TOTAL HEALTHCARE
CHARITABLE TRUST
Annual
Report
JUNE 2013 - JULY 2014
Total Healthcare Charitable Trust is an Auckland primary health organisation
that has medical provider groups serving patients in Counties Manukau, Auckland
and Waitemata districts.
Total Healthcare is committed to the following core values:
• Comprehensive healthcare – Including opportunistic and community based services
• Culturally competent –Treating people with respect and dignity; valuing individual and
cultural differences
• Accessible – Offering affordable and accessible services including extended hours
• Holistic – Aiming for total wellness
• Innovative – Actively seeking innovative and better ways to deliver services
• Collaborative – Working with other health providers to provide more effective services
For more information about the Trust, see www.totalhealthcare.org.nz
For more information about our provider East Tamaki Healthcare ETHC, see www.ethc.co.nz
CONTENTS
3
Chair’s report
5
From the Executive Officer’s desk
7
Clinical Director’s report
8
CASE STUDY: Kia Kaha
9
CASE STUDY: New Government funding helps nurses to pursue their dreams
10
11
CASE STUDY: Ranui
12
CASE STUDY: CVD target success
13
Community Manager’s report
14
Workforce report
15
Clinical Service Manager’s report
16-17
Medical provider contact details, hours & patient population
18-19
Patient population growth
20
21
22-23
”Our model of care ensures that
people who need it most, have access
to high-quality healthcare where
and when they need it, now and into
the future”
- william ropata, CHAIR
CASE STUDY: Healthy dose of fun
Governance & management
Contact details
Financial statements
CHAIR’s REPORT
No reira, tihei mauriora!
Programmes bolstered for patients
It is with pleasure Total Healthcare Charitable Trust’s Board
of Trustees submits the 2013/2014 Annual Report.
In addition, we have built up mental health expertise among
primary care teams and will continue to invest in growing
our mental health programme. We have also contributed
towards the Counties Manukau DHB 20,000 Bed Days
campaign. The campaign sought to reduce the number of
bed days by supporting initiatives that achieve this aim. The
campaign is now in its second phase, Beyond 20,000 Bed
Days.
Total Healthcare is a primary health organisation with a
medical provider group (East Tamaki Healthcare or ETHC)
that has 13 clinics serving more than 102,000 patients in
the Counties Manukau DHB area (around 80% of whom are
deemed high needs).
A further nine clinics (East Tamaki Healthcare, West Auckland
Healthcare, Mt Roskill Medical Centre) are located in the
Waitemata and Auckland DHB catchments serving 76,000
patients.
Clinics outside Counties Manukau are required to be part of
ProCare PHO due to DHB policy.
Nonetheless, this board still takes full responsibility for these
clinics and their patients, and they remain an integral part
of Total Healthcare. We are also a full partner to the DHB/
PHO Alliance Agreement ensuring our patients are fully
represented around the strategy and funding tables.
“
Hūtia te rito o te harakeke
Kei hea te kōmakō e kō?
Kiawhakatairangitia
Rere ki uta, rere ki tai
Kī mai kia ahau
He aha te meanui o te Ao?
Mākū e kī atu
He tangata, he tangata, he tangata.
What is the greatest thing in the world?
It is people.”
Lean infrastructure
This work, and the work of our clinical family navigators and
peer support people, has bolstered our ability to offer wraparound integrated health services to patients – something
we are always striving to improve and expand.
We have a growing PHO presence in the community
through the work of our community liaison officer, and we
have continued to fund FitLife. The bootcamp-style fitness
programme has seen 240 participants attending over 70% of
the six-weekly courses, which run at 6am for three mornings
a week. FitLife continues to be a success and we have
received many positive testimonials. We will continue to
invest in this initiative of which only 50% of the participants
are enrolled with Total Healthcare.
A key focus this year has been for us to retain our lean
infrastructure and focus on delivering high-quality
healthcare services to our mainly high-needs patient
populations. We have kept the PHO deliberately small with a
full time executive officer and the secondment of a general
manager for west and central clinics, who works closely with
the board, especially the chair and the executive trustee.
Sustainable and efficient model of care
Total Healthcare ensures the bulk of its revenue is available
to purchase services for patients by having a robust
service level agreement with ETHC’s management service
organisation and by using the services of accounting firm
Milne Maingay. In this way we can operate with significantly
reduced expenditure.
• The board has made sure it participates in local and
national forums where senior policy analysts and funders
are present. Attendance and participation not only ensure
we are consistently at the forefront of understanding the
changes to the system, but also offer an opportunity to
advocate to our providers unique clinical and business
models.
The trustees’ diverse skill sets combined with their extensive
reach across the health sector, ensures we are pivotal
in supporting our clinics in this ever-changing health
landscape.
