PM Meeting Minutes 31 May 2023

Western Bay of Plenty PHO Practice Manager’s Meeting Minutes

Date: 21/03/2023

Venue: Tauranga Yacht Club and Online

Time: 12 – 12.30 Networking & Lunch 12.30 pm Agenda Began

Video: Practice Managers Meeting 31st May 2023 - YouTube

Attendees (In person): Leigh Kennedy, Adele Hedges, Karilyn Lowe, Jane Wilson, Haly Robertson, Fiona Mears, Debbie Watters, Jo McIlwaine, John Thompson, Rowena Cook, Gareth Hudson, Harriet Brough, Sarah-Lee Barnett, Victoria Wilson, Lorraine, Deb Livingstone, Shona Campbell, Stephanie Birkbeck, Jude Clark, Jo Newtown, Pam Udnest, Rienie Delange, Ruakapua Bristowe, Trevor Deane, Guest John Thompson, Guest Keith Wamsley

PHO Attendees: Donna Hardie, Laura Penny, Bella Medeiros, Phil Back

Agenda:

1. Welcome and Karakia

2. PHO & Board Updates: Phil Back

3. Pathlab Updates: Keith Walmsley

4. Network Services Update:

a. VRM Workforce Reporting

b. Funding Streams: Cervical Screening, Immunisations, POAC

c. Spirometry Services in General Practice

5. Practice Debt Recovery + Q&A with John Thompson (Account Collections- Strategic Debt Resolutions)

6. Open Forum Session:

a. PM Suggested Topic for Discussion: Managing Staff Absence

7. Close of Meeting

PHO Update – Phil Back

• Lindsay recently returned from overseas travel. Unable to attend so Phil gave updates.

• Board had a national speaker talk to them about leadership

o What is the sign of a good leader? Calling people into collective action, bringing everyone into the same space. Ex: Covid- 19 response

• Board has defined clear response to governance’s recent strategic direction for the PHO.

o Strategic focus for the next 12 months is diabetes, ensuring clinical guidelines are clear and our network services are adequate for the populations they are intended to serve, ensuring there is a joining up of services, so patients have easy access and flow of care.

o Board is working through reviewing how they can operationally support diabetes care throughout the network; currently working on the framework and will be looking for network input in the future.

• StayWell Afterhours: looking into alternative rostering arrangements and virtual service providers as well as how we can improve accessibility and availability of services. The board has a meeting with the provider executive on June 7 to discuss findings they have done on virtual service providers, operational considerations, feasibility for implementation, and cost. That meeting will be the basis for broader stakeholder engagement and then deciding which service provider to proceed with.

• Funding Streams: Funding coming from Te Aka Whai Ora and Te Whatu Ora and longterm conditions and equity adjustments in kaupapa Māori practices and increasing immunisation and cervical screenings for eligible cares.

• Enhanced acute care: Tauranga hospital is under increased pressure especially during the winter months, so resources that responsive to Māori, Pasifika, Community Card

Western Bay of Plenty PHO Practice Manager’s Meeting Minutes

Service holders, and others are being planned. Everything will be done in conversation with our network services as part of our valued relationships and we understand our practices are also under pressure. We will be looking for your clinical team's feedback on this work. Funding is through the end of September.

Pathlab U pdates – Keith Walmsley

Pathlab rooms re -opening - from next week we will be back to having all rooms with the exception of Otumoetai (still under review) open and running normal hours.

• Te Puke - Monday to Friday 8am to 4pm

• Katikati - Monday to Friday 8am to 4pm

• Greerton - Monday to Friday 8am to 4.30pm

• Mt Maunganui will be re-opening Tuesday 6th June and will have extended hours of Monday to Friday 7am to 5pm. We will also have a greater capacity in these rooms.

Please see our webpage www.pathlab.co.nz and click on Locations and Hours for collection room hours and further information.

Thank you all for your support and understanding during the past months.

Results requests from Patients.

We are getting a number of results requests from patients who have contacted the practice and then getting asked to contact the lab for their results. This is not helpful.

Unless you have an issue with importing results into your system, results are being sent to the practice within a short time of completion of testing. If you have not received the results, this will generally mean they have not been completed or released at that stage. On another matter relating to results.

There have been a number of practices more recently that have switched PMS’s but have failed to inform Pathlab or Medical Objects of the switch. This has had an impact on results loading into their PMS. If you are upgrading from Medtech 32 to Evolution, or you are changing to a different PMS completely, please include Pathlab (myself is fine) and your resulting platform (Medical Objects/Healthlink) in your communications so we are aware of the change and can make any changes required.

Patients with suspected Measles or Covid being refer r ed to Pathlab for testing.

