Ms Petrina Clare McCann Georgia Clinical Lecturer Turner-Benny Wakefield University of Auckland Chair of Allied Health Dietitian Aotearoa New Zealand 11:00 - 11:55 WS #32: Mobilising Allied Health to Improve General Practice Output 12:05 - 13:00 WS #40: Mobilising Allied Health to Improve General Practice Output (Repeated)
Mobilising Allied Health to Improve General Practice Outcomes Petrina Turner-Benny, Georgia Wakefield, Clare McCann
A Quick Overview • Who/What is allied health and AHANZ? • Where does allied health fit? • Barriers and challenges to allied health integration • Battling the obesity epidemic - a grassroots case study • Connecting for integrated care • Your turn (to tell us what you think)…
Who are Allied Health? • I am someone who uses my expertise to meet your optical needs. Who am I? • I am here to listen to and understand your emotional and/or psychological problems, and to help you gain new understandings about yourself and to make positive changes in your life. Who am I? • I am someone who enables an individual to repair and rebalance, regardless of their pathology. Who am I?
Who are Allied Health? • I can treat people who suffer from injuries and I can also assist patients so they can be active without having pain. Who am I? • Through the treatment I provide to a child, I am a predictor of their future adult health. Who am I? • I am someone who will learn the lyrics and chords of an ACDC song in order to engage with my client. That's part of my job. Who am I?
Who are Allied Health? • I can see straight through you. Who am I? • I am a primary health care provider with a particular interest in the relationship between structure (primarily of the spine) and function (primarily of the nervous system) as that relationship may affect the restoration, preservation and promotion of health and well-being. Who am I? • I am someone who helps people to maximise their receptive communication. Who am I?
Allied Health, Scientific and Technical More than 50 professions with specialised bodies of knowledge and skills, providing a range of services within health and disability, education, social services and justice settings. Their activities include: Prevention; Assessment/Evaluation; Identification/Diagnosis; Treatment; Rehabilitation/Habilitation; Advocacy; Promotion of Health/Wellbeing; Education; Research; and Leadership/Management.
Allied Health, Scientific and Technical Allied health, scientific and technical professions work within the health and disability sector alongside medical, nursing and midwifery, and kaiawhina sectors. These professionals: • Have tertiary (or equivalent) educational qualifications; • Belong to a professional association; • Abide by a Code of Ethics and Standards of Practice; • Participate in professional development within a recognised system for monitoring ongoing competency; and • Many are registered under the HPCA Act 2003.
Allied Health Aotearoa New Zealand (AHANZ) • Society of Allied Health Professional Associations. • First established in 2001, as Allied Health Professional Associations’ Forum (AHPAF). • Incorporated in 2013 with newly established Executive Committee and formal Constitution. • New associate membership categories in 2014. • Connected voice of 28 allied health professional associations and four strategic partners, representing up to 30,000 allied health professionals across NZ.
Allied Health Aotearoa New Zealand (AHANZ) Our Strategic Goals: 1. To provide a supportive and effective forum for allied health professional associations; 2. To promote the value of the allied health workforce; and 3. To influence government and key stakeholders in relevant policy development, implementation and evaluation.
Allied Health Aotearoa New Zealand (AHANZ) Our Key Messages: 1. Allied health is crucial to improving patient health. 2. Allied health is fundamental to people living in the community and remaining independent. 3. Care is not truly integrated unless it includes allied health. 4. Allied health is key to the financial sustainability of our health system.
Our 21 st century patients need: • Largely community-based care • Multi-skilled health workers • Responsive systems • Readily accessible care • Connected care • Affordable care • And appropriately qualified health professionals and service providers
BUT…. • Our “let’s keep patients out of hospital” approach has not worked. • Our high-needs communities and populations still need! • Community-based care is still the poor cousin of factory- based care; underfunded, under-resourced, uncoordinated and disparate. • The motivated, educated and knowledgeable get great care, those who aren’t often don’t!
Definition of REALLY DUMB ……. Planning to care for tomorrow’s patients using a largely unchanged 19th century model of a hospital/medical-centric system that: • Was designed primarily for communicable diseases • In its day didn’t, and still isn’t, meeting the needs of the most dependent members of our society! • Has lost much of the community-based health support that existed when it was designed! • Is not utilising the rich spectrum of care capability and expertise developed over the past 150 years. • Is largely continuing to ignore the causative factors
The NZ Health Strategy NZ Health Strategy: Future Directions All New Zealanders live well, stay well, get well in a system that is people-powered , provides services closer to home , is designed for value and high performance and works as one team in a smart system .
The NZ Health Strategy FROM TO Treatment Prevention and support for independence; Focus on the individual Wider focus on family and whanau; Service-centred delivery People-centred services; Competition Trust, cohesion and collaboration; Fragmented health sector silos Integrated social responses.
Take Charge: Managing Six Transformations in Health Care Delivery, Issel et al, Nursing Economics FROM TO “MY” Patient My Customer Illness Wellness Cost reduction Total healthcare cost management Professional autonomy Professional interdependence Fragmented care Continuity of care and information Passive patient Quality conscious consumer This paper was published in 1996 !!!
Understanding the Need – What the Ministry Has Said
The NZ Health Strategy
The NZ Health Strategy Investment approach: Investment in long-term financial benefits (education, employment, alcohol/drug dependency, family violence, mental health) and non-financial benefits. Provide a strong incentive to focus on the long-term impacts and value alongside immediate short-term goals.
Closer to Home • Well-designed and integrated pathways • Services as close to home as possible • Identify, prevent and slow deterioration of early health problems • Well co-ordinated care for complex needs • Right services in the right location • Equitable • Cost-effective • Fully utilise health professional skills and training • Address common risk behaviours
One team • United approach and best use of skills – medical, nursing, allied health, Kaiawhina, researchers • Link health with related pressure points in housing, education and employment • Join up organisations with common interest / investment • Invest in capability and capacity of workforce.
NZ Health Strategy Some of the strengths: • Developed in context with a funded universal health system and a committed and highly trained workforce; • Health services with a strong focus on primary care and a widely supported focus on wellness; and • Strong Government desire for health and social services to work better together.
NZ Health Strategy Some of the challenges: • Aging population - more health and social services needed for people to remain healthy and independent; • Rise in obesity, with resultant social and long-term health impacts; • Does not effectively address our high-needs population, creating further inequity.
NZ Health Strategy Some of the challenges: • No leadership within the Ministry of Health • The Roadmap of Actions supporting the strategy are not actions, they are intents • Fragmented IT solutions with lots of reinvention • Current model of service provision is unsustainable, but appetite is limited to change the funding model.
Challenges to Better Integration Funding: Resourcing the integrated care laid out in the Health Strategy will require: • DHBs funding of services when they change setting (not a short-term cost-cutting exercise); and • Investment from general practice in workforce and facilities in order to provide services in a new way.
Challenges to Better Integration Funding: Current integrated service close to patients’ homes is geographically localised. The ability to shift services seen as dependent on: • Relative investment of resources in such services; and • Workforce development required to provide increasingly complex and interdisciplinary range of services.
Challenges to Better Integration Ministry of Health perceptions of allied health: • No strategic leadership allied health advisory position • Chief Medical Officer, Chief Nurse ???? • MOH tend to consult with pharmacy profession as the representative of the allied health sector.
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