Minutes 12 Oct 2010 - Nelson Marlborough District Health Board

MINUTES OF THE TE ROOPU TUPU TAHI HUI HELD ON
TUESDAY 12 OCTOBER IN THE FINANCE MEETING ROOM, NELSON
HOSPITAL AT 10.00AM
Chair
Carol Gowan
Present
Lorraine Eade, Lynda Sigglekow, Robyn Byers, Ryan Papps (NMDHB); Ron Keown
(Richmond NZ); Alison Graham (Marlborough PHO); Michele Parkin (Consumer
Representative, Marlborough); Susan O’Connell (SF Nelson); Janie McIntyre
(Gateway Housing Trust); David Hough (Nelson Bays PHO); Jenny Martin (Care
Solutions); Jo Johnson (Te Whare Mahana); Pat Duffy, Sue Bateup (Health Action
Trust); Katrina Martin (CARE Marlborough); Jos van der Pol (Health Action
Trust/Compass/Kotuku); Tipene Taylor (Te Rapuora); Maree Bone (MHCAS)
Guests: Mark Garisch, Jane Large, Rosey Wilson (NMDHB)
In Attendance
Gaylene Corlett (NMDHB)
Apologies
Rita Van Iddekinge (NMDHB); Carmen Lynskey (Richmond NZ); Mary Ellis (White
House); Rachel Davis (Te Awhina Marae); Cheryl Thompson (SF Marlborough);
Peter Rees (Te Ara Mahi); Warren Sadd (MH Consumer Advocacy); Lois Millar (St
Marks); Lee Pahl (MHSS)
Karakia:
Tipene Taylor
1. Welcome and Introductions
Carol welcomed everyone to the meeting.
2. Minutes of Previous Meeting
The minutes of the meeting held on 31 August 2010 were accepted as a true and
correct record.
3. Matters Arising from Previous Minutes
Nil.
4. Issues, Information and Celebrations
Congratulations to Robyn Byers; appointed to the position of Service Director Mental
Health Services Directorate, NMDHB. New structure starts on 1 st November.
Noted NMDHB has been placed in the top 3-4 of DHBs in New Zealand for DHB
performance for specialist mental health services, in the final MOH report on Mental
Health and Alcohol and Drug Sector Performance Monitoring and Improvement. This
is a testimony to DHB leadership in mental health and the staff in the service. Noted
should be celebrated at CPHAC and HAC. Demonstrates how well NMDHB is doing
compared to other DHBs. Lorraine to send out link to report.
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Mental Health Awareness Week 4-8 October.
SF Marlborough
• Successful mental health awareness week with a laughter workshop on 7 Oct
• Walk through the lower quail trail on Saturday 9 th , great community support with
over 100 people participating
• Newspaper article for the Soapbox in the Saturday Express and the SUN
newspaper regarding Mental Health Awareness week.
CARE Marlborough
Held an Open Day during MHA week with a large number of people going through
the house.
Marl PHO
Smart books launched during MHA week. Joint project with DHB and Marlborough
Libraries. Marlborough Libraries financed and bought self help books for Mental
Health illnesses. Brochures have been printed for distribution to GPs and providers.
Health Action Trust
Media coverage of the Business Forum on Mental Health’s luncheon at Trailways in
Nelson with guest speaker Denise L’Estrange-Corbet (WORLD fashion label coowner)
to be sent out to the network by Sue Bateup.
Link to piece on National Radio:
http://www.radionz.co.nz/audio/national/ckpt/2010/10/07/denise_lestrangecorbet_appeal_on_mental_health
Acknowledgement given to those who put the business forum together. Encouraging
businesses to join the forum to promote mental health in workplaces. Noted Mental
Health Foundation has a package Working Well for Employers which is available for
workplaces (NMDHB have joined).
White House
Held Open Day for families and community.
Like Minds Like Mine
Tipene conducted radio interviews during MHA Week. Has bi monthly 15 minute slot
at Fresh FM for next year to discuss topics of interest around mental health. Will
forward dates to group.
SF Nelson
Promoted groups they have including Carers Group, Writers Group etc.
Attended Chamber of Commerce luncheon – congratulations to Tipene and others at
Health Action for coordinating.
