Primary Care Update Information for general practices, pharmacy, PHOs and DHBs Update Five: September/October 2020 Māuri ora ki a koutou This is the fifth primary care update for general practice, pharmacy and primary health organisations (PHOs). Thank you for all the work you are doing to keep the primary health care system operating and our communities safe. We appreciate your effort and dedication. You can find previous primary care updates on the Ministry of Health website.
Introducing Nikki Canter-Burgoyne, Manager, Primary Care, Primary Health Care System Improvement Group, Health System Improvement and Innovation Directorate ______________________________________________________________________________________________
Nikki has a clinical background, having spent several years as a Paramedic for St John. She has subsequently served the primary care sector with roles at Northland District Health Board and more recently at the Mahitahi Hauora Primary Health Entity (PHE). Nikki left her role at Mahitahi Hauora PHE as the Care Improvement and Health Care Home Lead to join us at the Ministry. Nikki’s first day with the Ministry was Monday 17 August 2020. Nikki will be splitting her time between Wellington and her home in Northland. She has five tamariki, a lifestyle block and is also completing a Master of Science in Health Psychology in her spare time. Nikki has whakapapa to Ngāti Kahu and Te Rarawa in Tai Tokerau. Nikki is looking forward to connecting with the primary care sector and driving whānau led healthcare initiatives to improve outcomes and self-determined wellbeing. Primary Care Team Members Helen Topham, Principal Advisor (last day with the Ministry is 15 October 2020) Helen Francis, Principal Advisor Stephen Lavery, Programme Manager Rachael Bayliss, Senior Advisor Shung Wang, Senior Advisor Jordan Crosbie, Senior Advisor (going on parental leave 14 October 2020) Miriam Mitchell, Advisor Jess Crimp, Programme Administrator Vacant, Advisor
1
Introducing Monique Burrows, Group Manager, Primary Health Care System Improvement Group, Health System Improvement and Innovation Directorate ______________________________________________________________________________________________
Monique leads the group within the Ministry responsible for supporting improvement and innovation in the primary care, ambulance and pharmacy sectors. Monique is focused on working with sector stakeholders and across-government to deliver improvements in the primary health care sector to improve the lives of all New Zealanders – be it through the delivery of new health care initiatives, negotiating changes to funding and services, or advising Health Ministers. Monique has been with the Ministry since July 2016 and has held senior leadership roles in the strategy and policy function and in the Office of the Director-General. Prior to joining the Ministry Monique spent time in the private sector and several years in the Beehive working directly to Ministers. Monique has been in the role of Group Manager Primary Health Care System Improvement and Innovation since October 2019 and is excited to be back after a period of parental leave. Monique says it’s an interesting and exciting time for the primary care sector, with the Ministry’s immediate priorities being the response to COVID-19 and considering the issue primary and community nurses’ pay.
