Section 0 - Cover 15 December 2006 - West Coast · PDF fileOIA 1982 5.9(2)(i) Commercial ... solution during the busy tourist season. However, ... 15 December 2006 Page 3

West Coast District Health Board Te Poari Hauora a Rohe o Tai Poutini

BOARD MEETING

15 December 2006

AGENDA

AND MEETING PAPERS

ALL INFORMATION CONTAINED IN THESE MEETING PAPERS IS SUBJECT TO CHANGE

WCDHB Meeting Papers Table of Contents 15 December 2006

TABLE OF CONTENTS

AGENDA KARAKIA BOARD MEMBERS’ DISCLOSURES OF INTEREST ABBREVIATIONS DRAFT MINUTES OF THE WEST COAST DHB MEETING HELD FRIDAY 3 NOVEMBER 2006 CHAIRMAN’S REPORT BOARD AND CHAIRMAN’S CORRESPONDENCE FOR NOVEMBER / DECEMBER 2006 CHIEF EXECUTIVE’S REPORT FINANCE REPORT REPORTS FROM BOARD ADVISORY COMMITTEES • Hospital Advisory Committee • Community Public Health Advisory Committee • Disability Advisory Committee INTERSECTORAL FORUM INFORMATION PAPERS

WCDHB Meeting Papers Agenda 15 December 2006

AGENDA

FOR THE WEST COAST DISTRICT HEALTH BOARD MEETING TO BE HELD IN THE BOARD ROOM, CORPORATE OFFICE,

GREY HOSPITAL ON FRIDAY, 15 DECEMBER 2006 COMMENCING 10.00 AM

Karakia

1. Welcome

2. Apologies

3. Standing Orders

4. Disclosures of Interests

5. Minutes of the Meeting held Friday 3 November 2006

6. Matters Arising

7. Chairman’s Report

8. Board and Chairman’s Correspondence

9. Chief Executive’s Report

10. Finance Report

11. Reports from Board Advisory Committees

10.30 am – Presentation – Hari Hari Community Association – Mary Molloy

• Lunch – 12.30 pm

• Date of Next Meeting

• Information Papers

IN COMMITTEE OIA 1982 5.9(2)(i) Commercial NZPHDA Sch 3 cl 32(a)

• Minutes of the Meeting held Friday 3 November 2006

• Matters Arising

Board Delegation Policy

• Contracts - PACT Group - Home Based Support Services (MOH) Mon-Age Related Services - Clinical Training Agency - West Coast PHO Trust Deed

• Finance

WCDHB Meeting Papers Karakia 15 December 2006

KARAKIA

E Te Atua i runga rawa kia tau te rangimarie, te aroha, ki a matou i tenei wa Manaaki mai, awhina mai, ki te mahitahi matou, i roto, i te wairua o kotahitanga, mo nga tangata e noho ana, i roto i tenei rohe o Te Tai Poutini mai i Karamea tae noa

atu ki Awarua.

That which is above all else let your peace and love descend on us at this time so that we may work together in the spirit of oneness on behalf of the people of the

West Coast.

WCDHB Meeting Papers Disclosures of Interest 3 November 2006

BOARD MEMBERS’ DISCLOSURES OF INTERESTS

Member Disclosure of Interest Professor Gregor Coster Chairman

• Deputy Chair - PHARMAC • Director - Cornwall Management Limited

Dr Christine Robertson Deputy Chairman

As self employed person, does work on contract for: • HealthPAC - regularly

Husband is Deputy Chair of the Board of Coast Care Trust and is a Justice of the Peace who undertakes judicial duties in Court. Also Alternate Controller for Civil Defence for the Grey District Council

Dr Carol Atmore • Employed by WCDHB as a General Practitioner at Greymouth Medical Centre and as GP Liaison Officer

• Member – ASMS - Association of Salaried Medical Specialists • Contracted as Clinical Advisor to the Clinical Directorate of the

Ministry of Health in the Chronic Condition Management area.

Ms Robyne Bryant • None

Mrs Julie Kilkelly • Member - Pharmaceutical Society Incorporated • Member - New Zealand College of Pharmacists • Director - Kilkelly Kartage Ltd • Trustee - West Coast PHO Board • Director - Olsen’s Pharmacy (2002) Ltd.

Mr Mohammed Shahadat • Principal Partner - Murdoch James and Roper • Trustee - West Coast Development Trust

Dr Malcolm Stuart • Employed by WCDHB as Head of Department, Anaesthesia and Consultant Anaesthetist

• National Committee - Australian New Zealand College of Anaesthetists • Member - Association of Salaried Medical Staff

As a self employed person: • Medical Advisor - St John Ambulance Service

Mr John Vaile • Director - Vaile Hardware Ltd • Wife has an unresolved employment matter with WCDHB

Mr Brian Wilkinson • Member – Pharmaceutical Society Incorporated • Justice of the Peace • Trustee - West Coast Development Trust

Susan Wallace • Tumuaki -Te Runanga o Makaawhio • Mother employee of WCDHB

WCDHB Meeting Papers Abbreviations 15 December 2006

ABBREVIATIONS

# NOF Fractured Neck of Femur (broken hip) 1° Primary 2° Secondary 3° Tertiary A&E Accident & Emergency A+ Auckland Healthcare ADHB Auckland DHB ALOS Average Length of Stay ANDRG Australian National Diagnosis Related Group ASMS Association of Salaried Medical Specialists AT&R Assessment, Treatment & Rehabilitation Unit BDC Buller District Council BOPDHB Bay of Plenty DHB C&CDHB Capital and Coast DHB CAA Child Acute Assessment CAMHS Child & Adolescent Mental Health Service CAP Canterbury Association of Physicians CC Complications & Co-morbidity CCMAU Crown Companies Monitoring Unit CCN Clinical Charge Nurse CCU Critical Care Unit CD Clinical Director CDHB Canterbury DHB CEA Collective Employment Agreement CFA Crown Financing Agency CHA Crown Health Association CHL Canterbury Health Limited CICU Cardiac Intensive Care Unit CMDHB Counties Manukau DHB COMRAD Radiology Reporting System CPAC Clinical Priority Assessment Criteria CPHAC Community & Public Health Advisory Committee CSSD Central Sterile Supplies Department CTA Clinical Training Agency CWD Case Weighted Discharge DAO Duly Authorised Officer DAP District Annual Plan DDG Deputy Director General DHB District Health Board DHBNZ District Health Boards New Zealand DNA Did Not Attend DON Director of Nursing


DOSA Day Of Surgery Admission DRG Diagnostic Related Grouping DSAC Disability Services Advisory Committee DSD Disability Support Directorate DSP District Strategic Plan DSS Disability Support Services EAP Employee Assistance Programme ED Emergency Department EMT Executive Management Team ENT Ear, Nose and Throat ER Employment Relations FSA First Specialist Assessment GP General Practitioner HAC Hospital Advisory Committee HAHS Hospital and Health Services HBDHB Hawke’s Bay DHB HFA Health Funding Authority HHS Hospital & Health Service HMD Hospital Monitoring Directorate (former CCMAU) HNA Health Needs Analysis HOP Health of Older Persons HR Human Resources HTG Hospital Technical Group HVDHB Hutt Valley DHB ICD 9 International Code of Diseases ICU Intensive Care Unit IDF Inter District Flow IEA Individual Employment Agreement IEC Individual Employment Contract IPA Independent Practice Association (GP Group) IRF Inter Regional Flow ISDN Integrated Services Digital Network IT Information Technology KPI’s Key Performance Indicators LDHB Lakes DHB LMC Lead Maternity Carer MDHB MidCentral DHB MECA Multi Employer Collective Agreement MHAC Mental Health Advisory Committee MOH Ministry of Health MOSS Medical Officer Special Scale. A doctor with 4+ years post-graduate experience but not a

specialist MRT Medical Radiation Technologist NDHB Northland DHB NGO Non Government Organisation NICU Neonatal Intensive Care Unit NMDHB Nelson Marlborough DHB NZCM New Zealand College of Midwives NZNO New Zealand Nurses Organisation


O&G Obstetrician and Gynaecologist ODHB Otago DHB OIA Official Information Act OP Outpatients Ora Services Term used to describe all activities that promote health and prevent diseases that are

undertaken in the primary care setting for children and their families and whanau PBFF Population Based Funding Formula PCG Project Control Group Pegasus One of the IPA’s PHO Primary Health Organisation PMS Patient Management System PNA Professional Nursing Advisor Primary Services Services that receive self referred patients PRIME Primary Response in Medical Emergencies PSA Public Services Association QA Quality Assurance QHNZ Quality Health New Zealand RDA Resident Doctors Association RFP Request for Proposal RHA Regional Health Authority RHMU Residual Health Management Unit RMO Registered Medical Officer. A junior doctor with 0-4 years post-graduate experience Runanga Tribal Council SCDHB South Canterbury DHB SDHB Southland DHB Secondary Services Services where a primary carer must refer patients. Provided in a hospital supported by

specialists, and meeting standard clinical criteria SHO Senior House Officer SMT Senior Management Team SOI Statement of Intent SSC State Services Commission SSP Statement of Service Performance Stargarden Payroll System STD Sexually Transmitted Diseases TAIRDHB Tairawhiti DHB Tamariki Children – usually refers to children up to and including 14 years of age Tangata Whenua People of the land”, most commonly referring to traditional Maori Iwi occupants of a region

or district TARADHB Taranaki DHB Tino Rangatiratanga Sovereignty / Autonomy WAIKDHB Waikato DHB WAIRDHB Wairarapa DHB WAITDHB Waitemata DHB WCDHB West Coast DHB Whanau Family and Extended Family Whanau Ora Health and wellbeing of families WHANDHB Whanganui DHB WTF Waiting Times Fund YTD Year to Date

WCDHB Meeting Papers Section 5 – Draft Minutes of the Board Meeting 3 November 2006 15 December 2006 Page 1

DRAFT MINUTES OF THE WEST COAST DISTRICT HEALTH BOARD MEETING HELD ON FRIDAY

3 NOVEMBER 2006 COMMENCING AT 10.00 AM IN THE BOARD ROOM, CORPORATE OFFICE, GREY HOSPITAL

PRESENT Gregor Coster (Board Chair)

Christine Robertson Carol Atmore Julie Kilkelly Mohammed Shahadat Malcolm Stuart John Vaile Susan Wallace

IN ATTENDANCE Kevin Hague, Chief Executive Wayne Champion, Chief Financial Manager Carol Gaskell, Minute Secretary

APOLOGY Robyne Bryant Brian Wilkinson

KARAKIA 1. WELCOME AND AGENDA

The Chair welcomed everyone to the meeting, especially Susan Wallace who has been

appointed to the Board by the Minister of Health. The Chair advised that lunch will commence at 12.30 pm.

2. APOLOGIES

Apologies were received from the Robyne Bryant and Brian Wilkinson

Moved: Gregor Coster Seconded: Christine Robertson Motion: “THAT the apologies be accepted.” Carried.

3. STANDING ORDERS

The Chair waived the Standing Orders unless there was reason to reinstate them later in the meeting.

4. DISCLOSURES OF INTEREST

There were no changes to be made to the Disclosure of Interests.


5. MINUTES OF THE PREVIOUS BOARD MEETING HELD FRIDAY 22 SEPTEMBER 2006 The following changes were made to the Minutes of 22 September 2006: In the following instances change Deputy Chair to “Acting Chair”: - Page 1 – Present Page 1 – Section 1 - Welcome and Agenda – First sentence and second sentence Page 2 – Section 3 - Standing Orders – First sentence Page 2 – Section 6 - Matters Arising – Influenza Pandemic Planning – First sentence Page 3 – Section 6 - Matters Arising – Community and Public Health Advisory Committee

Vacancy - First sentence Page 3 – Section 7 – Chairman’s Report – First sentence. Other changes are as follows: Page 2 – Minutes of the Previous Board meeting held Friday, 11 August 2006 – Motion to

read “THAT the Minutes of the West Coast District Health Board meeting held 11 August 2006 be adopted as a true and accurate record.”

Page 3 – Section 7 – Chairman’s Report – Change heading to “Acting Chair’s Report Page 3 – Section 7 – Chairman’s Report – Second sentence change to read “…

Mohammed Shahadat has been acting for the Chair for the past 10 days.” Page 4 – Chief Executive’s Report – Reefton Area – Penultimate sentence to read “… by all

nursing staff during this period of reduced medical services.” Moved: Christine Robertson Seconded: Julie Kilkelly

Motion: “THAT the Minutes of the West Coast District Health Board meeting held 22 September 2006 be adopted as a true and accurate record subject to the above amendments.” Carried

6. MATTERS ARISING Influenza Pandemic Planning The Board Chair advised that this item is timetabled for

presentation at 11.00 am today, however the Quality and Risk Manager is the key person for the DHB in the Ministry of Health’s Pandemic Planning Exercise Magkill and apologises if he is late.

Fox Glacier and Franz Josef Glacier Clinics – Clinics and District Nurse Staffing The

Chief Executive advised that in the interim Management has reconfigured the Medical Clinic days and added an additional clinic and is working towards a more permanent solution during the busy tourist season. However, staffing of the major seasonal period is an issue.

Compliance with Contraception, Sterilisation and Abortion Act The Chief Executive

advised that we do not provide any of the services under the Act, to which the issue relates, and are therefore entirely compliant.

Waiting Lists A Board Member questioned whether West Coast patients who have been

removed from the Canterbury DHB waiting list have received clear instructions about returning to their GP for treatment or further referrals. The Chief Executive advised that we have been endeavouring to obtain information from Canterbury DHB around the number of West Coast patients and whether they have received clear guidance about the next steps to take. The Chief Executive stated that we have an interest in these patients, as they are


residents of the West Coast, but that they are Canterbury’s patients and are managed from Canterbury DHB.

Board and Advisory Committee District Annual Plan Workshop – Friday – 26 January

2007 The Chief Executive advised that the Advisory Committee Members will be contacted with information about this planning workshop.

Action: Chief Executive to advise Advisory Committee re DAP Workshop 7. CHAIRMAN’S REPORT

The Chair gave a verbal update to the Board. New Board Member – Susan Wallace - The Chair thanked the Board Members who were

able to attend the Mihi Whakatau for Susan this morning. PHARMAC The Chair attended the Pharmac meeting held in Wellington on Wednesday

25 October 2006. The DHBs as the provider of Pharmac funding have publicly supported the decision of Pharmac not to fund Herceptin for breast cancer at the present time.

Jude Bruce, Grey Hospital – Midwife of the Year The Deputy Chair advised that

Jude Bruce had been nominated as a Treasures, New Zealand Star Midwives Midwife of the Year. The Board asked that a letter of congratulation be sent.

Action: Deputy Chair to organise a letter of congratulations to Midwife Jude Bruce DHB Chairs Meeting in Christchurch – 22 September 2006 Mohammed Shahadat

attended this meeting on behalf of the Board and updated the Board. The Hon Pete Hodgson addressed this meeting. Mohammed said he found the meeting very interesting and thanked the Board for the opportunity to attend.

Moved: Gregor Coster Seconded: Mohammed Shahadat

Motion: “THAT the Chair and Acting Chair’s Reports be received.”

Carried. 8. BOARD AND CHAIRMAN’S CORRESPONDENCE

Hon Pete Hodgson, Minister of Health, Board Member Glenys Baldick’s passing and impact on Board Member numbers The Chair advised that an acknowledgement had been received. He read this to the Board and advised that this would form part of the December meeting correspondence.

Don Matheson, DDG, Public Health Directorate, Ministry of Health, CFA Variation for Healthy Eating Healthy Action The General Manager Planning and Funding advised that Workshops will be organised before the end of the year and that leadership and HEHA Champions were emerging. The Intersectoral collaborative model is being encouraged by the Ministry of Health; perhaps this could also be encouraged through the Intersectoral Forum. Some of the monies will be utilised to employ a HEHA Co-ordinator. A Board Member encouraged other Members to take part in the Push Play organised walking activity at ANZAC Park today.


Anthony Hill, DDG, DHB Funding and Performance, Ministry of Health, More funding for providing more elective surgery and interventional cardiology The Chief Financial Manager advised that our Board will have $250,000 available for this after negotiating with the Ministry around ESPI funding for baseline and target volumes. We need to be certain that we have the capacity for what the funding is allocated for and that the price offered by the Ministry will mean that we won’t lose money. As we do not provide Cardiology we have been notified that we can use this for sending patients to public and private facilities. John Wilson, Acting DDG Corporate and Information Directorate, Invitation to participate in Regional Meetings regarding the National Systems Development Programme The Chief Executive advised that it is worthwhile advancing our issues at every forum and if we can attend, we will do so.

Moved: Carol Atmore Seconded: Susan Wallace

Motion: “THAT the inwards correspondence be received and outwards

correspondence be approved.” Carried. 9. CHIEF EXECUTIVE’S REPORT

The Chief Executive spoke to his report.

Primary Care Plan The Chief Executive advised that he has heard from Pat Farry from the University of Otago that the Minister has approved funding for a pilot for an Immersion Year Undergraduate Medical Training Programme for 2007. The West Coast will be one of the rural satellites for the programme. This is a steep workload but the long term benefits are worthwhile. The Chair congratulated Management, and in particular Dr Greville Wood, for their efforts and the vision towards education.

