Advice to general practices after the health and disability sector review announcement

Jo Scott-Jones, Pinnacle MHN medical director, discusses the health and disability sector review changes, the anticipated impact on general practice, and what practices can do in preparation to get ahead of the curve. 

In summary the health and disability sector changes announced are:

• Health NZ commissioning a national health service through four regions with district level offices
• a Māori Health Authority independently commissioning Māori health services and monitoring the whole system for equity of outcomes for Māori
• a change in function of the Ministry of Health to one of overall monitor, strategic advisor and policy developer.

What impact will this have on us as practice owners and practice teams?

In the short term, nothing.

It is business as usual. Having said that we all know this isn’t usual.

We are planning for the COVID-19 vaccine rollout, managing the flu vaccine rollout, catching up on MMR vaccines for 15-29 year olds and coping with the ongoing fallout of lockdown as people are catching up on the concerns they put off last year.

We are adapting to the increased demand created by the sudden shift to telehealth services, patient expectation for responses to portal messages, an increase in phone calls and emails. The number of contacts we are having per patient has shot up.

We are also struggling with staff with a shortage of locums. No wonder the 2020 RNZCGP college burnout survey shows an increase in self-reported burnout from the baseline of 20-25 per cent to 30+ per cent.

In the long term, everything is set to change – our DHB partnerships will be gone, our contracts will no longer have to come through PHOs, who knows what will happen to quality payments and the primary options schemes?

As a team it is worth hunkering down for a few hours one day in the next few weeks and working out what your response needs to be to these oncoming challenges.

I think we can be confident that general practice as a model of care will survive this, the model has survived every other change and is fundamental to efficient and effective health services globally.

How can you strengthen the resilience of your team and your practice?

• Know your enrolled population. What is the ethnicity mix? Where do they live? What are the basic demographics?
• Ask yourself critical questions about the outcomes for your patients – in particular look at the gap between outcomes for Māori and European patients – look at some key indicators around cardiovascular disease, respiratory disease, cancer and diabetes.
• Look at your locality – get some information on the other services that work in your community or are available to your patients. Ask yourself how well you know each other and use each other’s services.

The place to start is where you are.

Over the next six months there will be a lot of talk, speculation and news  about the big system changes. It will be important to contribute to this discussion through your PHO and other networks, but start local.

When things change your practice team will be stronger and more resilient if you have strong functional relationships with the pharmacies, hauora providers, social services, district nursing services, and others that are also serving your community.

It’s not rocket science, it all starts with a cup of tea and a plate of biscuits.