

y ag

reed

reg

iona

l re

ferr

al p

athw

ays,

fun

ctio

nal c

linic

al n

etw

ork

s an

d c

ons

iste

ntly

ap

plie

d a

cces

s cr

iter

ia.

Link

ages

• H

ealt

h Ta

rget

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Imp

rove

d a

cces

s to

Ele

ctiv

e Su

rger

y

• T

he B

OP

DH

B w

ill im

ple

men

t th

e E

lect

ive

Ser

vice

s P

rod

ucti

vity

and

Wo

rkfo

rce

Pro

gra

mm

e: B

oo

king

and

Sch

edul

ing

Imp

rove

men

t In

itia

tive

Feb

20

16-F

eb 2

017

. In

sum

mar

y, t

he p

rog

ram

me

will

imp

rove

bo

oki

ng a

nd s

ched

ulin

g f

or

follo

w u

p

app

oin

tmen

ts in

the

fo

llow

ing

way

s:

-W

ork

ing

in p

artn

ersh

ip w

ith

pat

ient

s to

und

erst

and

, pla

n an

d d

evel

op

ch

ang

es t

o e

nsur

e th

e b

oo

king

pro

cess

es a

re p

atie

nt c

entr

ed.

-T

he d

evel

op

men

t o

f al

go

rith

ms

that

ena

ble

ap

po

intm

ents

to

be

mad

e ac

cord

ing

to

sp

ecifi

ed p

athw

ays

and

no

t re

liant

on

an in

div

idua

l bo

oki

ng

staff

s un

ique

und

erst

and

ing

and

inte

rpre

tati

on

of

an in

div

idua

l clin

icia

n’s

clin

ic m

ake

up.

Thi

s w

ill p

rovi

de

the

pla

tfo

rm f

or

confi

den

ce in

mak

ing

ap

po

intm

ents

acr

oss

a r

ang

e o

f sp

ecia

litie

s.

-T

he r

evie

w o

f o

utp

atie

nt s

ched

ule

tem

pla

tes

that

sup

po

rt m

eeti

ng w

aiti

ng

tim

e ta

rget

s an

d c

ont

ract

s w

ithi

n th

e av

aila

ble

cap

acit

y an

d r

eso

urce

s.

-C

lear

and

co

nsis

tent

gui

del

ines

, fo

r al

l ser

vice

s, t

hat

pro

vid

e p

resc

rip

tive

b

oo

king

pro

cess

es t

hat

are

not

per

son

relia

nt.

• H

ealt

h Ta

rget

: The

vo

lum

e o

f el

ecti

ve s

urg

ery

will

be

incr

ease

d b

y an

ave

rag

e o

f 4

,00

0

dis

char

ges

per

yea

r.

• D

eliv

ery

agai

nst

agre

ed v

olu

me

sche

dul

e, in

clud

ing

a m

inim

um

of

10,4

84

ele

ctiv

e su

rgic

al

dis

char

ges

in 2

016

/17

tow

ard

s th

e E

lect

ives

Hea

lth

Targ

et 1

0,6

12

and

a m

inim

um o

f 15

1 el

ecti

ve

ort

hop

aed

ic a

nd g

ener

al s

urg

ery

dis

char

ges

in 2

016

/17

as p

art

of

the

Bud

get

20

15 a

dd

itio

nal

inve

stm

ent.

• SI

4: E

lect

ive

serv

ices

sta

ndar

dis

ed

inte

rven

tio

n ra

tes

in M

od

ule

7.

Elec

tive

Surg

ery

Impr

oved

acce

ss to


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Imp

rove

d a

cces

s to

Ele

ctiv

e Su

rger

y

-Im

ple

men

tati

on

of

a si

ngle

po

int

of

cont

act

for

all f

ollo

w u

p a

pp

oin

tmen

t q

ueri

es.

-U

tilis

atio

n o

f a

rang

e o

f p

atie

nt c

ont

act

op

tio

ns t

o r

educ

ing

the

rel

ianc

e o

n le

tter

s to

man

age

pat

ient

ap

po

intm

ents

.

-T

he B

OP

DH

B w

ill im

ple

men

t th

e E

lect

ive

Ser

vice

s P

rod

ucti

vity

and

W

ork

forc

e P

rog

ram

me:

The

atre

Sch

edul

ing

Hub

fo

r E

NT.

The

hub

will

p

rovi

de

pat

ient

s th

e co

nnec

tio

ns, t

he in

form

atio

n, t

he e

duc

atio

n an

d t

he

op

po

rtun

ity

to e

ngag

e in

dir

ect

sche

dul

ing

of

thei

r th

eatr

e b

oo

king

at

the

tim

e th

e d

ecis

ion

for

surg

ery

is m

ade.

It is

ant

icip

ated

tha

t fo

r th

e m

ajo

rity

o

f p

atie

nts

this

will

be

on

the

sam

e d

ay t

hat

they

att

end

the

ir F

irst

Sp

ecia

list

Ap

po

intm

ent.

-In

teg

ral t

o t

he T

heat

re S

ched

ulin

g H

ub is

pre

-ass

essm

ent

sup

ply

ing

the

ce

ntra

l po

int

of

co-o

rdin

atio

n b

etw

een

the

clin

icia

n, p

atie

nt/f

amily

/wha

nau,

sc

hed

uler

, the

atre

, clin

ical

nur

se s

pec

ialis

ts a

nd p

rim

ary

care

.

-T

his

pro

ject

incl

udes

imp

rove

d r

efer

ral m

anag

emen

t b

etw

een

pri

mar

y an

d

seco

ndar

y ca

re w

ith

gre

ater

use

of

Bay

Nav

igat

or

pat

hway

s an

d e

xplo

ring

d

irec

t ac

cess

op

po

rtun

itie

s.

-T

he B

OP

DH

B w

ill c

ont

inue

to

imp

lem

ent

the

Pat

ient

Info

rmat

ion

Cen

tre(

PIC

) th

at p

rovi

des

a c

entr

al p

oin

t (a

cro

ss a

ll sp

ecia

ltie

s) f

or

pat

ient

s to

co

ntac

t re

gar

din

g t

heir

ho

spit

al a

pp

oin

tmen

ts.

• O

S3: I

npat

ient

Len

gth

of

Sta

y in

M

od

ule

7.

• E

lect

ive

Ser

vice

s P

atie

nt F

low

In

dic

ato

rs e

xpec

tati

ons

are

met

, an

d p

atie

nts

wai

t no

long

er t

han

four

mo

nths

fo

r fi

rst

spec

ialis

t as

sess

men

t an

d t

reat

men

t.

• In

clud

e m

easu

res

for

any

loca

l p

roje

cts/

acti

ons

iden

tifi

ed.

• A

ll p

atie

nts

are

pri

ori

tise

d u

sing

th

e m

ost

rec

ent

nati

ona

l to

ol

avai

lab

le.

• P

atie

nt le

vel d

ata

is b

eing

re

po

rted

into

the

NP

F c

olle

ctio

n,

in li

ne w

ith

spec

ified

req

uire

men

ts.

107


ANNUAL PLAN 2016/17

2B.1

.6 L

ivin

g W

ithi

n O

ur M

eans

The

BO

PD

HB

will

be

focu

sing

on

the

follo

win

g in

itia

tive

s to

ena

ble

us

to li

ve w

ithi

n o

ur m

eans

:

• P

eop

le, w

hāna

u, f

amily

cen

tred

car

e

• C

ont

inui

ng t

o b

uild

on

our

ser

vice

clin

ical

gov

erna

nce

stru

ctur

e w

ith

op

erat

iona

l man

agem

ent

incl

udin

g m

oni

tori

ng o

f co

sts

• C

linic

ian

invo

lvem

ent

and

lead

ersh

ip in

all

pat

ient

and

clin

ical

saf

ety

wo

rk s

trea

ms

• C

ont

inui

ng t

he d

evel

op

men

t o

f cl

inic

ian

reso

urce

uti

lisat

ion

and

co

stin

g r

epo

rts

• C

ont

inui

ng p

rog

ram

me

usin

g le

an m

etho

do

log

ies

to r

educ

e co

st t

hro

ugh

red

ucin

g w

aste

and

min

imis

ing

var

iati

on

• E

vid

ence

bas

ed b

est

pra

ctic

e m

od

els

of

care

• S

tren

gth

en a

nd m

anag

e o

ur w

ork

forc

e w

ithi

n fi

scal

co

nstr

aint

s

• C

ont

inui

ng t

o w

ork

wit

h na

tio

nal a

nd r

egio

nal i

niti

ativ

es a

nd p

rog

ram

mes

to

ena

ble

car

e cl

ose

r to

ho

me

for

our

pat

ient

s

• M

akin

g b

est

use

of

smar

t sy

stem

tec

hno

log

y an

d a

vaila

bili

ty.

The

se in

itia

tive

s w

ill a

ll ha

ve a

ro

le t

o p

lay

in e

nsur

ing

we

op

erat

e in

a fi

nanc

ially

res

po

nsib

le m

anne

r (w

hich

mea

ns e

nsur

ing

del

iver

y o

n ag

reed

fina

ncia

l fo

reca

sts

wit

hin

avai

lab

le f

und

ing

). W

e w

ill b

e d

oin

g t

his

whi

le im

pro

ving

pat

ient

exp

erie

nce

and

sup

po

rtin

g b

est

pra

ctic

e an

d c

heri

shin

g o

ur w

ork

forc

e. O

ur c

linic

al g

over

nanc

e st

ruct

ure

is e

mb

edd

ed t

o s

upp

ort

our

act

ivit

y.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Livi

ng w

ithi

n o

ur

mea

ns

The

BO

PD

HB

will

:

• O

per

ate

wit

hin

agre

ed fi

nanc

ial p

lans

(an

d f

und

cap

ital

inve

stm

ent

fro

m in

tern

al s

our

ces)

• P

rom

ote

Clin

ical

and

Exe

cuti

ve le

ader

ship

• P

roac

tive

ly m

anag

e co

st g

row

th a

nd im

pro

ve u

se o

f w

ork

forc

e

• C

ont

inue

to

mo

nito

r p

rod

ucti

on

and

op

erat

iona

l bud

get

pla

ns a

nd a

naly

se v

aria

nces

• U

tilis

e th

e ne

w H

ealt

h P

artn

ersh

ips

stra

teg

y fo

r o

ur p

rocu

rem

ent

req

uire

men

ts a

s ap

pro

pri

ate

• R

eco

nfig

ure

curr

ent

serv

ice

del

iver

y m

od

els

to s

upp

ort

imp

rove

d p

atie

nt a

nd c

linic

al s

afet

y an

d

fina

ncia

l sus

tain

abili

ty

• F

ocu

s o

n fr

eque

nt a

tten

dee

s to

em

erg

ency

dep

artm

ents

and

acu

te r

ead

mis

sio

ns

• C

ont

inue

on-

go

ing

ana

lysi

s o

f re

sour

ce u

tilis

atio

n an

d c

ost

s

• C

ont

inue

reg

iona

l co

llab

ora

tio

n o

n p

roje

cts

and

pro

gra

mm

es

• C

ont

inue

to

wo

rk w

ith

pri

mar

y ca

re t

o b

ette

r in

teg

rate

and

sup

po

rt m

anag

emen

t o

f ch

roni

c an

d

long

ter

m c

ond

itio

ns.

SI3:

Ens

urin

g d

eliv

ery

of

Ser

vice

Cov

erag

e.

OS3

: Inp

atie

nt L

eng

th o

f S

tay.

OS8

: Red

ucin

g A

cute

R

ead

mis

sio

ns t

o H

osp

ital

.

Out

put

1: O

utp

ut D

eliv

ery

Ag

ains

t P

lan.


2B.1.

7 O

ther

2B.1

.7.1

Nat

iona

l Ent

ity

Pri

ori

ty In

itia

tive

s

The

BO

PD

HB

is e

xpec

ted

to

alig

n o

ur p

lann

ing

wit

h th

e p

lann

ing

inte

ntio

ns o

f ke

y na

tio

nal a

gen

cies

. E

ach

of

thes

e na

tio

nal a

gen

cies

has

in

itia

tive

s fo

r th

e 20

16/1

7 ye

ar, w

hich

will

aff

ect

our

DH

B.

The

nat

iona

l ag

enci

es a

nd a

ligni

ng a

ctiv

itie

s o

f su

pp

ort

are

as

follo

ws.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Hea

lth

Pro

mo

tio

n A

gen

cy

• T

he B

OP

DH

B w

ill:

-S

upp

ort

nat

iona

l hea

lth

pro

mo

tio

n ac

tivi

ties

aro

und

the

hea

lth

targ

ets.

-S

upp

ort

alc

oho

l scr

eeni

ng a

nd b

rief

inte

rven

tio

n.

-S

upp

ort

the

pro

visi

on

of

rout

ine

and

co

nsis

tent

ad

vice

to

wo

men

of

child

bea

ring

ag

e ab

out

al

coho

l and

pre

gna

ncy.

Hea

lth

Wo

rkfo

rce

NZ

• In

crea

sing

the

num

ber

of

sono

gra

phe

rs -

The

BO

PD

HB

will

ind

icat

e (a

s ap

plic

able

): t

he n

umb

er

of

trai

nee

po

siti

ons

po

ssib

le u

nder

the

Med

ical

Rad

iati

on

Tech

nolo

gis

ts B

oar

d r

equi

rem

ents

giv

en

qua

lified

sta

ff, h

ow

the

y in

tend

to

incr

ease

the

num

ber

of

trai

nee

po

siti

ons

ava

ilab

le, a

nd h

ow

the

y in

tend

to

wo

rk w

ith

pri

vate

pro

vid

ers

to e

nsur

e a

smo

oth

flo

w o

f tr

aini

ng a

cro

ss b

oth

(d

isti

nct)

en

viro

nmen

ts.

• E

xpan

din

g t

he r

ole

of

nurs

e p

ract

itio

ners

, clin

ical

nur

se s

pec

ialis

ts a

nd p

allia

tive

car

e nu

rses

- T

he

BO

PD

HB

will

ind

icat

e it

s p

lans

to

exp

and

the

ro

le o

f nu

rse

pra

ctit

ione

rs, c

linic

al n

urse

sp

ecia

lists

an

d p

allia

tive

car

e nu

rses

in t

he B

ay o

f P

lent

y.

• C

reat

e ne

w n

urse

sp

ecia

list

pal

liati

ve c

are

educ

ato

r an

d s

upp

ort

ro

les

- T

he B

OP

DH

B w

ill

dem

ons

trat

e th

e st

eps

it is

tak

ing

to

sup

po

rt t

he r

egio

nal a

pp

roac

h to

imp

lem

enti

ng n

urse

sp

ecia

list

pal

liati

ve c

are

educ

ato

r an

d s

upp

ort

ro

les.

• E

xpan

din

g t

he r

ole

of

spec

ialis

t nu

rses

to

per

form

co

lono

sco

pie

s -

The

BO

PD

HB

sup

po

rts

the

reg

iona

l ap

pro

ach

to e

xpan

din

g t

he r

ole

of

spec

ialis

t nu

rses

to

per

form

co

lono

sco

pie

s.

• In

crea

sing

the

num

ber

of

med

ical

phy

sici

sts

- T

he B

OP

DH

B w

ill d

emo

nstr

ate

its

com

mit

men

t to

th

e re

crui

tmen

t o

f M

edic

al P

hysi

cs r

egis

trar

s to

red

uce

the

vuln

erab

ility

of

a sm

all a

nd c

riti

cal

wo

rkfo

rce.

• In

crea

sing

the

num

ber

of

med

ical

co

mm

unit

y b

ased

tra

inin

g p

lace

s an

d p

rovi

din

g a

cces

s to

pri

mar

y ca

re/c

om

mun

ity

sett

ing

s fo

r p

revo

cati

ona

l tra

inee

s -

The

BO

PD

HB

will

ens

ure

pre

voca

tio

nal t

rain

ees

have

acc

ess

to c

om

mun

ity-

bas

ed a

ttac

hmen

ts, w

ork

ing

in c

onj

unct

ion

wit

h th

e M

edic

al C

oun

cil o

f N

ew Z

eala

nd a

nd p

rim

ary

and

co

mm

unit

y-b

ased

pra

ctic

es.

109


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Nat

iona

l Hea

lth

IT B

oar

d

• N

atio

nal M

ater

nity

Info

rmat

ion

Sys

tem

Pla

tfo

rm –

The

BO

PD

HB

will

iden

tify

act

ions

and

mile

sto

nes

to s

how

tha

t M

ISP

-NZ

has

bee

n im

ple

men

ted

, or

is in

the

pro

cess

of

bei

ng im

ple

men

ted

acr

oss

all

20 D

HB

s.

• el

ectr

oni

c P

resc

rib

ing

and

Ad

min

istr

atio

n (e

PA)

– T

he B

OP

DH

B w

ill c

om

mit

to

wo

rk r

egio

nally

to

en

sure

ePA

has

bee

n im

ple

men

ted

, or

is in

the

pro

cess

of

bei

ng im

ple

men

ted

.

• R

egio

nal C

WS

, (In

clud

ing

Med

Man

), R

egio

nal C

DR

, Reg

iona

l PA

S, C

apab

ility

– T

he B

OP

DH

B w

ill

com

mit

to

wo

rk r

egio

nally

to

ens

ure

the

Mid

land

reg

ion

has

com

ple

ted

the

imp

lem

enta

tio

n o

f th

e re

gio

nal a

pp

licat

ions

, and

to

wo

rk r

egio

nally

to

ens

ure

the

Mid

land

s re

gio

n ha

s d

evel

op

ed a

ro

adm

ap f

or

del

iver

y o

f ea

ch c

apab

ility

.

• In

teg

rati

on

wit

h th

e na

tio

nal E

lect

roni

c H

ealt

h R

eco

rd (

EH

R)

– T

he B

OP

DH

B w

ill c

om

mit

to

wo

rk

reg

iona

lly t

o e

nsur

e p

arti

cip

atio

n o

n ad

viso

ry g

roup

s.

Hea

lth

Qua

lity

and

Saf

ety

Co

mm

issi

on

• S

urg

ical

sit

e in

fect

ion

pro

gra

mm

e (S

SIP

) -

Nat

iona

l Inf

ecti

on

Sur

veill

ance

Dat

a W

areh

ous

e -

The

B

OP

DH

B w

ill c

om

mit

to

mee

ting

infe

ctio

n co

ntro

l exp

ecta

tio

ns in

acc

ord

ance

wit

h th

e O

per

atio

nal

Po

licy

Fra

mew

ork

- S

ecti

on

9.8

.

• S

urg

ical

sit

e in

fect

ion

pro

gra

mm

e (S

SIP

) -

DH

B In

fect

ions

Man

agem

ent

syst

ems

- T

he B

OP

DH

B

will

co

ntin

ue d

evel

op

men

t o

f in

fect

ion

man

agem

ent

syst

ems

at a

loca

l DH

B le

vel.

• N

atio

nal i

npat

ient

pat

ient

exp

erie

nce

surv

ey a

nd r

epo

rtin

g s

yste

m -

Pat

ient

exp

erie

nce

ind

icat

ors

-

The

BO

PD

HB

will

co

mm

it t

o s

urve

ying

pat

ient

exp

erie

nce

of

the

care

the

y re

ceiv

ed u

sing

the

na

tio

nal c

ore

sur

vey,

at

leas

t q

uart

erly

.

• C

apab

ility

and

Lea

der

ship

- T

he B

OP

DH

B w

ill m

eet

exp

ecta

tio

ns in

acc

ord

ance

wit

h th

e O

per

atio

nal P

olic

y F

ram

ewo

rk S

ecti

on

9.3

and

9.4

.6.

• P

rim

ary

Car

e -

pat

ient

exp

erie

nce

surv

ey a

nd r

epo

rtin

g s

yste

m –

PH

Os

will

sur

vey

pat

ient

ex

per

ienc

e o

f th

e ca

re t

hey

rece

ived

usi

ng t

he n

atio

nal c

ore

sur

vey

- th

is in

itia

tive

is f

und

ed

dir

ectl

y b

y M

OH

fo

r a

3 ye

ar p

erio

d s

o n

o D

HB

fina

ncia

l im

plic

atio

ns.

• T

he B

OP

DH

B w

ill e

ngag

e w

ith

the

Min

istr

y o

f H

ealt

h o

n th

e w

ork

pro

gra

mm

e o

f th

e fo

rmer

N

atio

nal H

ealt

h C

om

mit

tee

(onc

e th

e p

rog

ram

me

is c

onfi

rmed

).


2B.1

.7.2

NZ

Hea

lth

Par

tner

ship

s Li

mit

ed

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

NZ

Hea

lth

Par

tner

ship

s Li

mit

ed

The

BO

PD

HB

will

wo

rk in

par

tner

ship

wit

h N

Z H

ealt

h P

artn

ersh

ips

to p

rog

ress

the

fo

llow

ing

init

iati

ves:

• N

atio

nal O

racl

e So

luti

on

(fo

rmer

ly F

inan

ce, P

rocu

rem

ent

and

Sup

ply

Cha

in)

-T

he N

atio

nal O

racl

e S

olu

tio

n w

ill d

esig

n an

d b

uild

a s

ing

le fi

nanc

ial m

anag

emen

t in

form

atio

n sy

stem

rea

dy

for

DH

B im

ple

men

tati

on.

The

des

igni

ng o

f th

e p

roce

sses

and

th

e sy

stem

of

the

Nat

iona

l Ora

cle

So

luti

on

pro

gra

mm

e w

ill b

e d

one

thr

oug

h a

co-c

reat

ion

app

roac

h w

ith

the

sect

or,

leve

rag

ing

exi

stin

g D

HB

exp

erti

se.

