Clinical Matters Newsletter - September 2021 23 Sep 2021
Welcome to the September 2021 Edition of Clinical Matters!
In this issue...
Webinars on Assisted Dying
The Ministry of Health has created a series of webinars on the topic of Assisted Dying. These webinars are for people working in the health sector only. They may be of particular interest to health practitioners who may choose to be involved in providing assisted dying services in New Zealand, as well as people working on planning related to assisted dying services.
Accessing the recording of the previous implementation webinars
We are making recordings of our previous webinars available through LearnOnline. These cover international experiences on providing assisted dying services, patient perspectives on assisted dying, and whānau centered end of life care.
Click here to access the recordings of our previous assisted dying implementation webinars.
You will need to have a log-in for LearnOnline to access these recordings – you can make an account through the above link.
Registrations of interest for the lists held by the SCENZ Group are now closed
Find out more about the SCENZ Group here.
Further information and guidance will be available over the coming weeks
The webinar series is part of the Ministry of Health's work to provide training, information and guidance about the implementation of assisted dying services. A range of resources are being created to help health professionals and health and disability service providers prepare for when assisted dying becomes available in New Zealand on 7 November 2021.All resources can be accessed through LearnOnline.
All health professionals are encouraged to complete the End of Life Choice Act 2019: Overview module to support their understanding of the Act and their obligations under the Act.
Further resources and training will be added over the coming weeks including:
- An e-learning module about the assisted dying pathway
- A guide to support conversations about assisted dying, and an accompanying e-learning module, developed with the Health Quality and Safety Commission
- Guidance to support health and disability service providers to develop internal policies and procedures
- Resources for health and disability service providers to use to educate the non-clinical and/pr non regulated workforce
- A series of e-learning modules for medical and nurse practitioners who are planning to provide assisted dying services
If you have questions, please contact us at: firstname.lastname@example.org End of Life Choice Act implementation programme team.
Online Clinical Hub for Primary Healthcare Providers
The BOPDHB COVID-19 response team has developed a private, online resource centre called the clinical hub. This is specifically for providers involved in the vaccination rollout and resurgence response.
Please note that access to the clinical hub is private, so only those with the link can view the content. Please do not share this link outside of your practice or vaccination service team. We recommend you save the clinical hub as a bookmark or similar in your internet browser, and check it regularly for new information.
Need more information?
Questions about the clinical hub can be directed to Kristina Hepburn via Kristina.Hepburn@bopdhb.govt.nz.
Ngā mihi nui
BOPDHB COVID-19 response team
Planned Care Services - Elective Services Name Change
The BOPDHB Electives Team has now been rebranded. In line with the Ministry's Planned Care strategic approach the Electives Team will now be known as "Planned Care Services and Planned Care Service Coordinators."
Excerpts from: Planned Care Strategic Approach 2019-2024
The term Planned Care is new, and reflects the new direction for publicly funded healthcare in New Zealand. Planned Care is about providing services based on clinical need and service user preferences to achieve better health outcomes, within the publicly-funded resources available. Planned Care encompasses medical and surgical activity traditionally known as Elective or Arranged services that are delivered by hospitals. Planned Care aims to consider medical and surgical activity in a way that is not limited to hospital settings or groups of health professionals. Rather than supporting just hospital-based care, Planned Care refers to services delivered in the most appropriate setting, by the most appropriate person, based on a person's clinical needs.
Although some things won't change for us, our process, protocols and compliancy measures will remain as they are. Electives remain a part of the planned care services that are delivered by hospitals.
The name on our letters have changed to say "Planned Care Services," so you may get calls or questions from your patients relating to planned care rather than elective services.
Our email address has changed to: Planned.email@example.com
We will of course still remain available for any questions, queries, and support you may need to help manage your services.
Ngā mihi nui
Planned Care Services Team
Introducing Paula Taylor - GP Liaison for Eastern Bay of Plenty
Hi everyone. Just a quick note to introduce myself. I have just taken up the role of GP Liaison Officer (GPL) in the Eastern Bay of Plenty while Rachel Shouler is busying championing our fight against COVID-19. I hope to further build on the strong links she has established between primary and secondary care so please do get in touch if you have any concerns or ideas you'd like to discuss. I will be working three days a week as a GP at Tarawera Medical Centre in Kawerau and one day a week (Thursdays) at the DHB in the GPL role.
Prior to obtaining my medical degree at Peninsula Medical School in the UK (BMBS 2008) I studied design at Middlesex University (BA Hons 1996) and worked as a graphic designer for a number of years after. I participated in an exchange program while studying for my degree in Visual Communication Design and was fortunate to study at Wellington polytechnic in 1994 (now Massey University) Having fallen in love with NZ, I eventually emigrated in 2016 with my husband, son and dog.
