Manawhenua Reports

	HAC Committee Report HAC Committee Report 1 HAC Committee Report 2		Past HAC Reports
	CPHAC Committee Report 04/08/09  CPHAC Committee Report		Past CPHAC Reports
	Pou Committee Report		Past Pou Reports
	DISAC Committee Report 1 DISAC Committee Report 2		Past DISAC Reports
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Rereokeroa Shaw

BACKGROUND:
HAC is the Hospital Advisory Committee made up of all Board Members of the CMDHB and is chaired by Paul Cressey.

This committee receives verbal updates from its other Advisory Committees CPHAC, POU, POAC etc.

It also receives a very comprehensive report from the Chief Operating Officer in relation to all the operations of CMDHB regarding Financial Performance, Volume Performance, Forecast vs Actual CMDHB Med/Surg.

This year both Bobby and I have been re-elected to represent MWiTM on this committee. Ahakoa te taumaha, kei kōra māua e whakarongo ana. Ētehi wā ka whakaputa a māua whakaaro e pā ana ki a tātou a ngai Māori.

NARRATIVE:

Tiaho Mai (Acute Mental Health Unit) Visit: Both Bobby and I did not attend this ‘Tiaho Mai Refurbishment Tour’, but the report back from those who managed to find parking at Middlemore Hospital at 8am that morning reported back to the HAC committee. The parking was so bad that the Chairperson of the HAC committee, Paul Cressey, could not find a park, so he did not attend either.

Anne Candy, Ruth DeSouza and Lope Ginnen attended. They reported that the layout of the Tiaho Mai clinic was a lot better but there is still a lack of private space for personal interviews with patients. The staffs were using the room that was allocated for this purpose as an office.

Tiaho Mai will become Smoke Free by the 1 August 2009.

If the model of the new building works, they will transfer the same model to the Manurewa clinic.

Volumes: It is good to hear that CMDHB are well ahead in achieving its operational volumes as allocated by MOH. This means that our people do not have to wait more than 6 months before having their surgeries done. This year CMDHB may treat 1300 more elective patients than would have been expected. The Ministry expects an increase of 4000 people nationally and CMDHB is making a big contribution to the national gain. Kia ora rātou mō tērā.

Swine Flu: It was pleasing to note that Influenza-like illness activity in Auckland has slightly decreases since last month. It was also noted that the screening at the airports have now been discontinued. There has been a focus to work more with the community. People are becoming more educated about Swine Flu. Middlemore are trialling a Portacom outside the Emergency Department for people with Flu-like symptoms only. The difference between ordinary flu and Swine flu is hard to determine. This can only be done by swabbing and having the swab tested. They are now only testing the very bad cases and the practice of swabbing everybody with flu symptoms was too hard to resource. It is expected that once the weather warms up the flu will run itself out.

Breast Screening: It was reported that the mobile unit has increased the percentage for women who have had there breasts screened. The volume of both Maori and Pacific Islanders who have not had their breasts screened is still higher than other ethnic groups, but the mobile did help lower this number slightly. Therefore there is value in having the Mobile Breast Screening Unit and hopefully this service will continue.

Kidz First: The Paediatric Emergency Care of kids for the month of June was up by 299. The increase can sometimes be related as being seasonal. Other factors may pertain to poor housing and overcrowding. The majority of cases pertain to respiratory illnesses.

RECOMMENDATIONS 1. That this Report be received

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Bobby Clarke

HOSPITAL ADVISORY COMMITTEE
MANA WHENUA I TAMAKI MAKAURAU
HAC COMMITTEE REPORT MEETING HELD AT MIDDLEMORE HOSPITAL
STAFF CENTRE, LEVEL 2.
JUNE MEETING.

The day started at 8am, in Staff Centre, Level 2.

This being a training session for those who had time in their busy schedule to attend, also acknowledging those that could not attend.

My colleague Rereokeroa Shaw and husband Urikore went on holiday to Maimi, USA.

