Action 10 Align funding better across the system with a rolling programme focused on getting the best value from health investment (including incentives where relevant to support Strategy direction). We strongly support (a) improving access to health services for those most in need through financial support eg very low cost access. However we would like to draw attention to the inequitable outcomes that can arise from well-intentioned initiatives. Eg $90 million allocated over three years to support access to GPs for under 13 year olds has according to many of our primary health care nurses improved access to the “white worried well”, but not to much more vulnerable group. Moreover not all GPs provide free access, and there are not enough GPs to provide the service in some areas. It is important that the right services are funded, in this case improving access to nurse-led clinics in community settings, pharmacies, schools, and after hour’s services outcomes would have delivered better fairer results for a fraction of the cost. b. with regard capital expenditure we note that HBL arose from a similar centralised government approach and the results were disappointing and divisive to say the least. The new owned” Health Partnership Limited should be encouraged to develop the “DHB expertise indicated and be able to call on government advice rather than have it imposed. Note comments above re commissioning d. We support aligned IT funding Action 11 Develop and use a health investment approach with DHBs. This could be used to target high-need priority populations to improve overall health outcomes, while developing and spreading better practices. This will increase knowledge about population segmentation, drive collaboration, build skills in developing investment cases in the system, improve visibility of value for money, and build on the New Zealand Productivity Commission’s recommendations around a learning system. As above re investment approach and trials. Action 12 Continuously improve system quality and safety We support these actions. Note the recent Adverse Events Report from the Health Quality and Safety Commission, which notes nurses keep patients safe in care. 4. One Team Nurses strongly object to being called in the system”. “actors The 5 year aim appears to be aimed at improved systems but delivering what, in terms of workforce, models of care? How does the Strategy take into account the IT ‘new’ changes that could happen ahead and the consequent staffing/role change implications that will ensue?
Action 10 Align funding better across the system with a rolling programme focused on getting the best value from health investment (including incentives where relevant to support Strategy direction). We strongly support (a) improving access to health services for those most in need through financial support eg very low cost access. However we would like to draw attention to the inequitable outcomes that can arise from well-intentioned initiatives. Eg $90 million allocated over three years to support access to GPs for under 13 year olds has according to many of our primary health care nurses improved access to the “white worried well”, but not to much more vulnerable group. Moreover not all GPs provide free access, and there are not enough GPs to provide the service in some areas. It is important that the right services are funded, in this case improving access to nurse-led clinics in community settings, pharmacies, schools, and after hour’s services outcomes would have delivered better fairer results for a fraction of the cost. b. with regard capital expenditure we note that HBL arose from a similar centralised government approach and the results were disappointing and divisive to say the least. The new “DHB owned” Health Partnership Limited should be encouraged to develop the expertise indicated and be able to call on government advice rather than have it imposed. Note comments above re commissioning d. We support aligned IT funding Action 11 Develop and use a health investment approach with DHBs. This could be used to target high-need priority populations to improve overall health outcomes, while developing and spreading better practices. This will increase knowledge about population segmentation, drive collaboration, build skills in developing investment cases in the system, improve visibility of value for money, and build on the New Zealand Productivity Commission’s recommendations around a learning system. As above re investment approach and trials. Action 12 Continuously improve system quality and safety We support these actions. Note the recent Adverse Events Report from the Health Quality and Safety Commission, which notes nurses keep patients safe in care. 4. One Team Nurses strongly object to being called “actors in the system”. The 5 year aim appears to be aimed at improved systems but delivering what, in terms of workforce, ‘new’ models of care? How does the Strategy take into account the IT changes that could happen ahead and the consequent staffing/role change implications that will ensue?
nzhs-submissions-346-360.docx