GPNZ MONTHLY ACTIVITY SUMMARY – DECEMBER 2023 -JANUARY 2024 KEY MEETINGS Chair and CEO · · · · ·
1 December: GPNZ Member Forum and AGM 18 January: Wayne Woolrich, CEO & Dr Stephanie Taylor, Green Cross 18 January: Janine Bycroft, CEO, Health Navigator Charitable Trust 18 January: Bindi Norwell, CEO & Dr Francesco Lentini, ProCare 19 January: Abbe Anderson et al and GPNZ CEOs Future of PHOs
Bryan Betty (Chair) ·
6 December: Visit Hawkes Bay with Dame Karen Poutasi
Maura Thompson (CEO) · · · · · · ·
7 December: ACC primary care leads 14 December: ACC Rehabilitation Improvement Group 18 December: THINK Hauora CEO pōwhiri 20 December: Tom O’Brien. GM Future of Health Workforce, Te Whatu Ora 19 January: Sarah Upston, Manager Clinical Quality, Ministry of Health 26 January: Sarah Clark, Clinical Director Commissioning, Te Whatu Ora 27 January: Jeff Lowe, Te Whatu Ora Board
ADVOCACY Future of PHOs ·
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Te Whatu Ora have committed to co-develop a discussion document on the future of PHOs by April 2024. This work will be undertaken by representatives from GPNZ, Te Kāhui Hauora Māori (Māori PHO Collective), Iwi Māori Partnership Boards, Te Whatu Ora, and Manatū Hauora. GPNZ acknowledges this will be an intense and high stakes period, and it is important in the years to come we can all look back and say we developed an inclusive process that everyone saw themselves in, supporting genuine co-design and collective solutions. The proposal for GPNZ representation in the working group includes the Chair, CEO, PHO CEOs on the Executive, together with Ngā Matapihi representation. (This includes three PHO CEOs who are elected representatives of PHOs with less that 250K ESU - Bridget Allan, CEO, Te Awakairangi Health Network, Irihāpeti Mahuika, CEO, Health Hawkes Bay and Barbara Stevens, CEO, Auckland PHO.) GPNZ is working with Te Whatu Ora to design an extensive engagement process that will take full advantage of the breadth and depth of knowledge present in our network.
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The first meeting of the national working group will be on 15 February. Some policy direction on the wider primary care environment is expected in February, following Ministry advice to the Minister. The work will look at the key functions of primary health/meso level organisations and then the structures to support them. A clear value proposition for the future organisations will be described around key functions including: o workforce development including employment of staff e.g. HIPs and coaches; role of the GP within a practice o service delivery o after hours and urgent care o standards and performance monitoring o clinical governance and quality o data and digital including provider capability and infrastructure development and cybersecurity; data standards o claims and payments o service innovation/model of care development/general practice model. The role of future PHOs as a facilitator and connector within the wider system will be considered, including enabling integration and joint planning with hospital and specialist services, and with wider primary and community services. Consistent and coherent solutions for urgent care and after hours also need to be developed. There is also an opportunity for facilitation of complex care planning and management. The work will take account of how provider networks develop, with a broader role than existing PHOs – including provider network support in place-based planning and delivery and an expectation of support to the whole of the population. There is an expectation of increased accountability and transparency, with accountability for outcomes. Discussions will also be had around potential conflict between being a provider and provider support organisation – for example, owning/providing services in the case of market failure but not routinely in competition with other providers. There will be regular updates provided along with opportunities to be involved with this key priority work in the coming months.
Comprehensive primary and community care team (CPCT) funding ·
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Budget 22 allocated funding through to FY 24/25 for additional frontline clinical team members in primary care. Te Whatu Ora wayfinders have signalled funding for CPCT could come to an end in line with these budget commitments. GPNZ has connected with clinical leadership and workforce leads within Te Whatu Ora and understands options to sustain CPCT roles are still being explored.