IFHC and STARcare progress
We have progressed with the development of integrated
family healthcare centres in the Otara Mall in south
Auckland and in Ranui in the west. This year, we have
continued to urge DHBs to devolve hospital services, where
appropriate, to our integrated family healthcare centres. Later
in 2014, Otara Mall IFHC added a Specialist Treatment and
Rehabilitation (STAR) Care Centre where professionals such
as dieticians, podiatrists, psychologists, nurses and GPs with
special interests and skills will be located. Self-management
education will also be provided.
One of Total Healthcare’s foremost goals is to be recognised
as a healthcare provider that exhibits leadership and
innovation in the design and delivery of its health services to
high-needs populations. We achieve this through a variety of
methods, for example:
• Total Healthcare is now regularly visited by senior
Government officials eager to better understand the
efficiencies our providers generate.
It is our mission to ensure everyone understands that our
sustainable and efficient model of care ensures that people
who need it most, have access to high-quality healthcare
where and when they need it, now and into the future.
No reira, ko te whakatauki e kii ana nei, “Ehara taku toa I te
toa takitahi, engari I te toa takitini”
Tena kotou, tena koutou kia ora tatou katoa.
– William Kato Ropata
It is our belief that if a patient does not need to stay
overnight for a health service, they should be offered
that service as close to their home as possible. Local,
convenient services lead to better, faster healthcare. As well
as benefiting the patient, this reduces acute demand for
hospital beds.
2
3
from the
EXECUTIVE OFFICER’s DESK
The Board and Executive team continue to be proud of the
care East Tamaki Healthcare, provides to our communities.
I want to reflect not only on the enhanced access East
Tamaki Healthcare (ETHC) offers but also on the quality of
its healthcare services.
Defining quality general practice
Some years ago, the well-known US health provider groups,
Kaiser Permanente and Group Health, sent representatives
to give a variety of presentations to a New Zealand health
sector conference. Delegates were in agreement with
what the groups proposed as being high quality and, more
importantly, sustainable indicators of good practice.
Excellent patient growth
This financial year, we have seen further increases in our
enrolled population from 160,000 to over 177,000 with ETHC
expanding to include three additional practices in south
Auckland.
However, growth has not been at the expense of quality, with
Total Healthcare’s practices consistently achieving highly in
the national health targets (see case story on page 12).
No doubt there will be further growth in the year ahead with
Total Healthcare secure in the knowledge that its provider
group is clinically-led and patient-centred.
– Mark Vella, Executive Officer
Three recurring indicators of good practice
First, they encouraged the Kiwi health sector to improve
access to services and suggested patients should be able to
see a GP in the same day they require GP services.
“
When I compare ETHC to the
sustainable indicators of good practice,
it appears our provider is offering a
leading service.”
Second, improving access requires a broader workforce that
uses nurses at the top of their scope to deliver services.
Third, they recommended investing in IT systems that allow
all general practice providers access to a patient’s notes and
the capacity to identify and grade a patient risk.
ETHC – a leading health service
When I compare ETHC to these indicators it appears our
provider is offering a leading service.
In terms of access, ETHC offers “walk-ins” and appointments
at low cost, where under 18s are free and over 18s are $10.
Clinics are open extended hours to accommodate the variety
of lifestyles and commitments of their patient bases.
ETHC achieves this by using a broad workforce that includes
receptionist/project manager, clinical assistants, nurses,
psychologists and, of course, GPs.
A single database accessible from any ETHC clinic across the
Auckland region is frequently used for queries and to stratify
patient risk.
There are other factors, too, that signal our high quality and
sustainable provision of healthcare services; patient and
staff loyalty being one.
ETHC, having been around for more than 35 years, is
now seeing its third generation of patients and the third
generation of staff is now beginning to emerge.
Low numbers of clawbacks is another. If a Total Healthcare
patient seeks services from another practice, that is with
another PHO, funding for that consult is “clawed back” from
Total Healthcare.
Total Healthcare’s clawback is rarely above 2% of its funding
for first level services. This extraordinarily low rate is a
significant indicator that our patients do not tend to shop
around for services from other practices.
4
5
CLINICAL DIRECTOR’s REPORT
Most health services in today’s environment are run with
limited resources, and face issues of demand exceeding
capacity. This reality is a significant issue for the primary
mental health programme funded by Total Healthcare.
Testing and implementing sustainable ways of providing
access to effective services, to as many people as possible, is
an ongoing challenge we face.
One key strategy employed by East Tamaki Healthcare’s
Primary Mental Health team to better meet demand, has
been to trial evidence-based group programmes.
The two programmes that have been successfully trialled,
and now implemented into business as usual, include the
Stanford Self-Management group programme, which is run
in five to six locations across the network at any one time
and is also a key element of Kia Kaha (for more see page
8); and the Mindfulness-Based Stress Reduction or MBSR
programme.
Evidence-based, well-researched
“
So far outcome data
for MBSR courses show
most patients achieve significant
reduction in both physical symptoms,
such as pain, and anxiety and
depression symptoms.”
