Your SlideShare is downloading. ×
0
Ensuring health for the future
Overview of the NZ Health system• 4.2 million population• 13.8 million GP visits, 65 million prescription items,24 million...
Challenges• Living within our means: our rate of growth in health spend isunsustainable – doubled in the previous decade• ...
Drivers for ChangePopulationWorkforceSustainabilityFacilities
Demand increase from existing population+ change in profile
MHN- NGO, not-for-profit- GP owned & governed- 400 GPs- 500 PNs- 100 practices- 500,000 patients- $135 million- Covering 4...
Ensure the future of high quality general practice….Be a vehicle to enable the development of new models,ownership etc to ...
CQI core value1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4 3.1 3.2 4.1 4.2 4.3 4.4 4.5 4.6 5.1 6.1 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 ...
Let the data sing – Present a Plan
Locality & System PlanningPopulationNGO servicesPrimary CareHospital servicesFacilitiesFuture configuration
Locality PlanningMHN – NewZealand
Locality – Planning Configuration
Helping Practices to understand future
New models of care• New way of working required to meet newdemands and capacity requirements• New facilities to support ne...
500,000 lives5 million + encountersHundreds of settingsLife long relationships60 years of unlearning
A new contracting enabler• A shift away from traditional funder/provider roles• Taking experiences from commercial applica...
The Alliance Agreement• A nationally determined agreement that is a relationship anddecision making agreement rather than ...
Alliance in action• The Alliance Leadership Team is the body for managingchange, not for managing business as usual.• Supp...
Alliance contractingAllianceMHNGP NetworkGPOtherproviders(pharmacy,Allied etc)DHBHospital
The road so far• Long term conditions management– The LTCM is a suite of resources and support designed toenable the gener...
Key components• Planned care: comprehensive assessment and a plannedapproach with a longer term view towards staying well ...
Elements and enablers
The effect to date• Havent had time to measure full impact• Noted increase in clinical leadership• Appears to be a reducti...
National performance data
HealthyCommunitiesFit for purposeGeneral PracticeModels of CareMDTsIntegrationRight sizingHospitalsSustainabilityHospitalp...
The risk ofdoingnothing….Thechallenge ofchange…
Upcoming SlideShare
Loading in...5
×

John Macaskill-Smith: General practice models in New Zealand

489

Published on

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
489
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
7
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "John Macaskill-Smith: General practice models in New Zealand"