Action: Chair to send letter of congratulations to Dr Greville Wood Secondary Care Plan The Chief Executive advised that our case for funding will no longer be required by the New Services and Technical Review to be consistent with a regional plan for the South Island. He advised that our Business Case will need to be very strong. There are considerations around Capital Funding; there is a view that there has been a lot of investment in bricks and mortar and that maybe the focus, needs to shift. Capital for Information Technology is the current focus as is Capital for Dental Facilities. Another issue is the Fiscal Impulse – this reflects the impact of Government spending on the economy, which may feed into inflation. Intersectoral Relationships The Chief Executive advised that he has accepted an invitation to become a member of the Industrial Advisory Council of the West Coast Development Trust, and advised that it is important to take a more sophisticated view of what growth is and what the importance of this in the economy. The Chief Executive attended the Greymouth District Council’s Development Forum. The meeting was very well attended and included; education, health, major businesses in the Grey District, housing and social services. The focus was to look at the projected economic and social service impact of the expected employment growth on employees, families and the economics of the district. It was a good to hear the collective views from such a wide variety of organisations,


The Intersectoral Forum will continue with fresh legs with money from the Ministry of Health. We will now have some capacity to achieve more. The HESDJ South Island Forum of Government Agencies Sector met and discussed what has been happening, in particular what are some of the successes. This was a useful day with; Ministry of Health, Ministry of Social Development, Ministry of Housing, Police, Ministry of Transport, Department of Corrective etc showing extreme willingness to be collaborative. The Primary Health sector has been saying for decades that these changes were necessary and the changes in the past year are pleasing. The Ministry of Social Development sees themselves as facilitating collaboration and this is occurring and producing gains. This collaboration is exciting for health as 85% of what makes up a person’s health status is outside of the health services. The “Great Little Cookbook” is becoming a national project, co-ordinated regionally. Project Kumara involving; Health, Department of Social Development, Education, Police, Westland District Council, Housing New Zealand and New Zealand Fire is working well and Kumara is the first of many communities for this type of work. Ministry of Health – DHB Account Manager The West Coast District Health Board had a visit this week from our new Account Manager – Rob Wilkinson. Addressing Disincentives – Elective Volumes The Ministry and DHBs are looking at addressing disincentives and have provided some funding. The Chief Executive announced that our application for funding for project one (patient pathways) has been accepted. Movember The Chief Executive advised that he has been challenged to grow a moustache. He has reluctantly agreed to do this as it is an excellent time to renew emphasis on the promotion of men’s health. The PHO is discussing renewing efforts to focus on Men’s Health issues. Grey Base 2020 Project The Chief Executive advised that the hiatus of activity around the Grey Base 2020 Project will not be detrimental to progressing the project. The Secondary Care Plan will be presented to the next Hospital Advisory Committee meeting and reported to the Board at the December meeting. Collaboration with Canterbury DHB The Chief Executive advised that there has been good progress with Canterbury DHB recently and our plan is to build on goodwill. Scholarships It was noted that scholarships will close at the end of this month. To date, unsolicited, we have received 25 scholarship applications. A breakfast meeting will be held at Tai Poutini Polytechnic where everyone can share ideas. The Board expressed their continuing interest in this project asking that they be advised before the announcements will be made.

“The Palms” An invitation has been made for a Committee to be set up. Terms of Reference have been designed and comments sought from the Cobden Residents Against Palms Patient Increased Numbers group.

Moved: Mohammed Shahadat Seconded: Christine Robertson Motion: “THAT the Chief Executive’s Report be received.” Carried.


10. FINANCE REPORT The Chief Financial Manager spoke to his report. Year to Date deficit (2 months to August)

is $736k versus the breakeven plan. The Chief Financial Manager advised that approximately $300k of this relates to timing issues with revenue not yet received or costs incurred that relate to more than the first two months. The rest of the deficit relates to the use of contracted services to cover medical vacancies and for ESPI Compliance (wherever possible we have seen patients rather than move them from the waiting lists). As well, we have revenue for new initiatives still being implemented.

Looking ahead to September results we will still be using locums to cover clinical vacancies

as the same pattern is occurring. We have invoiced for orthopaedic initiative volumes. The Funder arm has also accrued for a very high cost ($250,000) for an IDF case seen by another DHB.

The Board noted that the Hospital Advisory Committee asked that Management prepare a

Financial Recovery Plan. The Chief Executive advised that Management is concerned and is under pressure to produce a breakeven DAP. In answer to a question from a Board Member the Chief Executive said that they will not discuss details of individual IDF cases.

The Chief Financial Manager stated that in his Facilities portfolio the Nurses Home

demolition is now complete and the final concept design for the Dementia Unit is now in the Resource Consent Application stage. The Grey Base 2020 Project with detailed design of a High Dependency Unit is progressing and the plan is to bring this to the December Board Meeting.

The Chief Financial Manager discussed the Implementation stage of the I-Soft Project

where the system has been installed and initial staff training completed. There is still work to be done on Report Writing and training of new staff. The Chair suggested that the Audit Committee complete an audit on the implementation process.

Moved: Malcolm Stuart Seconded: John Vaile Motion: “THAT the Finance Report be received.” Carried.

11. REPORTS FROM BOARD ADVISORY COMMITTEES

11.1 Hospital Advisory Committee

The Chair of the Hospital Advisory Committee spoke to her report. She presented the following recommendations:

Maori Health Plan The Board discussed the importance of collecting ethnicity data and the necessity to continue with staff training in collecting this data. The difficulties involved with collecting the data were acknowledged and the Chief Executive agreed that this is an area in which the Board needs to do better. He also told the Board that within the South Island; Nelson/Marlborough and the West Coast have the best record in Ethnicity Data Collection. The Chief Executive said that the plan is for Mandatory Training of all staff in collecting ethnicity data and it is hoped there will be improvements with the new patient management software and Management’s messages that this is critically important.


Moved: Christine Robertson Seconded: Susan Wallace Motion: “THAT the WCDHB stress to management the importance of staff being compliant with the collection of correct / accurate ethnicity data and requires management to periodically report on progress in relation to ensuring compliance.” Carried

Finance Recovery Plan Moved: Christine Robertson Seconded: Gregor Coster

Motion: “THAT the Board direct management to provide the Board with a detailed recovery plan at the Board’s December 2006 meeting.” Carried

WCDHB’s Community Newsletter The Chair advised that a Hospital Advisory Committee member who resides in Reefton did not receive the Board’s Newsletter. A Board Member domiciled in Westport also stated that he had not received a copy of the Community Newsletter.

Action: Chief Executive to check whether Reefton and Westport areas are receiving the newsletter

11.2 Disability Services Advisory Committee The Chair of the Disability Services Advisory Committee advised that there is no report

from the Disability Services Advisory Committee for these papers. The next meeting of the Disability Services Advisory Committee will be held on Wednesday, 6 December 2006.

11.3 Community and Public Health Advisory Committee

The Chair of the Community and Public Health Advisory Committee advised that there is no

report from the Community and Public Health Advisory Committee for these papers as the meetings scheduled for 1 September 2006, 27 September and 13 October 2006 were cancelled due to the lack of a quorum.

The next meeting of the Community and Public Health Advisory Committee will be held on

Friday, 24 November 2006. 11.4 Audit, Risk and Finance Sub Committee

The Chair of the Audit, Risk and Finance Sub Committee advised that this would be discussed In Committee.

Moved: Gregor Coster Seconded: Christine Robertson Motion: “THAT the Reports from the Advisory Committees be noted.” Carried.


12. ADVISORY COMMITTEE AND BOARD QUORUMS The Deputy Chair discussed the recent problems with regard to reaching Quorums for

meetings. She advised that there have been no problems with the Hospital Advisory Committee but there have been with the other Advisory Committees and some problems with the last Board meeting.

The Advisory Committee Membership and Terms of Appointment were discussed and the

Board Chair advised that Quorum regulations are set by the New Zealand Public Health and Disability and Crown Entities Acts that a Quorum is half of the current members.

The current Advisory Committee requirements are:-

• The Hospital Advisory Committee requires a Deputy Chair. • The Disability Services Advisory Committee has one community vacancy. • The Community and Public Health Advisory Committee has the need for another Board

Member in order to fill the Deputy role and a community member to be nominated by the Runanga.

The Board Chair listed the following situations:

• The Board has received a resignation from Maureen Frankpitt from Disability Services Advisory Committee

• The Board has received resignations from Julie Kilkelly and Robyne Bryant from Community and Public Health Advisory Committee.

• It is noted that Barbara Greer’s term on the Community and Public Health Advisory Committee ends on 12 November 2006.

• It is also noted that Cheryl Brunton’s term (in her capacity as Medical Officer of Health) on the Community and Public Health Advisory Committee ends on February 2007.

• Community and Public Advisory Committee requires a Deputy Chair and it was agreed that Malcolm Stuart discuss with management the acceptability of his being absent from clinical duties to take on this role.

• HAC requires the appointment of a Board member as Deputy Chair.

Moved: Gregor Coster Seconded: Carol Atmore Motion: “THAT the vacancy created by Maureen Frankpitt on Disability Services Advisory Committee be advertised.” AND Motion: “THAT Susan Wallace be appointed as the West Coast District Health Board member on Community and Public Health Advisory Committee.” AND Motion: “THAT the interviews for West Coast District Health Board Iwi Representative be undertaken for the Iwi representative on Community and Public Health Advisory Committee.” AND


Motion: “THAT Cheryl Brunton (in her capacity as Medical Officer of Health) be re-appointed to the Community and Public Health Advisory Committee for a period of two years beyond February 2007.” AND Motion: “THAT Brian Wilkinson be approached to see if he will take on the role of Deputy Chair for HAC.” Carried

Action: Deputy Chair to organise the above

13. INFLUENZA PANDEMIC PLANNING PRESENTATION – QUALITY AND RISK MANAGER Mark Bowen, Quality and Risk Manager presented information about the Board’s Pandemic

Planning process. He started with some National figures around the Ministry’s stock of antivirals, masks, antibiotics, vaccine, needles and body bags. He advised that the Ministry has not as yet advised how the stock piles are to be financed. He advised that when an Influenza Pandemic occurs “most people will be okay” – it will be very different than the 1918 Influenza Pandemic as we now have antivirals, antibiotics and the ability to replace fluids.

It is expected that the number of people that will need to be hospitalised will be small as most

care will be undertaken in the homes. The people with the highest risk will be people with diabetes, cardiac and respiratory health issues. The National Guidelines have set Code levels for DHB and Emergency teams to follow. The Medical Officer of Health will have final control over community decision-making, including closing schools, ports etc. The West Coast will have a collection of CBACs (Community Based Assessment Centres) for urban areas, supplemented with Mobile teams for the more rural areas. The West Coast District Health Board’s pandemic plan has been created with collaboration from South Island DHBs, Community and Public Health, Regional Council, St Johns, Rest Homes etc and is over 200 pages in length and has been approved by the Ministry of Health. The Ministry of Health’s basic philosophy is for cluster control with the emphasis on “stamp it out”. The Ministry of Health’s plan is to focus on isolation and pouring resources into the first outbreaks.

The Human Resource component of the planning is the most unknown component. It is

expected that 40% of the population will be affected and that could mean that up to 75% of staff could be either sick or at home nursing unwell family members.

The Ministry of Health has planned three National exercises – the first exercise

(Exercise Magkill) is a desktop exercise designed to test communications and will be held next week.

The Board Chair thanked the Quality and Risk Manager for his presentation and said that the

amount of planning in place is impressive.

The Quality and Risk Manager completed his presentation at 11.50 am 14. PRIMARY HEALTH CARE STRATEGY IMPLEMENTATION – WORK PLAN 2006 – 2007

The Chief Executive acknowledged the document at the end of his Report in the meeting papers and outlined some of the challenges facing the Primary Health Care Strategy; the


aging population and the affects on the health services in the last years of their lives and the enormous affect on secondary care. The health services need to gear up for primary care intervention. The existing patterns of service are not going to be able to do this. The development of PHOs are one of the first steps and the West Coast PHO is one of the first (set up in July 2002). There are now 81 registered PHOs – with 94% of people enrolled. Many PHO’s are very small (50% have fewer than 20,000 people). The West Coast PHO is in the top half of the size of the PHO. Each workstream has a Ministry person and a DHB person and they cover; Development infrastructure, development of IT, development of service models with multidrop approaches, communication and ownership of PHOs. The Primary Health strategies focus on the wellness model. Access level funding to the PHO of the last age group – to keep people well, income from capitation and co-payments to minimise the visits once clinically appropriate. The Chief Executive said he was encouraged by the development of the workstreams – some are well advanced and others are still populating the work groups. Cost is now not a barrier with more and more people going to GPs and commenting this is because of lower fees. The pressure now comes on providers – volume related work in terms of health promotion so we do not get flooded. Commenting locally – things are happening right in Primary Care – what we are doing within the DHB and the PHO is nationally right. Chronic conditions contribute to major health issues and provides ideal vehicles of driving Models of Care change in the correct direction. This is excellent work. A Board Member said that relationships within Primary Care are well advanced and well established.

15. INTERSECTORAL FORUM MEETING

The next meeting of the Intersectoral Forum will be held on 7 December 2006. 16. IN COMMITTEE

Pursuant to Clause 32a, Schedule 3 of the New Zealand Public Health & Disability Act 2000 members of the public are to be excluded from the portion of the 3 November 2006 meeting of the West Coast District Health Board that relates to the following items on the grounds that the public conduct and discussion of the following items would enable the WCDHB to carry out, without prejudice or disadvantage, commercial activities granted by Section 9(2)i of the Official Information Act 1982. • Minutes of meeting held 22 September 2006 • Matters Arising from the Minutes of 22 September 2006 • Correspondence • Contract • Capex • Finance

Moved: Gregor Coster Seconded: Mohammed Shahadat Motion: “THAT the Board move into Committee 12.30 pm.” Carried.

The Board broke for lunch at 12.30 pm and agreed to reconvene at 1.15 pm


17. MOVING OUT OF IN COMMITTEE Moved: Christine Robertson Seconded: Carol Atmore Motion:

“THAT the Board move out of Committee at 2.45 pm.” Carried.

The Board spent 1 hour and 30 minutes In Committee (1.15 pm – 2.45 pm) 18. NEXT MEETING Friday, 15 December 2006 in the Board Room, Corporate Office, Grey Hospital. The

meeting will commence at 10.00 am.

There being no further business to discuss the meeting concluded at 2.46 pm.

WCDHB Meeting Papers Section 6 – Action and Responsibility List Board Meeting 3 November 2006 15 December 2006 Page 1

MATTERS ARISING FROM WEST COAST DISTRICT HEALTH BOARD MEETINGS

Item No.

Board Meeting

Date

Action Item

Action Responsibility

Reporting Status

Agenda Item Ref

9 22 September 2006 Provide an update on the Reefton Hospital and Medical Services

Chief Executive April 2007

9 22 September 2006 Provide a report measuring results against the objectives set for both Buller Health and the Buller Health Manager’s position.

Chief Executive March 2007

6 3 November 2006 Advise Board and Advisory Committee Members that the DAP Workshop will be held on 26 January 2007

Chief Executive Completed

7 3 November 2006 Write a letter of congratulations to Jude Bruce, Grey Hospital – Star Midwives – Midwife of the year

Deputy Chair Completed

9 3 November 2006 Write a letter of congratulations to Dr Greville Wood regarding his work in the Undergraduate Medical Training Programme for 2007

Chair

11.1 3 November 2006 Check that the WCDHB Community Newsletter was received in Reefton and Buller Districts

Chief Executive

12 3 November 2006 Ensure Advisory Committee requirements, as listed in the Minutes, are undertaken

Deputy Chair Progressing

WCDHB Meeting Papers Section 6 – Action and Responsibility List Board Meeting 3 November 2006 15 December 2006 Page 2

MATTERS REFERRED TO ADVISORY COMMITTEES FOR CONSIDERATION

Item No.

Board Meeting

Date

Committee

Item

11.1 22 September 2006 HAC Receive a report on the number of patients who take up the offer to be re-assessed at the WCDHB’s expense and impact on the waiting lists

WCDHB Meeting Papers Section 7 – Chairman’s Report 15 December 2006 Page 1

CHAIRMAN’S REPORT

The Chairman will give a verbal update at the West Coast District Health Board Meeting on Friday, 15 December 2006.