Establishment of the Ministry of Health’s COVID-19 Directorate ______________________________________________________________________________________________
The Ministry of Health has transitioned its COVID-19 Hub to a dedicated COVID-19 Health System Response Directorate, led by Sue Gordon as Deputy Chief Executive. The role of the new directorate is to support a coordinated national response for the health sector. On 1 September 2020, the directorate structure went ‘live’ with the following leadership team in place: • Chief of Staff: Wendy McEwan who joins us on secondment from the Defence Force •
Group Manager COVID-19 Response: currently vacant but with Brenda Hynes representing this group at the Senior Leadership Team table in the short term
•
Group Manager COVID-19 Border and Managed Isolation: Shona Meyrick
•
Group Manager COVID-19 Contact Tracing: Astrid Koornneef
•
Group Manager COVID-19 Immunisation, Testing and Supply: Kelvin Watson
•
Group Manager COVID-19 Strategic Operations: Jane Kelley
•
Group Manager COVID-19 Science and Insights: Rebecca Drew
•
Group Manager Office of the Deputy Chief Executive: Jane Kelley (Acting). 2
COVID-19 response ______________________________________________________________________________________________
New Zealand’s response to the COVID-19 pandemic is constantly evolving. We encourage you to keep checking the Ministry of Health and COVID-19 websites for new information. Information can be sourced from https://www.health.govt.nz/our-work/diseases-andconditions/covid-19-novel-coronavirus and https://covid19.govt.nz/ For COVID-19 primary care go to https://www.health.govt.nz/our-work/diseases-andconditions/covid-19-novel-coronavirus/covid-19-information-health-professionals/covid19-primary-care Services available to support health and disability workers Funded temporary accommodation for essential health and disability workers as part of the COVID-19 response. This is to make temporary accommodation available to workers who need to relocate to meet the COVID-19 response, or who have vulnerable people in their household. COVID-19 Surge Workforce to connect available health and disability workers with employers looking for health practitioners to support their COVID-19 response. COVID-19 clinical advice helpline – 0800 177 622 – for primary and community health providers, offering clinical support and advice Monday to Saturday from 8am to 7pm (except public holidays). Free counselling services through Health Care New Zealand for health care workers seeking mental health and wellbeing support. This confidential service can be accessed by calling 0800 820 080 to make an appointment with an experienced therapist. We need to look after ourselves so that we are able to care for others - please use this support line if you need help. We also have mental health resources and self-help tools available on our Ministry of Health website. Medicine supply COVID-19 has severely interrupted the international supply chain for medicines. Consequently, the medicines supply chain to New Zealand will be disrupted for 18 to 24 months, possibly longer. PHARMAC and Medsafe are working hard to ensure that funded medicines remain available in New Zealand. Whilst the medicines supply chain remains uncertain, some key messages for your patients and staff are provided below: • there is no need to stock-pile on medicines. Community pharmacies stay open to the public through all COVID-19 levels and will be available in your communities to support you with your medicine supply and information needs • if you don’t need your prescription straight away, arrange for the prescription to be sent through to the pharmacy of your choice and then contact that pharmacy to arrange a convenient time to pick up your medicine, or have it delivered. This will ensure the pharmacy team can be available to spend time with you and minimises numbers in pharmacies at any one time to support social distancing • as you would in your local supermarket, please be kind to those people in your local pharmacy. They are there to support you. We encourage you to keep checking the PHARMAC website for medicine and device supply chain issues (https://www.pharmac.govt.nz/information-for/enquiries/), and the Ministry of 3
Health and COVID-19 websites for new information. Information can be sourced from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus and https://covid19.govt.nz/
Āwhina app proving useful for health workers ______________________________________________________________________________________________
We’re continuing to receive positive feedback on the Āwhina app. The app was designed specifically for health workers, so we are glad you’re finding it useful and of course we encourage you to download the app if you haven’t already. Comments on the app include: • “It is a superbly easy way to ensure you are acting in the safest and best possible way for staff and patients.” •
“It’s a reassuring and convenient app. If it was not available, I would go back to foraging for information elsewhere. I would rather not.” As at September almost 15,000 health workers have used the app and over 83,000 articles were viewed in August alone on COVID-19 and a range of health topics. Recently, we’ve further updated the app to include: • an ability for users to indicate whether articles were useful and the ability to provide feedback on how we can improve these from within the app •
updated menu items, including a new resource for pressure injuries
•
the display of an app icon badge on all devices (typically a red circle indicating the number of unread updates)
•
improvements to the notifications list – notifications display in order of most recent first, and the notification bell count updates when articles are viewed in Latest Information feed.
Āwhina puts the latest COVID-19 information in your hands. More information, including how to download the app, is on the Ministry’s website. You can also email Awhina.info@health.govt.nz or call 0800 855 066 for more information.
