Contracts - Projects and Programmes
Whanganui Regional Primary Health Organisation is involved in a variety of projects and programmes. Following is an outline of current and previous activities:
B4 School pilot
Grab a Bite That's Right project
Healthy Homes project
Skin Lesion project
Diabetes Service
Performance Management Programme
Gonville Centre
Clinical Training Agency (CTA) Programme
Human Papillomavirus Vaccine (Gardasil)
B4 School Check (2008-ongoing as funding allows)
From 1 September 2008, a nationwide programme of health and development checks for four year olds begun. The B4 School Check is an important public health initiative that aims to identify children who will benefit from referral to services and additional assistance before starting school. Most New Zealand four year olds are ready for school and have already had the previous Well Child contacts and will not need referrals to other services.
Each DHB has put in place its own arrangements for the delivery of the checks. In Whanganui the check are provided mainly by the Practice Nurse. Parents and caregivers of four year olds will receive an invitation from their Practice Nurse or the WRPHO Before School Nurse inviting their child to attend a check. The B4 School Check replaces the new entrant school check. It includes a number of screening tools and will require a relatively high level of involvement from parents/caregivers. Registered nurses delivering the B4 School Check have all attended specific training.
The comprehensive assessment includes:
- Child health questionnaire
- Behavioural/developmental screening – Strengths and Difficulties Questionnaire (SDQ) and Parental Evaluation of Developmental Status (PEDS) tools
- Hearing and vision screening (Provided at your child's learning centre or in a community clinic)
- Measurement of height and weight recording
- Oral health assessment – 'Lift the Lip'
- Health promotion and education
- Referrals to appropriate health, education or social services and follow up
- Immunisation (if overdue) where possible
The pilot ran in Whanganui last year showed that the overall assessment for each child took, on average, 30 minutes. Well Child Tamariki Ora Providers and Plunket are still expected to provide the earlier Well Child checks as part of the Well Child framework.
For further information please contact Angela Johnson, Team Leader, Manaaki Te Whanau - Supporting Families at WRPHO on (06) 348 0109 extn 716.
Grab a Bite That's Right project (2006-2010)
'Grab a Bite That's Right' is a Healthy Eating Healthy Action (HEHA) innovations funded project that is being implemented in the Wanganui region. The Whanganui Regional Primary Health Organisation is coordinating this programme, along with the support of several local organisations, including:
- Whanganui District Health Board
- Public Health Unit
- NZ Tree Crops Association
- Wanganui District Council
- Sustainable Wanganui
- Te Oranganui Iwi Health Authority
- Cancer Society of NZ - Wanganui Rangitikei Waimarino Centre
Grab a Bite That's Right aims to encourage our communities to include more fruit and vegetables in their diet, by addressing barriers to affordability, accessibility and availability. This programme is a community based initiative that has been developed locally and is focused on the growth and distribution of fruit trees to the community, the development of community gardens, capacity building, and modelling a collaborative and strategic approach towards the continued development and implementation of programme interventions. A detailed evaluation of the programme and its key components will be completed in 2007/08, including process and outcome evaluation which will provide a tool for future development.
WRPHO has assisted Central Tree Crops Research Trust to raise funds for distributions. At present there are enough funds to continue to distribute trees and plants until the end of 2010.
Healthy Homes project (2007-2010)
Whanganui Regional Primary Health Organisation (WRPHO) holds the contract for the Healthy Homes project and in year two is rolling it out in collaboration with the Whanganui District Health Board (WDHB) and the Energy Efficiency and Conservation Authority (EECA), into the greater Whanganui region; Marton, Bulls, Ohakune, Raetihi, and Taihape. Energy Smart remain the contracted insulation company. Donated smoke alarms for all of the houses we are targeting in this project will be installed by the rural fire service crews.
The aim of the project in year two is to improve the health of children aged 0-14 who are regularly admitted to hospital with respiratory conditions, referred to the Community Respiratory Nurse or who are frequently seen by the GP with a respiratory condition and prescribed preventative medication. We hope to do this by providing free house insulation to home owners and subsidised insulation to landlords with rental properties who fit the criteria. There is no need for people to apply, as we will be contacting families based on the hospital admission rates of their children (with respiratory conditions) and general practitioner referral. This process is confidential.
The Healthy Homes project is being run over three years. In the first year (2007/08), 51 houses within Wanganui city were insulated. In 2008, EECA increased their contribution towards the funding of this project so that this year we plan to insulate 60 rural homes. If we are able to get further sponsorship the plan is to increase the number of houses being insulated in the following year. The criteria may also change for future retrofits.
In conjunction with the Healthy Homes project, the WRPHO and WDHB have developed a wrap around health assessment for the children and families who reside in the homes which have been insulated. This assessment will consider both the physical and social needs, such as the child’s immunisation status and safety, and the awareness and access to supportive services and programmes within our community. Whilst conducting the assessment it also offers an opportunity for sharing health information, reinforcing good practices and advocating or assisting with referrals to a wide range of agencies as required. The assessment will be carried out by a practice nurse at the recipient’s general practice.
Skin Lesion project (2006-2010)
This project involves the removal of cancer related skin lesions by credentialed GPs, at no cost to the patient. Expected outcomes include:
- Early intevention and management of high risk provisionally diagnosed cancerous skin lesions reducing the risk of more radical surgical procedures and reducing risk of required admission to hospital
- Reduced risk of mortality associated with late intervention of melanomas
- Quarterly report measures volumes
- Quality group monitors lab results
- Customer satisfaction is positive
The access criteria for this project will be reinstated from the 29th April 2008 and WRPHO will honour all claims up to this date. Any claims after that date must fit the access criteria. These are that the patient must be a registered and enrolled patient and satisfy one of the following:
- Are a community service card holder
- Live in a Deprivation 5 area
- Are of Maori or Pacific Island ethnicity
The access criteria will run to the end of the financial period 30 June 2010, at which time the project expires.
In 2004 the Whanganui District Health Board sought proposals from currently contracted health providers to undertake the provision of the Whanganui District Diabetes Service.
The type and nature of the service model the District Health Board sought was to reflect the following key principles: added value from the existing configuration, affordable and efficient, integrated across service components, met the needs of target groups, particularly Mäori and was supported by local diabetes team and key stakeholders.
The successful tender was a proposal from two PHO’s in Whanganui; Whanganui Regional PHO and Taumata Hauora Trust PHO. The proposal introduced a number of changes to the way services were provided and placed a greater emphasis on equity of access, services based within local communities, and a particular emphasis on targeting high risk, high needs patients, particularly Mäori and Pacific Island people. It also introduced the concept of primary fund holding for diabetes and focused on collaboration between a range of providers, consumers groups and communities. The overall aim was to; reduce diabetes risk, enhance diabetes management, develop community wide collaboration and relationships to change health systems, lifestyle and environmental factors that impact on health outcomes.
The Whanganui Regional Diabetes Service is governed by two Diabetes Governance groups. The Diabetes Governance Group is representative of consumers, providers, Diabetes Association, rural, Iwi, Pasifika, health promotion and the District Health Board funding division, and the Diabetes Clinical Governance Group is representative of Diabetes Clinical experts and community health workers.
Whanganui Regional PHO completed our first full year as contract holders as at 31st December 2006. A copy of the year’s progress is available here (397 KB). The progress made from 1st January 2008 to 31st December 2008 is available here (125 KB).
The Diabetes Annual Report 2007 (720 KB) outlines outcomes achieved for the year.
Performance Management Programme (2006-ongoing as funding allows)
The PHO Performance Management Programme (PMP) has been designed by primary care representatives, DHB’s and the Ministry of Health to improve the health of enrolled populations and reduce inequalities in health outcomes, through supporting clinical governance and rewarding quality improvement within PHOs. WRPHO entered this programme on 1st July 2006.
PMP involves receiving data on a range of nationally consistent indicators from DHBNZ. Information is extracted from existing data sets to which WRPHO contribute, e.g. Service Utilisation Reports.
The Whanganui Regional PHO Performance Management Team consists of Angela Johnson and Sue Hina – Urban Practice Facilitators, Gemma Kennedy – Rural Practice Facilitator, Karen Veldhoen – Communications Coordinator, Julie Nitschke – Strategic Development Manager and Matt Rayner – Projects Administrator.
Feedback to providers is made through provider feedback reports, enabling providers to benchmark their performance against other PHO providers. A copy of this feedback report will be available here soon.
Through this programme providers are entitled to claim Practice Review Activity credits towards their Maintenance of Professional Standards programme.
