The Clinicians’ Challenge is run by Health Informatics New Zealand (HINZ), the New Zealand Health IT Cluster, and the NHITB. 

We have received 55 entries in this year’s Challenge, showing once again that clinicians welcome a chance to connect with health IT vendors to find practical, effective solutions to problems that matter.

The entries identify work-related problems which clinicians believe could be solved the innovative use of information technology.

We have shortlisted the following three:

• improving the effective delivery of healthcare in a rural environment
• supporting integrated care and self care
• testing the best way to utilise new e-pad technology to improve productivity within hospitals.

Health IT vendors now have until 8 October to develop practical IT solutions, and we will announce the winning clinician and vendor at the HINZ conference in Rotorua on 7-9 November. You can read more about the three finalists in the NHITB’s newsletter due out at the end of October.

Graeme Osborne

Director, National Health IT Board

Rheumatic fever is a painful disease, often with serious long-term heart damage as a side-effect - yet it is entirely preventable.  In terms of the impact on the New Zealand health system, treating rheumatic fever and its side-effects costs an estimated $40 million a year.

HWNZ’s involvement in the programme is part of the Ministry of Health’s implementation of the Government’s Better Public Services (BPS) plan to achieve a reduction in new cases by two thirds within five years.

The wider BPS programme involves the Ministry of Health, government agencies, district health boards, primary health organisations, public health services, professional bodies and communities working together to reduce rheumatic fever. 

Chief Medical Officer of Health Don Mackie, leads the Ministry’s rheumatic fever response, he says HWNZ’s involvement is an important part of successfully reducing rheumatic fever.

“Tackling rheumatic fever needs everyone’s commitment at all levels of the health sector and that’s why a collaborative cross-government approach is needed.

Recruitment of a workforce to support the swabbing programme in traditionally hard to staff areas is a priority for us.

"This needs to be supported with a strong and well trained workforce in place across all of primary and secondary health care as well.”

HWNZ is working alongside others to find ways of boosting the trained workforce and increasing the scope of practice for some health professionals to be able to undertake additional tasks, such as swabbing.

As part of this, the Ministry has invested $24 million in a Rheumatic Fever Prevention Project, to target 35,000 at risk children.  The project aims to raise community awareness and provide access to throat swabbing and antibiotic treatment.

An expanded throat swabbing programme has already been launched in some of the most vulnerable communities in Northland, Counties Manukau, Waikato, Hawke’s Bay, Bay of Plenty, Lakes District, Tairawhiti and Porirua. Previously these areas have had the highest number of hospitalisations for acute rheumatic fever between 2006 and 2010.

Prevention of rheumatic fever is achieved by an early diagnosis and treatment of Group A Streptococcal throat infections, which can be the trigger for the disease. With proper antibiotic treatment at the sore throat stage, the risk of getting rheumatic fever is greatly reduced.

Following an attack of rheumatic fever, preventing further attacks through monthly antibiotic injections reduces the risk of heart damage by 80 per cent.  This early intervention also places less strain on the health system later, with better long term health outcomes for patients.

Rheumatic fever in New Zealand:

• Based on 2010-11 hospitalisation data, the annual rate of rheumatic fever initial episodes is 4.2 cases per 100,000 population.
• About 70 per cent of cases occur in children aged between 5 and 14 years of age.
• In 2011 there were 187 cases of initial episodes of acute rheumatic fever.

Many health and disability sector organisations participated in the drill on the 26 September at 9.26am. There were 470 health and disability providers registered to take part - with a total of 63,000 participants. The Ministry of Health, including the National Health Board, IT Health Board and Health Workforce New Zealand all took part on the day.

We are really pleased that so many health and disability sector providers used this opportunity to plan, prepare and participate in NZ Shakeout. From our perspective we can’t stress enough how important it is for the sector to be ready for a major event.

A key thing here is not to just do the drill and go ‘okay that’s it.’ It is important to discuss what happens afterwards and know how your organisation will get back on its feet, through business service continuity planning.

