Board. Nelson Bays Primary Health AGENDA. Open. Distribution. Date: 2 February Time: 2.00pm. Place: Meeting Room Queen Street Richmond

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1 Distribution Board Members: John Hunter (Chair) Pat Curry Philip Chapman Sarah Green Stuart Hebberd Helen Kingston Lisa Lawrence Sue Stubbs Management: Angela Francis, CE Emily-Rose, EA/Board Secretary Karen Winton, Acting GM Health Services Linzi Birmingham, GM Golden Bay Community Health Trudi Price, Human Resources Manager Wolfgang Kloepfer, Finance Manager Public: Hard copies (3) Open Agenda Distribution List (e) Website Contact Details Board Secretary: Emily-Rose Richards Tel: Nelson Bays Primary Health AGENDA Board Open Date: 2 February 2017 Time: 2.00pm Place: Meeting Room 2 Nelson Bays Primary Health 281 Queen Street Richmond Net Meeting Date: Thursday 2 March 2017

2 Nelson Bays Primary Health Board Meeting 2.00pm Thursday 2 February 2017 Open Agenda Page 1.0 Welcome/Karakia Philip 2.0 Apologies: Lisa Lawrence 3.0 Register of Interests 3.1 Amendment to the Register of Interests 3 For review 3.2 Declaration of Conflicts in Relation to Today s Business 4.0 Confirmation of Agenda For review 5.0 Minutes of 7 December Confirmation of Minutes 4 For approval 5.2 Matters Arising (and not for discussion in 5.3) 5.3 Discussion of Action Points 8 For review 6.0 Environmental Scan Discussion 7.0 Reports 7.1 Chief Eecutive s Report Open Section 9 For information 7.2 GM Health Services Operational Report 29 For information 7.3 Health and Safety Report 32 For information 8.0 Procedures for Review 34 For review Whistleblower/Protected Disclosures Procedure 35 For review 9.0 Board Work Programme 38 For information 10.0 General Business Discussion Net Meeting: Thursday 2 March 2017

3 Register of Interests Board as at 23 January 2017 Name Eisting Health Interest Relates To Eisting Other (Role) Chair John Hunter PHO Alliance Eecutive PHO Alliance Member PHO Ara Institute of Canterbury (Director since April 2011) Powerhouse Ventures Ltd Director Hydro Works Limited Director Possible Future Conflicts None notified Helen Kingston Abbeyfield Golden Bay Inc Medical Adviser and Committee Member Lisa Lawrence Member of the Order of St John Motueka Family Service Centre Motueka Family Service Centre Motueka Health Alliance PHARMAC Community Advisory Committee Pat Curry Board of Trustees Director Accuro Private Health Insurance Philip Chapman Employed by Nelson Public Health Manager Men s Centre (Male Room) Chair of Waimea Men s Shed National Chairman of Male Survivors Of Seual Abuse A.N.Z Sarah Green Tasman Medical Centre Nursing leadership Clinical Governance Committee NZNO College of Primary Nurses NZNO College of Respiratory Nurses Stuart Hebberd MIC Prices Pharmacy 2011 Ltd Prices Pharmacy Blenheim Nelson Care Chemist Sue Stubbs Tima Health Nelson Bays General Practice Limited ACC CE Angela Francis Institute of Directors, NZ Australasian College of Health Service Management Medical & Injury Centre Health Systems Solutions ToSHA Incorporated Society providing accommodation for elderly Have a provider contract with NBPH Location of a lactation clinic for Motueka area Primary Health Services in Motueka Member None declared Non- Governmental Provider Motueka Family Service Centre None notified (Kaiwhakahaere) Abbeyfield Nelson Inc. None declared None notified Men s health; positive fathering research; improve access to family health services for fathers, men & boys; The Male Room receives money from the NBPH Primary Mental Health Initiative. Employee Nursing Member Member Member Provider Contract DHB Contract DHB Contract DHB Contract General practice owner with PHO contract Shareholder Nelson Branch Medical Advisor Member Fellow Director Director Rotating Chair Whakatu Boing Trust Potential Community Initiative Funding None declared None notified None declared None notified None declared None notified None declared None notified 3

4 Nelson Bays Primary Health Board Meeting Minutes of meeting held at 11.00am on Wednesday 7 December 2016 at Golden Bay Community Health, 10 Central Takaka Road, Takaka O p e n PRESENT: John Hunter (Chair), Pat Curry (Deputy Chair), Helen Kingston, Lisa Lawrence, Philip Chapman, Sarah Green, Stuart Hebberd, Sue Stubbs. IN ATTENDANCE: Angela Francis, Chief Eecutive; Emily-Rose Richards, Board Secretary; Karen Winton, Mental Health Manager; Linzi Birmingham, GM Golden Bay Community Health (GBCH); Trudi Price, Human Resources Manager; Ward Steet, GM Health Services; Wolfgang Kloepfer, Finance Manager. Public: (11) Aaron Marshall, Golden Bay Physiotherapist; Tony Keatley, Golden Bay Mental Health Service; Roy Reid, Grey Power; Margaret Fricker; Hannah Gracefield, WellChild; Jennifer Cooper, GBCH; Anja Van Holten, GBCH; Angela Kno, GBCH; Hannah Cummins, GBCH; Dr Alannah Stockwell, GBCH; Dr Peter Gibbs, GBCH. 1.0 Welcome/Karakia Pat Curry 2.0 Apologies: Nil 3.0 Register of Interests 3.1 Amendment to the Register of Interests There were none. 3.2 Declaration of Conflicts in Relation to Today s Business There were none. 4.0 Confirmation of Agenda The agenda was confirmed. 5.0 Confirmation of Minutes of 3 November 2016 The minutes of 3 November 2016 were confirmed as a true and accurate record. Green/Curry 5.1 Matters Arising There were none. TO BE CONFIRMED 4

