GAIHN child health: supporting system integration Tim Jelleyman, Paediatrician, Waitemata District Health Board / GAIHN child health clinical lead & Louise McCarthy, GAIHN Child Health Project Manager April 2013

GAIHN Greater Auckland Integrated Health Network Partners: –DHBs: Auckland, Waitemata, Counties Manukau –PHOs: Auckland, East Health Trust, ProCare, Total Healthcare Objective: To reduce acute/avoidable hospital admissions. Aim: To improve integration between primary and secondary care, and to strengthen the regional capacity of primary care. GAIHN’s role: To lead and coordinate collaborative processes to develop initiatives which are then implemented across the region by the partners. Four Work Streams: 1.Identify and manage individuals at high risk of hospitalisation 2.Improve primary care responses to acute events 3.Enablers of better individual care – pathways, and e-tools (e.g. Shared Care) 4.Child health - aligns with Work Streams and Northern Regional Health Plan

Overview GAIHN child health work stream o alignment and areas of focus West Auckland Locality Child Health Plan o draft priorities and objectives

GAIHN Child Health Work Stream Aligned: National Better Public Services: Vulnerable children, Rheumatic Fever, Maternal/Child RegionalNorthern Regional Health Plan (NRHP) Child Services Plan District DHB Annual Plans Current focus (NRHP priorities): o Clinical pathways and decision support tools / resources: skin infections, lower respiratory tract infections, chronic cough, eczema o Support locality planning for child health: West Auckland o Counties Manukau Health 20,000 Days Campaign: report on prevention and management of skin infections / cellulitis in the community Planning for : o Improve enrolment, engagement and interventions for vulnerable children and pregnant women: focus on two localities o Support localities and GAIHN partners to implement NRHP priorities o Prevention and management of skin infections in the community: 20,000 Days Campaign, Otara pilot

West Auckland Locality Child Health Work Stream West Auckland locality: o Approx. 242,000 people. 0 – 14 year olds: 23% of the population o Ethnically diverse: Maori 12%, Pacific 14%, Asian 18%, Other 57% o Approx. 65% of the population live in NZDep 2006 deciles 6-10 o Three clusters of practices: New Lynn, Henderson and Massey o Top four child ASH volumes: gastroenteritis / dehydration, asthma, cellulitis, respiratory infections Development of West Auckland locality child health plan: o Stakeholders: secondary care paediatric and maternity services, GPs, Plunket, Whanau Ora service, DHB Funding and Planning and locality project manager, GAIHN, PHO liaison o Process: monthly meetings since November 2012 o Current status: draft plan with agreed priorities

Areas proposed by group Antenatal, birth, infancy continuum Rheumatic fever prevention Skin infection Asthma

West Auckland Child Health Plan priorities and objectives Maternal, child health, Well Child Tamariki Ora (WCTO) interface o Children at risk: e.g. Te Aka Ora model; information-sharing, coordination o e-Shared Care planning o Earlier registration with LMC by 12/40; newborn enrolment; risk awareness linked to social and health interventions Building service around continuums of life Rheumatic Fever o Guideline awareness and implementation o School-based throat swabbing in schools (high needs areas) o Community awareness: through Rheumatic Fever programme and local networks and providers, e.g. Plunket Population health in the locality

Skin infections o Clinical practice guidelines awareness and implementation o Locality-based social services engagement o Health literacy for whanau / families o Specialist / paediatric care in locality hub Increasing capability and capacity where it counts Asthma o Engage with asthma-related services in the area o Consider systematic use of clinical guidelines and tools e.g. GASP, chronic care planning templates o Use e-Shared Care Plan for high needs children and families o Explore establishing of a cluster-based practice nurse forum o Household smoking cessation Sharing goals, outcome measurements and responsibility

West Auckland child health next steps Finalise the plan o including detailed activities, roles, timeframes and measures Present the plan o to the locality governance group for endorsement Test the plan o Test in health system settings o Test with decision-makers: GAIHN approval of maternal and child health objectives and other priority areas such as skin infections

Contact details Dr. Tim Jelleyman, Paediatrician/Head of Department – Paediatrics and Newborn Services, Waitemata District Health Board DDI: Mobile: Louise McCarthy, Project Manager Child Health, GAIHN DDI: Mobile: