Health NZ Te Whatu Ora unveils winter preparedness plan

Expanding telehealth services and free pharmacy consultations are among 24 initiatives the government hopes will reduce pressure on the health system this winter.

It comes after steadily declining performance for shorter hospital stays, with Accident and Emergency wait times last winter being the worst on record. Other countries have been reporting similar declines.

The initiatives are wide-ranging but broadly aim to redirect unnecessary demand on hospitals to care in the community.

The plan involves rolling out local innovations more widely, with the government emphasising the health reforms as a way of scaling these up across the country. Verrall says a major feature of the reforms is the ability to bring care closer to home, making healthcare more convenient for patients.

All but one of the 24 initiatives have already been tested locally, and will continue to be delivered locally but will be expanded to other areas - in some cases nationally.

• 1. Using telehealth to support primary care

This includes expanding phone-based consults and health advice with more funding, and boosting information sharing between telehealth services and primary care in places that have fallen behind others

• 2. Clinical telehealth support for amublance and paramedics

Giving paramedics access to GP or specialist medical advice can mean better care for patients in ambulances, sometimes preventing the need to visit emergency departments (ED)

• 3. Remote patient monitoring prototype

Currently trialled in Te Tai Tokerau, Tai Rāwhiti and the Chatham Islands, this has been focused on increasing culturally appropriate care and monitoring in people's homes and convenient places, helping prevent the need to visit ED

• 4. Pharmacies to treat minor ailments

Pharmacies will be able to offer free consultations and treatment without the need for prescriptions or visits to a GP or ED, specifically for Māori, Pacific, under 14s and their whānau, and community service card holders. It includes, for instance, much easier access to paracetamol, or treatments for diarrhoea or scabies

• 5. Community radiology services

This means people can be referred by GPs directly to public or private x-ray and other imaging services without having to coordinate with hospitals

• 6. Comprehensive primary care teams

Increased funding allowing, for example, teams of GPs and specialists like physiotherapists and pharmacists to carry out multiple consultations with a patient in a single visit

• 7. Primary options for acute care

Increased access to services like intravenously delivered antibiotics in the home, allowing people to leave hospital earlier or preventing the need to enter it in the first place

• 8. More accessible after hours and medical care

Targeted particularly at priority populations, this is aimed at reducing congestion at EDs

• 9. Initiatives to support aged residential care

Boosting on-site and virtual medical and nursing support for aged residential care providers

• 10. Needs assessments occur appropriately and do not delay patients

Increased at-home or near-to-home assessment of needs, to reduce time in hospital. Previously some wait times have been three to five days in a ward

• 11. Community allied health and rapid response services

Increased access to allied health (specialist) and rapid response (coordination of ambulance, specialists, mental health and primary care responses to 111 calls) services, to reduce reliance on hospital

• 12. Hospital in the home

Increased use of in-home consultations and visits combined with virtual monitoring - using devices like the blood oxygen monitors for assessing Covid-19 - to reduce infection risks and other complications associated with long hospital stays

• 13. Rapid national data automation project

Provides regional and national health leaders real-time and daily access to hospital capacity data on their phones for easier and more responsive coordination and pressure management

• 14. Regional and national escalation pathways

Improve diverting patients and resources within and between regions to reduce local pressures

• 15. Mental health support to EDs

Increased ability for people with mental health concerns to be diverted to a mental health service rather than ED

• 16. Maintaining planned care capacity

Focusing the system on ensuring planned care is deferred as rarely as possible, including avoiding short-notice cancellations, so wait times for treatment are reduced

• 17. Bivalent Covid-19 boosters

Continuing the campaign of offering booster vaccinations that target Omicron, reducing the risk people who get the virus become unwell, and reducing the spread to at-risk populations

• 18. Influenza vaccination campaign

Encouraging vaccinations for flu - especially in Māori, Pacific, disabled and older people - to curb spread and severity, and the need to be admitted to hospital

• 19. Promote all childhood immunisations at convenient locations

Making vaccines for children more available at the same time, in convenient places

• 20. International nurse and other health professional recruitment

Aimed at shoring up health workforces

• 21. Earn and learn programmes for health care assistants

Expanding on-the-job training in Auckland, Middlemore and Christchurch to curb pressures on nurses, and boosting workforce diversity

• 22. Health staff influenza vaccinations

Encouraging the uptake of flu vaccines by health workers to reduce the impact of staff illness

• 23. Right Care Right Time communications campaign

This national drive is already under way, aiming to ensure people know how to access the variety of healthcare options - including virtually, over the phone, or in pharmacies - so they don't need to access a GP or hospital

• 24. Covid-19 specific surveillance, response and services

Monitoring Covid-19 spread, with surge and response plans, to reduce the effect on the health system

About $183m is being funded through the Covid-19 Contingency Fund, with the rest of the cost absorbed by Te Whatu Ora baselines.

Verrall said the plan meant resources would be more freely shared within regions, and encourage providers working together.

"This winter, a reformed health system is allowing us to identify successful local programmes and scale them across the country, tailoring any health care approach to meet unique needs," she said.

"These initiatives being driven by Te Whatu Ora reinforce care at the right time, at the right place. They will deliver health services to people closer to where they live, ultimately alleviating additional pressure on our hospitals."

She said people should also take practical steps to help like ensuring vaccinations were up to date.