5 5.2 Action Points Some matters for consideration this month had been dealt with, formed part of today s agenda or were discussed as follows: A49 Ministry of Health epectations for General Practices. Completed. A52 Golden Bay Board Meeting arrangements. Completed. A53 Discussions with Pharmacy Guild. Management have approached Jo Mickelson, Nelson Marlborough District Health Board (NMDHB) Pharmacy Services Manager, and asked her to facilitate a meeting between all parties and the Pharmacy Guild in February In progress. 6.0 Environmental Scan Mr Chapman noted Lifeline (Nelson) is now charging for their mental health services provided, and have a 8 week waiting list for their services. There was a discussion held on the additional funding for NBPH s mental health service. Ms Winton informed the Board there have been discussions held with NMDHB regarding securing additional mental health funding and Management are certain there is going to be additional funding coming to primary care. Once the additional funding is confirmed, there will be a plan in place to inform the community. Following the recent Kaikoura earthquakes, NBPH is invoicing NMDHB for patients seen with earthquake related aniety/mental health issues. Mr Chapman noted the review on seual and domestic violence for those who work for Non-Government Organisations has been released. By June 2017, there will be a new funding mechanism implemented to deal with seual and domestic violence. Ms Francis commended GBCH for their efforts following the recent Kaikoura earthquake. The staff went to great lengths to respond, including changing the roster for the days following the earthquake. 7.0 Reports 7.1 Chief Eecutive s Report Open Section Nationally for the health target results for quarter 1 of 2016/17, NBPH was placed second equal for the Better Help for Smokers to Quit target. The annual Employee Performance and Development Review process is progressing well. Discussions are being currently being completed between Employees and their Managers; this review process was due for completion by the end of November. The annualised Remuneration process is nearing completion, with the roll-out date due within the net month. NBPH has received official notification of a funding increase for Rheumatology. This is a good result for NBPH and will result in addressing the outstanding follow-up assessments and a sustainable model moving forward. The Primary Health Alliance meeting was held at NBPH on 2 December. The programme for the meeting included three health service presentations by NBPH on: The 5 P s of Pre-Diabetes (Problem, Partnerships, Programme, Prevention, Personal Success) TO BE CONFIRMED 5

6 Teen Health Fest Community-Based Specialist Service Infectious Diseases 7.2 Primary and Community Health Strategy Following the recent community engagement process undertaken in October and November, the Primary and Community Health Strategy has been updated to incorporate the feedback received and post-engagement review feedback. Mr Hunter noted the Strategy reads very well but there are no aspects included on how the Strategy will be implemented. Management need to initiate discussions on the rollout plan for NBPH and the changes required to funding lines and services. The draft Primary and Community Health Strategy implementation plan will come to the Board once it is completed by ToSHA in The Board will then consider this as a strategic topic. 7.3 NBPH Business Continuity Plan Condensed Staff Version Ms Curry asked whether or not it should be staff positions listed in the Business Continuity Plan, in place of names. Ms Francis noted the staff positions are listed in the full Business Continuity Plan and the plan will be reviewed annually and updated as staff leave. Mr Hunter suggested that the priorities listed on pages 6 7 focus too much on administrative and financial matters. Critical operational responses such as communications with General Practices, our enrolled population and scheduled clinics need to be included. Ms Francis will consider this. 7.4 Minister of Health s Visit to Richmond Health Hub On Wednesday 23 November 2016, the Minister of Health, Hon Dr Jonathan Coleman, visited the Richmond Health Hub. During the Minister s visit, a tour of the Hub was provided, along with an overview of NBPH, NMDHB and Te Piki Oranga (TPO) services. The Minister also spent time talking to Clinicians, and was accompanied by Jenny Black, NMDHB Board Chair, together with various NMDHB, NBPH and TPO staff. 7.5 General Manager Health Services Operational Report Open Report taken as read. NMDHB has begun their budget bid process for 2017/18. NBPH have submitted budget bids for services, with a focus on securing additional funding for the mental health service. Ms Lawrence asked how the Primary and Community Strategy engagement meetings, which Luke Katu attended on behalf of NBPH went. Management were asked to get Luke to write a paper for Te Tumu Whakaora on how the Primary and Community Strategy engagement meetings Luke attended went. A54 On behalf of the Board, John acknowledged that it was Ward s last meeting, and thanked him for his efforts over his tenure at NBPH. TO BE CONFIRMED 6

