Primary Health Care

Implementation Work Programme 2006 - 2010: Primary Workings - Issue 3, June 2007

Welcome to this issue of Primary Workings – keeping you informed of the Primary Health Care Strategy and supporting activities. This issue highlights the evolving PHCS work programme and how it’s working to support DHBs in primary health care delivery.

In this issue…

The Evolving Shape of the Work Programme: Building Capability

There has been a slight shift in the focus Primary Health Care Strategy work programme this year.

The early part of the programme was focused more on policy aspects of the Strategy – funding, fees, PHO governance and infrastructure (information and workforce).

The policy work will continue and be led by the Ministry of Health in consultation with DHBs and the sector. At the same time, there will be a greater focus on supporting the development of frontline capability at the provider, PHO and DHB level.

Capability in the sector is variable and a key area of activity that will be led by DHBs in 2007/08 is DHB-PHO relationships. This will include activities such as:

‘Sparking’ a greater awareness of primary health care’s contribution to DHB outcomes, especially amongst DHBs with a lower focus on primary health care
‘Supporting’ those keen to develop through initiatives such as toolkits, conferences, a PHO Governance Guide and training, supporting the spread of innovations and further development of the PHO Capability work, and
‘Sharing’ the good examples and disseminating information using vehicles such as demonstration sites and write ups

This shift reflects some of the key priorities identified by the ‘Connecting Voices’ workshop in November 2006 and by other stakeholders. Supporting local frontline delivery by DHBs and PHOs is crucial to meeting the changing needs of our populations so it needs to be a focus of the programme.

Joint Planning

One of the tangible examples of a well functioning DHB-PHO relationship is joint planning. While this needs support locally, it also needs to be in place at the national level. The work programme is putting a more formal annual planning process in place with sector engagement to provide input to the programme’s yearly work plan. This will help identify what is to be addressed at a national level compared with the development of local solutions.

To coincide with DHB and Ministry planning, a series of workshops will be held over February 2008 as part of this process. Keep an eye out for further information!

This is a key point of programme engagement which some felt was needed in the early development of the programme last year.

Update: 2007 Funding Roll Out, 25-44 year olds

The steps are in place for the final Roll Out on 1 July 2007 to ensure all 25-44 year-olds benefit from reduced fees for practice visits and prescription charges. It will be a significant milestone representing the government’s $2.2 billion investment in health ensuring better primary care access for all New Zealanders.

Update: PHO Governance

Effective PHO governance is a key component to improving health – it has the responsibility for improving the health of all its enrolled population, especially people with high needs. It is also that governance function that is one of the links to a PHO’s community.

A three-pronged approach is being used to ensure PHO Boards have the capability to guide and direct their organisations:

Some minor changes to the DHB-PHO Agreement to support good governance.
A Governance Guide for PHOs has been prepared with the assistance of a sector advisory group. An initial draft has recently been circulated to stakeholders for comment and a final version will be available by the end of July.
Training and facilitation will be made available for PHO board members later this year and in 2008. Keep your eye out for these sessions later in the year.

Update: PHO Funding

A report examining possible changes to the PHO funding formulae was sent to the Minister in March 2007. The focus was on the First Contact formulae and Services to Improve Access and Health Promotion were covered to a lesser extent.

As well as looking at options for change to the First Contact formula, the report also set out general principles for future development of the funding formulae.

The report was based on modelling work undertaken by the Ministry of Health and input from a broad-based expert advisory group as well as sector feedback.

The Minister regards the PHO Funding Formulae Review report as well informed and a useful basis for further work. However, in considering all the analysis, he indicated the need to incorporate a wider approach broader than the First Contact formula.

In particular, rather than amending the First Contact formula in isolation, the next phase of work on the PHO funding formulae will focus on populations with high health needs. As a result, the review will take a broader examination of how to address the needs of high needs populations including those with chronic illness. Funding streams among those being considered include the Very Low Cost Access initiative, Care Plus, Services to Improve Access and Health Promotion.

Over the longer term, the review will also take a more strategic view of the how the funding formulae can best support the objectives of the Primary Health Care Strategy.

Update: Workforce

The workforce team has now completed its stocktake of initiatives and priorities. Along with input from key stakeholders, this work is being used to finalise an action plan. The key priority areas identified by the sector included:

Funding and service delivery models
Recruitment and retention
Training
Career pathways and role definition
Maori health workforce
Pacific health workforce
Rural health workforce

A summary of the stocktake findings will be available shortly containing some valuable information on the types of initiatives currently underway as well as sector perspectives on workforce issues.

Update: Information

The Key Directions team has just completed its policy consultation which included 8 workshops around the country. The workshops attracted over 165 participants from over 80 organisations and 21 written submissions.

The consultation document proposed an improved information environment for five capabilities:

Enabling self management
Improving performance and evidence based decisions
Identifying and responding to population health needs
Supporting the tailoring of care for individuals
Enabling the coordination of care and integration of services

The Key Directions team is now analysing the feedback. Initial analysis was discussed with the Key Directions Advisory Group on June 6th. Changes based on the feedback will be incorporated into a final Key Directions document due for completion on June 22nd. The final Key Directions document will become input to the Road Map and Stage I Business Case

Copies of the draft initial strategy document are still available at www.moh.govt.nz/moh.nsf/indexmh/primary-health-care-information-environment-consultation-apr07 or via www.moh.govt.nz/primaryhealthcare.

Page last updated: June 2007