The following updates are provided by Hauora Tairāwhiti GP liaison Anna Meuli. Anna works 0.2FTE in this role (Thursday and Friday mornings) and can be contacted at firstname.lastname@example.org.
Radiology CT scanner installation
The radiology department is upgrading their CT scanner. The new scanner will provide higher quality imaging, lower dose radiation, and has the ability to perform cardiac imaging. This means from 29 October there will be no capacity to perform CT scans locally for two weeks. There will be a pathway for what to do about urgent CTs that are required in that period. This will include MRI/XR/USS as an alternative exam where appropriate or being transferred out of town if needed. I will forward once finalised. In the interim the message from radiology is: If you have a patient that you know will require a routine outpatient CT scan for early November, please get that scan ordered now so they can perform the exam prior to October 29.
Reinstating Tairāwhiti faculty of RNZCGP
As discussed at the recent education evening on wellbeing and self-care, we are keen to reinstate the local college faculty. This means we will have funding (approx. $3000/year and a starting pool of around $9000 that has accumulated over last few years) to spend however our committee decides. This is usually used for education or collegiality activities. You will have received an email from the college seeking involvement in the committee and thanks to those who have replied to this. To those that told me on the night they were keen, can you please follow up with an email so I don't miss anyone. I will send an email to all those who have replied to arrange a first meeting. One idea is to organise a local "symposium for primary care". I attended the Hawkes Bay faculty one in the weekend and I think it would be a really worthwhile thing to have locally. Will discuss further with the committee and happy to hear any other perspectives/ideas.
Bowel screening programme updates
The bowel screening programme is being rolled out nationally. This is looking to start in Tairāwhiti between July 2019-June 2020. There will be detailed information, resources and education provided prior to it starting but here is a brief overview. The national programme involves patients age 60-74 being invited for screening every two years. The recalls are done via a national coordination centre, who post out Faecal Immunochemical (FIT) test kits to patients. GPs are notified of positive results and asked to communicate these to patients and send a referral for colonoscopy. There are discussions happening around the particular needs of our population (with a high deprivation index and high Maori ethnicity) to reduce inequity in the screening process and bowel cancer outcomes. If anyone has interest in being involved in implementing the programme locally, or wants me to take any particular primary care concerns to the group feel free to contact me.
Funding has just been approved from the Ministry of Health for Te Kūwatawata to continue until June 2019, to allow it time to further establish and enable further evaluation of the service. I would like to take this opportunity to ask for your direct feedback on the service and how you think it is working from a patient/whānau and primary care perspective currently. Dr Jo Scott-Jones (Pinnacle MHN medical director) and myself are meeting with Diana Kopua from Te Kūwatawata and it would be good to take along any issues or feedback so we can continue to work together improving the way the service integrates with primary care.
There will be another fibroscan clinic happening 10-11 October, so please send through any referrals you have. There will also be a tent at the AMP show promoting Hep C awareness and offering point of care testing. Could you take the opportunity to check how your practice is going with recalling the patients on your list who have historical positive Hep C results? Community providers such as Turanga Health are happy to help with any patients that you have found it difficult to contact or engage with. Thanks to those who have noticed areas where the pathway is not complete (eg what follow up is required after treatment). The pathway is being updated by the Midlands gastroenterology group to reflect this. It will also likely have a recommendation about testing for Hepatitis B and HIV in those who are Hep C positive prior to treatment- as if a patient has concurrent infection they should be treated in secondary care. In the interim I have attached a national document that has a section on recommended follow up post hep C treatment. The fibroscan nurse will indicate on her letter of recommendation after scanning what the appropriate follow up is for your patient. Let me know if anyone has other feedback around the campaign, including with pathways, advanced forms or prescribing issues.
District nurses using clinical care form
From Monday 17 September, when a district nurse orders a laboratory specimen on one of your patients, they will notify you of this via an electronic clinical care form rather than fax. They will note the clinical concern, what investigation they have requested, and will request on the lab form that the result comes to you for your attention. Please contact them by phone if you wish to discuss a patient.
There is a new specific e-referral for sleep assessments. This requires more detailed information in the referral to ensure they triage them appropriately. The newsletter went out in the 16 August Pinnacle MHN Pin Points newsletter but I have attached again for anyone who missed it.