7 7.6 Health and Safety Update Report Report taken as read. 8.0 Policies for Approval Management of Policies, Procedures and Guidelines Framework Policy No amendments Whistleblower/Protected Disclosures Policy No amendments Whistleblower/Protected Disclosures Procedure Mr Hunter will send his comments on the Whistleblower/Protected Disclosures Procedure to Ms Curry, and the Procedure will come to the February Board meeting for review. The Board Secretary was asked to send the Procedure in word format, to Mr Hunter. A55 Appointment of Trustees Policy No amendments The Board approved the Management of Policies, Procedures and Guidelines Framework Policy, Whistleblower/Protected Disclosures Policy and Appointment of Trustees Policy. 9.0 Board Work Programme The Board Work Programme was received General Business There was none. The meeting closed at 12.09pm Net Meeting: Thursday 2 February 2017 TO BE CONFIRMED 7

8 OPEN Action List v 24 January 2017 Meeting date Action number Action Bring up Who Status Nov 16 A51 Mr Chapman asked if there is a comparison between Golden Bay Community Health (GBCH) and other providers for Health and Safety incidents/hazards. Ms Birmingham noted Gillian Robinson has offered to benchmark GBCH against 26 other facilities, to see the position GBCH is in. Once the benchmark is established, it will be presented to the Board. Feb 17 GM GBCH In Progress A53 The Board left Management to discuss local initiatives that can be developed further with the Pharmacy Guild. Dec 16 Feb 17 CE In Progress Management have approached Jo Mickelson, NMDHB Pharmacy Services Manager, and asked her to facilitate a meeting between all parties and the Pharmacy Guild in February Dec 16 A54 Management were asked to get Luke to write a paper for Te Tumu Whakaora on how the Primary and Community Strategy engagement meetings Luke attended went. Feb 17 GM Health Services Completed A55 Mr Hunter will send his comments on the Whistleblower/Protected Disclosures Procedure to Ms Curry, and the Procedure will come to the February Board meeting for review. The Board Secretary was asked to send the Procedure in word format, to Mr Hunter. Feb 17 Mr Hunter Refer to agenda item 8 8

9 To Nelson Bays Primary Health Board From Angela Francis, Chief Eecutive Meeting date 2 February 2017 Subject Chief Eecutive s Report Open Section For approval For action For information 1. PURPOSE To provide the Board with an update of the organisation s progress against strategy, risk and budget. Where appropriate, fuller details are provided in the Closed Section. 2. OVERVIEW Business as usual continues: Risk identification and mitigation. Refer Closed Section Risk Register Staffing levels NBPH staffing levels remain constant. Refer Closed Section for attrition rates Financial forecast With the eception of Golden Bay Community Health (GBCH), NBPH continues to track against budget. Refer to the Financial Report in the Closed Section for further details Progress against strategy continues as articulated through annual operational plan deliverables 3. MEDIA AND GOOD NEWS STORIES 3.1 Nelson Bays Primary Health Media Releases For the months of December and January, NBPH submitted a media release to the Nelson Mail and local community newspapers. The media release submitted was regarding Patient Portals. Refer to Appendi 1 for the NBPH Media Release on Patient Portals. 3.2 Nelson Bays Primary Health Media Coverage Summer Issue of Admire Magazine An article in the Summer issue of the Admire Magazine, was provided by NBPH on taking care of yourself over the festive season. Refer to Appendi 2 for the article in the Admire Magazine provided from NBPH. Toddler Better Health Programme An article in the Activity and Nutrition Aotearoa Newsletter (December issue) provided coverage on the Toddler Better Health Programme run by Tonia Talbot, NBPH Dietician, in conjunction with Sport Tasman. Refer to Appendi 3 for the article in the Activity and Nutrition Aotearoa Newsletter on the Toddler Better Health Programme. Providing Specialist Health Services in the Community An article in The Nelson Mail on 6 December 2016, provided coverage on Dr Richard Everts providing specialist health services in the community. This article refers to Dr Richard Everts being able to provide 9