One paper that was presented had the Odd Title of:

“Nuts and Bolts Elective Services Management”
“Liken to the Weaving and Threading of the Needle”, binding people together.

Reduced Waiting Times for Public Elective Services.

• Nationally consistent clinical assessment.
• Increase supply of Elective Services.
• Give Patients Certainty.
• Improve capability Public Hospital.
• Better liaison between Primary and Secondary Sectors
• Actively Manage Sector Performance.

Booking System Policy.

• Patients referred and Condition assessed by Clinician.
• Access criteria to Specialist services based on Need.
• Patients have Clarity about whether will or will not receive Treatment.
• Service provided in timely manner.
• Patients not meeting Access Criteria have a Plan of Care and Review.

Reduced Waiting Time for Public Hospital Elective Services.

• Maximum waiting time 6 months, for first Specialist assessment.
• Patients with Level of Need which can be met within the Resources “funding” available are provided Surgery within 6 months of Assessment, “decision to treat”.

Elective Services-3 Key Principles.

• Clarity, where patients know whether or not they will receive Publicly Funded Services.
• Timeliness, where services can be delivered with in the available capacity, patients receive them in a timely manner.
• Fairness, ensuring that the resources available are directed to those most in need.

Elective services / Priority / Managing Patient Flows /  Who Receives Services.
Prioritisation Scoring Systems / Scoring Tool General Surgey / Application of Scoring System Prioritisaton / Elective Services Performance Indicators, ESPI’s.
ESPI Dashboard / Managing Patient Flows / Who Receives Services / Who Receives Service / CMDHB Challenges / :

REFERENCES:

1. www.electiveservices.govt.nz 
2. www.nzhis.govt.nz/stats/surgical/
3. www.cmdhb.org.nz/publications and newsletters

TE POARI HŌHIPERA RATONGA WHAKAMAHEREHERE [HAC BOARD MEMBER] KO IHU RĀ TE ARA, KI TE ORANGA.

Ētehi kōrero he kīnaki tēnei Pūrongo.
Ka mihi anō ki a Rereokeroa mō tōna nohonga ki runga i te
Poari ō HAC.
Kei tēnei Rangatira Wahine ngā pūkenga mō tēnei mahi toimaha,
ana ka mihi, ka mihi.
Te kōrero ia hui, ia hui ō te Heamana me whakatuu mehemea
Mahi Papā “conflict of Interest” e koe.

• Ko heke ngā Taruru Mahi “Acute Care” nā, ko tonoa ki ngā  Whare Tapere.
• Ka tuku kōrero ā te tehi rangatira i te hui ō Hōngonui mō te Oranga Hinengaro, he kaupapa tino nunui kia tatou te Iwi Māori.
• Ko kōrero mō te hokinga mai ki te mahi ō ngā Nēhi tawhito, ki tēra nohonga, tēra nohonga, me ngā Nēhi Kaiwhakawhānau.
• Ko te patai ā POU ki te Poari ō CMDHB mō te Pūtea Penapena “Investments” mō te Hauora ō Māori. Me te patai, he aha te utu ināianei, me whakamōhio mai kia tatou he aha I roto te Tahua “Budget”, mō Māori.
• Oranga Hinengaro, ko piki haere te Hauora Tirotiro, [Growth of Relapse Prevention Plans] kia Māori te toimahatanga ki te Mate Hinengaro.
• Rongoa, ko piki haere te Umanga Whakaora “Time to be seen by Triage Category” e ko, me haere tōtika, piki atu tēnei mahinga.
• He huarahi anō kia tere te whakatu ia rima meneti ka timata ki te whakahou ngā kōrero ki ngā Nehi, “Cap plan live dashboard”.
• I te whitu karaka ia rangi ka taea ngā rangatira ki te whakatu ngā mahi mo te Rua Tekau Mā Whā Hāora, “24 hour Projection Recalculation”.
• Te Haumana whakatuku [Clinical Supplies] ko tinitini haere ngā rawa nā te whiwhi oranga kia whaka pai ngā Hope, ngā Turi, te Hekenga Wāru “Depreciation” me ētehi mahi nunui atu.
• Kāore noho pai ngā Rata, ngā SMO, I runga te puku-riri ō te RMO, Mahi Kore “Strike”. A te wā ka kitea ngā hua i taka mai.

