E22 A4 Annual Report 2010 FP.indd - Northland District Health Board

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22 ASSOCIATED HEALTH TARGET ACTIVITIES Cancer Control A stock-take and gap analysis of cancer services within Northland was conducted during the 2005-2006 fi nancial year and identifi ed signifi cant barriers for Northland patients diagnosed with cancer. In the Northern Cancer Control Strategic Action Plan, Northland DHB identifi ed that there were gaps in accessing available cancer services for the Maori population. The analysis found that cancer treatment services provided in Northland were chemotherapy and surgery treatment options. Complex chemotherapy and radiation therapies services are Auckland based and form part of a regional cancer service. Northland patients are required to travel for their complex care and are provided with accommodation and travel assistance through the New Zealand Cancer Society and Northland DHB. The Northland Cancer Control Strategic Action Plan 2006-2011 identifi ed breast cancer, lung and colorectal cancer as the top priorities for the fi ve year period. In July 2004, the eligibility for publicly funded breast screening was extended to 45-69 years’ thereby addressing the breast screening priority. In May 2007, the Northland Cancer Control Steering Committee agreed to establish cancer care coordination roles within the secondary care setting. It was agreed that two cancer care coordinators be appointed to assist in reducing the inequalities between Maori and non-Maori, and improve the access to cancer care services for Northland Maori patients diagnosed with lung and colorectal cancer. The two cancer care coordinator roles have now been in place for more than twelve months. Cardiovascular Disease Screening for Maori and Pacifi c Men Te Tai Tokerau PHO has been funded to coordinate and facilitate a process to ensure that the population at high risk from cardiovascular disease – Maori and Pacifi c men from 35 years – is risk assessed and receives appropriate management, through seamless follow up and referral systems. This project runs in parallel with a contract between Northland DHB and Te Hauora o Te Hiku o Te Ika that aims to extend the successful cardiovascular and diabetes awareness raising campaign across other Maori providers in Northland. In a nine month period, 5170 Maori have been screened within the programme, with 50% presenting with 15% or more high risk factors. One hundred and ninety seven Pacifi c men have been screened with 43% presenting with high risk factors. This work continues to expand as Te Tai Tokerau PHO plan and coordinate outreach screening programmes possibly going into work place not previously accessed across Northland. This acknowledges that Maori and Pacifi c men do not ordinarily access general practices until extreme health issues arise. While challenges have presented in the smooth running of the programme, these are not insurmountable and are being addressed through training on the use of the web-based clinical decision support programme for cardiovascular disease PREDICT-CVD, improving its functions and clarifying referral pathways and follow ups with practice nurses and Maori NGOs. Elective Surgery Northland DHB’s elective services have once again been rated gold star performers by the Ministry of Health. This meant we ensured that the vast majority of our patients were seen for a First Specialist Assessment within six months, and also received their treatment within six months of being seen. The district health board performed elective surgery on 6,675 Northlanders. This is an increase of more than 671 patients on the previous year. Emergency Department Length of Stay Programme Shorter stays in emergency departments is one of three hospital performance targets and Northland DHB continues to overcome challenges, with 86% of patients treated within six hours of presenting to an emergency department, still short of the 95% target. The ‘length of stay’ programme is ongoing and includes a number of initiatives such as weekly performance monitoring, the partial establishment of a short stay unit and meetings with primary care providers to discuss presentation demands on hospital emergency departments. A new model of care is also currently under development and will guide the future development of emergency services. Smokefree Northland Smoking is the single greatest preventable cause of illness and early death. Over 5,000 people die of smoking related disease in New Zealand every year. Smoking is a major drain on health sector resources, with signifi cantly increased use of health services and interventions by smokers. Northland has the second highest smoking rate (25.7%) in the country. Northland DHB’s recorded smoking rate in our admitted patients is 10.8%. Hence we have a gap (15%) between what we are recording and what is likely to be the true prevalence. In response to the challenge of meeting the required health target, Northland DHB’s provider arm is working to integrate the ABC approach into the every day practice of all secondary care workers. Trigger more quit attempts and improve the likelihood of success of each attempt through treatment. ABC is a memory aid for health care workers to understand the key steps to helping people to quit smoking. These steps are as follows: A. Ask all people about their smoking status and document this B. Provide brief advice to stop smoking