New services are planned for Horowhenua Health Centre – the main one being the establishment of three renal dialysis chairs.
This means suitable patients will be able to dialyse locally instead of people travelling to Palmerston North. Horowhenua staff will be involved in setting up the service.
With this new development in mind, and the retirement of a Horowhenua Health Centre medical officer, together with GP recruitment and retention and workload issues, the DHB is working with the Central Primary Health Organisation (PHO) to look at medical service delivery in the district.
Speaking today, General Manager, Clinical Services & Transformation Mike Grant said: “The number of services being provided in the community, particularly from Integrated Family Health Centres such as the Horowhenua Health Centre, is increasing and will continue to grow.
“It is important that these are supported with strong medical leadership and a model which enables a growing range of services to be delivered locally. The increasing older population is a particular focus and our goal is for the majority of care to be provided in the community, supported by hospital specialists working in partnership with general practice. It is not just about supporting services provided in the IFHC, but also those delivered in the community, like our Health of Older Persons Team and local rest homes.
“If we get the model right, it will support us to attract doctors to rural areas like Horowhenua. Today’s medical staff are looking for an innovative work place, contemporary models of care, a teamwork environment and good work/life balance.”
While the project is primarily focused on medical services for the centre’s inpatient service, other opportunities are being looked at a more integrated community approach for the Health Centre medical staff, and GPs working from it.
At present data is still being collected, taking into account the growing Horowhenua population, and discussions are taking place with many groups including the primary health organisation (Central PHO), GPs, aged residential care providers, MidCentral Health staff (medical, nursing, allied health), Supportlinks, St John, palliative care (hospice) and others. Models used in other rural areas in New Zealand are being explored.
Mr Grant said: “The feedback so far has been very positive. Everyone would like to see a solution which addresses the current vulnerabilities, and supports both local residents and doctors going into the future.
“One of the biggest issues being looked into is how to ensure there is sufficient medical coverage for the district. Over coming years, many of the current doctors will be thinking about retirement plans and it is important that we try and get ahead of this. Having an integrated model which has support and work/life balance will be attractive.
“The Central PHO is very supportive of our approach, and we are very appreciative of having their support to look toward sustainable solutions for the district.
“Until June this year, general practice support for five of the eight rest homes in Levin was provided by an Auckland based firm. Horowhenua Community Practice is now providing this support for four of these rest homes. Rest homes contacted say that regular GP medical rounds work well, but there is limited ability for the GPs to provide after-hours and urgent care (especially at their facilities) given their other workload. We need to get ahead of this growing issue, and support both general practice and the rest homes so that older people in our district get the care they need.
“We heard of a recent case of a rest home resident who had a strongly expressed wish to die at the rest home where she was living. There was a plan in place to enable this, but when she suddenly took a turn for the worse she needed an urgent medical assessment for pain relief and things didn’t go to plan. As it was outside the general medical round, there was difficulty getting a GP to come to the rest home, and the alternative of calling an ambulance to take the woman to Palmerston North Hospital was against her wishes. We just don’t have the local medical cover to be able to accommodate these acute situations. In this case, the rest home finally managed to get her medical assistance.”
It is hoped a new way of working together to provide a more integrated approach will be in place next year.
Contact: Communications Unit (06) 350-8945