  1. 1. Ensuring health for the future
  2. 2. Overview of the NZ Health system• 4.2 million population• 13.8 million GP visits, 65 million prescription items,24 million lab tests, 1 million E.D. attendances• Largely devolved system – Central ministry/ACC ,20 regional Distrist Health Boards, 30 primary carenetworks, large number of PPP (pharmacy, labs,private hospitals, General Practice)• In comparision to most OECD indicators we areperforming well and delivering value-for-money• Growth in NZers’ life expectancy is the highest inthe OECD• 19% of total government spending goes into voteHealth ($14 billion NZD)• Co-payments in primary care
  3. 3. Challenges• Living within our means: our rate of growth in health spend isunsustainable – doubled in the previous decade• Population ageing: increasing demands on health system (44% increasein demand)• Increased chronic conditions – 80% of deaths are a result of heartdisease, cancer, diabetes and tobacco related illness• Increasing expectations from the public on health system performance• Workforce ageing and changing expectations• Fragmentation and differences in service performance across adevolved health and disability system
  4. 4. Drivers for ChangePopulationWorkforceSustainabilityFacilities
  5. 5. Demand increase from existing population+ change in profile
  6. 6. MHN- NGO, not-for-profit- GP owned & governed- 400 GPs- 500 PNs- 100 practices- 500,000 patients- $135 million- Covering 4 DHBs- 100-40% geographical coverage- Holds the contract with the crown,sub contracts members- Regional Alliance contract- GP, acute A&M, community nursing,community mental health, PH, chroniccare
  7. 7. Ensure the future of high quality general practice….Be a vehicle to enable the development of new models,ownership etc to ensure sustainability of high quality GP.Sustainable & leading edge primary care servicesThe way to bring together the founding partners to ensure eachpartner is successfulVehicle to enable single contract/planPinnacleIncorporatedPrimary HealthCare LimitedMidlands HealthNetwork LimitedMidlands RegionalHealth NetworkCharitable TrustRole of Members of the GroupTui OraLimited Integrated health service organisation committed to enhancinghealth and wellbeing.General Practice network – sets the strategic framework, priorities, holdsand controls investment resources, monitors performance – Board electedfrom members – 350 GP members, 500 PN, 97 PMPinnacle provider arm for practice ownership –provides a vehicle to exploreand develop new practice models, supports at risk areasManagement company – employs staff, develops and operatessystems, operates a range of direct to non-GP patient services via providerarm (the engine room for getting stuff done) – Pinnacle/IndependentGovernanceVehicle for connecting with strategic partners + single point for contractingwith Multi DHBs, MoH – Community/Provider/Independent GovernanceMHN Family