WCDHB Meeting Papers Section 8 – Board and Chairman’s Correspondence 15 December 2006 Page 1

BOARD AND CHAIRMAN’S CORRESPONDENCE FOR NOVEMBER / DECEMBER 2006

OUTWARDS CORRESPONDENCE

Date Sender Addressee Details Response Date Response Details

6 November 2006 Deputy Chair Jude Bruce, Grey Hospital

Congratulations on being awarded by Treasures, NZ Star Midwives “Midwife of the Year”

6 November 2006 Deputy Chair Maureen Frankpitt Accepting resignation from DSAC and congratulations on new appointment with Board

6 November 2006 Deputy Chair

Chair, Runanga o Ngati Waewae and Chair Runanga 0 Makaawhio

Outlining process regarding appointment to CPHAC

6 November 2006 Deputy Chair Cheryl Brunton Extension of membership on CPHAC until February 2009 in the role of medical Officer of Health

WCDHB Meeting Papers Section 8 – Board and Chairman’s Correspondence 15 December 2006 Page 2

INWARDS CORRESPONDENCE

Date Sender Addressee Details Response Date Response Details

20 October 2006 Hon Pete Hodgson, Minister of Health Board Chair Acknowledgement letter re additional

Board Member

13 November 2006 Deputy Commissioner – Development, State Services Commission

Board Chair SSC’s Development Goals Research Programme

13 November 2006

DHBNZ / PHARMAC, David Meates, (DHBs) and Simon England (PHARMAC)

Board Chair PHARMAC achieves excellent results in 2006

13 November 2006 Doug Matheson Wairarapa DHB Board Chair Changes to Wairarapa DHB Chair

18 November 2006

People from the Catholic Parish of Ss Peter and Paul’s Reverence for Life Group, Johnsonville

Board Chair Caring for older people and people with dementia

27 November Jo Goodhew, MP for Aoraki, National Party Board Chair Thank you for information given and copy

of GP Pulse

27 November 2006 John Ayling, West Coast PHO Chief Executive WCPHO Annual Report 2006

30 November 2006 Mary Molloy, Spokesperson, Hari Hari Community Association

Board Chair Requesting rights to speak at the next Board meeting

1 December 2006 Matthew BROUGHAM, Acting Chief Executive, PHARMAC

Board Chair PHARMAC Annual Report – 2006 (Copies have been requested and will be distributed as soon as available)

5 December 2006 Mohammed Shahadat Board Chair Leave of Absence from the Board

WCDHB Meeting Papers Section 9. – Chief Executive’s Report 15 December 2006 Page 1

CHIEF EXECUTIVE’S REPORT

TO: Chair and Members

West Coast District Health Board FROM: Kevin Hague, Chief Executive DATE: 8th December 2006

STRATEGIC ISSUES Minister’s visit The Minister’s visit to the West Coast DHB at the end of November involved a very substantial amount of preparation time by the management team, but should be judged a worthwhile investment. Feedback from the Minister’s office and from the Ministry has been extremely positive about the visit and about the performance of the DHB. The presentations developed by the Executive Management Team of strategic issues for the Minister’s visit will also be delivered to the Board in January. In the two weeks preceding the Minister’s visit the DHB also hosted visits by Dr. David Galler (the Minister’s Principal Medical Adviser), Dr. Colin Feek (Deputy Director-General, Clinical Services) and Rob Wilkinson (our Ministry of Health account manager). These visits were also very positive and should stand us in good stead for the future. DAP and SOI Planning for 2007/08 is now well under way, with individual departments having had the opportunity to develop with Planning and Funding and Finance staff draft service plans and budgets for the year. These will have been considered by the Executive management Team in a special meeting on December 12th, and it may be possible to provide a further verbal report at the Board’s meeting. This timetable is significantly more ambitious than we have previously attempted, and is matched by a level of thought and work being put into these plans that exceeds previous years. This reflects an overall shifting of emphasis from strategic to implementation planning and a change in the Ministry-DHB relationships that we believe will be supportive of the use of the DAP for more meaningful planning (as opposed to compliance). A consequence should be that the Board and Committee workshop towards the end of January is likely to have a somewhat different tone to that of previous years, with the DAP having been significantly further advanced. West Coast PHO Copies of the West Coast PHO annual report are being distributed to all Board members. I believe that it makes very impressive reading, with very substantial progress having been achieved over the year towards the goals of the Primary Health Care Strategy.


Review and redrafting of the PHO’s Trust Deed has now been complete and signed off by all existing PHO Trustees. It remains for it to be approved and signed by the West Coast DHB (and is on the agenda for the December meeting) and by South Link Health. Adoption of the new Trust Deed will complete the transition process commenced with the mediation in 2005. Health Services in Reefton We are now ready to proceed with wider community consultation in Reefton concerning the future configuration of health services for the town, but have elected to defer this now until January, as we believe this will be more convenient for both community and staff. Secondary Care Plan The draft secondary care plan is now being adjusted in the light of the new census data (showing an increasing West Coast population) and the service development plans of the secondary care departments and will be circulated to HAC shortly for further consideration before coming to the Board. Facilities Planning The West Coast DHB application for funding for a mobile dental facility was lodged in the first round for such applications in late November. We are likely to learn in February whether or not this application has been successful. Former Special Medical Areas The formal consultation period has now been completed. A report that summarises and analyses the views expressed during this consultation period is being prepared and will be distributed under separate cover, for consideration during the ‘in committee’ section of the December meeting. The Board will also receive a presentation from community members from Hari Hari who wished to express their viewpoint directly to the Board.

MAORI HEALTH Hui Whakaprirpiri Ratoka On the 7th - 8th November at Waikawa Marae in Picton, the Annual Hui Whakaprirpiri Ratoka was convened. This event is organised by Te Herenga Hauora o te Waka o Aoraki (the South Island DHB Māori Managers Network) on behalf of the South Island Māori health providers.

The main theme of this hui was about ‘Leadership’ there were a number of key speakers including Bo Ngata, Chief Warrant Officer for the New Zealand Defence Force, and Shirley Simmons from the Eru Pomare Research Unit based at the Wellington School of Medicine. Other speakers included Nadia Glavish Chief Advisor Tikanga Best Practice at Auckland DHB and the current acting General Manager Maori health, ADHB.

There was also a strong ‘Workforce Development’ theme at the hui, presentations were made by Te Rau Matatini and Mokowhiti consultancy regarding Maori workforce planning and development.

These hui are annual hui events and give the South Island Mäori health provider workforce, an excellent opportunity and the right environment so they can share information, discuss key issues, and enable better collaboration regarding Māori health initiatives.

Maori Health Access In The Buller On the 9th and 10th November, the GM Māori Health and the Managing Director of PHOcus on Health Ltd Anthony Cooke and Manager of the West Coast Primary Health Care Organisation Mike Moore went to Buller to discuss issues regarding Maori accessing health services in the Buller region. There were hui with Maori Womens Welfare League members and Buller Reap and the Buller Medical Centre. Evidence indicates that Maori are not accessing services as well as they could. On Tai Poutini just 86% of Maori are enrolled in the PHO and of this number two thirds are accessing provider services. Consequently a proposal was presented to the PHO board that seeks


to rectify this problem. This was presented to the PHO Board on the 22nd of November. The PHO board has subsequently approved a Maori specific health position to be based in the Buller.

Māori Mental Health: Suicide Prevention Hui On the 19th November Dr Nikki Coupe, Maori Health Advisor Self Harm and Suicide Prevention Collaborative, NZ Guidelines Group came to the West Coast. Nikki is an Epidemiologist specialising in Kaupapa Māori methodology and has a PhD in Māori studies. Her thesis is titled “Whakamomori” Suicide. While here she kindly facilitated two workshops for West Coast DHB staff and community groups.

The workshops had several key strategic subjects which included enhancing culturally safe practices to increase cultural awareness, exploring Māori health and Māori mental health, discussing the impact that health issues have on Māori health in general, and identifying certain cultural differences in New Zealand society, and how these issues relate to the delivery of care.

The feedback from these hui was excellent and very encouraging with a number of community groups and staff giving positive feedback, which included further requests about this being incorporated into future mental health training.

Relationship between Crown and Maori On the 29th of November the GM Maori Health and the Chairperson of Tatau Pounamu travelled to Christchurch to meet with Maori health managers and chairpersons from the various Manawhenua committees throughout the South island. There were also officials from the Ministry of Health and representatives from Ngai Tahu.

There was considerable dialogue regarding relationships with the South Island DHBs and Iwi from throughout the different rohe/geographical locations. Forming Memoranda of Understanding between Iwi and the DHBs was high on the priority list for discussion. Many of the issues are similar throughout Te Waipounamu/South Island. The West Coast has made some significant progress in terms of its relationship with both Hapu on the West Coast and also with Maori committees here. However the issue of finalising a written MOU between Poutini Ngai Tahu and the WCDHB is still to be finalised.

EXTERNAL RELATIONSHIPS Intersectoral Relationships The West Coast Intersectoral Forum continues to grow from strength to strength with new agencies (most recently Housing NZ and the Department of labour) becoming involved. A proper work programme is also starting to coalesce, and we should make a focus for 2007 to be consolidating the work programme and achieving some clear gains against it. The particular areas in which the Forum is focusing energy are:

1. Youth development across the West Coast.

2. Use of Long Term Council and Community Plans as the basis for joint planning work across the various agencies involved in the Forum.

3. Establishment of a deliberate cycle of quality improvement associated with intersectoral action centred on particular communities. It is envisaged that the agencies will agree to focus on working with a particular community with multiple high priority needs, and that at completion of the intervention period we will collaboratively determine practice improvements that we can apply more generally across the district and in our work with the next community selected.


Patients 3rd Quarter Results Overall Level of Satisfaction Inpatient 88% Outpatient 94%

General Public The first meeting of The Palms Neighbourhood Liaison Group was to have been held before the Board’s December meeting. Unfortunately, despite initial positive comments from the group that has been campaigning against the Palms development, they subsequently appeared to have a change of heart and made a series of public statements indicating that they did not accept some of the basic principles behind the group and saw no value in it. In consequence the scheduled meeting was cancelled, but I have written to the group responding to the points they have made and expressing our view that the Liaison Group would still be a worthwhile development.

Of course we are aware that many people living near The Palms have no particular concerns about what is occurring there and it would be possible to establish the Liaison Group with these neighbours, but there seems little point in establishing the group without some involvement of those neighbours who do have concerns.

Ministry of Health Our relationship with the Ministry continues to be strong. The results of an internal review of the Ministry’s operations will be announced shortly, and it is likely that this will result in some new ways for the Ministry and DHBs to work together. We expect that these are likely to be positive for West Coast DHB.

OPERATIONAL MATTERS Collaboration with other DHBs The DHBNZ strategic plan and document on collaborative decision-making have previously been circulated but not yet considered by the Board. The Board may wish to discuss these documents, and possibly to endorse the approach to collaborative decision-making. Progress in developing a South Island service plan is slow. Influenza Pandemic Planning Board members will recall that on the day of their last meeting DHBs were all involved in a desktop simulation exercise to test communication and response protocols for our various pandemic plans. Feedback on this exercise was that much can be learnt from it, making the exercise very valuable. The next exercise will be held in April 2007, and will test (amongst other matters) whether we actually learnt what we could.

Scholarships update A total of 27 applications were received for the scholarships available to West Coasters training towards health careers next year. The panel who reviewed these applications was very impressed by the high quality of all applications received and management is now seeking ways to build relationships with all applicants, regardless of whether they receive scholarships or not.

Seven successful applicants have been chosen, and several others held in reserve in case any of these are discontinued for any reason. Those chosen are distributed across a range of health disciplines and originate from different areas within the Coast.

There is one further group of students who applied for scholarship assistance but who are well advanced in their training (third, fourth and fifth year students). As such they are a poor fit for the intent of the scholarship scheme to encourage young West Coasters into health careers. However, it would be a valuable opportunity missed if we did not find some way of building our relationship


with these students. In some ways this is an “initial year” problem, as if the scholarship scheme had been available in previous years it is highly likely that applications from these students would have been successful.

I therefore seek the Board’s approval to offer additional scholarships to this group of five students, and note that while this will increase the initial cost of the scheme somewhat, it will not ultimately increase the ongoing steady state cost.

Recommendation: THAT the Chief Executive be authorised to approve up to five scholarships for the 2007 academic year additional to those established in the Board’s scholarships policy.

Author: Chief Executive – 8th December 2006

WCDHB Meeting Papers Section 10. – Financial Report 15 December 2006 Page 1

FINANCE REPORT - OCTOBER 2006

OPERATING RESULTS The year to date consolidated result is a deficit of $1,566k, which is $1,566k worse than budget (breakeven). The year to date provider deficit of $3,314k is $1,553k worse than budget ($1,761k deficit). Year to date governance and administration result is a surplus of $38k, which is $81k better than budget ($43k deficit). The year to date funder arm surplus is $1,710k; $93k worse than budget ($1,803k surplus). The monthly consolidated result for October 2006 is a deficit of $359k, which is $359k worse than plan (breakeven). The provider deficit of $972k is $532k worse than budget ($440k deficit). The governance and administration surplus of $21k is better than budget of a ($11k deficit). The funder arm surplus of $592k is $141k worse than budget ($451k surplus).

REVENUE Year to date (October 2006) revenue of $33,311k is $122k under budget ($33,433k). As in previous months additional revenue for the revaluation of assets (to partially offset increased depreciation and capital charge) has not yet been finalised by the Ministry of Health and a number of new revenue initiatives (MoH funded IT projects, Laundry commercialisation) are still in the process of being implemented. Patient/consumer sourced revenue is $530k down on budget. This is partly due to the pharmacy having ceased dispensing outpatient scripts as a result of staff vacancies. Year to date provider revenue is $19,291k, down $813k on budget ($20,104k).

Financial Overview October 2006

Actual Budget Variance Variance Last Yr Actual Budget Variance Variance Last Yr Full Yr Full Yr Full Yr ActMonth Month Month YTD YTD YTD Forecast Budget Last Yr

REVENUEProvider 4,745 5,026 (281) (5.6%) 4,823 19,291 20,104 (813) (4.0%) 19,227 59,235 60,312 58,956Governance & Administration 92 92 0 0.2% 86 368 367 1 0.2% 351 1,102 1,102 1,071Funds & Internal Eliminations 3,798 3,240 558 17.2% 2,714 13,652 12,962 690 5.3% 11,250 38,885 38,885 34,262

8,635 8,358 277 3.3% 7,623 33,311 33,433 (122) (0.4%) 30,828 99,222 100,299 94,289

EXPENSESProvider Personnel 3,348 3,385 37 1.1% 3,036 13,303 13,541 238 1.8% 11,559 41,023 40,623 36,975 Outsourced Services 591 337 (254) (75.6%) 601 2,448 1,346 (1,102) (81.9%) 2,190 7,038 4,038 6,959 Clinical Supplies 469 499 30 6.1% 462 1,915 1,997 82 4.1% 2,008 5,351 5,991 5,924 Infrastructure 1,231 1,167 (64) (5.5%) 1,008 4,627 4,669 42 0.9% 4,106 14,007 14,007 12,747

5,639 5,388 (251) (4.7%) 5,107 22,293 21,553 (740) (3.4%) 19,863 67,419 64,659 62,605

Governance & Administration 149 181 32 17.5% 168 642 722 80 11.1% 637 2,167 2,167 1,888Funds & Internal Eliminations 3,206 2,790 (416) (14.9%) 2,554 11,942 11,158 (784) (7.0%) 10,012 33,475 33,475 29,955

8,994 8,358 (636) (7.6%) 7,829 34,877 33,433 (1,444) (4.3%) 30,512 103,060 100,300 94,448

Net Result (359) (0) (359) 292789.7% (206) (1,566) (0) (1,566) 319304.8% 316 (3,838) (1) (159)


The reasons for this match those given for consolidated revenue (above), namely the timing of revenue from new initiatives, pharmacy having ceased dispensing outpatient scripts and the fact that we have not yet received confirmation of the FRS3 asset revaluation funding. Year to date funder revenue $30,430k is $405k over budget ($30,025k), which is related to a year to date funding adjustment from the Ministry of Health. The monthly consolidated revenue of $8,635k is $277k better than budget ($8,358k). Increased Ministry of Funding (the year to date adjustment mentioned above) has been partially offset by the following items. Additional revenue for the revaluation of assets (to partially offset increased depreciation and capital charge) has not yet been finalised by the Ministry of Health, and a number of new revenue initiatives (MoH funded IT projects, Laundry commercialisation) are still in the process of being implemented (an area to watch as some of these projects need to operate for the full financial year in order to achieve DAP revenue targets). Monthly provider revenue of $4,745k, down $281k on budget ($5,026k). The reasons for this match those given for the year to date result (above), namely the timing of revenue from new initiatives and the fact that we have not yet received confirmation of the FRS3 asset revaluation funding. No allowance has been made for any wash-up liability owed to the funder arm for underproduction against contracted volumes as the reports that give this data are still being written for the iSOFT patient information system. Monthly funder revenue for the month of $8,005k is $499k over budget ($7,506k). This relates to a year to date funding adjustment from the Ministry of Health.

EXPENSES Year to date (October 2006) expenses totalled $34,877k, $1,444k over budget ($33,433k). Year to date provider expenses ($ 22,293k) are $740k over budget ($21,553k). Personnel costs are under budget ($239k) due to the timing of staff leave and staffing

shortages in some clinical areas. Outsourced services are above budget ($1,102k) as we have used locum staff to cover a

number of clinical vacancies. This is an area of concern as locum costs are usually dearer than the costs of employing staff for longer term placements. Clinical supplies are under budget by $82k due to the pharmacy having reduced dispensing

scripts as a result of staff vacancies. IT Costs are $123k over budget due to higher depreciation expense on completed IT projects.

Interest and Capital Charge costs are $249k under budget. We have not allowed for additional costs related to the revaluation of assets as these will not be charged until funding has been finalised by the Ministry of Health (which should offset this portion of the revaluation costs).

Year to date funder arm expenditure is $498k up against budget. Additional inter district flow costs of $250k have been accrued. This relates to a single high cost patient. Monthly expenses for the month of October 2006 ($8,994k) were $636k over budget ($8,358k). Monthly provider expenses for the month ($5,639k) were $251k over budget ($5,388k). Personnel costs are under budget ($37k). Medical Personnel costs were $15k over. The acquisition of the Reefton Medical Centre is

a contributing factor, as this was not budgeted for.


Nursing costs were $65k over budget. Allied Health Personnel were under budget by $ 75k due to staffing shortages in some

clinical areas. Outsourced services are above budget ($254k) due to the need to cover clinical vacancies.

