Primary Care Tobacco Health Target Faqs

Primary Care Tobacco Health Target FAQs

FAQs - July 2011

1. Does the target mean we have to re-check smoking status with non-smokers every visit?

GPs are not expected to reconfirm the status of non-smoker patients each visit.

It can pay to raise this matter with younger patients though - perhaps once a year - because they are more likely to take up smoking than their older counterparts.

For patients who smoke though, research indicates that revisiting smoking status is an effective intervention for encouraging quit attempts. How this is best delivered clinically though is up to the judgement of GPs and Nurses.

Smoking is an issue that needs active management but it doesn't need to be any more of an intrusion than checking other health stats such as blood pressure. It only needs to be a

30sec. conversation.

2. How do we code an 'ex smokers' who have quit decades ago?

All people who have quit remain ex-smokers>12 months.

3. When does the Primary Care Tobacco Health Target take effect?

The Primary Care Tobacco Health Target has been formally in place since 1 July 2011. The target is referred to, and summarised as: Better Help for Smokers to Quit.

General Practices are already reporting this information through the PHO Performance Programme (PPP).

The target requires that 90% of all patients who smoke and are seen in general practice, will be provided with brief advice and help to quit by July 2012. This takes the form of the evidence-based ABC approach: Asking about smoking status; providing Brief advice; and offering Cessation support.

4. Whatinformation are general practices expected to collect?

No additional information collection is needed beyond what is already being provided through the PHO Performance Programme.

5. What services will general practicesbe expected to provide?

General practices are expected to offer brief advice to quit smoking and then support to do so:

• either prescribing subsidised nicotine replacement therapies (NRT) or other cessation medications, and
• eitherthrough providing cessation support directly or referring to services such as those offered by Quitline.

6. How soonwill the target results be published?

A full overview of the expected reported timeline for DHBs can be found here.

The information will be published as part of our reporting on quarter one in this financial year. This report is expected before the end of the year.

The Primary Care Tobacco Health Target will bea separate, stand alone indicator. It will not be wrapped up with the target forhospitals.

7. Will this information then have to be included by the DHB in the MoH quarterly reports or will the MoH access this info?

The Ministry will access PPP data from DHBNZ each quarter and send it to DHBs for verification as part of the Health Target reporting process. Please refer to the attached timeline for 2011/12 Quarter One.

DHBs will also be expected to provide a narrative on the results as they do for reporting on the Tobacco Health Target for hospitals.

8. How does the Health Target link with the PPP target?

The 2011/12 PHO Performance Programme (PPP) Target has been aligned to the 2011/12 Better Help for Smokers to Quit Health Target for Primary Care: “90 % of enrolled patients, who smoke and are seen in General Practice, will be provided with advice and help to quit by July 2012’.

9. What are the Ministry’s requirements in terms of Primary Care Health Target reporting timeframes in relation to the availability of data through the PPP system – won’t working from PPP data create a 3-month lag?

We are working with DHBNZ on aligning PPP and the Health Target.

We expect to receive preliminary PPP data on the 2011/12 Quarter One from DHBNZ on 21 October 2011. The Ministry will then conduct the standard verification process for Health Target data with DHBs and report the final data to the Minister in mid-November.

DHBNZ will continue to manage the PPP and how PPP data is published on the DHBNZ website. Our understanding is that it will not involve any changes for PHOs.

10. What are the data sources that will be used to inform the Health Target?

PPP data will be used for reporting on this Health Target. DHBs will also be able to provide data from other sources if this is available.
11. How will the % rate be calculated based on the PPP information?
Aggregation of data from the PHOs to the funding DHB will be done in the same manner as DHBNZ does. The numerator and denominator are summed then the rates calculated from the results. For example, if PHO A would have 200 of 300 (60%) and PHO B 500 of 700 (71.4%), the DHB would be 700 of 1,000 (70%).
12. How much and when will we receive incentive payments for the recorded smoking indicators?

DHBNZ is managing and calculating the incentive payment for the smoking indicators. DHBNZ’s website has information on this: see “Recent Decisions”. For further information please contact DHBNZ.

13. There seems to be a disparity between the percentage of patients receiving ABC and the number reported on. What can we do?

DHBNZ is able to work with your PHO to resolve any data issues.

14. It took ten days to get our Champix Special Authority when we faxed our application. Is there a quicker way?

Sector Services in the Ministry of Health processes applications for Champix Special Authority (SA). They have a special authorities’ helpline: 0800 243 666.

You are able to make applications for SA electronically. Electronic application approval or decline is received within ten seconds of being submitted. Practices who wish to have electronic special authority (ESA) need to have a secure network connection, connected health approval, NHI approval and a digital certificate. The Ministry covers the cost of digital certificates. If you are interested in learning more about ESA, please call the team on 0800 505 125.

Sector Services have a 10 working day turn around for processing paper based applications. Sector Services try to keep the applications processing down to two to three days. Once the application is processed the SA number is available to practices and pharmacies. Once the SA is approved/declined a letter will be generated and posted to the applicant. General Practices can retrieve this number by ringing the special authorities’ helpline or contacting their pharmacy.

Therefore, there are three strategies for Practices to speed up the process. You can:

1. ring Sector Services after three days, getting the SA number and then providing the script for Champix to the patient
2. provide the script for Champix to the patient and advising to wait for three days before presenting it to the Pharmacy
3. best of all, by joining the electronic system.