Page 91 - Regional Services Plan 2016/19

testing likely to change models of care in the future by supporting home and primary care based testing for many conditions.
In relation to genomics, the number and range of potential tests for genetic susceptibilities are increasing at a rapid pace. Currently access to genomics is highly constrained in the Midland region.
The ageing population will place considerable strain on the available intensive care beds. Access to these beds and repatriation from then already creates some tensions between DHB clinical staff. This contrasts with the access to neonatal intensive care, which, while also constrained, was given as an example of a networked service with clear and equitable access criteria.
3.6 Primary and community services
Current services
Primary care services are available in all areas. Community nursing and allied health services are provided in all districts, by both NGO provisions and DHB provider arm provision of services in the community.
After-hours access to services differs by DHB and locality. In Hamilton and surrounding areas Anglesea Medical provides a 24/7 A&M service that most practices divert to afterhours. At the smaller DHBs access to services after 10pm is usually the local Emergency Department, with A&M or large primary care centres open until 10pm in Taranaki and to 8pm in Gisborne.
Data supplied on GPs per practice, show that the average number of GPs (excluding locums) per practice is 3.2. However, the median number is 2.0 – indicating that most practices consist of one or two GPs only.
Primary Health Organisations (PHOs) are non-profit organisations contracted to DHBs to provide a comprehensive set of preventative and treatment services for their enrolled population. Of note, nearly half the Midland population are members of one large PHO – the Midland Health Network PHO. A number of PHOs that have merged build critical mass and reduce overheads. The new organisational structures increase capacity, decrease overheads, are a platform for devolution and provide better patient access and coordination across the region.
There has been a great deal of innovation by DHBs and PHOs across the region resulting in locally targeted projects that focus on perceived areas of greatest need (e.g. diabetes, cardiovascular risk management, asthma, sexual health, youth health, mental health, refugee and migrant health and immunisations services).
For example a number of outreach services provided by primary health multi-disciplinary teams (including doctors, nurses and community health workers) have found real success in taking services to communities that would otherwise not engage with mainstream services (e.g. immunisation, breast and cervical screening, cardiac rehabilitation and respiratory services). Kaupapa Māori services have had a key role to play here. Considerable benefits have also been gained by working across and with other sectors (e.g. local City Councils, Work and Income New Zealand, Ministry of Social Development, Housing New Zealand and Accident Compensation Corporation).
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