MBSR is a very well-researched and strongly evidence-based
programme that integrates mindfulness-based practice from
eastern cultures with modern psychology and cognitive
behaviour techniques. Evidence shows that MBSR achieves
good outcomes for patients with stress, depression, anxiety,
and chronic pain.
Benefits for staff and patients
A number of ETHC staff have also completed the programme,
and all have spoken very highly of the benefits it has
brought them. From next year, the GP registrars who are
completing the Advanced GP Competency in Mental Health
and Addiction module we are piloting (for more see page
14) will be completing an MBSR course – both for their own
personal development, and also to understand what patients
go through when referred to MBSR.
Since the programme began in 2013, more than 250 patients
have completed the eight-week course. So far, outcome data
show most patients achieve significant reductions in both
physical symptoms such as pain, and anxiety and depression
symptoms. Patients report they have found the programme
enormously helpful in learning how to manage stress in their
lives.
Each MBSR group can take up to 15–20 people, and is run by
one therapist, so this is not only an effective element of the
menu of services offered by the team, but also a very costeffective approach. A completed programme requires about
20 hours of therapist time – providing services to those
15–20 people on a one-to-one basis would take 60–80
hours of therapist time.
– Dr David Codyre, Clinical Director – Mental Health
At East Tamaki Healthcare, the MBSR programme is being led
by Lila O’Farrell who has many years experience delivering
this programme. The programme is fully funded and
available to enrolled East Tamaki Healthcare patients who
have anxiety, depression or chronic pain, free of charge.
Patients attend weekly two-hour group sessions for eight
weeks where they learn a range of skills for better mental
health including slow breathing, mindful meditation and
basic cognitive behaviour principles.
At any given time, four to five MBSR groups are running
Auckland wide and we’d like to see that number double over
the next 12 months. To achieve this Lila is currently training
two junior members of the team to also deliver MBSR. She
also plans to trial early next year, a more open-ended MBSR
programme, in which it is delivered in four modules of two
sessions that roll over, so people can join and leave the
group in a more flexible way (ie they can join at any time
rather than having to wait till a new programme starts).
6
7
CASE STUDY
CASE STUDY
Collaborative mental health project
cuts down ED visits
New Government funding helps nurses
to pursue their dreams
photo: Western Leader
From left: Leona Didsbury, Pamela Low and Merle Samuels
A new collaborative primary care mental health project is
reducing hospital emergency department (ED) presentations
for high needs patients.
Kia Kaha is available to East Tamaki Healthcare (ETHC)
patients, who have two or more long term conditions and
had two or more presentations at ED in 12 months.
“This can be a physical or mental condition, or a combination
of both. For example, if they have diabetes, having depression
also is common,” ETHC health psychologist Leona Didsbury
says.
The rationale is that people with long term medical
conditions have higher risk of also having a common mental
health condition, such as depression or anxiety, and this
results in them struggling to manage their diabetes or other
conditions which leads to increased use of hospital services,
ETHC mental health lead and consultant psychiatrist David
Codyre says.
“People with severe mental health conditions also have
poorer physical health, and on average live 15–20 years less
than the rest of the population,” he says.
“Existing health services have struggled to meet this
combination of mental health and physical needs in many
cases, so a more flexible patient-centred approach was
needed.”
How Kia Kaha works
After patients are identified as qualifying for Kia Kaha, a
health psychologist and a peer support specialist organises a
meeting at a location of the patient’s choice: at home, at their
GP’s clinic, with or without whanau.
“And then we focus on what matters to them, not on what is
the matter with them,” Ms Didsbury says.
From left: June Mau loves working in the community she grew up in, Esther Allington enjoys the cultural diversity of Glen Innes and
Rohan Ratnayake says it’s rewarding helping high-needs patients
Kia Kaha patients are offered a choice of health psychology
and therapy, the Stanford Chronic Disease Self-Management
Programme, peer support, and case coordination – linking
them to the range of services to meet their need, but
ensuring that these services can be responsive to them.
The Stanford programme sessions, over six-weeks, are led by
fellow health consumers and health professionals who have
undertaken training to be group leaders.
East Tamaki Healthcare health psychologist Pamela Low
believes the role of peer specialists as mentors and in
engaging people who have previously been hard to reach,
has been the key factor in Kia Kaha’s success.
Graduate nurses Esther Allington, June Mau and Rohan
Ratnayake landed their dream jobs this year thanks to new
Government funding.
They are three of 48 graduate nurses nationwide whose
salaries are being funded by the Government to work in high
needs* communities. The employment of extra nurses has
also increased access for patients.
Mr Ratnayake also works at Henderson’s Wai Health Clinic
and told the Western Leader it’s rewarding helping up to 100
West Auckland high-needs patients a day.
Based at the East Tamaki Healthcare Glen Innes clinic, Miss
Allington simply loves her job.
It wouldn’t have been possible to employ the trio, without
the Government funding.
“I love the people. I love the cultures here. Primary care was
my favourite placement when I was studying,” she says.
