Project SPLICE - Taranaki District Health Board

Project SPLICE FINAL - February 2010
2.0 Key drivers and enablers for change
2.1 Introduction
A total of eight days were spent by the review team in Taranaki interviewing individual
stakeholders as well as multiple organisations through one-on-one interviews and focus
groups as appropriate (as described in Appendix III). Key drivers and enablers have been
identified on the basis of these discussions and a review against the evidence.
2.2 Key Enablers
The 2007 National Health Care Committee report [15] notes that there are two major foci of
chronic care models. The first is proactive support for people in a community setting, which
emphasises the central role of primary health care. The second looks for a redesign of the
health system to deliver a continuum of care across hospital and community-based services.
Both areas of change are required to successfully address issues for people with chronic
conditions. Taranaki DHB is therefore seeking a way forward that is comprehensive in its
approach to addressing chronic conditions. It looks to build on, and consistently implement,
work under way and achieve an integrated health sector. The findings identified here clearly
point to a focus on primary health care and indeed means to address health divides, as
evidenced by the success against the Ministry of Health (MoH) Health Targets.
2.2.1 Local strengths identified
The following key local strengths were identified:
Primary Care
Significant nursing development activity for Practice Nurses through PHO Nurse
Coordinators and Flinders Training;
Project underway using an “optimising the patient journey” approach in three practices
one of which involves exploring the district nursing interface;
Four planned Integrated Family Health Centres as part of the Better, Sooner, More
Convenient process;
Most of the population is still served by well established General Practice; and
Emergent long term conditions focus with an emphasis on screening, practice nurse
development and some development on additional coordinated allied service delivery.
Community Services
Innovative examples of rural locally delivered community nursing supported by Trusts
and / or local General Practice that have achieved significantly improved integration
with Primary Care and enhanced the role of nursing within the practice and community.
In particular this has provided some indication that a greater role could be taken by
mobile nursing in support of people with long term conditions and the elderly. Likewise
there is an indication that the practice nursing role can be developed to provide further
clinic based activity;
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