10 more services while working in the community, in place of working in the hospital setting. Refer to Appendi 4 for the article in The Nelson Mail on Dr Richard Everts providing specialist health services in the community. A link to a Stuff article follows: 4. CORPORATE SERVICES UPDATE Information Systems The key strategic projects of upgrading the IT Infrastructure, improving Disaster Recovery capabilities and the switching of Phone and Communication lines, have continued to be given priority to enable completion aligned to project plans. These projects substantially strengthen NBPH s IT resilience, disaster recovery capability, and will improve internet line speed. This will enable significant savings to be realised. Refer to item 3.5 IT Strategic Update in the closed section for further detail. The concerns raised regarding the stability of IT communications at GBCH and Collingwood have been investigated. Action plans have been agreed with the General Manager GBCH. These actions will be implemented throughout January and February Human Resources The annual employee Performance and Development Review (PDR) process for Richmond based employees was completed as scheduled in November. Annual remuneration reviews were implemented and finalised in December An update of NBPH Individual Employment Agreements (IEA) was actioned in December, with all Richmond based staff offered revised IEA terms effective January The revised IEA aligns documentation with current legal compliance requirements and provides greater transparency in benefits and employment terms. This update benefits NBPH and employees and was supported by a variety of internal communications. As at 18 January 2017, 70% of IEAs had been signed and returned, signalling the wide-spread employee acceptance of the updated documentation. The date for mediation for the GBCH Multi-Union (MUCA) has been set for 28 February 2017 in Nelson. This MUCA covers the significant majority of employees and roles based in the Golden Bay Community Health facility. 5. HEALTH SERVICES UPDATE Health Services are tracking well against contractual and financial targets. Refer to item 7.2 in the open section and item 3.3 in the closed section. 6. GOLDEN BAY COMMUNITY HEALTH UPDATE GBCH continues to perform in all areas. Refer to item 3.2 in the closed section. 7. LOCAL PLATFORM 7.1 General Practice Visits During the months of December and January, the NBPH Chief Eecutive and Primary Health Manager visited General Practices, with Cathy O Malley, General Manager Strategy, Primary and Community, in attendance for some of them. These meetings afford a useful opportunity to engage with our General 10

11 Practice colleagues and identify and address any issues or concerns raised. The visits were made to the following General Practices: Golden Bay Community Health General Practice Wednesday 14 December 2016 Nelson East Family Medical Centre Thursday 12 January NATIONAL FORUMS Primary Health Alliance The Primary Health Alliance Networking Meeting was hosted by NBPH on Friday 2 December Overall, the meeting was a success and the Chairs and Chief Eecutives thoroughly enjoyed learning about NBPH s successes and innovations, along with enjoying our beautiful region. Feedback from Attendees: On behalf of the Alliance may I thank you most sincerely for hosting our meeting in the manner you did. Feedback from participants was very positive not only about the concepts being rolled at in Richmond but also the opportunities to share good company in some of Nelsons better restaurants. In summary an ecellent day and once again demonstrates the value of meeting at a member venue and learnings on the ground. John Ayling, Chairman of Primary Health Alliance Thanks so much to you and your team for hosting the Primary Health Alliance meeting on the 2nd December. It was lovely to be so warmly welcomed and hosted by another PHO, while discussing matters of mutual interest with fellow PHO and primary care colleagues. Please convey my thanks to your team for their contributions to a successful meeting, and for the opportunity to learn about some of the good work happening in your area. Laila Cooper, Chief Eecutive of Christchurch PHO Dear Angela and John, Thanks so much for hosting us for our December PHA meeting. We greatly enjoyed your hospitality and learning of the ecellent initiatives underway by your NBPH team, including co-location with the DHB and the M&I service. The craft beers I had were pretty convincing too (for a non-beer drinker). Ian Macara, Chief Eecutive of WellSouth For updates on the PHO Alliance and PSAAP, refer to item 3.7 in the Closed Section. 9. CORRESPONDENCE Health Target Results for Quarter One 2016/17 Correspondence from the Minister of Health was received regarding the Health Target Results for quarter one 2016/17. Nationally, NBPH was placed second equal for the Better Help for Smokers to Quit target and obtained 89% for the increased immunisation target. Refer to Appendi 5 for the Correspondence from the Minister of Health regarding the Health Target Results for quarter one 2016/17. Raising Healthy Kids Target 2016/17 Correspondence from the Ministry of Health was received regarding the Raising Healthy Kids Target for 2016/17. Refer to Appendi 6 for the Correspondence from the Ministry of Health regarding the Raising Healthy Kids Target 2016/17. Christmas Cards Received for NBPH Chief Eecutive Throughout December, the NBPH Chief Eecutive received Christmas cards from various organisations such as Te Piki Oranga, Hon Dr Nick Smith and the Nelson City Medical Centre. Refer to Appendi 7 for the Christmas cards received for the NBPH Chief Eecutive. 11

12 Christmas Card Received for General Manager of GBCH In December, the General Manager of GBCH received a Christmas card from Maureen Pugh, National MP for West Coast Tasman. Refer to Appendi 8 for the Christmas card received for GBCH. 10. RECOMMENDATION It is recommended that: The Board receives the report. Appendices: 1. NBPH Media Release on Patient Portals 2. Article in the Admire Magazine provided from NBPH 3. Article in the Activity and Nutrition Aotearoa Newsletter on the Toddler Better Health Programme 4. Article in The Nelson Mail on Dr Richard Everts providing specialist health services in the community 5. Correspondence from the Minister of Health regarding the Health Target Results for quarter one 2016/17 6. Correspondence from the Ministry of Health regarding the Raising Healthy Kids Target 2016/17 7. Christmas cards received for the NBPH Chief Eecutive 8. Christmas card received for GBCH 12

