Extra strength enhancing the care team at Tokoroa Medical Centre

In 2012 many of the GPs in Tokoroa signalled their retirement after serving their community for 30 plus years. The Pinnacle Group stepped in to help, consolidating three of the practices and rebuilding an unused wing of the Tokoroa hospital to house a new practice. This helped delay the timing of some of the retirements and has ensured that a modern fit for purpose environment is in place for the community.

Primary Health Care Limited, a subsidiary of Pinnacle, runs the practice along with a number of other practices in rural areas throughout the Midlands region. Tokoroa, like many rural communities across New Zealand, faces challenges recruiting and retaining GPs, and at times all of the practices operating in Tokoroa have had periods of been under-staffed.

"In recent weeks there have been longer waiting times for Tokoroa Medical Centre patients due to a gap in GP recruitment, the usual increased winter illnesses and the measles outbreak. We never like to see these extended access times however, it is a reality for New Zealand rural communities," says John Macaskill-Smith, chief executive.

"Our Tokoroa practice uses a phone triage method to ensure the people with the highest need receive care on the same day - and we find that many people can be assisted with a quick phone call with their GP. Currently the team are managing 25 per cent of people who request a same day appointment in other ways, but that does mean the complexity of those who do come in for a same day face-to-face appointment is increasing."

John adds all patients are seen as quickly as possible and all urgent cases are dealt with, but if patients request to see a specific GP there can be delays due to regular leave and the demands of the winter season.

New staff joining from next week

Tokoroa Medical Centre are set to welcome a few new faces, with a nurse practitioner starting next week alongside new GP locums who are bridging the gap until a permanent GP starts in November.

Nurse practitioners are highly skilled autonomous health practitioners who have advanced education, clinical training and demonstrated competency. They make diagnoses and differential diagnoses, and order and interpret diagnostic and laboratory tests. They can also prescribe medicines within their area of competence with the same authority as medical practitioners.

In addition, a permanent physician assistant has been recruited for the practice, who will arrive once the credentialing process has been completed. A physician assistant is a health care practitioner who practices medicine in collaboration with or under the (indirect) supervision of a physician. They conduct examinations, diagnose and treat illness, order and interpret tests, and counsel patients on preventative health care.

These new faces join the extended primary care team at the practice, which already includes a clinical pharmacist, advanced nurses and GPs.

"We are keen to build more resilience into the team by increasing the number of permanent GPs, and will continue to work on that," says John.

New approaches

With the new leadership in place at Waikato DHB the Pinnacle Group is looking at opportunities to get back around the table and strengthen the practice along with broader primary and community services in Tokoroa by aligning primary care, community providers and hospital teams. Bringing together a multi-disciplinary team helps to ensure patients have more options and more practice care is provided. This extended care team model, combined with our fantastic facilities will help make Tokoroa Medical a more attractive place to work.

"We've seen the Health Care Home and extended care team models completely change the experience of primary care for patients and practitioners alike in Taupō-Turangi, and can't wait to implement the same for Tokoroa," says John.

Happy or not?

Listening to the patient voice is key for all Health Care Home practices and it is monitored in many ways, the most visible being our 'happy or not' terminals which allow patients to anonymously rate their experience on the day. 

The May-July data shows 74 per cent of patients rating their experience as either positive (12 per cent) or very positive (62 per cent) at Tokoroa Medical, which given the workforce pressures and the traditional winter bugs season is a really great result.