  8. 8. CQI core value1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4 3.1 3.2 4.1 4.2 4.3 4.4 4.5 4.6 5.1 6.1 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 DAMRDAMRHNCVRACVRAHN85.0% 85.0% 93.0% 93.0% 70.0% 70.0% 70.0% 70.0% 72.5% 72.5% 90.0% 90.0% 90.0% 90.0% 25.0% 25.0% 80.0% 80.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 30.0% 30.0% 70.0% 70.0% 70.0% 70.0% 75.0% 75.0%Pihanga Health ACHIEVEMENT 40 12 / 2685.7%(0)83.3%(0)75.0%(3)73.3%(3)- - - -72.5%(0)72.5%(0)96.6%(0)96.3%(0)33.9%(313)33.1%(281)8.6%(92)8.7%(80)- -73.6%(0)70.2%(0)88.9%(0)87.1%(0)65.2%(19)64.4%(17)46.5%(0)43.8%(0)43.0%(95)40.7%(79)39.0%(76)37.9%(64)66.9%(121)64.0%(115)Taupo Health Centre ACHIEVEMENT 40 12 / 26100.0%(0)100.0%(0)91.5%(1)100.0%(0)- - - -80.1%(0)77.0%(0)97.6%(0)96.7%(0)29.7%(665)35.8%(305)13.1%(132)14.1%(62)- -75.4%(0)66.0%(8)87.5%(0)91.3%(0)55.7%(118)53.6%(46)39.4%(0)36.4%(0)39.0%(218)38.6%(76)50.0%(105)45.0%(50)67.1%(296)57.7%(198)Taupo Medical Centre ACHIEVEMENT 36 12 / 2698.1%(0)95.7%(0)93.3%(0)100.0%(0)- - - -78.4%(0)74.5%(0)98.5%(0)98.0%(0)33.6%(796)39.9%(364)14.3%(151)16.4%(62)- -67.6%(12)57.4%(25)91.7%(0)88.2%(0)60.6%(78)56.2%(39)44.1%(0)43.4%(0)50.8%(122)51.9%(43)15.6%(278)17.9%(102)72.7%(100)62.6%(167)The Lake Surgery ACHIEVEMENT 70 18 / 26100.0%(0)100.0%(0)91.7%(0)100.0%(0)- - - -78.3%(0)73.4%(0)98.0%(0)96.4%(0)86.0%(11)83.2%(9)32.2%(0)33.6%(0)- -77.6%(0)77.2%(0)96.6%(0)100.0%(0)74.4%(0)79.7%(0)62.1%(0)47.3%(0)52.4%(29)42.2%(18)60.3%(15)59.6%(6)67.8%(81)66.2%(29)GOALACHIEVEMENT54 / 104 4 / 4 4 / 4 2 / 4 3 / 4 - - - - 4 / 4 4 / 4 4 / 4 4 / 4 0 / 4 0 / 4 1 / 4 1 / 4 - - 3 / 4 2 / 4 4 / 4 4 / 4 1 / 4 1 / 4 4 / 4 4 / 4 0 / 4 0 / 4 0 / 4 0 / 4 0 / 4 0 / 4ACHIEVEMENT97.0%(0)94.3%(0)90.4%(4)93.4%(3)- - - -78.3%(0)74.6%(0)97.9%(0)97.1%(0)36.5%(1785)39.7%(959)14.4%(375)14.9%(204)- -72.5%(12)65.7%(33)90.6%(0)90.2%(0)60.8%(215)59.9%(102)44.4%(0)41.8%(0)45.0%(464)43.5%(216)37.0%(474)36.0%(222)69.4%(598)61.8%(509)GOALACHIEVEMENT54 / 104 4 / 4 4 / 4 2 / 4 3 / 4 - - - - 4 / 4 4 / 4 4 / 4 4 / 4 0 / 4 0 / 4 1 / 4 1 / 4 - - 3 / 4 2 / 4 4 / 4 4 / 4 1 / 4 1 / 4 4 / 4 4 / 4 0 / 4 0 / 4 0 / 4 0 / 4 0 / 4 0 / 4ACHIEVEMENT97.0%(0)94.3%(0)90.4%(4)93.4%(3)- - - -78.3%(0)74.6%(0)97.9%(0)97.1%(0)36.5%(1785)39.7%(959)14.4%(375)14.9%(204)- -72.5%(12)65.7%(33)90.6%(0)90.2%(0)60.8%(215)59.9%(102)44.4%(0)41.8%(0)45.0%(464)43.5%(216)37.0%(474)36.0%(222)69.4%(598)61.8%(509)City Medical Gisborne Ltd ACHIEVEMENT 77 14 / 26100.0%(0)100.0%(0)90.9%(0)83.3%(1)- - - -86.6%(0)86.3%(0)97.6%(0)96.2%(0)53.0%(182)51.6%(109)15.1%(49)13.1%(34)- -75.6%(0)74.3%(0)100.0%(0)100.0%(0)70.3%(0)68.2%(4)52.1%(0)52.0%(0)54.4%(51)54.6%(22)41.8%(78)43.1%(39)73.0%(34)70.1%(33)Desmond