-D

HB

s w

ill c

om

mit

res

our

ces

to t

he im

ple

men

tati

on

of

Ora

cle

syst

em, a

nd w

ill f

ully

fac

tor

in

exp

ecte

d b

udg

et b

enefi

t im

pac

ts.

• Fo

od

Ser

vice

s

-N

Z H

ealt

h P

artn

ersh

ips

will

sup

po

rt t

he D

HB

s in

co

nsid

erin

g t

he F

oo

d S

ervi

ces

bus

ines

s ca

se.

If t

he D

HB

cho

ose

s to

pro

ceed

wit

h th

e b

usin

ess

case

, the

DH

B w

ill c

om

mit

the

ap

pro

pri

ate

reso

urce

s to

imp

lem

ent

the

serv

ices

.

• Li

nen

and

Lau

ndry

Ser

vice

s

-N

Z H

ealt

h P

artn

ersh

ips

will

co

ntin

ue t

o w

ork

wit

h th

e D

HB

s th

at a

re o

pen

to

co

nsid

erin

g a

co

llect

ive

arra

ngem

ent

for

out

sour

ced

Lin

en a

nd L

aund

ry S

ervi

ces

and

will

do

thi

s th

roug

h th

e d

evel

op

men

t o

f a

colla

bo

rati

ve s

trat

egy

for

the

sect

or.

• N

atio

nal I

nfra

stru

ctur

e P

latf

orm

-T

he N

atio

nal I

nfra

stru

ctur

e P

latf

orm

pro

gra

mm

e ai

ms

to a

chie

ve q

ualit

ativ

e, c

linic

al a

nd

fina

ncia

l ben

efits

fo

r D

HB

s th

roug

h a

nati

ona

l ap

pro

ach

to IS

infr

astr

uctu

re c

ons

ump

tio

n.

The

nat

iona

l ap

pro

ach

is d

rive

n b

y co

nver

gin

g 4

0 in

fras

truc

ture

fac

iliti

es in

to a

sin

gle

in

fras

truc

ture

pla

tfo

rm d

eliv

ered

fro

m t

wo

dat

a ce

ntre

fac

iliti

es.

It w

ill a

lso

alig

n th

e he

alth

se

cto

r’s

infr

astr

uctu

re s

ervi

ces

wit

h th

e G

over

nmen

t’s

over

all I

nfo

rmat

ion

Co

mm

unic

atio

ns

Tech

nolo

gy

go

al o

f ha

rnes

sing

tec

hno

log

y to

del

iver

bet

ter,

trus

ted

pub

lic s

ervi

ces.

-D

HB

s w

ill c

om

mit

to

wo

rkin

g c

olla

bo

rati

vely

wit

h N

Z H

ealt

h P

artn

ersh

ips

to p

rog

ress

the

N

atio

nal I

nfra

stru

ctur

e P

latf

orm

. D

HB

s w

ill c

om

mit

res

our

ces

to t

he d

ecis

ion

reac

hed

in

rela

tio

n to

the

imp

lem

enta

tio

n o

f th

e p

rog

ram

me.

111


ANNUAL PLAN 2016/17

2B.1

.7.3

Imp

rovi

ng Q

ualit

y

Qua

lity

and

pat

ient

saf

ety

are

a to

p p

rio

rity

fo

r th

e B

OP

DH

B.

The

on-

go

ing

invo

lvem

ent

of

clin

ical

lead

ersh

ip a

nd a

ro

bus

t cl

inic

al

gov

erna

nce

fram

ewo

rk t

hat

pro

vid

es m

oti

vati

on

and

ove

rsig

ht is

cri

tica

l to

pat

ient

saf

ety.

The

BO

PD

HB

is w

ork

ing

in p

artn

ersh

ip w

ith

the

Hea

lth

Qua

lity

and

Saf

ety

Co

mm

issi

on

to d

eliv

er o

n th

e na

tio

nal i

niti

ativ

es.

All

DH

B s

taff

, clin

ical

lead

ers

and

man

ager

s ar

e re

spo

nsib

le

for

imp

rovi

ng q

ualit

y an

d p

arti

cip

atin

g in

qua

lity

imp

rove

men

t in

itia

tive

s an

d p

roje

cts.

Thr

oug

h re

po

rtin

g a

nd m

oni

tori

ng a

dve

rse

even

ts

we

shar

e le

arni

ngs

to e

nsur

e “n

o o

ne e

lse

has

this

exp

erie

nce”

. We

will

str

eng

then

our

fra

mew

ork

to

cap

ture

the

co

nsum

er e

xper

ienc

e; t

he

cons

umer

vo

ice

will

be

inte

gra

l to

ong

oin

g s

ervi

ce d

evel

op

men

t an

d c

ont

inuo

us q

ualit

y im

pro

vem

ent.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Falls

• T

he B

OP

DH

B w

ill c

ont

inue

to

rev

iew

and

refi

ne d

ocu

men

tati

on

req

uire

d f

or

falls

ris

k as

sess

men

t an

d c

are

pla

nnin

g.

The

req

uire

men

ts f

or

falls

ris

k as

sess

men

t an

d c

are

pla

nnin

g w

ill b

e m

oni

tore

d t

hro

ugh

ind

ivid

ual t

race

rs a

nd N

urse

Lea

der

s au

dit

s o

f ch

arts

. Res

ults

will

be

dis

pla

yed

on

“kno

win

g h

ow

we

are

do

ing

bo

ard

s”.

90

% o

f o

lder

pat

ient

s ar

e g

iven

a f

alls

ri

sk a

sses

smen

t

98

% o

f o

lder

pat

ient

s as

sess

ed a

s at

ri

sk o

f fa

lling

rec

eive

an

ind

ivid

ualis

ed

care

pla

n ad

dre

ssin

g t

he r

isks

id

enti

fied

Han

d H

ygie

ne

• T

he B

OP

DH

B w

ill r

evie

w a

ll ha

nd h

ygie

ne r

esul

ts a

nd id

enti

fy o

pp

ort

unit

ies

for

cont

inuo

us im

pro

vem

ent.

Whe

re o

pp

ort

unit

ies

for

imp

rove

men

t ar

e id

enti

fied

fr

ont

line

staff

will

be

sup

po

rted

to

mak

e im

pro

vem

ents

usi

ng In

stit

ute

of

Hea

lthc

are

Imp

rove

men

t (I

HI)

met

hod

olo

gy.

We

will

co

ntin

ue t

o p

rom

ote

han

d h

ygie

ne t

hro

ugh

a ra

nge

of

acti

viti

es e

g r

egul

ar n

ews

sto

ries

on

the

intr

anet

, and

a c

amp

aig

n w

hich

w

ill in

clud

e re

fres

h o

f ap

pro

pri

ate

use

of

glo

ves

and

han

d h

ygie

ne, a

nd p

arti

cip

ate

in

WH

O in

tern

atio

nal h

and

hyg

iene

day

. W

e w

ill t

rain

new

aud

ito

rs a

s re

qui

red

.

80

% c

om

plia

nce

wit

h g

oo

d h

and

hy

gie

ne p

ract

ice

Safe

Sur

ger

y

• T

he B

OP

DH

B is

co

mm

itte

d t

o c

om

ply

ing

wit

h th

e ne

w s

afe

surg

ery

mar

ker

onc

e ag

reed

. O

rgan

isat

iona

l res

ults

will

be

pub

lishe

d in

Che

ck U

p f

ollo

win

g e

ach

aud

it

cycl

e an

d a

ll in

div

idua

l dep

artm

ents

’ res

ults

will

be

dis

trib

uted

.

• T

he B

OP

DH

B w

ill c

ont

inue

to

pro

mo

te f

ront

line

ow

ners

hip

and

IHI i

mp

rove

men

t m

etho

do

log

y.

• T

he B

OP

DH

B w

ill s

usta

in c

om

plia

nce

wit

h al

l par

ts o

f th

e W

HO

saf

e su

rger

y ch

eck

list

bei

ng u

sed

in a

min

imum

of

95%

of

op

erat

ions

thr

oug

h eff

ecti

ve t

eam

wo

rk a

nd

com

mun

icat

ion.

• T

he B

OP

DH

B w

ill c

ont

inue

to

wo

rk w

ith

the

Hea

lth

Qua

lity

and

Saf

ety

Co

mm

issi

on

(HQ

SC

) o

n it

s p

rog

ram

mes

to

pro

mo

te s

afe

surg

ery

and

will

imp

lem

ent

bri

efing

and

d

ebri

efing

fo

r ea

ch t

heat

re li

st.

All

thre

e p

arts

(si

gn

in, t

ime

out

an

d s

ign

out

) o

f th

e su

rgic

al s

afet

y ch

eckl

ist

are

used

in 1

00

% o

f su

rgic

al

pro

ced

ures

, wit

h le

vels

of

team

en

gag

emen

t w

ith

the

chec

klis

t at

5

or

abov

e, a

s m

easu

red

by

the

7-p

oin

t Li

kert

sca

le, 9

5% o

f th

e ti

me.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Surg

ical

Sit

e In

fect

ions

(SS

I)

• T

he B

OP

DH

B w

ill c

ont

inue

to

ach

ieve

or

exce

ed t

he t

arg

ets

for

SS

I. P

rog

ress

will

b

e m

oni

tore

d t

hro

ugh

ong

oin

g s

urve

illan

ce o

f hi

ps

and

kne

es. I

nsta

nces

of

non-

com

plia

nce

will

be

follo

wed

up

at

the

tim

e an

d o

n a

case

by

case

bas

is. T

he in

fect

ion

cont

rol c

om

mit

tee

will

iden

tify

are

as o

f co

ncer

n fo

r o

ther

pro

ced

ures

and

an

imp

rove

men

t p

rog

ram

me

will

be

com

men

ced

.

95%

of

hip

and

kne

e re

pla

cem

ent

pat

ient

s re

ceiv

e ce

fazo

lin >

2g

o

r ce

furo

xim

e >

1.5

g a

s su

rgic

al

pro

phy

laxi

s.

100

% o

f hi

p a

nd k

nee

rep

lace

men

t p

atie

nts

rece

ive

pro

phy

lact

ic

anti

bio

tics

0-6

0 m

inut

es b

efo

re

inci

sio

n.

Med

icat

ion

Safe

ty

• T

he B

OP

DH

B is

par

tici

pat

ing

in t

he r

egio

nal I

S p

rog

ram

me

and

will

imp

lem

ent

med

icat

ion

man

agem

ent

in li

ne w

ith

the

reg

iona

l tim

efra

mes

.

• Im

ple

men

tati

on

of

the

reg

iona

l ele

ctro

nic

med

icin

es r

eco

ncili

atio

n p

latf

orm

is

dep

end

ent

on

the

roll

out

of

the

Ori

on

suit

e o

f p

rod

ucts

. In

the

inte

rim

, BO

PD

HB

w

ill in

tro

duc

e a

hyb

rid

pro

cess

usi

ng t

he M

edC

heck

co

mm

unit

y m

edic

atio

ns d

ata

and

man

ual r

eco

ncili

atio

n fo

rms.

Imp

lem

enta

tio

n o

f th

e el

ectr

oni

c m

edic

ine

reco

ncili

atio

n p

latf

orm

. The

re

gio

nal s

olu

tio

n is

no

t ex

pec

ted

unt

il 20

18.

Med

Che

ck b

ased

rec

onc

iliat

ion

form

s Ju

ne 2

017

.

Pat

ient

Saf

ety

• T

he B

OP

DH

B is

co

mm

itte

d t

o r

educ

ing

har

m. I

n ad

dit

ion

to t

he p

rog

ram

mes

rel

ated

to

the

QS

Ms

we

will

fo

cus

on

pre

vent

ing

har

m in

Pre

ssur

e In

juri

es, r

educ

ing

har

m

fro

m V

eno

us T

hro

mb

oem

bo

lism

(V

TE

) an

d M

anag

emen

t o

f th

e D

eter

iora

ting

P

atie

nt.

• F

or

pre

ssur

e in

juri

es w

e w

ill r

evie

w lo

cal p

olic

y an

d p

roce

dur

e to

ens

ure

it in

clud

es

req

uire

men

ts f

or

rep

ort

ing

pre

ssur

e in

juri

es g

rad

ed t

wo

or

abov

e as

a t

reat

men

t in

jury

. The

BO

PD

HB

will

rep

ort

any

pre

ssur

e in

jury

gra

ded

as

thre

e o

r ab

ove

as

a se

rio

us a

dve

rse

even

t an

d r

epo

rt it

to

HQ

SC

. The

DH

B h

as im

ple

men

ted

the

W

ater

low

Ris

k A

sses

smen

t co

mp

lianc

e w

ith

this

will

be

mo

nito

red

thr

oug

h o

ngo

ing

au

dit

.

Pro

mo

te

Co

nsum

er

Eng

agem

ent

• T

he B

OP

DH

B is

co

mm

itte

d t

o w

ork

ing

co

llab

ora

tive

ly w

ith

cons

umer

s, in

ac

cord

ance

wit

h th

e B

OP

DH

B C

ons

umer

Eng

agem

ent

Fra

mew

ork

, to

dev

elo

p

effec

tive

par

tner

ship

s an

d c

om

mun

icat

ion

pat

hway

s w

here

it is

ag

reed

tha

t a

cons

umer

per

spec

tive

wo

uld

ad

d v

alue

to

dec

isio

n m

akin

g.

• T

he B

OP

DH

B w

ill c

ont

inue

to

invi

te p

atie

nts,

fam

ily m

emb

ers

and

car

ers

to

rep

rese

nt t

he v

oic

es o

f he

alth

co

nsum

ers

on

the

Vo

lunt

eer

Pat

ient

Ad

viso

ry

Co

mm

itte

e (V

PAC

) an

d t

he C

om

mun

ity

Liai

son

Gro

up.

A s

tock

take

of

the

num

ber

of

cons

umer

eng

agem

ent

acti

ons

/ac

tivi

ties

und

erta

ken

as a

res

ult

of

op

po

rtun

itie

s ar

isin

g f

rom

co

nsum

er

eng

agem

ent

and

pat

ient

exp

erie

nce

feed

bac

k.

113


ANNUAL PLAN 2016/17

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Bui

ldin

g

Cap

abili

ty

and

Clin

ical

Le

ader

ship

• T

he B

OP

DH

B is

co

mm

itte

d t

o m

aint

aini

ng a

n en

viro

nmen

t o

f p

atie

nt s

afet

y an

d w

ill

sup

po

rt lo

cal p

atie

nt s

afet

y in

itia

tive

s.

• T

he B

OP

DH

B w

ill c

ont

inue

to

incl

ude

info

rmat

ion

on

how

we

are

bui

ldin

g c

apab

ility

fo

r q

ualit

y im

pro

vem

ent

and

pat

ient

saf

ety

in o

ur Q

ualit

y A

cco

unt.

• T

he B

OP

DH

B w

ill e

xpan

d t

he Q

ualit

y Im

pro

vem

ent

(QI)

Res

iden

cy b

eyo

nd

Ho

use

Offi

cers

to

oth

er h

ealt

h p

rofe

ssio

nals

incl

udin

g n

ursi

ng, a

llied

hea

lth,

and

ad

min

istr

atio

n st

aff.

• T

he B

OP

DH

B w

ill p

rom

ote

key

mes

sag

es t

hro

ugh

our

act

ivit

ies

for

Pat

ient

Saf

ety

Wee

k th

e fo

cus

for

2016

will

be

rela

ted

to

VT

E.

Qua

lity

Acc

oun

t

• T

he B

OP

DH

B w

ill c

ont

inue

to

dev

elo

p t

he Q

ualit

y A

cco

unt

usin

g a

pro

ject

tea

m

whi

ch is

rep

rese

ntat

ive

of

the

who

le o

rgan

isat

ion

incl

udin

g t

he V

olu

ntee

r P

atie

nt

Ad

viso

ry G

roup

. W

e w

ill d

evel

op

a p

roje

ct p

lan

wit

h m

ilest

one

s an

d m

oni

tor

it t

o

ensu

re t

he Q

ualit

y A

cco

unt

is d

eliv

ered

wit

hin

req

uire

d t

imef

ram

es a

nd m

eets

the

H

QS

C g

uid

elin

es.

Qua

lity

will

rem

ain

as a

reg

ular

ag

end

a it

em a

t B

oar

d m

eeti

ngs.

Qua

lity

acco

unt

is d

eliv

ered

by

due

d

ate.

Per

form

ance

up

dat

es p

ublis

hed

by

the

HQ

SC

and

incl

uded

in t

he B

OP

DH

B’s

q

ualit

y ac

coun

t.

Pat

ient

E

xper

ienc

e

• T

he B

OP

DH

B w

ill p

rod

uce

a q

uart

erly

Pat

ient

Exp

erie

nce

Sur

vey

rep

ort

on

the

tren

ds

of

pat

ient

fee

db

ack

aris

ing

fro

m t

he P

atie

nt E

xper

ienc

e S

urve

ys.

Qua

rter

ly r

epo

rtin

g o

n p

atie

nt

exp

erie

nce

as s

et o

ut in

per

form

ance

m

easu

re D

V3

Imp

rovi

ng p

atie

nt

exp

erie

nce.


2B.1

.7.4

Sp

inal

Co

rd Im

pai

rmen

t A

ctio

n P

lan

2014

-20

19

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Spin

al C

ord

Im

pai

rmen

t A

ctio

n P

lan

The

BO

PD

HB

will

ens

ure

info

rmat

ion

and

act

ions

out

lined

in t

he p

lan

are

dis

sem

inat

ed t

o

clin

icia

ns v

ia it

s cl

inic

al g

over

nanc

e m

echa

nism

and

will

ens

ure

pat

hway

s ar

e d

evel

op

ed

that

exp

licit

ly o

utlin

e p

roce

ss a

nd a

lign

wit

h th

e ac

tio

n p

lan.

The

BO

PD

HB

inte

nds

to e

ngag

e w

ith

amb

ulan

ce a

nd o

ther

pro

vid

ers

to im

ple

men

t th

e S

CI p

re-h

osp

ital

d

esti

nati

on

and

ref

erra

l pat

hway

.

Rep

ort

on

pro

gre

ss m

ade

agai

nst

acti

ons

in t

he S

pin

al C

ord

Imp

airm

ent

Act

ion

Pla

n.

2B.1

.7.4

Act

ions

to

Sup

po

rt D

eliv

ery

of

Reg

iona

l Pri

ori

ties

The

BO

PD

HB

will

co

ntin

ue t

o p

arti

cip

ate

as p

art

of

the

Mid

land

DH

B R

egio

n. W

ithi

n th

e M

idla

nd R

egio

nal S

ervi

ces

Pla

n, w

e ai

m t

o a

chie

ve

heal

th a

nd w

ell-

bei

ng f

or

the

po

pul

atio

ns s

erve

d b

y th

e M

idla

nd D

HB

s. T

he f

ocu

s fo

r 20

16/1

7 is

on

colla

bo

rati

on

and

the

cha

lleng

e is

ab

out

b

ehav

iour

s, p

arti

cula

rly

how

we

will

beh

ave

in a

n en

viro

nmen

t w

here

we

exp

erie

nce

sig

nifi

cant

fina

ncia

l cha

lleng

es a

nd e

xpec

tati

ons

of

even

hig

her

per

form

ance

.

Thr

oug

hout

thi

s A

nnua

l Pla

n th

ere

are

a nu

mb

er o

f ac

tivi

ties

we

have

pla

nned

to

und

erta

ke w

hich

will

sup

po

rt d

eliv

ery

of

the

reg

iona

l p

rio

riti

es id

enti

fied

in t

he R

egio

nal S

ervi

ces

Pla

n. T

his

sect

ion

incl

udes

act

ions

fro

m t

he R

egio

nal S

ervi

ces

Pla

n th

at a

re n

ot

cove

red

el

sew

here

in t

his

Pla

n, m

ajo

r tr

aum

a, H

epat

itis

C, h

ealt

h w

ork

forc

e an

d in

form

atio

n te

chno

log

y. N

ote

tha

t th

e ex

tent

of

the

BO

PD

HB

’s

invo

lvem

ent

in t

hese

act

ions

has

no

t ye

t b

een

det

erm

ined

.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Maj

or

Trau

ma

• A

ctio

ns t

o s

upp

ort

tra

uma

in M

idla

nd c

om

mun

itie

s in

clud

e:

1.

Trau

ma

spec

ialis

t w

ork

forc

e is

op

tim

al, w

ell t

rain

ed a

nd s

usta

inab

le

-M

idla

nd h

as a

qua

lity

trau

ma

spec

ialis

ed w

ork

forc

e in

a s

upp

ort

ive,

p

rog

ress

ive

envi

ronm

ent,

wit

h th

e w

ork

forc

e m

atch

ed t

o t

he p

rio

rity

st

rate

gic

ele

men

ts, a

nd M

TS

per

sonn

el a

re s

upp

ort

ed in

car

eer

and

p

rofe

ssio

nal d

evel

op

men

t:

-O

pti

mal

FT

E a

pp

lied

to

tra

uma

po

siti

ons

wit

hin

each

Mid

land

DH

B,

wit

h ap

pro

pri

ate

reso

urce

s to

sup

po

rt t

rain

ing

and

ed

ucat

ion

(MR

TS

B

usin

ess

Cas

e -

stag

e 2

end

ors

emen

t)

-Im

ple

men

tati

on

of

an o

pti

mal

wo

rkfo

rce

pla

n fo

r M

TS

hub

gro

up

Rec

om

men

dat

ions

mad

e fo

r cl

inic

al a

nd d

ata

staff

in in

div

idua

l DH

Bs

Pro

visi

on

of

a si

ngle

pro

gre

ss r

epo

rt

on

beh

alf

of

the

reg

ion

agre

ed b

y al

l D

HB

s w

ithi

n th

at r

egio

n.