13 APPENDIX 1 Media Release Patient Portals 5 December 2016 Nelson Bays Primary Health Chief Eecutive Angela Francis is promoting the use of patient portals and describes it as an easy way to use technology that allows patients securely and conveniently to manage and keep track of their own health. Nelson Bays Primary Health have many practices that now offer a patient portal to their patients. Patient portals can be used to book appointments, order prescriptions, check immunisations, view lab results or even add personal measurements such as blood pressure or weight as part of goal tracking. As patient portals are an etension of your GP s current services, patients can trust that it is secure. Their information is kept totally confidential, protected by their own unique password. Rata Medical in Collingwood St Nelson have recently implemented their patient portal and Val, the practice manager, says We are getting lots of positive feedback from patients. As it is at no cost to the patient, they are finding the online portal etremely useful for re-ordering current medications among other things. Val also comments that Patients love the fact they don't have to pronounce the names of the medications (even we have trouble with that one!) and that they can go online and order all their current medications and 24hrs later walk into the surgery to pick up their prescription. To sign up for a patient portal, talk to your practice first to see if they are offering this new service. If they are, they will then get you set up with a secure username and password. Once signed up, you ll have access to a range of different tools that you can use to manage your health online - anytime. 13

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16 Toddler Better Health Programme APPENDIX 3 The Toddler Better Health Programme is an eciting new evidence-based healthy lifestyle programme for families with children aged 2-4 years old. It encourages healthy eating habits and being physically active each day. A joint initiative between Nelson Bays Primary Health and Sport Tasman it s the first of this kind in the Nelson region. the help of puppet Ma Moon, who came to Earth but was unsure of trying new foods. The kids touch, smell and even kiss foods to get familiar with it before tasting it. We find at this age there are a lot of fussy eaters and that often leads into behaviours which are really difficult to change and can influence their health and weight. We have seen changes in the kids, I think having the snack time has been great, watching children sit down and being very hesitant at first to try things like raw broccoli and cauliflower but they have given it a go says Tonia Talbot community dietitian at Nelson Bays Primary Health who facilitates the programme. The program was originally developed in the United Kingdom and has also been implemented in Australia. It was tailored to suit the New Zealand contet. There has been some great feedback and success stories from families participating so far: 60% of parents said their children were spending more time being physically active 60% of parents have seen a reduction in the time their children are spending on screens (such as TV, computer) 80% of parents also said their children are eating more vegetables on a daily basis. The programme has had a real flow on effect to my etended family. My mother sent the children money instead of chocolate for Easter this year and my sister and brother in law don t offer fizzy drinks when we come to visit now said a parent on the programme. Toddler Better Health aims to encourage families to be more active and make healthy choices with their food as well as making small healthy changes in the family home. It s a free programme and is delivered once a week over a ten-week period. Each session involves toddlers and parents/caregivers sharing the eperiences of learning in a fun way. Although the primary target is families with an overweight/ obese child or a child at risk of becoming overweight, it s suitable for all families with children aged between 2-4 years old. Families can be referred by a health professional or they can self-refer. It is advertised in a number of ways to the community including GP practices, public health nurses, Plunket, family start, dietitians, paediatricians and early childhood services. The programme includes 30 minutes of play-time (parents and children learning how to play together), snack time (children and parents get to try new and eciting healthy foods) and 45 minutes of fully supervised creative play for the children, while parents learn about healthy eating and how to make behaviour changes at home. Through the activities set up toddlers are able to practise basic skills like kicking, catching, jumping and balancing. Reducing sedentary behaviour is also a big part of the program and families are encouraged that children watch less than two hours of television a day. Snack time allows toddlers to try new foods and targets fussy eaters. Each week they try a different fruit and vegetable with For more information please contact: Tonia Talbot Nelson Bays Primary Health E: tonia.talbot@nbph.org.nz Jenny Dravitzki Sport Tasman E: jenny.d@sporttasman.org.nz 44 16

17 APPENDIX 4 Nelson doctor promotes move to get specialist health services in the community Stuff 6 December 2016 A Nelson specialist who moved into the community after being hospital-based says doctors in other regions should consider doing the same. Nelson Bays Primary Health infectious diseases specialist Dr Richard Everts says the move into the community meant he was more productive and able to see more patients. Everts, who is based at the Richmond Health Hub, spoke to health professionals from around the country at a Primary Health Alliance meeting last week. Out of 50 infectious diseases specialists in New Zealand, Everts said he was the only one based in the community. He was previously employed by the health board and based at Nelson Hospital, but said 90 per cent of what he did could be done in the community through the primary health organisation (PHO). "Being out here I have been able to focus more on primary care infection issues and prevention and early intervention. "It just felt like people were coming into hospital with problems that I could have nipped in the bud if I had dealt with them a week earlier." He was better able to follow up with patients, run clinics, conduct audits and would still visit the hospital to teach junior doctors and attend committee meetings when needed. "I think infectious diseases is the ideal specialty to run out of a PHO because a lot of antibiotics consults and work gets done in the community rather than the hospital." He said there were other specialties, including rheumatology and diabetes that would also work well based in primary care and he encouraged his colleagues from around the country to consider whether it would be appropriate Health Minister Dr Jonathan Coleman has previously said moving health services out of hospitals and into the community was one of the Government's priorities. Nelson Bays Primary Health chair John Hunter said Everts was now able to see more people thanks to virtual consultations which was a "resounding success for the community". Primary Health Alliance chair John Ayling said it was the first time the organisation had met in Nelson and it was good to hear about some of the initiatives in the region. He said Everts move into the community signalled specialists didn't always need to be based in a hospital. "Moving some of the specialist skills out of the traditional hospital setting into the primary care and general practice space is good for patients. Particularly for PHOs which have isolated communities where travel and access present real challenges." Ayling said the alliance advocated for policy and decision makers to move secondary services into the community. "We need to challenge some of the eisting thinking around how we organise and deliver some services so that they are more accessible." 17

