Copy
View this email in your browser

Waikato District Health Board

GP Liaison 

February 2020





Welcome to our February 2020 edition of GP Liaison and Happy New Year to everyone.

If you have any questions about the content or anything else please get in touch.
Waikato DHB is committed to support your practice and the patients you care for.

Please email the team should issues arise;

Damian.Tomic@waikatodhb.health.nz
Mark.Taylor@waikatodhb.health.nz
Sheril-Ann.Wilson@waikatodhb.health.nz
Fiona.Campbell@waikatodhb.health.nz
Angela.Fairweather@waikatodhb.health.nz
Geraldine.Tennent@waikatodhb.health.nz 
 
Contents
Waikato DHB Chief Executive Update 
Novel Coronavirus: COVID-19 
Waikato Transformation Programme
Acute Demand Management Advisory Group
Primary Options (POAC)
Clinical Workstation Updates
Pregnancy and Maternity information
Acute COPD service for GPs
Frail Elderly Admission Avoidance Service
Community HealthPathways and eReferral Developments
National Bowel Screening Programme 
New Zealand ePrescription Service (NZePS)
Waikato DHB Primary Secondary Integration Team

GP Liaison Updates

Mark Taylor
Fiona Campbell
Angela Fairweather
Sheril-Ann Wilson
Geraldine Tennent
Waikato DHB Chief Executive Update Dr kevin Snee
You can read the CE Update from cover to cover or download a PDF version on our website. You can also go straight to the article you want to read via the links below.
COVID-19 :Novel Coronavirus 
Please contact your PHO should you need Information and support concerning COVID-19. Comprehensive information can also be found on the Ministry of Health Website below. 

https://www.health.govt.nz/our-work/diseases-and-conditions/novel-coronavirus-covid-19

Please remember that the information for health professionals is updated regularly so it pays to regularly check for updates.

Key messages:
  • PPE to be used when assessing all suspected cases (travel through Mainland China in 14 days prior to symptoms starting plus fever > or = to 38 degrees plus shortness of breath or cough or sore throat or contact with confirmed case).
  • Notify Medical officer of health all suspected cases.
  • No diagnostic swabs to be taken in general practice unless instructed to do so by the Medical officer of Health (Public health unit)
Waikato Transformation Programme

 
To achieve equity, improve health outcomes and sustainability  Waikato DHB has commenced a bold programme of transformation. The programme covers the three key areas of system transformation and innnovation, business transformation and sustainability. 

The Direction is informed by the Waikato Health System Plan Te Korowai Waiora and a review of our resources. 
 
Key slides outlining the transformation approach
Read the full Waikato health System Plan Te korowai Waiora here
Acute Demand Management Advisory Group
I am Chairing the newly formed Waikato Acute Demand Advisory Group. Reps from our hospitals, ED, PHOs, Urgent Care, St John, Pharmacy, Community Services, nursing and allied health attend.

The main purpose of the group is to provide strategic leadership and direction to Waikato DHB to ensure urgent and acute presentations across primary and secondary care are managed safely and in the most appropriate setting generally determined by health need. Community -based alternatives to ED presentation and hospital admission will be developed where this makes sense.

Achieving equity and improved health outcomes for Maori is a priority.

The group has prioritsed 0-4 yrs childhood respiratory illnesses to focus on as these children present in high volumes to ED, there is significant inequity between Maori and no Maori and there is the possibility of new approaches improving the current situation.

We are now scoping up the project. We will move to a new area of focus later in the year.   

Don't hesitate to ask if you have any questions.
Primary options (POAC) 
The POAC Monitoring and Improvement Group continues to meet to ensure this programme is meeting the needs of general practice and the health system.
The POAC group will be using utilisation data to make recommendations around support or changes that may be required.
We are in the process of approving three new claimables within POAC;
  • GP/nurse observation and consult time for those rural practices following the accelerated chest pain pathway( point of care troponin)
  • GP home visit for patients referred to frailty admission avoidance service
  • Practice observation time for severe allergic reaction ( not anaphylaxis)
Clinical Workstation updates 
  • Try looking at progress notes under "documents". All DN’s, PHN’s, Ear Nurse Specialists, CNS Continence, Community Lactation Consultants record the care received in progress notes when they see your patient. The Wound Care team are also using them for some outpatient visits as well.
  • Ambulance notes can also now be accessed through CWS. There is an Ambulance Care tab under documents.
  • You can now access the inteRAI assessment results after your patient has been referred to Disability Support Link. Interesting to know what questions were asked and what the answers were. 
If any of the functionality doesn't work for you please let me know
 