Please do not send these patients to Pathlab collection rooms. These patients should be delt with at your practice at the time of consult.

Finally……. Is there anything we can do better to make things easier for patients to access our rooms? Any feedback would be gratefully received. You can either email or phone me to discuss.

Keithw@pathlab.co.nz - 075787073 ext 6616

Western Bay of Plenty PHO

Practice Manager’s Meeting Minutes

Network Services Updates- Donna

VRM Workforce Reporting

Thank you to those who have submitted already and those who are stilling working on filling out their Workforce Reporting Surveys while operating under capacity. We encourage you to update it weekly if there have been changes. Your previous answers pull over into the new survey so if there have not been changes, it can remain the same. Your survey results and data go to Te Whatu Ora and they actively use it and discuss it.

Funding Streams: Cervical Screening, Immunisations, POAC

Small project being run from Ministry of Health and some practices have been approached to participate in it. Purpose: strengthening the CVRA programme. The project is aimed at our high needs population- Māori and Pasifika. There are a core number of patients that go through the pilot so we can get a good snapshot of the data to ensure it works. There is an extra tab on Halycon with a care plan for clinicians to fill out if they want to participate. The clinician will look at the patient’s goals and the ways to reach those goals day-of and then the patient will take a print off of the sheet to take with them. After that appointment, a health coach will connect with that patient 4-6 weeks later to get feedback on how the appointment went, what worked, and what did not work. This session is funded when the full package of care is completed. The health coach session with the patient is funded. The health coach will also check in with the associated clinical to see how the session went from their end. This process will give us a good indication of if this is working for our clinicians and patients and eventually roll this out. For the immunisations and cervical screening, the priority is for women, and we have 3 practises who have already signed up for this campaign.

Immunisations: Referrals through the Hau Ora Immunisation Team

Spirometry Services in General Practice

Michelle Harding wants us to do a take of practises who are offering spirometry services. The last survey was sent out 2 years ago and received limited responses due to Covid-19, so we are trying to get a better assessment now. We want to understand who is offering spirometry, who are not and why they might not be, and what are the barriers to providing these services. We may be putting a survey out to capture this info and will help us get a better overview of this service across our network as we consider POAC and Winter Wellness funding allotments.

Practice Debt Recovery + Q&A with John Thompson

(Account Collecti ons - Strategic Debt Resolutions)

Account collections processes quite a bit of medical debt, they work with 35 medical centres, 150 dental practices, and 50 veterinary practices- all specialist medical spaces working with admin staff.

Three (3) Reasons for Medical Centre Debt:

1. Administrative: Can be an error by either the Medical Centre (eg. incorrect contact details) or the debtor (eg. both partners in a relationship understood the other partner was paying). Debtors are often unorganised and/or overwhelmed.

2. Psychological: The debtor either doesn’t like or doesn’t agree with the advice from the consultation and as a consequence believes that they do not owe.

3. Financial: The debtor has a lifestyle such that their usual periodic outgoings are greater than their income and so they prioritise their spending, but such prioritisation does not include paying the Medical Centre.

Western Bay of Plenty PHO Practice Manager’s Meeting Minutes

Regardless of the reason, communication from the debt collector to the debtor will finally shock the debtor into doing something. The shock created by the debt collector’s involvement is far greater than any communication or pressure that the Medical Centre can bring to bear.

Account Collections amplifies and harvests from the shock factor by using three communication tactics:

• Using colour, graphics, and pictures in all visual communications (so letters, emails, and texts). Debtors don’t read so other ways to get a message absorbed have to be used.

• Immediate telephone reception by mature staff. Debtors are put off by technological advancements and prefer to speak with someone who can guide and help.

• Repetition of communication. Debtors need lots of communication each week to get and keep a debt repayment in their priority list.

It is reasonable and even kind to get debtors to pay for their medical consultations rather than the Medical Centre having to wear the cost and increase prices to other patients and for the debtor to simply spend their money on other things such as big colour TV’s etc.

Debt collection agencies are useful for larger amounts of money that the practice cannot retrieve themselves. If a non-paying patient is in debt to a practice because of financial issues like poverty or lack of funds, it can be empathetic to try to understand that patient’s financial situation and give them support through HIPs. John, the presenter, notes that in his thousands of debt collection cases, inability to pay debts is rarely due to financial struggles and more often because the debtor is not prioritising their spending. Debt collection agencies do not place importance on paying the amount in full or large amounts, but even $5 or $10 a week is acceptable and encouraged. They only want people to be making payments towards resolving their debt. The debt collection services manages these small payments and following up with debtors, taking that administrative task and energy off of the practices.