Primary healthcare news, information & resources


GP updates Tairāwhiti


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 anna.meuli@tdh.org.nz

Hospital GP, radiology and emergency department referral updates

Hospital GP referrals

If you are referring to hospital GPs, but you want the patient to see someone with a subspecialty interest, please indicate the specialty on the referral rather than the GP's name (for example, request a 'renal review' rather than writing 'attention Dr Moore'). If a specific GP is indicated in the attention box, the referral will sit in a folder in clinic for them but if they happen to be away on leave, this will not be seen until their return. 

If there is not a GP indicated in the attention box, the referral will go to the GP reading all referrals, who will triage it to the appropriate clinic. 

The attention box can be useful if you want to pass non-urgent information to a specific GP involved in the patient's care, but for anything urgent please phone as appropriate. Also consider use of email, but be aware patient identifying information must not be shared via email as it is non-secure, and email communication will not recorded in the patient's medical record unless you enter it.

Radiology referrals

I've been asked what primary care would most like radiology to look at for their annual planning. I suggested electronic radiology referrals, and the possibility of GP direct MRI referrals if fulfilling certain criteria. We are continuing to discuss ways to improve USS wait times. Let me know if there are other things on your wish list I have missed. 

Things radiology ask from us: 

  • ensuring up to date contact details are on all referrals
  • ensuring patients have the right expectation for their appointment (for example discussing the need for a transvaginal probe when requesting pelvic USS, discussing that a patient may need oral or intravenous contrast for a CT, and making patients aware that CT appointments may take a couple of hours.) There are some new guidelines on who needs renal function checked prior to CT requests and I will forward these when I get them.

Radiology/emergency department referrals

If you are sending a patient to hospital radiology for an XR fracture please do not advise them to attend ED "if the radiographer says you have a fracture". The radiographers are not allowed to comment on the appearance of an XR as they are only qualified to take the films. If you want ED to review the films and patient rather than yourself, please phone an ED doctor and request this, as well as sending your usual BPAC e-referral to ED. If you send the patient via radiology first (which does smooth the patient journey) can you ensure a copy to an ED doctor is written on your radiology request. This ensures both you and the treating doctor receive the official report.

Emergency department

The emergency department is happy to see patients as required for review, but ask you please phone to discuss any referrals as you would with any other specialty. They currently only receive a phone call for about half of their referrals. They also ask you consider what services are available in ED and ensure your locums also know this. Sometimes they receive referrals for specialties such as neurosurgery that are not available. They will still see these patients and manage as appropriate but want to be sure that the GP and patient expectation matches what is available. 

June updates

District nursing service
Good news- staff and services are back to normal levels and happy to receive referrals as usual. The district nursing team would like to thank you all for your extra work, patience and understanding while they were unable to provide their normal service. 

ECHO reports
You should be receiving hard copies of these now (paper copies I'm afraid) as well as the reports being uploaded to isoft/healthviews. Let me know if you are not receiving them. 

BPAC e-referrals
If you are sending an acute referral for assessment/admission, please select Emergency-Paediatrics (or appropriate other specialty), as well as phoning the team. This ensures the e-referral arrives in the Emergency Department. If you are sending an outpatient referral, then select Paediatrics (or appropriate other specialty) then relevant category (HSC, urgent, semi-urgent, routine) and these referrals will go to outpatient clinic. This is important for ensuring the referrals go to the right place, and that they can be responded to appropriately with anticipated wider use of electronic response. If you are confused, I'll show you through next week at practice visit. 

RNZCGP education meetings
The RNZCGP is keen to re-establish our local faculty, and offering to bring two good speakers to town for education sessions. Can you please pencil in your diaries 30 Aug and 22 November. The topics will be Self Care for GPs and Digital Technology in Primary Care. 

Community response team
Reminder about this very useful service. The team is lead by Ann McNabb (021 817 466, 8-4:30 Mon- Fri) and is available to try and put in extra care to keep people out of hospital. You can refer by phone or via BPAC ereferral- Ann is notified of referrals as they come in. Scenarios where they may be of use - an elderly person who has a short term illness which makes it more difficult but still possible to cope at home with increased support, or someone who is starting to deteriorate in mobility such as high risk of falls/subsequent admission. 
Ann can coordinate physio/OT/equipment and temporary personal care to try and keep them at home. Ann can also coordinate temporary respite at rest home level care under primary options where you have initiated primary options and this is appropriate. 

Falls assessment funding
Did you know there is funding available for your practice nurse to perform falls risk assessment? $37.50 for each assessment, eligibility criteria are over 75 years or over 65 years for M?ori and Pacific Islanders. If they recognise a high risk of falls they can be referred for strength and balance programmes. If they have a high risk and medical conditions or medications that may be contributing they are also eligible for a funded extended GP consult ($75) to assess these factors. Pinnacle MHN local falls prevention nurse Kat Ngatai can answer any questions (027 602 6259). 

Hand physiotherapist
Leigh Morrissey the Hauora Tair?whiti hand physio is currently on maternity leave, returning in November. The general physios will see routine hand cases, those that need specialist input will be reviewed on a case by case basis as to where this is provided. If private is an option for your patient (eg ACC injury or able to self-fund) there are private hand therapists (Jane Moore and Claire Youmans) available in the community. 

Alzheimers Society
Just updating you on the useful services available through this group for people with any form of dementia and their families. You can refer via BPAC e-referral 
  • A day care centre called The Sherwood Club which is open Monday, Wednesday and Friday from 9am to 3.30pm providing activities, entertainment and lunch.  A diagnosis of dementia and a needs assessment service coordination (NASC) referral are required. The client's individual cultural and spiritual needs, past occupations, current levels of ability, hobbies and interests are all taken into consideration when planning the day programme.  Attendance at the day centre allows much needed respite for primary carers allowing them to attend to other activities or sleep. 
  • A community coordinator, who establishes initial contact with wh?nau/family following referral, provides support, advocacy, education in response to need. A NASC referral is not required as this service is not funded by the DHB. The work she does supporting people in their own homes delays their admission to aged care facilities.
  • Information and education for the community including other organisations and public forums as well as the person with dementia, their family/wh?nau and carers. 
  • A carer support group which meets once a month to provide support, education, information and the sharing of experiences among the group.
  • A social carer support group that meets informally for coffee and a relaxing social outing. 

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