Tēnā koutou katoa

Labour Day has come and gone, and Workforce keeps coming up as one of the pressing issues facing our Primary care teams, in general practices, community pharmacies and other community providers across the takiwā. So I want to take the opportunity to thank you all for the hard work and dedication that you bring to work every day, to support your communities. Ngā mihi nui ki a koutou. Thank you very much.

We are likely to see some change in the Health policy settings over the next few months as the new government is formed and its priorities are embedded. We should know more of the direction of these priorities over the next few weeks and months, and we keep you posted as things evolve.

The use of AI in primary care is a hot topic currently. Luke Bradford, RNZCGP medical director, spoke at the Otago RNZCGP faculty’s AGM about how we should explore the potential of AI tools  in general practice, being fully cognisant of the pitfalls and having robust solutions in place. Dr Janine Bycroft of Health Navigator fame is working with Dr Karl Cole and RNZCGP to set up a special interest group in AI (see info below), and the first meeting is next week – they already have over 50 people registered so join up if you are interested, as we need collective wisdom to progress along this journey safely. In addition, the next GPNZ Inbox Management series webinar is focused on technological solutions, again looking at bots and other approaches. So some interesting learnings and opportunities coming up in this space!

Key points today:

• Update on Toitū Takata - LTC programme

• Nurse Practitioner Transition programme – applications close Tuesday 31st October

• Patients on Triple Whammy medications – export now live!

• Clinical Needs Assessment Letters Otago

• The Winter Wellness Checks

• Primary Care AI Special Interest Group

• Southern Suicide Prevention Action Plan 2024 – 2027 Community Consultation Workshops

• 6th Annual Southland GP Weekend Education Conference

• Nurse Study Day – Respiratory Education

• Upcoming GPNZ Inbox Management Webinars

• Wānanga Tōkeke: Equity in Health Workshop

• Building the future of health 

What’s new

Update on Toitū Takata – LTC programme

The team from WellSouth presented Toitū Takata at the Primary Health Care Nurses Conference, earlier in the month. The kōrero was well received and there was lots of good conversation and questions. 

We look forward to meeting with more Practice Nurses from around the region at the Toitū Takata Nurse Champion Workshops over the next few weeks.

When it comes to Quick CLIC , feedback from practices has been clear. Quick CLIC was well liked by both clinicians and patients. As part of the refresh, the intention was for Quick CLIC to remain in place for patients. As CLIC is no longer active, Quick CLIC as a name no longer makes sense. Therefore, we are pleased to announce that Quick CLIC has been renamed Hāpai Atu. Hāpai Atu means to provide support and care.

Hāpai Atu will continue to provide support to those with long-term conditions who are experiencing a short-term exacerbation or acute episode, and who require a period of additional support to return to their usual level of wellness.

Nurse Practitioner Transition programme – applications close Tuesday 31st October

The intent of this programme is to ensure newly registered NPs have the time and opportunity to be well oriented and integrated into practice. The funding for the NP Transition Programme has been allocated from the EN/NP Workforce Programme, funded through Te Whatu Ora.  More information and the application are available here: https://nurseworkforce.blogs.auckland.ac.nz/np-transition-programme/

Info and tips to avoid Triple Whammy

One of the preventable causes of renal failure is patients being prescribed the combination of drugs known as Triple Whammy (an ACE or ARB, a diuretic and NSAID). 1:158 people who take this combination of drugs will end up with an admission with acute renal failure, while many others will have avoidable renal damage. More information available here: http://bpac.org.nz/2018/triple-whammy.aspx

We know that around 2000 people in Otago-Southland are being prescribed this potentially harmful combination, although there will be others who are purchasing their NSAIDs from the pharmacy or supermarket. Careful advice therefore needs to be given to patients to avoid NSAIDs when they are on an ACE/ARB and diuretic, or to have relatively frequent monitoring of their renal function, (preferably 1 month after starting the combination, and then every 3 months) if the Triple Whammy combination is unavoidable.  Triple Whammy – Patient Information Guide

Tips to avoid Triple Whammy:

• Prescribe regular paracetamol

• Use topical analgesics such as diclofenac gels or sprays or capsain cream.