Please contact me on the GP Liaison email address: baynav.bopdhb.govt.nz
New eReferral Now Live - Child Development Service
The CDS is a multidisciplinary, community-based service for children aged 0-16 years who have a diagnosed developmental disability and/or are at risk of a developmental impairment. They work in partnership with whānau/families, specialists and outside agencies
The Child Developmental Service Team includes Occupational Therapists, Physiotherapists, Speech Language Therapists, Social Workers, Dietitian, Psychologists, Visiting Neurodevelopmental Therapists (West), Te Pou Kokiri (East), Therapy Assistants (East) and Administration staff. They provide therapeutic intervention with the aim of improving the child's quality of life and to encourage them to reach their full potential.
- Children from 0-16 years who have been identified as having a physical, sensory, intellectual or neurodevelopmental disability which is likely to continue for at least 6 months
- Children who are at risk of developmental impairments as mentioned above or have a developmental delay which is having a functional impact on their daily life
- Whānau, families and caregivers associated with the above children
Child or young person
- With ministry of Education Physical Disability Service or ORS funding who do not have specialised home-based OT equipment or housing needs
- Who has ACC funding
- Who has a short-term acute illness and is expected to rapidly return to their former level of wellness or function
- Who has surgical intervention for an acute need
- Requiring palliative care who is terminally ill
- Requiring maintenance services only and not a multi-disciplinary developmental programme
- Diagnosed with ADHD
- Whose service needs are covered under another service specification+
Survey: Exploring Video and Phone use in General Practice
The University of Auckland is conducting a health provider survey about video and phone appointments with general practice doctors and nurses.
In the context of New Zealand and general practice and the COVID-19 pandemic, this survey aims to answer the question, "What is the health provider experience of telehealth and how they perceive this mode of care delivery going forward?" We will also invite consumers (patients) to complete a different survey.
As a general practice doctor or nurse, your participation is much appreciated. With your input, we will be able to achieve our aim, informing general practitioners, practice nurses, policy makers and government of the importance of video and phone appointments to better facilitate your interaction with patients for the benefit of their health.
Click here for the Provider survey
Audit Highlights Need for Increased GP Education
The need for improved GP education and awareness around hepatitis B has been highlighted by a recently completed audit into hepatitis B testing and management within the Southern District Health Board (SDHB) coverage area.
The audit identified gaps in GP testing and monitoring in some South Island regions. However, these gaps apply in all regions across the country, not just around the South Island. Mayn patients aren't getting recommended hepatitis B serology tests, and people with an increased risk of hepatocellular (liver) cancer (HCC) are often not receiving routine ultrasounds. Furthermore, many patients are not being referred for alpha-fetoprotein tests (AFP), which are crucial in monitoring for early HCC. All GP practices are busy, with many having more patients than they can handle. The Hepatitis Foundation of New Zealand is therefore working to build closer relationships with GPs and provide liver-related education for healthcare professionals to enable more effective treatment and monitoring. It currently operates solely in the North Island but is working to identify ways to build ongoing relationships with GPs in the SDHB area and hopes to eventually increase its reach to provide face-to-face education to South Island-based patients and healthcare professionals
Hepatitis B is prevalent in New Zealand; there are an estimated 93,600 people with the chronic form of the virus. This represents about two percent of the population, Hepatitis Foundation CEO Susan Hay says only about 50 percent of New Zealanders are diagnosed, and only 19 percent of them have been referred to the foundation. "Furthermore, 2017 modelling showed only 7000 are being treated. There should be three times this number. This means we need to use our patient register nationally to ensure people who need treatment get it. This is how we will ensure we meet World Health Organisation targets of reducing liver cancer, which disproportionately affects Māori and Pacific people."
Without proper monitoring and management, these people are at risk of poor health outcomes, including progression to cirrhosis and HCC.
The Hepatitis Foundation runs a long-term monitoring programme for people with CHB that provides access to community hepatitis nurses and specialist care (if needed), regular blood tests and liver assessments, resources and information about hepatitis B, advice and support, and a free helpline. It has also launched a series of online education courses for primary healthcare providers that are endorsed by the Royal NZ College of GPs. Participants will earn professional development credits upon completion of these courses. The courses are available at https://www.hepatitisfoundation.org.nz/healthcare-professionals/education-modules
For more information about the Hepatitis Foundation’s services, please visit www.hepatitisfoundation.org.nz.
Attachments to Cardiology Referrals - Please Use PDF Format
Attaching an ECG to a cardiology referral? Please could you use a PDF format, rather than other formats e.g., GIF. This makes it easier for the team to rotate the image and interpret the ECG.
Midlands HealthPathways Update
New pathways for GPs on HealthPathways
The following pathways are now live on our HealthPathways site for you to use:
- End of Life Choice Act
- COVID-19 Vaccination Preparation and Aftercare
- Breast Symptoms
And remember there is up-to-date information on all matters Covid-19 for primary care on Health Pathways, including national as well as local information.
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