NOHO ORA MAI KOUTOU IROTO Ō KAINGA.
NGĀ MAĀNAKITANGA Ō TE RUNGA-RAWA.

Naa matua Bob Clark

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Rereokeroa Shaw

Tēnā tātou katoa

I intended to leave Te Pūaha at 6.30am to allow sufficient time to crawl the 68kms through the motorway traffic and arrive at the meeting room of the Staff Centre at Middlemore Hospital in time for the 8am WIES training.  With my large mug of coffee I sat down to enjoy my ‘fix’, knowing that I had 30minutes for this morning ritual.  But I did the unthinkable and turned on Sky and proceeded to watch ‘Judge Judy’.  She kept me entertained and reminded me of my ‘nannies’.  She made decisions based on fact and the evidence in front of her and her ability to know when someone was trying to pull the wool over her eyes. 

I was so engrossed in the programme, I lost track of time.  6.50am...damn...I am going to be late!  I started going through my daily ritual...I felt my head to see if my glasses were on my head (check), slapped my hip to see if my office keys and phone were there (check), checked my bag to see if my car keys were still hanging off the loop. 1...2...3...4...all there... I am out of here!  Then hubby reminds me that we were carpooling and I had to drop him off to work in Pukekohe.  Oh heck!  Keeping calm but focused I made my way to Pukekohe to drop hubby off, but of course we had to stop to get hubby his morning herald and something for breakfast (diabetic must eat) another 15 minutes passes.

I was doing okay until I got on the motorway and hit the traffic.  I could feel my ‘road rage’ indicator changing from green to orange.  I am a very careful driver and always leave enough space between me and the car I am following to allow for unexpected sudden stops.  But idiots keep cutting in and filling the gaps that I leave.  Of course, being the conscientious driver I apply a little brake and again allow a safe gap between me and the idiot...and again it happens...and again it happens.  Orange is now starting to glow.  I could hear myself thinking...  “Get a move on!”  “Are you all out on a Sunday drive!”  “80km does not mean you have to do 80km, surely you can go a little faster!”   “Can’t you see that I have to be at a HAC Training by 8am?”

I had to remind myself... “Stay cool and calm!  You may arrive a little late for the training, but at least you will be really early for the HAC hui’. The moral of this story is; it is better to arrive late than ‘dead’ on time.  Always keep your eye on the clock, don’t watch ‘Judge Judy’ and leave at your prearranged time...on time.  And guess what, your ‘road rage’ indicator will remain green and the funny thing is, there really are no idiots on the road, with one exception.

WIES Presentation
WIES?  Here we go again, another acronym.   Will I be WIESing my time or should I attend the training and become more informed.  Deciding on the latter, I finally arrived just a little late.  In attendance was my fellow Mana Whenua colleague Bobby Clark, Anne Candy, the HAC Chair Paul Cressey, Gregor Coster and Arthur Anae. 

The presentation was delivered by Alan Wilson, General Manager of Surgery and Ambulatory Care.

What is WIES?
Weighted Inpatient Equivalent Separation (WIES) is the unit used to measure “Casemix” (“caseweighted”) services.  It is the Relative Value Unit for inpatient and day-patient activity.  It is the measure of average resource use required for treating discrete group of patients.  The price per caseweight for 2008/9 is $3,940 and is adjusted annually.

Activities and Caseweight Values

This information was very informative as it gave me a better understanding on the cost of each activity and how they are WIES weighted.  i.e. the cost for a hip replacement would be close to $15k and to remove someone’s tonsils would cost $2k.  Excellent training, I  am a lot WIESer now!