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29 To Nelson Bays Primary Health Board From Karen Winton, Acting GM Health Services Endorsed by Angela Francis, Chief Eecutive Meeting date 2 February 2017 Subject General Manager Health Services Operational Report Open Section For approval For action For information 1. SERVICE OVERVIEW The Health Services Division has a surplus position Year To Date (YTD) against budget as at 31 December The surplus position continues to be primarily due to revenue in advance of budget within the System Level Measures cost centre. The majority of cost centres remain tracking at, or close to, budget. The Health Services division remains set to achieve a small surplus position against budget at year-end. Unconfirmed System Level Measures (SLM) data as at 30 December 2016 indicate Nelson Bays Primary Health (NBPH) is on track to meet 1 of the 2 current measures, with the 8 month and 24 month 95% immunisation targets again being cause for concern. The Nelson Tasman catchment immunisation decliner rate remains the key issue regarding noncompliance with the two immunisation targets. The 8 month old immunisation rate is 91% (25 children, 6.2%), decliners removed the immunisation rate was 97.4%. This equates to 10 children who were not decliners who were not immunised at 8 months. The 24 month old immunisation rate is 90% (33 children, 8.1%), decliners removed the immunisation rate was 98.4%. This equates to 6 children who were not decliners and who were not immunised at 24 months. In total, ecluding decliners, 738 of a possible 754 children were immunised. The Health Services Team are focused on the year ahead and planning for their 2017/18 programmes and any new initiatives they can implement to best meet community needs. 2. HEALTH PROMOTION Falls Prevention The Nelson Marlborough District Health Board (NMDHB) contract for Falls Prevention Local and Regional Coordination has been signed off. The Request for Proposal for the ACC community-based Strength and Balance Falls Prevention programme has been submitted and we are awaiting the outcome. The Fracture Liaison Service (FLS) contract with NMDHB is progressing well. Green Prescription NBPH are still waiting for the Ministry of Health guidelines regarding the new requirements associated with gestational diabetes/pre-diabetes during pregnancy. NBPH have a 2 year contract for provision of Hip and Knee clinics across the rural areas, with a new staff member just commencing under the Green Prescription team to support this work. Community Nutrition A regular dietician clinic has been implemented at Te Awhina Marae in partnership with Te Piki Oranga (TPO). 29

30 Cardiac Rehabilitation This programme is strongly supported by NMDHB s Cardiology team and the Top of the South Health Alliance. A budget bid has been submitted as we have no contract for provision of this service and it is currently the only primary care programme across New Zealand. Interpreter Services A preliminary meeting has been held with NMDHB to discuss interpreter issues and progress is being made to contract a community organisation to manage this service line. This will include responsibilities for training, all bookings and financial responsibilities. This is a National problem and a report just released from the Ministry of Immigration has identified actions to be implemented to attempt to address the issues on a National level. 3. PRIMARY HEALTH After Hours Telephone Nurse Triage A South Island Alliance approach to the After Hours Telephone Nurse Triage issue will continue to be investigated, awaiting further information around progress to date. Respiratory Service There is a new Options for Care for delivery of spirometry, this is a diagnostic service used to identify Chronic Obstructive Pulmonary Disease (COPD). There is also a provision for COPD Acute eacerbation management within OFC, this should reduce presentations at the emergency department. A Pulmonary Rehabilitation Service is currently under development. This is for those diagnosed with COPD to support their self-management. Meetings are still to be held with the Asthma Foundation to plan out the proposed contract for their delivery of this service across the community. Smoking Cessation Our latest health target results for the first quarter shows a 93% result but we are yet to receive the confirmed results from the second quarter from the Ministry of Health. We are epecting this to show we have remained on target. National Enrolment Service (NES) All General Practices are required to be on NES by 31 March 2017, currently 72% of our practices have completed this process with the remaining 7 General Practices scheduled to complete prior to this date. 4. SPECIALIST SERVICES Infectious Diseases Our specialist has been involved in a large ACC funded research trial in Nelson over this summer which is focused on reducing infections for patients post operatively in the future. This has been very successful with more than 40% more recruits than epected. Care for individual patients within our community is continuing along with provision of teaching and audits. 30

