Clinical Matters Newsletter September 2022 30 Sep 2022
Welcome to the September 2022 Edition of Clinical Matters
In this issue...
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Social Event: General Practice Expo for SMOs & GPs
CLINCAL UPDATE: STI Collection Kit Change
Pathlab is excited to announce the implementation of a new BD COR high throughput molecular analyser to perform several tests including the STI panels (chlamydia, gonorrhoea, trichomonas). This is only the second instrument of its type commissioned in the world and offers improvements over the existing assay and instruments.
- Click here to read more on STI collection kit changes - August 2022
- Click here to view the PAL swabs chart - September 2022
New BPAC eReferral for Arranging Blood Transfusions in WBOP
A new BPAC eReferral form is available to arrange blood transfusions in Tauranga. This replaces the interim process of faxing the form to the Cancer Centre.
Please note the information which is required for the referral on the front page:
As before, requests for iron infusions in secondary care should still be sent via the ‘General Medical’ eReferral form.
Boostrix in Pharmacy Update
From 1 August Pharmacy can order Boostrix vaccine at no cost for administration to eligible individuals. From 1 September Pharmacy will be able to administer and claim the administration fee for Boostrix.
The Boostrix vaccine boosts immunity against diphtheria, tetanus, and pertussis (whooping cough)
In removing these costs and enabling administration of Boostrix by Pharmacy, we hope to make the Boostrix vaccine more accessible for eligible people.
Eligibility criteria can be found at: https://schedule.pharmac.govt.nz/ScheduleOnline.php?edition=&osq=Boostrix
- Click here to read more about Boostrix in Pharmacy Key Messages August 2022
- Click here to read Boostrix and CIR Inventory user FAQ
Epilepsy New Zealand eReferral now Live
Epilepsy NZ offers the following free service for all eligible people in New Zealand:
- support programmes for people and families living with epilepsy
- education and training tailored for individuals, families, schools, workplaces and community settings
- information and resources
- community awareness programmes
Epilepsy New Zealand is the voice for people living with epilepsy.
To contact our team phone: 0800 EPILEPSY (0800 374537)
Eligibility Criteria
- All individuals whether newly diagnosed with epilepsy or with a confirmed clinical diagnosis of Epilepsy and their whanau
- We also accept referrals from schools, aged care facilities and workplaces for our training and education services
- Non-residents
Resources and Links
For further information, please refer to:
CLINICAL UPDATE: Blood Groups & Antibody Screens Issue
A computer bug has been identified in a recent update of software (ImmuLink) used for the processing of diagnostic blood groups and antibody screens.
This computer bug has the potential to transmit results from earlier iterations of the same sample number. For example, the results from sample 21T1234567 could be transmitted rather than 22T1234567, the prefix isn’t considered.
CLINICAL UPDATE: Laboratory Testing for Monkeypox
There is currently an outbreak of Monkeypox in Europe, North America, and Australia.
- The virus is related to smallpox but is less severe. It is not easily transmitted between people. Infection occurs following close contact with an infected person, animal, or contaminated material. The virus enters the body through broken skin, mucous membranes, or the respiratory tract.
- Incubation period 5-21 days.
- The rash often begins on the face and spreads centrifugally. It goes through different stages before the resultant scabs fall off. Different stages may be present simultaneously.
- The rash is usually preceded by a prodrome including fever and lymphadenopathy.
- Genital lesions are also common and are the likely route of transmission in the current outbreaks.https://mcusercontent.com/44b7c39e3ff768164720288a9/images/c292175c-62fc-391c-c25b-fbbb12d3669a.jpg
Click here to read more from Pathlab on laboratory testing for Monkeypox
Community Women's Health Clinic Pilot Programme
A pilot Community Women's Health Clinic (CWHC) is in progress to provide assessment, support, and management for a range of women’s health conditions that either do not meet planned care thresholds, do not require surgical intervention, or are deemed more suitable for delivery in primary/community care settings.
Please click here to view a document containing more details about the project.
Part of the work involves identifying whether referral volumes have been affected by issues with thresholds and acceptance of referrals. We would be most grateful if you could complete the survey by clicking the button below so that we understand more about any barriers to women’s health care.
Referring to Mental Health Services – Improving the Process in WBOP
It can be tempting to concurrently refer our patients to both WBOP PHO and (former) DHB mental health services simultaneously to try to minimise waiting times.
However, due to contractual issues, the PHO is unable to accept a referral until the DHB has triaged and graded it, and in fact a dual referral can lead to delays.
The information contained in the DHB triage is sent to GPs only.
