Submission form

Draft Southern Strategic Health Services Plan

The Southern DHB has developed a draft Southern Strategic Health Services Plan that describes six priorities we think will respond to our district's health needs over the next few years.We want to know what you think of the six priorities.

Please fill in this word version of the online questionnaire. The consultation period has been extended to Monday 24 November 5pm.

To mark in the box, place cursor in box and double click. Select the check option as per below. This will put an X in the box you are selecting, like this . To uncheck, double click again and select uncheck.

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What are we asking? We are welcoming new ideas and alternatives to these priorities, rather than seeking feedback about individual healthcare services or healthcare service locations. These factors will be addressed in detailed implementation plans after the final plan is adopted by the Southern District Health Board.

For more information about the plan go to

The draft Strategic Health Services Plan is underpinned by two paramount goals: improving patient access and population health outcomes; and achieving clinical and financial sustainability.Improved patient access means getting the right care at the right place at the right time.There are many ways to describe health outcomes. These are measured at population level, not for individuals. Measures include life expectancy from birth, age-adjusted or age-specific mortality, condition-specific changes in life expectancy and mortality rates, and self-reported health status. It is also important to consider improved health outcomes in terms of reducing differences in outcomes between population groups.A sustainable health system will provide ongoing access for the Southern District’s resident population (and visitors to our district). Key aspects of sustainability include whether the service is affordable, is efficient, is of high quality and is fully staffed.The draft Strategic Health Services Plan suggests six priorities to achieving these goals. These are:- Develop a coherent Southern system of care- Build the Southern health system on a foundation of primary & community care- Ensure sustainable access to specialist services- Strengthen clinical leadership, engagement and quality improvement- Optimise system capability and capacity- Live within our means

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1.Broadly speaking, are the six strategic priorities the best areas for the Southern health system to focus on?

Yes

No

I don’t know

2.Are there alternative or additional strategic priorities you wish to suggest be included in the plan?Which of the proposed priorities would they replace?
3. Are there alternative or additional strategic priorities you wish to suggest be included in the plan?Which of the proposed priorities would they replace?
4.Do you have any comments about the draft Strategic Health Services Plan in general?

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PRIORITY 1. Develop a coherent southern system of care

Under this priority, the key actions are:1. There would be a greater emphasis on primary and community care, and same day procedures, with care provided closer to home where possible and appropriate.2. Service and facility planning and development by SDHB and its partners would reflect the SHSP’s strategic priorities and implementation roadmap.3. Rural hospitals would have a stronger focus on the core responsibility of initial assessment, stabilisation and short-stay observation of patients with acute needs, with advice from and transfer to a major hospital as required.4. A Southern acute care network would be established to link local, District-wide and regional services, including the rural and major hospitals, general practice and St John.5. A range of other services would be available through rural hospitals that would reflect local needs, and could include general practice, SDHB and NGO community services, visiting specialist clinics, primary maternity, short stay adult medical care, aged residential care and others.6. Locality networks would become the focus for planning and co-ordination of local services, and involve the local providers and the community.7. The intended individual roles and service levels for each component of the Southern health system would be defined, including their inter-relationships and likely development in the short to medium term, to avoid duplication and ensure a consistent approach.8. Similarly, the overall regional direction, key principles and care models appropriate for the South Island would be agreed by the South Island DHBs working together to develop more innovative and efficient health services than individual DHBs could do alone.

Question 5: Please tick a box to indicate your level of support for Priority 1 and its key actions

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 6:Broadly speaking, would Priority 1 and its key actions help us to

6a. Improve patient access

Yes No (explain below) Don’t know

6b. Improve population health outcomes

Yes No (explain below) Don’t know

6c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

6d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 7: Do you have any further comments or suggestions on Priority 1 or its key actions?