Discussion
Mention of film titled ‘Insatiable Moon’ by Mike Riddell which premiered at the Suter
during MHA Week. Disappointed more notice and information was not available
especially being MHA Week. Susan O’Connell to write to Mental Health
Foundation saying they missed a great opportunity to get more people to
attend.
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5. Proposal for changes to the Psychogeriatric Service
Rosey Wilson (DM Health of Older People & Rural Hospitals), Mark Garisch (Portfolio
Manager Specialist health Services and HOP), Jane Large (Service Development
Health of Older People) joined the meeting to discuss the proposal for changes to the
Psychogeriatric service at Alexandra Hospital.
Alexandra Hospital, originally a rest home, was adapted to provide residential
hospital services to people with psychogeriatric conditions when Ngawhatu Hospital
closed. Since this time the service has become more specialised with a greater
emphasis on the Assessment Treatment and Rehabilitation (AT&R) services as well
as the provision of community support services. The move to Acute/AT&R provision
of services requires a more specialised environment to meet patient care and safety
requirements. The old facility is no longer able to meet this changed service
provision without significant capital expenditure and the increasing acute nature of
patient conditions means the clinical demand on services is unable to be sustained in
Richmond away from supporting medical and diagnostic services.
The high number of people who are going to be affected by dementia as the
population ages means we need to change the way services are delivered to meet
this demand. The challenge will be met by Best Practice including improved access
to more services and specialised care for older persons, a service that is responsive
to the increasing demands of an aging population, provision of continuing care that
supports patient safety and modern best practice, an acute facility in a location that
provides clinical support to clinicians, more individualised care and services,
increased medication and specialist clinical staff, strengthening services in the
community, and speciality teams to work with older persons.
What this means is that those clients assessed as needing long term care can be in
the community (eg rest home) and others that require more care can receive
specialised care as part of a specially renovated wing of the Mental Health Unit.
The DHB has written to all residents in Alexandra Hospital (or their families) about
what the proposal means for them. Each individual will be assessed to ascertain
their needs and where they will be best placed for the care that is needed for them.
Noted there is only one other DHB that offers residential care with psychogeriatric
services. Most others have this care provided by service providers in the community.
Through Rutherford it has been agreed that the DHB exit from Alexandra Hospital but
provide services in the community. The consultation period closes on 2 November.
Submissions will be acknowledged, analysed and recommendations made by 16
November, with the final decision made towards the end of November.
The preferred options are that the current psychogeriatric community team becomes
a speciality team of the Mental Health Service, the seven beds for the assessment of
those who are acutely unwell be relocated into a specially renovated wing of the
Mental Health Admissions Unit on the Nelson Hospital site, long term continuing care
be provided in the community, a clinical leadership group be established with key
clinicians from across all relevant Provider areas for health of older people, mental
health, neurology and other surgical and medical areas where appropriate.
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Concern was raised about patients that moved to Alexandra Hospital from Ngawhatu
having to move again – anxiety, confusion etc. This was acknowledged and noted
that this is one reason why the consultation process is being conducted quickly rather
than drawn out. Noted that only two clients at Alexandra Hospital have come from
Ngawhatu; the remainder coming from the community.
Discussion held on use, by providers, of high levels of psychotics on elderly patients
with no known experiences of mental health to make them more compliant. It was
noted that the DHB is now in the best position with clinical leadership than have ever
been, with new staff that are very cognisant about better use of medication. The
DHB is entering into an alliance framework looking at pathways forward with those
with dementia working with services to move away from medication. Used to be
nursing based team but now is very multi-disciplinary team who are all up to speed
on other ways of dealing with patients rather than medication (where appropriate).
TRTT are asked to talk to the sector around issues and forward submissions,
especially from Marlborough, which will form part of the recommendations.
Noted no decision has been made regarding Alexandra Hospital site at this stage.
6. Workforce Development
• Alison Graham attended excellent seminar on Anxiety Disorders in Adolescents.
• Not for Profit diploma course through Unitec. Helpful for anyone working in NGO
sector. Can complete just this paper rather than whole Diploma if you wish.
• Second module of peer support course has been completed at Health Action.
Have 17 people on the last module (mostly from Nelson / Golden Bay area). Ten
people are completing the whole course and are enrolled for framework Social
Services Level 4 accredited certificate.
• Te Whare Mahana staff attended a Personality Disorders conference in Dunedin
where they presented on DBT.