Going forwards, it would be helpful if referrals, for people who you believe require secondary care level input, could be made to the DHB in the first instance, and only then to the PHO if the DHB referral is declined. Please can you also attach the outcome of the DHB triage, and any relevant clinical documents to your referral to the PHO, as this information is not available to the PHO mental health team otherwise.
Many thanks in advance.
Pre-Assessment / Pre-Operative Management Guidelines Available on Bay Navigator
Did you know that Bay Navigator hosts management guidelines to help get your patients ready for elective surgery?
We often receive letters from the Pre-Assessment Clinic asking for our help with optimisation of a patient’s blood pressure, diabetes control, iron deficiency or hyponatraemia. The newly overhauled Bay Navigator website has comprehensive guides to the required pre-operative thresholds for all of these conditions.
Links to the guidelines are below:
Pre-Operative Anaemia or Iron Deficiency
Pre-Operative Diabetes Mellitus
Pre-Operative Hypertension
Pre-Operative Hyponatraemia
Please contact the GP Liaison team with any queries at baynav@bopdhb.govt.nz.
Workforce Survey Abortion Services [Contraception, Sterilisation and Abortion Act 1977]
The Contraception, Sterilisation and Abortion Act was amended on 24 March 2020 to enable better access to abortion services.
Manatū Hauora - Ministry of Health has a team managing the ongoing implementation of this work.
Further information on the Act and the Ministry’s programme of work can be found at: https://www.health.govt.nz/our-work/regulation-health-and-disability-system/abortion-legislation-information-health-practitioners/abortion-legislation-changes
And via Learn online –https://learnonline.health.nz/admin/tool/sitepolicy/userpolicy.php
Overview
Thank you for participating in this abortion workforce survey.
This survey is aimed at individual health practitioners who currently provide, are looking to provide, or who want to know more about providing abortion care. This includes anyone who can provide an aspect of abortion care under the Act, including medical practitioners, nurses, midwives, as well as social workers or counsellors who may provide counselling.
The Ministry wants to support health practitioners in providing quality and culturally safe abortion services and post-abortion LARC contraception services to build a more sustainable and diverse workforce. This will help support better access to abortion care and give pregnant people more options. To do this, we need a better understanding of your interests and needs including:
- what you know about abortion
- if you currently provide abortion care (and if you want to provide more than you currently do), or, if you would consider providing abortion care
- if you currently provide LARC contraceptive services
- your opportunities for better service response to Māori and whānau and health equity
- what your understanding of culturally safe services is
- whether there are any barriers to service provision.
Health practitioners have a right to conscientiously object to providing abortion services. It’s important to note that your response to this survey is not a confirmation of your choice to either participate in, or opt out of, the service. The results will help inform our ongoing approach to workforce development for abortion services.
The survey is anonymous and will not identify individual responses to the Ministry unless you provide any details that enable you to be recognised.
We will publish the anonymised results of this survey on our website as part of ensuring a transparent process in implementing the Act.
The survey will run from 15 September until 31 October 2022
Please feel free to share this survey link with your colleagues.
This survey will take approximately 10 minutes to complete.
Any questions about the survey can be directed to abortionservices@health.govt.nz.
CLINICAL UPDATE: Respiratory Virus Testing
Spring is well and truly upon us; the weather is warming up and respiratory viruses are moving into their summer phase. Influenza and respiratory syncytial virus (RSV) numbers are down to almost nothing and SARS-CoV-2 numbers remain low.
This means that effective Monday 3rd October we will stop routinely performing the SARS-CoV-2/Influenza A+B/RSV multiplex molecular assay on all respiratory virus requests and only test for the virus(es) requested. Please remember to specify on the laboratory form the virus(es) that need to be tested because a blanket request for virus testing will be rejected.
Click here to read the full document
Rising Numbers of Meningococcal Cases Across BOP and Lakes
Over the last two months a number of meningococcal cases have been seen across Bay of Plenty and Lakes. Since January 2022 there have been 9 cases diagnosed across the 2 districts with 6 since mid-June. They have been typed as mostly Group B.
Meningococcal disease is seasonal with peaks seen in late winter into early spring and so it is not unexpected to see more cases at this time of year. However, it is timely to review the presentation and management of this serious condition which requires early recognition and swift management.
Whilst national cases this year are up on 2020 numbers, they are lower than 2017,18 and 19 and the August figures were declining on the previous months. The Tauranga Hospital Infectious Disease team will continue to monitor the situation carefully.
Upcoming Resus Course Dates
Midland HealthPathways Update
New pathways for GPs on HealthPathways
The following pathways are now live on our HealthPathways site for you to use:
- Depression in Adults and Older People
- Scrotal Lumps in Adults
- Incidental Findings on Imaging
- Gallbladder Polyps
- Incidental Renal Lesion
- Eczema in Children
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.