Whangaroa Health Services Review Preferred Model of Care

Implementing key performance measures at organisational, management, clinical, and service deliverylevels that enable the WHST Board and its committees to monitor achievement of priority actions.Revision of the strategic plan (and associated action plan) should be informed by input from WHST staff,from funders, and from partner organisations. A development process that also engages the Whangaroacommunity would address a number of the issues discussed above.There are stakeholder perceptions that management and administration infrastructure and costs at WHSTappear to be higher than would be reasonably expected of an organisation of its size, particularly given thatthe Trust has ceased to be a PHO (with those functions having been subsumed by TTTPHO).Administration costs have been increasing at a considerable rate at the Trust (131% over the past five years,or 18% a year), although they represent a small share of total expenses. The level of management costsand associated cost growth is less clear. An indication of estimated management costs for primary carelevel services is provided by management fees paid to PHOs by the Government, which for populationsunder 40,000 is $15.60 per person enrolled for each person up to 20,000. If this is applied to the Whangaroaregistered patient population, the implied management fee is $55,000.Given concerns raised by some stakeholders and the potential for more funding to be directed to frontlinecare, more detailed analysis of Trust administration, management, and other overhead costs relative torevenue could be commissioned by the Board, including benchmarking with like organisations.10. Enabling actionsAction in a number of important ‘enabler’ areas will support a refocussed model of care for the Whangaroacommunity including: Workforce capacity and capability Information sharing and technology Clinical and management networks Partnerships and community development Patient support to overcome access barriers.10.1 Workforce capacity and capabilityIt is vital that Whangaroa makes the best use of the available health and support workforce. This requiresinnovations aligned with moving towards coordinated and/or integrated multidisciplinary ways of working, inaccord with the direction of the NHSP.Assuming adoption of the preferred model of care described above, key actions related to workforce include: Ensuring the primary health care workforce (GPs, nurses, and allied health professionals) are workingeffectively together, developing their skills, working at the full scopes of their practice, and utilisingsupport roles effectively Establishing additional health care assistant and other support worker roles where these are costeffective Strengthening the primary health care multidisciplinary team, particularly in regard to the roles of clinicaland community pharmacy, community nursing, and home-based support services Developing the health of older people workforce to support ageing-in-place, including linkages withclinical services and support for voluntary services Strengthening the Māori health and support workforce.24