115


ANNUAL PLAN 2016/17

2B.1

.7.4

Sp

inal

Co

rd Im

pai

rmen

t A

ctio

n P

lan

2014

-20

19

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Spin

al C

ord

Im

pai

rmen

t A

ctio

n P

lan

The

BO

PD

HB

will

ens

ure

info

rmat

ion

and

act

ions

out

lined

in t

he p

lan

are

dis

sem

inat

ed t

o

clin

icia

ns v

ia it

s cl

inic

al g

over

nanc

e m

echa

nism

and

will

ens

ure

pat

hway

s ar

e d

evel

op

ed

that

exp

licit

ly o

utlin

e p

roce

ss a

nd a

lign

wit

h th

e ac

tio

n p

lan.

The

BO

PD

HB

inte

nds

to e

ngag

e w

ith

amb

ulan

ce a

nd o

ther

pro

vid

ers

to im

ple

men

t th

e S

CI p

re-h

osp

ital

d

esti

nati

on

and

ref

erra

l pat

hway

.

Rep

ort

on

pro

gre

ss m

ade

agai

nst

acti

ons

in t

he S

pin

al C

ord

Imp

airm

ent

Act

ion

Pla

n.

2B.1

.7.4

Act

ions

to

Sup

po

rt D

eliv

ery

of

Reg

iona

l Pri

ori

ties

The

BO

PD

HB

will

co

ntin

ue t

o p

arti

cip

ate

as p

art

of

the

Mid

land

DH

B R

egio

n. W

ithi

n th

e M

idla

nd R

egio

nal S

ervi

ces

Pla

n, w

e ai

m t

o a

chie

ve

heal

th a

nd w

ell-

bei

ng f

or

the

po

pul

atio

ns s

erve

d b

y th

e M

idla

nd D

HB

s. T

he f

ocu

s fo

r 20

16/1

7 is

on

colla

bo

rati

on

and

the

cha

lleng

e is

ab

out

b

ehav

iour

s, p

arti

cula

rly

how

we

will

beh

ave

in a

n en

viro

nmen

t w

here

we

exp

erie

nce

sig

nifi

cant

fina

ncia

l cha

lleng

es a

nd e

xpec

tati

ons

of

even

hig

her

per

form

ance

.

Thr

oug

hout

thi

s A

nnua

l Pla

n th

ere

are

a nu

mb

er o

f ac

tivi

ties

we

have

pla

nned

to

und

erta

ke w

hich

will

sup

po

rt d

eliv

ery

of

the

reg

iona

l p

rio

riti

es id

enti

fied

in t

he R

egio

nal S

ervi

ces

Pla

n. T

his

sect

ion

incl

udes

act

ions

fro

m t

he R

egio

nal S

ervi

ces

Pla

n th

at a

re n

ot

cove

red

el

sew

here

in t

his

Pla

n, m

ajo

r tr

aum

a, H

epat

itis

C, h

ealt

h w

ork

forc

e an

d in

form

atio

n te

chno

log

y. N

ote

tha

t th

e ex

tent

of

the

BO

PD

HB

’s

invo

lvem

ent

in t

hese

act

ions

has

no

t ye

t b

een

det

erm

ined

.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Maj

or

Trau

ma

• A

ctio

ns t

o s

upp

ort

tra

uma

in M

idla

nd c

om

mun

itie

s in

clud

e:

1.

Trau

ma

spec

ialis

t w

ork

forc

e is

op

tim

al, w

ell t

rain

ed a

nd s

usta

inab

le

-M

idla

nd h

as a

qua

lity

trau

ma

spec

ialis

ed w

ork

forc

e in

a s

upp

ort

ive,

p

rog

ress

ive

envi

ronm

ent,

wit

h th

e w

ork

forc

e m

atch

ed t

o t

he p

rio

rity

st

rate

gic

ele

men

ts, a

nd M

TS

per

sonn

el a

re s

upp

ort

ed in

car

eer

and

p

rofe

ssio

nal d

evel

op

men

t:

-O

pti

mal

FT

E a

pp

lied

to

tra

uma

po

siti

ons

wit

hin

each

Mid

land

DH

B,

wit

h ap

pro

pri

ate

reso

urce

s to

sup

po

rt t

rain

ing

and

ed

ucat

ion

(MR

TS

B

usin

ess

Cas

e -

stag

e 2

end

ors

emen

t)

-Im

ple

men

tati

on

of

an o

pti

mal

wo

rkfo

rce

pla

n fo

r M

TS

hub

gro

up

Rec

om

men

dat

ions

mad

e fo

r cl

inic

al a

nd d

ata

staff

in in

div

idua

l DH

Bs

Pro

visi

on

of

a si

ngle

pro

gre

ss r

epo

rt

on

beh

alf

of

the

reg

ion

agre

ed b

y al

l D

HB

s w

ithi

n th

at r

egio

n.

Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Maj

or

Trau

ma

2.

Mai

ntai

n cl

inic

al in

terf

ace

All

trau

ma

staff

exp

ose

d t

o c

urre

nt t

raum

a b

est

pra

ctic

e, a

nd t

raum

a st

aff c

ont

rib

utin

g t

o t

raum

a fo

rum

s at

reg

iona

l and

nat

iona

l lev

el. R

oyal

A

ustr

alas

ian

Co

lleg

e o

f S

urg

eons

Tra

uma

Ver

ifica

tio

n P

rog

ram

me

and

re

com

men

dat

ions

ad

dre

ssed

. MT

S t

o le

ad a

n an

nual

tra

uma

sym

po

sium

, wit

h al

l tra

uma

staff

att

end

ing

and

co

ntri

but

ing

to

the

sym

po

sium

:

DH

Bs

sup

po

rt a

pp

rop

riat

e ed

ucat

ion

and

tra

inin

g t

o m

aint

ain

clin

ical

ski

lls a

t ex

per

t le

vel

Pat

ient

and

fam

ily s

urve

ys t

o b

e co

nduc

ted

at

each

DH

B

Clin

ical

sta

ff m

emb

ers

are

sup

plie

d w

ith

info

rmat

ion

to im

pro

ve t

raum

a q

ualit

y, e

g, c

linic

al m

atri

ces,

gui

del

ines

, TQ

IP r

epo

rts,

etc

.

Pro

visi

on

of

a si

ngle

pro

gre

ss r

epo

rt

on

beh

alf

of

the

reg

ion

agre

ed b

y al

l D

HB

s w

ithi

n th

at r

egio

n.

3.

Dat

a m

anag

emen

t p

latf

orm

sup

po

rts

the

inte

gra

tio

n an

d o

pti

mal

use

of

trau

ma

and

rel

ated

dat

a

Co

mp

leti

on

of

the

rela

tio

nal d

atab

ase

by

Wai

kato

IS w

ith

a su

stai

nab

le

sup

po

rt p

lan

in p

lace

. Tra

uma

dat

a b

ackl

og

res

olv

ed a

s a

pri

ori

ty e

nab

ling

re

al t

ime

trac

king

and

ana

lysi

s th

at is

info

rmat

ive,

effi

cien

t an

d r

esp

ons

ive

to s

take

hold

ers.

The

Tra

uma

Qua

lity

Imp

rove

men

t P

rog

ram

me

(TQ

IP)

is f

ully

su

pp

ort

ed b

y an

acc

urat

e an

d u

p t

o d

ate

rela

tio

nal d

atab

ase.

Suc

cess

ful

inte

gra

tio

n o

f as

soci

ated

dat

abas

es in

to t

he r

elat

iona

l dat

abas

e. T

he M

idla

nd

Trau

ma

Res

earc

h C

entr

e (M

TR

C)

is f

ully

fun

ctio

ning

to

max

imis

e th

e tr

aum

a re

gis

try

and

ass

oci

ated

hig

h q

ualit

y d

ata

rese

arch

act

ivit

y:

-E

nsur

e up

-to

-dat

e in

put

ting

of

dat

a at

DH

B o

f o

rig

in

-D

evel

op

pro

cess

es t

o s

upp

ort

the

effi

cien

t an

d a

ccur

ate

colle

ctio

n an

d

entr

y o

f d

ata

and

qua

lity

chec

king

pro

cess

es a

t p

oin

t o

f co

ntac

t

-E

nsur

e a

com

mo

n la

ngua

ge

bas

ed o

n th

e M

TS

Dat

a D

icti

ona

ry.

Pro

visi

on

of

a si

ngle

pro

gre

ss r

epo

rt

on

beh

alf

of

the

reg

ion

agre

ed b

y al

l D

HB

s w

ithi

n th

at r

egio

n.


Ob

ject

ives

Act

ions

to

del

iver

imp

rove

d p

erfo

rman

ceM

easu

red

by

Hep

atit

is C

• A

ctio

ns t

o s

upp

ort

the

imp

lem

enta

tio

n o

f in

teg

rate

d h

epat

itis

C a

sses

smen

t an

d

trea

tmen

t se

rvic

es in

clud

e:

-ra

isin

g c

om

mun

ity

and

GP

aw

aren

ess

and

ed

ucat

ion

of

the

hep

atit

is C

vir

us

(HC

V)

and

the

ris

k fa

cto

rs f

or

infe

ctio

n

-p

rovi

din

g t

arg

eted

tes

ting

of

ind

ivid

uals

at

risk

fo

r H

CV

exp

osu

re

-ra

isin

g p

atie

nt a

nd G

P a

war

enes

s o

f lo

ng t

erm

co

nseq

uenc

es o

f H

CV

and

the

b

enefi

ts o

f tr

eatm

ent,

incl

udin

g li

fest

yle

man

agem

ent

and

ant

ivir

al t

hera

py

-p

rovi

din

g c

om

mun

ity

bas

ed a

cces

s to

HC

V t

esti

ng a

nd c

are

that

will

incl

ude

Fib

rosc

an s

ervi

ces

to a

ll re

gio

ns a

s a

mea

ns f

or

asse

ssm

ent

of

dis

ease

se

veri

ty a

nd a

s a

tria

ge

too

l fo

r re

ferr

al t

o s

eco

ndar

y ca

re a

nd p

rio

riti

sati

on

for

anti

vira

l the

rap

y

-es

tab

lishi

ng s

yste

ms

to r

epo

rt o

n th

e d

eliv

ery

of

Fib

rosc

ans

in p

rim

ary

and

se

cond

ary

care

set

ting

s

-p

rovi

din

g c

om

mun

ity

bas

ed o

ngo

ing

ed

ucat

ion

and

sup

po

rt (

incl

udin

g

refe

rral

to

nee

dle

exc

hang

e se

rvic

es, c

om

mun

ity

alco

hol a

nd d

rug

ser

vice

s,

GP

pri

mar

y ca

re s

ervi

ces

or

soci

al s

ervi

ce a

gen

cies

)

-p

rovi

din

g lo

ng t

erm

mo

nito

ring

(lif

e-lo

ng in

peo

ple

wit

h ci

rrho

sis

and

unt

il cu

red

in p

eop

le w

itho

ut c

irrh

osi

s)

-p

rovi

din

g g

oo

d in

form

atio

n sh

arin

g w

ith

rele

vant

hea

lth

pro

fess

iona

ls

-w

ork

ing

co

llab

ora

tive

ly w

ith

pri

mar

y an

d s

eco

ndar

y ca

re t

o im

pro

ve a

cces

s to

tre

atm

ent

Pro

visi

on

of

a si

ngle

pro

gre

ss r

epo

rt

on

beh

alf

of

the

reg

ion

agre

ed b

y al

l D

HB

s w

ithi

n th

at r

egio

n.

Wo

rkfo

rce

Ref

er s

ecti

on

5.3.

2 in

Mo

dul

e 5

ITR

efer

sec

tio

n 5.

2.1

in M

od

ule

5

117

Module Three: Statement of Performance Expectations

ANNUAL PLAN 2016/17

3.1 Statement of Performance Expectations (SPE)The BOPDHB has worked with other DHBs in the Midland region, its primary care partners as well as other key stakeholders, to develop the Statement of Performance Expectations (SPE) in which we provide measures and forecast standards of our output delivery performance. The actual results against these measures and standards are presented in the Annual Report 2015/16. The performance measures chosen are not an exhaustive list of all of our activity, but they are a good representation of the full range of outputs that we fund and / or provide. Also, they have been chosen to show the outputs that contribute to the achievement of national, regional and local outcomes (see module one and two).

Activity not mentioned in this module will continue to be planned, funded and provided to a high standard. We do report quarterly to the Ministry of Health and / or the Board on our performance related to this activity.

3.1.1 Output Classes

DHBs must provide measures and standards of output delivery performance under aggregated output classes. Outputs are goods and services that are supplied to someone outside our DHB. Output classes are an aggregation of outputs, or groups of similar outputs of a similar nature. The output classes used in our statement of forecast service performance are also reflected in our financial measures. The four output classes that have been agreed nationally are described below. They represent a continuum of care, as follows:


Act

ivit

ies

alo

ng t

he

Co

ntin

uum

of

care

Research and Evaluation

Promotion/Prevention

Detection/Screening

Diagnosis and Treatment

– Cure/Maintenance

Recovery/Rehabilitation

Supportive Care

Palliative Care

Support for Family/

Whānau

General population living healthy and

well

At risk population Focus: Keeping

healthy

Population developing early conditions Focus: Managing health

Population with long-term conditions

Focus: Preventing deterioration/complications

Population with end-stage

conditionsFocus: Support

Population Health Continuum of Care

Public Health• Social and environments (eg. Housing, transport,

water quality, communicable disease)• Lifestyle (eg. Tobacco, Alcohol, Sexual Health,

Mental Health, Injury Prevention, Nutrition)• Primary Care (eg. Access, Immunisation,

Screening)

Community ServicesPrimary HealthCareCommunity HealthNGO (Non-government)Supportive Care

Primary CareGeneral PractitionerPractice NurseNurse PractitionerAllied HealthPharmacists

Expert/Specialist CareMultidisciplinary TeamsSecondary CareTertiary CareCondition-Specific Care

Services and products delivered and provided to the population - DHB Output Classes

Output Class: Public Health Services

Output Class 2: Primary and Community Services

Output Class 3: Hospital Services

Output Class 4: Support Services

Adapted from The Bay of Plenty District Health Board’s Journey towards ‘Healthy Thriving Communities”, Conceptual Frameworks developed by the Planning & Service Development Unit, Planning and Funding Corp, April 2003 and Hawkes Bay DHB’s 2010-13 Statement of Intent

118 MODULE THREE: STATEMENT OF PERFORMANCE EXPECTATIONS

For each measure in this section we have indicated which output class the measure relates to and the appropriate dimension of performance (quality, quantity, timeliness or coverage). Some measures may cover multiple dimensions (for example quality and timeliness).

Output Class Funding Allocation

The following table outlines the funding and expenditure associated with the allocation of the output classes described above.

Prospective Summary of Revenues and Expenses by Output Class

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

Early Detection

Total Revenue 190.9 199.4 207.9

Total Expenditure 190.1 198.6 207.3

Net Surplus / (Deficit) 0.8 0.8 0.6

Rehabilitation & Support

Total Revenue 114.1 119.2 124.3



Prevention

Total Revenue 15.0 15.7 16.4



Intensive Assessment & Treatment

Total Revenue 426.2 445.1 464.1



Consolidated Surplus/(Deficit) 3.1 3.1 2.6

119


ANNUAL PLAN 2016/17

Over the next three years, we will fund and provide outputs (goods and services) which will make a positive impact on the health and wellbeing of our population. Our key outcomes are as follows:

Healthy, Thriving Communities - Kia Momoho Te Hāpori OrangaHealthy Futures - Pae Ora

Po

pul

atio

n P

rio

riti

es




Strategic D

irection M

od

ule 1

Bay of Plenty Population Accountabilities (Local Outcomes):1. All people have healthy lifestyles

with a good quality of life


3. People die in comfort in their place of choice

Bay of Plenty Population Accountabilities (Local Outcomes):1. Family/whānau live well with long-

term conditions


Bay of Plenty Population Accountabilities (Local Outcomes):1. All people live, learn, work and play

in an environment¹ that supports and sustains a healthy life

2. Our population is enabled to self- manage


Population Indicators:Fewer people smoke

Reduction in vaccine preventable diseases

Improving healthy behaviours


Fewer children and adolescents have decayed missing filled teeth

People with a terminal illness or life limiting chronic disease die in their place of choice

Population Indicators:Fewer people are admitted to hospital for avoidable conditions

Long-term conditions are detected early and managed well


Families and whānau are at the centre of their healthcare

Population Indicators:Providing healthier homes

Connecting with agencies to meet community needs


People receive prompt and appropriate acute and arranger care

Services provided or funded by the BOPDHB contribute to the transfer of knowledge and skills to family/whānau to enable self-management

Mo

dules 1, 2 and

3

Population Measures:How much did we do?# referrals of adults to the Green Prescription programme

# general practices offering patient portals

# enrolled patients² with a patient portal

# of future care plans that are shared with health professionals

Population Measures:How much did we do?# of whānau ora referrals/promotional activities undertaken

% eligible population who have their cardiovascular disease (CVD) risk assessed completed in the last 5 years

Population Measures:How much did we do?A BOP Healthy Housing Improvement Plan in place

# governance group meetings held for co-designed multi-agency initiatives

# governance group meetings attended for Healthy Families initiatives

# people supported by specialist palliative care

# registered users of CHIP client health information portal

Statement o

f Perfo

rmance E

xpectatio

ns M

od

ule 3

How well did we do?% of people received smoking cessation advice

% pregnant women who identify as smokers

% children fully immunised at eight months

% population over 65 years who have had influenza immunisation

% infants receiving any breastfeeding at six months

% children age 5 caries-free

How well did we do?Reduced ASH rates

% of population enrolled with a Primary Health Organisation

% eligible women (45-69) have breast screen examination every three years

% eligible women (20-69) have a cervical cancer screen every three years

# presentations to Emergency Department - Triage Level 4 and 5 as a percentage of the total population

How well did we do?Number of inpatient surgical discharges under elective initiative

Percentage of patients admitted, discharged or transferred from an ED within six hours

Standardised Intervention Rates meet national expectations

% improvement in access to mental health services

improved wait times for diagnostic services

% patients to receive their first cancer treatment within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks

% patients reporting better understanding of their health journey

Is anyone better off?% obese children identified in the B4SC programme will be offered a referral to a health professional

% patients receiving specialist palliative care die in their place of choice

Is anyone better off?Average age of entry into aged residential care

Hospitalisation rates per 100,000 for acute rheumatic fever

Is anyone better off?Hospitalisation rates per 100,000 for acute rheumatic fever

% of long-term condition clients reporting an improved quality of life

ResourcesWorkforce, performance management, risk management, quality improvement, information communications technology,

capital investment partnerships, collaboration, innovation

Steward

ship

Mo

dule 5

Mao

ri H

ealt

h -

Ach

eivi

ng E

qui

tyH

ealt

h o

f O

lder

Peo

ple

Chi

ld a

nd Y

out

hLo

ng-t

erm

Co

ndit

ions

¹ Environment includes social, econmic, natural and cultural attributes.² Enrolled in a Primary Health Organisation


3.2 Healthy Individuals – Mauri Ora

Healthy Individuals – Mauri Ora

All people have healthy lifestyles with a good quality of life

All children have the best start in life

People die in comfort in their place of choice

Fewer people smoke

Reduction in vaccine

preventable diseases

Improving healthy

behaviours


Fewer children and adolescents have Decayed Missing Filled

Teeth

People with a terminal illness or life limiting

chronic disease die in their place

of choice

3.2.1 Fewer People Smoke

Outputs Output Class

Measure Type Baseline Target

2016/17

National/Regional Average

Midland National

Providing smokers who access primary and secondary services with smoking cessation advice and support.

Hospitalised smokers

• Total Population

• Māori

1 qn/t

94%

92%

95%

95%

96%

97%

96%

96%

Primary care

• Total Population – see Health Target

• High needs

1 qn/t 93% 90%

90%

TBC 90%

Percentage of pregnant women who identify as smokers at the time of confirmation of pregnancy in general practice or booking with Lead Maternity Carer are offered advice and support to quit - See also Health Target and Māori Health Plan(MHP)

• Māori

• Non-Māori

• Total

1 qn/t

94%

94%

94%

90%

90%

90%

92%

95%

93%

91%

93%

92%

121


ANNUAL PLAN 2016/17

3.2.2 Reduction in vaccine preventable diseases



2016/17


Midland National

Children are fully immunised at eight months – see Health Target and MHP

• Māori

• Total

1 q/qn/t 87%

87%

95%

95%

TBC 89%

Percentage of the population (>65 years) who have had the seasonal influenza immunisation. See also the PHO Performance Programme (PPP) and MHP


• High Needs

1 qn/t

70%

68%

75%

75%

TBC TBC

3.2.3 Improving Healthy Behaviours



2016/17


Midland National

Number of schools engaged in the Health Promoting Schools programme13 1 qn/t 44 48

The number of referrals to adult GRx (Green Prescription) programmes14

• Māori

• Non-Māori

1 qn/t 905

1,280

NA

2,23315

712

2,054

Percentage of infants fully and exclusively breastfed16 at six months- See also the PHO Performance Programme (PPP) and MHP

• Māori

• Total

1 qn/t60%

66%

>60%

>60%

13 This programme supports healthy school environments, aims to improve students’ health and wellbeing and contributes to learning outcomes. See www.healthed.govt.nz.