PRIORITY 2. Build the Southern health system on a foundation of primary & community care

Under this priority, the key actions are:1. Locality planning will strengthen networks of local health providers for co-ordination of care.2. The role of general practice as the patient’s ‘health care home’ with responsibility for continuity of care will be strengthened.3. DHB community services will focus their skills within a primary health care multi-disciplinary team.4. Evidence-based models of care will be tailored for population groups with different risk profiles, including an appropriate mix of health professionals and support staff, method of contact, and resource allocation.5. Urgent, after-hours and acute care services, health of older people, and nursing/allied health integration initiatives will be aligned with these new models of primary and community care.6. Demonstration sites of preferred models of primary and community care will be identified, supported and innovation shared across the District.7. Prevention and early intervention will be included within the scope of primary and community teams and linked with SDHB health promotion programmes.

Question 8: Please tick a box to indicate your level of support for Priority 2 and its key actions:

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 9:Broadly speaking, would Priority 2 and its key actions help us to

9a. Improve patient access

Yes No (explain below) Don’t know

9b. Improve population health outcomes

Yes No (explain below) Don’t know

9c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

9d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 10: Do you have any further comments or suggestions on Priority 2 or its key actions?

PRIORITY 3. Ensure sustainable access to specialist services

Under this priority, the key actions are:1. Specialist services will be assessed to identify those at risk of unsustainability, and the extent of patient flows from SDHB to higher level care in Christchurch or Auckland. The clinical capability of Dunedin and Southland hospital services will be reassessed using the Role Delineation Model, an internationally recognised tool.2. With these results, the most appropriate service models can be agreed, taking into account options for District and regional collaborative provision.3. Where collaborative South Island service models are the most sustainable solution, potential effects will be considered in each case, including impacts on access; funding; governance; teaching, training and research; other professional health staff and services; acute and planned provision; and local practitioner capability and support.4. A stocktake of rural outpatient clinics supported by visiting specialists will be undertaken, to enable a planned, locality-based approach whereby equitable local access for patients is facilitated for high volume specialties, and the demands of distance and travel are balanced between patients and specialists.

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Question 11: Please tick a box to indicate your level of support for Priority 3 and its key actions:

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 12:Broadly speaking, would Priority 3 and its key actions help us to

12a. Improve patient access

Yes No (explain below) Don’t know

12b. Improve population health outcomes

Yes No (explain below) Don’t know

12c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

12d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 13: Do you have any further comments or suggestions on Priority 3 or its key actions?

PRIORITY 4. Strengthen clinical leadership, engagement and quality improvement

Under this priority, the key actions are:1. The expected role and nature of clinical leadership will be defined, and appropriate supports put in place where necessary to facilitate performance expectations.2. The Performance Excellence and Quality Improvement Strategy will be reviewed to ensure a comprehensive, whole of system approach and implementation, including links with Alliance South.3. The Performance Excellence & Quality Improvement Strategy will be a key way to ensure financial sustainability into the future, by explicitly linking quality improvement with cost reduction.4. SDHB will decide on the areas for focus to lift performance to world-class levels, and develop action plans for each.5. Locality networks will be developed to build effective clinical relationships that will support local service improvement and integration.6. Working with Alliance South, the approach to developing and implementing clinical pathways will be revised to ensure meaningful involvement, better communication, and enhanced professional relationships for the whole system to jointly deliver trusted and relevant outcomes.

Question 14: Please tick a box to indicate your level of support for Priority 4 and its key actions:

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 15:Broadly speaking, would Priority 4 and its key actions help us to

15a. Improve patient access

Yes No (explain below) Don’t know

15b. Improve population health outcomes

Yes No (explain below) Don’t know

15c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

15d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 16: Do you have any further comments or suggestions on Priority 4 or its key actions?

PRIORITY 5. Optimise system capability and capacity

Under this priority, the key actions are:1. The Joint Education Committee comprising the District’s three tertiary educational institutions and SDHB will be re-established as the leadership body to plan the Southern health workforce, based on intended models of care, workforce roles, and demand and supply forecasts.2. A Southern health system workforce plan will be developed, beginning with a stocktake of the District’s estimated 9000 current health workers, and including clear priorities for workforce development based on the strategic direction presented in the SHSP.3. SDHB professional leadership roles will be expanded to include a whole-of-system view across primary care, NGOs and rural health services, with a focus on standards, credentialing, continuing professional development and advice.4. Detailed facility capacity planning will be completed as part of the development of the business case development for upgrade of prioritised Dunedin Hospital buildings.

Question 17: Please tick a box to indicate your level of support for Priority 5 and its key actions:

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 18:Broadly speaking, would Priority 5 and its key actions help us to

18a. Improve patient access

Yes No (explain below) Don’t know

18b. Improve population health outcomes

Yes No (explain below) Don’t know

18c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

18d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 19: Do you have any further comments or suggestions on Priority 5 or its key actions?

PRIORITY 6. Live within our means

Under this priority, the key actions are:1. SDHB will continue building its capability to deliver improved and sustainable clinical and financial performance.2. Cost reduction initiatives will not be taken without equal emphasis being given to consideration of the impacts on patient experience and population access and outcomes.3. The rationale for resourcing decisions will be more transparent and reflect the priorities of the Southern health system.4. Higher value interventions will be prioritised, with disinvestment from interventions that are either not clinically effective or not cost effective (or both), based on systematic and evidence-based information sourced from the National Health Committee, National Health Board and international experts.5. When available, resources will be shifted to a new Strategic Investment Fund to support prioritised higher value services and models of care, and emphasising cost-effective delivery in community settings.6. Areas with high expenditure compared with similar organisations across the sector will be reviewed against best practice.7. While SDHB compares favourably against other DHBs in average length of stay, day surgery and day of surgery admission, small enhancements will be sought to further improve patient experience and save unnecessary costs.8. Operational cost management will be tightened, including moderating recent staffing cost growth in key personnel areas.9. Provision of timely and accurate reporting of performance information will be strengthened.

Question 20: Please tick a box to indicate your level of support for Priority 6 and its key actions:

Strongly oppose

Oppose

Neither oppose nor support

Support

Don’t know

Question 21:Broadly speaking, would Priority 6 and its key actions help us to

18a. Improve patient access

Yes No (explain below) Don’t know

18b. Improve population health outcomes

Yes No (explain below) Don’t know

18c. Improve Maori and Pacific Island health Outcomes

Yes No (explain below) Don’t know

18d. Ensure the DHB is clinically

Yes No (explain below) Don’t know

Comment

Question 22: Do you have any further comments or suggestions on Priority 6 or its key actions?

Enablers

Successful implementation of the draft Strategic Health Services Plan relies on DHB partnerships with primary and community care providers, rural health providers, Maori health providers and other NGOs, and linkages with professional bodies and peer organisations. It requires commitment from the whole Southern health system.Collaborative working across the Southern system will support development of:1. Information and communications technology2. Health literacy3. Intersectoral action.A structured and disciplined approach will be taken to implementation of the Strategic Health Services Plan, through Board oversight, executive leadership and accountability, organisational and system development, and project management.

Question 23: Can you think of anything else that would support the successful implementation of the proposed Southern strategic priorities, if adopted?

Question 24: Do you have any further comments about the enabling actions that will support the achievement of the proposed Southern strategic priorities if adopted?

Question 25: Do you have any final comments about the draft Strategic Health Services Plan?

Finally, we need some demographic information about you to help summarise our findings.

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26.What age group do you belong to?

17 or younger

18-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65 years or older

27.What is your gender?

Female

Male

28.Which ethnic group(s) do you belong to?

New Zealand European

Maori

Samoan

Cook Island Maori

Tongan

Niuean

Chinese

Indian

Other (please specify)

29.Which city/town do you live in?

30.What is your occupation?

31.Do you work for the Southern District Health Board?

Yes

No

Thank you for submitting to the Southern Strategic Health Services Plan Draft.

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