Opportunities for wellness.
Who owns Whakarongorau Aotearoa?
Whakarongorau Aotearoa is a social enterprise owned collectively by ProCare (a co-operative of over 200 GP practices across Auckland) and Pegasus Health (a Canterbury-based charity).
Why did Pegasus and ProCare create Whakarongorau Aotearoa?
Between 2013 and 2015 Whakarongorau Aotearoa (or Homecare Medical as it was known then) participated in a competitive dialogue procurement process with the Ministry of Health for the creation of the National Telehealth Service. Pegasus and ProCare (alongside 8 other iconic NGOs and charities) believed, having looked extensively overseas, that services like the National Telehealth Service needed to be run as a social enterprise for New Zealand by New Zealand in a for purpose, open platform, single provider model.
Underpinning the National Telehealth Service is a commissioning model. A copy of the agreement which outlines that model can be found here. At the heart of the commissioning model is the requirement to follow the Public Finance Act, deliver clinically safe services, and be fully transparent on costs associated with delivering services to the relevant purchasers.
What happens to the surpluses?
Whakarongorau Aotearoa has contracts with the Ministry of Health, the Ministry of Social Development and others, to run services that give everyone in Aotearoa the opportunity for wellness.
Between 2015 and 2020 the surpluses generated within Whakarongorau Aotearoa were used to pay back the investment from ProCare and Pegasus required to create the National Telehealth Service ( $6 million). From 2020 any surpluses have been used to improve health outcomes across the Auckland and Canterbury regions and to continue to improve health outcomes and service delivery for Whakarongorau Aotearoa.
FY 2020/21 – what did we invest in?
In the 2020/21 financial year the increased surplus and resultant distributions is the combination of new contracts outside of the national telehealth service including additional COVID response services, DHBs, PHOs and general practices purchasing services like GP After Hours, DHB Mental Health After Hours and Puāwaitanga.
Whakarongorau Aotearoa - to give everyone in Aotearoa the opportunity for wellness
This year we invested in the key areas of equity, population health, and technology enablers for digital care. Over the 12 months to 30 June 2021 the investments included:
- Approximately 5650 hours of cultural and diversity face-to-face and online training for all our staff.
- Investment in a new Auckland site, bringing our teams (approximately 300 staff) together in a safe, acoustically appropriate, disaster and pandemic resilient site from our 3 sites across Auckland.
- Investing in 450 new computers and communications equipment for all our work from home frontline staff – to improve the experience they offer service users.
- Embedding a complex caller programme to provide more consistent and planned support for service users who have complex health needs.
- Part-funding of the Puāwaitanga app which gives clients the option of video sessions as well as making it easier to manage appointments - important experience improvements for a service that is having such a positive impact for Māori clients in particular.
- Migration of key service websites to Sitecore, with bilingual capability we can build on.
ProCare – excellence delivered with humanity
ProCare has a strong philosophy of investment in care and support. Over the 12 months to 30 June 2021 distributions from Whakarongorau Aotearoa have enabled:
- ProCare has made a significant investment in supporting Equitable Health Outcomes. It launched a ProEquity plan which embeds a commitment to Ti Tiriti o Waitangi and a range of initiatives to help improve Equitable health across the organisation and the ProCare network.
- ProCare has developed a Mobile outreach service to support whānau with unmet needs and help support health directly within communities. The service will provide key health screening, and health promotion, with a focus on improving health literacy.
- ProCare launched an ACC GP MRI (High Tech Imaging) referral pathway from primary care covering four clinical pathways (cervical spine, lumbar spine, post traumatic knee, gleno-humeral joint) to meet the following objectives:
- To reduce the time to definitive diagnosis for clients requiring an MRI , saving an average of 16 working days
- First specialist appointment is avoided.
- Some clients do not need to be referred to a specialist for further assessment after diagnosis.
- ProCare invested in a new innovation called Unify health, a universal booking platform connecting patients with healthcare provider booking systems. This service will be made available at a national level to support the wider healthcare system.
- ProCare has continued to invest in its Population Data and Analytics tool to help healthcare professionals understand the health issues and opportunities of their enrolled populations enabling them to develop plans to address unmet need and monitor results. Data capability has advanced to allow real time performance monitoring and a wider selection of health metrics are now available.
People centred services
- ProCare developed Here Toitū – a general practice-based service in partnership with the Ministry for Social Development that supports patients on a main Work and Income benefit, with a medical condition or disability. This programme enables access to additional resources to support patients with individual needs and to provide practical assistance to improve the wellbeing and aspirations of patients and where appropriate, support them to engage in meaningful and sustainable, earning, learning, caring or volunteering.
- ProCare continues to support those with mental health and addiction challenges via ProCare Fresh Minds which is supporting the roll out of the Te Tumu Waiora model of care ensuring immediate and free access to wellbeing support in general practice. In addition Fresh Minds is implementing digital tools to support self-management psychoeducation for those with mild to moderate mental distress.
ProCare launched a new training programme to address general practice nursing workforce issues. The six-week training programme provides a supported pathway for nurses from secondary or age care to transition to general practice nursing with the offer of employment following the course.
Pegasus Health - supporting all Cantabrians leading healthy lives
Over the 12 months to 30 June 2021 distributions from Whakarongorau Aotearoa have enabled:
Development of its Equity Strategy brings a strong focus to achieving equitable access to health care. The emphasis is on Hauora Māori, Pasifika, Culturally and Linguistically Diverse and Rainbow communities (priority populations) includes a newly created codesign approach.
Research was funded into barriers to good access to primary care for priority populations, which identified issues and looked at how Pegasus can work with communities to overcome these.
Support for sustainable services
Investment in Health Intelligence, claiming, and payments systems and in enhancing building configuration to position Pegasus to sustainably deliver services to the people of Canterbury and to primary care providers.
Pegasus has developed and rolled-out the Hikitia (Health Care Home Fundamentals) initiative to general practices, as part of its commitment to patient centred models of care and is supporting practices to go through this change management programme.
Pegasus has extended its services to support the sustainability of the primary care nursing work force. Including:
- Management of career development through a nursing workforce development coordinator.
- Student summer scholarships.
- Locum nurse hui.
- Professional supervision and oversight by the nurse advisor.
- Assisting with conference attendance.
- Post graduate scholarships.
The Pegasus pastoral care programme supports GPs through times of increased stress, burnout or personal problems. The programme has proven pivotal through recent events including earthquakes, fires, terrorism and now COVID, increasing the resilience of the GP workforce and their ability to care for patients.
HealthOne’s purpose is to use the power of information to transform health and wellbeing outcomes. It achieves this through bringing together an integrated electronic health record, sharing knowledge to support better, safer care in primary and secondary services. Pegasus have invested additional capital to support further development of this platform.
Supporting primary care practices
Pegasus provides a range of services which assist primary care in providing high quality care to patients. This includes
- Support to achieve Cornerstone and Foundation Standards.
- Hosting and delivering an annual education seminar for practice administration staff. focusing on subjects such as health and disability, privacy, enrolment and, best practice.
- Orientation days for new nurses and practice managers.
- Funding PMAANZ Scholarships.
- Supporting the Active Canterbury Network agreement.