Primary care in Northland, New Zealand wide and internationally is undergoing a time of great change. There is pressure from an increasing and ageing population; through increased people living with one or multiple long term conditions; there are new options through technology for engagement, and consumer expectations around quality of health services has grown.
The Neighbourhood Healthcare Homes (NHH) programme is a collaborative piece of work between Northland DHB and the Northland PHOs, which aims to reorganise systems in primary care to respond to these challenges.
The NHH project has been in operation since October 2014. This has involved the design and development of the new primary healthcare model of care.
A Neighbourhood Healthcare Home is:
To achieve this high quality operating and sustainable model three key areas need to be addressed by, and within, general practice:
The specific way that the internal general practice change is delivered in the NHH model includes 15 change components of care:
• Equity management
• GP telephone triage of patients requesting urgent care
• Call management
• Clinical and administrative pre work
• Patient and whanau centred appointments
• ‘Extended hours’, to meet the needs of your population
• Patient portal
• Telephone consults
• Expanded and new roles Extended GP team – including participation in community multi-disciplinary teams (MDTs)
• ‘Advanced care plus
• Community and consumer participation
• Social and health integration
• Engagement with Nursing MOC
• LEAN work
• Quality and safety
These components are all based on evidence and come as a complete change package that will release capacity within the general practice to do things differently and increase access especially to the highest need patients. These changes are intended to be better for the patients, better for the workforce and better for the system as a whole.
There will be improvements in the areas of:
• Timely acute and unplanned care for patients
• Proactive care for high needs patients
• Excellent routine and preventative care
• Improved business efficiency.
Six practices have been selected to commence conversion to the new model of care in 2016/17:
They are :
• Te Whare Ora O te Hiku O Te Ika
• Kerikeri Medical Centre
• Bush Road medical centre
• Paramount Medical Centre
• Widdowson Sprague Ltd
• Te Whare Ora o Te Hiku O Te Ika
More practices will commence over the next two years. The work within the practice is supported by two new staff employed by the DHB, and working within the PHOs. Further information about the change process and the compnents of care will soon be available on a dedicated NHH page on the NDHB community site.