Respiratory programme

Overview

The Respiratory programme is designed to support proactive management of respiratory conditions to try to optimise patients’ chances of staying well during winter months. It provides funded consultations to undertake a comprehensive review and care planning for patients who are at high risk of respiratory exacerbation requiring hospital care during the winter months are also eligible.

This service is part of the Advanced Primary Options programme.

Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.

This is NOT a clinical guideline.

Details

Which practices can claim for this service?

Service components

This service includes funding for two consultations with any clinical member of staff and one consultation with a prescriber.

This will enable full review of the patient’s respiratory condition, identification of any unmet needs or education requirements, development of a management plan and follow up to evaluate the patients understanding of their self-management.

The key outcomes from these extended consultations should include:

full review of the patients’ respiratory condition including ACT/CAT assessment
spirometry testing if appropriate
review of medications which may include a referral to pharmacy for further detailed medication education
education of inhaler technique
development of written patient self-management/action plan
provision of subsidised vaccine (e.g. influenza, shingles) - note patients can be charged for non-subsidised vaccines such as pneumovax if clinically indicated
discussion of eligibility for anti-virals should patient test positive for COVID-19
Referral to relevant services which may include
- Smoking cessation support
- Healthy homes service
- Pulmonary rehab
- Social services
- Pinnacle extended care team

Who is eligible for the service?

Patients may be identified for the programme through clinical judgement of high risk of respiratory exacerbation requiring hospital care during the winter months.

Patients eligible for NZ funded healthcare.

The programme will fund a total of three consultations per patient per calendar year.

Patients who accessed the service in previous years will be eligible for this service again if they meet the access criteria.

Who is excluded from the service?

Claiming guidelines

Please make your claim via Primary Options, select Winter Respiratory Programme and then attach the appropriate invoice(s).

The prices listed below are GST inclusive.

Proactive Respiratory RN review - In person (once only): $83.53
Full review of the patient’s respiratory condition to include ACT/CAT assessment, spirometry testing as appropriate, review of medications, development of a management plan, inhaler and condition education, referrals as appropriate. This consultation should be a face to face.

Proactive Respiratory Prescriber review - In person or virtual (once only): $83.53
To include medication review, authorisation of a management plan, prescriptions for medications to treat exacerbations. This consultation can be provided by any prescriber.

Proactive Respiratory RN follow-up - In person or virtual (once only): $41.24
Follow up consultation to ensure the patient is comfortable managing their respiratory condition, including appropriate inhaler use and provision of further education.

These consultations cover all time and consumables and there can be no extra charge to the patient.

You cannot claim under this service for a patient who is acutely unwell at the time of consultation.

Submit your referral via Primary Options using the initial condition coding: Winter Respiratory Programme

When invoicing for the service please lodge an 'outcome and invoice' form and select the appropriate invoice(s).

If the patient presents acutely and meets POAC criteria, please initiate a separate referral for any invoices claimed under that POAC pathway.

What level of clinical notes do I need to submit?

Does the patient have to pay?

How the service is funded?

Want 24/7 health advice?

Where can I go for after-hours care?

Need a GP appointment

Overview

Details