HAC Meeting
It was the usual ‘over-my-head’ stuff, but I must admit I am getting a lot more familiar with the kōrero around the table.  I have now realised that receiving my Meeting Package at the meeting does not allow me to be proactive in the discussion.  I have now arranged for my package to be couriered to me prior to the hui. This will give me time to read the package and to get familiar with all the kaupapa.  Thanks to one of the Board Members who continually asks questions throughout the whole meeting.  The answers to his questions gave me a better understanding of each kaupapa.  Kia ora e hoa!

Lunching with the Paul Cressey (Chair)

After the Hac hui Bobby and I had lunch with the HAC Chairperson, Paul Cressey.  He wanted to reassure us to actively participate in the HAC hui and to call him if we had any questions or wanted anything to be brought up in the HAC hui.  We went over the ‘conflict of interest’, how it is best to over declare your conflicts of interest rather than under declare it.  Thanks Paul for that.

Kāti rā mo tēneki wā.  Mā te Atua o te runga rawa tātou katoa i manaaki i ngā wā katoa.

Rire, rire, hau!  Pai Marire

Rereokeroa Shaw

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Counties Manukau District Health Board
Hospital Advisory Committee, 25th March, 2008.

• Chief Operating Report.
  
  • Emergency Department.
  
  
  • A final model of care is now circulating through Clinical staff.
    
    
  • Patient Safety Programme. Finalising plans for the roll-out of the pilot Pyxis machine.
    
  • Release Time to Care. Already six wards are participating in this project, phase 1.
    
    
  • Surgery. Elective volumes were 14%behind contract “904 Wies”, as at January “489 Wies behind.
    
    
  • Medicine. A publicity campaign to target patients that go to Emergency Care, using the radio station rather than newspaper to encourage people to go to their GP not E/Care. The need is to target Mâori and Pacific Radio.

• Capacity Utilisation Plan. The demand on beds over the winter months has contingencie plans.
  
  
• Payroll. The service has improved?
  
  
• Women Health. On going recruitment and appointment of new Midwifery? And preparation of high level proposal for maternity work force strategies.
  
  
• Noted / Action. The emphasis and highlight on the work force shortage, and in two months time what is the actual plan and to see practical solutions.
  
  
• Mental Health Respite Care. Discussion on Respite Care, relieving the Care Giver.
  
  
• ARHOP. Needs Assessment and Service Co-ordination, improvement NASC, wait list with a reduction from over 400 to 73.
  
  
• General Comments. The chairman has advised that time will be set a side for training.
  
  
• Positive work in the EG. Progress in Triage 3, 4, 5.
  
  
• Sentinel and Serious Events Reports by DHB’s. The aim is to have all DHB’s record and investigate Preventable Adverse Events. The ADHB and CMDHB, Waitemata, are setting up a Northern Region Collaborate Group to share some of the work.
  
  
• Nursing and Allied Health Workforce. Prevention-Assessment / Evaluation-Identification

Diagnosis-Treatment / Rehabilitation-Advocacy-Promotion of Health and wellbeing-Education and research.

• AHW/F-AH, Planning to develop Best Practice and innovative models of care, respond to new initiatives including Community and Primary Care.
  
  
• Skill Mix. Challenges to the model of Care-Second Tier Practitioners, use of Support Workers and Advance Practice Roles.
  
  
• NZ Allied Health Professions.

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BACKGROUND:
CPHAC stands for Community Public Health Advisory Committee

Committee is made up from elected Board members, community, public health and 2 from Mana Whenua.

All Advisory Committees advise the Board through resolutions on matters they want done. The Chair and CEO often sits on this committee as does the director Planning & Funding as well as the General Manager Maori, he also sits on POU.

Te Kupenga has a delivery health service, their distribution is through patients by quintile Te Kupenga O Hoturoa. Gender & Age, An analysis of TKOH Enrolled Population, Support Services for Providers & their patients, Pu Ora Matatini – Maori Nursing Workforce Initiative with an aim to recruit & train Maori Nurses for the CM rohe by 2014, Achievements were noted, PHO Performance Indicators through cervical & breast screening indicators.

