Primary Health Care

Implementation Work Programme 2006 - 2010: Primary Workings - Issue 1, October 2006

Welcome to the first issue of Primary Workings which will provide regular updates on how we’re making real the Primary Health Care Strategy (PHCS). We would welcome your suggestions or feedback to help us improve the content and circulation. We are also looking for a permanent name for the newsletter so any thoughts would be helpful.

In this issue…

What’s happening?
What’s on our to do list?
How you can help?
Keeping it all on track
Project profile: Reviewing the funding formula
PHCS Implementation Work Programme Project Outline for October 2006

What’s happening?

Many of you will have participated in a series of meetings in April this year discussing the work involved in the next phase of putting the Primary Health Care Strategy into action. The feedback we received for our Next Steps helped inform our plans. A summary of the feedback was published in July at: http://www.moh.govt.nz/primaryhealthcare.

The projects involved in these next steps are now getting underway and the processes underpinning them are now being formalized. A project list and contacts is attached.

What’s on our to do list?

The foundations for the Primary Health Care Strategy are now largely in place - with PHOs, patient registers and new funding arrangements all established.
We’re aware of a significant number of great initiatives that are already taking advantage of the new arrangements under the Primary Health Care Strategy.

The next step in the strategy is to shift from establishment to meeting the key goals of the strategy – and making a difference to health outcomes. Our efforts will now be focusing on reducing health inequalities, engaging communities, and improving the prevention and management of chronic conditions.

The PHCS Implementation Work Programme helps provide that focus on the key goals for 2010. The four key areas for national policy and coordination are:

Funding and Accountability
Service Development
Infrastructure and Sector Development, and
Change Management

The programme was developed over the last year. Key stages were:

Project initiation and development of an initial working document, Sept 2005 – March 2006
Working document release (see www.moh.govt.nz/primaryhealthcare) with road shows, April 2006 – May 2006
Work Programme finalised - incorporating feedback July 2006 (see Next Steps at www.moh.govt.nz/primaryhealthcare)
Funding confirmed and programme manager recruited, July 2006
Programme established and project managers recruited, Aug – Sept 2006

As we progress there will be more ways to be involved and engaged in the work programme and helping realise our vision of the “new way of working”.

How you can help?

The Next Steps document released in July asked for people to register their interest to be involved in the various project workstreams.

A large number of people have registered. Your active involvement is crucial to ensure we reflect the wide range of health professionals and health workers involved in the delivery of primary care and generate workable solutions and solutions that will be supported.

In some areas, projects are now well underway involving those who registered their interest (see the spreadsheet attached). In other areas we have yet to begin work or determine how to best involve all those who’ve registered interest. If you have registered and we’ve yet to contact you please be patient as your involvement will come at a later stage in the project through workshops and other activities.

If you haven’t yet registered your interest and would like to do so, please contact Kim Arcus, Programme Manager of the Implementation Work Programme (kim.arcus@dhbnz.org.nz).

Keeping it all on track

The group responsible for ensuring the work programme overall stays on track is the
Primary Health Care Strategy Implementation Group (PHIG).

PHIG’s role is akin to a steering group and is to ensure the effective delivery of the four workstreams within the Work Programme. Their job is to keep programme’s workstreams on target, manage the programme’s scope, mitigate risks, and ensure the sector is engaged.

A major part of PHIG’s work will be to concentrate on process rather than content. The development of the content and any associated recommendations, proposals or guidelines will be the focus of the workstreams.

The PHIG’s objectives, as expressed in their Terms of Reference, are:

To ensure the successful implementation of the work programme against agreed milestones
Agree and prioritise the inclusion of new projects into the PHCS Implementation Work Programme as issues are identified by the sector
Ensure active engagement and participation of all sector participants

To meet these objectives the PHIG membership largely contains workstream personnel and representatives from the PHO Taskforce and Community Council.

The engine room of the work programme is the individual workstreams and it is here that there is more concentrated sector involvement as they are the ones developing the project content.

Implementation Work Programme Workstreams

Project Profile: Reviewing the Funding Formula

The PHO Funding Formula Review is one of the early projects in Workstream 1. It is a key piece of work to ensure the funding formulae works as intended.

Compared with five years ago, public funding of primary health care is now through population or capitation based funding formulae rather than fee-for-service. This change represents a fundamental shift in how the primary sector is funded.

When the PHO funding formulae were implemented in July 2002, the Ministry of Health committed to reviewing them within three to five years to assess their appropriateness in light of actual PHO experience and patient need. The project to review the PHO funding formulae is now underway.

The key objectives of the review are to answer the following questions:

Does it work? (assess the effectiveness of the current PHO funding formulae against the objectives of the Primary Health Care Strategy)
Does it put funding where it’s most needed? (review the variables used in the formulae to assess their suitability vis a vis alternative measures in terms of aligning funding to population health needs)
Do we use a good measure of health need? (assess alternative measures of “health needs”)
Do we use the right formula for the right job? (review the mix of the different formulae for the different funding streams)
How easily can we change formulae? (assess the financial, administrative and implementation implications arising from any recommendations concerning funding formula).

The Review is being conducted within a tight timeframe and will focus on three main patient services funding streams; First Contact, Services to Improve Access, and Health Promotion. The first stage of the review won’t consider PHO Management Services and other funding streams.

The Review will only look at the existing funding formulae and won’t be revisiting other funding mechanisms such as fee-for service or salary payment.

The project has a core working group as well as an expert advisory group (as outlined in the attached spreadsheet). The Expert Advisory Group will:

Provide specialised input into the review
Discuss issues and options to inform the review
Assess and quality assure the outputs from the review
Assist with communicating the objectives and outputs of the review to the primary health care sector.

The intention is to have the Review completed in time to present options to the Minister of Health before the end of 2006.

The project team will distribute a background paper later this month (October) seeking feedback on the funding formulae. If you would like to register your interest to be sent the background document please contact Neri Short (neri_short@moh.govt.nz).

PHCS Implementation Work Programme Project Outline for October 2006

Download the PHCS Implementation Work Programme Project Outline for October 2006 (.XLS, 24kB)

Page last updated: March 2007