Day services ease after-hours pressure
Work to improve day-time consultations for people with urgent health needs has helped decrease after-hours calls but better communication with the community is still needed, a district health board audit says.
The MidCentral District Health Board ticked most of the boxes in a performance audit review focused on after-hours services released by the Auditor-General's office this week.
DHB primary healthcare senior portfolio manager Craig Johnston said the DHB and Primary Health Organisation had been working with general practices to improve access to day-time consultations for people with urgent health needs.
"Our experience is that this helps people avoid the need for after-hours calls. This is supported by overseas research," he said.
The audit in 2010 found that after-hours services were available within 60 minutes' drive for 99.7 per cent of people.
"In general, people living in remote rural areas did not have these services available within 60 minutes' drive. Although DHBs had good service coverage, most had not clearly identified or addressed transport and affordability barriers to accessing after-hours services," the report said.
"Our follow-up review showed that many DHBs have identified and/or addressed barriers and improved access. The introduction of free after-hours services nationally for children under-6 years has also helped to improve access for these children. However, access problems (such as cost) remain for Maori, Pasifika, rural communities, and people living in the most deprived areas."
Since the first audit in 2010 the MidCentral board has integrated several new services aimed at improving access to after-hours healthcare in the region, including a pilot service where paramedics treat patients at home, free after-hours care for under-6s and introducing Heathline as the first point of contact for after-hours services. Community forums and a review of access barriers had been undertaken.
In January 2011 Healthline became the first point of contact for after-hours services across the district, Johnston said. "The role of Healthline has grown to the point where we have the highest utilisation rate per head of population in the country."
MidCentral's use of Healthline is at 18 per cent, compared to the national average of 9.5 per cent. In Horowhenua the access to Healthline is about four times the overall MidCentral average.
Community forums in Levin had raised the issue of people not knowing what health services were available after hours, Johnston said.
"Members of the Acute and Urgent Care District Group were surprised at the lack of knowledge about these services in the community. There clearly needs to be greater communication with the community about service availability. This has been carried forward onto the Acute and Urgent Care District Group's work programme for 2013/14 and 2014/15."
Johnston said the Horowhenua community had a wide range of health services directed at long-term conditions, acute healthcare needs, child health, elder care and family wellbeing through Whanau Ora.
A reorganised after-hours service in the Horowhenua was also introduced last year, he said. "Now the after-hours service is provided from the Horowhenua Health Centre and it operates according to fixed hours, which means the community can be certain about where to go to receive care.
"Central PHO has indicated that the service is being well used and we have had positive feedback from the community."
Last year a Horowhenua man questioned the effectiveness of after-hours health services in Levin after having to drive his 3-year-old daughter to Palmerston North for treatment.