Pregnancy and Maternity information 
  • The Pregnancy and maternity information for women is live on the DHB website you can access it via www.waikatodhb.health.nz/pregnancy
     
    Plus read about the launch on the DHB newsroom
    https://www.waikatodhbnewsroom.co.nz/2019/12/04/pregnancy-and-maternity-information-for-waikato-women/
     
  • MoH-sponsored Find Your Midwife site www.findyourmidwife.org.nz  - an information website where women can find out about midwifery care, and see which midwives may have space in each month. It works a little like ‘book a bach’ with women able to see who has space. We have printed resources (cards, posters) which I have sent out to the majority of Waikato GP practices (Hamilton, Huntly, Cambridge, Te Awamutu). I enclosed my contact details for further supplies. I’ve not had any requests for more info/resources.
Many women find it challenging to secure a midwife; this helps a little.  Please remind GPs giving early pregnancy care that women should not delay contacting a midwife. 

Regards, 
Fiona Hermann

Fiona.Hermann@waikatodhb.health.nz>
Acute COPD service for GPs

Waikato DHB's acute COPD service continues to expand. This service helps you manage your COPD patients in the community rather than referring to ED when it is safe and appropriate to do so.
You can read about the new service below.  Information is also in the POAC manual.
You MUST  ring the dedicated COPD hotline first on 0272 026 208 and follow this with an eReferral (COPD ACCESS).
If you are unsure about where to send an acute COPD patient please ring the service for advice.
Please let me know if you have used this service and have not been satisfied by the response
Community Clinics
Amanda works out of Anglesea Pharamcy, the District Nurse rooms at Ngaruawahia, and Matariki in Te Awamutu.  We are currently looking at moving to Morrinsville, as we are now getting a large cohort in that direction.
For further regions, we are managing these with advice phone calls.
Education Sessions
We have done education and teaching sessions at the Northern education Network.
Amanda and Glenda have done a small roadshow to the GP practices in Te Awamutu and Cambridge.  This is to introduce our service, offer education as wanted, and find practice nurses to be our link person.
Read about the new COPD service here
Frail Elderly Admission Avoidance Service

The acute Frailty Admission Avoidance Service is meant to support GPs and their vulnerable elderly patients by providing alternatives to Emergency Department referral. There are times when a hospital is not the right place to be if you are frail with a minor medical issue. In fact hospital  admission can make the outcome worse.

To see if your patient can benefit acutely ring the triage Coordinator on 027 552 0187.

If accepted please follow this with an eReferral.

See the eReferral section of this newsletter for more information.

The service aims to support GP’s to link patients into the most appropriate short-term community service:

  • Acute Home Based Support – in home
  • Respite  - in a rest home facility 
  • START – in own home but provides a rehab service 
Read how to refer your frail patient
Community HealthPathways and EReferral Developments
HealthPathways and eReferral work continues to gather pace. Many of you are now using the HealthPathways site.
Read about all the work going on below.
If you need a login please contact; 
Joanne Hollobon  :  Jo.Hollobon@healthshare.co.nz
HealthPathway and eReferral Developments
National Bowel Screening Programme (NBSP) goes live November 2020.

Waikato go-live scheduled for November 2020.

Primary care has an important part to play in the success of the National Bowel Screening Programme (NBSP). General Practitioners and practice nurses will discuss and manage positive test results with their patients. .They also have a key role in encouraging participation, helping achieve equity and raising awareness of bowel cancer symptoms and family history.
As we get closer to go live you will be receiving opportunities around education, advice on the payment you will receive for managing a positive result and information regarding changes to your dashboards and eReferral to support you. 

In the meantime if you have any questions please let me know
Thank you
Damian
New Zealand ePrescription Service (NZePS)
Waikato DHB would like to see general practice using this service.

Key GP benefits:
  • Prescribing controlled drugs will no longer need to be handwritten and in triplicate.
  • The prescriber can choose to be notified when a patient's medication has not been dispensed, which can help determine whether a patient's treatment plan is working.
  • Faxed NZePS prescriptions no longer need originals ( for non-controlled drugs only).
Useful information on how to get started can be found on the Ministry of Health webiste.  

https://www.health.govt.nz/our-work/digital-health/other-digital-health-initiatives/emedicines/new-zealand-eprescription-service

https://www.health.govt.nz/system/files/documents/pages/getting_started_guide_updated_20_dec_2019_final.pdf
Waikato DHB Primary Secondary Older Persons Integration Team
Debbie Gordon and Karen Griffin work as a link between hospital, primary health, non-government organisations and Aged Residential Care (ARC); providing support and education for health professionals in the hospital and community setting throughout the Waikato. Needs are identified and they follow these up with GP practices, ARC facilities, home based care providers and any other group requiring support. Their work includes;
  • How to access interRAI reports ( DSL assessment)
  • Providing "Cognitive Assessment" workshops discussing the MoCA tool for GPs 
Read about their work here
GP Liaison Updates

Mark Taylor

You can read mark's update here

Thank you

Mark.Taylor@waikatodhb.health.nz

Fiona Campbell

The ereferral for USS requests is helping greatly to reduce waiting times and ensure that those who need a scan are seen in a timely fashion and the backlog is reduced. If your patient falls outside the access criteria please provide sufficient clinical information on the form to enable triage. Any feedback or concerns around the new process are always gratefully received so we can aim iron out any issues early on.