Road Health ACHIEVEMENT 46 11 / 2680.0%(2)84.6%(0)89.5%(1)85.0%(2)- - - -77.6%(0)74.4%(0)94.6%(0)93.7%(0)25.2%(509)25.3%(297)6.6%(145)6.5%(85)- -78.4%(0)75.1%(0)96.2%(0)93.8%(0)69.5%(3)67.5%(6)45.4%(0)40.1%(0)44.1%(132)44.7%(55)14.4%(216)16.9%(100)56.8%(521)55.1%(215)The Village Clinic Ltd ACHIEVEMENT 45 12 / 2687.5%(0)100.0%(0)91.7%(0)100.0%(0)- - - -89.2%(0)88.6%(0)98.6%(0)97.7%(0)55.4%(87)56.3%(43)20.7%(11)18.0%(9)- -78.2%(0)81.0%(0)75.0%(0)66.7%(0)68.6%(3)60.2%(10)28.4%(3)26.2%(4)60.0%(16)57.1%(10)40.3%(37)41.4%(17)61.1%(131)66.8%(30)Three Rivers Medical Centre ACHIEVEMENT 27 7 / 2680.5%(4)81.5%(2)92.2%(1)97.1%(0)- - - -70.0%(109)66.3%(171)94.8%(0)93.8%(0)20.3%(1262)19.9%(964)6.0%(345)5.6%(267)- -60.7%(63)57.3%(62)81.0%(0)80.0%(0)60.9%(111)59.0%(91)34.9%(0)33.7%(0)52.8%(180)52.4%(126)25.8%(301)27.0%(210)64.5%(492)60.7%(406)Waikohu Health Centre ACHIEVEMENT 58 13 / 2687.5%(0)85.7%(0)100.0%(0)100.0%(0)- - - -74.7%(0)73.3%(0)94.0%(0)93.7%(0)53.6%(86)53.2%(80)24.3%(2)22.9%(5)- -69.4%(0)69.2%(1)100.0%(0)100.0%(0)69.4%(1)67.0%(4)33.1%(0)33.9%(0)67.6%(3)67.3%(3)44.4%(18)46.2%(16)48.6%(119)50.0%(97)GOALACHIEVEMENT57 / 130 3 / 5 4 / 5 3 / 5 3 / 5 - - - - 4 / 5 4 / 5 5 / 5 5 / 5 0 / 5 0 / 5 0 / 5 0 / 5 - - 4 / 5 3 / 5 5 / 5 5 / 5 1 / 5 0 / 5 4 / 5 4 / 5 0 / 5 0 / 5 0 / 5 0 / 5 0 / 5 0 / 5ACHIEVEMENT84.0%(6)84.5%(2)91.8%(2)94.2%(3)- - - -76.4%(109)72.2%(171)95.5%(0)94.3%(0)30.5%(2126)29.4%(1493)9.6%(552)8.8%(400)- -69.6%(63)65.7%(63)88.8%(0)88.5%(0)65.5%(118)62.3%(115)39.7%(3)36.7%(4)52.2%(382)52.8%(216)27.8%(650)29.6%(382)62.8%(1297)60.4%(781)GOALACHIEVEMENT57 / 130 3 / 5 4 / 5 3 / 5 3 / 5 - - - - 4 / 5 4 / 5 5 / 5 5 / 5 0 / 5 0 / 5 0 / 5 0 / 5 - - 4 / 5 3 / 5 5 / 5 5 / 5 1 / 5 0 / 5 4 / 5 4 / 5 0 / 5 0 / 5 0 / 5 0 / 5 0 / 5 0 / 5ACHIEVEMENT84.0%(6)84.5%(2)91.8%(2)94.2%(3)- - - -76.4%(109)72.2%(171)95.5%(0)94.3%(0)30.5%(2126)29.4%(1493)9.6%(552)8.8%(400)- -69.6%(63)65.7%(63)88.8%(0)88.5%(0)65.5%(118)62.3%(115)39.7%(3)36.7%(4)52.2%(382)52.8%(216)27.8%(650)29.6%(382)62.8%(1297)60.4%(781)Central Medical Centre ACHIEVEMENT 31 10 / 26100.0%(0)100.0%(0)100.0%(0)100.0%(0)- - - -82.3%(0)78.1%(0)83.5%(106)86.4%(8)57.7%(36)60.0%(8)16.2%(10)16.0%(2)- -73.8%(0)66.7%(0)77.8%(0)100.0%(0)67.9%(3)58.1%(4)15.7%(23)6.5%(7)52.8%(21)40.0%(8)26.3%(35)33.3%(4)65.2%(77)63.6%(11)City West Medical Centre ACHIEVEMENT 135 24 / 26100.0%(0)100.0%(0)100.0%(0)0.0%(0)- - - -88.3%(0)83.3%(0)99.8%(0)100.0%(0)95.7%(0)100.0%(0)70.0%(0)90.0%(0)- -87.7%(0)100.0%(0)100.0%(0)100.0%(0)75.7%(0)72.2%(0)41.7%(0)55.6%(0)81.1%(0)90.9%(0)34.9%(37)63.6%(1)87.2%(0)87.1%(0)Devon Medical Centre ACHIEVEMENT 138 24 / 