Penny Dewar, Emergency Management Co-ordinator at South Canterbury District Health Board, was busy in the weeks leading up to the drill, getting staff ready for NZ Shakeout.

“In order to get our staff ready, we created a display in the hospital cafeteria of an emergency kit. We’ve also sent regular NZ Shakeout newsletters to all staff and asked managers to place them on notice boards. I have also talked to them about NZ Shakeout and given out some tips on being prepared.”

The health and disability sector will play an important role in providing services after any major event.

Regardless of how badly affected services are - the sector’s ability to recover and get back up and running is critical.

More information on registering for NZ Shakeout is available here.

Charles Blanch

Director, Emergency Management

Care workers perform a valuable service by supporting people with a physical disability or mental illness in their homes at night.  They help deal with any incidents or assistance the client needs at all hours.

Previously, care workers were paid a shift allowance for their work, rather than the hourly minimum wage.  Under the Act care workers are now entitled to the full minimum wage (currently $13.50 an hour) and will receive gradual increases up to this amount by July 2013.

Jill Lane, Director, National Services Purchasing says, “There has been a lot achieved in the year since the Act was passed, including the first Order in Council that joined eight employers of care workers to the Act.

“Employers who have joined the Act are now able to transition to paying care workers the full minimum wage, with the help of additional funding from the Crown. We are also making good progress on the next Order in Council to include another 22 employers.  If time allows, we are hoping to have a third Order approved before the end of the year.”

To settle backdated wage claims going back to 2007, the Government is providing $27.5m to assist Crown funded employers in the health and disability sector.  Additionally there is up to $90m over three years for the progression to the full minimum wage for care workers.

The Act and funding from the Government enables eligible care workers to get back pay from their employer, who may not have otherwise been able to afford it.  It also provides care workers with a more certain future around payment for their work.

Without the Act in place, we faced a situation where many providers of sleepover services would not have been able to stay in business long-term, which had serious implications for both their clients and care workers.

However, with the collective work of employers, care workers, the Government and Ministry of Health, we have helped ensure at-risk people continue to get the quality care they need to remain independent in their homes and communities.

Mark Powell

Group Manger, Contract & Information Support

Health Workforce New Zealand (HWNZ) is holding meetings around the country, which are an informal opportunity for anyone interested to drop by and find out what the review is all about and how they can take part.

The full public consultation looks at the review of the Act, which is an important piece of legislation affecting all health practitioners and how they practise in New Zealand. The Act is central to protecting the health and safety of the public and the review will consider how it is functioning in the health system and how it could be improved.

It is important that anyone with an interest – including healthcare professionals, agencies and health care consumers – have an opportunity to put forward a submission during the consultation process.

Full information, including an outline of the scope of the review, the consultation documents and details of all public and health professional meetings, can be found at: http://healthworkforce.govt.nz/tools-and-resources/consultations

Any questions and comments about the HPCA review can also be submitted to HWNZ by emailing: info@healthworkforce.govt.nz

We are using this external review to look at the productivity gains achieved for elective services, the lessons learned, and the value for money received from the projects we funded.

The external review is due to take place between October and December this year, and we have placed a request for proposals (RFP) on the Government Electronic Tenders Service (GETS).

The review looks at the completed first round of funding, to 13 district health boards (DHBs), which covered over 30 projects to support significant productivity initiatives and increases in elective surgery.  The review will initially focus on 17 of these projects.

The first round of projects covered a range of areas from operational and management efficiencies, to redesigned patient pathways and revised peri-operative techniques. 

We supported each project on the basis that, if successful, it would be rolled out to the wider health sector.

An evaluation panel, made up of health sector representatives, the Ministry of Health and NHB experts selected the projects to be reviewed. The projects were then endorsed by the programme’s sector-led steering group.

The RFP is available on www.gets.govt.nz.

Tony Crane

Senior Project Manager

Elective Services

The district experiences one of the highest proportions of older people in New Zealand and the Bay of Plenty District Health Board has recently published a five year strategy to help cope with the demand on services.

