The 2012 Continence Education and Consumables

Service Specification

- what is it, why is it needed and what has improved.

Jane Craven, Senior Advisor Ministry of Health

November 2012

What is a service specification?

• used in contracts for funding health services

• not all services have nationwide service specifications because nationwide consistency is not required for every DHB funded service.

• DHBs allocate funding for these health services

• nationwide service specifications are jointly developed by, and agreed between the Ministry and DHBs.

Why have a service specification for Continence Services?

The 2003 Continence service specification has been updated by a joint sector working group to: • update the content and clarify what is being funded as

part of this service

• provide minimum level of requirements for the funder to:

– facilitate service planning and monitoring

– allow comparison of aspects of service delivery and service availability between DHBs

– provide a mechanism to ensure that nationwide service specific requirements are provided throughout the sector.

What’s different?

.

The three tiered structure:

supports understanding the total description of the service to be funded

supports flexibility and a consistent minimum level of services

avoids repetition of content common to a range or group of services.

STRUCTURE:

under the overarching Tier 1 Community Health, Transitional and Support Services service specification

NAME: Tier 3 Continence Education and Consumable Services

Tier StructureEach tier describes a different level of detail:

Tier 1 contains generic principles and content common to all the tier specifications below it.

Tier 2 includes the elements specific to that particular service and includes a reference to its generic overarching document so that the total service requirements are explicit.

Tier 3 more detailed specific service descriptions for a specific service.

What has improved? expressly includes children four years of age or

over

strengthens the role of the Continence Advisor

references a range of DHB and Nurse Maud Continence Assessment tools (for both adults and children)

updated indicative referral management timeframes

updated language and expectations of continence education and consumable service components

requires assessment for the need for Continence Consumables to be completed annually to ensure correct level of consumables meet the assessed need of the person

strengthened quality requirements and linkages to other services

updated guidelines of consumables.

What has improved?(cont)

Appendix 2 comparisonNew wording (2012)

Guidelines for the Supply of Continence Consumables• All items are supplied at the discretion

of the Specialist Continence Nurse, as clinically appropriate and are to be included in the consumable prescription.

• Provision of consumables will usually be prescribed as per the guidelines given in the table below and where they meet the DHB’s own criteria for supply.

• These guidelines are a tool to assist decision making about the appropriate prescription of product based on the Service User’s assessed need.

Old wording (2003)

Supply of Consumables• All items are supplied at the

discretion of the Specialist Continence Nurse, and are to be included in the consumable prescription.

• Provision of consumables will usually be prescribed as per the guidelines given in the table below.

• These guidelines are a tool to assist decision making about the appropriate prescription of product based on need.

Appendix 2 comparison (cont)New wording (2012)

Note: There may be occasions when it is appropriate to prescribe more product than is indicated in the guidelines, or when it may be justifiable to prescribe products not included in these guidelines that are listed in the relevant National Product Supply Agreement.

Old wording (2003)

There may be occasions when it is appropriate to prescribe more product than is indicated in the guidelines, or when it may be justifiable to prescribe products not included in the guidelines.

Thank you to:

• the Continence Services Working Group provided expert advice and development of the draft service specification.

• Work commenced in Oct 2011, completed in May 2012 for consultation, for final endorsement by 20 DHBs GMs F&P by 30 Oct 2012.

• Service Specification will be published on: http://www.nsfl.health.govt.nz/apps/nsfl.nsf/pagesmh/472

Tier 3 Continence Services - Community Health, Rehabilitation and Support Services Working Group:Helen Peek, Frances Ryan, Lucy Keedle, Jan Zander, Pam Chapman, Julie Eilers, Helen Brown, Ann Foley, Louise Mills, Alison Meerman Cheryl Hammond, Nicky Plant, Jane Stewart, Rowanne Bridge, Shirley Clover, Kate Mather, Nicky Solomon, Vanessa Russell, Sue Morrow, Karen Armstrong, Cushla Hannan, Janet Thackray, Jenny George, Ainslie Shann, Dianne Ogle.

Other DHB and Ministry staff consulted: Valerie Smith, Monica Moulson, Jane Craven, Lorraine Hercus, Anne Foley, Noeline

Whitehead, Berta Nicoll, Robyn Henderson, Tor Wainwright, Louise Allsopp, Adele Knowles. And the joint DHB Ministry Service Specification Programme Executive members.