More accessible and integrated healthcare on the way for the Southern district

Southern DHB and WellSouth Primary Health Network are embarking on a bold journey that will transform how healthcare services are delivered in Otago and Southland.

They have worked together to develop a new Primary and Community Care Strategy and Action Plan and will be sharing their proposals at public meetings on 31 January and 1 February.

The presentations will outline long and short-term changes that will improve primary and community healthcare services across the district, making them easier to access, and giving healthcare providers more time and flexibility to work with patients.

The goal of the Strategy is to improve the way all health services, from GPs and district nurses to physiotherapists and pharmacists, as well as specialist medical care, work together. It also aims to help patients better manage their own health and wellbeing, and to increase the use of technology -- including telehealth and electronic health records – so people can better manage their healthcare information wherever they live.

Among the improvement initiatives will be an increase in the number of specialist services - those usually provided in either Southland or Dunedin hospitals – being delivered at the community level. These will start out as visiting specialist appointments, but over time will become part of the extended range of services able to be routinely accessed in community settings.

SDHB commissioner team, Kathy Grant, Graham Crombie and Richard Thomson, along with Chief Executive Chris Fleming and WellSouth Chief Executive Ian Macara, will be leading the public meetings which will take place in Oamaru, Cromwell, Invercargill, Balclutha and Dunedin. A number of WellSouth Trustees will attend in their locality, including Chair Dr Doug Hill and Deputy Chair Tony Hill.

The launch of the new Strategy follows focus groups, wānanga and a round of public meetings outlining proposed directions last year, generating more than 300 items of written feedback.

“We have listened to our patients and their families, general practitioners, community-based healthcare providers, iwi, our own staff and clinicians and what we have been told is that healthcare must change to meet the changing needs and preferences of the communities we serve,” says Southern DHB Chief Executive Chris Fleming. “We can do better with the resources we have and our new Primary and Community Strategy and Action Plan is designed to do this by reorienting healthcare around primary and community care.

“A good example of this is helping people to be able to securely access their own health information online, as many patients and families have told us they want to participate more in their own care.”

Health Care Homes

 (HCH) A new development proposed in the strategy is the introduction of the Health Care Home model of care, widely adopted elsewhere in New Zealand. These expanded, multidisciplinary general practices will be able to provide more services and better coordinate patients’ care with other health providers, including hospital specialist services.

Where appropriate, Community Hubs – larger clinics or facilities, whether physical or virtual – would be developed to support the new integrated healthcare services. These would reflect the location and population in which they are situated and could be an extension of existing rural trust hospitals, for example, or they might be the joining-together of smaller practices to form a larger clinical service. They might also be newly created hubs that support several HCHs or general practices in an area and could include space for visiting secondary care services and increased urgent care capability.

In addition to primary care services, Community Hubs might also include rehabilitation and outpatients services, such as diabetes clinics, as well as needs assessment and service coordination (NASC) support.

Locality Networks will be established to tailor health services to the needs of local communities and populations, involving community-based healthcare providers such as pharmacies, physiotherapists, mental health services, St John and more working with Health Care Homes and community hubs. These Networks will be closely supported by SDHB and WellSouth.

For patients and their families, the new model of care will mean improved access to health services: care that is easier to access and is integrated across a range of health care providers. It won’t take away the many positive aspects of the current way of delivering care, such as the continuity of care currently experienced by people with their General Practice team.

Among the benefits for patients will be shorter wait times for acute appointments in practices, more access to care outside of usual practice hours, and better coordination of care amongst different providers.   

“The Health Care Home approach has been successful throughout New Zealand and we are picking up and improving on this,” says WellSouth’s Chief Executive Ian Macara. “The benefit is that patients will have better access to primary healthcare when they need it urgently, a more ‘joined-up’ approach to managing their ongoing conditions, and more convenient alternatives for dealing with routine things like making appointments.”

It is expected implementing the new Primary and Community Care action plan will begin within months, with the first group of GP practices starting the journey towards a Health Care Home in the middle of the year.

“We face unique challenges in the Southern district: our geographic size and the dispersed population mean it is not always straightforward to deliver equitable health services,” says Chris Fleming. “The health system that has developed over time is not the right fit for the future and we need to make changes now to ensure healthcare services meet the needs of our population for years and decades to come. Our new Primary and Community Strategy and Action Plan are a significant step forward and we look forward to sharing them with the people of the Southern district.”