Conference presentations

Presentations from the NZHHA Conference 2011 are now available below.

More will be added as they become available.

Thursday 4 August

Opening Address
Hon Tony Ryall, Minister of Health, opened the conference. He acknowledged the work of home care workers and organisations in their outstanding efforts and perseverance during and after the Christchurch earthquakes. He talked about the global and national financial situation, how the Government is looking to protect and grow the public health service, putting more emphasis on efficiency and productivity. He talked about managing future demand through integration and moving services closer to home. He acknowledged the Association’s publication Making the Most of Home Support Services, and talked about some of the issues raised in that report which are also being addressed by the Government, particularly in areas of quality assurance, minimum training, standardising contract documentation and reducing audit duplication.

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Keynote 1 – Performance audit of MoH and DHBs in relation to older people
Phillippa Smith, Deputy Auditor-General – 9.20am
By 2031 one in five New Zealanders will be over 65, and the population aged over 85 is likely to have doubled to about 144,000. As well, the range and complexity of older people's needs is increasing. The Auditor-General has carried out a performance audit into how well the Ministry of Health and DHBs are ensuring that older people get the care and support they need to remain living independently at home.

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Keynote 2 – Homecare re-ablement: the development and effectiveness of services in England
Gerald Pilkington – 10.30am
In this presentation, Gerald Pilkington will outline the progress and evidence base behind the implementation of homecare re-ablement services across England. Drawing from his work with services over five years, he will set out the benefits, both quantitative and qualitative, the lessons learnt and future opportunities. The findings show that services can appropriately reduce the demand for homecare packages by up to 60% in the first year and that, for many people, the benefits can last for at least two years. In addition, by mainstreaming the service, it can become the default pathway for the majority of referrals that have historically been provided with maintenance homecare services for many years.

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Keynote 3 – Person-centred care, outcomes-based services and complaints handling
Tania Thomas, Deputy Health and Disability Commissioner – Disability – 11.15am
Consumer-centred care: easier to say than done. Find out what it takes to be consumer-centred. Know what the barriers to consumer-centred care are and work to get rid of them. See complaints for the treasure they are and get better at handling them.

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Keynote 4 – Results-based accountability
Rod Watts, Presbyterian Support Northern – 12.00pm
Increasingly, government, as part of the reprioritisation process to ensure available funds are best utilised, is requiring demonstration that funded services are of benefit. To demonstrate benefit, the Ministry of Social Development is beginning to use results-based accountability (RBA) as the mechanism for contracted providers to report on both service quality and outcomes achieved. Presbyterian Support Northern has, over the past four years, developed and has been using a RBA mechanism for measuring quality and outcomes, which includes two years of collecting evaluative information for its Enliven Services for older people living in the community. This presentation will outline the RBA framework, the importance of this being integrated into an organisation’s performance framework, and provide examples of its value in demonstrating quality of services, and their benefit for home support, particularly from a client perspective.

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Keynote 5 – Diversity
Phillip Patston, Diversity New Zealand – 1.30pm
Understanding of diversity is changing – and indeed it must change for society to evolve and develop wiser ways of interacting. Dysfunctionphobia pervades the world and change needs to be led by the disability sector. A deepened understanding of functional diversity is a social imperative. A vision of a collective ideology that continually delights in the next unique characteristic that humanity exhibits is needed, to allow us all to embrace our vulnerability, increase our connection with each other and realise our fundamental purpose for being.

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Concurrent 1 – Services and funding, new ways for supporting disabled people
Jenny Moor – 2.15pm
Jenny Moor from the Ministry of Health, and Bronwen Foxx as a member of the National Reference Group for the work, will give an overview of the Ministry’s new model for supporting disabled people, and bring you up to date with its demonstration in the Western Bay of Plenty. This includes leading a programme of work internally, with four work streams which mirror the four components of he new model.

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Concurrent 1 – Quality improvement and control, home is where the heart is... nursing in the home support sector
Bridget Smith, Access Home Health and Sara Shaughnessy, Healthcare of NZ – 2.15pm
It is recognised that models of home and community care will require delivery by qualified support workers and registered nurses. They will need increased quality standards, greater clinical and operational governance, assessment models and frameworks and the development of training and support worker competencies. We explore the shift to community care, and examine the resources for service delivery and challenges for the workforce.

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Keynote 6 – Key trends and new models of care
Chai Chuah, National Director, National Health Board – 3.30pm
Key Trends and New Models of Care. What are the key trends, why do we need to follow them and how do we go about implementing new models of care and key trends? There is also the need to look at who is involved in implementing these trends and the importance of getting buy-in for the change management process.

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Friday 5 August

Concurrent 2 – Supporting communities: supported living, is this one of the answers to aged residential care demand?
Nicola Turner,Presbyterian Support Central – 1.30pm
Separating the cost of care and accommodation has been discussed for some time as one possible answer to the spiralling financial demands of aged residential care. This may be an answer for a specific group of older adults, especially in rural areas, who are unable to access the community supports available to their city peers, or for those who are unable to afford or cope with retirement village offerings. Ngahuru House is a supported living establishment for up to nine older adults in Hawera, South Taranaki, run by Enliven, Presbyterian Support Central. The experience of the past three years will be discussed, and the costs and benefits for client, funders and provider examined.

