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| 2.1 Each DHB will outline in its annual plan how it will develop an integrated continuum of care for older people and implement the Health of Older People Strategy. | | DHBs have until 2010 to implement the Health of Older People Strategy and develop an integrated continuum of care approach to service planning, funding and provision for older people. |
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| | 2.1.1 From 2003/04 each DHB will include in its annual plan its broad approach to services for an ageing population and milestones for implementing the Health of Older People Strategy. Each plan will be informed by consultation with the DHB’s community, aged-care providers and consumer groups, and an analysis of the district’s health and support needs. |
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| | 2.1.2 ‘Early leader’ DHBs (Canterbury and Northland), with assistance from the Ministry, will develop and test models for delivering an integrated continuum of care. Their experience, and that of others at similar stages of developing integrated service provision for older people, will inform development in other DHBs. |
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| | 2.1.3 DHBs, in collaboration with the Ministry, will progressively review priorities for services in anticipation of growth in older age groups and to support ageing in place. This will require DHBs to identify:
- barriers to implementing an integrated continuum of care in current planning and service practices
- changes necessary to transfer funding between services within their DHB to support an integrated continuum of care.
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| 2.2 The Ministry of Health will facilitate implementation of the Health of Older People Strategy. | | 2.2.1 The Ministry of Health will organise a workshop in 2002 for DHBs, service providers, health sector workers and older people’s representatives, to support implementation of the Health of Older People Strategy. |
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| | 2.2.2 The Ministry will establish a web page on its website by June 2002 providing access to information about health of older people, including information about statistical data on service utilisation and health status and best practice examples of integrated services. |
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| | 2.2.3 The Ministry will work with DHBs to develop performance indicators to measure progress on implementing the Health of Older People Strategy. |
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| 2.3 The Ministry, in collaboration with DHBs, will establish a process for collecting reliable data to model current and projected demand for services. | | 2.3.1 By June 2003 the Ministry, in collaboration with DHBs, will have agreed a standard set of data to model current and projected demand for services for people aged 65 and over, and established a process for collecting and collating reliable data. Key components of the model will be demographic change, health status, and service utilisation trends and projections by age group, ethnicity, and geographical location. |
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| | 2.3.2 The Ministry will work with DHBs and relevant agencies to improve the quality and coverage of existing databases and targeted surveys to model demand. |
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| | 2.3.3 The Ministry will work progressively to improve the quality and availability of disability support services data, including service utilisation by older people. |
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| | 2.3.4 The Ministry will publish preliminary statistics on mental health service utilisation by older people, drawing on the Mental Health Information National Collection (MHINC) by December 2002, with an updated statistical reference report by December 2004. |
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| 2.4 The Ministry will implement a planned approach to strengthening the health workforce to meet the needs of an ageing population. | | The health sector workforce consists of a broad range of workers contributing to the health of older people. These include hospital and community-based health professionals such as doctors, nurses, and therapists; social workers; health aid workers; orderlies and kitchen staff. In addition, family, whanau, individuals and a range of voluntary and community agencies play a significant role in providing care and support for older people. |
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| | Developing a workforce that is able to meet the needs of an increasingly culturally diverse older population will require an education system that responds effectively to health sector needs. |
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| | Workforce development will draw, where appropriate, on work being undertaken within the Ministry of Health that includes: implementing the nurse practitioner role; developing regulations for nurse prescribing, including for nurse practitioners in aged care; developing a framework for primary health care nursing; and options for developing the health aid workforce. |
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| | 2.4.1 The Ministry of Health will advise the Ministry of Education by June 2003 of the nature of the future health workforce required to meet the needs of the New Zealand Health and Disability Strategies. This will include a preliminary analysis of current workforce issues for health of older people services. |
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| | 2.4.2 By June 2004 the Ministry of Health will produce a report on the workforce needs of the ageing population. This will involve working with DHBs and consulting Maori and mainstream service providers, the Ministry of Pacific Affairs and Office of Ethnic Affairs, health sector workers, relevant community and voluntary agencies and older people. The plan will identify what action needs to be taken by the health and education sectors, and at what level (policy, funder or provider), to address the following issues:
- ensuring that older people’s health issues are adequately covered in the basic training of health professionals who work with older people (for example, medical students, general medical practitioners, nurses, therapists, pharmacists, public health professionals and social workers)
- ensuring that mainstream services are culturally appropriate for the increasing ethnic diversity of older people
- ensuring continuing education for the existing health workforce includes older people’s health issues and appropriate interventions
- developing the specialist professional workforce in older people’s health
- promoting working conditions that support the development and retention of appropriately trained staff, particularly in rural areas
- ensuring that the state, as a major health sector employer, models the Equal Employment Opportunity and good employer obligations of the New Zealand Public Health and Disability Act 2000 and the objectives of the Employment Relations Act 2000
- the role of family and whanau carers and volunteers.
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| | 2.4.3 The Ministry will work with DHBs to monitor changes in the size, composition and competency levels of the workforce, including the contributions of family, whanau and volunteers, to feed back into policy and funding decisions. |
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| 2.5 The Ministry, in collaboration with relevant DHBs and the Ministry of Pacific Island Affairs, will plan for Pacific and mainstream health and disability support services to meet the needs of older Pacific peoples and their families. | | DHBs with significant numbers of Pacific peoples in their regions will take particular responsibility for Pacific peoples’ health issues. Key areas for development are building capacity in health promotion and primary health care. There is a need for trained ethnic promoters to deliver health and service information, as language is a major barrier for Pacific elders in accessing services. This work will be done in conjunction with implementing the Pacific Health and Disability Action Plan. |
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| | 2.5.1 By 2006 the Ministry will have worked with DHBs to plan to meet the health needs of the rapidly increasing number of Pacific elders from 2010. This work will be undertaken in discussion with the Ministry of Pacific Island Affairs, Pacific health workers and Pacific peoples themselves. It will include:
- extending and enhancing culturally appropriate mainstream health and support services for Pacific elders
- developing the Pacific health workforce
- building on the Pacific provider development work in the Pacific Health and Disability Action Plan to develop Pacific providers of services for Pacific elders.
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| 2.6 The Ministry will work with the Office of Ethnic Affairs to develop guidelines for DHBs on the health and disability support service needs of ethnic minority communities. | | Although many of the ethnic communities in New Zealand are small in numbers, they are growing, as is the proportion of people in these communities who are aged 65 and over. The number and proportion of older people in ethnic communities are expected to increase significantly over the next two decades. Key current issues are the cultural appropriateness of services, particularly health promotion and primary care, and addressing language barriers. |
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| | 2.6.1 By 2006 the Ministry will have worked with the Office of Ethnic Affairs to develop guidance for DHBs on health services for older people in ethnic minority communities. |