This is an area to watch, as locum costs are usually dearer than the costs of employing staff for longer-term placements. Clinical supplies are $30k under budget for the month, mainly relating to pharmaceutical costs. IT Costs were $25k over budget due to the higher depreciation expense resulting from new IT

systems (iSOFT and PACS). Interest and Capital Charge costs were $60k under budget. We have not allowed for additional

costs related to the revaluation of assets as these will not be charged until funding has been finalised by the Ministry of Health (which should offset this portion of the revaluation costs).

Monthly funder arm expenditure of $7,413k is over budget by $358k, due mainly to the Primary Mental Health initiatives being brought into account.

STATEMENT OF FINANCIAL POSITION We are in a strong financial position with a debt to debt + equity ratio of 41.6%. The balance sheet now reflects the audited opening balances and includes the re-valuation of fixed assets.

CASHFLOW At 30 October 2006 we had $9.5M in cash and investments.

CAPEX Approved capital expenditure for the year to date is under budget.

FORECAST The forecast has been revised after having identified the following areas where the actuals are expected to have a variance against budget for the year ending June 2007. Laundry – Decrease in revenue ($285k) due to the commercialisation of the laundry service not

being fully rolled out. Pharmacy – Both a decrease in revenue ($792k) and expenditure ($640k) due to the ceasing

of dispensing outpatient scripts. Outsourced Services – Increase in expenditure ($3.0m) due to the employment of locum staff,

the main contributor being for anaesthetic services. Nursing cost – Increased in expenditure ($400k) due to the full effect of the nursing MECCA

not being budgeted for. The forecast deficit ($3.9M) does not take into account any gains from the deficit recovery plan to be presented to the Board in its December meeting. Author: Chief Financial Manager/GM Facilities & Support Services – 22 November 2006

Approved: Chief Executive – 23 November 2006



DHB PROVIDER ARM - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF OCTOBER 2006

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full Yr

RevenueCore MoH Funding 4,163 4,235 (72) (1.7%) 4,217 16,619 16,939 (320) (1.9%) 16,658 50,818 50,818 50,756 Other MoH Funding 362 379 (17) (4.5%) 356 1,753 1,516 237 15.7% 1,646 4,547 4,547 5,232 Patient / Consumer Sourced 175 307 (132) (43.0%) 175 698 1,228 (530) (43.1%) 698 2,891 3,683 2,281 Non Health Related 45 105 (60) (57.3%) 75 221 421 (200) (47.5%) 225 979 1,264 687

4,745 5,026 (281) (5.6%) 4,823 19,291 20,104 (813) (4.0%) 19,227 59,235 60,312 58,956

Personnel CostsMedical Personnel 763 748 (15) (2.0%) 532 2,754 2,993 239 8.0% 2,054 8,978 8,978 7,707 Nursing Personnel 1,402 1,337 (65) (4.9%) 1,319 5,539 5,348 (192) (3.6%) 4,782 16,443 16,043 15,290 Allied Health Personnel 715 789 74 9.3% 691 3,040 3,154 114 3.6% 2,776 9,462 9,462 8,371 Support Personnel 97 112 15 13.0% 93 411 446 35 7.9% 397 1,339 1,339 1,214 Management / Admin 371 400 29 7.3% 401 1,559 1,601 42 2.6% 1,550 4,802 4,802 4,393

3,348 3,385 37 1.1% 3,036 13,303 13,541 238 1.8% 11,559 41,023 40,623 36,975

Outsourced Services 591 337 (254) (75.6%) 601 2,448 1,346 (1,102) (81.9%) 2,190 7,038 4,038 6,959

Clinical SuppliesTreatment Disposables 86 88 2 2.4% 81 374 352 (22) (6.1%) 345 1,057 1,057 1,087 Diagnostic Supplies 9 11 2 16.3% 11 32 43 11 25.6% 54 129 129 161 Instruments & Equipment 126 97 (30) (30.6%) 103 474 386 (88) (22.8%) 368 1,158 1,158 1,170 Pt Appliances, Implants, Prostheses 87 91 4 4.1% 72 407 363 (44) (12.1%) 370 1,089 1,089 1,117 Other Clinical & Client Costs 161 213 52 24.5% 195 628 853 225 26.3% 871 1,918 2,558 2,389

469 499 30 6.1% 462 1,915 1,997 82 4.1% 2,008 5,351 5,991 5,924 Infrastructure CostsHotel Services, Laundry & Cleaning 233 227 (6) (2.6%) 204 936 908 (28) (3.0%) 860 2,725 2,725 2,889 Facilities 453 330 (123) (37.3%) 258 1,440 1,320 (120) (9.1%) 1,104 3,960 3,960 3,444 Transport 121 112 (9) (7.9%) 92 461 449 (12) (2.7%) 423 1,346 1,346 1,254 IT Systems & Communication 119 94 (25) (26.3%) 88 500 377 (123) (32.6%) 352 1,131 1,131 1,053 Interest 157 217 60 27.5% 157 617 866 249 28.8% 627 2,599 2,599 1,842 Professional Fees & Expenses (9) 41 50 121.9% 53 78 164 86 52.5% 158 493 493 475 Other Operating Costs 157 146 (11) (7.5%) 156 595 584 (11) (1.8%) 582 1,753 1,753 1,790

1,231 1,167 (64) (5.5%) 1,008 4,627 4,669 42 0.9% 4,106 14,007 14,007 12,747

Expenses Total 5,639 5,388 (251) (4.7%) 5,107 22,293 21,553 (740) (3.4%) 19,863 67,419 64,659 62,605

Allocated from Governance & Admin 78 78 0 0.0% 78 312 312 0 0.0% 312 936 936 936 Surplus (Deficit) (972) (440) (532) 120.8% (362) (3,314) (1,761) (1,553) 88.2% (948) (9,120) (5,283) (4,585)


DHB GOVERNANCE AND ADMIN - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF OCTOBER 2006

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full Yr

Revenue 92 92 0 0.2% 86 368 367 1 0.2% 351 1,102 1,102 1,043

Personnel CostsManagement / Admin 85 96 11 11.1% 84 369 383 14 3.6% 344 1,148 1,148 971

Outsourced Services 19 14 (5) (32.6%) 21 72 57 (15) (25.6%) 66 172 172 268

Infrastructure CostsTransport 0 0 0 100.0% 8 0 1 1 100.0% 21 2 2 72 IT Systems & Communication 10 6 (4) (69.0%) 0 33 24 (9) (39.4%) 3 71 71 4 Professional Fees & Expenses 1 1 0 14.3% 18 3 5 2 35.7% 71 14 14 207 Other Operating Costs 28 48 20 42.1% 16 135 193 58 30.2% 58 580 580 158 Democracy 6 15 9 60.0% 21 30 60 30 50.0% 74 180 180 217

45 71 26 36.2% 63 201 282 81 28.8% 227 847 847 658

Expenses Total 149 181 32 17.5% 168 642 722 80 11.1% 637 2,167 2,167 1,897

Allocated to Provider (78) (78) 0 0.0% (78) (312) (312) 0 0.0% (312) (936) (936) (936)Surplus (Deficit) 21 (11) 32 (296.3%) (4) 38 (43) 81 (188.8%) 26 (128) (128) 83

DHB FUNDER ARM - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF OCTOBER 2006

Actual Budget Variance Variance Actual YTD Actual YTD Budget Variance Variance YTD Actual Forecast Full Budget Last Full YrPersonal HealthFunding Received 7,135 6,637 498 7.5% 5,082 26,950 26,547 403 1.5% 20,471 79,640 79,640 62,592 Provider Payments (5,154) (4,988) (166) 3.3% (4,917) (20,486) (19,953) (533) 2.7% (19,451) (59,860) (59,860) (59,122)

1,981 1,648 333 20.2% 165 6,464 6,593 (129) (2.0%) 1,020 19,780 19,780 3,470 Mental HealthFunding Received 870 870 0 0.1% 821 3,480 3,478 2 0.1% 3,284 10,435 10,435 9,852 Provider Payments (1,039) (869) (170) 19.5% (848) (3,579) (3,477) (102) 2.9% (3,281) (10,430) (10,430) (9,649)

(169) 0 (169) (43123.4%) (27) (99) 2 (101) (6400.8%) 3 5 5 203 Disability SupportFunding Received 0 0 0 0.0% 955 0 0 0 0.0% 3,820 0 0 11,449 Provider Payments (1,128) (1,106) (22) 2.0% (958) (4,287) (4,424) 137 (3.1%) (3,718) (13,273) (13,273) (11,235)

(1,128) (1,106) (22) 2.0% (3) (4,287) (4,424) 137 (3.1%) 102 (13,272) (13,273) 214

Funds ManagementFunding Received 0 0 0 0.0% 86 0 0 0 0.0% 344 0 0 1,032 Interest on Funds Account 0 0 0 0.0% 25 0 0 0 0.0% 113 0 0 456

Allocation to DHB Governance (92) (92) (0) 0.2% (86) (368) (367) (1) 0.2% (344) (1,102) (1,102) (1,032)(92) (92) (0) 0.2% 25 (368) (367) (1) 0.2% 113 (1,102) (1,102) 456

TotalsTotal Funds Revenue 8,005 7,506 499 6.6% 6,969 30,430 30,025 405 1.3% 28,032 90,075 90,075 85,381 Total Funds Expenditure (7,413) (7,055) (358) 5.1% (6,809) (28,720) (28,222) (498) 1.8% (26,794) (84,665) (84,665) (81,038)Surplus (Deficit) 592 451 141 31.3% 160 1,710 1,803 (93) (5.2%) 1,238 5,410 5,410 4,343


DHB CONSOLIDATED - STATEMENT OF FINANCIAL POSITION AS AT OCTOBER 2006

Actual Budget Variance Variance Last Yr Act

Current AssetsCash 4,502 3,911 591 15.1% 3,469 Short term Investments 830 7,730 (6,900) (89.3%) 3,406 Debtors & Prepayments 1,939 2,050 (111) (5.4%) 6,299 Inventory 559 650 (91) (14.0%) 583 Assets for Sale 264 207 57 27.5% 205

8,094 14,548 (6,454) (44.4%) 13,962 Non Current AssetsLand & Buildings 23,235 27,301 (4,066) (14.9%) 20,096 Equipment (incl IT) 6,485 6,584 (99) (1.5%) 5,165 Vehicles 139 20 119 583.6% 50 Investments 4,265 2 4,263 213150.0% 2

34,124 33,908 216 0.6% 25,313 Current LiabilitiesAccounts Payable 8,104 8,123 (19) (0.2%) 7,753 Employee Entittlements 4,777 4,900 (123) (2.5%) 4,453 Current Portion of Term Loans 0 0 0 0.0% 0

12,881 13,023 (142) (1.1%) 12,206

Net Funds Employed 29,337 35,433 (6,096) (17.2%) 27,069

Term LiabilitiesEmployee Entittlements 2,430 2,490 (60) (2.4%) 2,339 Other Term Liabilities 11,201 11,701 (500) (4.3%) 11,201

13,631 14,191 (560) (3.9%) 13,540 Crown EquityCrown Equity 44,147 45,147 (1,000) (2.2%) 44,147 Retained Earnings (28,482) (23,954) (4,528) 18.9% (30,659)Trust Funds 41 49 (8) (16.3%) 41

15,706 21,242 (5,536) (26.1%) 13,529

Net Funds Employed 29,337 35,433 (6,096) (17.2%) 27,069


DHB CONSOLIDATED - STATEMENT OF CASHFLOWS FOR THE MONTH OF OCTOBER 2006

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD

Operating ActivitiesOperating Receipts 8,736 8,358 378 4.5% 8,102 33,565 33,433 132 0.4% 30,735

Payments to Personnel 3,213 3,481 268 7.7% 2,838 13,670 13,924 254 1.8% 11,740 Payments to Providers 1,777 1,719 (58) (3.4%) 1,411 7,051 6,875 (176) (2.6%) 5,860 Interest & Capital Charge 177 215 38 17.5% 192 536 858 322 37.5% 774 Payments to Suppliers, GST, etc 3,348 2,687 (661) (24.6%) 2,163 12,196 10,746 (1,450) (13.5%) 8,315 Operating Payments 8,515 8,101 (414) (5.1%) 6,604 33,453 32,403 (1,050) (3.2%) 26,689 Net Cashflow from Operating 221 257 (36) (14.1%) 1,498 112 1,030 (918) (89.1%) 4,046

Investing ActivitiesSale of Fixed Assets 0 0 0 0.0% 0 0 0 0 0.0% 0 Increase (Decrease) in Investments 0 0 0 0.0% 0 0 0 0 0.0% 0 Purchase of Fixed Assets 449 583 134 23.0% 679 1,055 2,333 1,278 54.8% 1,366 Net Cashflow from Investing (449) (583) 134 (23.0%) (679) (1,055) (2,333) 1,278 (54.8%) (1,366)

Financing ActivitiesFinancing ReceiptsEquity Injections 0 0 0 0.0% 0 0 0 0 0.0% 0 Loans Raised 11,195 0 11,195 0.0% 11,195 0 0 0 0.0% (11,195)

11,195 0 11,195 0.0% 11,195 0 0 0 0.0% (11,195)Financing PaymentsRepaid Debt 11,195 0 (11,195) 0.0% 11,195 0 0 0 0.0% (11,195)

11,195 0 (11,195) 0.0% 11,195 0 0 0 0.0% (11,195)Net Cashflow from Financing 0 0 0 0.0% 0 0 0 0 0.0% 0

Opening Cash 4,730 3,985 745 18.7% 2,650 5,445 3,985 1,460 36.6% 3,672 Net Cashflow (228) (326) 98 (30.0%) 819 (943) (1,304) 361 (27.7%) 2,680 Closing Cash 4,502 3,659 843 23.0% 3,469 4,502 2,681 1,821 67.9% 6,352


WEST COAST DISTRICT HEALTH BOARD DEBT REGISTERAS AT OCTOBER 2006

Lender's name CHFA CHFA CHFA BNZLoan Identified As Renewal Renewal Dementia Unit OverdraftDebt Amount - face value $7,695,000 $3,500,000 $2,500,000 $3,600,000Instrument type Term Loan Term Loan Amortising Loan OverdraftFixed / Floating interest rate Fixed Fixed TBA FloatingFixed rate 6.11% 6.31% TBAFloating rate base and margin BKBM+0.225%Interest payment frequency Quarterly Quarterly Quarterly DailyCovenants (Debt to Debt + Equity ratio) 55% 55% 55% 65%Covenants (Interest Cover EBID) 1.3x 1.3x 1.3x

Next Payment Due When 31/10/10 31/10/07 any time How much $7,695,000 $3,500,000 any amount

Next Rollover / Refinance Due When 31/10/10 31/10/07 How much $7,695,000 $3,500,000 Plan Refinance CHFA Refinance CHFA

5 year renewal 2-5 year renewal

Upcoming Loan RepaymentsOctober 2007 CHFA Term Loan Fixed 3,500,000$

(Excludes Overdraft and Lease Payments)


Fortnight Ended 14/12/2006 28/12/2006 11/01/2007 25/01/2007 08/02/2007 22/02/2007 08/03/2007 22/03/2007

Opening Balance 570,037 2,369,772 532,265 1,885,000 456,492 2,463,227 1,410,009 3,415,744

Cash InRevenue 4,866,243 532,000 4,694,243 766,000 4,726,243 688,290 4,850,243 734,000 Loan Funds - - - 250,000 - 250,000 - 250,000 Equity - - - 500,000 - 1,500,000 - 500,000 Asset Sales - - - - - - - -

Cash OutPayroll Costs 1,140,758 1,140,758 1,140,758 1,140,758 1,140,758 1,140,758 1,140,758 1,140,758 Creditors Payments 1,022,000 875,000 897,000 1,250,000 875,000 1,397,000 1,000,000 1,397,000 GST 350,000 - 350,000 - 350,000 - 350,000 - PAYE / ACC 353,750 353,750 353,750 353,750 353,750 353,750 353,750 353,750 Loan & Interest Pmts - - - 200,000 - - - - Capex 200,000 - 600,000 - - 600,000 - 600,000

Closing Balance 2,369,772 532,265 1,885,000 456,492 2,463,227 1,410,009 3,415,744 1,408,237

AssumptionsThis cash flow forecast is for the provider arm of the West Coast DHB only"Early Payment" funding of $5.087M has been received from the Ministry of Health but isn't shown in this cash flow forecast as it has been set aside for Debt repayment. (by way of investing it for fixed terms that expire when our core CHFA loan is due for renewal).

Note: Our Overdraft limit is $3.6M

WEST COAST DISTRICT HEALTH BOARDCASH FLOW FORECAST AS AT 20 NOVEMBER 2006


WEST COAST DISTRICT HEALTH BOARDDIRECTORS SCHEDULE

SUMMARY OF EXPENDITURE YEAR TO DATE TO 31 October 2006Note: Figures GST Exclusive

Actual Budget VarianceAnnual Budget

Directors Fees 54,460 60,000 (5,540) 180,000

Directors ExpensesTravel Expenses 8,030 8,668 (638) 26,004Other 3,664 12,272 (10,179) 36,816Total 11,694 20,940 (10,817) 62,820

Advisory Committee Costs 8,963 20,000 (11,037) 60,000Community Consultation Costs 1,668 (1,668) 5,004

TOTAL EXPENSES 20,657 42,608 (23,522) 127,824

WCDHB BOARD OF DIRECTORS FEES & EXPENSES $75,117 $102,608 ($27,491) $307,824


NOTES 1 Net result as a percentage of Net Funds Employed

Provides a projected annual return on Long Term Funding based on current months performance.

