Transcript Document

PASIFIKA GP NETWORK
11 February 2015
MoH Strategic Priorities
• Better integrate services within health and across the social sector
• “Health is a social issue with medical outcomes”
• It is key to improving equity.
• Alliances
• Regionalisation
• Transition between services eg: between Health and Education when children
turn 5; between hospital and residential care for funding food supplements
• Improve the way services are purchased and provided
• Ensure funding models support change
• Building & supporting key enablers and drivers for change e.g. workforce,
health information and capital
2
MoH Strategic Priorities
• Lift quality and performance
• Driving performance through measuring and rewarding the right things to
improve quality
• E.g. IPFI, health targets …
• Support leadership and capability for change
• Supporting sector wide governance and capability
• Support and encourage ways to ensure greater community and consumer
voice in a people-centred system
• Supporting greater public choice
3
MoH Strategic Priorities
• New Zealand Health Strategy update
• Funding Review
• Capacity and Capability Review
• All three to be completed by 30 June 2015
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Direction of travel for the NZ Health system
5
Challenges
• The way the system manages and responds to demand makes it
difficult for some people to access appropriately integrated and
coordinated health care within their community, which can result in
poor clinical outcomes
• Some service approaches still do not actively engage some of the
population in the management and prevention of illness and disease
• The design of current healthcare business models reflects long term
adaptation to historical demand; they are not configured to
sustainably meet future need
• Underestimation of the complexity of change required to implement
the health care strategy resulted in variable implementation of the
strategy’s intent which is now a limitation on the system’s ability to
respond to need
21st Century Burden of disease- Non communicable
diseases
The Pacific adult obesity rate is comparatively high at 68 percent and diagnosed diabetes 13
percent. Pacific children have high levels of obesity (27 percent), which is likely to increase their
risk of developing diabetes as adults.
Smoking is also an issue, with the Pacific adult smoking rate at 24.7 percent
The sector is diverse in its appetite, capability and capacity
to change (this could be a practice, a PHO or DHB)
Reluctant changers: Will
need convincing to
change or unaware they
could
How do we share their
experience?
Fast followers: Would
change if knew how or
had time
Dyed in the wool:
Probably won’t
change
Prepare to
change
Help to
change
Have provided a good
indication of key
enablers of change in
our system
High performers leading
change in components of
health care.
Driven by thought leaders
(management and clinical)
The “New Way”
The “Old Way”
Convince to
change
Encourage to continue to
change (in the right direction)
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Solutions- What are we working on…
Yet to be described for our system
High-level strategic direction
Picture of future P&CHC state
Barriers & enablers Interventions
BSMC BC
NZ Health
Strategy &
Triple Aim
Primary Health
Care Strategy
Models of Care characteristics
and success factors that define
the future state
Barriers and enablers
to achieving the
desired state
Alliancing
IPIFF
Option 1
Option 2
Remain fit for purpose
Good solutions emerging
The challenge is to shift the sector
How can we support the sector/ the system to do this?
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Consistent themes from national and international
literature about models of care
Effective
triage
function
Clinical
Governance
(CQI)
Enablers
• Access to information when needed
• Access to shared planning
• Agreed clinical pathways
Accessible
• Access to diagnostics
information
• Access to information to drive
Personalised
Team
continuous improvement
and flexible
Patient
Multi
•
Sharing
of best practice and success
based
Structured
discipline
• Evidence based clinical education and
centred
complex
approach
leadership
Accessible and
care
Integrated,
• Funding model that target those who
equitable
coordinated
need it most
Reflective of
service for all
• Strong Primary-Secondary
Acute
Population
community
relationships
care
Move from
needs
Barriers
needs
demand to
addressed
• Capital investment constraints
Collaborative
need model
• Legacy professional cultures
approach with
Prevention
• Clinical and Management leadership
stakeholders
services
capability
Imms
wellbeing
• Change capacity constraints
Screening
Exercise
• Trust
• Interpretation of Privacy laws
Earliest and
lowest level of
intervention
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Integrated Performance and
Incentive Framework
Peter Jones
11 February 2015
Measures Framework
System performance measures
• Nationally set
• Support high level goals of the health system
• Reflect performance of the system as a whole
• Organised according to life stages
Contributory measures
• Selected at a local level for quality improvement
• Support achievement on system performance measures
• Measures library and guidance
IPIF Measures 2015
Improved Health and Equity for All Populations
Healthy Start
Healthy Ageing
Registration with LMC within 12
weeks of conception
Polypharmacy: number of
people taking 11 or more
medicines (no increase)
Enrolment with a PHO/Practice
within 4 weeks
Completed all scheduled
immunisations by 8 months
Healthy Child
 2 year immunisation rate
Healthy Adult
 Cervical Screening rate
 Smoking Health Target
 Cardiovascular Disease Health
Target
IPIF Measures 2015
Capacity and Capability
Patient Safety and
Experience of Care
Support for multichannel
access to clinical services
HQSC developing
• % of practices using eportals
• Measured at PHO level
• Incentivised by NHITB
• Australian collaboration
• Online questionnaire with
submenus
• SMS, email invitations to
those with recent contact
Implementation July 2o15
• Cognitive testing for NZ
• Pilot in 3 PHOs
Incentives and Reporting
Various financial incentive payment models in discussion
• Top slice for capacity and capability
• Weighting for high need
Reporting disaggregated by ethnicity and deprivation
Reputational incentives and tiered structure are in development