World Pharmacists Day ______________________________________________________________________________________________
Friday 25 September 2020 was World Pharmacists Day. The Ministry would like to thank pharmacists, technicians and their teams for the important part they play in improving the health outcomes of New Zealanders. Refer to https://www.health.govt.nz/news-media/media-releases/pharmacists-recognizedvital-work-they-do
Prescriber Update 41(3) – September 2020 ______________________________________________________________________________________________
The September 2020 edition of Prescriber Update is available on the Medsafe website. This edition includes a spotlight article on Maviret (used for the treatment of patients with chronic 4
hepatitis C), information about the possible effects of gastrointestinal surgery on medicine pharmacokinetics, Kounis syndrome, importing unapproved medicines for supply, and more. Prescriber Update is written for healthcare professionals to provide information on safety concerns with medicines and medical devices. You can subscribe to Medsafe’s email list to receive Prescriber Update and Medsafe safety communications. If you have any questions, please email: medsafeadrquery@health.govt.nz
Rural Health Workforce Update ______________________________________________________________________________________________
On Wednesday 16 September 2020, the Health Workforce Sector update was sent out. The following update on rural health workforce was included. With the changes in COVID-19 alert levels the Ministry has been able to progress the mediumterm initiatives discussed with the sector to strengthen the rural health workforce pipeline. These initiatives are focused on attracting new people into rural health care careers, ensuring education and training meets rural health workforce needs, recruiting and retaining healthcare workers to rural locations, and then supporting them to develop professionally and in their careers. We now have three initiatives underway, each of these contributing to the rural health workforce pipeline. • Rural Health Careers Promotion Programme - the New Zealand Rural General Practice Network (NZRGPN) started its Rural Health Careers Promotion Programme two years ago and witnessed first-hand the success this programme has had in addressing the very beginning of the rural health workforce pipeline. Over the last year, the Rural Health Careers Promotion Programme team has visited around 80 rural schools and reached approximately 5,000 mainly Year 9-10 students (aged 13-14). • Rural Hospital Locum Recruitment Scoping Project - the Rural Hospital Summit Report, September 2019, identified the recruitment and retention of medical staff as one of the biggest challenges all hospitals represented at the Summit experience. The Ministry is supporting the NZRGPN, in partnership with the Rural Hospital Network, to undertake a Scoping Project to ensure there is an up to date and agreed understanding of the role of rural hospitals, their workforce, and the issues they are dealing with. • Continuing Professional Development (CPD) Education Programme - Mobile Health has provided a video-based CPD Education Programme to the rural health workforce for almost 20 years. These sessions are 100 percent based on local needs and support the provision of a competent and confident rural health workforce. With the Ministry’s support, this service will be scaled up to broaden their reach with a focus on supporting high need areas. If you have any questions, please email Kathy Phillips. If you would like to sign-up to receive the Health Workforce Sector newsletter, go to https://www.health.govt.nz/our-work/health-workforce/subscribe-health-workforce-sectorupdates
New pathway for accelerated silicosis assessment ______________________________________________________________________________________________
The Ministry of Health, WorkSafe, and ACC have been working collaboratively with health professionals to understand and respond to the emerging risk to engineered stone workers of exposure to respiratory crystalline silica (RCS). RCS can cause accelerated silicosis, a 5
potentially serious lung disease. This has been seen overseas in those working with artificial or engineered stone found in composite benchtops used in kitchens, bathrooms and laundries. An assessment pathway has been developed for health professionals to help assess and diagnose people who may be at risk of contracting accelerated silicosis. A copy of the pathway along with guidance to support GPs and other medical practitioners in assessing a patient is available on the Ministry’s website including information for patients. A Silica Exposure Health Pathway has also been developed to enable general practice teams to access information most needed at the point of care (registered users can access the new pathway on the Canterbury Community HealthPathways site). In early September 2020, WorkSafe inspectors began visiting businesses and workers known to work with engineered stone. People who have worked with engineered stone for at least six months in the last 10 years were encouraged to visit their GP for assessment. ACC will cover patients if their injury is identified as a result of working with engineered stone in a New Zealand workplace. There is more information about accelerated silicosis on the following websites: • Ministry of Health: https://www.health.govt.nz/silicosis • WorkSafe New Zealand: www.worksafe.govt.nz/dust • ACC: www.acc.co.nz/silicosis
