Media Release: 23 October 2014
Central PHO CEO Chiquita Hansen and Te Rununga o Raukawa General Manager Ana Winiata met today to work through the issues raised at a recent community meeting.
“We understand the community frustration about having a brand new building but still not being able to get appointments promptly and we really are working hard behind the scenes to get the new service appropriately staffed and running efficiently. It has been a big project with many staff working long hours” said Ms Hansen.
Ms Winiata and Ms Hansen outlined the overall plan for Te Waiora as a community hub of health and related social services. This is starting to bear fruit with the DHB Community Nurses, the B4 School Checks and other services now collocating with the General Practice. “There is a lot more of this development to come, and the Te Waiora General Practice is now engaged in a major development plan that will unfold over the next 12 months”, continued Ms Hansen.
More funding is not necessarily required. A lot of additional funding already made available to help get Te Waiora off the ground. There is the philanthropic support of the building funders, Horowhenua District Council gifted the land and local businesspeople Larry and Jane Ellison and others financed the building. MidCentral DHB, Central PHO, Te Rununga o Raukawa and even the Ministry of Health have contributed to the start-up budget or to ongoing additional financial support. “We are immensely grateful for all the additional financial support that we have got for Te Waiora, and whilst impressed that our community is willing to go in to bat for us to get access to even more funding, we suggest that this issue be parked for the time being, to give us some space to get on with completing our Te Waiora development plan,” said Ms Winiata.
The role of Primary Health Care Nursing is changing rapidly as we move into the 21st century. We are very fortunate that MidCentral DHB has a strong commitment to developing Nursing capability in our District. We have the highest ratio of Nurse Practitioners in NZ. These are Nurses with a Master’s degree and prescribing rights for defined drugs – they are in many respects as highly trained in their field as a Doctor. We have one Nurse Practitioner fully employed at Te Waiora. We also have some very capable Nurses on our team.
“General Practice is now very much a team effort”, said Ms Hansen. “I understand that people would love their family Doctor to pop around for a chat and a cup of tea, but nowhere in New Zealand is that a reality now. Our Doctors are an increasingly scarce resource and it is important that we use them effectively. This does mean that Primary Health Care Nurses must pick up a lot more of the workload. They are trained to involve the Doctor when that really is required. When our staff suggest an appointment with a nurse is appropriate they are doing that based on their training and experience, and the protocols we have put in place for them to work to. We need our community to support us in ensuring that we can all get the best possible result from the health care team at Te Waiora – it can’t be all about seeing the Doctor”, said Ms Hansen.
Te Waiora Implementation Project Manager Angela Johnson said GP recruitment issues are prevalent across most of rural New Zealand, and a that more money alone won’t resolve this. “Actually we are doing quite well in comparison to some rural locations with the number of loyal GPs that we have retained at Te Waiora and our recruitment will have us up to the planned GP staffing ratio by March next year, well before the next winter season. In the meantime we are using Locum GPs and are deploying more Nursing resource into the centre.
The General Practitioner to enrolled patient ratio varies a lot around the country, dependant on the ability to recruit, the strength of the local Primary Healthcare Nursing team and the presence of Nurse Practitioners. “We are planning to have a high performance team at Te Waiora, with GPs, Primary Healthcare Nurses, Nurse Practitioners and other allied health professionals working together very collaboratively”, said Mrs Johnson.
“There are some things that our people can do to help Te Waiora succeed”, continued Mrs Johnson. “These include not waiting until the last minute to phone for their script renewals, where possible planning for healthcare in advance and being patient about getting appointments for non-urgent matters. It really is important to discuss their situation openly with the triage Nurse on the phone so that the Nurse can assess how urgently the person needs to be seen. This is becoming standard practice right around the country, and is not a new development at Te Waiora. If something really is an urgent matter we will make sure people are seen promptly by the most appropriate clinician”, said Mrs Johnson.