The Government announced a funding injection of $2.4
million for 48 graduate nurses in early 2014; $50,000
goes directly to eligible general practices to employ a
new graduate nurse and support their development for 12
months.
Reduced depression and anxiety
“This is grassroots nursing and I want to make a difference to
people and work to improve their health outcomes.”
Since July 2013, 44 Kia Kaha patients have shown reduced
PHQ-9 and GAD-7 scores for depression and anxiety.
Manukau resident Ms Mau is working at the East Tamaki
Healthcare Dawson Road clinic.
Last year, the patient group’s collective attendances at ED
numbered as many as 25 presentations in a month, but the
rate has now dropped to below 15, and some months to
fewer than 10 attendances.
“I love how I can help people now rather than after they go
into hospital,” she says.
“Our aim was to reduce the number of unplanned
presentations for this group by 25%, and we’ve reduced it by
much more,” Ms Low says.
Rohan Ratnayake, a 45-year-old primary healthcare nurse,
started work at East Tamaki Healthcare on Lincoln Road
in January after completing a Bachelor of Nursing at
Henderson’s Unitec.
“I like being at Dawson Road because this is the area I grew
up in.”
In addition, the local district health board provides support
through the Nurse Entry to Practice Programme.
*A high needs population as defined by the Ministry of Health
is when a general practice’s enrolled population is at least 50%
Māori, Pacific or New Zealand Deprivation Index Quintile 5.
The patient feedback is overwhelmingly positive; one patient
sums it up: “This programme is fricken awesome... it feels
like I got my life back.”
The project is a collaboration with Counties Manukau Health,
Ko Awatea and the Beyond 20,000 Bed Days campaign.
Kia Kaha is believed to be the first peer support/mental
health team collaboration of its kind in primary care in New
Zealand.
The answer to the question: what matters to you, isn’t often
health-related but addressing the patient’s foremost concerns
often have a flow-on effect for their health. For example, one
patient’s concerns for her adolescent children overrode her
need to monitor her diabetes or address weight loss.
8
9
CASE STUDY
CASE STUDY
Healthy dose of fun
Ranui – from Lockwood house to
a modern, $5m purpose built facility
From left: Student nurses Silky Silky (ETHC Dannemora) and Maraia Saurara (ETHC Sylvia Park), ETHC clinical support facilitator
Reshmi Lata Chand, nurse Esther Allington (ETHC Glen Innes) and project team member Pretesh Natani (ETHC Glen Innes) are
excited about improving screening data
From left: Dr John Lindsay, Dr Kantilal Patel, Dr Chris Smith, MP Paula Bennett and Ranjna Patel
In April, staff donned wigs, wings and hula skirts and
decorated clinics in a bid to promote health issues that can
cause disease and premature death.
Ranui Medical Centre’s new premises is a far cry from the
Lockwood three-bedroom house the practice began as more
than 30 years ago.
East Tamaki Healthcare, West Auckland Healthcare, Ratanui,
Raukura clinics and Mt Roskill Medical Centre took part in a
drive to ensure enrolled patients are having the free health
screening to which they are entitled:
• For children: vaccinations up-to-date for their age and
oral health check
• For men: diabetes, cardiovascular risk assessment
(diabetes and heart checks) and, if eligible, influenza
vaccination
• For women: diabetes checks, cervical smear, mammogram,
cardiovascular risk assessment and influenza vaccination
(if eligible).
By having these tests patients not only have a better idea of
how they can improve their health, but the PHO will better
meet its health targets set by the Government.
“Just recalling by phone or letter doesn’t always work, asking
them in the middle of their busy days to take some extra
time doesn’t always work either,” Clinical Services Manager
Nursing and Allied Health at East Tamaki Healthcare Gillian
Davies says.
“We think that by decorating our clinics and dressing up all
our staff for a month help us improve the screening data and
make patients smile at the same time,” Mrs Davies says.
10
Patients were also put in the draw to win vouchers for the
Warehouse, Rebel Sport or the supermarket each week.
By the end of the month, hundreds of patients had taken up
the opportunity to have free screening tests or vaccinations,
15 of these had each received a $200 voucher, and the PHO
was closer to meeting its health targets.
The success of this promotion was assisted by extensive
coverage, including the prize-winning photograph (above), in
a range of media – the New Zealand Herald, Manukau Courier,
Eastern Courier, East & Bays Courier and World TV News.
Space became such an issue in the waiting room, patients
stood on the front porch when the house was full.
The centre’s long-serving GPs Dr John Lindsay and Dr Chris
Smith long held the dream of a modern, purpose-built facility
for the community they’ve served for decades.
By teaming up with additional partners, consolidation of
nearby medical clinics and an investment of $5 million their
dream is finally realised.
