General Practice Services QUICK GUIDE Services for patients Enrolled & Funded with WBOP PHO
“WBOP PHO Guide to Programmes & Funding for Patient Services” supports this guide with greater detail and includes CPO Mental Health and Acute Demand Services
Service/Programme
Service
Eligibility Criteria
Outreach Support Service to encourage women to be screened.
No patient co-payment unless otherwise stated Free Breast Screening for women between the ages of 45 – 69 years who are Māori or Pacific & all other women who have never been screened, or haven’t had their free mammogram for more than 5 years.
How to Refer and / or Claim
Breast Screening – GP Support & Outreach CarePlus
Aims to support and coordinate care of people with high health needs. Offers 4 x nurse or GP consults (1 Assessment & 3 reviews) at a reduced cost to the patient.
Patient to meet at least one of the following criteria: 1. 2 or more chronic health conditions or 2. 2 or more medical or mental health admissions in last 12 months (excludes surgical admissions) or 3. 6 first level service primary care visits/services in the last 6 months or 4. Has terminal illness & likely to die in 12 months or 5. Is on active review for elective services
No referral process. MedTech & My Practice - submit an Advanced Form. Profile & Houston - enter clinical details into PMS. Then generate an invoice & fax to 07 5773191 or email Annette; annettel@wboppho.org.nz
Service for priority women who are due for their cervical smear, are under screened /unscreened.
1. Māori women 2. Aged 20 to 69 years 3. Provider’s service must comply with the Guideline for Cervical Screening in NZ & National Cervical Screening Programme (NCSP) policies
No referral process. MedTech - submit an Advanced Form. Non-MedTech - complete a Manual claim form.
Cervical Screening – GP Support & Outreach
GP Outreach Support Service to encourage women to be screened.
Free Cervical Screening for women between the ages of 20 – 69 years who are Māori, Pacific or Asian & other women who have never had a Cervical Smear, or have not had a smear in more than 5 years since the last one.
Medtech - submit BPAC Midland eReferral. Non-MedTech - complete H&W referral template & fax to 5782657.
COPD Management
Funding to support GOLD standard management of COPD patients - up to 4 GP or Nurse consults.
1. Clinician has done WBOPPHO COPD training within last 12 months 2. Spirometry confirms COPD 3. Patient is high needs or is a CSC holder or newly diagnosed COPD in last 12 months or admitted to hospital in last 12 months (COPD related issue) 4. ‘Blue Card: Plan for People with Lung Conditions’ completed 5. Care Plan developed with patient
BPAC Midland eReferral. For 23PPV Sanofi vaccination administrated after eReferral submitted, send manual invoice to the WBOP PHO.
A free COPD rehabilitation programme & education provided by Asthma & Respiratory.
Patients with a diagnosis of COPD who: 1. Require close monitoring of exercise & risk reduction therapy 2. An impairment that could benefit from pulmonary rehabilitation 3. A medical clearance/GP referral
1. Written referral with relevant clinical history & diagnostic data sent via fax to Asthma & Respiratory on 07 578 5100 2. Discharge letter will be sent to practice prompting booking of Post Programme GP consultation 3. After GP consult send manual invoice & discharge summary to PHO
DAR: An annual assessment to establish health status of a diabetic patient. DCIP: Funding to support management of patients with diabetes to improve their health outcomes.
Patients diagnosed with Type 1 or 2 diabetes, excluding Impaired Glucose Tolerance (IGT) & gestational diabetes
MedTech - submit BPAC Common Form. My Practice - complete Diabetes template. Manual invoice to PHO. Profile - enter details in Encounter screen. Manual invoice to PHO. MedTech - submit BPAC Common Form. My Practice - enter clinical details in Best Practice. Manual invoice to PHO. Profile - enter clinical details in PMS. Manual invoice to PHO.
Package includes 6 patient contacts to deliver education, advice & time required to safely initiate insulin therapy.
1. Clinician had WBOP PHO approved Insulin Therapy training in last 3 years 2. Had a DAR in last 12 months 3. Diagnosed Type 2 > 6 months 4. Most recent HbA1c > 64mmol/mol 5. Patient suitable for primary care diabetes management 6. Enrolled in Care Plus or has valid HUHC
$69.91 per nurse or GP consult $279.64 p.p. per year Co-payment may be charged
Cervical Screening $27.93 per woman
$184.00 p.p. per year + $46.00 for 23PPV Sanofi vaccination
COPD Rehabilitation $109.70 p.p. per year
Diabetes Annual Review $65.58 p.p. per year
Diabetes Care Improvement Programme $238.51 p.p. per year
Diabetes Insulin Starts $190.81 p.p. Limited to once only
1. Had a DAR in last 12 months 2. HbA1c > 75mmol/mol 3. Referral to diabetes self-management group education is offered to patient
September 2018 version 1 Medtech - submit BPAC Midland eReferral Non-MedTech - complete H&W referral template & fax to 07 578 2657
MedTech - submit a form via BPAC. My Practice - enter details into patient notes & email manual invoice to PHO. Profile - complete the Diabetes Insulin Start template in the Encounter screen & email manual invoice to PHO.
