Important News and Information from Hauraki PHO

GP Research Review - Latest Issue Attached

27/7/2021

Welcome to issue 176 of GP Research Review. Incorrect inhaler technique
is prevalent in patients with COPD, ranging from 80% to 100% in an Egyptian study. A systematic review and costeffectiveness
analysis demonstrates that ambulatory BP is the most cost-effective method of BP monitoring, and likely
to lead to cost savings compared with clinic BP and home BP measurement. In COVID-19, we discover that older
adults with low vitamin D levels may have worse outcomes. In our Natural Health section, Dr Chris Tofield has reviewed
two interesting studies, one on osteopathic manipulative treatment for chronic low back pain, and the other on scalp
electroacupuncture plus memantine for vascular dementia

Click here to read the the GP Research Review Issues 176

Respiratory Nurse survey

26/7/2021

You are invited to take part in and/or share the Respiratory Nurse Survey.

Please share this email and the link below with all nurses working with respiratory patients within DHB’s, PHO’s and NGO’s.

Apologies if you receive this email multiple times as we are sending this out via a variety of sources.

We are keen for all respiratory nurses to take part in this study “The role of the Respiratory Nurse in the New Zealand.”

We are a group of 2 respiratory Clinical Nurse Specialists and 1 Nurse Practitioner at HVDHB and CCDHB wanting to find out more about Respiratory Nursing in New Zealand.

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The aim of the study is to describe the respiratory nurse’s role and to gain a better understanding of this role. This will provide an insight into the skill and diversity of our respiratory nursing work force in New Zealand.

There are 2 parts to this study.

Part one is a questionnaire that will explore the practice of respiratory nurses working with respiratory patients. It is an approximately 15 minute questionnaire covering topics such as area of work, health conditions seen and education background. This is an anonymous questionnaire.

At the end of the questionnaire you will be offered to go to a separate link to do part two, if you are a nurse prescriber.

Part two is a three month self-report of medicines prescribed and patients seen in clinical practice. This involves filling out an excel worksheet for each patient seen – up to 50 patients. Each patient will take approximately 2-5 minutes to fill out. Further information can be found when you click on the link below.

This study has both ethics and locality (HVDHB and CCDHB) approval.
Approval: 21/STH/67

Results of this study will be presented at the Thoracic Society of Australia and New Zealand Conference and written up for publication.

http://vuw.qualtrics.com/jfe/form/SV_e50j78qJjsYpmNo

St John - Extreme Demand Pressure - Advice for Primary Care and Aged Care

21/7/2021

Tēnā Koutou katoa

Over the past month St John Ambulance has been experiencing intermittent but persistent episodes where demand has exceeded resourcing. While there are always peaks and troughs, over the past two weeks demand has been consistently high. Last week was our highest 111 call and ambulance response volume since records began, and we have also seen significantly greater demand within patient transfer service (PTS).

We had predicted an increase in demand through this time due to winter illness, however the increase has been more profound than anticipated, which appears to be reflected throughout all of health.

As a result, we have decided to stand up an Emergency Operations Centre (EOC) in Auckland, to provide operational support through this period of high demand and to help ensure the welfare of our people and our patients.

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We released public advice last week, and have now developed specific advice for primary care and aged care. Please support by cascading this advice to your networks.

Primary care
Please have a higher than usual threshold for requesting an ambulance response to your medical facility, ensuring that prior to calling an ambulance:

It is clear that the patient requires transport to hospital by ambulance and that other forms of transport (for example, transport by taxi or a family member) have been considered.
If an ambulance response is required, the person requesting the ambulance has all of the required information (for example, patient name, NHI and provisional diagnosis) and uses the health professionals’ line on 0800 262 665 (not 111) to enable the call to be triaged by a clinician.
Please appreciate that due to the high demand, there is likely to be delays in St John being able to respond an ambulance if the patient’s condition is not immediately life-threatening.

Aged care
Please have a higher than usual threshold for requesting an ambulance response to your aged care facility, ensuring that prior to calling an ambulance:

It is clear that the patient requires transport to hospital by ambulance.
If the patient has a non-urgent clinical problem, all efforts are made by aged care facility staff to liaise with clinicians in primary care (for example, an on-call GP and local DHB/PHO services such as catheter nurses or district nurses) and for the patient to be clinically managed within the aged care facility if possible.
If an ambulance response is required, the staff member requesting the ambulance has all of the required information (for example, patient name, NHI and provisional diagnosis) and uses the health professionals’ line on 0800 262 665 (not 111) to enable the call to be triaged by a clinician.
Please appreciate that due to the high demand, there is likely to be delays in St John being able to respond an ambulance to aged care facilities if the patient’s condition is not immediately life-threatening.

