1. Capital Coast Palliative Care Forum Waikato Experience of Developing a District Palliative Care Strategy Jan Hewitt

2. Background NZ Cancer Control Taskforce Midland – regional approach to planning services How it was at the time January – July 2005 Strategy endorsed August 2005

3. Six Month Project Strategic blueprint reflects views & expectations of the district Gold standard - attain best practice standards and outcomes Integrated & planned service delivery model approach Good linkages with & between providers Awareness of services

4. Project Methodology Steering Group Stocktake HNA Patient mapping Comparison with National strategies Literature review – internal & external

5. Project Methodology Models of best practice Agree common definitions SWOT analysis Site visits Expert Peer Review

6. Project Communication Steering Group – minimum monthly Face to face meetings Allowed service providers to present Documentation / information Monthly reports to CEO & Board Project Manager weekly CEO updates Strategic Project Steering Group Report Community Health Forums

7. Pitfalls Individual agendas People getting stuck and not be able to move to next stage in project Time constraints People want to restart process Primary Engagement Hard work - requires effort & commitment Logo & Title Money & Contracts–become the focus

8. 4 Key Result Areas Integrated & collaborative care Patient focus on improved access and equity of services Workforce & resource development Quality Systems

9. What worked well Strong executive leadership Project management GP Liaison Getting everyone to the table GP Peer Support Groups Have a plan – parameters set Real inclusion of all stakeholders

10. What worked well Have a common language / definition Keep the Plan and language to a level that everyone can understand Regular brief presentations as you progress – the end plan is not a surprise Build on what you have The Plan is a start of the journey

11. What worked well Manage expectations Work between meetings is most valuable Stick to the timeframe, but allow time to develop Have more than a Plan define how you are going to keep momentum and the way forward Establish a Palliative Care Network

12. The Decision Matrix Grid Showing Prioritisation of Palliative Care Recommendations (Nov. 2005) Low High 1 2 3 4 5 6 654321654321 4.6 2.1 1.3 3.43.3 2.2 4.1 a-c 1.1b 2.4 2.3 2.5 4.1b 1.1 a 1.4 4.5 2.6d 4.2 1.1 To establish PC Network 1.2 PC approach & inform public 1.3 Formal links between services & providers 1.4 PC clinical leadership 2.1 Culturally appropriate PC 2.2 Patient journey & processes 2.3 Improve rural access 2.4 Strengthen links with GP 2.5 Specialist PC links to resthomes 2.6 Assessment single point of entry 2.7 Clinical pathways - Liverpool 2.8 Specialist PC resources 3.1 Practice PC approach 3.2 Adequate trained PC staff 3.3 Adequate Hospice inpatient beds 3.4 Adequate, safe equipment 4.1 Culture CQI best practice care 4.2 Transition pathway child-adult 4.3 To establish baseline data & KPIs 4.4 National initiatives 4.5 Review DSL PC admin function 4.6 Review PC service specifications Impact of Intervention Amenability for Intervention 1.2 a 1.1c 2.8 2.6 a-c 2.7 4.4 4.3 3.1 3.2 1.1 c

13. Palliative Care Network Formalises relationship between generalist & specialists Don’t try to get everyone to the table Work with those that make things happen Operational responsibility to implement and monitor the Plan

14. Palliative Care Network Terms of reference Tools to prioritise Strategy recommendations Annual action plan with responsibilities Monthly reporting mini projects Annual report on progress - celebrate