1. Making it Better Cutting through the red tape without too much bleeding Jeff Brown Elective Services Forum 17 November 2010

2. My Challenge H&DC Urology Cardiology Bowels and Breast ORL (ENT) Musculoskeletal Neurology Operating theatre HIRC ESP

3. Charter Improve quality and safety of health care and meet increased service demand, within funding allocation, by ensuring: –planned and funded at the right level –models of care and service configurations –sustain high quality national health service –investments in workforce, IT, facilities

4. Charter Key principles to guide deliberations –improves outcomes –reduces disparities –affordable access to strong public health system –provides world class quality care –components operate effectively together as a more unified system

5. Integrating Primary and Secondary Care and Clinical Leadership Developing one “NZ health system” What does it mean for organisations? Sharing a vision and core values What does it mean for patients? Putting the interests of the patient first

6. It is all about patients Nothing else is as important All else must result in better patient outcomes “The best interest of the patient is the only interest to be considered” Mayo Clinic, 1911

7. Ask a patient Boy with … Now has …

8. Who is his primary carer? Rare disease More common disease Travails of childhood

9. Who will be his primary carer? Transition to adult life Rare disease More common disease

10. ASMS – GPNZ Joint Agreement All work together in the interests of individual patients All work together for groups of patients to design systems and pathways All organisations work together to transform the system

11. Charter Clinical and financial sustainability –effectively engaging clinicians –engage wider health workforce –deliver within funding allocation –effectively engage NZers and their families and whanau greater role in staying healthy managing their healthcare needs

12. BSMC ?! Devolution, or dumping ? Budget holding, or cost shifting ? Primary vs Secondary ? OR Integration ?

13. Truly integrated health care Requires a truly integrated health care system All of us working for a common goal All of us working for the patient outcome

14. Effective Change Model Clear vision of new model Pressure for change Capacity for change Actionable first steps

15. My Challenge to You Cut through the red tape Ideas have to stick Everyone has to win Not too much bleeding

16. It isn’t all about us… But it really is… …about us working together