A recent population needs assessment showed that
Henderson, compared with the rest of West Auckland, has the:
• highest proportion of Maori/Pacific patients (34%)
• highest proportion of high needs patients (43%)
• highest age-standardised adult hospitalisation rate for
CVD, diabetes and mental health
• highest rate of emergency department attendance for
adults and children.
Ranui Medical Centre is the next site to be considered as a
STARCare centre (see Executive Officer’s report on page 5).
The development of the new two-storey centre was made
possible with investment from East Tamaki Healthcare,
original Ranui doctors Drs Lindsay and Smith, Ranui
pharmacist Daniel Adams and Malcolm Johnston of Johnston
Group.
The new centre provides extended hours services at the
lowest fees in West Auckland. Ranui Medical Centre also brings
physiotherapy and dental services to Ranui for the first time,
and hopes to bring other health services into the area over
time with 800m2 of space still available for future growth.
On Friday 2 August 2013, the then Social Development
Minister and Waitakere MP Paula Bennett officially opened
Ranui Medical Centre.
Henderson has a fast-growing patient population with a
projected annual growth of 1.54% per year (compared with
rest of New Zealand which is 0.86% per year).
11
COMMUNITY MANAGER’S REPORT
Working together
for a safer community
Total Healthcare’s provider East Tamaki Healthcare
continues its close involvement with the communities
it serves. Community Manager Joseph Liava’a reports
on the new community events held in 2014.
CASE STUDY
Emergency services, Thai kickboxing and a car chopped in
half called Clicki Ricki sound more like the elements of a
Hollywood movie than a community event.
Leading the way with heart and
diabetes checks
Indeed, these elements were star attractions at the inaugural
Safer Families Papatoetoe and Safer Families Manurewa
events held in 2014.
The events were organised in response to the high levels of
domestic violence within the South Asian community, and as
a response to some of the wider safety issues emerging from
the community.
Non-clinical staff participated in the CVD project, from left, Paresh Vekriya, Ranjna Patel, Namrita Chand, Rebecca Crichton
and Eden Park.
Innovative use of workforce is the driver behind our PHO’s
consistently high success rate for heart health and diabetes
testing.
If the patient has a spouse or other relative with them at the
time, ie, family members, who sometimes carry similar risk
factors, they are also offered the free check.
For the first quarter of the 2013/14 year, Total Healthcare
took the top national spot with 83% of its eligible population
having had their risk assessed as part of the national health
targets.
Word spread among local families registered with East
Tamaki Healthcare clinics that the free check was available
and more people made the most of this opportunity.
The PHO has improved its rate each quarter; up to 84%
in the second quarter, 85% in the third and 89.75% in the
fourth.
Safer Families Papatoetoe, held in February, was a
collaboration with Police, the Department of Corrections, East
Tamaki Healthcare and the Manukau Indian Association, who
played the lead role.
The purpose of the event was to raise awareness within
the South Asian community of the many support services
available, while creating a fun and interactive atmosphere
for the whole family to enjoy.
A heart and diabetes check (or cardiovascular risk
assessment) gives patients information on their risk of
having a heart attack or stroke. It also determines the risk of
having diabetes.
Some of the demonstrations included the Fire Service
and one of its appliances, the Police, local crime watch
organisations, Watersafe, Plunket and Clicki Ricki (a car
chopped in half to help demonstrate the correct use of child
restraints) and Elite Thai Kickboxing, to name a few.
The check will let patients know what their risk is and
suggest the best ways to improve their health.
East Tamaki Healthcare Clinical Services Manager, Nursing
and Allied Health, Gillian Davies attributes the success to
innovative use of the non-clinical workforce.
“We recruited and educated staff to approach eligible
patients at East Tamaki Healthcare clinics,” Mrs Davies says.
Community feedback told us there were raised levels of
awareness of issues such as domestic violence and where
to go for help, elder abuse, self defence, fire alarm safety,
community safety, safety around the home and water safety
following the event. It was also an opportunity for East
Tamaki Healthcare to engage with patients outside the usual
healthcare settings.
The Government target is to have 90% of the eligible
population’s heart and diabetes risk assessed.
Patient eligibility is determined by gender, ethnicity and age.
When a patient who is eligible for the heart check arrives
at a clinic, the computer system alerts the receptionist that
the patient can have a free check. Staff then conducted the
check, which takes 10 minutes.
Based on the success of the Papatoetoe event, a second
event Safer Families Manurewa was held on the grounds of
the Manurewa Sikh Temple in May.
Performance against Health Targets
Indicator
Central & West Auckland ETHC/Procare
Metro Auckland-wide all ETHC clinics
Target
CVD Risk Assessment
89.75%
91%
90%
90%
8 month Immunisations
91.18%
90.77%
90%
90%
2 year Immunisations
89.50%
94.39%
91.95%
90%
90% adjusted
109.8% adjusted
100% adjusted
90%
Help for Smokers to Quit
12
CMDHB Total Healthcare
East Tamaki Healthcare volunteer Shital Patel takes
Mandeep Kaur’s blood pressure during Safer Families
Manurewa
The event, led by the Sikh Temple’s social arm Anand
Isher Education and Community Trust, was also a success,
especially in terms of engaging with the Sikh community,
many of whom are migrants.