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Keynote 7 – Releasing commercial potential through training
Ray Lind, CEO Careerforce – 8.50am
Realising the potential of the care and support workforce is crucial if New Zealand is to have an efficient, innovative and sustainable health system. This presentation focuses on ways to increase the capability and productivity of the 'unregulated' workforce, and assess the impact this could have throughout the health system.

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Keynote 8 – Securing the future: working together to deliver sustainable services
Liz Cairns, Manager, Serious Injury Service, ACC – 9.15am
Securing the future: working together’. Liz Cairns will discuss the respective roles of ACC and rehabilitation community in security a sustainable future for seriously injured clients.

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Panel 1 – Canterbury service design – CREST
Nancy Stewart (CDHB), Pauline Edmunds (Access Home Health), Dr Matthew Parsons (University of Auckland) – 9.40am
Canterbury Service design – CREST supported early discharge, and home support programme – leading edge service design. This presentation highlights the joys of – and learnings from – pilots of restorative home support and district nursing in Canterbury DHB in conjunction with the development of our response to 'Better, sooner, more convenient' primary care and shows how these developments paved the way for rapid implementation of our supported discharged service – CREST – in three weeks.

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Plenary session – Managing services in a crisis

Keynote 9 – Managing services in a crisis, part 1: Preparing for a future emergency – 11.00am (large file: 5.63Mb)
Dr Philip Schroeder, Primary Care Coordinator, Canterbury Primary Response Group
On both September 4 2010 and then again on February 22 2011 and 13 June 2011, Canterbury was thrown into sudden crisis when high magnitude earthquakes shook our province. Although there was previous emergency management in the primary sector when we launched plans to deal with the 2009 influenza pandemic, we were only partially equipped to deal with these sudden catastrophes. The Canterbury Primary Response Group’s lesson capture has led to a comprehensive set of plans which would be implemented in the3 event of a future emergency and would help coordinate a whole-of-health response, should it be required.

Panel 2 –Managing services in a crisis, part 2: Disaster response, Christchurch home support providers – 11.30am
Mavis Shirtcliffe, Florence Nightingale Agency; Esther Perriam, Eldernet, Anne Schumacher, Healthcare of NZ, Wellington; Fran Cook, Nurse Maude, Christchurch
Experience and responses to the Christchurch earthquakes

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Concurrent 2 – Services and funding: models, mixes and navigators (large file: 3.14Mb)
Prof Matthew Parsons, The University of Auckland – 1.30pm
Casemix funding, supported discharge and clinical pathways. This session will look at a number of developments around community services over the preceding years.

1. Identifying an appropriate funding model is only part of the story. More exciting is organising the most appropriate response according to the needs of the client group.
2. We are hearing about CREST, but it started with START in Waikato.

START is a rapid response/supported discharge team operating across the Waikato which will go through a randomised controlled trial evaluation later this year.

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Concurrent 2 – Quality improvement and control: developing new roles; a Leap of Faith
Sylvia Meijer and Katie Bolton, Central PHO – 1.30pm
Older people’s health is often more complex. With increasingly less resources to manage, different ways of healthcare delivery are explored nation-wide. Nurse practitioners (NPs) participate in a health of older people team in the MidCentral region, providing care across services, working collaboratively and autonomously to provide clinical expertise, leadership and education. Nurse practitioners are well placed to address health issues in a variety of settings, linking healthcare and social services to benefit the client in a client-centred model of care. This presentation demonstrates that NPs can reduce fragmentation and identify health issues to enable proactive care. This reduces client stress and enables clients to maintain a manageable health status for longer, delaying need for facility-based care. Nurse practitioners work with communities, NGOs and DHB services, providing a client supportive and cost-effective service.

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Concurrent 3 – Services and funding: Auckland District Health Board service model – enhanced home-based support services
Lisa Gestro, Auckland DHB; Andrea McLeod, Lifewise; Carmel Conaghan, Royal District Nursing Service – 2.30pm
In 2009, ADHB began implementing in partnership with Home based support providers an enhanced model of service delivery for older adults, reflecting the DHB’s Healthy Aging 2020 Strategy. Its aims included streamlining access for service users, using a strengths-based delivery model that promotes independence, increased flexibility for clients, and the use of assessment tools. The needs assessment function for non-complex clients moved to the home-based support providers and for complex clients to gerontology nurses within the provider arm of the DHB. Two years on, case mix-based Packages of Care Funding is being implemented. This presentation will provide an overview of the development and aims of the model from the providers ‘perspective and the implementation of the model from the perspective of an existing provider and a new provider. We will also share some case studies that reflect the model at work.

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Concurrent 3 – Supporting communities: Te Whiringa Ora – establishing a kaitautoko-led, technology-enabled chronic care management service to support people with long-term conditions at home
Anton Ventner/Erica Amon, Healthcare of NZ – 2.15pm
Te Whiringa Ora is an evidence-based integrated family health network for people with complex long-term conditions. It complements and extends the reach of general practice by coordinating a local network of providers in the home and navigating the patient to better self management. The team consists of registered nurses as case managers, kaitautoko (specialist support workers) as navigators and care is enabled and connected through the smart use of technology. This includes an electronic shared care plan accessible by providers and patients and sophisticated telehealth monitoring. Six months after implementation, we illustrate the service through case studies, including patient videos.