2696.2%(0)100.0%(0)95.5%(0)100.0%(0)- - - -91.4%(0)91.2%(0)92.8%(0)92.2%(0)91.8%(0)95.3%(0)46.2%(0)51.8%(0)- -87.9%(0)82.5%(0)89.3%(0)100.0%(0)71.5%(0)76.2%(0)32.3%(0)38.6%(0)74.3%(0)76.7%(0)39.9%(97)50.9%(11)76.7%(0)85.5%(0)Family Health Centre ACHIEVEMENT 93 14 / 2666.7%(1)0.0%(1)100.0%(0)0.0%(0)- - - -81.9%(0)80.8%(0)99.2%(0)98.4%(0)73.0%(37)82.5%(4)20.0%(11)22.8%(1)- -87.4%(0)85.3%(0)90.0%(0)100.0%(0)65.5%(14)60.6%(7)38.1%(0)39.4%(0)46.6%(54)44.4%(14)32.6%(71)50.0%(7)87.1%(0)89.2%(0)Inglewood Medical Centre - DrFinniganACHIEVEMENT 21 9 / 2688.9%(0)100.0%(0)66.7%(1)0.0%(0)- - - -79.6%(0)72.5%(0)93.6%(0)92.8%(0)13.7%(162)17.0%(34)4.2%(44)4.3%(10)- -65.6%(4)52.9%(3)50.0%(1)0.0%(1)54.0%(18)45.0%(5)68.1%(0)65.0%(0)46.0%(24)26.3%(8)36.7%(30)41.2%(5)41.7%(245)35.9%(40)Inglewood Medical Centre - DrJonesACHIEVEMENT 29 13 / 26100.0%(0)0.0%(0)100.0%(0)0.0%(0)- - - -80.5%(0)80.5%(0)92.2%(0)91.6%(0)72.2%(26)71.9%(6)16.0%(13)15.6%(3)- -81.9%(0)75.0%(0)60.0%(1)0.0%(0)58.9%(14)27.3%(5)54.3%(0)81.8%(0)45.9%(26)40.0%(3)24.1%(53)25.0%(4)48.5%(178)53.6%(15)Parklands Medical Centre ACHIEVEMENT 41 14 / 2694.7%(0)91.7%(0)100.0%(0)100.0%(0)- - - -91.6%(0)91.5%(0)93.3%(0)93.2%(0)31.9%(226)32.4%(119)7.7%(67)8.7%(34)- -77.6%(0)77.0%(0)66.7%(0)77.8%(0)52.5%(63)52.1%(25)51.7%(0)44.3%(0)52.7%(52)44.4%(32)31.3%(104)36.8%(29)69.1%(74)63.8%(54)Patea & District CommunityMedical TrustACHIEVEMENT 109 13 / 2666.7%(3)42.9%(3)83.3%(1)100.0%(0)- - - -64.6%(59)59.8%(52)91.8%(0)92.0%(0)59.2%(95)59.3%(64)12.0%(40)12.4%(26)- -81.2%(0)79.1%(0)96.4%(0)95.7%(0)80.8%(0)82.6%(0)34.6%(0)30.3%(0)75.6%(0)72.6%(0)55.5%(28)56.7%(18)73.4%(14)73.6%(8)Powderham Medical Centre ACHIEVEMENT 45 12 / 2687.5%(0)66.7%(1)100.0%(0)0.0%(0)- - - -74.1%(0)72.5%(0)84.1%(96)82.6%(26)36.5%(73)28.0%(31)8.0%(23)4.0%(11)- -82.8%(0)81.8%(0)92.3%(0)80.0%(0)73.6%(0)64.7%(2)56.2%(0)61.8%(0)62.4%(8)65.5%(1)36.9%(40)27.3%(14)67.4%(52)62.1%(19)Regan Street Medical Centre ACHIEVEMENT 45 9 / 2644.4%(4)0.0%(3)50.0%(1)0.0%(0)- - - -95.4%(0)96.8%(0)80.9%(96)76.5%(34)76.2%(26)71.9%(10)25.4%(0)22.8%(1)- -64.2%(6)52.0%(5)60.0%(1)100.0%(0)93.5%(0)88.0%(0)32.7%(0)32.0%(0)51.0%(19)26.1%(10)29.4%(44)20.0%(13)70.8%(17)60.5%(12)SouthCare ACHIEVEMENT 55 11 / 2697.0%(0)100.0%(0)93.0%(0)92.3%(0)- - - -70.2%(62)62.5%(57)84.1%(452)85.2%(78)36.4%(421)33.9%(132)12.0%(102)11.0%(33)- -77.5%(0)75.0%(0)93.1%(0)100.0%(0)70.2%(0)74.6%(0)32.9%(0)26.1%(5)65.4%(19)66.7%(4)38.2%(186)37.2%(54)38.2%(1058)35.8%(259)Te Aroha Medcare Ltd ACHIEVEMENT 72 16 / 2693.3%(0)100.0%(0)91.7%(0)100.0%(0)- - - -92.8%(0)92.5%(0)89.8%(2)89.4%(6)63.4%(94)64.9%(62)14.5%(37)16.1%(22)- -73.2%(0)72.8%(0)72.7%(0)80.0%(0)81.5%(0)82.2%(0)48.8%(0)50.8%(0)74.1%(0)73.4%(0)43.7%(37)42.1%(32)64.0%(56)63.6%(41)Tukapa Medical Centre ACHIEVEMENT 41 9 / 