Message from the Chair - NOVEMBER 4 2021 - General Practice NZ

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NOVEMBER 4 2021

Message from the Chair
                  This past week has seen significant progress in the health
                  system reforms with the establishment of interim Health New
                  Zealand and the interim Māori Health Authority and the passage
                  of the first reading of the Pae Ora Healthy Futures Bill.

                  Despite the all-encompassing nature of what is in front of us each
                  day, that progress is a reminder that we can’t lose sight of the longer
                  term changes that we need to deliver improved equity and
                  outcomes.

                  We now have stronger primary care representation in the Transition
                  Unit, with Helen Parker and Chiquita Hansen having joined in recent
                  weeks to lead important pieces of work on localities and the Health
                  Plan. With Martin Hefford as Acting Health New Zealand CEO
                  alongside Chad Paraone at the Māori Health Authority, we have
                  primary care insight and influence at the heart of decision-making,
                  which is essential if we are to turning the goals of the reforms into
                  reality.

                  GPNZ will make a submission to the Select Committee on the reform
                  Bill, but what we most need to influence are not the words in the Bill,
                  but the detailed work that sits behind it. The system operating model,
                  and the Health Plan that the system will be expected to deliver, will
                  take shape over the next few months. That will include – finally –
                  proposals to redesign the general practice funding model.

                  This is our opportunity to create funding mechanisms that meet our
                  Te Tiriti obligations and ensure equitable access to first contact
                  services, that incentivise health promotion, that encourage
                  innovation and collaborative working, and that support general
                  practice stability and sustainability.

                  We know how challenging it will be to achieve that but, despite the
                  current pressures on general practice, we need to make the time to
                  come up with the solutions that will work for our services and
                  communities. GPNZ will be feeding into the early work of the new
                  entities, and the TU's working groups and consultations. So let us
                  know your views on the draft legislation, but even more
                  importantly share your ideas on what constitutes a funding model for
                  general practice that would actually achieve pae ora.

Meanwhile, as we transition to wider community management of
                             COVID-19, the confirmation this week of a centralised process for
                             approving exemptions to the vaccine mandate was a welcome
                             step. It was a sign that the Ministry of Health listened and responded
                             to the growing pressure on our teams.

                             We hope there will be a similarly speedy response to the calls from
                             the sector to speed up the rollout of Pfizer booster shots for health
                             care workers. As we increasingly manage COVID-positive people,
                             there is understandable concern from staff who want to ensure
                             protection for themselves, their patients and whānau.

                             The Ministry of Health is due to provide advice to Cabinet on
                             international data in relation to ideal timing. Through the Health
                             System Readiness Group I am urging the Ministry and Cabinet to
                             expedite that process and to ensure rapid rollout of the booster
                             programme to ensure sustained immunity across our workforce.

                             He waka eke noa.

                             Dr Jeff Lowe

   COVID-19 vaccine
   The Ministry of Health has confirmed that it will operate a centralised system to manage
   and approve applications for exemptions from the COVID-19 vaccine mandate. Details will
   be published on the Ministry website next week before the mandate is due to come into
   effect on November 15.

   Additional resources to challenge vaccine misinformation have now been made available
   on the Unite Against COVID-19 website: https://covid19.govt.nz/covid-19-vaccines/get-the-
   facts-about-covid-19-vaccination/
   and IMAC website: https://covid.immune.org.nz/covid-19-vaccines-nz/comirnaty-mrna-
   pfizerbiontech-vaccine/how-comirnaty-vaccine-works-and. A series of Facebook Live
   sessions to provide support and information for people who are vaccine hesitant is also
   underway.

   MoH is now publishing the number of vaccines needed to get each DHB to 90% on this
   webpage. This same page houses the latest vaccine data COVID-19 vaccination data
   through 26 Oct 2021 (Excel, 363 KB).

COVID-19 in the community - learning from overseas
Dr Sue Wells, ProCare Associate Clinical Director and Associate Professor at the University of
Auckland School of Population Health has been seconded to the Northern Region COVID-19 Co-
ordinating Centre to undertake research into international experience of models of care in general
practice in COVID recovery.

Dr Wells will collate learning and good practice from countries including the UK, Canada, Sweden
and the Netherlands on issues including managing the physical general practice environment,
staff protection and wellbeing, creating a welcoming environment for patients,
improving/increasing access and maintaining core primary care alongside COVID -elated care.

The first step will be determining the core questions people need answered, such as managing
respiratory illness and unvaccinated patients in waiting areas, the balance of face to face and
virtual consultations and equity considerations. A literature review and input from key
stakeholders will be completed with recommendations by December 9, and then an opportunity

for feedback and refinement before Christmas.