2 Earning / Net Funds Employed

Provides a projected annual return, from normal operations, as a percentage of Long Term Funding, based on current months performance.

3 Debt to Debt + Equity Ratio

A measure that indicates the extent to which assets are financed by debt (excluding any overdraft balance). (This is consistent with the Bank of New Zealand definition of debt).

4 Interest Cover

Shows ability to meet interest expense from Operating Surplus. Calculated as: operating surplus before interest, capital charge and depreciation divided by interest expense.

Financial Performance Indicators for October 2006

Net result after tax $000 -359 0 -206

Net Result/Net Funds Employed % (Annualised) % -14.7 0.0 -9.1

Earnings* /Net Funds Employed % (Annualised) % 1.7 16.0 7.1

Revenue/Net Funds Employed (Annualised) times 3.5 2.8 3.4

Debt** /Debt + Equity (BNZ definition) % 62.8 56.2 65.6

Debt*** /Debt + Equity (CFA definition) % 41.6 35.5 45.3

Revenue/Fixed Assets (Annualised) times 3.0 3.0 3.6

Interest cover times 0.7 7.0 2.6

** Debt exclusive of Overdraft - Bank of New Zealand definition of Debt / Debt + Equity*** Arranged Debt inclusive of Overdraft - Crown Funding Agency definition of Debt / Debt + Equity

Month Actual

Month Budget

* Earnings = operating surplus/(deficit) before interest, capital charge, tax and depreciation.

Month Last Yr


GLOSSARY OF FINANCIAL TERMS Assets - Economic resources owned or controlled by the WCDHB, as a result of past transactions, for the entity’s future benefit.

Current Assets are those assets that are expected to be converted into cash in the next accounting period, i.e. within the next 12 months.

Non Current Assets are long-term assets that are held for use in the productive process and are not expected to be converted into cash in the next accounting period. CAPEX (Capital Expenditure) - The Purchase of non-current assets. Capital Charge – All DHBs are required to pay capital charge in order to recognize the cost of financial resources vested in them by the Crown. Capital Charge is levied at 11% per annum on the DHBs Crown equity balance. Capital charge is equivalent to the value of dividends and capital gains that shareholders would normally require from a private organization. Debt - An obligation of WCDHB to pay a sum of money within a specified time.

Debt to Debt + Equity Ratio - A measure that indicates the extent to which assets are financed by debt. (Excluding any overdraft balance). (This is consistent with the Bank of New Zealand definition of debt).

Equity (Owners Equity, Shareholders Funds) - A claim against the assets of the WCDHB. Represents a residual claim to all assets not claimed by holders of external liabilities. FTE - Full Time Equivalent employees

Interest Cover - Shows ability to meet interest expense from Operating Surplus. Calculated as: Operating surplus before interest, tax & depreciation divided by interest expense. Liabilities - An amount owed by WCDHB to non-owners. Current Liabilities are obligations to pay an amount or perform a service in the next accounting period, i.e. within the next 12 months. Non-Current Liabilities are those obligations requiring settlement beyond the next accounting period. Net Funds Employed - The total of Non current Liabilities plus Total Shareholders’ Funds.

NHPIDE (Nursing Hours Per Inpatient Day Equivalent) - Nursing Hours is the sum of total hours spent in direct patient care over each shift. Calculated as: Actual Nurse hours divided by total inpatient bed days.

Operating Surplus- Surplus attributable to ordinary and continuing operations. Leave Liability – The total amount of accrued leave benefits owing to employees. Covers Annual, Long Service and Parental leave as well as Retirement Gratuities and Lieu days owing. Author: Chief Financial Manager/GM Facilities & Support Services – 20 November 2006

Approved: Chief Executive – 23 November 2006

WCDHB Meeting Papers Section 11 – Reports from Board Advisory Committees 15 December 2006 Page 1

REPORTS FROM BOARD ADVISORY COMMITTEES


HOSPITAL ADVISORY COMMITTEE

RECOMMENDATIONS TO THE BOARD Nothing noted.

REPORTING BACK ON WORK PLAN AND BOARD REFERRED ITEMS

• 20/20/Project A draft plan is being finalised and will be sent to HAC members in preparation for deliberation at the January 12th meeting prior to the January workshop and Board meeting.

• Health Information Strategy A report on the overview of the WCDHB’s Health Information Strategy was presented and discussed. HAC members wish to strongly commend the staff involved for the comprehensive forward looking strategy—a job very well done!

• Theatre Utilisation Plan A high level plan was presented to HAC outlining the areas requiring change in order to maximise theatre utilisation. Staff are to be commended on both the report and the activities being undertaken.

• HR matters/Key vacancies − HAC was again reassured that there are currently no staffing issues which might impact on

the ability to deliver services. − Locum costs are having to be borne in order to provide cover for acute orthopaedic cases.

Elective work continues as expected. − The two psychologist vacancies are being addressed but are not having a major impact on

service provision. − Progress continues to be made and the situation is improving in finding GP cover for the

Reefton practice. − HAC is pleased to read of the interest being shown in the scholarship programme and

acknowledges that this is only one component of a comprehensive strategy to improve long term recruitment.

TO: Chair and Members West Coast District Health Board

FROM: Christine Robertson - Chair, Hospital Advisory Committee Chair DATE: 1 December 2006


PROVIDER ARM PERFORMANCE / OTHER MATTERS

• Finance HAC is aware that the Board has accepted the committee’s recommendation in relation to a recovery plan so decided not to make further comment on the financial situation as this point

• Trendcare As a follow up to the report received at the last HAC meeting, the DON attended

the meeting to answer questions. The DON is working with staff and Trendcare suppliers in order to increase the value of the tool to the DHB and to enhance the ability to plan service utilisation both on a day to day basis and strategically.

• ESPIs Again, a pleasing report on the DHB’s performance in meeting the ESPIs was

provided. HAC is aware that any outstanding issues are being addressed • Review of Data to be provided to HAC Work has been done to analyse the data currently

provided to HAC: its usefulness to the committee, the need to ensure that it is also useful to the organisation and an assurance that it is not creating unnecessary work for staff. The new format will be used in February at which time the committee will comment on whether or not the material and form of presentation meets its needs.

• Barrier Free Audits Buller and Reefton A report on work done to date was presented and

plans for further action outlined. A further report will come to HAC in 6 months time. • Monitoring of Maternity Statistics by CQIT A report was requested by HAC particularly

relating to the Caesarean Section rates. This was provided along with an outline of the content of future reports which will be presented annually to HAC. It was decided that some maternity service statistics currently provided to HAC would be more usefully monitored as part of the brief of the CQIT and hence included in the annual report.

HAC would like to send its best wishes to a member of the HR team who is retiring soon. Pic Neilson has made an outstanding contribution to managing the OSH risk of the DHB and its predecessor organisations. We wish her well in her retirement.

SEEKING BOARD APPROVAL FOR FURTHER ADVISORY COMMITTEE CONSIDERATION OF AN ITEM

Nothing noted.

ITEMS OF INTEREST FOR THE BOARD TO BE AWARE OF

Nothing noted. Author: Christine Robertson – Chair, Hospital Advisory Committee 1 December 2006


HOSPITAL ADVISORY COMMITTEE WORK PLAN 2005/2006 AS AT 1 DECEMBER 2006

Mission Statement: To fund a continuum of quality health services aimed at providing improved health outcomes and maximise the independence

of people with disabilities.

Progress Objective Responsibility End Date Reporting Frequency

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To receive a report on relevant section for HAC

1. District Annual Plan – progress report

GM Planning & Funding

Ongoing Quarterly √ The first quarterly report for the 2006/2007 is in progress and will be presented at the December HAC meeting.

2. Maori Health Plan GM Maori Health 31/12/06 Quarterly √ Maori Health Plan The Maori Health Plan 2003-2010 was presented to Tatau Pounamu / Maori Health Advisory Committee on the 20 November 2006. Tatau Pounamu have indicated they are happy with progress made on the plan to date. Individual members will provide further written feedback if that is required The next stage in this process will be to consult with the Maori community throughout Te Tai Poutini.

To develop

1. Asset Management Plan Chief Financial Manager

Oct 2008 3 yearly √ 3 yearly – next due 2008.

2. Information Services Strategic Plan

Chief Financial Manager

31/12/07 Annual

This report is included in the December papers.

3. Workforce Development HR Manager Ongoing Quarterly √ Continue to support national initiatives. Various WCDHB projects about to kick off, Exit process, generic induction process this year and competencies project early next year.

4. 10 Year Strategic Site Plan Chief Financial Oct 2008 3 yearly Not yet begun.



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Manager

5. Secondary Care Plan GM Planning & Funding

Quarterly

Provide input into

1. District Strategic Plan GM Planning & Funding

Oct 2008 Annually Not yet begun.

2. 07/08 District Annual Plan GM Planning & Funding

31/01/07 Annually √ The draft 07/08 district annual plan is due with the Ministry of Health on 09.03.07. The Board and advisory committee workshop on developing the DAP & SOI is to be held on 27.01.07.

3. 07/08 Statement of Intent GM Planning & Funding

31/01/07 Annually The draft 07/08 statement of intent is due with the Ministry of Health on 09.03.07. The Board and advisory committee workshop on developing the DAP & SOI is to be held on 27.01.07.

4. Annual Report Chief Financial Manager/General Manager Planning And Funding

Annually √ Completed

To monitor

1. Financial performance Chief Financial Manager

2. Provider performance to contract

GM Secondary Health Services

√ No data available.

3. Productivity GM Secondary Health Services

Progress report on theatre utilisation included in December papers.

4. ESPI Indicators GM Secondary Health Services

√ Report included in December papers.

5. Recruitment and retention initiatives

HR Manager On-going Quarterly √ New HR Adviser Recruitment is on-board, new HR Administrator appointed and starts end Nov. E-recruitment business plan is completed and with CEO. Scholarships and careers project launched with breakfast meeting held in early Nov. Applications for scholarships are being received. On-going recruitment mostly on target.



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6. Barrier Free Audit implementation

Chief Financial Officer Report included in December papers.


DRAFT MINUTES OF THE HOSPITAL ADVISORY COMMITTEE MEETING HELD FRIDAY 1 DECEMBER

2006 AT 9.46 AM IN THE BOARDROOM, CORPORATE OFFICE, GREYMOUTH

PRESENT

Christine Robertson Gregor Coster (joined via teleconference) Elizabeth Rock Richard Wallace Brian Wilkinson Kathryn Cannan Barbara Beckford (arrived 9.59 am)

IN ATTENDANCE Chris Le Prou, GM Secondary Health Care Services Wayne Champion, Chief Financial Manager Jane O’Malley, DON / Midwifery Kevin Hague, Chief Executive Officer (arrived 9.51 am)

Karakia – Richard Wallace 1. WELCOME AND APOLOGIES The Chair welcomed attendees to the meeting and no apologies were received. 2. DISCLOSURE OF INTEREST The following amendments were made to the Hospital Advisory Committee Members’

disclosures of interest. Richard Wallace

• Daughter appointed to the Board of West Coast District Health Board 3. MINUTES OF THE LAST MEETING The minutes of 19 October 2006 were accepted as a true and accurate record. Moved: Richard Wallace Seconded: Elizabeth Rock

It was RESOLVED to accept the minutes. 4. MATTERS ARISING Refer monitoring of maternity figures to the Clinical Board for reporting to HAC on an

annual basis. Included in papers.


Provide a copy of ISSP for HAC comment. Included in papers. Provide a high level of summary of theatre utilisation. Included in papers. Chair HAC and Board Chair to liaise with CEO re resourcing for work on Maori Health

Needs Analysis. The Chief Executive will monitor the workload and take action if required. 5. CORRESPONDENCE There was no correspondence received or sent for the month of November 2006. 6. WORK PLAN Clarification was sought on some items listed in the work plan such as timeframes for reporting

and scope. Maori Health The next quarterly report will be due March 2007.

The Chief Executive arrived 9.51 am. Secondary Care plan Clarity was sought whether the secondary care plan is tied in to the 2020 project. The Chair

was advised that the secondary care plan and 2020 project are effectively the same for these initial stages.

ISSP / Health Information Strategy West Coast DHB is ahead of the planned national strategy for an ISSP. The West Coast DHB

decided to undertake this plan without national instruction as part of our major phase of IT capital investment. The Chair and committee members were impressed with the details and issues covered in this plan and wished to pass on the positive comments to the writer and other parties involved.

Committee members were provided an opportunity to comment and provide any feedback on

the plan. A committee member asked whether the Introduction was inclusive of all peripheral sites. They were advised that external sites are included. Clarity was sought about the logic of the environmental scan, in relation to the likely rise of unemployment once the mines are well established. It was explained that the initial set up of mines has a large capital investment in operations. A major amount of work is put in place to develop the mine. Once the mine has been established the work becomes less people intensive.

A committee member noted that the comment under the heading Information, on tracking

health outcomes, is really positive and asked when we would expect this capability to be available? The committee were advised that it is a real tool but is data entry reliant. They were advised that some of this information is already available at a patient level but not population level. The committee were advised that this will occur as the West Coast DHB own ¾ of the primary services on the West Coast.

The Chair queried the audits being completed regularly in relation to who is viewing data and

asked if this would include external auditors.

Barbara Beckford arrived 9.59 am


The committee were advised that there is current auditing systems in place that can advise who has correct access. The current audit processes in place are not as robust within the primary health systems. A committee member asked who owns the data, particularly in primary care settings, the PHO or the individual practice? It was advised that patients can request restrictions for their privacy but that the DHB, in its practices, owns the intellectual property. The DHB would be able to produce a report that has access to patient information.

A committee member asked about the patients having the ability to choose whether to share

primary / secondary health information and what would be the consequences, as stated in the plan, of not agreeing to share this? Patients will be advised that not allowing the sharing of information could provide a barrier to the ability to care for patients with complex needs where it would be helpful for service providers to be able to access all of a patient’s medical history.

The Chair to the Board advised that this is an excellent report and that all should be

congratulated. The Minister of Health was shown our current IT systems at Buller detailing the integration between primary and secondary at his recent visit. West Coast DHB’s work in IT was acknowledged and congratulated.

A committee member queried whether private practices have compatible systems. He was

advised that it will depend whether they have the same systems and what kind of interface is intended. There will be the ability to have capacity to give discharge information and the ability to access a webpage for electronic referrals. There are some issues to be sorted inclusive of refining PAC images. The goal is to have integration between the secondary and primary health services. It was asked once this computerised system has been established whether the Pharmacies would be able to be included into this system. It was discussed that Pharmacy software matters and integration are being driven from the Ministry and work is being undertaken nationwide. Once this has been developed it would be possible for a Pharmacist to produce a script from the computer system. The biggest issue currently is legislation law which requires a signature on the script so a system for an electronic signature needs to established inline with legislation. It was reiterated that consultation for integration between primary, secondary health and the pharmacists is essential to the success of a seamless transition.

A committee member enquired if a number of the GPs are part of the PHO on the West Coast

whether the PHO liaise with secondary health on behalf of the GP practices to discuss IT integration / network. The committee were advised that this has the potential to complicate negotiations, as a third party would be involved. Discussions have already commenced with the GP practices. It was suggested that it could be a policy of the PHOs that members have an IT system that can be integrated with the DHB. This would enhance patient flow.

A committee member asked about the integration of primary / secondary whether it would be

inclusive of independent midwives, Rata Te Awhina, or Plunket etc. The committee were advised that Rata Te Awhina will be on the Prism system and that discussions are in the final stages. Other external agencies such as Plunket will be addressed once a national directive has been given.

The Chair indicated that her report to the Board that HAC members wish to strongly commend

the staff involved for the comprehensive forward looking strategy. Action: Chair

The Chair of the Board advised that this is a good paper and thought it would be ideal to

provide the Minister of Health a two page summary on the work the West Coast DHB has undertaken already along with a copy of the report.


The ISSP report in the work plan is annual. The Chair indicated that the committee would like to be provided a progress report in 6 months.

Action: Chief Financial Manager / Facilities / IT Services

Workforce Development The HR Team are a new team. They are about to commence workforce initiatives and a report

on workforce development / retention report will be available March 2007. It was noted that a longstanding member of HR team is departing the DHB in February. The

committee were also advised that the Team wishes to enhance a learning and development role but there has been no advancement due to no funds being available. It is anticipated to review the team and look at the possibility to improve external training which could possibly be self funding.

6.1 THEATRE UTILISATION REPORT The committee reviewed the report and were provided an opportunity to ask questions.

A progress report will be provided in 6 months. The report provides clear detail and is tied in with the 2020 project. HAC members were impressed by the clarity of the report in identifying issue and how they are to be addressed.

Action: General Manager Secondary Health Services Day cases were discussed. Some procedures undertaken at the DHB involve an overnight

stay where as in other DHBs they are performed as a day case. This often relates to geographic reasons. This is where a step down facility would be ideal as some patients stay may not necessarily be of clinical need but geographic need.

