1. Healthy Ageing - Integrated Support Canterbury DHB Older People’s Health Services Strategy 2006 - 2010 Dr Karleen Edwards General Manager, Planning & Funding

2. Recent History of Aged Care Planning in Canterbury Strong foundations - Elder Care Canterbury Devolution of Aged Care Contracts October 2003 NZ Positive Ageing Strategy Health of Older People Strategy 2002 (Ministry of Health) Healthy Ageing Integrated Support (CDHB)

3. Challenges Increasing demand to services Resources - Population Based Funding Formula (PBFF) Workforce Changing expectations/models of care

4. Canterbury’s Aged Population CDHB Population Projections 2001 - 2021

5. Canterbury’s Aged Population 13% of Canterbury DHB population is aged 65 years and over By 2021 this group will represent 20% of our population. Nationally the annual expenditure on health and support services for over 65’s for last year was: - $2000 per person for 65-69 year olds - $7,800 per person for 80-84 year olds - $12,000 per person for 85 and over In Canterbury, this year we will spend $195 million on Aged Care Health Services

6. Canterbury’s Aged Population cont…. Each Year: 5% of people over 65 years in Canterbury are in residential care (Rest Homes, Private Hospitals, Dementia Care) costing $97 million 15% of people over 65 years in Canterbury receive Home Support (house cleaning, personal care) costing $22 million 20% of people over 65 years in Canterbury receive inpatient hospital services costing $76 million

7. But Local Context - Population Based Funding (PBF) Determines our share of health funding based on: our population weightings for unmet need rural adjuster overseas visitor adjuster Tertiary Adjuster Inter District Flows

8. Advantages of PBF Almost all funding at a local level to enable: innovative models of care and service delivery optimising use of resources and future investment integration of services and funding systems approach across services focus on health outcomes innovative contracting

9. Disadvantages of PBF Canterbury DHB ‘overfunded’ Prices paid for inter district flows Prioritisation and targeting of resources Doesn’t determine the size of the pool - just relative shares X

10. Older Persons Health Strategy Development Process Sector Expert Group Older Persons Health Needs Assessment National and international research Best practice, literature reviews Consultation

11. Underlying Principles Older person centred ‘Ageing in Place’ Preventative Integrated planning and delivery Participation and collaboration Best use of resources Building capacity Holistic model focused on wellness Flexible Funding / Evidenced based

12. What will we do? 8 Workstreams: Underpinning foundation issues Health Promotion Effective primary health services Improved coordination Enhance home and community based services Improving the Patient Journey through the hospital Improving long term services Palliative and ‘end of life’ care

13. Aged Care - Safety Nets 1) Helping people stay fit and healthy 2) Good primary care and support (catching problems before they worsen) 3) A smooth path in, through and out of specialist services 4) Slowing the progression of deteriorating health and dependence 5) Appropriate ‘end-of-life’ care