Midlands DHB’s Board Development Rotorua 10th April 2017 Integrated Care Midlands DHB’s Board Development Rotorua 10th April 2017

What are our challenges? An ageing population Increasing complexity due to multiple comorbidities Technological advances increasing costs Continuing inequity of outcomes Access is a problem Services are frequently neither soon or convenient

What is Integrated Care? World Health Organisation Integrated care is a concept bringing together inputs, delivery, management and organisation of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve services in relation to access, quality, user satisfaction and efficiency

Strategies to support integrated care

Person and whānau centred care Organising services around our people’s needs Including people in service design Co-design has been shown to improve outcomes without increasing costs Improving outcomes for our community is something all healthcare providers can agree on

Health Literacy For people – empowering them to take control of their care For providers – understanding what is available and helping navigate patients through the system

Access to information Rotorua hospital specialists can now access general practice records Community based clinicians in BOP can access all DHB health records Whānau tahi aims to created shared care plans Indici has a health integrated plan Access to information supports better decision making by people and by healthcare works

Co-ordinated care Clear care pathways designed by all healthcare providers and including patient input Reducing inappropriate variation Electronic referrals that support clinicians to do the right thing Focus on equity

Creating an environment for integration MURIAL Contracting for outcomes Flexibility of funding Move from protecting our patch to serving our communities Using technology to support integration

System Level Measures The Ministry’s tool to drive better integration Only by working together will we achieve these outcomes Uses quality improvement methodology Districts choose their own local contributory measures Improvement plans are developed to achieve against the contributory measures Over seen by Alliance Leadership Teams

System Level Measures Reducing hospital admissions for children aged 0-4 Reducing the number of days people spend in hospital receiving unplanned care Reducing the number of people dying of preventable conditions before the age of 75 Improving peoples experience of care - Empowerment Youth health Children living in smoke free households – BOP merging with ASH 0-4

Health in all policies How wide should we seek to integrate? Iwi Social Welfare Police Schools Council

The Board’s role What will you do to support integrated care? How will you know that we are improving? What information do you need? How can we communicate with our communities?

Simple!

It’s complicated but… What is more important than.. Reducing the number of children accessing specialist care Reducing the number of people dying prematurely Reducing the number of people having to stay in hospital as an emergency Better supporting youth Improving people’s experience of our services