Safer Families Manurewa was also a success with regard
to the collaboration between the Police, ETHC and the
Manurewa-based council departments who, together, were
able to raise awareness of the many different facets that
make up a safer community.
13
CLINICAL SERVICE MANAGER’S REPORT
WORKFORCE REPORT
Hopes high for teaching the
entire GP continuum
Whooping cough
vaccinations prevent
distressing illness
Total Healthcare is hoping to host post graduate years
1 and 2 doctors in the near future. This presents an
excellent opportunity to provide the continuum of
undergraduate, graduate and postgraduate medical
training through ETHC.
Clinical Services Manager, Nursing and Allied Health at
East Tamaki Healthcare Gillian Davies vaccinated her
entire family against whooping cough on Good Friday
2014.
While the undergraduate medical training programme saw
a significant reduction in student placements, ETHC did this
year manage to secure a new agreement with the University
of Otago School of Medicine.
I jabbed my entire family, well, almost.
I wasn’t wishing them harm, quite the opposite. Rather, I
wanted to protect them all from pertussis, more commonly
known as whooping cough.
We are now the only general practice organisation north
of the Bombay Hills that can host these students. This is
significant as a historical arrangement between Auckland
and Otago universities has previously prevented medical
students from the South Island from coming to Auckland.
New Zealand experiences an outbreak of whooping cough
every three to five years. The latest outbreak began in August
2011 and since then more than 11,200 cases have been
reported.
On Good Friday, I gathered my pregnant daughter, son-inlaw and his brothers, my husband, my son and son’s partner
at East Tamaki Healthcare’s Bairds Road clinic in Otara to
vaccinate them myself.
Increase in teaching practices
We are also pleased to report that negotiations are under
way with the Royal New Zealand College of General
Practitioners (RNZCGP) to credential another 20 of our
doctors as registrar teachers, and another seven clinics as
teaching practices.
Why we encourage Boostrix vaccinations
Bairds Road is now a credentialed GPEP1 registrar training
site, bringing our GPEP1 training sites to five. We have three
more in the processes of credentialing.
I encouraged pertussis vaccination personally because we
were expecting our first grandchild and I’d read about the
strong evidence around “cocooning” or encouraging “herd
immunity”.
Despite the offer of $10,000 to attract GPEP1 registrars,
again, this has not been taken up. We look forward to having
this available over the coming year.
Three out of four newborn babies with whooping cough
catch it from their mother or other close family members.
Associate Professor at Auckland University and Starship
Hospital Consultant Paediatrician Cameron Grant says if
all those in the community who can be immunised are,
it renders them incapable of passing the disease to the
vulnerable.
Mental health training progressing well
The first three GP registrars to enter Total Healthcare’s new
Advanced GP Competency in Mental Health and Addiction
Programme are making great progress.
Children younger than 12 months of age are at the highest
risk of developing serious complications such as pneumonia
and brain damage from whooping cough, according to the
Ministry of Health.
Registrars are acquiring increased knowledge of mental
health in primary care as well as clinical skills in screening,
assessment, formulation and management.
For these reasons, ETHC staff members also actively
encourage patients and their family members to consider
vaccination against whooping cough.
Psychiatrist Dr David Codyre and his team are providing an
excellent training ground for these doctors.
Following negotiations with the RNZCGP, the programme
began in January 2014 with four registrars. One registrar has
unfortunately since left for Australia.
The programme is a collaboration between Total Healthcare,
RNZCGP and Health Workforce New Zealand.
Gillian Davies vaccinates her son-in-law Michael Briscoe,
while his brother Stephen Briscoe looks on
All pregnant women between 28 and 38 weeks of pregnancy
and all children as part of their childhood immunisations are
eligible for free vaccinations against whooping cough. And,
for all other patients, it costs $40 per vaccination at Total
Healthcare clinics.
We are pleased to note that the RNZCGP has confirmed six
registrars for the mental health training programme.
– Dr Tane Taylor, GP teacher
14
15
Auckland DHB
42,000
These practices all offer comprehensive general practice services and accident (minor trauma, long term condition
management visits, care plus consults).
The Bairds Road, Dawson Road and Mangere Town Centre Clinics are all accredited Accident and Medical Service Providers.
Dannemora and Sylvia Park clinics offer surgical clinics and specialist clinics.
178,000
X-ray facilities are available at: Bairds Road, Dawson Road, Mangere Town Centre, Dannemora and Lincoln Road.