The challengenes facing TKOH DHB Funding cuts for fit For Purpose, need ongoing funding for Pu Ora Matatini, Ensuring a focus at a National and DHB level on addressing Health Inequalities for Maori.

CONCLUSION:

CPHAC to make recommendations to Board.

RECOMMENDATIONS

1.   That the information be received
2.    Basically all areas throughout the DHB has been cut and still being cut. Any suggestions to assist should be explored

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Nganeko Minhinnick

MANA WHENUA I TAMAKI MAKAURAU
Purongo mo te roopu  POU I tu ki te Poari Hauroa I Manukau I te
18 Pipiri 2008

Tena Koutou

I muri I te karakia I mihia nga mate ara kia Pat Te Paa, te whaea o Bernard Te Paa te Tumuaki o te Tari Maori o te Poari Hauora.  I tukuna nga mihi mo Fred Kaa e takoto mai ra I te marae o Manurewa. He mema ia I mua no te Poari o Tainui. I tukuna nga mihi ki nga mate maha huri noa te motu.  No reira nga mate, haere, haere, haere.

Hei Whakatupato

Ia marama ka ata titiro nga mema ki te ture e pa ana ki ia mema kei tupono raru i runga i nga whiwhinga. Ko tenei mahi hei tiaki I nga mema me te Poari hoki kia kaua e porarutia. Ko tona tikanga me whakaatu a ia mema I ona mahi kia pai ai te noho I runga I tenei komiti.

HPV Vaccination

E kimi tonu ana nga kupu o te rohe mo tenei take/
Na runga I te awangawanga o Takuta Colin Mantell I korerotia ano tenei take, ko tana tino pouri kaore I korerotia te raru ka pa ki nga tan,e e hake te mea he mate mo nga wahine anake. No reira ka whai te komiti o POU kia tonoa te kai panui o tenei take kia hoki mai ano kite whakamarama heaha I whakarerea ai nga tane ki waho, I te mea e pa ana tenei mate ki nga tane me nga wahine.

Haere Whakamua

I tae mai to roopu Maori o te Poari ki te whakatakoto I ou ratou whakaaro mo tenei kaupapa. I tukuna mai a ratou whakaaro, a ratou hiahia, a ratou tumanako a ratou patai.
I whakae katoa nga mema o POU he tino pakari  te roopu Maori, he maia a ratou whakaturanga.
Kaore ano kia whakaritea he ra hei whakahaere i I tenei hui.
I mihi nga mema ki te marama o te whakatakoto I ta ratou take.  

Xenotransplantation/Organ Doning

E kimi tonu ana I nga kupu o te rohe hei whakahua I enei take.
Kaore ano kia whakaritea he ra hei korero I enei take. He take tino nui. He wahanga korero tenei mo te katoa, I te take tuatahi ka whiriwhiri mo te whakauru whekau mai I te kararehe ki te tangata, mo ko te take tuarua ko te whiriwhiri mo te whoatu koha o te whekau mai I te tangata ki tetehi tangata.

1. Etehi Take I Puta

a)   I whakae te Komiti o POU ki te tuku e rua mema ki te hui o Tainui Taonga Tuku Iho Survival 2050. I tatu ko Donna Richards raua ko Martin Cooper 1-3 Hereturikookaa 08

e)   E kimi ana a Tania Kingi etehi putea hei awhina I Te Roopu Waiora kia haere ki Poneke ki te whakataetae e whakahaerengia ana I Tari Hauora 12 Mahuru. He nui te utu mo te kawe I te roopu  ki Poneke.

i)   Kua uru a Te Roopu Waiora ki tetehi kawenata I waenganui ia ratou me Te Kohanga
Reo o Aotearoa.

o)   E hiahia ana Te Roopu Waiora ki te whakatu I tetehi marae mo te katoa engari kia rite mo nga kaiako tauira haua, me etehi atu ahuatanga mo te iwi haua kia pai ai to ratou haere, mahi, noho, takaro era ahua mea katoa.

u)   E haere ana a Martin Cooper ki tetehi hui mo nga TANE e mate ana I te Mate Huka. E tu ana te hui I te Tari Hauora ko Richard Cooper te kaiwhakahaere, katahi ano ia ka hoki mai ia Kanata mo nga mahi hauora. Te kaha o te pai ko tonoa kia hoki atu ano ia.