14 This excludes people enrolled on the Active Families Programme

15 Target is the total number of people enrolled in the programme and is determined in conjunction with Toi Te Ora Public Health Unit

16 This is a quality measure because breastfeeding helps lay the foundations of a healthy life for a baby and also makes a positive contribution to the health and wider wellbeing of mothers and whānau. Key actions include health promotion activities and the baby friendly hospital initiative (BFHI) accreditation. Previous Annual Plans measured fully and exclusively breastfed at six months. This measure was changed in 2015 to include partial breast feeding as well so that the new target only excludes babies fed exclusively by artificial milk.


3.2.4 People Can Access their Health Information



2016/17National Average

The number of general practices offering patient portals. 2 qn New TBD

The number of enrolled patients17 with a patient portal. 2 qn New TBD

3.2.5 Fewer Children and Adolescents have Decayed Missing Filled Teeth



2016/17


Midland National

Percentage of children who are caries free at age five PP1118

• Māori

• Total

2 qn 26%

46%

56.5%

56.5%

38%

58%

Percentage of adolescent utilisation of DHB funded dental services - PP12 2 qn 68% 85% 70% 70%

Percentage of children (0-4 years - % year 1) enrolled in DHB funded dental service - PP13 (measure 1)

• Māori

• Non-Māori

• Total

2 qn 63%

99%

84%

95%

95%

95%

Not reported

73%

Percentage of enrolled19 pre-school and primary school children (0-12) overdue for their scheduled dental examination - PP13 (measure 2)

2 qn/t

11% 10% 9% 10%

3.2.6 People with a terminal illness or life limiting chronic disease die in their place of choice




Percentage of patients receiving specialist palliative care who die in their chosen place of death20 4 qn/ql New New

17 Enrolled in a Primary Health Organisation.

18 This information is reported annually for the school calendar year

19 The number is calculated and reported as a percentage and aligns to the Module 7 Performance Measures

20 This developmental measure will be derived from reporting within PalCare – the Patient Management System of choice for our Hospices.

123


ANNUAL PLAN 2016/17

3.3 Healthy Families – Whānau Ora

Healthy Individuals – Whānau Ora

Family/whānau live well with long term conditions

People are safe, well and healthy in their own homes and communities

Fewer people are admitted to hospital for

avoidable conditions

Long-term conditions are detected early and

managed well


Families and whānau are at the centre of their

healthcare

3.3.1 Fewer people are admitted to hospital for avoidable conditions



2016/17


Midland National

Reduced ASH rates:21

45-64 years – Total 2,3 qn 102 3,741 22 TBC 3,560

Percentage of eligible population who have had their Before School Checks23 (B4SC) completed

Total Population

High Needs

1 qn/t88%

78%

90%

90% TBC

91%

90%

Incidence number of acute rheumatic fever cases 2,3 qn 8 24 3

Hospitalisation rates per 100,000 for acute rheumatic fever – PP28 2,3 qn/t 3.2 25 1.3 4

Percentage of Rest Home residents receiving vitamin D supplement from their GP26 1, 2 qn 74% 70%

Percentage of triage level 4 and 5s presenting to the Emergency Department (ED)27 3 qn 67% <65%

21 Baseline has been calculated from the 12 months to 31 March 2016. The baseline rate is per 100,000 population. 22 The target rate is per 100,000 population for total population.

23 A nationwide programme offering free health and development checks for four year olds. It aims to identify and address any health, behavioural, social or developmental concerns which could affect a child’s ability to get the most benefit from school. Health checks include vision, hearing and oral. This service is provided by CCYHS (Community Child and Youth Health Service through the Provider Arm and Nga Mataapuna Oranga PHO.

24 Baseline has been calculated using a three year average.

25 Ibid

26 Vitamin D strengthens bones, and reduces the negative impact of falls. While we would prefer to include data for the at risk population (ie over 75 years), we can only access data for rest home residents.

27 ED services in New Zealand utilise a scale of 1-5 triage, with 1 being the most urgent. These principally determine who should be seen first. This is a quality measure because triage categories 4 and 5 may be more appropriately seen in the primary sector and poor performance in this area impacts on our capacity to provide quality services for triage 1-3.


28 Home. Education. Employment. Activities. Drugs and Alcohol. Sexuality. Suicide. Spirituality (HEEADSSS) assessments

29 Access to primary care has been shown to have positive benefits in maintaining good health, including early detection and managing long term conditions. It also reduces the economic cost of ill health and is key in reducing disparities in health.

30 The MHP indicator is calculated between the ages of 25-69 years as opposed to 20-69 years of age. The Annual Plan measure was adjusted in 2015/16 to better align to the MHP.



2016/17


Midland National

Number of presentations to Emergency Department – Triage Level 4 and 5 as a percentage of the total population 3 qn/t 22% 12% 15%

Increased numbers of Year 9 students receiving HEEADSSS28 assessment in decile 1-3 schools 1 qn/t 281 250 N/A

3.3.2 Long-term conditions are detected early and managed well



2016/17


Midland National

Percentage of population enrolled with a Primary Health Organisation (PHO)29

• Māori


2 qn93%

98%

100%

100%

94%

98%

91%

96%

Percentage of eligible population who have their cardiovascular disease (CVD) risk assessed completed in the last five years. See MHP.

• Māori

• Non-Māori

• Total

2 qn/t83%

90%

89%

90%

90%

90%

61%

74%

71%

78%

85%

80%

Percentage of eligible Maori men in the PHO aged 35-44 years who have had their cardiovascular risk assessed in the last five years.

2 qn/t New 90%

Eligible women (25-69) have a cervical cancer screen every three years. See MHP30

• Māori

• Non-Māori


1 qn/t 64%

83%

79%

80%

80%

80%

TBC 63%

78%

76%

125


ANNUAL PLAN 2016/17



2016/17


Midland National

Eligible women (50-69) have a breast screen examination every three years.31 See MHP

• Māori

• Non-Māori

• Total

1 qn/t59%

71%

69%

70%

70%

70%

TBC 65%

73%

73%

Focus area 2 - Diabetes Management (HbA1c)

Improve the proportion of patients with good or acceptable glycaemic control– PP20

2 qn/t 78% 85% TBC TBC

Focus area 5 – Stroke services

Percentage of potentially eligible stroke patients thrombolysed – PP20

3 qn/t New 6%

Focus area 5 – Stroke services

Percentage of Stroke patients admitted to a stroke unit or organised stroke service with demonstrated stroke pathway – PP20

3 qn/t 96% 80%

Focus area 5: Stroke Services

Percentage of patients admitted with acute stroke who are transferred to inpatient rehabilitation services are transferred within 7 days of acute admission.

3 Qn/t New 80%

31 Breast screening has been included as a measure to reflect the commitment indicated in the MHP. Annual Report 2014 indicator specified an eligible population of women aged 45 to 69 to align with national coverage. This measure was amended to the 50 to 69 eligible population in the Annual Plan 2015 to align with Breast Screen Aotearoa’s target.


3.3.3 People Maintain Functional Independence




Maintain current percentage of population over 65 years who have accessed aged residential care (ARC) 4 qn 5.10% 5.03%

Percentage of the population 65+ years that access Home Based Support Services (HBSS)32 4 qn 11.08% <12.15%

Increase in occupancy rate for Residential Respite Bed Days33 4 qn 73% 82%

Increased number of dementia specific day programme attendances for clients with dementia34 4 qn 3105 2692

Percentage of older people receiving long term home support who have had a comprehensive clinical assessment and a completed care plan in the last twelve months – PP1835

4 qn/t/ql 100% 100% 100%

3.3.4 Families and whānau are at the centre of their healthcare




# of whānau ora referrals/ promotional activities undertaken 2 qn New 30

32 Lifelong supports for people under 65 years with a disability are funded by the Ministry of Health.

33 Residential respite care provides carers with rest opportunities, which enables them to maintain the functional independence of the person being cared for in their own home.

34 This measure is reported quarterly by providers within Performance Monitoring Returns for Day Programme Services.

35 This is a quality measure because older people have complex needs. By providing a comprehensive clinical assessment and a completed care plan, older people will have better outcomes in terms of treatment, and will be better able to access a range of coordinated services. These assessments are based on a robust international, clinically verified assessment tool (interRAI). Target set nationally.

127


ANNUAL PLAN 2016/17

3.4 Healthy Environments – Wai Ora

Healthy Environments – Wai Ora

All people live, learn, work and play in an environment that supports and

sustains a healthy life

Our population is enabled to self-manage

All people receive timely, seamless and appropriate care

Providing healthier homes

Connecting with agencies

to meet community

needs


People receive prompt and appropriate acute and

arranged care

Services provided or funded by the BOPDHB contribute to the transfer of knowledge and skills to family/

whānau to enable self-management

3.4.1 Providing Healthier Homes




A Bay of Plenty Healthy Housing Improvement Plan in place 1 Qn New

Number of governance group meetings attended for Healthy Families initiatives 1 Qn New

3.4.2 Connecting with Agencies to Meet Community Needs




Number of governance group meetings held for co-designed multi-agency initiatives 1 Qn New


3.4.3 Appropriate Access to Services



2016/17

Number of inpatient surgical discharges under elective initiative (includes all discharges regardless of whether they are discharged from surgical or medical specialty) - Total36

3 qn 9,388 10,612

Standardised Intervention Rates as per 10,000 of population – SI4

• Coronary Angiography

• Cardiac

• Percutaneous revascularisation

• Major joint replacement

• Cataract procedures

3 qn

30.28

6.70

10.51

25.78

30.29

34.7

6.5

12.5

21.0

27.0

ESPIs (Elective Services Performance Indicators)37 –

• ESPI 1 – timely processing of referrals in 15 calendar days or less

• ESPI 2 - Percentage of patients waiting longer than four months for their first specialist assessment

• ESPI 3 – patients waiting without a commitment to treatment

• ESPI 5 – patients given a commitment to treatment but not treated within four months

• ESPI 6 – patients in active review who have not received assessment within six months

• ESPI 8 – proportion of patients treated who were prioritised using a recognised tools and processes

3 qn/t/ql

100%

0%38

0%

0%

0%

100%

100%

0%

0%

0%

0%

100%

Did-not Attend (DNA) rate for outpatient services39 See also Māori Health plan

• Māori

• Non Māori


3 qn/ql 15.4%

4.0%

6.6%

5%

5%

5%

36 The Health Target - Improved access to elective surgery - reflects a national increase of 4,000 discharges per year.

37 ESPIs are seen as quality measures for elective services because underperformance against any of these indicators has the potential to impact negatively on patient outcomes. For ESPI3 and ESPI6, the target has been set lower than the baseline because we want to reduce the number of patients who are either waiting for a commitment to treat, or who have not received an assessment within six months.

38 This is a quality measure because clinical best practice suggests that timely assessment is likely to lead to better patient outcomes. The reason why the target is lower than the baseline is because we are aiming to have all FSAs undertaken within four months.

39 This is a quality measure because by reducing our DNA rate, we free up a lot of capacity for people who require treatment. The targets are lower than the baseline, because fewer DNAs means less resources are wasted. To improve our DNA rate for Māori, the BOPDHB has created a DNA Action Group. Actions include surveying patients as to the reasons for a DNA and actions that respond to those reasons so that the BOPDHB can lower the rate for Māori.

129


ANNUAL PLAN 2016/17



2016/17

Number of clients supported by specialist palliative care40 4 qn 800 711

Percentage of people supported by specialist palliative care, other than cancer or end stage renal failure41 4 qn/ql 29% 25%

Number of community pharmacy prescriptions 2 qn/ql 3,457,589 3,408,11842

Improved wait times for diagnostic services – accepted referrals receive their scan for - PP29

• Coronary Angiography (within 90 days)

• Diagnostic Colonoscopy (within six weeks)

• Surveillance Colonoscopy (within 84 days)

• Computing Tomography (CT) (within six weeks)

• Magnetic Response Imaging (MRI) (within six weeks)

2 qn/t

90%

38%

12%

82%

78%

95%

70%

70%

95%

85%

Total number of community referred radiology Relative Value Units (RVUs)43 2 qn 73,560 73,680

Total number of community laboratory tests 2 qn 1,325,30744 1,450,000

Non-urgent community laboratory tests are completed and communicated to practitioners within the relevant category timeframes:

Category 1: Within 24 hours



2 ql/t Work in progress

95%

100%

100%

Percentage of community laboratory tests completed:

Within 48 hours for routine tests; and

Within 3 hours for urgent tests;

from receipt of the specimen at the laboratory45

2 qn/t/ql100%

99%

90%

80%

40 Once our providers have changed to a new data system, we are hoping that we can access a broader range of data, including automating reports by ethnicity etc.

41 This is a quality measure because typically, most people who receive specialist palliative care have either cancer or end stage renal failure. By identifying the proportion of people who do not have either of these two conditions, we will also be broadening the scope of our service and ensuring greater equity of access.

42 This calculation is based on the current intent of the new community pharmacy service model with zero growth in total dispensing items. It is expected to have initial items growth between 2.5% and 5% with a significant reduction in repeats dispensing. As the service model is expected to change, the actual volume will vary from the target. Note this is also a quality measure, as by managing demand / volume to this level, it demonstrates effectiveness in implementation of the new pharmacy service model.

43 An individual operative / diagnostic / assessment according to the Royal Australian and New Zealand College of Radiologists.

44 Baseline is calculated on actual delivery in the community

45 This is a quality measure because timely laboratory tests can improve the likelihood of a positive health outcome.




2016/17

Patient Experience Survey46 All qn/t/ql new 80%

Improving mental health services using transition (discharge) planning for child and youth - PP747

• Māori

• Total

3 qn/ql

N/a

66%

95%

95%

Average length of acute adult (18+ years) inpatient stay – KPI 8 (days) 48 3 qn/t 17 days 14-21 days

Rates of 7 day follow-up in the community post discharge - KPI 19 3 qn/t/ql 69% 90%

A referral of a young person (0-19 years) is seen by Alcohol and Other Drug health professional within 3 weeks of referral being received – PP8

3 qn/t 83% 80%

Percentage of people referred for non-urgent mental health or addiction services are seen within 3 weeks49

Mental Health (Provider Arm)

% people seen <3 weeks

0-19 yrs

20-64 yrs

Addictions (Provider Arm and NGO)


0-19 yrs

20-64 yrs

2 qn/t/ql

86%

75%

83%

80%

80%

80%

80%

80%

Percentage of people referred for non-urgent mental health or addiction services are seen within 8 weeks

Mental Health (Provider Arm)


0-19 yrs

20-64 yrs



0-19 yrs

20-64 yrs

2 qn/t/ql

98%

95%

96%

95%

95%

95%

95%

95%

46 This is a quality measure because the survey will measure the quality of our services from the patient’s perspective. It is aligned to the NZ Triple Aim and the HQSC QSM. Note that this work is currently being developed, so the precise scope of the survey has yet to be determined and, it is hoped, that we will be in a position to implement the survey regionally. For this reason, the scope of the survey will, in part, be determined in collaboration with our Midland colleagues.

47 This is a quality measure because relapse prevent plans are client-centred, and reflect their individual needs and contribute to a quality treatment. The same also applies for child clients.

48 The target of 14-21 days is a national target set as a result of the KPI project.

49 Annual Plan 2015 targets were set for 0-19 years only. Achievement is expected to match these levels for all age groups.

131


ANNUAL PLAN 2016/17

3.4.4 People receive prompt and appropriate acute and arranged care




Percentage of patients admitted, discharged or transferred from an ED within six hours – Health Target

3 qn/t 93% 95% 95%

Focus area 3 – Acute coronary syndrome services

> 70% of high-risk patients will receive an angiogram within 3 days of admission. (‘Day of Admission’ being ‘Day 0’)– PP20

3 qn/t 77% 70%

Focus area 3 – Acute coronary syndrome services

>95% of patients presenting with ACS who undergo coronary angiography have completion of ANZACS QI ACS and Cath/PCI registry data collection within 30 days - PP20

3 qn/t New >95%

Standardised Elective Inpatient length of stay (LOS) reduced (days)– OS3 (i) 3 qn/t 3.20 1.55

Standardised Acute Inpatient length of stay (LOS) reduced (days)– OS3 (ii) 3 qn/t TBC 2.58

Part A Faster Cancer Treatment – 62-day indicator - proportion of patients with a confirmed diagnosis of cancer who receive their first cancer treatment (or other management) within 62 days of decision-to-treat – see Health Target

3 qn/t 66% 90% 68%

Part B Faster Cancer Treatment – – 31 day indicator – proportion of patients who require radiotherapy and chemotherapy and are ready for treatment, wait less than four weeks for their first treatment. < 10 % of the records submitted by the DHB are declined - PP30

3 qn/t 76% 100%

Percentage of patients reporting better understanding of their health journey (from Patient Health Survey and Quality Account) 4 qn New TBC


3.4.5 Services provided or funded by the BOPDHB contribute to the transfer of knowledge and skills to family/whānau to enable self-management




Number of registered users of the client health information portal (CHIP) 2 Qn New

Percentage of long-term conditions clients reporting an improved quality of life50 4 Qn/ql New

50 This measure will be derived from quarterly Performance Monitoring Returns submitted by providers. A proxy measure will be “% diabetes clients who report greater self-management and an improved health status”.

133

Module Four: Financial Performance

ANNUAL PLAN 2016/17

4.1 Financial PerformanceThe BOPDHB has displayed a strong commitment to operating within its budget whilst delivering its operational commitments, the Government’s expectations and the Board’s priorities.

Living within our means

A fundamental requirement of the BOPDHB is to live within its means. This is a key commitment and the BOPDHB has a strong record of financial delivery whilst remaining focussed on good patient outcomes. The financial pressure exerted from population growth and change in population mix as well as unprecedented demand on health services has been particularly intense during 2014/15 and 2015/16. This has exerted considerable pressure on the BOPDHB to achieve its financial objectives which the DHB has been responding to.

2016/17 will bring new challenges which the DHB is in good shape to face building on that work.

The BOPDHB is committed to meeting this challenge and is submitting a surplus budget for the three year period 1 July 2016 to 30 June 2019. A significant risk to achieving this position is the demand and cost pressures from population growth, an increase in our vulnerable population and an ageing population mentioned above. The BOPDHB is responding to this by looking at different models of care to reduce hospitalisation and shift more care to community and primary care settings, working with other local and central government partners, and looking at ways to increase efficiency. Other risks and challenges to overcome are outlined through this section of the Annual Plan.

Regional and National Collaboration

An important expectation of DHBs is that we work together and collaborate both nationally and with our regional neighbours.

Regionally we continue with the implementation of the Regional Services Plan (RSP). Its outcomes are fully reflected in this plan. Many Information Technology (IT) projects are being delivered as regional projects under the guidance from the National Health IT Board (NHITB).

New Zealand Health Partnerships Limited (NZ HPL) was set up to help DHBs find ways of saving money through more efficient back office functions. NZ HPL has continued with the four Business Cases to the sector, originally devised by Health Benefits Limited and the DHB remains committed to implementation.

Detailed planning information is still under construction for these important national projects and estimates have been included for their delivery in 2016/17.


134 MODULE FOUR: FINANCIAL PERFORMANCE

4.1.1 Financial Performance Summary

The BOPDHB is committed to living within its means by delivering a surplus over the next three years.

PROSPECTIVE STATEMENT OF FINANCIAL PERFORMANCE (COMPREHENSIVE INCOME) FOR THE THREE YEARS ENDED 30 JUNE 2017, 2018 AND 2019

Consolidated Statement of Comprehensive Income

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

Revenue

Ministry of Health Revenue 663.9 686.2 714.7 746.5 778.3

Other Government Revenue 23.8 21.9 23.7 24.7 25.9

Finance Income

Other Revenue 9.7 8.3 7.8 8.2 8.5

697.4 716.4 746.2 779.4 812.7

Expenditure

Employee Costs 222.3 227.1 237.4 247.1 257.7

Outsourced Costs 30.0 29.6 27.5 29.2 32.0

Clinical Supplies 51.6 53.9 54.1 56.4 58.8

Infrastructure and Non Clinical 31.1 33.1 35.5 38.3 41.3

Payments to Non DHB Providers 330.0 335.5 352.1 367.9 383.5

Interest 7.0 6.5 6.1 6.1 6.1

Depreciation and Amortisation 19.8 20.1 21.1 22.0 21.4

Capital Charge 6.6 9.2 9.3 9.3 9.3

Total Expenditure 698.4 715.0 743.1 776.3 810.1

Share of Profit of Associates 0 0 0 0 0

Net Surplus/(Deficit) (1.0) 1.4 3.1 3.1 2.6

Other Comprehensive Income

Revaluation of Land and Building 33.7 0 0 0 0

Total Comprehensive Income/(Deficit) 32.7 1.4 3.1 3.1 2.6

135


ANNUAL PLAN 2016/17

Financial Performance by Division and Output Class

The BOPDHB operates through three divisions for the purposes of reporting on its Annual Plan to the Ministry of Health.

Funding

The BOPDHB receives, within the Funding division, a Crown appropriation for the purchase of health and disability services. This funding revenue is used to purchase services from the Non-Government Organisation (NGO) sector and the DHB itself.

Governance and Funder Administration

Governance and Funder Administration is the division that includes the Board and governance costs of the BOPDHB along with the costs of administrating the ‘Funds’ output class by the Planning and Funding division.

Provider Arm

This division includes the health and disability services directly provided by the BOPDHB in the two hospitals under its control and various community services along with the necessary support functions.