The administration ereferral can be used for all non-clinical queries regarding patient appointments.

Please continue to send through any problems or concerns with patient access or others issues as this really helps with our goal of working to continuously improve services.


Thanks 
Fiona
Fiona.Campbell@waikatodhb.health.nz

Angela Fairweather


 
From late last year Mirena IUCDs have become fully funded and the Ministry has provided a new funding package to cover both consultations for contraception and for insertion and removal  of Long Acting Contraceptives .(LARCS). There is also provision of money to offer training in LARC insertion
The first training session for LARC insertion in our region, will be held on the 21st of March and an invitation for enrolment will be asked for shortly. The session will be run by Dr VP Singh.
Numbers will be limited and I am presuming that there will be enough interest to look at repeat sessions through the year for those who may miss out.
 
Breast care are looking at significant changes to their  referral process with imaging being needed prior to referral to breast care clinic. A specialty form for breast imaging and referral to Breast care will be available soon.
 
 
I am currently working on the Hyperemesis and Hypertension in pregnancy pathways and there has been a request regionally to work on a combined referral for endoscopy which will utilise our current Colonoscopy referral and add a new upper GI referral pathway.
 

 
Thanks Angela
Angela.fairweather@waikatodhb.health.nz
 
 

Sheril-Ann Wilson

 

DVTs- a new localised Health Pathway should be available very soon. Do NOT send uncomplicated DVTs to ED as this is inappropriate. If you cannot book a same day ultrasound POAC will fund you to administer exonaparin until a scan is completed. If it is the weekend or Friday afternoon phone the on call hospital Radiology registrar who will arrange an after hours ultrasound. 

Anglesea Clinic require a GP referral letter ( and POAC number ) for any patients that you are referring  for POAC management. These patients will not be surcharged. If there is no referral letter the patient will pay the initial consultation fee. 

ACC cellulitis surcharge is no longer funded through POAC . This is because non rural GPs can claim both a consult and a procedure code ( MM2)  for administration of antibiotics. A new iv does not have to reinserted on each visit to claim this. 

Recently there have been several referrals for GCA which have been sent via bpac as urgent referrals and taken time for processing . Please refer to the GCA pathway ( current link soon to be updated with new  localised Health Pathway) It clearly states than any suspicion of GCA needs a GP phone call to on call Rheumtologist to initiate imaging/biopsy before referral . 

The POAC monitoring group are keen to hear suggestions from GPs regarding additional acute conditions that would be suitable for funding to prevent hospital admission . We have had good feedback from those who have used the new Frail Elderly Admission Avoidance service.

If you have complaints ( or positive feedback) please send them to the GP Liaison team as investigating these can ( and does) produce changes in the system benefiting both GPs and patients. 

Thank you

Sheril-Ann

Sheril-Ann.Wilson@waikatodhb.health.nz

 

 

Geraldine Tennent

The paediatric medical team has asked that I remind GPs that they wish to support us in the care of our mutual patients.  If a GP has concerns about a complex paediatric patient (eg who is or has been recently under the care of a paediatrician) and would like advice, they are encouraged to contact the named paediatrician or on-call paediatric consultant directly. 
 
Don’t forget that accessing clinical workstation will also provide considerable information.  The ‘documents’ node includes clinic letters and discharge summaries, whilst the ‘progress notes’ node includes more detail about immediate aspects of current management.
 
The paediatric surgical team have asked that I remind you that if you wish to refer a child acutely, their registrars would appreciate a phone call to discuss in advance.
 
Localisation of healthpathways is an ongoing process, we have Pertussis, Cough in Children and UTI in Children near publication.
 

Dr Geraldine Tennent
GP Liaison - Child Health
email: Geraldine.Tennent@waikatodhb.health.nz
mobile: 021 0234 7173

Copyright © 2020 Waikato District Health Board Strategy and Funding, All rights reserved.


Want to change how you receive these emails?
You can update your preferences or unsubscribe from this list.

Email Marketing Powered by Mailchimp