• A weak opioid such as codeine or tramadol may be necessary.

• Weight loss and increased physical activity (where achievable) will also reduce joint pain.

Sick day advice is important for all patients.  This needs to include advice to stop certain medications if you are off your food, have vomiting and/or diarrhoea or have a high fever. Particular medications that may need to be stopped include blood sugar lowering agents (gliclazide, glipizide, empagliflozin, metformin), anything ending in -pril or -sartan, diuretics and NSAIDs.

More detailed patient resources can be found at:

• https://healthed.govt.nz/products/kidney-health-at-home-sick-day-advice-he2647

• https://healthify.nz/medicines-a-z/n/nsaids-and-blood-pressure-medicines/

• https://healthify.nz/assets/avoiding-anti-inflammatories-when-taking-blood-pressure-medicines.pdf

For practices using MedTech 32 and Evo, Indici and MyPractice PMSs, it is now possible to generate on Thalamus a list of patients who have been prescribed this combination over the past 6 months. This has been placed as part of the CVD dashboard. Please see below screenshot on how to get to the information you require – you may be surprised how many patients come up!

For further assistance with Thalamus, please contact Susie.Lawless@wellsouth.govt.nz or Glen.knol@wellsouth.govt.nz

Clinical Needs Assessment Letters Otago

Following feedback and consultation with primary care, Clinical Needs Assessment (NASC) letters for the Otago catchment area (covering Dunedin, Oamaru, Balclutha regions) will now be sent directly to Primary Care teams via EDI. Previously, notifications were issued informing us a letter has been uploaded to Health Connect South. This new process ensures appropriate clinical information is included in the primary care clinical record directly, while reducing inefficiencies in accessing it. This is already the situation for Southland hospital catchment practices so it brings it into line across the region.

What did you think of the Winter Wellness Checks?

The Winter Wellness Checks programme, running between April and July this year, was offered to patients who were at risk of deteriorating over the winter months.

What was the impact? How can we improve the delivery of the Winter Wellness Checks for both patients and clinicians, if we were to offer the checks again in 2024?

To understand the impact and processes, we would like to speak to clinicians and patients about their experiences of the Winter Wellness Check. Let us know what you think, and please let us know of any patients that would like to have their say, especially Māori and Pasifika patients. Contact marc.haughey@wellsouth.org.nz with your feedback or to take part.

Opportunities to be involved

Primary Care AI Special Interest Group – Updated Link

GPs, nurse practitioners, HIPs and primary care professionals who are interested in exploring the opportunities, risks, and guidance needed for incorporating AI tools such as clinical scribes, Nabla Co-Pilot, Chart-Note, and others into primary care practices are invited to join a special interest group focusing on the use of AI tools in primary care.

The aim of this group is to facilitate discussions, share experiences, and collaborate on best practices for the successful implementation and utilisation of AI tools in primary care settings.

The first meeting is likely to be Thursday November 2 from 7.00pm – 8.30pm. 
To register, please click here.
From this meeting ongoing interest, frequency and format will be assessed.

Any questions you may have, please contact Dr Janine Bycroft janine@healthnavigator.org.nz / Tom Broadhead tom.broadhead@rnzcgp.org.nz / Dr Karl Cole karl@pfd.co.nz

Upcoming training and webinars

Southern Suicide Prevention Action Plan 2024 – 2027 - Community Consultation Workshops

Upcoming workshops:

Dunedin – 1 November
Queenstown – 8 November
Invercargill – 17 November
Oamaru – 23 November

Register for your local workshop here.

WellSouth are currently developing the Southern Suicide Prevention Action Plan 2024 – 2027. As part of this, we are carrying out community consultation with individuals and organisations across the Southern region. We want to hear from you.

