Urgent care service to be redesigned

Last updated 12:00 06/12/2013

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A second-stage pilot of MidCentral District Health Board's besieged Urgent Community Care service will likely be based in Horowhenua.

An initial trial of the service, to decrease hospital admissions, was pulled earlier this year after research found little change and that some people had been taking advantage of free healthcare.

The MidCentral District Health Board's portfolio manager of primary healthcare, Craig Johnston, said the Ministry of Health had indicated it would fund a second-stage pilot once a revised and innovative service model had been designed. "Clinical leaders from Horowhenua and Palmerston North are working together to design an improved model, with work expected to be completed early in the new year," he said. "The Ministry of Health is generally pleased with the direction the project is taking. The new model is likely to be based out of the Horowhenua Health Centre, where it will be tightly connected to Horowhenua Community Practice."

Mr Johnston said it was likely it would take a while to transition across to the new service model - the aim would be to manage the transition seamlessly.

"The second-stage pilot will be more effective in managing patients in the community without the need to transport them to hospital services in Palmerston North," he said. "It will be better integrated with existing primary healthcare services in the Horowhenua, for example the after-hours service and general practice, which is expected to result in better quality of healthcare in the Horowhenua.

"It will also be more cost-effective, so the service is financially sustainable."

The Urgent Community Care Horowhenua pilot began in December 2010 after the district was identified as an area of high health needs, with a significant number of over-65s and a shortage of primary care services.

It was to be trialled by Levin St John to reduce transfers to Palmerston North Hospital until January 2014 - at a cost of $761,000 a year.

It was anticipated that if the pilot was successful, it would be rolled out across the country.

But a report by Sapere Research Group in March this year found the Palmerston North Hospital emergency department did not notice a decrease, and a new model of care was recommended.

"The evaluation has shown some avoidance of ED attendances . . . but not enough to justify the cost," the report said.

It also found issues with people using the service to replace their doctor.

"Patients are aware that UCC is free and are contacting St John whereas previously an ailment may have gone untreated or been seen by a GP," the report said.

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"It has been popular with patients and has generated demand from people who would otherwise have pursued other avenues to obtain care."

- © Fairfax NZ News

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