16
CENTRE
ADDRESS
SUBURB
PHONE
Airport Oaks
149 Kirkbride Road
Airport Oaks
(09) 275 1202
Bairds Road
160 Bairds Road
Otara
Chapel Park
160 Chapel Road
Clendon
Counties Manukau DHB
102,000
PATIENT population
Waitemata DHB
34,000
Medical provider contact details & hours
(as at June 2014)
OPENING HOURS
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
(09) 275 1205
Airport Oaks
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
Closed
Closed
(09) 274 3414
(09) 274 0676
Bairds Road
8.00am
11.00pm
8.00am
11.00pm
8.00am
11.00pm
8.00am
11.00pm
8.00am
11.00pm
8.00am
11.00pm
8.00am
11.00pm
Chapel Park
(09) 271 2670
(09) 271 2679
Chapel Park
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
1.00pm
8.30am
5.30pm
Closed
Closed
459 Roscommon Road
Clendon
(09) 266 6646
(09) 266 6678
Clendon
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
Closed
Closed
Dannemora
1 Redcastle Drive
Dannemora
(09) 272 4163
(09) 272 4173
Dannemora
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.30am
6.00pm
9.00am
5.00pm
Dawson Road
124 Dawson Road
Chapel Downs
(09) 274 3468
(09) 274 3547
Dawson Road
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
East Tamaki
275 East Tamaki Road
East Tamaki
(09) 274 9264
(09) 274 3173
East Tamaki
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
12.00pm
Closed
Glen Innes
5 Mayfair Place
Glen Innes
(09) 528 9054
(09) 528 9058
Glen Innes
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
5.00pm
9.00am
5.00pm
Hill Road
7 Hill Road
Manurewa
(09) 267 6883
(09) 267 7854
Hill Road
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
Closed
Closed
Lincoln Road
131 Lincoln Road
Henderson
(09) 837 2056
(09) 837 8426
Lincoln Road
8.00am
5.00pm
8.00am
5.00pm
8.00am
5.00pm
8.00am
5.00pm
8.00am
5.00pm
Closed
Closed
Mangere Bridge
41 Coronation Road
Mangere Bridge
(09) 254 4290
(09) 254 4291
Mangere Bridge
9.00am
5.00pm
9.00am
5.00pm
9.00am
5.00pm
9.00am
5.00pm
9.00am
5.00pm
Closed
Closed
Mangere Town Centre
10 Waddon Place
Mangere
(09) 275 7954
(09) 275 0183
Mangere Town Centre
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
8.00am
8.00pm
Mt. Roskill
445 Richardson Road
Mt Roskill
(09) 627 0015
Mt. Roskill
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.30am
6.00pm
Closed
Otahuhu
15 - 23 Station Road
Otahuhu
(09) 276 3000
(09) 270 4957
Otahuhu
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
Closed
Closed
Otara Mall
120 East Tamaki Road
Otara
(09) 274 9354
(09) 274 1703
Otara Mall
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
Closed
Closed
Ranui
421 Swanson Road
Ranui
(09) 833 6033
(09) 832 3746
Ranui
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
Closed
Closed
Sandringham
546 Sandringham Road
Sandringham
(09) 849 2111
(09) 849 8220
Sandringham
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
1.00pm
Closed
Stoddard Road
20 Stoddard Road
Mt Roskill
(09) 557 1551
Stoddard Road
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
Closed
Closed
Sylvia Park
L1, Shop N215, 286 Mt Wellington Hwy Mt Wellington
(09) 573 1265
(09) 579 6417
Sylvia Park
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.00am
5.30pm
8.30am
1.00pm
Closed
Te Puea Marae Clinic
34 Miro Road
Mangere Bridge
(09) 636 5683
(09) 636 5682
Te Puea Marae Clinic
9.00am
1.00pm
9.00am
1.00pm
9.00am
1.00pm
9.00am
1.00pm
9.00am
1.00pm
Closed
Closed
Wai Health Clinic
Cnr Edsel & Catherine Streets
Henderson
(09) 839 0280
(09) 839 0842
Wai Health Clinic
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
5.30pm
8.30am
1.00pm
Closed
Weymouth
235 Browns Road
Manurewa
(09) 264 1640
(09) 264 1578
Weymouth
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.00am
6.00pm
8.30am
1.30pm
Closed
(09) 627 8552
> extension 1
> extension 1
(09) 627 8552
> extension 2
FAX
17
Number of enrolled patients
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
76,049
81,434
84,720
84,719
109,836
137,308
160,000
178,000
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
63,198
62,326
61,068
62,692
80,180
96,515
105,000
119,816
190,000
13
%
3
60
%
IN TEN
are of Asian decent
of patients are European
180,000
170,000
160,000
are Māori or
Pacific Islanders
150,000
140,000
130,000
120,000
ETHNIC GROUP
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
110,000
100,000
European
AK
4,799
WA 13,064
SA
6,222
90,000
13%
80,000
70,000
Māori
Pacific Island
Asian
AK
WA
SA
3,856
8,393
18,707
17%
AK 11,817
WA
6,179
SA 156,438
High needs patients
43%
AK 18,965
WA
4714
SA 117,511
140,000
23%
120,000
100,000
Other
AK
1,334
WA
1,216
SA 13,753
4
%
80,000
60,000
Unknown
AK
WA
SA
40,000
508
10
60
20,000
Maori/Pacific Island patients
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
51,686
56,563
55,068
59,303
73,450
86,814
93,230
105,390
140,000
120,000
100,000
PATIENTS
Number
AUCKLAND (AK)
41,279
WEST AUCKLAND (WA)
33,576
SOUTH AUCKLAND (SA)
102,691
TOTAL
177,546
80,000
60,000
40,000
20,000
18
19
governance & management
CONTACT DETAILS
We have a robust governance and lean management structure whereupon the Board has three sub-committees with delegated
operational duties and responsibilities.
