Coverage
• Healthcare structure in NZ• What/who influences health care policy and
direction• What is the role of the Midland DHB’s?• How are DHB’s structured?• What opportunities and limitations for DHB’s
in the current health care structure?
Strategies• Child Health Strategy• Health of Older People
Strategy• He Korowai Oranga: Maori
Health Strategy• NZ Disability Strategy
• NZ Health Strategy• NZ Palliative Care Strategy• Pacific Health & Disability Action
Plan• Sexual and Reproductive Health
Strategy
• Primary Health Care Strategy• Youth health: A Guide to Action• Our Health, Our Future• Inhaling Inequality
Chief Advisors• Services• Nursing• Disability Support Services• Maori Health
• Mental Health• General Practice• Child and Youth Health• Oral Health
• Medical Advisor• Pacific Health• Health Information Strategy & Policy• Media
DIRECTORATES
Corporate and Information
DHB Funding and Performance
SectorPolicy
ClinicalServices
Public Health Maori Health DisabilityServices Mental Health
Policy Frameworks• Treaty of Waitangi• Legislation
• NZ Health Strategy• NZ Disability Strategy
• Monitoring and Accountability
MoH Expectations
• Regional planning and delivery• Health Targets• HQSC – falls prevention, surgical site infections• Elective Service Performance Indicators• Stroke• Trauma• Cardiology• Oncology• Financial Performance
Regional ObjectivesSix Regional Objectives:
– To improve Maori health outcomes– Integration across continuums of care– To improve quality across all regional services– To build the workforce– To improve clinical information systems – Efficient allocation of public health system
resources
Regional MeasuresRegion to monitor progress:
– Life expectancy: life expectancy is a calculation of life expectancy at birth based on the mortality rates of the population in each age in a given year
– Premature death: early death is the rate of deaths before the age of 75 years
– Amenable mortality: are deaths that could, in theory, be averted by good healthcare
– Fewer people smoking– Reduction in vaccine preventable diseases– Improving health behaviours
The Midland Region
• Covers 56,728km2 (21% of NZ land mass)• 5 DHB’s: Lakes, Waikato, Tairawhiti, Bay of
Plenty & Taranaki• Approximately 853,725 people• Maori population: 205,590 identifying as
Maori (24% total population) – proportion much higher in Midland against the national proportion
Midland Region (continued)
• Low proportion of the population identified as Asian or Pacific peoples
• Higher number of people living in rural areas• Relatively higher proportion of people living in
areas identified as high deprivation (quintile 4&5)
Each Day within the Midland Region:
• 541 people are admitted to a Midland hospital• 837 people have a first specialist or follow up
appointment• 5,033 people have a general practice
consultation, and• 17 people die
Regional Vision
• All residents of Midland Health Boards lead longer, healthier and more self-sufficient lives
TDHB Aims
• To promote healthy lifestyles & self responsibility• To have the people & infrastructure to meet
changing health needs • To have people as healthy as they can be through
promotion, prevention, early intervention & rehabilitation
• To have services that are people centred and accessible, where the health sector lives as one
• To have a multi agency approach to health• To improve the health of Maori & groups with
poor health status• To lead & support the health & disability
sector & provide stability throughout change• To make the best use of resources available
TDHB Aims (continued)
Regional Networks & Action Groups
• Midland Cancer Network Programme• Cardiac services• Elective Services• Health of Older People• Mental Health & Addiction Network• Regional Trauma Service• Child Health action Group• Maternity Action Group• Radiology Group
Project Maunga
• Theatre Suite• Enhanced Day Stay • Endoscopy Suite• Medical Floor• Surgical Floor• Older Peoples Health Ward• Children's Ward
Taranaki health targets: quarter 1 (July–September) 2013/14 results
Shorter stays in emergency departments
Increased access to elective surgery
Shorter waits for cancer treatment (radiotherapy & chemotherapy)
Increased immunisation (8-month-olds)
Better help for smokers to quit – hospitals
Better help for smokers to quit – primary care
More heart & diabetes checks
Ranking quarter 1, 2013/14
12 6 1 13 9 10 7
Quarter 4, 2012/13 95.5% 112.1% 100.0% 89.3% 97.3% 65.2% 73.1%Quarter 1, 2013/14 94.0% 111.8% 100.0% 89.9% 96.5% 66.5% 75.6%National goal 95.0% 100.0% 100.0% 90.0% 95.0% 90.0% 90.0%
Ministry Policy: Elective Services
• Original policy released March 2000• Intended to ensure patients with highest
priority are treated ahead of those with a lower priority
• DHBs required to comply with the policy• Previously it was a “never ending” waiting list
Aims
• Maximum waiting time of 5 months for a first specialist assessment (moving to 4)
• All patients who have been assessed clinically as having a level of need, which can be met within resources available, receive surgery / procedure within 5 months (moving to 4)
Planning for next year• Live within our means• Maintain a Quality focus• Regional planning & delivery• Link with Regional Services plan• Link with Maori Health Plan• Implement more meaningful primary /
secondary integration