Long-term look at East Coast health services

A review into how health services are provided on the East Coast is continuing.

Te Runanganui o Ngati Porou, Ngati Porou Hauora and Tairawhiti District Health are working together to improve the health of people on the coast and their access to services.

“We know there are opportunities to deliver better health outcomes on the East Coast to work more efficiently,” says Tairawhiti District Health Chief Executive Jim Green.

“We are now at the next stage of the review into East Coast health services. We have considered initial feedback but now need more information. It is important people understand that no decisions have been made. The conversation is ongoing and all three organisations are listening. There will be opportunities for East Coast people to have a look at proposals and provide feedback in August before the proposals go to the three boards for consideration, and then again in October once the three boards have considered the second and final report that is being prepared now.

Feedback from the community in 2013 highlighted that people want to keep community health clinics on the Coast. They are working well. The next stage is to look at the best model for East Coast health services using the existing community clinics.

The need for a central, fit-for-purpose base to support the clinics was also highlighted in the community feedback. This is most likely to be at Te Puia Springs but a feasibility study is required. The study will focus on maternity care, aged care and long term beds. It will also consider seismic issues at Te Puia. A unique aspect of the review is the expert advisory group, including three rural based doctors, who will provide an independent, external view on options presented.

“We need to be thinking about the future and how we can create a fit-for-purpose community health hub that meets the needs of unique East Coast communities.” says Ngati Porou Hauora Chief Executive Rose Kahaki.

While the three boards have agreed that no decisions are being made at this stage in regards to the main centre of health services on the Coast, or about what sort of facility is there, they are committed to obtaining more in-depth information so these decisions can be made this year.

 The project plan from consultants Saphere Research Group.

What has been happening?

The 2013 initial Review, carried out by Sapere consultants for the three partner Board – Te Runanganui o Ngati Porou Ngati Porou Hauora and Tairawhiti District Health, provided a useful overall picture of health needs and current health services on the Coast, however the three Boards agreed there was further and more detailed information required before final decisions could be made.

The Boards decided the best way to do this would be to tender for a second Review that specifically focussed on:

1. Identifying a model of health care and service delivery on the East Coast, using the existing community health clinics, that would best meet the needs of the communities
2. Completing a feasibility study of the base facility that will work as the central point for the outlying health clinics. (Te Puia is being recognised as the probable central point as was made clear in the community consultation feedback)

The three Boards agreed to go out to tender in late December. It is important to remember that this second tender is a continuation of the journey that the three Boards and the communities of the East Coast together commenced with the 2013 Sapere review.

What happened with the tendering process?

A Review Oversight Group was set up – the people on this were:

•  TRONPnui: Teepa Wawatai (Chief Executive), Allen Jensen (CFO).
•  NPH: Rose Kahaki (Chief Executive), Georgina Paerata (Primary Care Manager), Dr Helen Gardyne (GP).
•  TDH: Jim Green Chief Executive), Johan Peters (Clinical Director Surgical Services), Virginia Brind (GM Planning, Funding &Population Health).
•  Community representatives: Amos Forrester, Pierre Henare, Huti Puketapu Watson, and Donna Atkins

Five proposals were received, two of these proposers were asked to meet with the Oversight Group to further discuss their proposals. Sapere Consultants were selected as the successful provider.

Why was Sapere selected?

•  Innovative approach - proposed an Expert Advisory Group to develop service model design
•  Proposed service model evaluation framework incorporates East Coast uniqueness, Ngati Poroutanga
•  Ngati Porou will govern, own, take responsibility, and be held accountable for, the delivery of the health services on the East Coast, including provision of primary care services in Puhi Kaiti.
•  Sapere’s proposed project management role – to ensure Review progresses and finishes
•  Emphasis on empowering communities

What will the Expert Advisory Group do?

The focus of the Expert Advisory group will be identifying a model of health care and service delivery on the East Coast, using the existing community health clinics that would best meet the needs of the communities

Who is the Expert Advisory Group?

A group of 3 rurally based GPs (Northland, Opotiki and north of Auckland) and a fourth person whose strength is service and organisational level strategic planning, facilitation and managing strong inclusive stakeholder processes.

• They can provide an independent, external view on options
• Help NPH reach consensus when there are very disparate views on pros and cons of options
• Will have ideas and good practice
• All regarded as successful
• Help validate preferred service model option

They have voiced a long term (3-5 years) commitment to making this work… however all 4 agreed that

•  Their expertise is specific and relates to their professional lives
•  They do not have expertise in Maori tikanga or Ngati Poroutanga, and they are not Maori
•  They believe that unique expertise is here, within TRONPnui, within NPH, within the people and communities of the East Coast
•  They have committed to recognising and working with TRONPnui, with NPH, with the people and communities of the East Coast

What about the other piece of work - feasibility study of the base facility that will work as the central point for the outlying health clinics?

Sapere have partnered with KGA Geotechnical Ltd to undertake this piece of work.

Who is KGA Geotechnical Ltd?

They have extensive experience with the type of work required for this project. They have carried out several projects around Taupo which has a similar environment to that in Te Puia (in terms of geo thermal activity). They have a staff member in Tolaga Bay who is very familiar with Te Puia and the issues we would need to take into consideration regarding facility options. Sapere has worked with them before and have forged a strong and successful working relationship.

So what is the next step?

1. The Expert Advisory Group will be in Tairawhiti on 8 and 9 August as they believe in meeting the community as their first priority - there will be further communications in the next 2-3 weeks about where and when. Meeting management from the three Boards, and senior clinicians from NPH and TDH is their second priority.

2. KGA Geotechnical Ltd. In July (date to be confirmed) the geotechnical engineer, architect and Quantity Surveyor will make a site visit to Te Puia to assess building, site and interview relevant people, and gather relevant information

Will the communities on the Coast be involved and how?

Yes- the communities are crucial to the final outcomes and will definitely be involved. The first involvement will be meeting the Expert Advisory Group in early August- 8 and 9 August. There will also be community hui in regard to the draft report, and again after the three Boards have considered the final report

Is there any other information I can get as background?

 Yes - copies of the Ngati Porou Hauora (NPH) Health Services on the East Coast: Service model and base facility feasibility review, and  Sapere’s project scope

When will reports be completed?

•  A draft report to be reviewed by the Oversight group by the end of September.
•  A final report to be considered by the three Boards by the end of October
•  Only after this point will the three Boards consider their response and then take that out to community consultation.

 For more information please contact:

Ngati Porou Hauora, Rose Kahaki, phone: 06 864-6803email: rose.kahaki@nph.org.nz 

 Te Runanganui o Ngati Porou, Teepa Wawatai, Phone: 06 869-7600email: twawatai@tronp.org.nz 

 Tairawhiti District Health, Virginia Brind, 06 8692095 extension 8551 email: Virginia.brind@tdh.org.nz 

 Please direct media enquiries in the first instance to:

Toni Lexmond • Communications Manager • 06 869 0500 ext 8115 • 021 223 7094 • toni.lexmond@tdh.org.nz