Total Healthcare Executive Officer
East Tamaki Healthcare Executive Trustee
Mark Vella
Ranjna Patel
The day-to-day operations of TH are managed by the Executive Committee.
2/12 Laidlaw Way
11/42 Ormiston Road
East Tamaki
East Tamaki
Auckland 2016
Auckland 2016
PO Box 61047, Otara
Phone: +64 9 274 7823
Auckland 2159
Email: [email protected]
Phone: +64 9 271 5371
Web: Clinical governance is overseen by the Health Outcomes Committee, and matters related to frameworks for internal processes
of audit and financial management are managed by the Audit & Finance Committee.
NAME
POSITION
REPRESENTATIVE
Willie Ropata
Chair, Executive Committee,
Health Outcomes Committee
Maori
OCCUPATION
Teacher
Email: [email protected]
Web: Tupou Manapori
Health Outcomes Committee
Pacific
Teacher
Dr Richard Hulme
Executive Committee, Clinical Director TH,
Chair of Health Outcomes Committee
Medical
General Practitioner
Dr Kanti Patel
Trustee
Medical
General Practitioner
Ranjna Patel
Chair of Executive Committee
Medical
Practice Manager
Navin Patel
Chair of Audit & Finance Committee
Medical
Chartered Accountant
Dr Ellis Situe
Trustee
Medical
General Practitioner,
Consultant
Dr Mahesh Patel
Trustee
Medical
General Practitioner
Kerry Oxenham
Trustee
Other Health
Pharmacist
Karen Sutton
Trustee
Other Health
Physiotherapist
Jordan Situfu Salesa
Trustee
Other Health
Physiotherapist
Len Brown
Patron
Community
Mayor
www.ethc.co.nz
www.totalhealthcare.org.nz
The compositions of the sub-committees are:
20
Executive Committee
Health Outcomes Committee
Audit & Finance Committee
Ranjna Patel, Chair Mark Vella, Chief Executive
Kate Moodabe, GM Auckland & West
William Kato Ropata, Chair of TH Board
Dr Richard Hulme, Chair
Denise Kivell, CMDHB Nurse Representative
William Kato Ropata, Maori Representative
Ranjna Patel
Gillian Davies
Dr Devarajah Mutthuvel
Dr Oruba Khalil
Dr David Chee
Dr John Roke
Navin Patel, Chair
William Kato Ropata
21
FINANCIAL STATEMENTS
(Summary of Financial Statements)
Total Healthcare 2013/2014 Consolidated Account
Summary Statement of Financial Position
2014
2013
INCOME
2014
2013
2,617,301
643,770
Assets:
Funding – Capitation
CURRENT ASSETS
28,092,828
24,782,875
Funding – Management and Administration
1,205,617
1,120,138
Cash and cash equivalents
Funding – Flexible Funding
6,631,554
6,352,213
Term deposits
894,416
1,277,036
Funding – Additional Health Services
3,942,919
2,358,579
Health Service Funds receivable
773,251
1,297,379
330
320
117
6467
39,030
62,590
47,017
200,576
$ 39,912,278
$ 34,676,715
4,332,102
3,425,228
31,319
43,359
$ 4,363,421
$ 3,468,587
79,838
132,809
2,757,371
2,107,310
Total liabilities
$ 2,837,209
$ 2,240,119
Net assets
$ 1,526,212
$ 1,228,468
1,526,212
1,016,882
0
211,586
$ 1,526,212
$ 1,228,468
Dividends received
Interest received
Less EXPENSES
Interest receivable
GST refund
Interest received
NON-CURRENT ASSETS
Capitation
28,092,828
24,771,429
Management and Administration
1,337,328
1,307,022
Flexible Funding
6,037,932
5,692,493
Additional Health Services
3,934,963
2,798,790
THCT Funded
0
33,135
IFHC Expense
211,483
808,558
$ 39,614,534
$ 35,411,427
Property, plant & equipment
Total assets
Less liabilities:
CURRENT LIABILITIES
Trade & Other Payables
Health Services Funds Payable
Net Surplus/(Deficit)
$ 297,744
$ (734,712)
Represented by:
Accumulated Surplus
IFHC Reserve
Total equity & reserves
22
23