DHB Health of Older People & Palliative Care Portfolio Manager Sarah Davey says health of older people is one of the priority areas for the DHB.

“The five year strategy aims to promote healthy independent and dignified ageing,” says Sarah.

“We want to provide quality health and disability services for our growing older population and ensure we can manage the likely growth in demand for services in the future.”

The strategy identifies nine standards that encompass the Government’s Health of Older People Strategy (2002) and includes:

• Promotion of health and wellbeing through education, information, prevention and restoring function.

• A stronger focus on service integration with community services and primary care.

• Development of services that aim to address health problems that are particularly significant for older people, such as: stroke; falls and bone health; dementia and mental health in older people; and medications management.

The key impacts we are seeking over the next three to five years include:

• Older people, their carers, family and whanau are supported and informed about their choices.

• Government agencies and local government develop policies that are age-friendly and reflect opportunities and impacts of population ageing.

• The growth rate of acute or unplanned admissions to hospital for people over the age of 75 is reduced.

• The proportion of people over 65 admitted acutely to hospital, who then return to live independently in their own homes, increases.

• The proportion of eligible people over 65 that are supported in their own homes increases.

• The proportion of eligible people over 65 living in long term residential care reduces.

• More older Maori are supported to live independently in their own homes for longer.

• More people with dementia are able to live in the community.

Another area of particular focus for longer term planning is adult palliative care services.

We aim to strengthen and manage the growing demand for palliative care over the coming years driven largely by an ageing population.

“Priority areas include: develop hospital palliative care services; improve equity of access to community support (home care and aged residential care); and education and training for primary and community providers, family and whanau," says Sarah.

Copies of the Health of Older People Strategy and the Adult Palliative Care Services Plan are available on our website: www.bopdhb.govt.nz.

More information related to aged care is available on the Health Workforce New Zealand website including the palliative care workforce and aged care workforce service forecasts.

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Between them, social workers Sasha Naicker and Sheree Wilton are providing a full-time ASD service for Whanganui and MidCentral DHB children and their families, who until recently had little or no support.

Sheree and Sasha are two of many ASD developmental coordinators appointed across New Zealand’s district health boards (DHBs). Sasha says she became interested in autism while working for Whanganui’s Open Home Foundation where some clients were on the autism disorder spectrum.

“Inspired by their families, I researched the condition and learnt that if children are diagnosed early, the interventions and support that are available can make a significant difference to the children and their families,” Sasha says.

It’s widely recognised that children with autism behave differently with some children’s behaviour more extreme than others.

“Some children we work with might flap their hands incessantly; others might rock back and forth for hours; some may need visual, tactile, auditory and movement stimulation to be kept to a minimum; others may prefer a firm hug to a light touch. Many children with autism find change difficult, stressful and unsettling.

“We work with children who are very sensitive to things such as seams on their clothing and the feel of some fabrics; children who can hear sounds like water flowing through a pipe or a clock ticking which most people are unaware of. And with children for whom visual noise, such as paintings all over a classroom wall, can overwhelm them.”

Working with paediatricians, schools, parents, GPs, Public Health nurses and anyone else involved in the child’s life and linking families to the right resources is a critical part of Sasha and Sheree role.

Also Tim Dunn has been appointed regional occupational therapy professional adviser to provide professional leadership and advice to occupational therapy staff and managers across Whanganui and MidCentral DHBs.

Besides his former role of professional adviser occupational therapy at MidCentral Health for several years, Mr Dunn has worked across many MidCentral Health clinical areas. His career began in Whanganui in 1990 working with the elderly in what was Wanganui Hospital’s Newcombe Ward and then at Lake Alice Hospital. He looks forward to the challenges his new role will bring to his career.

The Ministry of Health’s Disability Support Services is working to improve services for people with Autism Spectrum Disorder (ASD).  The autistic spectrum disorder coordinators are funded by the Ministry through their local DHBs.