PROSPECTIVE FINANCIAL PERFORMANCE BY ANNUAL PLAN DIVISION FOR THE THREE YEARS ENDED 30 JUNE 2017, 2018 AND 2019

$m Actual 2015

Estimate 2016 2017 2018 2019

Provider Arm 3.4 8.3 7.1 7.7 8.7

Gov. & Funder Admin (0.4) (2.7) (2.4) (2.7) (2.8)

Funds (2.0) (7.0) (7.8) (8.1) (8.5)

1.0 (1.4) (3.1) (3.1) (2.6)

National prices, as calculated and advised by the Ministry of Health, have been used to generate the Production Schedule between Planning and Funding and the Provider Arm.

For the purposes of the Statement of Intent, the BOPDHB operates the following output classes:

• prevention

• early detection and management

• Intensive assessment and treatment services

• rehabilitation and support.

These output classes are defined in Module 3 of this Plan.


PROSPECTIVE FINANCIAL PERFORMANCE BY STATEMENT OF INTENT OUTPUT CLASS FOR THE THREE YEARS ENDED 30 JUNE 2017, 2018 AND 2019

Prospective Summary of Revenues and Expenses by Output Class2016/17

$MPlan

2017/18$M

Plan

2018/19$M

Plan

Early Detection

Total Revenue 190.9 199.4 207.9



Rehabilitation & Support

Total Revenue 114.1 119.2 124.3



Prevention

Total Revenue 15.0 15.7 16.4



Intensive Assessment & Treatment

Total Revenue 426.2 445.1 464.1



Consolidated Surplus/(Deficit) 3.1 3.1 2.6

137


ANNUAL PLAN 2016/17

Financial Assumptions

The BOPDHB has made a number of significant assumptions in arriving at its Prospective Financial Performance Statements as summarised in the following table.

The following further assumptions have been made by the BOPDHB:

Assumption 2017 2018 2019

Revenue increase $33.2m $33.2m $33.2m

Staff Costs (average movement) 1.500% 1.500% 1.500%

Interest Rate - Crown 4.010% 4.010% 4.010%

• The cap on Management and Administration Full Time Equivalents has been reflected in the forecasts

• Cost challenges, contract changes and exits, and service changes developed across the range of DHB funded and provided services are achieved and delivered

• Further assumptions have been made anticipating successful mitigation of the risks in the section following, and introductory remarks to this Module

Significant Financial Risks and Cost Pressures

All DHBs face pressure to meet additional expenditure which must be managed within allocated funding.

The following Financial Risks and Cost Pressures exist within the budgets outlined in this section.

Crown Revenue

The BOPDHB will continue to operate within the long term revenue provided by Government.

Risk Mitigation

Outer year forecast revenue may change as a result of government policy, new initiatives and other factors.

Estimates of future revenue have been based on information supplied from the Ministry of Health. Level of service to be provided for that funding is not specifically known in the outer year forecasts.

Increases in Government revenue fail to adequately compensate for the population growth of the Bay of Plenty and step increases in costs.

Revenue is allocated using a Population Based Funding approach and this is updated as census information becomes available. Adjustments are generally made over a 2-3 year period but are not included in the Ministry of Health’s demographic adjuster estimates until they occur. The delay in conducting the census has heightened this risk for BOPDHB as our population increase is usually at a rate higher than the New Zealand average; therefore our ability to mitigate the impact of any shortfall is limited to increasing efficiency.


Risk Mitigation

Increases in Government revenue fails to adequately compensate for the costs and service pressures and significant increase in vulnerable populations faced by the DHB Funder and Provider Arm services.

BOPDHB is experiencing significant increases in demand for all health services across the health system well in advance of what was anticipated e.g. 13% increase in ED volumes year on year, significant increases in Home and Community Support Services costs due to increasing complexity of care.

Revenue is allocated using a Population Based Funding approach and this is updated as census information becomes available. This does not necessarily keep pace with current population changes and trends.

BOPDHB is looking at different models of care to reduce hospitalisation and shift more care to community and primary care settings. We are also working with other partners such as Councils and MSD to respond to the increasing needs of vulnerable populations.

Non achievement of the expected $3.1m surplus position due to risks associated with acute demand pressure in the Provider Arm, growth in IDFs, demand and cost pressure across all aged care services and containment of the growth in pharmaceuticals.

Wherever possible, services are purchased on a capitated, risk share or fixed basis to reduce the DHB’s exposure to unexpected increases in demand driven volumes.

Unable to realise reserve funds for future years to support DHB capital investment in the medium term / or provide for organisational operational contingency / or for strategic investment to progress an integrated systems approach.

Delivery of expected efficiency gains from changes in models of care, managing acute demand across the health system and looking for new ways to respond to demand pressures i.e. responsive community based care, robust forecasting, service improvement initiatives to reduce duplication and improve efficiency across health services.

Other Revenue

Other revenue is earned from a variety of sources and is expected to continue to grow at a rate approximately equal to inflation:

Risk Mitigation

The BOPDHB has no long term undertakings for much of this revenue.

The revenue has multiple sources and the risk of significant change is minimised although it is clear that pressure on funding for other Government agencies such as ACC impacts BOPDHB.

Net Inter-District Flows (IDFs)

All DHBs have some instances where people who are resident within their district receive services in other districts.

The BOPDHB has significant outflows throughout the year to Auckland City Hospital, Auckland City Children’s Hospital and Waikato Hospital for tertiary services and some upper level secondary services. Outflows also occur to Lakes DHB for some persons resident in the Murupara/Urewera areas who may access services at Rotorua Hospital rather than travelling to Tauranga or Whakatane hospitals. A similar inflow occurs to Tauranga Hospital for people residing in the Waihi area (which is within the Waikato DHB region). The BOPDHB’s major inflow is through holiday makers over the Christmas and New Year period in particular.

The management of IDFs has been a significant cost pressure for BOPDHB in recent financial years and successfully ensuring that only appropriate IDF flows are incurred will be key to achieving the budgeted 2016/17 and following years’ financial position.

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Risk Mitigation

New or additional inter-district flows are identified by other DHBs.

There is an established national process for identification and wash-up of IDFs.

Some DHBs provide services that are not prioritised for purchase by the BOPDHB.

Where possible efforts are made to minimise outflows to other DHBs and access criteria are agreed.

Other DHBs may no longer be able to deliver IDF volumes to Bay of Plenty residents due to change in their services or population/volume growth.

There is an established national process for changes to IDFs.

Payments to Providers

Payments are made to health and disability service providers in both the Non-Government Organisation (NGO) sector and the BOPDHB’s own Provider Arm.

The BOPDHB allocates funding received through a Crown appropriation and uses a robust process to prioritise funding to ensure the greatest benefit in meeting health needs. Contracts placed are evaluated on a regular basis to ensure value for money and specified outcomes are achieved.

Expenditure on health and disability services within the district is expected to grow in line with long-term revenue growth. The BOPDHB is committed to not expending more funding than it is allocated.

Risk Mitigation

Impacts of new government initiatives such as improving outcomes for specific population groups such as child and youth, Maori, vulnerable populations or mental health services may result in new services being purchased at additional cost.

The BOPDHB would expect either to receive additional revenue to meet the additional costs associated with particular government initiatives introduced outside the DHB’s prioritisation process or will be required to substitute for existing services.

Delivery of a $3.1m surplus in the 2016/17 financial year assumes that a number of initiatives are delivered which result in service changes and, in some cases, exits. Failure to deliver these will impact on the financial result.

Close liaison with the Ministry of Health and other stakeholders through the service change process.

Many health and disability services are demand driven and unmanaged increases in volumes result in increased costs.

Wherever possible, services are purchased on a capitated, risk share or fixed basis to reduce the DHB’s exposure to unexpected increases in demand driven volumes.

Employment Costs

The largest single cost for the BOPDHB, either directly through its own Provider Arm or indirectly through the Non-Government Organisation sector, is employee costs.

The BOPDHB is expected to directly employ 2,517 full time equivalents during the year ended 30 June 2017.

Many employee groups are on regional or national Multi-Employer Collective Agreements (MECA) with the consequence that bargaining is conducted in a larger arena than just the DHB.

Risk Mitigation

Employee expectations may exceed affordable parameters.

BOPDHB works to clearly explain the funding available to it for pay increases and the cost pressure it faces.

The move to national and regional MECA have made local management of cost growth difficult.

BOPDHB works to clearly explain to all parties the funding available to the DHB for pay increases. Bargaining is carried out within the Health Sector’s ‘good faith’ process. Some agreements are on a partnership basis.


Operating Costs

The BOPDHB operating costs are broken into three classifications:

Outsourced costs Costs related to parts of the services that have been outsourced or subcontracted to third parties.

Clinical costs Costs directly related to the provision of the health and disability services provided by the BOPDHB, including pharmaceuticals and consumables.

Infrastructure Costs Costs indirectly related to the provision of health and disability services by the BOPDHB, including transport, hotel services, interest, depreciation and capital charge costs.

Each classification has different imperatives around cost growth but as an average increases are expected to remain within the long term revenue growth.

Risk Mitigation

Cost growth expectations remain high particularly for clinical supplies.

National provider and supplier contracts (including NZ Blood and Pharmac) are often negotiated on a national level.

A significant proportion of purchases are influenced, directly or indirectly, by movements in the exchange rate, the majority in relation to the United States Dollar. The current relative strength of the New Zealand dollar could deteriorate.

Purchasing is in New Zealand Dollars wherever possible.

Longer term contracts are used to help minimise short-term fluctuations in price.

For significant items, purchased in a foreign currency, foreign exchange hedging is considered and utilised where appropriate.

Fuel prices can have a significant impact on the running costs of around 250 vehicles.

BOPDHB has limited ability to control the direct impact of a fuel price increase. The DHB does encourage efficient use of vehicles including carpooling. Fuel price is negotiated through a multi-agency contract.

Interest rate increases. BOPDHB manages interest rate risk through the use of interest rate hedging and fixed interest mechanisms if appropriate.

The capital charge rate may change. No change is expected in the current year. The DHB would expect revenue to be adjusted accordingly to neutralise any change in rate.

The BOPDHB will continue to participate in national and regional purchasing actions and projects as a key mechanism to drive down costs. There remains a risk however that projects are either not delivered on time or with the expected savings, which will impact BOPDHB’s costs. A further pressure on BOPDHB is funding the changes, which is a cost on top of business as usual, until benefits are delivered.

A number of efficiency adjustors have been incorporated into cost planning for the DHB, for example, we have assumed a further improvement in patient length of stay over the last financial year. Failure to deliver on the projects, which must provide that improvement, will cause cost overruns.

Prospective Cashflows

Operating cashflows remain materially cumulatively positive throughout the forecast period.

The operating cashflow surplus along with additional borrowings, if necessary, will be utilised for capital investment.

Active cash management uses excess cash balances ahead of borrowing or equity injections to delay and reduce the level of borrowing or equity injections through a national cash pooling arrangement.

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PROSPECTIVE STATEMENT OF CASHFLOWS FOR THE THREE YEARS ENDED 30 JUNE 2017, 2018 AND 2019

$m Actual 2015

Estimate 2016 2017 2018 2019

Operating 16.5 26.7 30.0 30.5 29.4

Investing (19.3) (19.2) (19.0) (22.8) (18.1)

Financing 1.7 (6.5) (6.1) (6.1) (6.1)

Total Net Cashflow (1.1) 1.0 4.9 1.6 5.2

4.2 Prospective Statement of Financial PositionThe BOPDHB remains in a strong financial position, necessary to service the current and upcoming levels of borrowing required for redevelopments.

The Statement of Financial Position reflects the increased investment in the building infrastructure of the DHB which is partially supported by increased borrowing and operating cashflow.

PROSPECTIVE STATEMENT OF FINANCIAL POSITION AS AT 30 JUNE 2017, 2018 AND 2019

$m Actual 2015

Estimate 2016 2017 2018 2019

Current Assets 45.7 43.2 48.5 50.4 55.9

Current Liabilities 92.3 69.4 70.5 71.6 72.7

Working Capital (46.6) (26.2) (22.0) (21.2) (16.8)

Term Assets 299.2 299.7 298.6 300.9 299.1

Term Liabilities 133.5 153.0 153.0 153.0 153.0

Equity 119.1 120.5 123.6 126.7 129.3

Equity and Long-Term Debt Facilities

The BOPDHB relies on a mix of debt and equity to fund assets utilised in the delivery of health services.

Government policy requires the BOPDHB to source all long-term debt and equity from the Crown through the Ministry of Health. The Ministry of Health facilities are secured by a negative pledge.

The BOPDHB is a party to the DHB Treasury Services Agreement between Health Benefits Limited (HBL) and the participating DHBs. This agreement enables HBL to sweep DHB bank accounts and invest surplus funds on their behalf.

The DHB Treasury Services Agreement provides for individual DHBs to have a credit facility with HBL, which will incur interest at on-call interest rates received by HBL plus an administrative margin. The maximum credit facility that is available to any DHB is the value of one month’s Provider Arm funding, less net Inter-District In-Flows, plus GST.


As at 31 January 2016, the BOPDHB had the following borrowings:

Westpac $nil

Ministry Of Health $152.2 million

Project LEO (redevelopment of Tauranga Hospital) and Project WAKA (redevelopment of Whakatane Hospital) required increased levels of borrowings and equity support.

BOPDHB remains committed to minimising its reliance on additional borrowings or equity support.

Increased interest costs and capital charge costs from additional borrowings and equity support are to be affordable and must be met from within the operational budget of the BOPDHB.

PROSPECTIVE ESTIMATES OF DEBT AND EQUITY AS AT 30 JUNE 2017, 2018 AND 2019

$m Actual 2015

Estimate 2016 2017 2018 2019

Long-term Debt 132.7 152.2 152.2 152.2 152.2

Equity from the Crown 119.1 120.5 123.6 126.7 129.3

Current & Long-term debt drawn 8.5 0.0 0.0 0.0 0.0

Current & Long-term debt repaid 0.0 0.0 0.0 0.0 0.0

Net Equity injections 0.0 0.0 0.0 0.0 0.0

All debt is unsecured.

4.3 Asset ManagementThe BOPDHB maintains a long term Asset Management Plan, which delivers a strategic approach to asset maintenance, replacement and investment. The plan was refreshed in 2014/15. The plan reflects the joint approach taken by all DHBs.

The plan itself utilises the framework identified as most appropriate by a joint DHB workgroup and was based on the International Infrastructure Management Manual.

Currently the Board has allocated funding for investment in normal asset replacement and some new assets.

Project LEO, the Tauranga Campus Redevelopment Project, is outside the scope of the normal capital investment and has been funded by a combination of debt, equity and operating cashflows, including cashflows generated from efficiency and effectiveness projects as part of the process reengineering.

Project WAKA, the Whakatane Campus redevelopment was funded utilising debt and operating cashflows.

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$m Actual 2015

Estimate 2016 2017 2018 2019

Annual Depreciation 19.8 20.1 21.1 22.0 21.4

Strategic 5.4 12.2 10.3 13.7 8.6

Regular Capital Expenditure 15.7 8.3 10.0 10.5 11.0

Total Capital Expenditure 21.1 20.5 20.3 24.2 19.6

Capital Expenditure Business Cases

The BOPDHB understands that approval of this Plan is not approval of any specific capital business case. Some business cases will still be subject to a separate approval process that includes Ministry of Health, National Health Board and Treasury officials prior to a recommendation being made to the Minister of Health.

The Board also requires management to obtain final approval in accordance with delegations prior to purchase or construction commencing.

Alternate Funding

As business cases are finalised for presentation to the Board or Ministry, managers will review the most appropriate financing option currently available for the particular item. This may result in items being acquired via donation or leasing options and therefore not being purchased via the capital expenditure programme.

Strategic Capital Developments

Provision has been made in the fixed asset additions for the completion of any strategic capital projects.

Asset Disposals

The BOPDHB actively reviews assets to ensure that it has no surplus assets. No significant assets are scheduled for disposal during the plan period as a result of being surplus. Some minor asset disposals will occur as part of the regular capital replacement programme.

Disposal of Land

The approval of the Minister of Health is required prior to the BOPDHB disposing of land. The disposal process is a protective mechanism governed by various legislation and policy requirements.

Revaluations

All Land and Buildings were fully revalued during the year ended 30 June 2015, the next such review being due as at 30 June 2018.

Procedure for Buying Shares

The approval of the Ministers of Health and Finance is required prior to the BOPDHB taking a shareholding interest in any entity.


Significant Accounting Policies

The following accounting policies have been directly extracted from the BOPDHB Annual Report 2015. There have been no changes to accounting policies since that time and they therefore apply to the prospective financial statements in this Plan:

Reporting entity

Bay of Plenty District Health Board (DHB) is a District Health Board established by the New Zealand Public Health and Disability Act 2000. Bay of Plenty DHB is a crown entity in terms of the Crown Entities Act 2004, owned by the Crown and domiciled in New Zealand. Bay of Plenty DHB is a reporting entity for the purposes of the New Zealand Public Health and Disability Act 2000 (NZ PHD), the Financial Reporting Act 2013, the Public Finance Act 1989 and the Crown Entities Act 2004 (CEA).

Bay of Plenty DHB is a public sector, public benefit entity (PS PBE), as defined under External Reporting Board (XRB) Standard A1. PS PBEs are reporting entities whose primary objective is to provide goods or services for community or social benefit and where any equity has been provided with a view to supporting that primary objective rather than for a financial return to equity holders.

The financial statements of Bay of Plenty DHB for the year ended 30 June 2015 incorporate Bay of Plenty DHB and Bay of Plenty DHB’s interest in associates and joint ventures. Bay of Plenty DHB is required under the CEA to prepare consolidated financial statements in relation to the economic entity for each financial year.

Consolidated financial statements for the economic entity have not been prepared due to the small size of the controlled entities which means that the controlling entity and economic entity amounts are not materially different. The following are the Bay of Plenty DHB controlled entities which have not been consolidated in the financial statements:

Tauranga Community Health Trust (Inc.) and Whakatane Community Health Trust (Inc.) are charitable trusts which administer donations received which are tagged for specific use within the Bay of Plenty DHB. The Bay of Plenty DHB has no financial interest in either of these trusts. The trusts are controlled by the Bay of Plenty DHB in accordance with PS PBE IPSAS 6 as the Bay of Plenty DHB is able to appoint the majority of the Trustees of the Charitable Trusts. The objective for which the Charitable Trusts are established is entirely charitable.

Bay of Plenty DHB’s activities involve funding and delivering health and disability services and mental health services in a variety of ways to the community.

Statement of compliance

These financial statements, including the comparatives, have been prepared in accordance with Public Sector PBE Accounting Standards (PS PBE IPSAS) – Tier 1. These standards are based on International Public Sector Accounting Standards (IPSAS). Previously published financial statements have been prepared in accordance with New Zealand equivalents to International Financial Reporting Standards as appropriate for public benefit entities (NZ IFRS). The impact of moving from NZ IFRS to PS PBE IPSAS was not significant. This is due to a strong degree of convergence between the two suites of standards.

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Basis of preparation

The XRB issued PS PBE IPSAS that apply to the financial statements of PS PBEs for the financial years beginning on or after 1 July 2014. These financial statements have been prepared in accordance with Tier 1 PS PBE IPSAS.

The financial statements are presented in New Zealand Dollars (NZD), rounded to the nearest thousand. The financial statements are prepared on the historical cost basis except that land and buildings are stated at their fair value.

The following accounting policies have been applied consistently to all periods presented in these financial statements.

The preparation of financial statements in conformity with PS PBE IPSAS requires management to make judgements, estimates and assumptions that affect the application of policies and reported amounts of assets and liabilities, revenue and expenses. The estimates and associated assumptions are based on historical experience and various other factors that are believed to be reasonable under the circumstances, the results of which form the basis of making the judgements about carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

Judgements made by management in the application of PS PBE IPSAS that have significant effect on the financial statements and estimates with a significant risk of material adjustment in the next year are discussed in note 21.

Financial instruments

Non-derivative financial instruments

Non-derivative financial instruments comprise available for sale financial assets, instruments at fair value through the surplus or deficit, trade and other receivables, cash and cash equivalents, loans, other financial liabilities, and trade and other payables.

Non-derivative financial instruments are recognised initially at fair value plus, for instruments not at fair value through the surplus or deficit, any directly attributable transaction costs. Subsequent to initial recognition non-derivative financial instruments are measured as described below.

A financial instrument is recognised if the Bay of Plenty DHB becomes a party to the contractual provisions of the instrument. Financial assets are derecognised if the Bay of Plenty DHB’s contractual rights to the cash flows from the financial assets expire, or if the Bay of Plenty DHB transfers the financial asset to another party without retaining control or substantially all risks and rewards of the asset. Regular purchases and sales of financial assets are accounted for at trade date, i.e., the date that the Bay of Plenty DHB commits itself to purchase or sell the asset. Financial liabilities are derecognised if the Bay of Plenty DHB’s obligations specified in the contract expire or are discharged or cancelled.


Cash and cash equivalents

Cash and cash equivalents comprise cash balances and call deposits with maturity of no more than three months from the date of acquisition. Bank overdrafts that are repayable on demand and form an integral part of the Bay of Plenty DHB’s cash management are included as a component of cash and cash equivalents for the purpose of the statement of cash flows.

Trade and other receivables

Trade and other receivables are initially recognised at historical cost and subsequently assessed for an allowance for doubtful debts (if any). The carrying value of trade and other receivables that are of a short term duration is a reasonable approximation of their fair values. Bad debts are written off during the period in which they are identified.