BreastScreen Aotearoa (BSA) – PHO data match ______________________________________________________________________________________________
BreastScreen Aotearoa is New Zealand’s national breast screening programme which provides free breast screening to eligible women aged 45 to 69. For more details see the www.nsu.govt.nz website. The National Screening Unit has recently completed a new Datamart and reporting solution for BreastScreen Aotearoa. The reporting solution will include access to a new report which matches PHO enrolment information with BreastScreen Aotearoa data to identify women who are eligible for screening services but who are not enrolled for breast screening. The report will be available to the eight BreastScreen Aotearoa screening lead providers. This information is hugely important as it offers women who are eligible for breast screening services the opportunity to enrol for free breast screening. BreastScreen Aotearoa providers currently work with primary care providers in their region individually to manually data match and contact women who are not enrolled for breast screening. This report will automate that process but the relationships between primary care and breast screening providers will continue to be key for supporting women to access breast screening services. The Ministry is completing a privacy assessment that will cover sharing of PHO information. This will be completed before the report is made available to the breast screening providers. Guidelines for the use of this information include the expectation that breast screening providers continue to work with the PHOs and GPs in their region on a coordinated approach to contacting women. For more information contact Jennifer Cox: Jennifer.Cox@health.govt.nz
6
National Primary Care Patient Experience Survey ______________________________________________________________________________________________
COVID-19 patient experience survey update During June and July 2020, the Health Quality Safety Commission (HQSC) and interested PHOs surveyed primary health care patients to understand their experience of accessing health care during COVID-19 lockdown levels 3 and 4. Nearly 25,000 people responded to the survey; around 14,000 of whom had an appointment during the period 27 April to 10 May 2020, and just over 10,000 who had not accessed primary health care during this period. The 22 participating PHOs have received their results and HQSC is preparing a national report which will be available on the HQSC website later this year. Primary care patient experience survey In August 2020, the first iteration of the refreshed primary care patient experience survey was run by the new provider, Ipsos. This is the first time the survey has been run since November 2019; the usual February survey was put on hold with the change in survey provider, and the planned May release was delayed due to COVID-19. PHOs and practices will soon be able to access their results through the reporting portal. Looking forward to November 2020, the primary care patient experience survey will be available in Te Reo Māori. HQSC is also implementing actions to encourage increased participation, particularly for Māori and Pacific patients. If you would like further information, please email: Catherine.Gerard@hqsc.govt.nz or Avril.Macfarlane@hqsc.govt.nz
Immunisation ______________________________________________________________________________________________
Measles immunisation campaign Last month we updated you on the year-long measles immunisation campaign that’s underway to address the immunity gap among 15-30 year olds. Artwork files including brand guidelines, campaign logos, posters and website banners are now available on Te Hiringa Hauora/Health Promotion Agency’s website here for you to use to promote the campaign. More content will be added to the resource page during the campaign so please check back. Clarification about doses of MMR Two doses of the measles vaccine provide the most effective protection against measles. After one dose of the measles, mumps and rubella (MMR) vaccine, about 95 percent of people are protected from measles. After two doses more than 99 percent of people are protected. The campaign is targeting people aged 15-30 years who have not had any doses of MMR or are unsure whether they’ve had it. The campaign is targeting this age group for one dose of MMR as a priority. The vaccine can be given even if the person is unsure whether they have been fully immunised. Campaign promotion and advertising will reach some people who only had one dose as a child. Please continue giving a second dose where requested. However, resource and effort should be 7