Patient flows were discussed. How patients prepare before they come into surgery is a key

area and a review is being undertaken. 6.1 2020 PROJECT The Chief Executive provided a brief update. He advised that the Secondary Health services

Managers had a meeting this week to discuss services and that this meeting was beneficial. He advised that census data will be available 6 December which will provide accurate numbers of our population and assist with forward planning of the 2020 project. The Chief Executive advised that he will distribute a 2020 update via email prior to next meeting. Due to the timeframes HAC will not have an opportunity to review before the December’s Board meeting so it was agreed to review the plan at January’s meeting, prior to the workshop and board meeting.

6.1 QUARTERLY REPORT DAP IMPLEMENTATION This report has been streamlined so that HAC can focus on the areas relevant to the work of

the committee. It contains information relating to the DAP and SOI. Committee members were provided an opportunity to ask questions and provide comments.

A committee member enquired about CPH’s involvement in collecting data. The Chief Executive advised that he could not provide an answer to that.

A query about chemotherapy volumes being increased and a decreased patient demand was

discussed. This may be as a result of good early intervention. It was advised that it could be


due to a small number of patients and with one person’s death, results in an over estimation of services.

A committee member enquired about the objectives (CVD and Stroke Services) being in red

and how long it is anticipated that they would remain red. The committee were advised that the AT&R ward requires a major refurbishment in order to achieve a better result but it is a question of whether a large amount of money is spent on the ward with the 2020 project being discussed. HAC wishes to know what can be done to progress this service area regardless of the need to refurbish. A response to this concern will be provided at the next HAC meeting.

Action: General Manager Secondary Health Services

HAC was pleased to note that under the heading Elective Services that for the orthopaedic and

cataract initiatives, waiting list times have been met and contracted volumes have been delivered.

Efficiency Gains in the report were discussed in particular the ability to recover debts from

overseas patients. There is a focus on charging patients for overseas and the collection of charges needs to be improved. A committee member asked what happens for debt recovery. The committee were advised that the first thing is to get payment at the time of treatment. Travel insurance is the other source of seeking payment, patient and insurance details are collated at the time of treatment and payment is sought via the travel insurance company. Most charges for overseas patients are claimed via insurance companies. Claims are generally for people who become sick on holiday rather than accidents. Accidents are covered by ACC regardless of nationality. Any outstanding debt is sent to the debt collectors.

The next DAP quarterly report will be provided at the March meeting. 6.2 CHIEF EXECUTIVE REPORT As this and other reports are discussed, areas will be identified as to whether or not they are to

remain included in future HAC papers. Recruitment The Chair asked if any of the vacancies have the ability to impact on services. The committee

were advised that we are filling, at a cost, orthopaedic vacancies with locums to maintain acute cover. The electives are running as business as usual.

A question was asked about Psychologist vacancies and whether services for mental health

are still being provided. The committee were advised that they are still providing service. The Reefton GP vacancy is being filled by locums and active recruitment continues with the

situation there improving. Buller GPs have five doctors working at Buller Medical Services, almost a full complement. It is

worth highlighting that vocationally registered doctors are being successfully recruited. OSH Report The Chair indicated that the current OSH Advisor, who is about to retire, has done a huge

amount of work on reducing the DHB’s ACC levies and that she should be commended for such a great achievement.

Action: Chair


Mandatory Training A committee member noted that mandatory training is not always complied with and that if it is

mandatory Managers should ensure staff attend. Scholarships A committee member commented that it is great to see the scholarship programme is

underway. The Chief Executive advised that this will commence in 2007 and that includes encouraging students into the healthcare industry. Supporting students to continue maths, science and mentoring will be a part of the total programme along with holiday job placements/work experience. The Minister of Health advised that he was pleased with the implementation of this initiative.

Data for risk management and the nursing report will stay in the HAC papers. A committee

member advised that the figures for accidents / incidents on medication errors are of concern. The Chief Executive advised that overall New Zealand data there is a lot of medication errors occurring and that this is one of the Ministers quality improvements objectives.

Primary Practice The primary practices graphs have not been supplied for sometime and the Chief Executive

was requested to see whether the data being supplied is a practice based problem as the committee was advised that there is no issue with the DHB software system.

Action: Chief Executive Officer

Mental Health The data for MHINC has been discussed with the Mental Health team. All issues with data

have been resolved and it is anticipated that the report should be available next year. The Chief Executive advised that if this data is not ready for next meeting, the Project Manager has been manually producing data.

Moved: Elizabeth Rock Seconded: Barbara Beckford

It was RESOLVED to accept the Chief Executive’s Report. FINANCE REPORT The Chief Financial Manager advised that the DHB now has 4 months of data to present. He

advised that YTD October resulted deficit is $1.5 m versus break even plan. This result relates to staffing the provider arm with contracted staff versus employed staff and their rates. The provider arm deficit is $3.3m, which is $1.5 worse than planned.

Outsourced services are $1.1 m worse than planned. Pharmacy revenue costs are down $200k

due to not dispensing outpatient scripts. Nursing costs are up; budgets were set before the national MECA was negotiated.

The committee discussed the deficit and agreed that, as the Board had accepted HAC’s

recommendation on the need for management to provide a recovery plan for the December Board meeting, this matter will be left at Board level meantime.

Financial indicators were discussed as to what is to be retained in the papers. It was agreed

that the capex expenditure remain. The leave analysis is no longer required, and that personnel graphs are no longer required. There are other measures already in place with management in relation to personnel; these graphs are only provided to HAC. The debtors graphs are to remain. The Chief Financial Manager discussed the reasons for some debt


exceeding 60-90 days, an example is the time taken to collect rest home subsidies. He also advised that the Reefton debtors are not previous debt carried on from the previous provider.

Moved: Barbara Beckford Seconded: Brian Wilkinson

It was RESOLVED to accept the Finance Report. OPERATIONAL INDICATORS HAC considered the data provided to this meeting. Some of it will not be provided again as it is

the background data for the ESPI report which HAC receives. Some will be retained but reported on a “by exception” basis as outlined in the following paper.

OPERATIONAL DATA FOR HAC The Chief Executive tabled a report on performance indicators in HAC papers. It is important

to know how the DHB is performing against contract. The previous data supplied for HAC needed to be reviewed against what is provided to the Ministry and what is provided purely to HAC.

The report included a list of indicators. Benchmarking undertaken by the Ministry provided

feedback against other DHBs. The table presented (PAM framework) is in alignment with the national framework. It is anticipated that a new report template will be provided at the March meeting. There will be a reduction in lengthy tables and exception data provided as to why clinics were cancelled, how many were cancelled, and reasons that should have been avoidable. The Chief Executive suggested that the trigger points for exception reports would be a variation of 10% or 5 patients whatever is larger.

The HAC statistics for the February meeting will reflect the ideas in the CEO’s paper. Members

will then have the chance to say if the data meets HAC’s needs or not. 6.3 ESPI DATA The ESPI data is the West Coast DHB’s own; the national data is not correct and has errors

that are being corrected. Until this matter is resolved HAC will continue to get the locally produced ESPI report.

While the DHB meets the targets overall for surgery there are areas of concern which relate to

the availability of visiting specialists and to the issue of how many follow ups versus new appointments are being scheduled. Further work is being done to address this matter.

6.3 TRENDCARE REPORT The paper included in the papers was presented at the last HAC meeting. The Director of

Nursing / Midwifery was not available last meeting so has attended today to discuss this report in detail.

Questions were asked and the Director of Nursing / Midwifery provided feedback. She advised

that peripheral hospitals do not use Trendcare as trending data. Trendcare’s value to the organisation relates to the way data is being currently captured and reported and is not as useful as it could be. Capacity planning needs to match nursing work flow to patient flow. At the moment the report is by month by month aggregated data while day to day information (across a month and across a year) is much more relevant. The Director of Nursing / Midwifery


advised that she is working with Trendcare in Australia to get this data. There currently is a huge variance in data. This variance has a lot to do with surgical flow. By getting the data set correctly there is the opportunity to plan on a yearly basis for smoother patient flows. This is currently being worked on by the GM Secondary Health Services and Director of Nursing / Midwifery.

6.3 BARRIER FREE AUDITS – BULLER AND REEFTON The Chief Financial Manager advised that a lot of activity has occurred in Buller to resolve any

issues. Car parking has been rectified, and signage addressed. The Chief Financial Manager advised that he would provide an update in 6 months time as he is planning visits to Reefton and Buller to ensure progress.

Action: Chief Financial Manager 6.3 MATERNITY REPORT The Director of Nursing / Midwifery provided an update and advised that she has been in

discussion with one of our O&Gs. Our caesarean rate is been reviewed against the national figures and caesarean rates are being broken down further as to why they occurred. HAC has requested that figures (births per DHB facility and home births) currently provided to the committee, now be included in the brief of the CQIT when considering maternity matters. HAC will cease to get this data. The Chair of HAC, when reviewing data for the committee, felt that the birth rate information was more appropriately considered as part of credentialling. The credentialling process, for all staff involved, looks at a variety of issues around clinical practice including that of the environment in which a discipline works. Currently there is a debate with the College of Midwives around the DHB’s credentialling process. The Director of Nursing / Midwifery advised the Midwife College credentials midwives and looks at competency, births, number, and type. She will provide a copy of the College’s requirements to the Chair of HAC and will discuss with the Chair any issues around the credentialling process and the role of the CQIT.

A committee member enquired about the number of ultrasounds performed as the Ministry

report indicted that we have a large number of ultrasounds. However, this may have occurred when there were limited O&Gs and this would have been a midwife ensuring patient / baby welfare.

The report on Caesarean section rates and related matters will be provided annually to HAC

but will have a brief update at next meeting. Action: Director of Nursing / Midwifery

7. KEY ISSUES / ITEMS OF INTEREST TO REPORT TO THE BOARD 7.1 Reporting back on work plan and Board referred items • 2020/Project • Health Information Strategy • Theatre Utilisation Plan • HR matters/Key vacancies

7.2 Provider Arm Performance/Other Matters • Finance • Trendcare


• ESPIs • Review of Data to be provided to HAC • Barrier Free Audits Buller and Reefton • Monitoring of Maternity Statistics by CQIT 8. GENERAL BUSINESS 8.1 Workshop The committee was advised that a workshop will be held on the 26 January 2007. 9. NEXT MEETING The next meeting is Friday 12 January 2007 and will commence at 9.45 am. 10. ATTENDANCE AND ADMINISTRATION FORMS Actioned.

There being no further business the meeting closed at 12.07 pm


MATTERS ARISING FROM HOSPITAL ADVISORY COMMITTEE MEETINGS

Item No.

Meeting Date

Action Item


Reporting Status

Agenda Item Ref

7 October 2005 Provide a management response with the next completed Paediatric Society report.

Executive Managers On receipt of Paediatric Society report for 2006

28 July 2006 Check progress of IDFs being referred directly from GPs Chief Executive January 2007

28 July 2006 Provide MHINC data for HAC papers. GM Mental Health / Primary Care

January 2007

8 September 2006 Provide an update of the use if the Inpatient Unit, Manaakitanga after one year of the extended Palms being opened.

GM Mental Health / Primary Care

When data available.

1 December 2006 Provide an ISSP progress report. Chief Financial Manager

1 December 2006 Include in Chair report to the Board that HAC members wish to strongly commend the staff involved for the comprehensive forward looking strategy.

Chair 6 months

1 December 2006 Provide an update on the theatre utilisation plan. GM Secondary Health Services

6 months

1 December 2006 The Chair indicated that the current OSH Advisor be commended for such a great achievement in reducing ACC levies.

Chair

1 December 2006 Provide a progress update in 6 months time on the Reefton and Buller Barrier Free Audits.

Chief Financial Officer


Item No.

Meeting Date

Action Item


Reporting Status

Agenda Item Ref

1 December 2006 Provide a brief update on Caesareans at the next meeting.

Director of Nursing / Midwifery

January 2007


DISABILITY SERVICES ADVISORY COMMITTEE


West Coast District Health Board FROM: John Vaile DATE: 7 December 2006

RECOMMENDATIONS TO THE BOARD DSAC recommends to the WCDHB that they endorse the WISE Plan DSAC recommends to the WCDHB that they endorse the Maori Health Plan

REPORTING BACK ON BOARD REFERRED ITEMS Nil

SEEKING BOARD APPROVAL FOR FURTHER ADVISORY COMMITTEE CONSIDERATION OF AN ITEM Nothing noted.

ITEMS OF INTEREST FOR THE BOARD TO BE The Physiotherapy and Occupational Heads of Departments spoke on the Draft Discharge Plan Template and how it will be implemented. This will help people being discharged particularly to the rural areas. This was well received by the committee. Author: Disability Services Advisory Committee Chair – 7 December 2006


DISABILITY SERVICES ADVISORY COMMITTEE WORK PLAN 2005/2006 AS AT 6 DECEMBER 2006

Mission Statement: To fund a continuum of quality health services aimed at providing improved health outcomes and maximise the independence

of people with disabilities.

Progress Objective Responsibility Date Reporting Frequency

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Progress Reports

1. District Annual Plan GM Planning & Funding

Feb 07 Quarterly January workshop

2. Maori Health Plan GM Maori Health Feb 07 Quarterly Going to December Board meeting

To develop

1. Disability Plan / describe disability sector


Feb 07 Will be reported on six monthly

2. Advocacy Services GM Planning & Funding

Feb 07 Clarification being sought

Provide input into

1. District Strategic Plan GM Planning & Funding

Annually

2. District Annual Plan GM Planning & Funding

Annually

3. Statement of Intent GM Planning & Funding

Annually

4. Annual Report Chief Financial Manager

Annually

To monitor

1. West Coast Improved Services for the Elderly (WISE)


June Going to December Board meeting


Progress Objective Responsibility Date Reporting Frequency

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2. Dementia Unit building CEO Each meeting A standing agenda item

To investigate/scope


DRAFT MINUTES OF THE DISABILITY SERVICES ADVISORY COMMITTEE MEETING HELD WEDNESDAY 6 DECEMBER 2006 IN THE

BOARDROOM, CORPORATE OFFICE, GREYMOUTH

PRESENT John Vaile, Chairman, WCDHB member Elinor Stratford Gloria Hammond Patrica Nolan

IN ATTENDANCE Wayne Turp, General Manager Planning & Funding Bianca Kramer, Minute Secretary

APOLOGIES Gregor Coster, Chair WCDHB Kevin Hague, CEO Mohammed Shahadat

1. APOLOGIES, WELCOME

The Chair welcomed those present to the meeting

2. KARAKIA

Elinor Stratford said the Karakia


Elinor Stratford • Remove – Member of Executive Federation of Disability Information Centres

4. AGENDA CHECK

The Chair requested the resignation letter from Maureen Frankpitt be included under inwards correspondence

5. MINUTES OF THE PREVIOUS MEETING HELD 3 FEBRUARY 2006

A committee member mentioned she had no recollection of the letter or the contents of the letter mentioned under the heading of “Matters Arising/Action and Responsibility List”. The Chair informed the committee that this letter was received by the Chair, but on advice from both the West Coast DHB Chair and the CEO it was established the contents were out of DSACs scope of responsibility

General Manager Planning & Funding joined the meeting at 1.06pm


Moved: Elinor Stratford Seconded: Gloria Hammond

It was RESOLVED that the Minutes of the Disability Services Advisory Committee meeting held 6 September 2006 were a true and accurate record.

6. MATTERS ARISING / ACTION AND RESPONSIBILITY LIST

Ask for any further updates associated with the “barrier free” audits carried out at Buller and Reefton Hospitals and a time line for the identified issues being actioned. This has been completed and can be removed Talk to GM Mental Health about areas that DSAC should be monitoring now MHAC has been disbanded Meeting has taken place, this will be an agenda item for the meeting scheduled for Wednesday 28 February 2007. Invite the Occupational and Physiotherapy Heads of Department to the next meeting to discuss discharge plans This an agenda item for this meeting

7. CORRESPONDENCE

It was RESOLVED that the Disability Services Advisory Committee correspondence Inwards endorsed. Moved: Patrica Nolan Seconded: Gloria Hammond

8. WORK PLAN

After a brief discussion, it was identified that the Work Plan needs to be updated/ reconfigured for next year to take into account the change in the new meeting schedule. This will be an agenda item for the meeting scheduled for 28 February 2007.

Action: Minute Secretary

General Manager Planning & Funding’s Report

The General Manager Planning & Funding reminded the committee of the ½ day planning day relating to the DAP/SOI scheduled to be held on 26 January. This is for both Board members and Advisory Committee members. After the initial group discussion, smaller workshops will be run simultaneously on areas relevant to the individual committees. The agenda and papers will be sent out in early January 2007.