31 Community Rheumatology Service NMDHB has provided some additional funding for the programme to address the lengthening followup review waitlist. The structure of the clinics is being adapted to ensure these occur within the scheduled clinic times as a mied workload. NMDHB is yet to confirm increased funding for the ongoing provision of the suggested increased clinics, following a requested budget bid in December The latest available waitlist report shows a further slight reduction in numbers for both Wairau and Nelson. 5. MAORI HEALTH Kaiatawhai Service The TPO secondment of one of their staff to Kaiatawhai service to 30 June 2017, is working well. Introductions and engagement with local General Practices is continuing. Kaitakawaenga Luke Katu continues to support the Victory Community Be Well service. Their Nurse is retiring after 10 years of service, so they are currently advertising for a replacement. 6. MENTAL HEALTH Primary Mental Health Initiative (PMHI) and Brief Intervention Service (BIS) Demand for services across PMHI and BIS remains etremely high. NMDHB has recently requested some initial proposed costings for improving provision of services across primary care in response to continued feedback regarding resourcing limitations. 7. RECOMMENDATION It is recommended that: The Board receives the report. 31

32 To Nelson Bays Primary Health Board From Naomi Johnson, Lead Health and Safety Representative Endorsed by Angela Francis, Chief Eecutive Meeting date 2 February 2017 Subject Health and Safety Report For approval For action For information 1. OVERVIEW AND UPDATE The following provides a high level update on Health and Safety for Nelson Bays Primary Health (NBPH). This report presents records from both the Richmond and Golden Bay locations. This month there are no issues of concern to report. 2. INCIDENT AND HAZARD REPORTING Consistently higher number of incidents reported for Golden Bay Community Health (GBCH) in comparison to Richmond, as is epected due to the nature of the work-types. There is an increase in the number of staff minor accidents, but all accidents are being managed and suitable prevention plans have been put in place. Health and Safety Representatives conducted monthly walk-arounds, and identified minor environmental hazards which were reported and managed. Table 1: Near Miss and Incident Records October to December 2016: Incident Reporting: 1 October to 31 December GBCH Richmond GBCH Richmond GBCH Richmond October November December Near-Miss: no harm Actual: no harm Actual: injury Serious Harm 32

33 3. OTHER HEALTH AND SAFETY ACTIVITIES Stress in the Workplace It is difficult to identify stress in the workplace, as stress can be mediated by both workplace and personal factors. To guide the organisation in this, the workplace usage of the Employee Assistant Programme (EAP) services over the last two months has been reviewed. EAP is a confidential service and the matters raised are not necessarily stress related. There was no usage of EAP services during November and December Golden Bay Community Health Activities In the process of updating GBCH Business Continuity Plan and GBCH Emergency Management Plan Etra outside lighting (with sensors) have been installed by the GBCH Trust to light up the carpark area at night. 281 Queen Street Activities Redevelopment of NBPH Emergency Management Plan Health and Safety Committee planning drills, training and other Health and Safety activities for 2017 Regular input into Staff Newsletter 4. RECOMMENDATION It is recommended that: The Board receives the report. 33

34 To Nelson Bays Primary Health Board From Emily-Rose Richards, Eecutive Assistant/Board Secretary Endorsed by Angela Francis, Chief Eecutive Meeting Date 2 February 2017 Subject Procedures for Review For approval For action For information 1. PURPOSE To provide the Board with an updated version of the Whistleblower/Protected Disclosures Procedure. 2. SUMMARY At the Board Meeting on 7 December 2016, Mr Hunter was asked to make his amendments to the Whistleblower/Protected Disclosures Procedure and bring back to the February Board meeting for further review. The Procedure now incorporates Mr Hunter s minor amendments. Refer to Appendi 1 for the Whistleblower/Protected Disclosures Procedure. 3. RECOMMENDATION It is recommended that the Board: Reviews the Whistleblower/Protected Disclosures Procedure Appendices: 1. Whistleblower/Protected Disclosures Procedure 34

35 APPENDIX 1 TITLE: Whistleblower/Protected Disclosures Procedure 1. Scope This procedure applies to all Nelson Bays Primary Health (NBPH) employees. For this purpose employees includes: Current employees and Chief Eecutive; Former employees and Chief Eecutives (90 day timeframe from the date that employment ceases); and Contracted individuals supplying services to the Organisation. 2. Procedure Any employee of the organisation who wishes to make a protected disclosure should do so using the following procedure. 2.1 How to submit a disclosure The employee should submit the disclosure in writing. The disclosure should contain detailed information including the following: The nature of the serious wrongdoing; The name or names of the people involved; and Surrounding facts, including details relating to the time and/or place of the wrongdoing, if known or relevant. 2.2 Where to send disclosures A disclosure must be sent in writing to the Chief Eecutive who has been nominated by the Board under the provision of Section 11 of the Protected Disclosures Act 2000 for this purpose. OR If you believe that the Chief Eecutive is involved in the wrongdoing, or has an association with the person committing the wrongdoing that would make it inappropriate to disclose to them, then you can make the disclosure to the Board Chair. OR If you believe that the Chief Eecutive and/or Board Chair are involved in the wrongdoing, or has an association with the person committing the wrongdoing that would make it inappropriate to disclose to them, then you can make the disclosure to the Board Deputy Chair. The above persons are referred to in this Procedure as the Disclosee. Nelson Bays Primary Health Organisation Authorised by: Issue Date: February 2017 CE Version Date: February 2017 Procedure: Whistleblower/Protected Disclosures Procedure Review Date: February 2020 Version: 1 Page 1 of 2 35