to all people who smoke, regardless of their desire or motivation to quite C. Make an offer of, and refer or provide, evidence based cessation treatment. The key goal of the ABC approach is – “more supported quite attempts, more often”. This year, nearly 500 district health board staff received education about the use of the ABC smoking cessation intervention and they are now able to give advice on the benefi ts of quitting and support patients to quit by offering nicotine replacement therapy and/or referring them to a cessation support service. The implementation of new data collections methods for staff, to help hospitalised smokers quit, saw the health target for smoking prevention leap from 12% in the fi rst quarter to 55% in quarter four. Northland DHB has allocated $650,000 over a three year period to meeting specifi c objectives for supporting more quit attempts across primary care services. One of the key objects for this funding is to integrate the ABC into everyday practice of primary health care workers. Manaia PHO is the lead primary health organisation for this initiative. Funding arrangements should enable the achievement of agreed quit attempts targets and ensure that individual patients are managed within budget. REGIONAL ACTIVITIES AND ACTIONS Regional Collaboration One of the Government’s key responses to the Ministerial Review Group report, released in 2009, is the expectation of better coordination between neighbouring district health boards. Northland DHB is actively seeking a closer relationship with the three Auckland district health boards and healthAlliance. Mutual cooperation with other district health boards is also showing benefi ts. This is working hand-in-hand with a review and refi nement of Northland DHB procurement methodology and procedures. A key component to this is the development of a northern regional service plan and potential establishment of a northern regional shared service. The Northern DHB Support Agency (NDSA) provides regionally coordinated support to the metro Auckland and Northland district health boards and is
coordinating the development of the regional service plan for 2010/11. The plan due at the end of September 2010, will describe the many and varied streams of work being undertaken across the northern region. This plan will become the medium-term (5-10 years) accountability document for northern district health boards, and will have a strategic focus on intended service confi guration and models of care, and will identify short term implementation actions. The intention of the northern district health boards is to work together more effectively, at a regional level to make better use of available resources (workforce, funding, capital and IT), strengthen clinical and fi nancial sustainability, and improve equity of access across the region. Regional Detoxifi cation Unit Northland DHB’s Mental Health and Addiction Service recently opened a new Northland regional detoxifi cation unit called Timatanga Hou or New Beginnings, to support existing mental health services and addiction services in the region. Located at Dargaville Hospital, the new three bed unit provides 24-hour care, counselling and treatment programmes. To date, the main indicators for admission to this unit are alcohol, followed by cannabis and methamphetamine addiction. Regional Sub Acute Inpatient Unit A new regional sub acute inpatient unit is due to open in Kaikohe on 1 July 2010. The unit will be part of Northland DHB’s Mental Health and Addictions Service and will provide intensive six week rehabilitation care and treatment to clients / tangata whaiora, aged between 18 years to 65 years, who reside in the Mid North District. Based on a similar sub acute unit in Kaitaia, the new facility will support mental health and addictions clients that need more intensive support than their usual environment can offer. Northland DHB staff will be on-site to provide 24 hours a day, seven days a week care and observation, with visitors permitted, as and when appropriate. Recidivist Drink Driver Programme Northland DHB’s Alcohol and Drug Service have been piloting a programme for Recidivist Drink Drivers since June 2007. The pilot began due to an increased number of referrals from the Justice Department for Recidivist Drink Driving offenders to engage in treatment. The aim of the programme is to reduce recidivist drink driving, address the level of binge drinking or dependence and provide strategies for reducing alcohol consumption levels. The programme is psycho-educational and includes elements of motivational interviewing, cognitive behavioural therapy, relapse prevention, problem solving theories and victim empathy. Overall the programme has made an impact, reducing the amount of alcohol consumed and the rates of re-offending for participants who have completed the programme. A proposal has been submitted to RoadSafe Northland for funding to support the extension of the programme across Northland. A proposal has also been prepared for presentation to the Northland Intersectoral Forum (NIF) with the aim of securing facilitators from other organisations to work in partnership with alcohol and drug counsellors to deliver the programme. Northland Intersectoral Forum (NIF) In early March 2002 a forum was held in Whangarei, chaired by the Mayoral Forum and run in conjunction with the Ministry of Social Development. Some 25 representatives from the government and