Media release from South Canterbury District Health Board

South Canterbury District Health Board members agreed today to make primary and community services an integrated operating unit within the DHB and not an external organisation.

This means that when the current PHO in South Canterbury, Aoraki PHO, is disestablished on April 30, services will be transferred to a new division of the District Health Board called "Primary and Community Services".  

SCDHB chairman Murray Cleverley says he is delighted with the leadership shown by board members in voting to integrate health services in South Canterbury.

"Today we have been pioneers at integrating health services in New Zealand," he says. "This is still subject to the Minister's approval but I am confident about that."

"I want to say thank you to all stakeholders in primary care, and in particular the Establishment Board who have done a great job for the community.

"I also recognise that people is what we are all about. Our staff and our health providers are very important to us. Change brings uncertainty and we have empathy for the people going through these changes. We will endeavour to move forward as quickly as possible to create the least impact on people's lives."

Chairman of the Primary Health Establishment Board Tony Shaw is pleased the recommendations have been accepted.

"This is a unique primary health care model, the first of its type in the country, but one which we think will be very successful and likely to be followed in other parts of New Zealand.

"When we embarked on this project, we anticipated that we would be recommending a new PHO in South Canterbury. However, consultation indicated a different primary health care model would have the potential to bring significant improvements in South Canterbury. We realised that putting clinical governance and leadership at the forefront of primary health care was the key.

"Doctors, nurses and other health professionals at the coal face know what is best for their patients, so we needed a model that elevated the role of health professionals in determining the design and delivery of primary health care. This model provides much greater opportunity for GPs and other health professionals to have a say in how primary health care should be delivered.  

"The high degree of support from GPs for our recommendations, and the acceptance of our proposals by the board and community groups promises well for the future.

Timaru General Practitioner Dr Bruce Small believes this will benefit the population of South Canterbury while giving health providers a unique environment to work in.

"As a GP working in this new environment, I see a lot of potential and I'm excited by what the future holds for health, both from a delivery and a provider point of view. There is still a lot of detail to be "nutted out" but I believe with an element of goodwill, all people in South Canterbury will eventually benefit from what is proposed," he says.

SCDHB Chief Executive Chris Fleming says the decision is great for the DHB, great for GPs and great for the community, but now is the time to move forward.

"It's time to get primary clinical leadership groups up and running, and start embedding the cultural changes that primary care have asked for," he says.


The following recommendations were considered at the meeting today (with decisions in red):

Recommendation
That the Board:
•    Receives this report Received
•    Notes the contents of the report from the Establishment Board to the Chief Executive entitled Primary & Community Health in South Canterbury dated 21 March 2010  Noted
•    Approves  subject to resolution of any outstanding policy issues with the Ministry of Health:
o    That Primary Care becomes an integrated operating unit within the SCDHB and not an external organisation, sitting at the same level organisationally within the SCDHB as Secondary Services. Approved
o    That a process be developed to transition services to the Primary & Community Services, and that the development and implementation of this transition be delegated to the Chief Executive Officer Approved
o    That the Management and Clinical Leadership structures noted in the report from the Establishment Board Approved
o    That recruitment commences
o    That the Fixed Term contracts / services contained in table 2 of the report from the Establishment Board transition to Primary & Community Health Services Approved
o    That services contained in table 3 of the report from the Establishment Board be suspended until appropriate clinical governance review and recommendations have been made Approved
o    That services contained in table 4 of the report from the Establishment Board be transitioned until appropriate clinical governance review has been undertaken Approved
o    That the DHB negotiate with Aoraki PHO on the transfer of existing leases or operational contracts deemed appropriate by the Chief Executive Officer Approved
o    That the DHB negotiate with Southlink Health for a temporary contract for appropriate management services Approved and noted that this refers to operational services such as maintaining patient registers and cash flow to GPs.
o    That the DHB negotiate with Aoraki PHO on the transition process for the return of appropriate unclaimed funding provisions, subject to the Ministry of Health confirming acceptable arrangements which will enable the DHB to utilise the funding in the same manner as PHOs are able too. Approved
o    That the Operating Budget contained in Table 19 of the report from the Establishment Board Approved
o    That the principles for funding of general practice contained in Table 23 of the report from the Establishment Board Approved
o    That the subject to legal advice being obtained,
    Support for the transitional contracting framework in Table 25 of the report from the Establishment Board Approved and noted that this will see a transitional contract for the period of May to October.
    Either a DHB - GP Direct (Negotiated through a Third Party), or DHB - Third Party - GP contracting arrangement is acceptable, subject further to clarification of the Third Party's role in either option, and such arrangements being acceptable to the Chief Executive Officer. Approved with the addition of the words in italics and also the addition that the preference of the board is for Option 3 in the report due to majority support from GPs for this option.
    Delegate to the Chief Executive Officer the authority to approve the transitional contract to ensure General Practice funding continues uninterrupted from 1 May 2010 Approved
    An additional delegation was given to the Chief Executive to seek legal advice on whether there is any way to improve the privity clause between the DHB and GPs to improve relationships between the parties.
•    Notes  the Establishment Board's recommendations for transitioning services currently managed by either Planning & Funding, or the Secondary Service Provider Arm, Noted
•    Notes where the Chief Executive Officer transitions services from Planning & Funding or Secondary Services to Primary & Community Services this will not affect either contractual obligations between the DHB and Primary or NGO provider, or employees of the DHB as Primary & Community Services are a part of the DHB. Noted
•    Approves that the Disability Support Advisory Committee will meet independently from the CPHAC but on a no more than quarterly basis Approved with the deletion of the last eight words.
•    Approves the revised terms of reference for CPHAC Approved
•    Notes the intention to review the membership of CPHAC once the General Manager Primary and Community, Chief Primary Care Officer, and the Primary & Community Clinical Leadership Group are in place Noted
•    Notes a vote of thanks to the Establishment Board for a job well done. Added to the recommendations and noted.


A copy of the Establishment Board report mentioned

Or visit  www.scdhb.co.nz and the reported is listed under "Whats New"