Trade and other payables

Trade and other payables are stated at historical cost.

Property, plant and equipment Classes of property, plant and equipment

The major classes of property, plant and equipment are as follows:

• freehold land

• freehold buildings

• plant and equipment

• leasehold improvements

• work in progress

Land and buildings are re-valued to fair value as determined by an independent registered valuer, with sufficient regularity to ensure the carrying amount is not materially different to fair value, and at least every three years. Any increase in value of a class of land and buildings is recognised directly to the property revaluation reserve unless it offsets a previous decrease in value recognised in the Surplus or deficit. Any decreases in value relating to a class of land and buildings are taken directly to the property revaluation reserve, to the extent that they reverse previous surpluses and are otherwise recognised as an expense in the surplus or deficit. Additions to property, plant and equipment between valuations are recorded at cost.

Where material parts of an item of property, plant and equipment have different useful lives, they are accounted for as separate components of property, plant and equipment.

Property, Plant and Equipment Vested from the Hospital and Health Service

Under section 95(3) of the NZ PHD, the assets of Pacific Health Limited (a hospital and health service company) vested in Bay of Plenty DHB on 1 January 2001. Accordingly, assets were transferred to Bay of Plenty DHB at their net book values as recorded in the books of the hospital and health service. In effecting this transfer, the Health Board has recognised the cost and accumulated depreciation amounts from the records of the hospital and health service. The vested assets will continue to be depreciated over their remaining useful lives.

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Disposal of Property, Plant and Equipment

Where an item of property, plant and equipment is disposed of, the gain or loss recognised in the surplus or deficit is calculated as the difference between the net sales price and the carrying amount of the asset.

On the sale or retirement of a re-valued property, the attributed revaluation surplus remaining in the property revaluation reserve is transferred directly to retained earnings. No transfer is made from the revaluation reserve to retained earnings except when an asset is derecognised.

Subsequent costs

Subsequent costs are added to the carrying amount of an item of property, plant and equipment when that cost is incurred if it is probable that the service potential or future economic benefits embodied within the new item will flow to Bay of Plenty DHB. All other costs are recognised in the surplus or deficit as an expense as incurred.

Depreciation

Depreciation is charged to the surplus or deficit using the straight line method. Land is not depreciated.

Depreciation is set at rates that will write off the cost or fair value of the assets, less their estimated residual values, over their useful lives. The estimated useful lives of major classes of assets and resulting rates are as follows:

Class of asset Estimated life Depreciation rate

Buildings 15 to 50 years 2 - 6.67%

Plant and equipment 5 to 10 years 10 - 20.0%

Vehicles 5 to 10 years 10 - 20.0%

Fixture and fittings 3 to 25 years 4 - 33.0%

The residual value and useful lives of assets is reassessed annually.

Freehold land and work in progress are not depreciated.

The total cost of a project is transferred to the appropriate class of asset on its completion and then depreciated.

Intangible assets

Intangibles

Intangible assets that are acquired by Bay of Plenty DHB are stated at cost less accumulated amortisation and impairment losses.

NZ Health Partnerships Limited (NZHPL) Finance Procurement Supply Chain rights (FPSC) is an intangible asset recognised at the cost of capital invested by the Bay of Plenty DHB in the FPSC programme being a national initiative undertaken by NZHPL to deliver sector wide benefits. This represents the DHB’s right to access, under a service level agreement, shared FPSC services


provided using assets funded by DHB’s. NZHPL are the lead agency for this work, following a transition from Health Benefits Limited (HBL) on 15 June 2015.

The rights are considered to have an indefinite life as DHB’s have the ability and intention to review the service level agreement indefinitely and the fund established by HBL through the on-charging of depreciation on the FPSC assets to the DHB’s will be used to, and is sufficient to, maintain the FPSC assets standard of performance or service potential indefinitely.

As the FPSC rights are considered to have an indefinite life, the intangible asset is not amortised and will be tested for impairment annually.

Subsequent expenditure on intangible assets is capitalised only when it increases the service potential or future economic benefits embodied in the specific asset to which it relates.

Amortisation

Amortisation is charged to the surplus or deficit on a straight-line basis over the estimated useful lives of intangible assets unless such lives are indefinite. Intangible assets with an indefinite useful life are tested for impairment at each statement of financial position date. Intangible assets with a definite useful life are amortised from the date they are available for use. The estimated useful lives are as follows:

Type of asset Estimated life Amortisation rate

Software 2 to 3 years 33 - 50%

Inventories

Inventories are stated at the lower of cost and net realisable value. Net realisable value is the estimated selling price in the ordinary course of business, less the estimated costs of completion and selling expenses. Cost is based on weighted average cost.

Impairment

The carrying amounts of Bay of Plenty DHB’s assets are reviewed at each balance date to determine whether there is any indication of impairment. If any such indication exists, the assets’ recoverable amounts are estimated.

If the estimated recoverable amount of an asset is less than its carrying amount, the asset is written down to its estimated recoverable amount and an impairment loss is recognised in the surplus or deficit.

For intangible assets that have an indefinite useful life and intangible assets that are not yet available for use, the recoverable amount is estimated at each statement of financial position date and was estimated at the date of transition.

An impairment loss on property, plant and equipment re-valued on a class of asset basis is recognised directly against any revaluation reserve in respect of the same class of asset to the extent that the impairment loss does not exceed the amount in the revaluation reserve for the same class of asset.

Impairment losses on an individual basis are determined by an evaluation of the exposures on an instrument by instrument basis. All individual trade receivables that are considered significant are subject to this approach. For trade receivables which are not significant on an individual basis, collective impairment is assessed on a portfolio basis based on number of days overdue,

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and taking into account the historical loss experience in portfolios with a similar amount of days overdue.

Calculation of recoverable amount

Estimated recoverable amount of other assets is the greater of their fair value less costs to sell and value in use. Value in use is calculated differently depending on whether an asset generates cash or not. For an asset that does not generate largely independent cash inflows, the recoverable amount is determined for the cash-generating unit to which the asset belongs.

For non-cash generating assets that are not part of a cash generating unit, value in use is based on depreciated replacement cost (DRC). For cash generating assets value in use is determined by estimating future cash flows from the use and ultimate disposal of the asset and discounting these to their present value using a pre-tax discount rate that reflects current market rates and the risks specific to the asset.

Impairment gains and losses, for items of property, plant and equipment that are re-valued on a class of assets basis, are also recognised on a class basis.

Reversals of impairment

Impairment losses are reversed when there is a change in the estimates used to determine the recoverable amount.

An impairment loss is reversed through the surplus or deficit, unless the relevant asset is carried at a re-valued amount, in which case the reversal of the impairment loss is reversed through the relevant reserve.

All other impairment losses are reversed through the surplus or deficit.

An impairment loss is reversed only to the extent that the asset’s carrying amount does not exceed the carrying amount that would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised.

Interest-bearing borrowings

Interest-bearing loans and borrowings are classified as other non-derivative financial instruments.

Interest-bearing borrowings are recognised initially at fair value less attributed transaction costs. Subsequent to initial recognition, interest-bearing borrowings are stated at amortised cost with any difference between cost and redemption value being recognised in the surplus or deficit over the period of the borrowings on an effective interest basis.

Employee Benefits

Defined contribution schemes

Employer contributions to KiwiSaver, the Government Superannuation Fund, and the State Sector Retirement Savings Scheme are accounted for as defined contribution plans and are recognised as an expense in the surplus or deficit during the period as they arise.

The Bay of Plenty DHB has no legal or constructive obligation to pay future benefits, the Crown guarantees these benefits, and as a result the plans are accounted for as a defined contribution plan.


Long service leave, sabbatical leave and retirement gratuities

Bay of Plenty DHB’s net obligation in respect of long service leave, sabbatical leave and retirement gratuities is the amount of future benefit that employees have earned in return for their service in the current and prior periods. The obligation is calculated using the projected unit credit method and is discounted to its present value. The discount rate is the market yield on relevant New Zealand government bonds at the statement of financial position date.

Annual leave, sick leave and medical education leave

Annual leave, sick leave and medical education leave are short-term obligations and are calculated on an actual basis at the amount Bay of Plenty DHB expects to pay. Bay of Plenty DHB accrues the obligation for paid absences when the obligation both relates to employees’ past services and it accumulates.

Other Liabilities

Provisions

A provision is recognised when Bay of Plenty DHB has a present legal or constructive obligation as a result of a past event, and it is probable that an outflow of economic benefits will be required to settle the obligation. If the effect is material, provisions are determined by discounting the expected future cash flows at a pre-tax rate that reflects current market rates and, where appropriate, the risks specific to the liability.

Onerous contracts

A provision for onerous contracts is recognised when the expected benefits to be derived by Bay of Plenty DHB from a contract are lower than the unavoidable cost of meeting its obligations under the contract.

Income tax

Bay of Plenty DHB is a crown entity under the NZ PHD and is exempt from income tax under section CW38 of the Income Tax Act 2007.

Goods and services tax

All amounts are shown exclusive of Goods and Services Tax (GST), except for receivables and payables that are stated inclusive of GST. Where GST is irrecoverable as an input tax, it is recognised as part of the related asset or expense.

Revenue

Crown funding

The majority of revenue is provided through an appropriation in association with a Crown Funding Agreement. Revenue is recognised monthly in accordance with the Crown Funding Agreement payment schedule, which allocates the appropriation equally throughout the year.

ACC Contracted revenue

ACC contract revenue is recognised when eligible services are provided and any contract conditions have been fulfilled.

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Goods sold and services rendered

Revenue from goods sold is recognised when Bay of Plenty DHB has transferred to the buyer the significant risks and rewards of ownership of the goods and Bay of Plenty DHB does not retain either continuing managerial involvement to the degree usually associated with ownership nor effective control over the goods sold.

Revenue from services is recognised, to the proportion that a transaction is complete, when it is probable that the payment associated with the transaction will flow to Bay of Plenty DHB and that payment can be measured or estimated reliably, and to the extent that any obligations and all conditions have been satisfied by Bay of Plenty DHB.

Revenue relating to service contracts

Bay of Plenty DHB receives revenue for service contracts on an invoice or payment schedule basis. Bay of Plenty DHB is required to expend all monies appropriated within certain contracts during the year in which it is appropriated. Should this not be done, the contract may require repayment of the money or Bay of Plenty DHB, with the agreement of the Ministry of Health, may be required to expend it on specific services in subsequent years. The amount unexpended is recognised as a liability.

Financing Revenue

Interest received and receivable on funds invested are calculated using the effective interest rate method and are recognised in the surplus or deficit.

Inter-District Flow Revenue

Inter-District Flow revenue is received for activity undertaken by Bay of Plenty DHB for patients domiciled in other DHB regions. Receipts are based on an agreed level of production and are subject to wash-up rules if actual volumes are different to agreed volumes.

Expenses

Operating lease payments

Payments made under operating leases are recognised in the surplus or deficit a straight-line basis over the term of the lease. Lease incentives received are recognised in the surplus or deficit over the lease term as an integral part of the total lease expense.

Financing costs

Financing costs comprise interest paid and payable on borrowings calculated using the effective interest rate method, are recognised in the surplus or deficit.

The interest expense component of finance lease payments is recognised in the surplus or deficit using the effective interest rate method.

Standards, Amendments and Interpretations Effective in the Current Period

All mandatory Standards, Amendments and Interpretations have been adopted in the current year. None had a material impact on these financial statements, although minor disclosure changes are made to accommodate for PS PBE requirements. This has resulted in further componentisation of receivables and payables in the Statement of Financial Position and revenue in the notes to financial statements for the exchange and non-exchange portions of each reported item.


New Standards Adopted

The External Reporting Board (XRB) has established a new Accounting Standards Framework based on a multi-sector, reporting tiers approach. The new accounting standards framework consists of two sets of accounting standards, one to be applied by entities with a for-profit objective and the other to be applied by public benefit entities (PBE’s). The Public Sector PBE standards (PS PBE IPSAS) are based largely on International Public Sector Accounting Standards (IPSAS), and apply from 1 July 2014. BOPDHB have adopted all PS PBE IPSAS and interpretations issued to date for the 30 June 2015 financial statements.

Comparatives

When presentation or classification of items in the financial statements is amended or accounting policies are changed voluntarily, comparative figures have been restated to ensure consistency with the current period unless it is impracticable to do so.

Statement of Performance Expectations by Output Class

The statement of performance expectations by output class, as reported in the statement of performance expectations, report the net cost of services for the outputs of Bay of Plenty DHB and are represented by the cost of providing the output less all the revenue that can be allocated to these activities.

Cost Allocation and Policy

Bay of Plenty DHB has arrived at the net cost of service for each significant activity using the cost allocation system outlined below.

Direct costs are charged directly to output classes. Direct costs are those costs directly attributable to an output class. Indirect costs are charged to output classes based on cost drivers and related activity and usage information. Indirect costs are those costs that cannot be identified in an economically feasible manner with a specific output class. The cost of internal services not directly charged to outputs is allocated as overheads using appropriate cost drivers such as actual usage, staff numbers and floor area.”

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4.4 Prospective Detailed Financial Statements

Consolidated Statement of Prospective Financial Performance

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

Revenue 697.4 716.4 746.2 779.4 812.7

Less operating expenditure

DHB Provider expenditure 328.5 337.1 347.7 364.0 382.5

External provider expenditure 330.0 335.5 352.1 367.9 383.5

Governance & Funding Administration 6.5 6.6 6.8 7.0 7.3

Taxation (may apply to subsidiaries and associates)

- - - - -

Total Operating Expenditure 665.0 679.2 706.6 738.9 773.3

Surplus/(Deficit) before Interest, Depreciation and Capital Charge

32.4 37.2 39.6 40.5 39.4

Interest 7.0 6.5 6.1 6.1 6.1

Depreciation 19.8 20.1 21.1 22.0 21.4

Capital Charge 6.6 9.2 9.3 9.3 9.3

NET SURPLUS/(DEFICIT) (1.0) 1.4 3.1 3.1 2.6


Consolidated Statement of Prospective Financial Position

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

CROWN EQUITY 119.1 120.5 123.6 126.7 129.3

CURRENT ASSETS:

Bank balances, deposits and cash 20.0 21.0 25.9 27.5 32.7

Receivables 22.0 19.0 19.4 19.7 20.0

Properties intended for sale

Inventory 3.7 3.2 3.2 3.2 3.2

45.7 43.2 48.5 50.4 55.9

CURRENT LIABILITIES:

Payables and Accruals 92.3 69.4 70.5 71.6 72.7

Net Working Capital (46.6) (26.2) (22.0) (21.2) (16.8)

NON CURRENT ASSETS:

Fixed Assets 299.2 299.7 298.6 300.9 299.1

Investments

299.2 299.7 298.6 300.9 299.1

NON CURRENT LIABILITIES:

Borrowings & Provisions 133.5 153.0 153.0 153.0 153.0

NET ASSETS 119.1 120.5 123.6 126.7 129.3

Consolidated Statement of Prospective Movements in Equity

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

Crown equity at start of period 86.4 119.1 120.5 123.6 126.7

Surplus/(Deficit) for the period (1.0) 1.4 3.1 3.1 2.6

Contributions from Crown 0.0 0.0 0.0 0.0 0.0

Distributions to Crown -

Revaluation adjustments 33.7 0.0 0.0 0.0 0.0

Crown equity at end of period 119.1 120.5 123.6 126.7 129.3

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Consolidated Statement of Prospective Cash Flows

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

OPERATING CASHFLOWS

Cash inflows from operating activities 687.3 718.5 744.6 777.7 810.9

Cash outflows for operating activities 670.8 691.8 714.6 747.2 781.5

16.5 26.7 30.0 30.5 29.4

INVESTING CASHFLOWS

Cash inflows from investing activities 2.2 1.3 1.3 1.4 1.5

Cash outflows for investing activities 21.5 20.5 20.3 24.2 19.6

(19.3) (19.2) (19.0) (22.8) (18.1)

FINANCING CASHFLOWS

Cash inflows from financing activities 8.5 0.0 0.0 0.0 0.0

Cash outflows for financing activities 6.8 6.5 6.1 6.1 6.1

1.7 (6.5) (6.1) (6.1) (6.1)

Net increase/(decrease) in cash held (1.1) 1.0 4.9 1.6 5.2

Add opening cash balance 21.1 20.0 21.0 25.9 27.5

CLOSING CASH BALANCE 20.0 21.0 25.9 27.5 32.7

Made up from:

Balance Sheet Bank and Cash 20.0 21.0 25.9 27.5 32.7

Consolidated Statement of Prospective Commitments and Contingent Liabilities

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

COMMITMENTS

Capital commitments 1.9 1.9 1.5 1.5 1.5

Operating lease commitments 2.6 2.6 2.5 2.5 2.5

Other operating 60.7 61.0 61.0 61.0 61.0

TOTAL COMMITMENTS 65.2 65.5 65.0 65.0 65.0

CONTINGENT LIABILITIES - - - - -


DHB Provider Statement of Prospective Financial Performance

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

REVENUE

Government Revenue 348.1 355.8 368.6 384.9 401.4

Other Revenue 9.7 8.0 7.8 8.2 8.5

357.8 363.8 376.4 393.1 409.9

EXPENSES

Personnel Costs 217.1 221.9 231.9 241.6 251.9

Outsourced Services 29.6 29.1 27.1 28.8 31.5



361.2 372.1 383.5 400.8 418.6

SURPLUS/(DEFICIT) (3.4) (8.3) (7.1) (7.7) (8.7)

DHB Governance Statement of Prospective Financial Performance

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

REVENUE


Other Revenue

7.6 10.0 9.9 10.4 10.8

EXPENSES

Personnel Costs 5.2 5.3 5.4 5.5 5.8

Outsourced Services 0.3 0.5 0.4 0.5 0.5



7.2 7.3 7.5 7.7 8.0

SURPLUS/(DEFICIT) 0.4 2.7 2.4 2.7 2.8

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DHB Funds Statement of Prospective Financial Performance

2014/15$M

Actual

2015/16$M

Forecast

2016/17$M

Plan

2017/18$M

Plan

2018/19$M

Plan

REVENUE


EXPENSES

Personal Health 483.5 492.9 519.7 542.8 565.9

Mental Health 60.1 62.6 63.0 65.8 68.6

Disability Support Services 101.7 102.3 105.6 110.3 115.0

Public Health 2.1 2.7 2.5 2.6 2.8

Maori Health 4.6 4.3 5.1 5.3 5.5

Governance & Administration 7.5 9.8 9.9 10.4 10.8

659.5 674.6 705.8 737.2 768.6

SURPLUS/(DEFICIT) 2.0 7.0 7.8 8.1 8.5

158 MODULE FIVE: STEWARDSHIP

Module Five: StewardshipTo deliver on the functions required as a DHB, the BOPDHB has a broad set of responsibilities and interacts with a diverse range of individuals and groups. To be as effective as possible, the BOPDHB must have capable leadership, an engaged workforce, a healthy organisational culture, sound relationships, robust and rigorous systems and the right infrastructure and assets. This module describes the resources necessary to provide the services of the BOPDHB.

5.1 Managing our BusinessThe BOPDHB operates in a changing environment. The levels of success achieved over the next few years will depend on our ability to adapt to this changing environment as we continue to improve the health of the BOPDHB population and reduce or eliminate health inequalities.

5.1.1 Our People

The central part of our capability is our people. Our ability to provide health and disability services now and into the future depends on having a workforce that is well matched to the health needs of the community and appropriately skilled and located.

As at 30 June 2015, our 3,201 strong full and part time workforce was made up of 80.6% female, with an average age of 47. 10% of the BOPDHB workforce identify as Māori.

For further statistics about the DHB workforce please refer to the BOPDHB Annual Report 2015 at http://www.bopdhb.govt.nz/media-publications/a-z-publications.

5.1.2 Organisational Performance Management

The BOPDHB’s performance is assessed on both non-financial and financial measures. The table in section 5.4.3 of this module provides an overview of the external reporting we produce which incorporates a significant amount of performance reporting. Our planned performance as a planner, funder and provider of health services is outlined in this plan and our service plans.

5.1.2.1 Non-financial Performance Reporting

Non-financial performance relates to volume and performance expectations for health service provision by Tauranga and Whakatane Hospitals, PHOs and the NGOs funded by the BOPDHB. This performance is monitored regularly.

As a funder, the BOPDHB monitors its agreements with providers through regular performance reports and data analysis. It also monitors the quality of services provided through reporting of adverse incidents, routine audits, service reviews and issue-based audits.

The BOPDHB reports quarterly to the Minister of Health on the indicators in the DHB Non-Financial Monitoring Framework and regularly feeds into benchmarking and quality programmes to compare our performance with other providers.

We report to our Board on performance against the Annual Plan at six-monthly and 12-monthly intervals. These reports are part of the Board meeting agenda and are made available to the public on the DHB website.

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5.1.2.2 Financial Performance Reporting

As part of the annual planning process, the BOPDHB submits a set of financial templates to the Ministry of Health. These templates inform the tables and narrative presented in Module 4. We report on our financial performance monthly to our Board and the Ministry of Health. This report includes commentary and financials as well as actions planned to improve financial performance.

As part of our financial reporting we include full time equivalent (FTE) reporting. This covers areas like:

• Accrued FTE

• Management/Administration FTE Cap

• Clinical FTE

• Out-sourced Services FTE.

The BOPDHB uses financial performance information to identify issues and inform decision-making to improve performance.