260.0%(1)0.0%(1)66.7%(1)0.0%(0)- - - -76.7%(0)78.0%(0)89.6%(5)89.5%(1)51.5%(38)55.9%(12)16.2%(9)20.6%(2)- -76.9%(0)66.7%(1)66.7%(0)100.0%(0)63.6%(7)76.5%(0)30.9%(0)35.3%(0)26.3%(42)33.3%(6)38.5%(41)37.5%(8)60.9%(75)52.0%(23)Vogeltown Medical Centre ACHIEVEMENT 49 13 / 2682.4%(0)100.0%(0)86.4%(1)100.0%(0)- - - -87.1%(0)90.4%(0)94.8%(0)98.5%(0)74.4%(21)66.7%(6)18.0%(9)0.0%(6)- -82.2%(0)69.2%(0)87.5%(0)100.0%(0)69.1%(1)61.5%(1)49.1%(0)46.2%(0)45.4%(24)25.0%(5)31.4%(46)38.5%(4)47.7%(164)51.2%(21)GOALACHIEVEMENT191 /36410 / 14 9 / 14 9 / 14 14 / 14 - - - - 12 / 14 12 / 14 8 / 14 8 / 14 2 / 14 2 / 14 3 / 14 2 / 14 - - 12 / 14 11 / 14 11 / 14 13 / 14 7 / 14 7 / 14 13 / 14 12 / 14 4 / 14 4 / 14 0 / 14 0 / 14 3 / 14 3 / 14ACHIEVEMENT87.9%(9)78.8%(9)92.4%(5)97.8%(0)- - - -81.4%(121)78.6%(109)90.3%(757)90.1%(153)53.9%(1255)53.4%(488)17.2%(365)15.8%(151)- -79.5%(10)75.6%(9)86.4%(3)92.2%(1)69.0%(120)70.8%(49)39.7%(23)38.7%(12)59.9%(289)60.1%(91)36.9%(849)42.4%(204)61.7%(2010)61.6%(503)Avon Medical Centre ACHIEVEMENT 56 14 / 2688.0%(0)92.9%(0)92.3%(0)100.0%(0)- - - -74.0%(0)70.6%(5)97.2%(0)96.6%(0)53.7%(140)47.9%(50)8.0%(66)6.7%(22)- -0.0%(0)0.0%(0)88.2%(0)83.3%(0)68.4%(4)72.7%(0)34.6%(0)34.8%(0)51.4%(35)58.2%(7)40.2%(55)32.7%(18)71.6%(34)72.1%(6)Bellomo Family Health ACHIEVEMENT 49 14 / 2692.9%(0)100.0%(0)87.5%(0)100.0%(0)- - - -85.8%(0)82.8%(0)99.8%(0)100.0%(0)79.8%(13)91.7%(0)22.5%(3)27.1%(0)- -68.6%(1)55.0%(3)100.0%(0)100.0%(0)66.7%(4)58.3%(3)38.7%(0)50.0%(0)48.4%(20)59.1%(2)48.8%(18)50.0%(4)68.7%(27)65.9%(8)Carefirst Medical Centre ACHIEVEMENT 116 19 / 2693.5%(0)100.0%(0)93.3%(0)91.7%(0)- - - -87.5%(0)86.1%(0)96.0%(0)95.1%(0)79.7%(80)78.8%(26)46.9%(0)43.6%(0)- -82.2%(0)80.0%(0)85.0%(0)78.6%(0)67.8%(16)69.0%(2)52.0%(0)45.5%(0)70.3%(0)67.8%(3)49.7%(119)53.0%(20)79.6%(0)80.6%(0)Dr Marie Fonseka ACHIEVEMENT 35 13 / 26100.0%(0)100.0%(0)100.0%(0)100.0%(0)- - - -75.6%(0)73.5%(0)91.1%(0)89.3%(1)22.6%(78)18.5%(19)8.7%(19)11.1%(4)- -82.6%(0)100.0%(0)0.0%(0)0.0%(0)61.6%(7)60.0%(2)64.0%(0)53.3%(0)56.9%(9)41.7%(3)2.9%(46)8.3%(7)62.5%(66)71.2%(3)Dr R G Radich ACHIEVEMENT 43 11 / 26100.0%(0)0.0%(0)100.0%(0)100.0%(0)- - - -83.2%(0)80.9%(0)97.1%(0)96.8%(0)67.6%(40)63.0%(12)6.1%(34)4.3%(10)- -67.3%(3)59.1%(2)100.0%(0)100.0%(0)58.1%(20)51.6%(6)24.6%(9)12.9%(5)42.3%(41)37.0%(9)34.6%(37)36.4%(7)77.6%(0)71.6%(4)Eastside Medical Centre ACHIEVEMENT 134 20 / 2688.2%(0)100.0%(0)100.0%(0)0.0%(0)- - - -77.9%(0)77.2%(0)96.3%(0)94.8%(0)78.7%(29)89.7%(0)28.7%(0)31.0%(0)- -82.4%(0)69.0%(0)80.0%(0)85.7%(0)61.9%(25)62.3%(5)45.5%(0)42.0%(0)53.4%(44)47.6%(14)68.9%(2)81.0%(0)86.6%(0)80.0%(0)Eltham Health Centre ACHIEVEMENT 64 15 / 26100.0%(0)100.0%(0)83.3%(1)100.0%(0)- - - -67.8%(30)62.6%(11)95.1%(0)93.7%(0)81.3%(21)80.3%(7)80.0%(0)78.9%(0)- -86.7%(0)76.5%(0)100.0%(0)100.0%(0)82.4%(0)76.5%(0)95.9%(0)70.6%(0)68.9%(2)57.6%(4)28.3%(72)20.6%(17)64.8%(81)60.8%(21)Medicross