These workshops are being held across the region and will help us understand the needs and priorities of your community, and what actions are needed to prevent suicides.

Your feedback will be collated and included in the Southern Suicide Prevention Action Plan to inform local organisations and government agencies what actions they should take to prevent suicides.

Please note these workshops are not aimed at providing support or therapy. If you are needing support, please talk to your GP or call/text 1737.

There are a number of events across the region, click here to find your local workshop.

6th Annual Southland GP Weekend Education Conference

4 - 5 November 2023
Distinction Hotel, Te Anau
Register here.

The Annual Southland GP Education conference is back for the 6^th year, hosted by the RNZCGP’s Southland Faculty in Te Anau.

We have a fantastic line up of speakers across the two days.

9 CME points, and practitioners from Southland will be offered a 50% discount.

For the full schedule of events and speakers click here. 

If you require assistance, please contact workforce@wellsouth.org.nz.

Nurse Study Day – Respiratory Education

Saturday 4 November, 8.30am
Dunedin
Register here.

Jointly delivered by Secondary Care based Respiratory Clinical Nurse Specialists and WellSouth Primary Care LTC Nurses, the first nurse study day is about respiratory management.
The session will be held in Dunedin on Saturday November 4, this date was based on feedback.
The Respiratory Connections study day is an integrated approach to respiratory care in Secondary and Primary Health Care. 
See the flyer with further details here. Join the WellSouth Long term conditions team to upskill and refresh in respiratory management.

If you have any questions, please do not hesitate to contact Marryllyn Donaldson Marryllyn.Donaldson@wellsouth.org.nz

Upcoming GPNZ Inbox Management Webinars

GPNZ held its first (and very successful) inbox management webinar on October 18, on the topic of Workforce.
If you missed it, you can watch it here: https://www.youtube.com/watch?v=7M6II27cF-o

There are two more upcoming webinars:

• November 8, 12.30pm – Technology advancements

• November 22, 12.30pm – Medico-legal perspectives

To register, click here.

Wānanga Tōkeke: Equity in Health Workshop

A further series of our Wānanga Tōkeke: Equity in Health workshops are coming up, with dates added across November and December. These are open to all people working in primary care, be that general practice, community pharmacy and other primary care settings.

Register for your local workshop below:

Invercargill - 21 November
Alexandra - 29 November
Queenstown - 30 November
Dunedin - 5 December
Oamaru - 6 December

Feedback from previous participants is that this workshop is a ‘must-do’ for all team members within practices.

The three-hour workshop will provide you with a general understanding of the below topics while helping you honour your obligations to Te Tiriti o Waitangi and present you with some practical skills that you can take into your practices. 

Learn about:

• Mihimihi & pepeha

• Foundations of Te Ao Māori

• Equity in General Practice

• Decolonising Primary Care: Overview of Cultural Safety and Cultural Competency

For information and to register click here. 

Invitation: Building the future of health 

Stakeholder virtual hui 
Date:         Wednesday 1 November 2023
Time:         3.00pm - 3.45pm
Link:          Building the future of health 

The next stakeholder virtual hui with Chief Executives Margie Apa, Te Whatu Ora and Riana Manuel, Te Aka Whai Ora, who will update on the Health Workforce Plan.
 
Special guests include Gary Jackson, Director, Population Health Gain, Te Whatu Ora and Kadin Latham, General Manager Data, Digital & Knowledge, Te Aka Whai Ora, who will give updates on the Health Status Report. Gary and Kadin will headline some key findings in our health status – this will be the first produced as a national report and will inform further deeper dives on health status within specific groups and regions.

I hope that you all are planning a bit of a break over the coming summer, as we turn our minds to Christmas rosters and end of year do’s etc. The work you do is crucial to the health and wellbeing of your community, so take some time to look after yourself.

Ngā mihi nui

Carol