The indicators for the Programme as of 1st July 2007 with a financial weighting attached are:
- Cervical Cancer Screening Coverage - total population
- Cervical Cancer Screening Coverage - high needs population
- Breast screening coverage
- CVD-Diabetes Capability Assessment
- Inhaled Corticosteroids
- 65+ Flu Vaccine Coverage - total population
- 65+ Flu Vaccine Coverage - high needs population
- Age appropriate vaccinations for 2 year olds - total population
- Age appropriate vaccinations for 2 year olds - high needs population
- Percentage Valid NHI on Register
- Utilisation by High Need enrolees
- GP Referred Laboratory Expenditure
- GP Referred Pharmaceutical Expenditure
More information about the Performance Management Programme is available on the DHBNZ Performance Management Programme webpage
The concept of this venture began mid-2007. It started with the set up of the Gonville Health general practice in temporary premises (Wicksteed Street) June 2007, with the idea of eventually building a practice in Gonville. This project then took on a life of its own and has since progressed to the point where we have developed a large community centre based in the heart of the Gonville shopping area. The centre includes a general practice clinic, pharmacy, library and internet/cafe, community room, access to a range of health services, and potential for a chronic care facility. This timeline outlines the process:
- July 2007 - Gonville community consultation at Gonville School hall (80 attended)
- August - September 2007 - Estimate of costs and early discussions with developer, and options placed on land
- November 2007 - WRPHO Board authorised to start negotiations with the developer and secure funding to make the project possible
- December 2007 - WRPHO met with the Whanganui Community Foundation, Powerco Trust, Wanganui District Council and the Whanganui Distrcit Health Board and presented the project proposal
- December 2007 - Gonville Centre governance - WRPHO Board recommended that the governance structure include Gonville Advisory Group representation, other centre partners, WRPHO Board and clinical representation and Iwi
- February 2008 - Confirmation of funding:
- Powerco Trust approved a donation of $350,000
- Whanganui Community Foundation have offered a $500,000 interest free loan
- WRPHO have pledged $200,000
- April 2008 - Two public meetings held at Gonville School hall to celebrate the launch of this new venture and to inform the community of future plans (150 attended). Gonville Centre Community Advisory Group is established and engagement with local health partners begins.
- May 2008 - Heads of Agreement signed between WRPHO and Gonville Investments Ltd (developer)
- August 2008 - Abbot Street land is blessed by Kaumatua, John Maihi, and a mauri is buried on the site
- November 2008 - First site meeting for building project held with Gonville Investments, Coalspec Contractors and Craig Dalgleish Architects
- July 2009 - Formal contractual hand over to WRPHO from developer/contactor. Whakawatea/blessing of facility by Kaumatua, John Maihi. Gonville Health general practice relocated to the centre and open for business
- August 2009 - Formal opening of Gonville Centre and unveiling of a plaque by Associate Minister of Health, Hon Tariana Turia and MP for Whanganui, Chester Borrows
Clinical Training Agency (CTA) Programme
CTA funding assists Registered Nurses undertaking postgraduate (level 8) Nursing Council of New Zealand and New Zealand Qualifications Authority approved papers towards a formal postgraduate qualification. This programme is a joint agreement between the WRPHO, Te Oranganui Iwi Health Authority and the Whanganui District Health Board - provider arm.
Registered Nurses working in clinical practice in the Wanganui region (Primary Health Organisations, Whanganui DHB provider arm, Non-government Organisations and Aged Care sector) are able to apply. Please see CTA Funding Information Sheet 2010 and Request for CTA Funding form.
For further information please contact:
Declan Rogers
CTA Programme Coordinator
(06) 348 0109 extn 718
E-mail: declan@wrpho.org.nz
Human Papillomavirus Vaccine - Gardasil (2008-2010)
The Human Papillomavirus Vaccine (HPV) Immunisation Programme is a national cervical cancer prevention initiative aiming at reducing the incidence of HPV infection and the subsequent development of cervical cancer in New Zealand women through vaccination, particularly for those groups most at risk of developing cervical cancer. The WRPHO has the contract to manage the roll out of this immunisation programme.
Key messages:
- The aim of the programme is to immunise girls against the two HPV types that cause most cervical cancers
- Each year in New Zealand about 160 women are diagnosed with cervical cancer and 60 die from it
- In the long term about 30 lives per year will be saved
- From 1st September 2008 all young women born in 1990 or 1991 can make an appointment with their family doctor, practice nurse, health clinic or approved primary health provider to receive the HPV immunisation
- The HPV immunisation is free for young women aged 12–18 who are eligible for the programme
- From 2009 the HPV immunisation will be part of the National Immunisation Schedule for 12 year old girls and will be delivered through the school based programme, via the Public Health centre nursing team
- Women still need to have regular cervical smear tests even if they have been immunised, however it is expected that there will be less abnormal smear results, with fewer women having to go through the stress of receiving an abnormal smear result, extra tests and invasive treatments which can follow as a result
Please contact your Practice Nurse to make an appointment for this free immunisation. If you have any other questions or wish to know more information please visit the Cervical Cancer Vaccine website. For further information please contact Angela Johnson, Team Leader, Manaaki Te Whanau - Supporting Families at WRPHO on (06) 348 0109 extn 716.