admin @ nurse. org. nz
( 06) 358 6000
well. We understood that the PHOs would be the arm of the DHB focused on the front end of keeping the population well and out of hospital.
As history and many thoughtful publications have shown in most DHBs there was / is limited engagement in primary health care. Because PHOs encompassed the private businesses of General Practitioners it was difficult in most instances for DHBs through PHOs to have any influence on what might happen. As we now move into alliance contracting the million-dollar question is; Will it make any difference? Will it change the barriers that have obstructed full-scale implementation of the intent of the primary health strategy?
The second much larger workshop was labeled“ Integrated Performance and Incentive Framework and aimed to answer two questions
What is the biggest challenge you face in achieving high performance?
· What are you looking for in a performance and incentive framework? As a participant in that workshop I shared a table with a range of disciplines and sector leaders. While work shopping these questions it became painfully apparent that the immediate focus immediately closed in on front line appointments with a GP and the need to provide these in a timely manner. It was difficult to lift the conversation to a higher system wide and integrated perspective encompassing such critical issues as:
• how primary and secondary care need to be able to work together through shared funding and workforce
• the need for full use of the multi disciplinary team all working at the top of scope
• issues of electronic information sharing
• the challenges of electronic access for vulnerable or marginalized populations
• the need to protect and support vital services being provided by NGOs and smaller more vulnerable providers
It was however encouraging to see that in the final feedback at the workshop it was agreed that the way forward must encompass a system wide focus in which the DHB truly does fund and focus across the traditional walls between primary and secondary care. At the end of the day it remains a huge challenge to the New Zealand health system that hospital and ED care is free and primary health care is mostly not free and still prohibitively expensive for those in most need.
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admin @ nurse. org. nz
( 06) 358 6000
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