It was moved that the General Manager Planning & Funding report be accepted

Moved: Elinor Stratford Seconded: Gloria Hammond


Maori Health Plan

As the General Manager Maori Health was not available, the General Manager Planning & Funding walked the committee through the Maori Health Plan after explaining he would answer any questions he was able to and those he wasn’t he would take back to the General Manager Maori Health. Initially the Chair directed the committee to the section of the plan under the heading ‘Disability Support Services (DSS)’ on page 69. A committee member felt that this section was based on statistics, not giving any indication on how the plan was going to make improvements for Maori living with disability or how the plan intended to engage the Maori community. The General Manager Planning & Funding directed the committee to the section of the plan starting on page 41 which showed the ‘strategies’, ‘priorities’ and ‘success indicators’, explaining this section will answer the committees concerns. The plan being an overview of state of Maori health on West Coast through Maori eyes. After a brief discussion, it was mentioned a main concern should be to encourage Maori to use the services available and reduce what has in the past been seen as the stigma of having a disability. It was mentioned that process is being made in the acceptance of disabilities, with Maraes being made more accessible. The General Manager Planning & Funding walked the committee through the strategies and priorities of the plan and committee looked at those they felt reflected the brief of the committee. 1 – Increase investment in Maori Health – it was explained that whilst covered under the mainstream health services, Maori health receives and additional 1% of the total funding received for dedicated Maori health, to target specific areas of need. An objective of the plan is to increase this funding by 5% per annum to improve Maori health and reduce Maori health and disability inequalities. 2.4 – Developing the Maori Health and Disability Workforce – to remove barriers for Maori with disabilities so they can fully participate in New Zealand society. This point reflects the way all the West Coast District Health Boards 15 plans intertwine, this area is also covered in the West Coast District Health Board’s Disability Action Plan. 3.2 – Improve Maori Heath Information – the committee felt it was important to know that strategies implemented where actually working and effective data collection would be the answer. 3.3 – Improve The Responsiveness of Mainstream Services to Maori Needs and Concerns - With the geographic nature of the West Coast and the distribution of the population over this area, it was felt that a dedicated Maori health service in each town was not realistic. There is currently only one Maori health provider contracted through the West Coast DHB, this provider covers the entire West Coast with their services. A committee member asked whether other areas of the community, such as Pacific Island people, had dedicated health services. The General Manager Planning & Funding indicated that because of the small numbers of Pacific Island people resident on the West Coast, the West Coast DHB are not required to show specific initiatives


to improve the health of Pacific people in the District Annual Plan, they are covered under the mainstream health service, but reiterated that this may change in the future. After further discussion, the committee was informed that nationally Maori health is worse than that of non Maori, but on the West Coast when comparing the difference between Maori and non Maori health is not as evident as on a national scale the health of non Maori West Coasters is not good.

DSAC recommends to the WCDHB that they endorse the Maori Health Plan

Moved: Elinor Stratford Seconded: Patrica Nolan

9. GENERAL BUSINESS

The committee agreed to bring the General business agenda item of ‘Discharge Plans’ forward. The Chair welcomed both the Physiotherapy and Occupational Therapy heads of department to the meeting, explaining that at a previous meeting a concern regarding discharge plans had been discussed. It was explained to the committee that a new discharge plan template was currently being devised, and this should go some way to addressing any concerns identified. It was felt that the current line of discussion was of an operational theme and therefore not relevant to this committee and at this point the General Manager Planning & Funding advised if the committee had any concerns he would raise them with management. The Chair thanked both the Physiotherapy and Occupational Therapy heads of department for taking the time to come to the meeting.

8. WORK PLAN

WISE Plan

The Chair introduced the Planning & Funding Analyst to the committee. The Planning & Funding went through the Action Plan which The plan has four goals and they are as follows: GOAL A – To Protect the Health, Independence and Social Networks of Older People Housing, an intersectoral approach looking at ensuring housing is warm, dry and safe. Transport, also an intersectoral collaboration to seek ways to improve access to transport. It also includes mobility schemes, car relicencing. The transport topic has been brought up by the committee on a number of occasions. Promotion of activity and fall prevention, ACC and the Ministry of Health are keen for DHBs to work on this area and funding has been offered. The West Coast DHB has


obtained some of that funding. Older people included in health promotion campaigns, covering physical and nutritional, Promoting a greater uptake of the ‘green prescription’ and ‘get active stay active’. GOAL B – To Catch Illness and Disability Before they Worsen Reduce barriers to access to primary healthcare and disability support services, this area it covers a large area and has been covered in the Primary Care Plan. A review of the Home Care Services will cover the a section of this as well. Ensure good management of chronic conditions. Implement a more flexible and restorative model of home support services, There is a planned review of the Home Support Services. In the North Island Presbyterian Support Services fund care for a set time, and it covers everything, it is flexible home support or restorative care, they are there to help the client, not do everything for them. Paid workforce, in primary, community and home based situations. The goal is to ensure an adequate primary workforce and improve training and retention of home based support workers along with supporting skill development in residential care facilities. Currently this group of workers are one of the lowest paid. The West Coast has highest rate of entry into residential care in the country. There is no supportive housing. Grey District Council has 102 council pensioner flats, but with long waiting lists. Statistics show that people living in pensioners housing are not admitted to the hospital as much as those in rest homes or their own homes. GOAL C – To Ensure Older People Experience a Smooth Path Into and Back Out of Specialist Services. Streamlined access to services, a single point of contact for any community services that may be needed, a single patient record. Monitoring of waiting time to ensure timely access to specialist treatment.

Gloria Hammond left the meeting at 2.51 pm

GOAL D – To Put in Place a Strong Organisation Infrastructure for Older Persons Services The WISE Plan is strong on ensuring excellent awareness of disability issues in all clinical services, when the plan is implemented and a person in place to monitor and manage it they could also be an advocate for the older people.

DSAC recommends to the WCDHB that they endorse the WISE Plan

Moved: John Vaile Seconded: Elinor Stratford

The Chair thanked the Planning and Funding Analyst, and commended her on the progress of the plan


Dementia Unit

This item has been deferred to the meeting scheduled for Wednesday 28 February, where the General Manager Community and Primary Health Services will give an update.

10. NEXT MEETING

Wednesday 28 February 2007, 1.00 pm, Boardroom, Corporate Office Greymouth

11. ATTENDANCE AND ADMINISTRATION FORMS

The chair requested all Attendance and Administration forms be completed and return prior to leaving. The Chair wished the committee and management a Happy Christmas and Prosperous New Year.

There being no further business to discuss the meeting concluded at 2.58 pm


MATTERS ARISING FROM DISABILITY SERVICES ADVISORY COMMITTEE MEETINGS

Item No.

Meeting Date

Action Item


Reporting Status

6 December Reconfiguration of Work Plan to go on the Agenda for February meeting

Minute Secretary


COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE CHAIR’S REPORT


West Coast District Health Board FROM: Dr Carol Atmore, Community and Public Health Advisory Committee Chair DATE: 7 December 2006

RECOMMENDATIONS TO THE BOARD A number of plans were considered at the recent marathon CPHAC meeting. The following recommendations are brought to the Board. It is possible that due to time constraints not all of these plans may be ready for Board perusal at this meeting.

CPHAC recommends to the WCDHB that they endorse the Maori Health plan as a 2007/2012 plan subject to input from individual CPHAC members on specific points to the General Manager General Manager Mental Health and subject to the General Manager Maori Health producing a brief three year action plan CPHAC recommends to the WCDHB that they endorse the Youth Rangatahi Health Plan 2007-20010, subject to the changes as discussed at the CPHAC meeting. CPHAC recommends to the WCDHB that they endorse the Primary Health Plan, for 2007-2012, subject to the changes as discussed at the CPHAC meeting. CPHAC recommends to the WCDHB that they endorse the West Coast Chronic Conditions Management Strategy, subject to the changes as discussed at the CPHAC meeting and ratified by committee members by e-mail.


REPORTING BACK ON BOARD REFERRED ITEMS The Committee wishes to thank management for the effort put into, and quality of the various plans that were presented to the last CPHAC meeting. It was noted that a large number of plans have come to CPHAC in recent times. CPHAC would like to highlight to the Board the need for all plans to be integrated so that the Board is working towards common goals and themes. Ideally CPHAC would like to see one monitoring tool for all these plans. The West Coast PHO presented its annual report. The organisation has a strategic direction in line with WCDHB goals, and the West Coast PHO has made significant progress towards these goals during this period.

ITEMS OF INTEREST FOR THE BOARD TO BE AWARE OF The scholarship scheme has proved very popular, and has received at least 17 applications for the 7 scholarships being offered. The Committee had an opportunity to comment on the WISE plan, comments on which are in the meeting minutes. Dr Greville Wood tendered his resignation from CPHAC, due to other work commitments, which was accepted with regret. Dr Cheryl Brunton has accepted a continuation of her appointment. The interviews for Maori representation will be on 8 December. At the time of writing, CPHAC membership is comprises of 3 Board members, the Medical Officer of Health and 2 lay representatives. Author: Dr Carol Atmore, Chair Community and Public Health Advisory Committee 7 December 2006


COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE WORK PLAN 2005/2006

AS AT 24 NOVEMBER 2006 Mission Statement: To fund a continuum of quality health services aimed at providing improved health outcomes and maximise the

independence of people with disabilities.

Progress Objective Responsibility Next Due Date

Reporting Frequency

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To report on relevant section

1. District Annual Plan, including Maori Health Plan and Primary Mental Health Plan

GM Planning & Funding, GM Maori Health, GM Mental Health

Feb 07 Quarterly Not reviewed this meeting

To develop

1. Child Strategy and Youth Health Strategy

Shona McLeod, Planning and funding analyst

√ Child plan previously presented; Youth plan to December Board meeting

2. Information Services Strategic Plan

Chief Financial Manager February 07 Six monthly √ Workplan coming to end, need for strategic steering group for future work plan

3. Post graduate GP Training program

GM Primary Care Each meeting √ To start November 06, awaiting applicants

4. Greymouth Health Centre GMPF/GM Primary Each meeting √ Nothing new to note

5. Primary Care Plan GM PF √ Draft Primary Care Plan to come to December Board meeting

Provide input into

1. District Strategic Plan GM Planning & Funding January 07 Annually

2. District Annual Plan GM Planning & Funding Annually √



Reporting Frequency

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January 07

3. Statement of Intent GM Planning & Funding January 07 Annually

To monitor

1. Referred Services. Community laboratory and pharmacy

GM Planning & Funding February 07 Six monthly √ Invite SISSAL to provide a comparative analysis between WCDHB and other DHBs over last 5 years

2. PHO a) Review criteria being

considered towards meeting

(i) Aims of Primary Care Strategy

(ii) Contractual obligations to the WCDHB

GM Planning & Funding/ PHO

February 07 Quarterly √ Annual report received at November CPHAC meeting

3. West Coast Public health Plan

CPH February 07 Six Monthly

4. Healthy eating Healthy Action Plan implementation

GM Planning & Funding Febraury 07 Six monthly √

5. Neighbourhood Nursing Project

DON February 07 Six monthly √ Preliminary report to CPHAC, final report in February

6. Diabetes services through LDT report

GM Planning & Funding March 07 Annually

7. Undergraduate medical student training program

Dr Wood, convenor March 07 Annually Points 7 to 14 delayed to March meeting

8. Green prescription uptake GM PF March 07 Annually

9. Nicotine replacement therapy uptake

GM PF March 07 Annually



Reporting Frequency

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10. Healthline usage GM PF March 07 Annually

11. Breast screen Aotearoa uptake for WC women

GM PF March 07 Annually

12. National Cervical Screening Program uptake for WC women

Cervical screening co-ordiantor

March 07 Annually

13 Immunisation rates Planning and Funding March 07 Annually

14. Sexual Health Janet Hogan, nurse manager

March 07 Annually

15. Student scholarships ?CEO May 07 Six monthly

To investigate/scope

1. West Coast Community Dental Centre


2. The most efficient use of direct financial incentives and scholarships to recruit and retain health professionals.

GMPF/CFM √ Completed

3. Achieving parity of access for WC women at high risk of breast cancer

GM PF √ Completed

4. Breast feeding strategic plan development

GM PF √ Part of HEHA Breastfeeding initiative


DRAFT MINUTES OF THE COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE MEETING HELD

24 NOVEMBER 2006 IN THE BOARDROOM, CORPORATE OFFICE, GREYMOUTH

PRESENT Carol Atmore, Chair Barbara Beckford Shar Ransom Cheryl Brunton Susan Wallace Gregor Coster, Chair WCDHB - teleconference

IN ATTENDANCE Wayne Turp, General Manager Planning & Funding Gary Coghlan, General Manager Maori Health Bianca Kramer, Minute Secretary

APOLOGIES Greville Wood Cheryl Brunton (for lateness) Kevin Hague – CEO

1. APOLOGIES, WELCOME

The Chairman welcomed everyone to the meeting. The Chair welcomed Susan Wallace, a new member to CPHAC. Susan Wallace said a karakia

Moved: Babara Beckford Seconded: Shar Ransom It was RESOLVED to accept the Apologies.

10.09 am Gregor Coster joined the meeting via teleconference

2. STANDING ORDERS

The Chairman waived the Standing Orders.


Susan Wallace • to be provided to the minute secretary Barbara Beckford • add member of the National Screening Advisory Committee


Barbara Greer • Disclosures to be removed as her term on CPHAC has expired

4. AGENDA CHECK

• As this agenda contains a number of plans, times for each plan have be set at half an hour.

5. MINUTES OF THE PREVIOUS CPHAC MEETING HELD 21 JULY 2006

Moved: Shar Ransom Seconded: Barbara Beckford It was RESOLVED that the Minutes of the Community and Public Health Advisory Committee meeting held 21 July 2006 were a true and accurate record.

6. MATTERS ARISING

Investigation of most efficient use of direct financial incentives & scholarships to recruit and retain health professionals Significant progress has been made in this area. There is now an established scholarship scheme. Seven tertiary level scholarships have been advertised, the final date for applications is today (Friday November 24), the committee was informed that as of 10.00 am this morning 17 applications had been received for consideration. CPHAC would like to thank management for the progress achieved. The committee would like an update at a future meeting. It was decided that this item should be placed on the CPHAC Work Plan and to be reported on a six monthly basis. Investigate ways to achieve parity with neighbouring DHBs for access to screening & mammography for high risk women A paper complied by SISSAL in located in the Information Papers section of today’s meeting papers. The paper indicated that women eligible for two yearly breast screening are able to utilise either the mobile bus or the Christchurch base of the service provider. Those women who are in the ‘high risk’ category and meet the criteria are eligible for yearly breast screening. The conclusion of the paper was that “Access to free breast screening for West Coast women is the same as for Canterbury women”. After a brief discussion, it was decided the WCDHB’s GP Liaison Officer would inform other GPs on the West Coast of the services available. Other ways of getting the information out to women who are in the high risk category could be through community awareness, via WCDHB Communications Officer, and also the Ngai Tahu newsletter

Action: GM Planning & Funding to arrange press release with Communications Officer Action: Susan Wallace to liaise with Communications Office with regard to newsletter

Action: GP Liaison to communicate this information with other GPs


General Manager Planning & Funding is to clarify with Tony McDonald (author of the referred services report) whether it is possible to separate the hospital and community statistics from the report The figures in the last Referred Services report were for community referrals, not hospital referrals. Currently community referrals equate to 1.7m/annum. Of that amount, $464,000 comes from outside the WCPHO. This is made up by other specialists, not based on the West Coast. The General Manager Planning & Funding has asked for a breakdown on this 27% and how it occurs. Next report is due for the meeting scheduled on 16 February 2007.

Cheryl Brunton joined the meeting at 10.18am

Updated report on electronic communication between secondary and primary services Scheduled for next Meeting in February. Community support group for new workers to the Coast (eg RMOs) to be taken to Intersectoral Forum Scheduled for next Meeting in February.

6.0 CORRESPONDENCE

The Chair informed the committee that a letter addressed to West Coast DHB had been received from Julie Kilkelly tendering her resignation from CPHAC.

Action: Chair to write to three out going committee members thanking them It was RESOLVED that the Community and Public Health Advisory Committee correspondence Outwards be endorsed. Moved: Carol Atmore Seconded: Susan Wallace

7.0 GENERAL BUSINESS

7.1 CPHAC Chair’s report to committee

• The committee was informed that Barbara Greer’s term on CPHAC expired on 15 November. Two names have been put forward by the Runanga. The interview process will take place shortly with Carol Atmore (CPHAC Chair), Christine Robertson (WCHDB Deputy Chair) and Susan Wallace interviewing the candidates.

• The Minister of Health appointed Susan Wallace as a member of the West Coast DHB The West Coast DHB in-turn made the appointment of Susan Wallace to CPHAC to fill the vacant position.

• There is a joint planning day (DSP/SOI) scheduled for Friday 26 January. • The Recovery Plan is being presented to next board meeting. • The South Island Pandemic Plan was presented to the Board, this plan contained high

level of West Coast input. The Chair’s report was noted


7.2 Work Plan

Because the of the number of items on the agenda for today’s meeting, it was decided to defer the quarterly DAP report

General Manager Planning & Fundings report to committee

2007/2008 DAP/SOI The Letter of Expectation for the 07/08 DAP/SOI has been received from the Minister of Health and the West Coast DHB’s plans align with those expectations from the Minister. The date for the submission of the new DAP is 9.00am on 9 March 2007. Discontinuation of subsidy for GP & Nurse clinics in the former Special Medical Areas Currently the General Manager Planning & Funding and his team are in the process of having meetings with communities to inform them about the changes surrounding the former special medical areas”. These areas have experienced either free access or subsidised access to general practice services since 1940. With the final section of the community about to receive low cost access to general practice services through the PHO in July 2007, the whole of the West Coast will have access to low cost general practice services. A report will be presented to the Board at the meeting scheduled for Friday December 15. GP Service in Karamea GP currently servicing the Karamea area will be leaving at the end of this month. This practice is a private practice, but the WCDHB in consultation with the Karamea Medical Trust and the West Coast PHO have ensured that residents will not be without medical coverage. The General Manager Planning & Funding made reference to a recent newspaper article around services at Ngakawau and mentioned that the points of concern are being addressed

Moved: Carol Atmore Seconded: Cheryl Brunton

It was moved that the General Manager Planning & Funding report be accepted

Maori Health Plan

The Chair welcomed the General Manager Maori Health to the meeting. The General Manager Maori Health proceeded to work through a Power Point presentation which consisted of the ‘Priorities’ listed on pages 47-59 of the Maori Health Plan included in the meeting papers. It was commented that there is a large amount of work in the plan with a lot of detail and the biggest challenge is going to be the implementation. A number of questions where asked regarding the achievability of the plan in the four years indicated. It was suggested that the plans timeframe should be pushed out to make it more achievable, possibly 2007/2012. The Maori Health Needs Assessment is seen as an important part of the process and progress needs to be made on obtaining correct local data. It is difficult to move forward if there is no point to move forward from.