36 2.3 Decision to investigate On receipt of a disclosure, the Disclosee must acknowledge receipt within 5 working days to the person submitting the disclosure, and the Disclosee must within 20 working days eamine seriously the allegations of wrongdoing made and decide whether a full investigation is warranted. If warranted, a full investigation will be undertaken by the Disclosee, or arranged by him/her as quickly as practically possible through an appropriate authority. 2.4 Protection of disclosing employee s name All disclosures will be treated with the utmost confidence. When undertaking an investigation, and when writing the report, the Disclosee will make every endeavour possible not to reveal information that can identify the disclosing person, unless the person consents in writing, or if the person receiving the protected disclosure reasonably believes that disclosure of identifying information is essential: To ensure an effective investigation; or To prevent serious risk to public health or public safety or the environment. 2.5 Report of investigation At the conclusion of the investigation the Disclosee will prepare a report of the investigation with recommendations for action if appropriate. This report will be sent to the Board Chair and the Board. 2.6 Disclosure to an appropriate authority in certain circumstances A disclosure may be made to an appropriate authority (including those listed below) if the employee making the disclosure has reasonable grounds to believe: Immediate reference to another authority is justified by urgency or eceptional circumstances; or There has been no action or recommended action within 20 working days of the date of the disclosure. Appropriate Authorities include (but are not limited to): Commissioner of Police Controller and Auditor General Director of the Serious Fraud Office Inspector General of Intelligence and Security Ombudsman Parliamentary Commissioner for the Environment Police Complaints Authority Solicitor General State Service Commissioner The head of any public sector organisation 2.7 Disclosure to Ministers and Ombudsman A disclosure may be made to a Minister or an Ombudsman if the employee making the disclosure has made the same disclosure according to these internal procedures and clauses of the Whistleblower/Protected Disclosure Policy and reasonably believes that the person or authority to whom the disclosure was made: has decided not to investigate; or Nelson Bays Primary Health Organisation Authorised by: Issue Date: February 2017 CE Version Date: February 2017 Procedure: Whistleblower/Protected Disclosures Procedure Review Date: February 2020 Version: 1 Page 2 of 2 36

37 has investigated but has not taken or recommended any action; and The employee continues to believe on reasonable grounds that the information disclosed is true or is likely to be true. Approved By: Chief Eecutive Nelson Bays Primary Health Organisation Authorised by: Issue Date: February 2017 CE Version Date: February 2017 Procedure: Whistleblower/Protected Disclosures Procedure Review Date: February 2020 Version: 1 Page 3 of 2 37

38 Board Work Programme v 18 January Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec BOARD Meetings Richmond 7 4 TC TC Golden Bay 7 7 Strategic Planning Day NBPH and MPH Board Meeting Havelock Events Board dinner 6 Agenda items Board appointment process (A6) Delegations policy (A9) Appointment of Deputy Chair Subcommittee appointments review Review of Trustee Register/Reappointment Process Approve audited financial statements Approve 2017/18 Budget Other Review annual formal appointments of Board members to AFRIC and Gov and Rem Send Fit and Proper declarations to Trustees for completion Management to provide Solicitor s review of NBPH s statutory compliance register Management to provide summary paper from Solicitor on new legislation relevant to the Board, as required COMMITTEES Remuneration and Governance Meetings TBC TBC TBC TBC Chief Eecutive performance Staff/Providers/Stakeholders Survey carry out appraisal Staff/Providers/Stakeholders Survey review Chief Eecutive performance appraisal Agenda items Review of Trustee Register/Reappointment Process Board Appraisal (every 2 years) Review of Terms of Reference (every 2 years) Trustee Position Description Other Review Fit and Proper declarations 38

39 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Audit and Financial Risk Meetings Agenda items Review and recommend the budget Consider year-end audited financial statements Meeting with Auditor/Setting Audit Fee Reappointment of Auditor Insurance of renewal review Review of Reporting to Board Review of Terms of Reference, Chair, Committee Performance Te Tumu Whakaora Meetings Clinical Governance Committee Meetings AGM Meeting Agenda items Adopt Annual Report Appoint Auditors for net financial year OTHER Strategy and Budget Cycle Strategic Planning Day Strategic Plan Annual Plan Audit Budget process Consider 2017/18 Budget Marlborough Primary Health Board meetings Blenheim AGM Blenheim 21 Public Holidays Nelson Anniversary Day 30 Waitangi Day 6 Good Friday 14 Easter Monday 17 Anzac Day 25 Queen s Birthday 5 Labour Day