focused on outreach to as many people aged 15-30 years as possible who didn’t receive the first dose of MMR as children. Please contact these patients to come in for an MMR vaccine if they haven’t had one yet. Take every opportunity to give MMR to this age group. Please also continue actively recalling any other patients under 15 years who have not had two doses of MMR. Anyone born after 1969 is also eligible for two free MMR doses, whether they have these through campaign activity or as a routine immunisation. Childhood immunisations It’s also important to continue giving MMR as part of the childhood immunisation schedule (moving to 12 and 15 months from 1 October 2020). We realise the current environment may make this more difficult than usual, but protecting young children through routine, on-time childhood immunisations will be easier and more effective than trying to catch up later. This applies to MMR and any other scheduled vaccines. Please also make sure all MMR administered through the campaign is recorded onto the National Immunisation Register (NIR). Update for those using Medtech Practice Management System (PMS) and implementing the new immunisation schedule From 1 October 2020, the National Immunisation Schedule is changing, and we ask that immunisation providers vaccinate children against MMR at 12 months and 15 months. This replaces the current schedule of 15 months and 4 years. Medtech will be updating the new schedule on 21 November 2020. This means that Medtech PMSs will not automatically be able to issue reminders for MMR vaccinations at age 12 months until 21 November 2020. Practices should recall their children at 12 months to receive their MMR -1 and PCV10 dose 4 and record these by selecting the existing MMR-1 15M and PCV10-4 15M vaccination tasks within the Medtech PMS. Medtech has issued guidance on how to do this on their customer portal – please contact Medtech if you need any further support. These vaccination administration guides will be available in Medtech’s Insight Customer Portal from the following locations: For Medtech32 customers: https://insight.medtechglobal.com/downloads/Medtech-32Training-Guides-and-Manuals/#chapter7. For Evolution customers: https://insight.medtechglobal.com/downloads/evolution-training-guides-andmanuals/#chapter14 Please contact Medtech Support via support@medtechglobal.com or by raising a Help Desk ticket in their Insight Customer Portal if you need further assistance. After 21 November 2020, practices using Medtech should recall children according to the new 2020 schedule.
FluTracking continues for COVID-19 surveillance ______________________________________________________________________________________________
Although we are leaving the 2020 flu season behind, FluTracking will continue running. FluTracking is one of New Zealand’s key surveillance programmes for tracking COVID-19 symptoms so please encourage your patients to keep on submitting their surveys and spread the word about it. 8
FluTracking is an online initiative that lets you, help us track flu and COVID-19 symptoms across Aotearoa New Zealand. Each week participants receive a link to a short survey (it takes less than 30 seconds to complete) asking whether they have had fever, cough or other related symptoms in the last week. It has over 90,000 registered participants and currently receives about 50,000 completed surveys each week. This information allows us to map flu and COVID-19 symptoms across the country. This helps us prioritise where surveillance efforts are needed. FluTracking could be particularly valuable in helping us detect a return of COVID-19. We encourage people to register online at www.flutracking.net and invite colleagues, friends, family and whānau to participate.
Communications to Ministry of Health Sector Operations ______________________________________________________________________________________________
Important Notice From 1 October 2020, all communication to Sector Operations via fax will cease. You can email us at customerservice@health.govt.nz or call us on 0800 855 066. Information can be sourced from https://www.health.govt.nz/publication/hiso-100292015health-information-security-framework
Ministry of Health Director-General sector updates. ______________________________________________________________________________________________
For those who don’t already receive the Director-General’s regular messages to the health sector, you can subscribe through this link. These messages provide news and updates relating to the Ministry of Health’s COVID-19 response.
Further information ______________________________________________________________________________________________
We welcome your feedback on the information you would find useful from us. Please email Rachael.Bayliss@health.govt.nz with your suggestions or to be added to the email distribution list. Thank you for your support and hard work to provide people with greater access to primary care, particularly during the response to COVID-19. Ngā mihi nui ki a koutou katoa
9