community attended the meeting which included facilitated workshops. The fi rst action identifi ed following the meeting was the establishment of a collaborative networking mechanism that would ensure that the Mayoral Forum and the government agency representatives worked closely together on an ongoing basis. As a result, the Northland Interagency Forum (NIF) was established. The NIF consists of the chief executive of the Northland DHB and Regional Managers of Work and Income, Police, Housing, Community Employment, Te Puni K kiri, Child Youth and Family, Ministry of Education and the chief executive of Enterprise Northland who provides the link between the economic and social strategies. Since the establishment of the group, it has spent time looking at what is already under way across Northland and has identifi ed where it can add value. The Forum developed a Strategic Plan for 2010 – 2012, which refl ects the Forum’s collective priorities across four elements: social, environmental, cultural and economic. Benefi ts of collaboration include: • The establishment of the Far North Alcohol Team (FNAT) by Northland DHB, New Zealand Police and the Far North District Council, co-locating and integrating working on alcohol in the Mid and Far North undertaking a wide range of activities. After a focus on licensed premises, alcohol-fuelled violence where the last drink was at a licensed premise prior to offending has dropped by over twothirds. • “The Pulse” located in Raumanga brings government and non government agencies together to meet the needs of youth in the Raumanga and wider Whangarei area. The collective approach has attracted a range of national interest and there is strong agency buy-in and support. The Pulse is utilised for a range of events, including Children’s Day 2010. • Child Youth and Family and Northland DHB are able to discuss mutual cases, and be proactive in supporting staff to work together better. Whanau Ora Earlier this year, Whanau Ora was launched as an inclusive approach to providing services and opportunities to families across New Zealand. The primary focus of this new initiative is on achieving best outcomes for whanau through the development of whanau leadership and integrated whanau-centred service delivery. To support the implementation of Whanau Ora, a national governance group provides strategic advice on policy priorities and ensures coordination across government agencies and key stakeholders. The governance group’s role is to facilitate the implementation of Whanau Ora. It does this through advice to the Minister Responsible for Whanau Ora and providing leadership and co-ordination across government agencies and stakeholders. The Northland regional leadership group provide recommendations to the Whanau Ora Governance Group on the selection of Whanau Ora service providers and the development and implementation of programmes and initiatives. The group includes between three and seven community representatives and offi cials of Te Puni K kiri, Ministry of Social Development and Northland DHB. PRIMARY HEALTH CARE ACTIONS Clinical Director Primary Health Care Clinical governance at a primary health care level is a necessary requirement for primary health organisations. In Northland the role of clinical director primary health care originally sat within the district health board’s service development and funding team. The opportunity arose to relocate this position within primary health care with the aim of linking more actively with those at the frontline of primary care and providing a strong primary health voice in Northland DHB strategic developments, and to complement the role of the two general practitioner liaison clinicians. Te Tai Tokerau PHO agreed to act as the lead primary health organisations on behalf of the then six Northland primary health organisations. Dr Russell Smart was appointed as the primary health care clinical director on 1 August 2009. Dr Smart works on four tenths basis, and utilises several bases around Northland to maximise links with general practitioners in the various Northland localities. Shifting Services from Secondary to Primary Care In March 2009, Government indicated its intention that planning should 23
Page 1 and 2: 2009 2010
Page 3 and 4: Contents INTRODUCTION NORTHLAND DIS
Page 5: Our Role Northland DHB, established
Page 9 and 10: Our Vision, Mission & Values Our Vi
Page 11: The Board Chair and Chief Executive
Page 15: Our Services Health Portfolio No of
Page 18 and 19: 18 NATIONAL: Health Workforce New Z
Page 20 and 21: National Health Targets Health Targ
Page 24 and 25: 24 comment to shift some secondary
Page 26: 26 implement a comprehensive health
Page 31 and 32: Our Health Priorities Northland DHB
Page 33 and 34: Financial And Audit Reports Content
Page 35 and 36: Northland District Health Board Boa
Page 37 and 38: Northland District Health Board Boa
Page 39 and 40: Northland District Health Board Aud
Page 41 and 42: Northland District Health Board Sta
Page 43 and 44: Northland District Health Board Con
Page 45 and 46: Northland District Health Board Not
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Northland District Health Board Sta
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NORTHLAND DISTRICT HEALTH BOARD Mau
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E22 A4 Annual Report 2010 FP.indd - Northland District Health Board

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