Taranaki Ltd ACHIEVEMENT 51 14 / 2666.7%(1)100.0%(0)100.0%(0)100.0%(0)- - - -75.8%(0)74.5%(0)93.2%(0)94.2%(0)32.0%(131)33.9%(35)10.2%(33)11.3%(9)- -77.3%(0)81.8%(0)87.5%(0)100.0%(0)70.7%(0)66.7%(1)39.0%(0)38.1%(0)47.8%(15)41.2%(5)37.3%(25)36.4%(4)55.5%(92)52.8%(28)Moturoa Medical Centre ACHIEVEMENT 105 14 / 2680.0%(1)100.0%(0)100.0%(0)100.0%(0)- - - -79.7%(0)73.6%(0)94.3%(0)94.6%(0)59.0%(85)59.4%(32)19.4%(15)23.6%(2)- -86.0%(0)78.0%(0)87.5%(0)100.0%(0)73.5%(0)60.8%(7)44.2%(0)41.9%(0)56.1%(29)44.3%(16)44.2%(56)42.0%(14)73.4%(18)73.7%(3)Oakura Medical Centre ACHIEVEMENT 43 14 / 2660.0%(3)0.0%(0)92.3%(0)100.0%(0)- - - -81.4%(0)79.2%(0)99.8%(0)100.0%(0)45.3%(57)45.8%(11)18.0%(9)25.0%(0)- -81.8%(0)75.0%(0)100.0%(0)100.0%(0)60.7%(14)61.5%(1)42.8%(0)38.5%(0)46.9%(30)41.7%(3)33.8%(28)25.0%(4)58.6%(102)36.1%(24)Opunake Medical Centre ACHIEVEMENT 50 16 / 26100.0%(0)100.0%(0)100.0%(0)100.0%(0)- - - -79.6%(0)78.7%(0)99.7%(0)99.5%(0)76.5%(33)87.3%(4)43.3%(0)47.3%(0)- -75.6%(0)78.5%(0)95.0%(0)93.8%(0)62.9%(16)60.6%(12)47.6%(0)46.5%(0)46.4%(49)43.9%(30)31.9%(61)32.3%(35)68.4%(57)70.9%(17)TaranakiBarbPurdiePL TOTALSWendyMarshallLakesJoanneMintoftPL TOTALSSERVICE DELIVERY TOTALSTairawhitiTiaMoekePL TOTALSSERVICE DELIVERY TOTALSGOAL DISTRIBUTION MAP - Q2 SUMMARY GOALS.D PL PRACTICEPOINTSAWARDEDGOALSACHIEVED
  9. 9. Let the data sing – Present a Plan
  10. 10. Locality & System PlanningPopulationNGO servicesPrimary CareHospital servicesFacilitiesFuture configuration
  11. 11. Locality PlanningMHN – NewZealand
  12. 12. Locality – Planning Configuration
  13. 13. Helping Practices to understand future
  14. 14. New models of care• New way of working required to meet newdemands and capacity requirements• New facilities to support new models of care• Integrated information systems• New contracting arrangements to support newmodels• Retraining the workforce• Resetting the commercial/business model
  15. 15. 500,000 lives5 million + encountersHundreds of settingsLife long relationships60 years of unlearning
  16. 16. A new contracting enabler• A shift away from traditional funder/provider roles• Taking experiences from commercial application of risksharing contracting arrangements in construction and oilsectors• Evidence points to better performance of alliancegoverned contracts vs. traditional approaches• Process and patient focused vs. transactional• Driven by front line clinicians• Clinical commissioning in another language
