1. Better Sooner More Convenient Demonstration site Phase 1 : Taranaki Dr Heble Executive Clinical Director Ronél Marais ADON. TDHB November 2010

2. Towards partnerships and collaborations...

3. Key players: Taranaki DHB, Provider Arm (MH and AOD) Pathways Health (NGO) Tui Ora (NGO) MidlandsHealthNetwork (PHO)

4. Phases Phase 1 : Current – started Oct 2010 : Taranaki is a ‘Demonstration site’ for Phase 1. Initiatives will be showcased. Phase 2 : IT integration. Discussions in progress. Phase 3 : Actual integration : primary and secondary. Potential ideas being explored.

5. Phase 1 : Specialist telephone advice to GPs.

6. Phase 1 : Specialist phone/email advice from Psychiatrists to GPs within Taranaki Inclusions: Supporting a treatment plan. Supporting training, diagnosis and treatment. Exclusions: Acutely suicidal clients. Acute crisis. Note: A telephone discussion between a GP and a Psychiatrist is not to be considered as a referral into the provider arm service.

7. Tel advice, continued... Clinical Responsibility: Duty of care, within this telephone/email service, rests with the GP. Specialist is responsible for the quality of clinical advice given via email/phone. The patient remains in the care of the GP who may act on the specialist advice as they see fit. Service Coverage: GP’s only. Monday to Friday 9am to 4pm. Service start date Monday 11 October 2010. Target response time -within 24 hours.

8. Tel advice, continued... Method of Contact:Telephone or email GPs provided with “one pager” outlining scope and contact detail for TDHB Psychiatrists GP responsible for documenting specialist advice given in patient notes Psychiatrists responsible for completing TDHB Spread sheet

9. TDHB Excel spreadsheet includes: Time / Date Name of consulting psychiatrist GP name Patient name / NHI Reason – tick all that apply from a. Discuss complex case to clarify diagnosis, management b. Simple medication advice request c. Request for info re appropriate referral/community resources d. Other (please specify - free text field) Duration of phone consult Other notes

10. Phase 2 IT Integration – The sharing of basic electronic notes will enhance – ‘any door is the right door philosophy’ Shared electronic notes would enhance the collaboration and partnership to move forward Discussions commenced

11. Phase 3 ideas: Integration of Primary and secondary Services: ideas... Clozapine clinics for stable Clozapine clients Stable methadone clients- shared care between PHO & TDHB Uncomplicated dementias Maternal MH support Still needs further exploration and discussion across the sector

12. Discussion points/questions: Do GPs have enough time slotted in to see pts with MH and AOD issues? Co payments? Who will pay when the pts go to see their GPs through the BSMC process?