GP explains Health Care Home decision
Dr Susie Lawless, of Amity Health Centre, Dunedin, explains why becoming a Health care Home is a good fit for her practice
From left: Practice Nurse Anna Boyd, Dr Susie Lawless and Practice Manager Catherine Daly-Reeve
Why is your practice becoming a Health Care Home?
We see the HCH philosophy as aligning well with the changes already underway in our practice. In general, the principles of HCH are around supporting patients to be much more involved in their health care through the use of patient portals, direct access to health care providers and improved chronic disease management.
We already have over 55% of our eligible patients using a patient portal to make appointments, email their doctor or nurse, keep an eye on their own results and recalls and to request repeats of regular medication.
As a small practice with only 3700 patients we are excited to be part of the change process and feel we can help create a model that fits well with the existing GP environment in the South, where small practices are delivering personalised care close to home for patients.
We support General Practice moving away from a doctor-centric model towards one that is more team based and patient centred.
What are its feature that you think make it a particularly good model for General Practices in this district?
HCHs emphasise greater flexibility in health care delivery. In Otago/Southland we have a large geographic area with a widely dispersed patient population. Increasing use of e-consults and video consults will be helpful to reduce inequity of access for rural populations.
There is also a looming workforce crisis in General Practice in New Zealand, with GPs being, on average, 57 years old and 50% of current GPs planning to retire in the next 15 years. We need to find ways to work smarter, with more pre-consultation planning and greater efficiency in the use of precious face-to-face consultations.
Also, the use of GP triage will improve patient access to same-day care when needed.
What do you hope it will mean for patients in your practice?
Being more involved in their own care is resulting in increased patient satisfaction and improved health literacy. In other parts of NZ there is emerging evidence of reduced ED presentations and hospital admissions for patients of practices that are HCH. An emphasis on better long term condition management results in earlier intervention in relapses or exacerbations and therefore better health outcomes in conditions such as heart failure and chronic lung disease.
What does HCH mean for staff?
In the short term, we will be collectively working hard to upskill the team in newer ways of working that better support patient autonomy and practice responsiveness to patient needs. In the longer term the aim is to have all staff working at the top of their scope, with Practice Nurses taking on more roles as lead clinicians for patients with long term health needs, and non-clinical tasks being devolved to health care assistants.
It will also mean we will need to be more flexible about the hours we work, as part of the HCH ethos is to provide more out-of-hours care for our patients. This will need to be balanced against the needs of staff to have work-life balance and to be sustainable for the team.
Do patients still get to see their regular GP?
Likely more easily than ever, as this is built in to the HCH approach.
Alison Wilden, RN, General Manager, Gore Medical Centre, what a Health Care Home will mean for GM's patients
Why is your practice becoming a Health Care Home?
The HCH model will mean better access to urgent care, coordinated care for those with chronic conditions, good health promotion services, all taking account the need to ensure good business continuity and longevity.
It covers our vision statement “Your partners in health” very well. We want to partner with our patients. We cannot always give them exactly what they want (no healthcare system can) but wish to work with them to ensure services are at an expected standard and that the business remains viable, ensuring quality primary healthcare is available in Gore for the future.
What are its features that you think make it a particularly good model for General Practices in this district?
We always strive to provide the best services that we can and be very patient-focused but this is sometimes difficult within our existing business model, and the principles of HCH makes for a more balanced business model.
What do you hope it will mean for patients in your practice?
We have been working toward some of the parts of HCH for some years (for example, including acute services) so we hope that we are able to streamline all services to function better. We also hope that our patients’ will be able to take advantage of the changing technology that is becoming available in health care – patient portals, email/video/phone consultations. The development of WellSouth’s long term conditions management programme (CLIC) will also ensure patients’ are enabled to manage their conditions with good acute and long-term planning, ensuring they have better health outcomes.
What will it mean for staff?
Staff are expecting changes. We have a Change Team ready to start on our implementation plan. Funding associated with HCH means that staff are able to take the time out from usual work to plan and implement the changes. Change takes time and planning. We believe our team is ready for this and they are excited for the possibilities of where HCH can take our practice into the future.
Do patients still get to see their regular GP?
Yes, for any routine appointments. Acute and on-the-day appointments may be with another doctor in the practice. And by providing better long-term conditions programmes should mean that continuity of care can occur even if a patient does need to see a different doctor.