Service/Programme
Service
Eligibility Criteria No patient co-payment unless otherwise stated
Discretionary Funds
Sport BOP
High Needs and Minor Surgery Funds available for patients in need. To increase patient physical activity & help manage chronic conditions.
For more information on discretionary funds please see the High Needs Discretionary Fund and Minor Surgery Fund sections in the “WBOP PHO Guide to Programmes & Funding for Patient Services”. 1. Green Prescription: Patient aged ≥ 18 years 2. Active Families: Patient aged 4 to 17 years & is whānau based 3. Must be medically stable & able to undertake physical activity
Health & Wellness
WBOP PHO Nursing services.
BPAC Midland eReferral under WBOP PHO Nursing Service.
Outreach Immunisation Service
Mobile immunisation service to assist general practices in the delivery of timely immunisations to their enrolled children.
Services include General Practice Outreach support, Outreach Support Whānau Nursing, Dietician, Whānau Cancer Nurses, Diabetes Nurse Educator and Diabetes Self- Management Groups. 1. Children <6 years old & 2. Children who are behind in their immunisation schedule or 3. Children of anxious or needle phobic parents or 4. Children who are anxious or needle phobic or 5. Children who cannot be contacted or DNA appointments
Palliative Care
Supporting general practice continuity of care for terminally ill patients & their whānau.
1. Terminal patients likely to die within 12 months 2. Care Plan development preferred 3. Patients to be enrolled in WBOP PHO, not necessarily funded.
No referral process / practice may have an internal approval process. A record of expenditure including utilisation details, $ value, & if care plan was developed is to be maintained for six monthly reporting.
Positive parenting for parents, caregivers & whānau. Service provided by specialist clinical pharmacists to optimise medicine utilisation to improve individual patient health related outcomes. Service provider is Foot Mechanics for diabetic feet & at-risk / high-risk feet.
Email Ardell Unsworth on ardell.triplep@kaitiakiservices.co.nz Enrol online at www.triplep-parenting.net BPAC Midland eReferral to Medwise.
Co-payment may be charged
Green Prescription & Active Families
Co-payment may be charged.
Parenting Support
How to Refer and / or Claim
September 2018 version 1 No referral process. Practice may have an internal approval process. A record of utilisation to be maintained for six monthly reporting. BPAC Midland eReferral to Sport Bay of Plenty.
BPAC Midland eReferral.
Retinal Screening for Diabetics
Service provider is Tauranga Eye Specialists.
1. Children must be aged 12 years & under 2. Offers Individual & Discussion group support. Medicines Therapy Assessment and Comprehensive Medicines Management available for patients who have had 6 or more inpatient admissions in 12 months (excl ED) and require further support. Please see the “WBOP PHO Guide to Programmes & Funding for Patient Services” for full eligibility criteria. People at risk of developing foot complication due to a chronic condition, esp. type 1 or 2 diabetics with high at risk feet. Refer to the “WBOP PHO Guide to Programmes & Funding for Patient Services” for full eligibility criteria. People with a diagnosis of Type 1 or 2 Diabetes. Gestational diabetes & pre-diabetes are excluded.
Smoking Cessation General Practice team Service Delivery
See below 3 programmes. Funding to enable practices to invest in clinical resources to support smokers to quit. Ideally over 4 contacts.
1. Provider must be GP, Reg. Nurse &/or Quit Card Provider. 2. Service delivery must adhere to NZ National Guidelines for Helping People to Stop Smoking. 3. Current smoker ≥ 15 years old.
MedTech - submit an Advanced Form. Non-MedTech - complete WBOPPHO claim template & email to chris@wboppho.org.nz
Current smokers who reside in the Bay of Plenty.
BPAC Common Form.
Smoking, hapū Māori woman or a non-smoking, hapū woman (any ethnicity) with a Māori partner or a non-smoking, hapū woman (any ethnicity) with Māori whānau around her who smoke.
Contact Tiana Bennett at the WBOP PHO for next course dates, locations & an enrolment form on phone 07 577 3195 or email tiana@wboppho.org.nz
Referrals are sent from Community Co-ordination Centre (CCC) to practices for patients needing Level 1 or 2 wound care. Practice needs to have had a Registration of Interest (ROI) accepted by the BOP DHB.
MedTech practices to complete Advanced Form. My Practice, Profile & Houston practices complete template provided by WBOPPHO. Template & invoices to be emailed to chris@wboppho.org.nz
Triple P programme
Pharmacy Community Medicines Medwise
Podiatry Services for At-Risk & High-Risk Foot
$138.00 p.p. claimable at the completion of programme
Hāpainga Ūkaipō for Hapū Māmā
Wound Care Level 1: $95 p.p. 1 - 3 visits Level 2: $300 p.p. 4 - 7 visits
Support for BOP residents who are motivated to quit smoking. Marae based 4 day programme supporting hapū māmā to quit smoking and whanau to have a smokefree home. Funding routine wound care cases which can be managed by general practice rather than secondary care.
MedTech, My Practice & Profile - submit BPAC Midland eReferral. Houston send via Healthlink to Foot Mechanics or fax 07 577 1222.
BPAC Midland eReferral.