Any suggestions regarding GP leaders and organisations overseas to provide input,
relevant policy/papers/literature and advice on key questions to address can be sent to
s.wells@auckland.ac.nz

COVID-19 in the community - RNZCGP Survey
In October, RNZCGP released a survey to members looking to identify immediate needs to
support the delivery of care for people with COVID-19 in the community. The following were the
highest needs identified for general practice teams:

       Funding
       Workforce
       Home monitoring coordination
       Building changes
       PPE
       IT systems

Further information on the survey and results can be found here

   Health reform bill progresses to select committee
   The Pae Ora Healthy Futures health reform bill passed its first reading in Parliament this
   week and now moves to the Select Committee stage. Rather than being considered by the
   Health Select Committee, the Bill will be managed by a dedicated Pae Ora Legislative
   Committee, chaired by Deborah Russell, with Tamati Coffey as deputy chair:
   https://www.parliament.nz/en/pb/sc/scl/pae-ora-legislation/

   Submissions on the bill are being invited until December 9:
   https://legislation.govt.nz/bill/government/2021/0085/latest/LMS575405.html In addition to
   any submissions from your own organisations, GPNZ is proposing making a submission on
   behalf of members. You can feed into the GPNZ submission by e-mailing
   maura.thompson@gpnz.org.nz

Ministry for Disabled People to be established next year
The government has announced that a new Ministry for Disabled People will be formally
established from July 1 next year. It will eventually be a stand-alone ministry, but will begin in the
Ministry of Social Development, which is setting up an establishment unit.

The new ministry will take on most functions currently delivered by the disability directorate in the
Ministry of Health, as well as taking on new responsibilities. It will lead cross-government strategic
disability policy, deliver and transform Disability Support Services and progress work on broader
Disability System Transformation. The Ministry of Health remains responsible for the health
outcomes of all New Zealanders, including people with a disability, and will work closely with the
new Ministry.

Building on the Enabling Good Lives vision, the voices of the disabled community will be
embedded at all levels of the new Ministry and establishment unit. New legislation on accessibility
is also to be developed.

   Feedback sought on consumer engagement code
   The Health Quality & Safety Commission is seeking feedback on a draft Code of
   Expectations for engaging with consumers and whānau.

   Ensuring the voice of whānau and consumers is clearly represented is key to the health
   reforms, with work to develop new processes being led by the Commission, supported by
   the Transition Unit.

The final Code of Expectations will set out how local, regional, and national organisations
   should engage and involve consumers, whānau and communities in the design, delivery,
   evaluation and governance of health services.

   The draft Code of Expectations has been developed with members of the Commission’s
   consumer network, consumer advisory group, and Te Rōopu Māori. A number of hui with
   consumers and other stakeholders will be held to incorporate views for the final version.

   Feedback on the draft Code is sought by February 2022:
   Health Quality & Safety Commission | Draft code of expectations – welcoming feedback
   (hqsc.govt.nz)

Whakarongarau image tool popular with patients and clinicians
Healthline’s software tool image upload has allowed more than 15,000 images to be shared to
help with triage and assessment since it was launched a year ago. Data collected over the 12
month period indicated that a third of callers received enhanced advice as a direct result of their
image being viewed.

If the clinician believes an image would be useful to assist with diagnosis, a link is sent to the
caller allowing them to upload a photo securely.

The tool is particularly popular with families, with images of rashes comprising 20% of the total
received, and more than one third of images relating to children under six.

Healthline chief clinical officer Dr Ruth Large said that the image upload option has been
particularly well received by Māori and Pacific peoples, with more than 22% of images sent from
Māori.

Whakarongorau Aotearoa’s professional workforce now totals more than 2,500 people in contact
centres in Auckland, Kaikohe, Ōtara, Rotorua, Heretaunga, Wellington, and Christchurch, and
from their homes across Aotearoa. The team responded to 2.55 million contacts in the twelve
months to 30 June 2021, an increase of 92% on the previous year.

ACC personal information
You may have seen the recent media coverage about the alleged sharing of ACC claim
information via a private social media group. ACC has suspended a number of staff and a formal
investigation is now underway.

The ACC Board will also conduct an independent review of the management of data and client
information, including sensitive claims.

If any ACC clients have concerns about the use of their personal information, please encourage
them to contact their Recovery Team member, or call the contact centre on 0800 101 996.

   PMS changes required for maternity claiming
   As you will be aware the amended Primary Maternity Services Notice 2021 (the 2021
   Notice) was gazetted on 30 June 2021 and comes into effect on 29 November 2021.

   Providers of primary maternity services under the 2021 Notice, will need to make changes
   to PMS systems in order to submit claims. If PMS system changes have been
   implemented in preparation for the go live date, then no further action is needed. However,
   if PMS system changes have not been implemented prior to 29 November, claims for
   services provided under the 2021 Notice can not be made until the relevant changes have
   been implemented by the IT vendor.

The Ministry of Health is working with IT vendors to support the required PMS changes in
order to minimise any delays.

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