  17. 17. The Alliance Agreement• A nationally determined agreement that is a relationship anddecision making agreement rather than a service deliveryagreement.• The agreement establishes a structure to enable clinicians,alongside managers and others, to make decisions about howto apply resources to specific services to achieve the bestoutcomes. Commissioning & decommissioning• Decisions involve less specification and an emphasis on qualityprocesses and transparency of information to assureaccountability and best value for money.• The scope of the agreement has been broadly developedcollectively around agreed key health areas.• It places the risk and rewards of success on all parties.
  18. 18. Alliance in action• The Alliance Leadership Team is the body for managingchange, not for managing business as usual.• Supported by– The Alliance Agreement– The Alliance Charter– Underlying agreement with Government• Each party to the Alliance retains their role and owngoverance.• Resources around agreed areas are pooled byagreement to support Alliance recommendations• Requires strong senior clinical and managementleadership and committment
  19. 19. Alliance contractingAllianceMHNGP NetworkGPOtherproviders(pharmacy,Allied etc)DHBHospital
  20. 20. The road so far• Long term conditions management– The LTCM is a suite of resources and support designed toenable the general practice team to proactively providetargeted care to patients diagnosed with a LTC• Getting resources upfront– Traditional post hospitalization resources being shifted topreventative roles• Medical Home– Primary care taking broader responsibility for coordinatingcareCo-designed – co-funded
  21. 21. Key components• Planned care: comprehensive assessment and a plannedapproach with a longer term view towards staying well inthe presence of an incurable disease (rather than acutecare for an episode of ill health)• Patient led care with the health care team as the patientsagent• Co-ordinated complete care for people with complexneeds• Commissioning resources to those in greater need• Wider scope of services being available in the patientsHealth Care Home (primary care)• Integrated services that are "seamless" from the patientspoint of view.
  22. 22. Elements and enablers
  23. 23. The effect to date• Havent had time to measure full impact• Noted increase in clinical leadership• Appears to be a reduction in acute EDpresentations – 11- 7%• Patient satisfaction higher• Workforce satisfaction higher• Improvement in related quality programperformance
  24. 24. National performance data
  25. 25. HealthyCommunitiesFit for purposeGeneral PracticeModels of CareMDTsIntegrationRight sizingHospitalsSustainabilityHospitalperformanceBSMC ServicesMDTperformanceProactivecareGeneral PracticeperformanceSelf careWhole of system thinking& commissioning
  26. 26. The risk ofdoingnothing….Thechallenge ofchange…
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×