1. Midland Region Primary Healthcare Forum 30 May 2014

2. Integration of Primary / Secondary Services within the Region

3. Coverage Healthcare structure in NZ What/who influences health care policy and direction What is the role of the Midland DHB’s? How are DHB’s structured? What opportunities and limitations for DHB’s in the current health care structure?

5. Strategies Child Health Strategy Health of Older People Strategy He Korowai Oranga: Maori Health Strategy NZ Disability Strategy NZ Health Strategy NZ Palliative Care Strategy Pacific Health & Disability Action Plan Sexual and Reproductive Health Strategy Primary Health Care Strategy Youth health: A Guide to Action Our Health, Our Future Inhaling Inequality Chief Advisors Services Nursing Disability Support Services Maori Health Mental Health General Practice Child and Youth Health Oral Health Medical Advisor Pacific Health Health Information Strategy & Policy Media DIRECTORATES Corporate and Information DHB Funding and Performance Sector Policy Clinical Services Public HealthMaori Health Disability Services Mental Health Policy Frameworks Treaty of Waitangi Legislation NZ Health Strategy NZ Disability Strategy Monitoring and Accountability

7. MoH Expectations Regional planning and delivery Health Targets HQSC – falls prevention, surgical site infections Elective Service Performance Indicators Stroke Trauma Cardiology Oncology Financial Performance

8. Regional Objectives Six Regional Objectives: – To improve Maori health outcomes – Integration across continuums of care – To improve quality across all regional services – To build the workforce – To improve clinical information systems – Efficient allocation of public health system resources

9. Regional Measures Region to monitor progress: – Life expectancy: life expectancy is a calculation of life expectancy at birth based on the mortality rates of the population in each age in a given year – Premature death: early death is the rate of deaths before the age of 75 years – Amenable mortality: are deaths that could, in theory, be averted by good healthcare – Fewer people smoking – Reduction in vaccine preventable diseases – Improving health behaviours

10. The Midland Region Covers 56,728km 2 (21% of NZ land mass) 5 DHB’s: Lakes, Waikato, Tairawhiti, Bay of Plenty & Taranaki Approximately 853,725 people Maori population: 205,590 identifying as Maori (24% total population) – proportion much higher in Midland against the national proportion

11. Midland Region (continued) Low proportion of the population identified as Asian or Pacific peoples Higher number of people living in rural areas Relatively higher proportion of people living in areas identified as high deprivation (quintile 4&5)

12. Each Day within the Midland Region: 541 people are admitted to a Midland hospital 837 people have a first specialist or follow up appointment 5,033 people have a general practice consultation, and 17 people die

13. Regional Vision All residents of Midland Health Boards lead longer, healthier and more self-sufficient lives

14. TDHB Aims To promote healthy lifestyles & self responsibility To have the people & infrastructure to meet changing health needs To have people as healthy as they can be through promotion, prevention, early intervention & rehabilitation To have services that are people centred and accessible, where the health sector lives as one

15. To have a multi agency approach to health To improve the health of Maori & groups with poor health status To lead & support the health & disability sector & provide stability throughout change To make the best use of resources available TDHB Aims (continued)

16. Regional Networks & Action Groups Midland Cancer Network Programme Cardiac services Elective Services Health of Older People Mental Health & Addiction Network Regional Trauma Service Child Health action Group Maternity Action Group Radiology Group

18. Project Maunga Theatre Suite Enhanced Day Stay Endoscopy Suite Medical Floor Surgical Floor Older Peoples Health Ward Children's Ward

19. Taranaki health targets: quarter 1 (July–September) 2013/14 results Shorter stays in emergency departments Increased access to elective surgery Shorter waits for cancer treatment (radiotherapy & chemotherapy) Increased immunisation (8-month-olds) Better help for smokers to quit – hospitals Better help for smokers to quit – primary care More heart & diabete s checks Ranking quarter 1, 2013/14 1261139107 Quarter 4, 2012/1395.5%112.1%100.0%89.3%97.3%65.2%73.1% Quarter 1, 2013/1494.0%111.8%100.0%89.9%96.5%66.5%75.6% National goal 95.0%100.0% 90.0%95.0%90.0%

20. Elective Services

21. ESPI compliance

22. Ministry Policy: Elective Services Original policy released March 2000 Intended to ensure patients with highest priority are treated ahead of those with a lower priority DHBs required to comply with the policy Previously it was a “never ending” waiting list

23. Aims Maximum waiting time of 5 months for a first specialist assessment (moving to 4) All patients who have been assessed clinically as having a level of need, which can be met within resources available, receive surgery / procedure within 5 months (moving to 4)

24. Planning for next year Live within our means Maintain a Quality focus Regional planning & delivery Link with Regional Services plan Link with Maori Health Plan Implement more meaningful primary / secondary integration

25. Questions?