Clinical Matters Newsletter - June 2020 29 Jun 2020
Welcome to the June 2020 Edition of Clinical Matters
In this issue...
Chronic Pain a Problem?
If you have a patient who would benefit from some coping strategies for pain, you can refer to the Chronic Pain Programme at Tauranga Hospital. This programme is separate from the Pain Clinic in that it employs non-medication management, with input from OT, physiotherapy and/or a psychologist.
Referrals can be made via the 'Pain Clinic' e-referral, but make sure you mention 'for Chronic Pain Programme' in the referral.
Note that the pain clinic have advised that the commonest reason for declined referrals is inadequate information, so make sure you include a good history.
Click here to read the flyer
Brief Statement to GPs Regarding Change to Post-Polypectomy Surveillance Protocol BOPDHB
Internationally, colonic polyp follow up recommendations are being revised in order to reflect latest evidence. The main change is a reduction in the intensity of post-polypectomy surveillance for most individuals. Some patients are no longer recommended to undergo surveillance colonoscopy, particularly when they are eligible to be enrolled in a national bowl cancer screening program within the next 10 years.
The Gastroenterology Department, in conjunction with the Endoscopy Users Group, Bay of Plenty District Health Board, have revised the post-polypectomy surveillance protocol to be in line with latest international guidelines.
Gastroenterology consultants have reviewed the records of the many thousands of people who are currently on our surveillance waiting lists and changes have been made to bring surveillance plans in line with the new protocol. Individual patients and their GPs have been notified if their surveillance recommendations have been changed.
Please see this information sheet for more detail.
Kaupapa Māori Community Nursing Service, Māori Health Gains and Development
Please advise all Māori patients of the option of Māori Health Community Nursing Service available out of Bay of Plenty District Health Board.
All referrals will be triaged via Bay of Plenty Community Care Co-ordination Centre but for those who have chosen for consideration of a Kaupapa Māori service the referral will be sent to Māori Health Gains and Development for community care that delivers with an emphasis on tikanga and kawa.
This aligns strategically and ethically with Te Toi Ahorangi 2030 and He Korowai Oranga
- All patients who identify as Māori who require community nursing care
- Patient condition cannot be managed by patient's attendance at a general practice
- Limited mobility or lack of transport precludes attendance at GP or clinic
Services provided include but are not limited to:
- All those that are provided by district nursing
- Catheter care - indwelling and suprapubic
- Continence assessment and on going follow up
- Wound care - medical and surgical
- Rheumatic fever care
- On site clinics
- For those services that are not specifically provided by the Kaupapa Māori community service it works in conjunction and collaboratively with a wide range of specialist health care providers.
- Weekend care - Māori Health Services collaborative with District Nursing Services to ensure that the patient has access to weekend care.
- Currently we work with District Nursing Services around ACC patients. Māori Health community nursing services is working to be able to take this cohort of patients
- Individual assessment
- There are no exclusion criteria
- All tangata whenua should be given the option of Māori Health service to provide their care.
When it is not possible options will be discussed with the patients on alternative providers
Referring for Sleep Apnoea Assessment - Throat Examination and Correct Referral Form
When referring for suspected sleep apnoea, the sleep service have asked that we include details of a throat examination. It is very helpful for them to have an idea about tonsillar size/Mallampati score, and whether there is any sign that the lower jaw is set back/retrognathia.
Please also remember to use the "BOPDHB - Public, Medical, Respiratory - sleep study/sleep apnoea" e-Referral, rather than the Allied Health "Sleep" form.
Many thanks for your help.
Changes to Reports from the Pacemaker Clinic
Starting from 1st July, routine reports about implantable devices will not longer be sent to GPs.
Where actions are request or important findings are present, a report will still be printed and sent out.
All other reports will be available on Éclair in CHIP.
COVID-19 Info Now Live on HealthPathways with Local Information
We now have an online hub for primary care COVID info in BOP (East and West).
Located in HealthPathways (direct link is in your PMS), click on the 'COVID' tab at top left, then 'Requests & Local Processes', and you'll see lots of useful stuff such as:
- Funding information and contacts
- Notification information and contacts
- PPE order forms
- Pathlab testing sites, opening hours, forms and information
- Clinical advice phone numbers - local and national
There's lots of other clinical info such as Managing Contacts, Medicines & Covid, Breastfeeding with Covid, etc.
Updates from the CE:
Latest from the BOPDHB CE:
Midland HealthPathways Update
New pathways for GPs on HealthPathways
The following pathways are now live on our HealthPathways site for you to use:
- Asymmetrical Hearing Loss
- Abnormal Liver Function Tests
HealthPathways is a collection of management guidelines specifically tailored to primary care. Our GP Liaison team is in the process of 'localising' these pathways to the Bay of Plenty, i.e, making them relevant to GPs and other primary care providers specifically in the Bay of Plenty. You'll find valuable pointers on History, Examination, Treatment and of course when and how to refer patients on to other services. These pathways will, over time, be replacing the Bay Navigator pathways.
Dr Chris Tofield, Dr Dan Jackson, and Dr Paula Taylor
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