5.1.3 Funding and Financial Management

We have an objective of strong financial performance and plan to manage and balance our financial position and to minimise cyclical deficits. The following table sets out our key financial indicators:

2014/15$M

ACTUAL

2015/16 $m

PLANNED

2016/17 $m

PLANNED

2017/18 $m

PLANNED

2018/19 $m

PLANNED

Revenue (after adjustments) 697.4 716.4 746.2 779.4 812.7

Net Surplus/(Deficit) (1.0) 1.4 3.1 3.1 2.6

Total Fixed Assets 299.2 299.7 298.6 300.9 299.1

Net Assets 119.1 120.5 123.6 126.7 129.3

Term Borrowings and Provisions

133.5 153.0 153.0 153.0 153.0


5.1.4 National Health Sector Entities

The BOPDHB is expected to align its planning with the planning intentions of key national agencies. These national agencies have initiatives that will impact on our DHB. The national agencies are:

1. Health Shared Services

2. National Health Information Technology Board (NHITB)

3. Health Quality and Safety Commission

4. PHARMAC

5. Health Workforce New Zealand

6. New Zealand Health Partnerships Limited (and their suppliers).

Further information and actions that the BOPDHB are supporting in relation to these agencies are set out in section 2B.1.7.1 and Module 5.

5.1.5 Risk Management

The BOPDHB risk management process identifies and manages risk to ensure quality care is provided for patients, a safe environment is maintained and resources are available to achieve organisational objectives.

In 2016 we will implement Datix which is an electronic Integrated Quality and Risk Management system used across the five Midland DHBs. The risk module is used to identify, report and monitor risks. The system is accessible to employees at all times for ease of reporting and assists with creating risk reports and the BOPDHB Risk Register for the organisation.

Risk reports are generated monthly for the Performance and Environment Committee and the Audit, Finance and Risk Committee (AFRM), a sub-committee of the Board responsible for reviewing risks to the organisation. A full summary of graded organisational risks are viewed by the Board quarterly.

Sector Services also provide a range of routine and special audits on behalf of the BOPDHB with response to primary care services and Fee for Service Agreements (including pharmacy, dental, home based support services and aged care).

The risk management system is internally audited annually to ensure compliance with the Standard ISO AS/NZS 31000:2009 Risk Management Principles and Guidelines.

The types of risk the BOPDHB manages are:

• Strategic risks relating to the governance, funding and strategic direction of the DHB. These risks can be affected by external influences such as budget changes from the Ministry of Health.

• Operational risks relating to the functions within the DHB and can include Property Management, Information Management, Business Continuity Planning and Project and Change Management.

• Clinical risks relating to the delivery of patient care.

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5.1.6 Performance and Management of Assets

The BOPDHB’s asset management plan financials show the full picture of the capital intentions planned in response to identified service needs and planned configuration of services. The BOPDHB has a robust asset management plan and process in place to ensure timely and appropriate management of:

• Regular capital expenditure – the replacement of clinical and non-clinical equipment, information technology, and existing building services; and

• Strategic capital expenditure - other large-scale building, information technology and clinical development plans.

In addition, the asset management plan process includes an ongoing review of the affordability to the BOPDHB of the capital developments set out in the plan. Over the next three years the proposed capital expenditure and funding is summarised as follows:

2015/16Actual($M)

2016/17Plan($M)

2017/18Plan($M)

Capital Expenditure:

Regular Capital Expenditure 8.3 10.0 10.5

Strategic Capital Expenditure 12.2 10.3 13.7

Total Capital Expenditure 20.5 20.3 24.2

Funded by:

Internal (depreciation and free cashflow) 20.5 20.3 24.2

External (MoH Loans)

Total Financing 20.5 20.3 24.2

5.1.7 Quality Assurance and Improvement

The BOPDHB has a number of different initiatives for ensuring it provides quality outcomes and services. These initiatives are briefly described below.

Health Excellence

The BOPDHB sets strategic priorities by determining what matters to people, family, whānau and our healthcare workforce and leading by example to build and improve a connected healthcare system. The internationally recognised Health Care Criteria for Performance Excellence underpins everything we do and shows our commitment to Health Excellence as we work towards achieving the intentions of the New Zealand Triple Aim for quality improvement and the IHS. Quality assurance is monitored against compliance with the Health and Disability Sector Standards NZS 8134:2008 through the MoH certification process. This includes the code of rights and the Privacy Act.

Quality and Safety Markers (QSMs)

The BOPDHB aligns its patient safety programme with the Health Quality and Safety Commission’s (HQSC) work programmes. In doing this we work collaboratively with the other Midland DHBs to share resources and ideas to improve and meet the targets for QSMs. We report on this regularly to the Ministry of Health.


Quality Account

The BOPDHB Quality Account tells the story of our commitment to continuous evidence based quality improvement. It is prepared annually for our stakeholders and community using guidelines issued by the Health Quality Safety Commission (HQSC) and community feedback.

Patient Experience

The voice of the customer is important to us for ongoing service improvement. We send out a national patient experience survey fortnightly which provides valuable feedback at a ward level. This data is analysed and reported to the Board and the Ministry with recommendations for areas needing improvement.

5.2 Building CapabilityThe BOPDHB will continue to work towards supporting and building the capability of the Bay of Plenty health system as outlined in the IHS. Many of the initiatives are being progressed through collaboration and co-operative developments between the BOPDHB, the community, and include patients, family and whānau. The BOPDHB is working towards becoming a boundary-less organisation as we look to other sectors to help address complex problems involving the social determinants of health, and improving the capability of family/whānau, through health literacy, to self-manage their health and well-being.

The BOPDHB works through its established formal alliances, including the Bay of Plenty Alliance Leadership Team and the Child and Youth Strategic Alliance to progress its work programme.

5.2.1 Information Communications Technology

The BOPDHB’s goal of supportive ICT capabilities to advance integrated healthcare aligns with the national and regional strategic directions as outlined in the Ministry of Health’s National Health IT Programme (NIP) and the Midland Region Information Services Plan (MRISP).

Delivery on the national and regional priorities requires BOPDHB to transition from the existing “owner / operator” model of localised ICT delivery to one of consuming nationally and regionally delivered ICT services supported by local capability.

The BOPDHB will use the national ICT service delivery solutions available via NZ Health Partnerships Limited workstreams and the Department of Internal Affairs All of Government initiatives (aimed at improving performance of, and public confidence in, Government services) as set out in the table below.

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National Priority Initiatives BOPDHB’s 2016/17 Intentions

Clinical Workstation Being addressed via Regional Clinical Workstation initiative - Refer comments below.

Clinical Data Repository Being addressed via Regional Clinical Workstation initiative - Refer comments below.

Self-Care Portal BOPDHB to continue working with PHO and GP practices to expand adoption and implementation of patient portals in 2016/17.

eMedicines Reconciliation Being addressed via the Regional Medications Management Programme the first stage of which is the CSC ePharmacy system – refer comments below. Subsequent phases of regional Medication Management Programme are yet to be planned.

Maternity Information System Platform (MISP) Establishment of project to implement the MISP is currently on hold due to system issues. Once the issues are resolved with the national system BOP expects to commence implementation in 2016/17. The DHB expects to get approval of its business case in early 2016/17 for implementation of the system later in the year with the aim of being live on the national system by June 2017.

National NewBorn Hearing System (NHIMS) Establishment of project to implement the NHIMS. Linked to the MISP this project is on hold while the system issues noted above are being addressed.

Finance Procurement & Supply Chain (FPSC) The DHB will commit resources to the implementation of Health Partners FPSC initiative, and fully factor in expected budget benefit impacts. Updated financial information is awaited.

National Infrastructure Programme BOPDHB is one of the early adopter DHBs and will continue to work with NZ Health Partners to transition to national infrastructure in 2016/17.

All of Government (AoG) Procurement Opportunities BOPDHB will continue to use AoG procurement solutions as appropriate.

The Midland Region’s ICT strategies and initiatives, as set out in the Midland Region Information Services Plan (MRISP), aim to:

• Provide integrated/shared information to enhance health care planning and improve population health outcomes

• Mitigate the fiscal, technical and business risks within ICT areas

• Provide technical and information support for non-ICT shared service and cross provider initiatives.

The MRISP outlines a number of work streams aimed at advancing regional and national capability and ICT service consolidation. The BOPDHB is committed to participating in these initiatives as it transitions from localised to regional solution delivery, as set out in the table below.


Regional Initiatives BOPDHB’s 2016/17 Intentions

Regional Medications Management Programme As noted above this regional programme was delayed in late 2014/15 but is expected to become progressively live across the region during 2016/17.

BOP MedCheck participation by community pharmacies to increase from 90% achieved in 15/16 to 100% in 16/17.

Electronic Prescribing and Administration (ePA) implementation in the Midland Region is dependent on ePA working as required with the NZULM, and a need to demonstrate the working integration between ePA, ePharmacy and the Regional Clinical Workstation. Taranaki DHB will be the lead implementation for the integrated solution prior to regional rollout. The current non-integrated state, and reliance on Regional CWS, means that regional implementation is unlikely in 2016/17.

Regional Clinical Workstation (RCWS) Implementing a single instance of the Orion Concerto Clinical Workstation (CWS) and Sysmex Eclair Clinical Data Repository (CDR) system across the region via a phased DHB by DHB approach.

BOPDHB will migrate its existing Éclair CDR to the regional platform in 16/17 – exact timing dependent on the NIP transition process.

Regional CWS programme roll out will see BOPDHB begin its adoption of Orion in 2017. Timeframes are still being worked through in the regional programme.

Delivering the Midland One Health programme – implementing regional platform and service delivery capacity and capability.

The regional platform will be transitioned to the NIP programme at a similar time to BOPDHB’s transition enabling BOPDHB to utilise the regional platform for ePharmacy, CWS, CDR.

Regional Integrated Quality and Risk Roll out of the regional Datix system and adoption of regional processes as appropriate.

5.2.2 Clinical Technology

A new clinical workstation (CWS) system is being designed and introduced across the five DHBs in the Midland Region. The BOPDHB is heavily involved in this project, which is scheduled to be operational in the Bay of Plenty in 2017. This new system will provide powerful capability to drive clinical pathways, with benefits to patient safety, timeliness of care, and improve cost efficiency. Preparations have begun to engage clinicians at all levels to maximize the clinical input into the development of this tool.

The capability of the health system will be built through progressing data sharing initiatives with sound data governance. The Bay of Plenty Information Systems (BOPIS) Group has a key role in delivering the shared information requirements that will enable achievement of the major goals of the IHS. The Group advises and reports to BOPALT. The BOPIS Group’s work seeks to reinforce and foster the ‘alliancing’ environment required for success in the integration environment.

The main objectives of the Group include information governance; providing leadership on the appropriate and safe sharing of health information; promoting a culture and building sector confidence to enable appropriate use of, and access to, patient information; supporting the implementation of the IHS and development of clinical pathways through Bay Navigator; and integrating information systems to promote seamless care co-ordination.

Specific actions for 2016/17 are:

1. CHIP4GPs - Increasing the number of community based healthcare professionals that have access to Éclair;

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2. BOP MedCheck – Ensuring 100% of pharmacies in the Bay of Plenty join BOP Medcheck, the dispensing data sharing initiative;

3. Primary Care Data Set – Ensuring an agreed set of patient information from general practice data bases is shared with the hospital and community providers;

4. Increasing the number of patients with a patient portal with their general practice;

5. Reviewing systems and processes to ensure that the right health information is communicated between health providers and families for people aged over 65 (see section 2B.1.5.4).

5.2.3 Quality Assurance and Improvement

One of the principles of the IHS is that the BOP health system functions as one system and that we support quality improvement across the hospital and community. More and more people across the whole system are learning about quality improvement, supported by the Service Improvement Unit, in collaboration with Governance and Quality Team. The Clinical Quality Facilitator works with the Aged Residential Care providers to improve Certification Audit results.

5.2.4 Capital and Infrastructure Development

The DHB plans and implements capital upgrades and replacements in accordance with its current Asset Management Plan and its underlying Capital Intentions.

We are engaging with our local councils about future health service provision through their spatial planning processes.

5.2.5 Improvement and Sustainability Initiatives

Creating an environment for integration includes developing clinical leadership required to support integrated healthcare. The IHS is based on two broad concepts to improve capability: the concept that ‘everyone is an improver’; and Whānau Ora, strengthening capability of family/whānau.

The BOPDHB has adopted the Institute of Healthcare Improvement (IHI) Model for Improvement, a scientific approach for accelerating improvement in healthcare. By using this agreed methodology, we are building a common language of improvement through the organisation and community closer to where healthcare is delivered. The result being more people empowered to make positive change. In 2016/17 we will continue to grow a culture of quality improvement by:

• Increasing the numbers of secondary care health care professionals that have completed the Model for Improvement training using the IHI Open School including access to quality improvement mentors from the Service Improvement Unit to walk alongside and support health care teams

• Providing support for community based health care professionals to undertake quality improvement training through the IHI Open School by increasing the number of licences available

• Expanding the Quality Improvement (QI) Residency, a programme that is supporting young leaders of the future to have dedicated time to learn quality improvement skills that can be applied throughout their careers, beyond House Officers to other health professionals including nursing, allied health, and administration staff

• Supporting clinical and administration line managers to lead quality improvement initiatives through secondment opportunities to the Service Improvement Unit (SIU). This will enable staff with expert subject knowledge to undertake improvement work with the support of SIU change


management expertise and methodologies. The aim of this approach is to increase the likelihood of success, sustainability and to grow capability of project and change management skills across the organisation.

The BOPDHB recognises that, due to the constantly changing demands for service delivery, the administration support workforce needs to have the skills and structure to be responsive to change. Initiatives to be delivered in 2016/17 include a dedicated communication intranet site, appointment of an administration trainer, development of standardised processes, and standardised position descriptions for recruitment.

The BOPDHB aims to improve cultural intelligence and an understanding of the values and principles of Whānau Ora. In 2016/17 we will continue to encourage clinical leaders, managers and executive staff to complete the Whānau Tu Whānau Ora training through Nga Mataapuna Oranga PHO.

5.2.6 Cooperative Developments

The BOPDHB has agreements with tertiary providers for under-graduate student placements. Currently we have agreements with eight tertiary providers for student placements in a diverse range of specialities and occupational groups. The contracts are reviewed yearly to ensure that we have the capacity to meet the needs of the tertiary institutions. Cooperative agreements have also been made with other organisations such as Waipuna Hospice to provide under-graduate student placements in palliative care in the community. The placements assist the BOPDHB with our “grow your own” initiative, as under-graduate students have placement experience in the BOPDHB region and return for employment opportunities. This assists with meeting our future workforce needs.

The Education team works closely with training providers to regularly review and update the training needs for BOPDHB. This includes reviewing potential education through a Learning Needs Analysis process to ensure training is aligned with operational and future strategic demands.

A shared Midland E-learning platform has been developed with the Midland DHBs to provide consistency, efficiency gains and 24/7 access to online modules throughout the region. This is continually being developed and updated with new modules.

The BOP Clinical School’s Clinical Trials Unit (CTU) has established relationships with a number of external organisations to ensure that the CTU has a steady stream of new trials. Current trials include over 30 international trials for Oncology, Infectious Disease, Haematology, Gastroenterology, Cardiology, Radiotherapy, Rheumatology, Internal Medicine and Respiratory specialties. The Clinical Trials Unit also provides support for BOPDHB-led research and establishes the internal processes associated with trials such as Ethics approvals. Research is an area of growth and opportunity for the BOPDHB.

5.3 Workforce

5.3.1 Managing our workforce within fiscal constraints

To meet the Government Expectations for Pay and Employment Conditions in the State Sector, the BOPDHB has addressed the following:

• Recent settlements for both national and DHB-specific collective agreements have been successfully achieved within government parameters and the BOPDHB’s budget plan with the aims of:

- delivering organisational and sector performance improvement

- fostering continuous improvement and productivity enhancement

- supporting effective employee engagement.

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• Identified business imperatives (such as improved performance and demonstrable recruitment and retention difficulties) have been considered to ensure:

- improved performance through meeting organisational financial and clinical guidelines and expectations for the BOPDHB

- specific attention to those areas where there are difficulties in recruitment and retention

- a stable workforce with a relatively low turnover rate.

• Pay structures and other conditions for employees necessary to support the BOPDHB’s business and workforce objectives continue to be the subject of ongoing review. These include:

- Alignment of rates and conditions across occupational groups where this is appropriate

- Application of merit pay steps to enable employee’s contributions to be recognised consistently across the organisation.

5.3.2 Strengthening our workforce

To enable a consistent approach to leadership, the national DHB General Managers Human Resources (GMsHR) group, DHB Shared Services and Health Workforce New Zealand developed a national leadership domains Framework, which was approved by DHB Chief Executives in October 2015. The BOPDHB will use the framework to help develop leadership capability.

To enable a consistent approach to workforce planning, the national DHB General Managers Human Resources (GMHRs) Group and Health Workforce New Zealand have collaborated in the development of a Workforce Intelligence and Planning Framework. The framework aims to assist DHBs when undertaking workforce planning at the individual DHB, regional and national level for the immediate planning horizons – up to three years. The BOPDHB will use the framework to help with workforce planning.

The BOPDHB will continue to work in collaboration with Regional Directors - Workforce and in conjunction with Health Workforce New Zealand to achieve agreed regionally-based solutions for:

• implementation of community based attachments for prevocational trainees

• increased participation of Māori and Pacific in the health workforce

• building on the 2016/17 RSP, demonstrating further progress on actions to meet milestones

• development of vulnerable workforces

• introduction of 'new models of care' planning and development

• establishment of specialist roles, such as palliative care specialist nurses and educators, nurse practitioners, clinical nurse specialists, nurses performing endoscopies, and medical physicists.

5.4 Organisational HealthThe BOPDHB has well developed human resource policies such as the Equal Employment Opportunities policy, where it states that all employment related decisions are made on the basis of relevant merit and not on the basis of factors that have nothing to do with the ability to perform the job.

5.4.1 Governance

Our Board provides governance of the organisation and is responsible to the Minister of Health for the overall performance and management of the DHB. Its core responsibilities are to set the strategic


direction for the DHB and to develop policy that is consistent with Government objectives and improves health outcomes for our population. The Board also ensures compliance with legal and accountability requirements and maintains relationships with the Minister of Health, Parliament and the Bay of Plenty community. We currently have 11 Board members, with seven elected by the Bay of Plenty DHB community and four appointed by the Minister of Health.

The BOPDHB is unique in that it shares governance with our Rūnanga. The BOPDHB Rūnanga affirms the BOPDHB’s commitment to the Treaty of Waitangi principles, and most importantly recognises that Māori have an important role to play in determining their own aspirations and priorities for health. The Board acknowledges the important role of Iwi and looks to the Rūnanga and its 18 mandated Iwi health representatives to provide both strategic direction and connection to the Māori community on issues of importance to Māori. The Rūnanga is integral to providing a mechanism to enable Māori to contribute to decision-making, participate in the planning and delivery of health and disability services as well as providing an effective forum for consultation and engagement with Whānau, Hapu and Iwi.

There are two statutory advisory committees that have been established to assist the Board to meet its responsibilities: (i) the Community and Public Health Advisory Committee/Disability Services Advisory Committee (CPHAC/DSAC); and (ii) the Bay of Plenty Hospital Advisory Committee (BOPHAC). The Board is also supported by the Audit Finance and Risk Management (AFRM) Committee. The membership of these committees is comprised of a mix of Board members and community representatives. The public is welcome to attend meetings of the Board and its statutory committees. However, for some items during a meeting the Board or Committee may exclude the public. The Official Information Act states the grounds on which the public may be excluded. Such items are clearly noted on the agenda in question. Details of meetings are available on the BOPDHB website www.bopdhb.govt.nz.

5.4.2 Management

While responsibility for the BOPDHB’s overall performance rests with the Board, operational and management matters have been delegated to the Chief Executive Officer (CEO). The CEO is supported by an Executive Management Team, which includes: General Manager Planning and Funding, General Manager Māori Health Planning and Funding, Chief Financial Officer, General Manager Information Management, General Manager Property Services, General Manager Governance and Quality, Director of Nursing, Chief Medical Advisor, Director of Allied Health and Head of the Clinical School.

5.4.3 Assessing Performance

The Ministry of Health monitors our performance on behalf of the Minister. The mechanisms currently in place to achieve this are outlined in the following table.

Table: External Reporting Framework

Reporting Frequency

Information Requests Ad Hoc

Financial Reporting Monthly

National Data Collections Monthly

Risk Reporting Quarterly

Health Target reporting Quarterly

Crown Funding Agreement non-financial reporting Quarterly

Indicators of DHB Performance (IDP) Reports Quarterly

Annual Report and audited statements Annually

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Module Six: Service Configuration

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Module Six: Service Configuration

6.1 Service CoverageAll DHBs are required to deliver a minimum of services, as defined in a document called “The Service Coverage Schedule” (SCS). DHBs deliver services in two ways – either by providing a service ourselves, or by paying someone else to deliver it, where it makes sense to do so. Some of the services in the SCS are the responsibility of the Ministry of Health to deliver. In other cases we share responsibility. In the majority of cases, we take sole responsibility for a service being delivered.

The volume of service delivery is determined by a number of factors, including;

• the Minister’s and Ministry’s expectations;

• national and best practice guidelines;

• health needs assessments at a local level;

• evidence based data, drawn from other studies.

The BOPDHB has no approved service coverage exceptions.

Our plan is to deliver services that are closer to home and that benefit our community and population as a whole. Changes to services are always carefully considered, not only for the benefits they can bring, but also the impact they may have on other key stakeholders.

