1. Primary options in the Waikato Midland PHO

2. Principles Currently in: Northland, Auckland, BoP, Hawkes Bay, Christchurch Managing patients in the community 24-hour access Using existing services (with extra funding and FTE) Free (if meet criteria) to the patient “reducing GP referrals to ED”

3. Eligibility Usually referred to ED GP/A&M able to deal with the problem Patient may be charged if declined by PO Cost not to exceed $300 Exclusions Other funding – ACC… or maternity

4. PO services Entry via GP, A&M, ambulance, ED? Includes Diagnostics – lab & rad Home care & visits Observation Transport Respite care Anglesea A&M – including overnight

5. Diversion from ED Condition does not require admission Patient is stable & condition not time-critical Transport – includes taxi/ambulance

6. Conditions DVT Cellulitis Headache D&V Abdo pain (no F or V) Sore throat Mild-mod ‘flu-like illness UTI Urinary retention Chronic pain

7. Numbers Oct12 Nov12 Dec12 Jan13 Feb13 Mar13 Total Q2 YTD Referrals to PO 167 168 179137209343 6891203 Percentage of clients without admission and referred to ED 87% 88% 86% 87% 84% 82% 84% 85.6%

8. And stories COPD patient given O 2 & IV abs Cellulitis patient looking after terminally ill wife Premature twins needing CXR Home visits and home care package to elderly patients Frequent (ED) attender managed at home by practice nurse Acute abdo pain needing USS