A point was raised by a committee member that the data appearing on page 21 relating to the Age & Ethnic Distribution of the West Coast Population is not consistent with other organisations data on this topic. The General Manager Maori Health will meet with the committee member to discuss. It was established that there were some missing components to the plan that committee members felt should be included, such as breast feeding support and ante natal care. It was suggested by the CPHAC chair that a summary of the key issues in each section would be useful for readers. The Chair and committee thanked the General Manager Maori Health for his presentation.

Moved: Carol Atmore Seconded: Susan Wallace CPHAC recommends to the WCDHB that they endorse the Maori Health plan as a 2007/2012 plan subject to input from individual CPHAC members on specific points to the General Manager General Manager Mental Health and subject to the General Manager Maori Health producing a brief three year action plan.

Youth Health Strategy

Community & Public Health presented the Youth Health Strategy to the committee. The committee was reminded that a copy of the draft health profile had been supplied earlier this year giving a brief overview of what would be contained in the Youth Health Strategy. After consultation with youth groups up and down the West Coast, and a survey completed in the West Coast high schools the plan was compiled. The Youth Health Strategy’s goal and objectives went out for consultation at the same time as the Child Health Plan. The Youth Health Strategy has been back to child and youth health committee and management of the West Coast PHO. It is noted that the Youth Health Strategy does not address any HEHA related strategies, as through the consultation period this was not identified as a priority area of focus. In the process of completing this strategy those involved were mindful of the ‘do ability’ of items. Focus was placed on those things the WCDHB, C&PH and the West Coast PHO could do. Some points are already taking place. CPHAC suggested that the plan be for the period 2007-2010 Under the heading of Sexual Health concern was expressed that the promotion is not reaching the out of school youth, this concern is evidence based. In the Mental Health section, note was made of the need to monitor self harm, as well as suicide. Young people need to be able to have their say in Health Services provided for them, and be aware of the services available for them. A database is currently in the process of being compiled which will allow young people to know what services are available and what they can do for them.


Chair commended those involved with the high quality of the Youth Health Strategy.

Moved: Barbara Beckford Seconded: Shar Ransom CPHAC recommends to the WCDHB that they endorse the Youth Rangatahi Health Plan 2007-20010, subject to the changes as discussed at the CPHAC meeting.

Primary Health Plan

The duration of the Primary Heath Plan has not determined as yet. The writing of this plan has a number of people, both internal and external making contributions. The table on page 11 (Table 1) was brought to the committee’s attention as the information is not current. After some discussion it was identified that the West Coast PHO would be able to supply updated information. It was suggested that to be consistent all tables in the plan should be a snapshot of the same period in time, and that time frame should be in the title of the table The question of how to measure whether items in the plan were making progress was raised. It was thought that setting some measurable targets along the way would be a way to achieve this. It was asked what process was planned to report to CPHAC on the objectives listed in the plan. It was suggested that the traffic light format with points taken out of the plan be used. It was mentioned that reading the Mission and Goals bullet points on Page 5 there was nothing that identified them as being specific to the West Coast as a rural area, and some rewording of this section would reflect our rural nature. , It was felt that the last point “There is good health for all” should be removed. In Changing Models of Care/Innovations on the West Coast (page 17) it was questioned whether the GPs had been missed out. There could be more mention about how GPs and Practice Nurses work together. It was noted that there was very little around information technology, data transfer etc. It was acknowledged that the plan was light on content in this area, as contribution was light. The area of continuity of care in regard to after hours care (after 8 pm) is something that should be flagged as an area that needs addressing. After a discussion, the committee recommended that the Primary Health Plan should be a five year plan (Primary Health Plan 2007-2012)

Moved: Carol Atmore Seconded: Shar Ransom CPHAC recommends to the WCDHB that they endorse the Primary Health Plan, for 2007-2012, subject to the changes as discussed at the CPHAC meeting.


PHO Quarterly and Annual Report

Chair introduced Anthony Cooke, PHOcus on Health The PHO are currently focussing on three priorities:

1. Chronic disease management, with an initial focus on cardiovascular disease and diabetes, which would provide the basis for a more mature relationship with the PHO’s communities and better integration amongst providers.

2. Continued improvement of existing screening and prevention initiatives, such as breast and cervical screening and immunisation programmes.

3. Youth health to include drug and alcohol and sexual health to be the next area of focus.

The PHO are more focussed on the first two as the West Coast DHB is doing the Youth Health Plan and the third priority will be covered in there. It was explained that the PHO were extremely proud of the establishment of Mental Health service results and the Care Plus enrolments. The PHO are trying to reach the upper limits of Care Plus enrolments in terms of funding. There is a maximum of 1500 people on the West Coast we can be funded for. The Committee Chair congratulated the PHO for the markedly increase in functionality of the organisation. This is a credit to new management and provider community. The West Coast PHO had a surplus of $392,782 in 2006 and $100,102 in 2005. The increase in equity was $662,296 in 2006 and $269,514 in 2005. The PHO did not plan on the surplus being as big as it was however this has allowed them to plan for an additional position. The Committee Chair asked what a reasonable level of retained earnings would be. Some NGOs work on two years worth of funding, and the WCPHO currently has about three months of operating expenses, which is not unreasonable. The PHO’s current revenue is from Health services. Hopefully in the future, PHO’s could be more than umbrellas for practices and could hold other community contracts, as befits a community organisation. The PHO is going to do a summarised version of the Annual Report to feature in The Messenger. It was suggested the PHO have someone interviewed and an article of what the organisation has been doing. The PHO has been working through the final transition of the change in Trust Deed with South Link Health. Once this has been finalised, the West Coast PHO will begin the process of appointing nine new trustees to the PHO Board. These will include three local government, three Maori and three provider representatives. The Chair thanked Anthony Cooke for attending the meeting..


Neighbourhood Nurse Project

The welcomed the General Manager Community and Primary Health Services to the meeting in her capacity as Project Sponsor for the Neighbourhood Nurse Project. The aim of Neighbourhood Nursing was to provide nursing interventions in community settings. This was initially trialled in Reefton but difficulties arose on how it would be implemented.. The final Neighbourhood Nurse project involved two nurses in Hokitika, one in Greymouth and one part-time Whanau nurse in Reefton. The project comes to an end this month. Surveys have been distributed to 177 consumers and 80 people have returned to date. Evaluations are due for completion in December. There has been positive feedback received from the principal at Reefton Area School. On the 14th – 15th December the Director of Nursing and Midwifery and the General Manager Community and Primary Care Services will be presenting the evaluations to the West Coast. The final conclusions and decisions will not be available until next month. This item is on the CPHAC work plan. Once the final report is presented to CPHAC in February it will be able to be removed from the work plan. The Chair thanked the General Manager Community and Primary Care for the update.

7.3 Chronic Disease Management Plan

The Chronic Disease Management Strategy 2006/09 was completed to identify ways of approaching Chronic Disease management, primarily Cardiovascular disease and Diabetes, with other illness being identified over time. Respiratory illnesses has been identified as the next focus. It was felt that the plan could be condensed, especially the preamble, along with the “frame work and action plan for year 1 – matrix. It was identified that the table spanning page nine and ten and the table on page 12 could be removed from the plan. In the “Implementation of Framework” on pages 17,18 and 19, it was indicated that the text under each theme could be condensed. It was proposed that CPHAC refer back to management to condense the content. In the Year 1 action plan some things have already begun. Some things are already resourced and budgeted for so are not unachievable. The Cardiac nurse been employed. The wording “self-management” needs to be explained as ‘promote empowerment of individuals and whanau in health interventions’.


Moved: Carol Atmore Seconded: Barbara Beckford CPHAC recommends to the WCDHB that they endorse the West Coast Chronic Conditions Management Strategy, subject to the changes as discussed at the CPHAC meeting and ratified by committee members by e-mail.

7.4 WISE Plan

The Chair welcomed and introduced the Planning & Funding Analyst to the committee via video conference facilities. The committee focussed on the timelines and responsibilities portion of the WISE plan. The timelines fall into four main goals and prevention activities: • To protect the health, independence and social networks of older people. • To catch illness and disability before they worsen. • To ensure older people experience a smooth path into and back out of specialist services • To put in place a strong organisational infrastructure for older persons services. There was concern raised around the improved transport to hospital and health services component of the plan as this may be interpreted as an implication of funding from the West Coast DHB. The GM Planning & Funding explained our plans often do not pay attention to financial implications on what we propose to do. We either should change all plans to meet financial aspects or we should not put this in as an objective at all. The committee agreed to leave this in and suggested there be a clause in the plan stating we are able to put objectives in place within our financial capability. Concern was raised with lack of Treaty of Waitangi principles and participation through out the plan. The GM Maori Health and Planning & Funding Analyst will discuss this further and insert data into the plan showing Maori life expectancy. The following items were items were identified: • Objective Three: ‘Green Scripts’ to be replaced with ‘Green Prescription’. • Objective Five: Reduce barriers to Primary Care and Chronic Illness Management • Objective Six: Change the wording around Glaucoma Screening as current wording may

create unrealistic expectations. • Objective Eight (B): The intention is to up-skill and train homecare workers in a different

way. • Objective Nine: It was noted that there is not enough supportive housing on the West

Coast. We should support other entities to contribute to this. • The plan is currently lacking an executive summary. A suggested time frame for the plan

was 2006-2016. The Chair congratulated the Planning & Funding Analyst on the plan. The Chair would forward CPHACs comments to DSAC and then DSAC could make a recommendation to the Board.

7.5 OTHER BUSINESS

After a brief discussion, the committee expressed concern that due to the large number of plans currently being written and put into place within the WCDHB there is the possibility of


the same work being completed and reported on by a number of people. The DAP and SOI should be the vehicle for integrating the plans. The Chair felt this should be brought up at the Board and Committee workshop scheduled for January, and she will include this in her report to the Board.

A fax had been received from Greville Wood indicating his intention to resign his position on CPHAC. The Chair tabled this as correspondence.

Moved: Carol Atmore Seconded: Susan Wallace It was RESOLVED that the Community and Public Health Advisory Committee correspondence Inwards be accepted.

Action: Chair to send letter thanking Greville Wood for his contribution to the committee

9. NEXT MEETING

Friday, 16 February 2007, 10.00 am, Boardroom, Corporate Office Greymouth

10. ATTENDANCE AND ADMINISTRATION FORMS

The Chair requested the committee members fill out the Attendance and Administration forms prior to leaving.

There being no further business to discuss the meeting concluded at 3.02 pm


MATTERS ARISING FROM COMMUNITY & PUBLIC HEALTH ADVISORY

COMMITTEE MEETINGS

Meeting Date

Action Item


Reporting Status

15 June Report bac to CPHAC on progress with scholarship scheme CEO Report back to May meeting

11 November Press release to inform women of access

Inform West Coast GPs of this arrangement


Community Liaison officer, and Susan Wallace for Ngai Tahu newsletter

GP Liaison officer

Report on progress as available

Work with WCPHO on pharmaceutical and laboratory spending GM Planning & Funding, September meeting

9 June Updated report on electronic communication between secondary and primary services Next Meeting

CFO February 2007 meeting

21 July Community support group for new workers to the Coast (eg RMOs) to be taken to Intersectoral Forum Next meeting

CEO February 2007 meeting

24 November 2006 Write to four out-going committees members thanking them Chair

WCDHB Meeting Papers Information Papers 15 December 2006

INFORMATION PAPERS


WEST COAST DISTRICT HEALTH BOARD ADVISORY COMMITTEE MEMBERS TERMS OF APPOINTMENT

HOSPITAL ADVISORY COMMITTEE Member Date of Appointment Length of Term Expiry Date Dr Christine Robertson 7 February 2002

(Re-appointed 17 December 2004) For the period served as an appointed Board member. December 2007

Professor Gregor Coster (Re-appointed October 2004) For the period served as an appointed Board Chair. While Board Chair

Barbara Beckford 25 June 2003 (Re-appointed 30 June 2006) 3 years 30 June 2009

Kathryn Cannan 1 May 2002 (Re-appointed 13 June 2005) 3 years 13 June 2008

Elizabeth Rock 13 June 2005 2 years 13 June 2007

Richard Wallace 25 July 2005 3 years 25 July 2008

Brian Wilkinson 17 December 2004 For the period served as an elected Board member. December 2007

DISABILITY SERVICES ADVISORY COMMITTEE Member Date of Appointment Length of Term Expiry Date John Vaile 7 February 2002 (Re-appointed 17 December 2004) For the period served as an elected Board member. December 2007

Mohammed Shahadat 17 December 2004 For the period served as an elected Board member. December 2007


Gloria Hammond 1 May 2002 (Re-appointed 13 June 2005) 2 years 13 June 2007

Patricia Nolan 18 July 2005 (Re-appointed 18 July 2006) 2 years 18 July 2008

Elinor Stratford 1 May 2002 (Re-appointed 13 June 2005) 3 years 13 June 2008

Ned Tauwhare 25 July 2005 3 years 25 July 2008


COMMUNITY & PUBLIC HEALTH ADVISORY COMMITTEE

Member Date of Appointment Length of Term Expiry Date Dr Carol Atmore 17 December 2004 For the period served as an elected Board member. December 2007


Susan Wallace Appointed 3 November 2006 For the period served as an appointed Board Chair. December 2007

Barbara Beckford Co-opted September 2004 Appointed 4 March 2005 3 years (from date of co-opt) 30 September 2007

Cheryl Brunton Appointed 1 February 2005 (Re–appointed 3 November 2006)

2 years (While holding position of Medical Officer of Health) November 2009

Sharon Ransom September 2004 3 years September 2007


WEST COAST DISTRICT HEALTH BOARD AND ADVISORY COMMITTEE TIMETABLE

FROM JANUARY 2006 TO DECEMBER 2006

DATE MEETING TIME VENUE Friday 20 January 2006 Board 9.30 am Ashley Hotel, Greymouth

Friday 3 February 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 3 February 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 10 February 2006 HAC 9.00 am Boardroom, Corporate Office, Greymouth

Friday 24 February 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 17 March 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 17 March 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 24 March 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 7 April 2006 Board 9.30 am Te Tauraka Waka a Maui Marae, Bruce Bay

Friday 28 April 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 28 April 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 5 May 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 19 May 2006 Board 9.30 am Westland District Council, Hokitika

Friday 9 June 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 9 June 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 16 June 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 30 June 2006 Board 10.00 am Boardroom, Corporate Office, Greymouth

Friday 21 July 2006 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 28 July 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 11 August 2006 Board 10.00 am Boardroom, Corporate Office, Greymouth

Friday 1 September 2006 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Wednesday 6 September 2006 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 8 September 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 22 September 2006 Board 10.00 am Boardroom, Corporate Office, Greymouth

Friday 13 October 2006 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 20 October 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 3 November 2006 Board 10.00 am Boardroom, Corporate Office, Greymouth

Friday 24 November 2006 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 1 December 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Wednesday 6 December 2006 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 15 December 2006 Board 10.00 am Boardroom, Corporate Office, Greymouth


WEST COAST DISTRICT HEALTH BOARD AND ADVISORY COMMITTEE PROPOSED TIMETABLE JANUARY 2007 TO DECEMBER 2007

DATE MEETING TIME VENUE

Friday 12 January 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 26 January 2007 Board 10.00 am Tai Poutini Polytechnic – Room 13

Wednesday 28 February 2007 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 16 February 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 23 February 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 9 March 2007 Board 10.00 am Westport - Venue to be advised.

Friday 30 March 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 6 April 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 20 April 2007 Board 10.00 am To be advised.

Friday 11 May 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 18 May 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 1 June 2007 Board 10.00 am Boardroom, Corporate Office, Greymouth

Wednesday 6 June 2007 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 22 June 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 29 June 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 13 July 2007 Board 10.00 am Boardroom, Corporate Office, Greymouth

Friday 3 August 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 10 August 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 24 August 2007 Board 10.00 am Boardroom, Corporate Office, Greymouth

Wednesday 5 September 2007 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 14 September 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 21 September 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 5 October 2007 Board 10.00 am To be advised.

Friday 26 October 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 2 November 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 16 November 2007 Board 10.00 am Boardroom, Corporate Office, Greymouth

Wednesday 5 December 2007 DSAC 1.00 pm Boardroom, Corporate Office, Greymouth

Friday 7 December 2007 CPHAC 10.00 am Boardroom, Corporate Office, Greymouth

Friday 14 December 2007 HAC 9.45 am Boardroom, Corporate Office, Greymouth

TBA December 2007 TBA 10.00 am Boardroom, Corporate Office, Greymouth

Documents

Section 0 - Cover 15 December 2006 - West Coast · PDF fileOIA 1982 5.9(2)(i) Commercial ... solution during the busy tourist season. However, ... 15 December 2006 Page 3