The ideal result is a solution that yields the maximum benefit and population gain with the least amount of disruption, be it to other providers who may no longer be required to deliver services; clinicians who may find themselves working in a different way; workforce in terms of future employment and workload; infrastructure or the bricks, mortar or other assets impacted by the proposal; and finally, but most importantly, the patients in our, and other, communities.

All service reviews/changes with likely material impacts must be signalled to the Ministry of Health for an opinion about whether or not they can or should be actioned. Ultimately, if the impact is significant, consultation with key stakeholders, including our community, may be required before Ministerial approval is given.

6.1.1 Service Issues

The BOPDHB provides a comprehensive range of health services across the continuum of care and relies on its DHB partners to also support our population for tertiary and national health services. One of the emerging key challenges for the BOPDHB is the growth in acute demand impacting both our hospitals and our primary care partners. Some of this growth is due to our increasing population but also to the changing demographic of our population which is growing in the older age group. The system cannot sustain year on year growth so demand needs to be managed in a different way, such as changing models of care, technology enablers or other tools, that will help us ensure that our population gets the healthcare they need. We will be progressing initiatives this year, under the banner of acute management that will test different ways of managing acute flow that might result in changes to where patients receive their care.

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6.2 Service ChangeThe table below describes all service changes that have been approved or proposed for implementation in 2016/17.

Change Description of Change Benefits of ChangeChange for local, regional or national reasons

Opotiki Locality Planning Implementation

We will implement the agreed model of care from the Stage 1 and Stage 2 Opotiki Locality Planning process

• Ensuring services meet local community’s needs.

• Long-tern sustainability of local services.

• Recruitment and retention of health workforce to support service delivery.

• Cost effectiveness of services through optimum resource utilisation.

Local

Renal Services We will review how the BOPDHB might better meet the renal needs of the Bay of Plenty community with a specific focus on Eastern BOP demographics.

Improved access, reduced cost, earlier intervention, improvement of long term outcomes

Local

Interventional Cardiology

We will explore the clinical effectiveness and value for money of interventional cardiology services being provided in the BOP with a view to establishing long-term sustainability within the region.

Reduced early mortality, reduced travel, earlier intervention and treatment

Local

Integrated Community Nursing Services Implementation

We will implement the agreed model of care for Community Nursing - Co-ordinated model of care.

• Improving quality, safety and experience of care

• Improving health and equity for all populations

• Achieving best value for public health system resources

• Exploring new ways of addressing growth in demand for acute care

• Embracing and exploring innovations in chronic conditions management of patients in the community.

Local

Home Based Support Services (HBSS) reconfiguration

We will implement the Restorative Model of Care for Home Based Support Services and provider configuration as a result of the RFP.

• Supports a restorative model for HBSS for the population.

• Puts in place a provider configuration who can deliver on the new model.

• Potential to reduce hospital and Aged Residential Care utilisation by maximising patients in their own homes.

Local

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7.1 Monitoring Framework Performance Measures

7.1.1 Dimensions of DHB Performance Measures (non-financial)

The DHB monitoring framework aims to provide a rounded view of performance using a range of performance markers. Four dimensions are identified reflecting DHB functions as owners, funders and providers of health and disability services. The four identified dimensions of DHB performance cover:

• achieving Government’s priority goals/objectives and targets or ‘Policy priorities’

• meeting service coverage requirements and Supporting sector inter-connectedness or ‘System Integration’

• providing quality services efficiently or ‘Ownership’

• purchasing the right mix and level of services within acceptable financial performance or ‘Outputs’.

Each performance measure has a nomenclature to assist with classification as follows:

Code Dimension

PP Policy Priorities

SI System Integration

OP Outputs

OS Ownership

DV Developmental – Establishment of baseline (no target/performance expectation is set)

7.1.2 Performance Measures 2016/17

Performance measure 2016/17 Performance expectation/target

PP6: Improving the health status of people with severe mental illness through improved access

Age Maori Total

0-19 6.5% 5%

20-64 9.7% 5.5%

65+ 4% 3.45%

PP7: Improving mental health services using transition (discharge) planning

Long term clients Provide a report as specified

Child and Youth with a Transition (discharge) planAt least 95% of clients discharged will have a transition (discharge) plan.

172 MODULE SEVEN: PERFORMANCE MEASURES


PP8: Shorter waits for non-urgent mental health and addiction services for 0-19 year olds

Mental Health Provider Arm

Age <= 3 weeks <=8 weeks

0-19 80% 95%


Age <= 3 weeks <=8 weeks

0-19 80% 95%

PP10: Oral Health- Mean DMFT score at Year 8

Ratio year 1 1.68

Ratio year 2 1.65

PP11: Children caries-free at five years of age

Ratio year 1 56.5

Ratio year 2 58

PP12: Utilisation of DHB-funded dental services by adolescents (School Year 9 up to and including age 17 years)

% year 1 85

% year 2 85

PP13: Improving the number of children enrolled in DHB funded dental services

0-4 years - % year 1 95

0-4 years - % year 2 95

Children not examined 0-12 years % year 1 10

Children not examined 0-12 years % year 2 10

PP20: Improved management for long term conditions (CVD, Acute heart health, Diabetes, and Stroke)

Focus area 1: Long term conditions

Report on delivery of the actions and milestones identified in the Annual Plan.

Focus area 2: Diabetes services

Reporting on implementation of actions in the Diabetes plan “Living Well with Diabetes”

Improve or, where high, maintain the proportion of patients with good or acceptable glycaemic control (HbA1c indicator).

85%

Focus area 3: Cardiovascular (CVD) health

Indicator 1: 90 percent of the eligible population will have had their cardiovascular risk assessed in the last five years.

Indicator 2: 90 percent of ‘eligible Māori men in the PHO aged 35-44 years’ who have had their cardiovascular risk assessed in the last five years.

90%

Report on delivery of the actions and milestones identified in the Annual Plan 90%

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Focus area 4: Acute heart service

70 percent of high-risk patients will receive an angiogram within 3 days of admission. (‘Day of Admission’ being ‘Day 0’) by ethnicity.

70%

Over 95 percent of patients presenting with ACS who undergo coronary angiography have completion of ANZACS QI ACS and Cath/PCI registry data collection within 30 days.

>95%

Over 95 percent of patients undergoing cardiac surgery at the five regional cardiac surgery centres will have completion of Cardiac Surgery registry data collection with 30 days of discharge.

>95%

Report on deliverables for acute heart services identified in annual plan and actions and progress in quality improvement initiatives to support the improvement of agreed indicators as reported in ANZACS-QI

Focus area 5: Stroke Services

6 percent of potentially eligible stroke patients thrombolysed 6%

80 percent of stroke patients admitted to a stroke unit or organised stroke service with demonstrated stroke pathway

80%

80 percent of patients admitted with acute stroke who are transferred to inpatient rehabilitation services are transferred within 7 days of acute admission

80%


PP21: Immunisation coverage

Percentage of two year olds fully immunised Target: 95%

Percentage of five year olds fully immunised Target: 95%

Percentage of eligible girls fully immunised - HPV vaccine Target: 70%

PP22: Improving system integration


In relation to System Level Measures – A jointly agreed (by district alliances) system level measure improvement plan, including improvement milestones, will be provided at the end of quarter one 2016/17.



PP23: Improving Wrap Around Services – Health of Older People


The % of older people receiving long-term home support who have a comprehensive clinical assessment and an individual care plan

Percentage of people in aged residential care by facility and by DHB who have a subsequent interRAI long term care facility (LTCF) assessment completed within 230 days of the previous assessment.

The percentage of LTCF clients admitted to an Aged Residential Care (ARC) facility who had been assessed using an interRAI Home Care assessment tool in the six months prior to that first long term care facility (LTCF) assessment.

Provision of data that demonstrates an improvement on current performance

PP25: Prime Minister’s youth mental health project

Initiative 1: School Based Health Services (SBHS) in decile one to three secondary schools, teen parent units and alternative education facilities.

1. Provide quarterly quantitative reports on the implementation of SBHS, as per the template provided.

2. Provide quarterly narrative progress reports on actions undertaken to implement Youth Health Care in Secondary Schools: A framework for continuous quality improvement in each school (or group of schools) with SBHS.

Initiative 3: Youth Primary Mental Health

1. Provide quarterly narrative progress reports (as part of PP26 Primary Mental Health reporting) with actions undertaken in that quarter to improve and strengthen youth primary mental health (12-19 year olds with mild to moderate mental health and/or addiction issues) to achieve the following outcomes:

- early identification of mental health and/or addiction issues

- better access to timely and appropriate treatment and follow up

- equitable access for Maori, Pacific and low decile youth populations.

2. Provide quantitative reports using the template provided under PP26

Initiative 5: Improve the responsiveness of primary care to youth.

1. Provide quarterly narrative reports with actions undertaken in that quarter to ensure the high performance of the youth SLAT(s) (or equivalent) in your local alliancing arrangements.

2. Provide quarterly narrative reports with actions the youth SLAT has undertaken in that quarter to improve the health of the DHB’s youth population (for the 12-19 year age group at a minimum) by addressing identified gaps in responsiveness, access, service provision, clinical and financial sustainability for primary and community services for the young people, as per your SLAT(s) work programme.

PP26: The Mental Health & Addiction Service Development Plan

Provide reports as specified for each focus area:

• Primary Mental Health

• District Suicide Prevention and Postvention

• Improving Crisis response services

• Improve outcomes for children

• improving employment and physical health needs of people with low prevalence conditions

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PP27: Supporting vulnerable children Report on delivery of the actions and milestones identified in the Annual Plan.

PP28: Reducing Rheumatic fever

Provide a progress report against DHBs’ rheumatic fever prevention plan

Hospitalisation rate (per 100,000 DHB total population) for acute rheumatic fever 1.3 per 100,000

Reports on progress in following -up known risk factors and system failure points in cases of first episode and recurrent rheumatic fever.

PP29: Improving waiting times for diagnostic services

1. Coronary angiography – 95% of accepted referrals for elective coronary angiography will receive their procedure within 3 months (90 days)

95%

2. CT and MRI – 95% of accepted referrals for CT scans, and 85% of accepted referrals for MRI scans will receive their scan within than 6 weeks (42 days)

a. 95% of accepted referrals for CT scans

b. 85% of accepted referrals for MRI scans will receive their scan within 6 weeks (42 days)

3. Diagnostic colonoscopy

a. 85% of people accepted for an urgent diagnostic colonoscopy will receive their procedure within two weeks (14 calendar days, inclusive), 100% within 30 days

b. 70% of people accepted for a non-urgent diagnostic colonoscopy will receive their procedure within six weeks (42 days), 100% within 90 days

a. 85%

b. 70%

c. 70%

PP30: Faster cancer treatment

Part A: Faster cancer treatment

– 31 day indicator

85 percent of patients receive their first cancer treatment (or other management) within 31 days from date of decision-to-treat

Part B: Shorter waits for cancer treatment

– radiotherapy and chemotherapy

All patients ready-for-treatment receive treatment within four weeks from decision-to-treat.

PP31: Better help for smokers to quit in public hospitals

95 percent of hospital patients who smoke and are seen by a health practitioner in a public hospital are offered brief advice and support to quit smoking

SI1: Ambulatory sensitive (avoidable) hospital (ASH)admissions

Age group 0 – 4 years

A jointly agreed (by district alliances) System Level Measure improvement plan, including improvement milestones, will be provided at the end of quarter one 2016/17 via measure PP22.

Age group 45-64 years 3,741

SI2: Delivery of Regional Service Plans

Provision of a single progress report on behalf of the region agreed by all DHBs within that region



SI3: Ensuring delivery of Service Coverage

Report progress achieved during the quarter towards resolution of exceptions to service coverage identified in the Annual Plan , and not approved as long term exceptions, and any other gaps in service coverage (as identified by the DHB or by the Ministry)

SI4: Standardised Intervention Rates (SIRs)

major joint replacement an intervention rate of 21.0 per 10,000 of population

cataract procedures an intervention rate of 27.0 per 10,000

cardiac surgery

a target intervention rate of 6.5 per 10,000 of population

DHBs with rates of 6.5 per 10,000 or above in previous years are required to maintain this rate.

percutaneous revascularizationa target rate of at least 12.5 per 10,000 of population

coronary angiography servicesa target rate of at least 34.7 per 10,000 of population

SI5: Delivery of Whānau Ora

Performance expectations are met across all the measures associated with the five priority areas:

• Mental health

• Asthma

• Oral health

• Obesity

• Tobacco

and narrative reports cover all areas indicated

SI7: System Level Measure – total acute hospital bed days per capita


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SI8: System Level Measure – patient experience of care

Hospital

Provide a report each quarter as specified in the measure definition.


Primary Care

A jointly agreed (by district alliances) System Level Measure improvement plan, including improvement milestones, will be provided at the end of quarter one 2016/17 via measure PP22



SI9: System Level Measure amenable mortality


OS3: Inpatient Length of Stay

Elective LOS 1.55 days

Acute LOS 2.58 days

OS8: Reducing Acute Readmissions to Hospital tba - indicator definition under review

OS10: Improving the quality of identity data within the National Health Index (NHI) and data submitted to National Collections

Focus area 1: Improving the quality of identity data

New NHI registration in error

A. Greater than 2% and less than or equal to 4%

B. Greater than 1% and less than or equal to 3%

C. Greater than 1.5% and less than or equal to 6%

<3%

Recording of non-specific ethnicity

Greater than 0.5% and less than or equal to 2%<2%

Update of specific ethnicity value in existing NHI record with a non-specific value

Greater than 0.5% and less than or equal to 2%

<2%

Validated addresses unknown

Greater than 76% and less than or equal to 85%>76%

Invalid NHI data updates (no confirmed target)

Focus area 2: Improving the quality of data submitted to National Collections

NBRS links to NNPAC and NMDS Greater than or equal to 97% and less than 99.5% >97%

National collections file load success

Greater than or equal to 98% and less than 99.5%>98%

Standard vs edited descriptors

Assessment of data reported to the NMDS - Greater than or equal to 75%

>75%

NNPAC timeliness

Greater than or equal to 95% and less than 98%>95%

Output 1: Mental health output Delivery Against Plan

Volume delivery for specialist Mental Health and Addiction services is within:

a) five percent variance (+/-) of planned volumes for services measured by FTE,

b) five percent variance (+/-) of a clinically safe occupancy rate of 85% for inpatient services measured by available bed day, and

c) actual expenditure on the delivery of programmes or places is within 5% (+/-) of the year-to-date plan

Developmental measure DV6: System Level Measure - youth access to and utilisation of youth appropriate health services

No performance target/expectation set

Developmental measure DV7: System Level Measure - number of babies who live in a smoke-free household at six weeks post-natal

No performance target/expectation set

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Module Eight: Glossary of Terms

ANNUAL PLAN 2016/17


Activity What an agency does to convert inputs to outputs.

Advance/future care planning

Advance/Future Care Planning is the process of planning for your future health and end of life care. It is a series of conversations giving people a chance to say what is important to them and to share their wishes and preferences with their family/whānau.

Bay of Plenty Alliance Leadership Team (BOPALT)

The BOPALT is comprised of key members from the three Primary Health Organisations and the District Health Board.

Capability What an organisation needs (in terms of access to people, resources, systems, structures, culture and relationships), to efficiently deliver the outputs required to achieve the Government's goals.

Crown entity 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, Crown entity companies, Crown entity subsidiaries, school boards of trustees, and tertiary education institutions. Crown entities are legally separate from the Crown and operate at arms-length from the responsible or shareholding Minister(s); they are included in the annual financial statements of the Government.

Deprivation A state of observable and demonstrable disadvantage relative to the local community or the wider society or nation to which an individual, family or group belongs.

For the purposes of this plan, mentions of deprivation relate to the NZDep2006. It is a relative measure, and refers to the average level of deprivation of people living in an area at a particular point in time, relative to the whole of New Zealand. An individual residing in that area cannot be assumed to have that level of deprivation. Areas are often not homogenous in terms of the socio-economic status of the inhabitants.

NZDep2006 was created from data from the 2006 Census of Population and Dwellings. The index describes the deprivation experienced by groups of people in small areas. Nine deprivation variables were used in the construction of the index.

The index gives a score on a scale between 1 and 10 to each identified geographic area. The scale is a ten category ordinal scale from 1 (assigned to the 10% of areas with the least deprived NZDep2006 scores) to 10 (assigned to the 10% of areas with the most deprived NZDep2006 scores).

It is important to note that deprivation is based on a geographic location rather than an individual.

Efficiency Reducing the cost of inputs relative to the value of outputs.

180 MODULE EIGHT: GLOSSARY OF TERMS

Effectiveness The extent to which objectives are being achieved. Effectiveness is determined by the relationship between an organisation and its external environment. Effectiveness indicators relate outputs to impacts and to outcomes. They can measure the steps along the way to achieving an overall objective or an outcome and test whether outputs have the characteristics required for achieving a desired objective or government outcome.

Financial Statements

AP financial statements are forecast financial statements required to cover five years: prior year audited actual, current year forecast and three years’ plan.

Home and Community Support Service (HCSS)

These are services that are services funded by the Ministry of Health to help people live at home. They can help with both household management and personal care.

Input The resources such as labour, materials, money, people, information technology used by departments to produce outputs, that will achieve the Government's stated outcomes.

Intervention An action or activity intended to enhance outcomes or otherwise benefit an agency or group.

Intervention logic model

A framework for describing the relationships between resources, activities and results. It provides a common approach for integrating planning, implementation, evaluation and reporting. Intervention logic also focuses on being accountable for what matters – impacts and outcomes.

Living within our means

Providing the expected level of outputs within a break-even budget or Ministry agreed deficit step toward break even by a specific time.

Management systems

The supporting systems and policies used by the DHB in conducting its business.

Measure A measure identifies the focus for measurement: it specifies what is to be measured.

Objectives Is not defined in the legislation. The use of this term recognises that not all outputs and activities are intended to achieve “outputs”. For example, increasing the take-up of programmes; improving the retention of key staff; improving performance; improving Governance etc. are ‘internal to the organisation and enable the achievement of ‘outputs’.

Outcome 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 a end outcome, but, in itself, is not the desired result. An end outcome is 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).

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Output classes An aggregation of outputs, or groups of similar outputs. (Public Finance Act 1989)

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).

Outputs Final goods and services, that is, they are supplied to someone outside the entity. They should not be confused with goods and services produced entirely for consumption within the DHB group (Crown Entities Act 2004).

Ownership The Crown's core interests as 'owner' can be thought of as:

Strategy - the Crown's interest is that each state sector organisation contributes to the public policy objectives recognised by the Crown;

Capability - the Crown's interest is that each state sector organisation has, or is able to access, the appropriate combination of resources, systems and structures necessary to deliver the organisation's outputs to customer specified levels of performance on an ongoing basis into the future;

Performance - the Crown's interest is that each organisation is delivering products and services (outputs) that achieve the intended results (outcomes), and that in doing so, each organisation complies with its legislative mandate and obligations, including those arising from the Crown's obligations under the Treaty of Waitangi, and operates fairly, ethically and responsively.

Performance Measures

Selected measures must align with the DHB’s RSP and AP. Four or five key outcomes with associated outputs for non-financial forecast service performance are considered adequate. Appropriate measures should be selected and should consider quality, quantity, effectiveness and timeliness. These measures should cover three years beginning with targets for the first financial year (2016/17) and show intended results for the three subsequent financial years.

Productivity Increasing outputs relative to inputs (ie: either more outputs produced with the same inputs, or the same output produced using fewer inputs)

Quintile Deprivation quintiles divide areas in fifths according to NZDep2006. Each quintile relates to:

Quintile 1 – NZDep2006 scores of 1 and 2





Quintile 1 is assigned to the 20% of areas with the least deprived NZDep2006 scores. Quintile 5 is assigned to the 20% of areas with the most deprived NZDep2006 scores.

182 MODULE EIGHT: GLOSSARY OF TERMS

Regional integration

Regional integration refers to DHBs across geographical ‘regions’ for the purposes of planning and delivering services (clinical and non-clinical) together. Four regions exist.

• Northern: Northland, Auckland, Waitemata and Counties Manukau DHBs

• Midland: Bay of Plenty, Lakes, Tairawhiti, Taranaki and Waikato DHBs

• Central: Capital & Coast, Hawke’s Bay, Hutt Valley, MidCentral, Wairarapa Whanganui DHBs

• Southern: Canterbury, Nelson Marlborough, South Canterbury, Southern and West Coast DHBs.

A region for some clinical networks may vary slightly to the four regional groupings described above. For example, Central Cancer Network contains seven DHBs, with Taranaki DHB in addition to the Central Region DHBs.

Statement of Performance Expectations (SPE)

Government departments and Crown entities are required to include audited statements of objectives and statements of performance expectations with their financial statements. These statements report whether the organisation has met its service objectives for the year.

Targets Targets are agreed levels of performance to be achieved within a specified period of time. Targets are usually specified in terms of the actual quantitative results to be achieved or in terms of productivity, service volume, service-quality levels or cost effectiveness gains. Agencies are expected to assess progress and manage performance against targets. A target can also be in the form of a standard or benchmark.

Value for money The assessment of benefits relative to cost, in determining whether specific current or future investments/expenditures are the best use of available resource.

www.bopdhb.govt.nz

The full Annual Plan document is available on theBay of Plenty District Health Board website:

www.bopdhb.govt.nz

Published in September 2016 by theBay of Plenty District Health Board

P O Box 12024, Tauranga, 3143

See also our Māori Health Plan, the Midland Regional Services Plan and Toi Te Ora – Public Health Service’s Annual Plan.

bay of plenty district health board 2016 … · 2 bay of plenty district health board contents...

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