Whangaroa Health Services Review Preferred Model of Care

The overall goals of shifting to planned and preventive care include: Improved population health outcomes Reduced health inequalities between Māori and non-Māori Increased patient satisfaction Increased staff satisfaction Improved health literacy.Key early actions include: Identifying the most appropriate methodology for risk stratification, and ensuring baseline data is ofappropriate quality Factor into design of the model of care learning on what already works well in Whangaroa (eg, selfmanagementgroup sessions, home visits) Identify evidence-based models of care for different risk profiles and population groups (eg, frail elderly;children; adults with diabetes) Define the scope and mix of health professionals at each level of risk stratification and associatedmodels of care Identify varying methods of patient contact, including nurse-led models, home visits, mobile clinics, and‘virtual consults’ (eg, telephone), and the suitability for patient groups Undertake a task and activity analysis to identify appropriate clinical and support staff input to models ofcare, and identify where possible staff substitution opportunities to improve efficiency and free up timefor more specialised professionals to focus on more complex cases Size resource and utilisation intensity for different models of care to inform resource and fundingallocation Align with urgent, after-hours and acute care, services for older people and nursing integration initiativesdescribed below.6. Urgent, after-hours, and acute care6.1 Urgent accessThe NHSP places significant focus on ensuring that all Northlanders have good access to primary careservices. A key measure of the responsiveness of health services is the ability for patients to have timelyaccess to appropriate services when urgent health needs arise. There is a perception amongst some in theWhangaroa community that getting same-day access to primary care services can be difficult.Often the key drivers of access issues in primary care relate to how effectively the practice triages patientneeds, how it uses the available workforce, and how productive that workforce is enabled to be by thepractice’s systems and processes. Currently, the Whangaroa Health Centre uses nurse triage to determinewho should receive a same-day appointment, who should see the patient, and the duration of theappointment. Conflicting views were expressed by stakeholders on how well the triage process is working.It was also noted that triage is challenging given the low health literacy and high expectations of thecommunity.A refocussed model of care would include as an immediate priority a review of Centre activity including: When do patients call or present? What are their needs? When are peak times?17