Outpatient acute care will free up funds

LYN HUMPHREYS
Last updated 05:00 05/02/2013

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Extensive changes to Taranaki's mental health and addiction services are being implemented as a result of tighter funding.

The Taranaki District Health Board's review of adult mental health and residential services aims to make the region's services more flexible in times of less money, coupled with staffing challenges and an increasingly ageing population.

The review, given the go-ahead in June last year, found a need for more dedicated community facilities for seriously ill patients to be cared for within the community rather than in hospital.

The report notes that the level of community-based care, termed acute respite care, in Taranaki was inadequate, with funding well below the national average, and therefore unable to support acute patients in a community setting.

While acute crisis respite services did exist, they were piecemeal and needed redevelopment.

Patients were often unnecessarily being admitted to the Taranaki Base Hospital inpatient ward, Te Puna Whaiora.

As a result the service will be bolstered by about $550,000 a year.

Acute respite care allows patients short-term care in a dedicated facility within the community.

A four-bed community facility would cost half as much as caring for patients in hospital, the report says.

Developing the community service would both reduce admissions to the ward and give earlier and more appropriate community based care. Such a facility would also allow inpatients to leave hospital earlier.

An analysis of all the DHBs found Taranaki's adult acute crisis respite budget, at 93 cents per head of population, was second-lowest in the country after South Canterbury. The average rate was $4.97.

The report notes that there is a similar gap in youth crisis respite services.

Conversely, the review also found that more acutely unwell people were being cared for in the hospital's mental health ward compared with other DHBs.

Like Minds manager Gordon Hudson commented on the situation two weeks ago, praising the move for improved community services but urged the board to ensure they were properly funded and staffed.

He was incorrectly quoted as saying acute services for mental health were ineffective in Taranaki.

Mr Hudson in fact said it was acute crisis respite care that had been underfunded and was not as effective as it should be.

Yesterday, a hospital spokeswoman said the implementation phase was now under way and potential service providers were being asked to put forward their proposals.

Other review recommendations include:

Better care within rest homes for aged patients with complex medical and physical conditions. Rest homes and mental health services to jointly manage their care. Increase skills of current rest home staff.

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Services for younger patients with severe and chronic conditions. Focus on keeping the patients connected with both their families and communities.

Alcohol and drug services: Medical community-based residential care detoxification to be developed. Improvement of day treatment programmes including family.

South Taranaki: Creating a holistic South Taranaki mental health and addictions identity including a drop-in centre.

Improving mobile support services including acute home based treatment and crisis team.

Transport for patients and their family to access crisis respite.

Adult rehabilitation and recovery beds. Recovery-focused activity programmes. Better community-based services, eg medication oversight (particularly in the south).

Improved early intervention systems to give quicker access to services.

- Taranaki Daily News

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