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GPNZ have convened a group to discuss next steps on CPCT and wider workforce development in primary care.
Te Whatu Ora board member visits · ·
We have confidence these visits have made a strong impression and helped to cement a role for PHOs in our emerging new system. Another series of these visits is currently being coordinated for the coming months, with Di Sarfati, New Zealand's Director–General of Health expected to attend some of the engagements.
Reconvening PSAAP ·
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Last year GPNZ shared proposals for contracted providers to appoint their own representatives at PSAAP with our membership, coordinating final feedback and liaising with the Contracted Provider Caucus in December. Following further discussions GPNZ prepared a letter to Te Whatu Ora on behalf of the Contracted Provider Caucus and GPNZ member PHOs, summarising the shared position. Te Whatu Ora has agreed to the proposals and a meeting will be convened in the next few weeks where it is expected the proposed changes will be formally approved.
Vision documents / white papers · ·
The data and digital opportunities for primary care paper is at final draft stage and is expected to be completed in February. To follow are papers on nursing workforce development in primary care and Māori workforce development.
PROJECTS Sapere report · ·
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GPNZ was proud to release Securing sustainable general practice in Aotearoa at the end of January. This is a culmination of our work with Sapere in 2023, and a credit to the level of engagement and expertise within our network. The contributions made by members during workshops in November and December were vital in developing a range of solutions we believe are essential not only to sustainable and thriving general practice, but also to creating a world-leading health system that supports all people to live well in their communities. The solutions we describe fall under a few key and interdependent themes: funding; complexity; models of care; rural general practice; workforce; integration; and primary care development and structures. GPNZ has distributed copies of the report to Te Whatu Ora, Manatū Hauora, sector partners and to a range of key figures across the Government and opposition parties.
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This paper will be a key publication to support the three critical issues GPNZ will advocate for in 2024: o a continued focus on equitable health outcomes for all, in particular whānau Māori, Pacific, and rural communities o the stabilisation and recovery of general practice to play a vital role in emerging primary and community care networks, requiring substantial revision to the current capitation model along with dedicated investment in workforce and data development o co-design of strong and stable network support functions building on the expertise and leadership in PHOs.
Unmet need research · ·
The research continues, with data provided by Te Whatu Ora in December and practice interviews/qualitative research completed in 4 of 6 participating practices. The project is due for completion in April.
Emergency planning in primary care ·
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This project aims to share learnings on emergency preparedness produce a primary care emergency preparedness plan alongside a comprehensive toolkit. This work is being paced with exploring emergency management as a potential key function of primary health/meso level organisations in the future – see Future of PHO work in the advocacy section above. In line with Future of PHO timelines, next steps include a survey to measure and understand the current baseline, including gaps and opportunities.
National Cervical Screening Unit – Primary Care Working Group · GPNZ will continue to facilitate a NCSU primary care working group who have been meeting weekly. · Next steps are expected to include participating in the re-design of the phase 2 HPV rollout, including the funding model and the model of care associated with cervical screening.
GPNZ immunisation working group · ·
GPNZ has created a working group to support the National Public Health Service with increasing immunisation uptake in Aotearoa. A work plan for the group will be created, with key themes to include: o workforce o access, including outreach and removal of barriers o disinformation and messaging, acknowledging there are demand and supply issues o funding, contracting arrangements and measurement
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performance and accountability.
In the short time the group have been working together there have been two priority discussions: development of outreach services and the proposal to enable childhood vaccinations through community pharmacies. It is recognised that general practice has a particular skill in leveraging immunisation visits to check in on any other health needs of pepi, māmā and the wider whānau. It’s important, regardless of the place people access their vaccination, that robust systems are in place to enable broader screening of whānau clinical needs with effective referral pathways back to general practice. Identifying and mitigating unintended consequences of this proposed change will be a key contribution of the working group, helping to shape the implementation to ensure it is safe, supported, equitable and effective in addressing priority areas of need.