• David Hough mentioned Aged Concern (Marlborough branch) presenting ‘Beating
the Blues in Over 65s’ on 11 November 1-4pm. Aimed at those over 60, families
and support carers in the community. David to forward information to Lorr for
workforce development calendar.
• Care Marlborough are participating in a Mauri Ora course through Te Wananga o
Aotearoa, gaining a NZQA Certificate on completion.
7. Reports from Cluster Groups, Special Interest Groups, Other Networks etc
Motueka Mental Health Network – noticeboard is still work in progress. Hoping to
launch on 26 November. Group have completed TOR for sign off next meeting. Will
be working with employers of seasonal workers. Hilary Genet and Sue Bateup are
meeting with WINZ to address support for itinerant workers.
8. Collaboration and Consolidation
NGO providers group meeting today at 1pm – Gateway Housing Trust.
9. Key Performance Indicator Framework for Mental Health
Presentation by Lorraine on overview of Key Performance Indicator Framework for
Mental Health.
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Key Performance
Indicator Framework
The Ministry of Health funded the development of a Framework of Key Performance
Indicators (KPI) to enable services to learn about practices that lead to improved
outcomes for service users. The project has a quality improvement focus and has
been designed as a generic framework for use across the sector. Benchmarking
applies.
The two year project is hosted by Northern Districts Support Agency (NDSA) and
several sponsoring DHBs. There are nine participating DHBs. The aim is to develop
a common language regarding patient care and service changes represented in the
data. There will be combined clinical, management and NGO participation, with data
sharing and a view to publication. It is hoped to promote quality improvement, learn
about practices that lead to quality improvements and will focus on 10 Key
Performance Indicators and >30 supplementary indicators.
There are four phases: Phase 1 Design and Develop already completed, Phase 2
Live Testing also completed, Phase 3 Implementation being undertaken at the
moment, and Phase 4 Operation to be completed later.
Local coordinator is Ryan, NGO partner is Te Whare Mahana. Noted the Consumer
representative is not known at this stage.
It is planned that information on indicators will be presented to TRTT to discuss and
gauge where we are against other DHBs. Eventually PRIMHD data will be included
which will give a good picture overall of range of services we provide.
Quick information sheet handed out.
Any queries contact Lorraine, Ryan or Jo Johnson.
10. Mental Health Planning & Funding Report
Annual Workplan
Lorraine asked members to forward details of any work being done in the community
that she may not be aware of that we should be celebrating. Contact Lorraine for
more information.
Models of Care
DHB Provider Division are aligned to the new service specifications for 2010/11.
They have been operating with the new specs for the last quarter and NGOs will
come under the new specifications from the 1 st July 2011. The service specifications
and expectations differ from the old service specifications. Lorr is completing an
analysis comparing the old with the new service specifications and will meet with
providers to look at service specs to ensure expectations can be delivered.
SIRMHN
Te Pou have transferred funding to SIRMHN to assist with a regional approach to
Let’s Get Real. A number of proposals were forwarded for consideration including
one from Health Action Trust.
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PRIMHD continues to be a concern for the network. PRIMHD officials have been
requested to attend the next SIRMHN meeting to work through the issues of concern.
LOAD
First meeting held 30 September. The membership identified several key priority
areas for the next year.
New ELT
The new ELT has been announced which takes effect on 1 November 2010. The
Mental Health Services Directorate comprises of:
Service Director – Robyn Byers
Executive Clinical Director Specialist – Dr Heather McPherson
Executive Clinical Director Community – Dr Jocy Wood.
This is a very strong, knowledgeable and experienced leadership team which is very
good for mental health across the continuum.
Any queries regarding the report, please contact Lorraine.
11. Any other Issues
Maori Like Minds Like Mine have designed a workshop which is highly interactive
and informative. Workshop is between 2-2½ hours (as it is interactive length varies).
Target audience is employers who employ those with mental illnesses, however they
can focus on families etc. Tipene to send email of details to TRTT network. Contact
Tipene for more information. Noted next year NMIT have included the workshop into
the curriculum for three of their programmes. .
12. Next Meeting Topics
Carol to look at dates for next year.
Please forward any topics for the next meeting to Carol or Gaylene.
Close:
Tipene Taylor
Meeting closed at 12.18pm.
The next meeting will be held on Tuesday 23 November in Room 2, Seminar
Centre, Nelson Hospital at 10.00am.
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