 I ki a Martin mehemea e hiahia ana nga tane ki te haere ki te hui o nga tane tono atu ki te Poari mo nga ra

Na Martin te karakia whakamutunga

Ka mutu I konei nga korero mo tenei wa

Whaea Nganeko

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Joanne Katipa

Disability Advisory Committee Report
To Manawhenua i Tamaki Makaurau

On the 12th of May Te Aomarama and I attended our first DiSAC Committee meeting.
We were greeted warmly by all members and it was obvious to us both that strong Maori representation was present. In saying this, there were four Māori women appointed to the Board that day; and in essence a positive step for Māori.

However, there was a lack of Pacific representation. It was stated in the meeting that the need for Pacific participation was encouraged, and that their input was gravely needed to assist the growing Pacific populace.

CMDHB – Child Disability Allowance:
Statistics showed that only a small percentage of Disabled children in the CMDHB had applied for the Child Disability Allowance, when in fact more children aged from 0 - 14 years were eligible.

Work and Income (Winz):
Work and Income are there to provide a service to the community; for example if you have a change in circumstances Winz will be able to make the necessary adjustments to your entitlements based on your current situation. However, these changes will only take effect from the date that you apply.

• Your GP is your first point of call, a Paediatrician can also sign.

  Modern Technology:
For the DiSAC Committee it was mentioned that email is the most preferred method of communication because it is fast, effective and instantaneous.  Internet access to the CMDHB Website is also helpful for those who are searching for health products and services offered by CMDHB.

 Conflicts of Interests, Codes of Conduct:
It was important for all members that they are aware of the rules and regulations of the CMDHB, and that we understand that as a Committee Board member we must declare all conflicts of interests, and if in doubt declare it anyway.

An overview of the meeting seemed to focus on Awareness. This will be a topic of discussion that will continue to be addressed in all Forums throughout the Health sector.

Ka kite ano
Joanna Katipa

Te Aomarama Wilson

Disability Advisory Committee Report
To Manawhenua i Tamaki Makaurau

From the meeting Monday 12 May 2008
Manukau Boardroom,
19 Lambie Drive,
Manukau City

Te Aomarama Wilson

The meeting was very productive.

Following on from the report presented by Joanna Katipa information shared and discussions that took place was useful and very valuable to improve the health status and wellbeing of all cultures with particular emphasis on Maori and Pacific in communities with high needs.

The Vision for greater outcomes is to work in partnership to address those needs.

I in particular took an interest in the discussion around WORK and INCOME and CHILD DISABILITY ALLOWANCE and their entitlement.

Access:

The need to engage with other services is very important. This supports the disabled to link with other services.

Advocacy support to meet individual needs.

DISABILITY WEBSITE an advantage for information hot off the press an exciting tool for the disabled. Kia kaha koutou.

Non-Profits welcome GOVERNMENT'S CARER'S STRATEGY.
Media release 29 April 2008 John Formans launch (Alliance Chair)

Hon. Ruth Dyson

The Carers Strategy was launched by the Hon Ruth Dyson on behalf of the Government at Parliament on the 28 April 2008.

John Forman, chair of the Alliance, says we can all expect to receive or provide family support during our lives.

Caring is a fact of life for every New Zealander, but often we are ill equipped to provide this support for loved ones.

Carers need quality, consistent learning so they can care safely.

The need to be recognised by society for their valuable economic role as the country's biggest workforce, and they need supports just for them because caring can be a demanding role.

WATCH FOR NEXT MONTHS report of John Forman's launch will continue.

Nga mihinui

Ki a koutou katoa.

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