We continue to monitor demand for ambulance services and will advise when we are able to return to our business as usual state. Please let me know if you need anything in the meantime.

Ngā mihi nui

eCALD News - 68th Edition

20/7/2021

Click here to read the eCALD News 68th Edition

Te Manawa Taki Mental Health & Addiction Winter Newsletter

16/7/2021

Kia ora and Greetings

Please click here to read the Te Manawa Taki Mental Health & Addiction Winter Newsletter. We hope that you find it informative and helpful. Please feel free to distribute widely.

Healthy Primary Care newsletter April - June 2021

14/7/2021

Click here to read the April -June 2021 Newsletter

Heart Valve Disease Awareness Campaign

12/7/2021

A nationwide campaign aiming to raise awareness around the symptoms of heart valve disease is being run in July and August. There will be adverts on Family Health Diaries on TV1 with Jude Dobson and on radio and digital platforms. You may notice more patients coming in and asking for a Heart Check.

Click here for more information

Implementation update on delivery and funding of assisted dying

6/7/2021

Tēnā koutou,

We are pleased to update you about the progress to implement the End of Life Choice Act 2019 (the Act) and assisted dying services in New Zealand. Assisted dying will be legal in New Zealand from 7 November 2021.
There is also further information available on the Ministry’s website.

Implementation is progressing and a number of decisions have been made on the delivery of assisted dying, and the funding model.

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Delivery of assisted dying services

Assisted dying services will be publicly funded in New Zealand and the Ministry of Health will be responsible for overseeing the funding and provision of assisted dying services. These decisions have been made by Cabinet and the background Cabinet paper can be seen here.
To support equitable access to services, any medical or nurse practitioner who is suitably qualified, and willing to do so, will be able to provide parts of the assisted dying services.

If a practitioner is providing services through private practice, a non-government organisation or primary practice, they will be able to access funding through a fee-for-service model. This model is being developed.

Assisted dying services are most likely to be provided in a person’s home or other community settings, rather than in hospital settings. A person’s medical or nurse practitioner will be able to travel to the person to provide care, and travel costs will be funded.
The Support and Consultation for End of Life in New Zealand (SCENZ) group will maintain the lists of practitioners who will be involved in assisted dying services. This group is expected to be established during July, and expressions of interest will be invited from practitioners willing to provide assisted dying services.

For more detail, about the delivery and funding of assisted dying please see the detailed information sheet on the Ministry website.

Funding mechanism

The funding mechanism to pay health practitioners for providing assisted dying services will be created through a section 88 Notice, under the New Zealand Public Health and Disability Act 2000.
The implementation team will now begin to work directly with representative groups of health and disability organisations to inform and develop the details of the Notice. This approach will ensure the funding mechanism is in place in time for 7 November 2021.
The Ministry will receive independent advice on the costing model and price schedule, and the level of funding that practitioners should be able to claim for completing parts of the service, and that advice will be informed by discussions with health and disability organisations representative of the sector.
If a practitioner is providing services as part of their employment within a district health board (DHB), DHB funding will cover these costs where assisted dying is bring provided in the DHB setting.

Medicines

An eligible patient will not need to pay additional fees (such as prescription co-payments) when medications are prescribed for assisted dying.
The Ministry has work underway to ensure appropriate medicines are available.

Guidance and training resources for the health sector

Information and learning resources for health professionals and health service providers can be found on the Ministry’s LearnOnline platform.
The following resources are now available:

An e-learning module about the Act and assisted dying: this module is suitable for all health professionals and can be completed by individuals or used as part of team meetings or for group learning.
A recording of the June webinar: this webinar features medical practitioners sharing their experiences of providing assisted dying services overseas.
Planning resources for health service providers: These include a preparation checklist and a scenario document to support planning for situations where a person may request assisted dying.

Further resources, including recordings of the implementation webinar series, will be added on LearnOnline as this work progresses. A module on the care pathway is expected in August/September.

Health professionals can register for the next implementation webinar on patient perspectives

Hosted on 14 July between 7-8pm, this webinar will cover research on patient perspectives of assisted dying, and will also provide an update about implementation progress.
Find out more and register here: https://mohnz.zoom.us/webinar/register/WN_d3IQgmnxSuqv6Dobo4hbsw

Upcoming workforce survey

An invitation to complete a workforce survey will be issued over the next week. This is an opportunity for health professionals to provide their current views around the implementation of the assisted dying in New Zealand. The survey will be open until the end of July and will inform our implementation planning.

If you have questions, please contact us at eolc@health.govt.nz
Remember to sign up for our regular newsletters here.

Nga Mihi nui
End of Life Choice Act Implementation programme team