By Hayley Redpath

Detail was missing from a public presentation last week about two successful proposals for a new-look health system in the district.
 
Turanganui Primary Health Organisation Chief Executive Keriana Brooking and Ngati Porou Hauora Primary Health Organisation Acting Chief Executive Amos Forrester were invited to reveal more about new primary health systems they might be involved in, at a Tairawhiti District Health open forum.
 
While Mr Forrester admitted there was still a lot he and his PHO didn’t know about the proposal they were involved in, Keriana was more direct as to why she would be withholding information.

“I am not going to speak in detail because I consider that to be premature. There is a considerable amount of thinking that went in to the Expression of Interest. Some of it has been shared and some of it will not be shared at this stage.

“While I consider there are key stakeholders here today, you are not at the start of the queue. I need to talk to those people first.”

Instead, Keriana discussed the values behind the PHO’s successful proposal which was part of a pitch to the Minister of Health made by ‘Midlands’ group. The Midlands group includes primary health organisations from Taranaki, Taupo, and Waikato, and Pinnacle a management organisation providing clinical and administration services in the same regions.
 
Keriana said Turanganui PHO’s new health system focuses on “patients never feeling unsupported on their journey through the health system”.

“It’s staff who understand that the health system can be complicated, scary and intimidating and who work to find ways to make it less so.”

By way of example Keriana referred to a recently publicised investigation that showed health providers missed opportunities for intervention in the days before the death of a 68-year-old diabetic in Auckland City hospital.

“The patient had six different interactions of some kind in the health system. It shows that the system is big and complex to some and sometimes it doesn’t work, and that’s not okay.”

Keriana said another focus of the Turanganui PHO proposal was that “health literacy” be improved.

According to 2006 research just under half of New Zealanders over the age of 16 did not possess the minimum health literacy skills to read and understand medication and nutrition labels. Speaking plainly, confirming understanding, checking information and slowing down were all techniques health staff could employ to help the situation, she said.

Ngati Porou Hauora PHO’s successful pitch was part of a proposal from a group known as the National Maori PHO Coalition representing 11 PHOs in the North Island. 

Mr Forrester said Ngati Porou Hauora believed it was the right organisation to carry on delivering services in Gisborne and on the East Coast, but the PHO was the first to admit it had “some work to do to improve our credibility”.

The PHO looked forward to improving services particularly in the areas of prevention and promotion, delivery, effectiveness, and convenience for patients. 

On behalf of Tairawhiti District Health’s advisory committees hosting the open forum, Pene Brown said while the presenters had steered clear of detail, the proposals were exciting. He expected everyone would learn more over the next few weeks. 

“This district was at the forefront of a changing landscape eight years ago when it became one of the first areas to have Primary Health Organisations.” Once again Tairawhiti appeared to be leading the way, he said.
PHOs and their associated proposal team members have until February 15, 2010 to prepare their business cases for sign off from the Minister of Health. 

By Helen Peterson

Improving quality of life is the aim of the Turanganui Primary Health Organisation’s Cardio and Pulmonary Rehabilitation Programme established this year and people who have attended the sessions have recognised the benefits.

As a result, Turanganui PHO has signalled that the service will be continued into next year – with a few minor changes.

The programme, run by the PHO in conjunction with Turanga Health and Sport Gisborne, adopts a multi-faceted approach to helping people to self-manage their conditions.

Appropriate graded physical activity, education, and psychological assistance are incorporated into an eight-week programme that helps empower people to make positive lifestyle changes, says PHO Health Right Manager Diane Williams.

The programme also features weekly guest speakers including clinical nurse specialists, a pharmacist, a nutritionist and a mental health nurse, as well as representatives from other community groups. 

A main focus of the programme is to improve access for Maori and Pacific Island, says Diane.

“Specific aims of the programme are to help people improve their cardiac fitness and activity endurance as well as help them to improve their breathing so they can enjoy life.”

There have been four intakes and 73 percent of people referred to the programme have taken the opportunity to improve their lives. The largest group were Maori men aged 45-64 years.

People are referred to the programme either by Tairawhiti District Health’s Cardiac/Pulmonary Clinical Nurse specialist or their own GP. To qualify for referral candidates must have had an acute cardiac event or chronic pulmonary disease which leaves them considerably short of breath.

Before beginning the course a comprehensive individual health assessment is done to ensure people can attend. 

At the first group session a six minute walk test and other measurements to gauge improvement are done and used for comparison levels at the end of the eight weeks. 

The sessions are held at Turanga Health’s gym and experienced qualified nursing staff monitor those people taking part while activities are set by a Sport Gisborne specialist exercise therapist.

“Often a bond of support between members of the group develop and people are generally feeling less anxious about their futures.” says Diane.

On completion of the sessions the people are reassessed and Diane says most have better endurance with a marked increase in the six minute walk test, improved blood pressures and cholesterol levels.

“There are a wide variety of referrals from the programme to other agencies and some people have also made use of the PHO’s primary mental health and social services in order to further improve their lives,” said Diane

“Due to funding availability only four courses are held locally each year but it would be more beneficial if the courses could be run back-to-back for people to get maximum benefit from the programme and reduce waiting times between courses.”

After each course staff look at ways to continually improve the programme and how they can better measure individual successes.