combined meeting hospital advisory committee …...apr 08, 2020 · aroha haggie – director,...

‘Aakina to ora, hei oranga mauroa’ – Mahaki Albert, Tumu Tikanga CM Health Look after yourself to preserve health and wellbeing

Counties Manukau District Health Board – Combined HAC/CPHAC/DiSAC Meeting

COMBINED MEETING HOSPITAL ADVISORY COMMITTEE (HAC), DISABILITY ADVISORY COMMITTEE (DiSAC)

and COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE (CPHAC) Wednesday, 8 April 2020

Venue: Ko Awatea, Room 107, Middlemore Hospital (https://cmhealth.zoom.us/j/325747147) Time: 10.00am

Committee Members Vui Mark Gosche (Board Chair) Barry Bublitz (Mana Whenua) Catherine Abel-Pattinson Colleen Brown Dianne Glenn Garry Boles Katrina Bungard Lana Perese Paul Young Pierre Tohe Apulu Reece Autagavaia Robert Clark (Mana Whenua) Tipa Mahuta

CMDHB Management Fepulea’i Margie Apa – Chief Executive Aroha Haggie – Director, Funding & Health Equity Dr Campbell Brebner – Chief Medial Advisor, Primary Care Christina Mallon – Chief Midwife, Women’s Health Dr Gary Jackson – Director, Population Health Dr Jenny Parr - Chief Nurse and Director of Patient & Whaanau Experience Dr Kate Yang – Executive Advisor to the CE Mary Burr - General Manager, Women's Health Mary Seddon – Director, Ko Awatea Dr Peter Watson – Chief Medical Advisor Sanjoy Nand - Chief of Allied Health, Scientific & Technical Professions Vicky Tafau - Secretariat

AGENDA: PART I – Items to be considered in this public meeting

10.00am 1. AGENDA ORDER AND TIMING Page No.

2. GOVERNANCE HAC

10.00am 2.1 Apologies 2.2 Register of Interests

2.2.1 Does any member have an interest they have not previously disclosed? 2.2.2 Does any member have an interest that may give rise to a conflict of interest with a

matter on the agenda? 2.3 Confirmation of Public Minutes of HAC Meeting – 26 February 2020 2.4 Action Items Register – agree to defer action points

002

003 005

006 019

3. GOVERNANCE CPHAC

10.05am 3.1 Apologies 3.2 Register of Interests

3.2.1 Does any member have an interest they have not previously disclosed? 3.2.2 Does any member have an interest that may give rise to a conflict of interest with a

matter on the agenda? 3.3 Confirmation of Public Minutes of CPHAC Meeting – 26 February 2020 3.4 Action Items Register – agree to defer action points

022

023 025

026 030

4. BRIEFING

10.10am 10.20am

10.25am 10.35am 10.45am

4.1 Staff Health & Safety, including PPE (Elizabeth Jeffs – verbal) 4.2 Patient Safety & Quality, variance reporting only (Mary Seddon, covering for Deputy CMO)

4.2.1 Patient Experience Survey – Local Results 4.2.2 Safety, Experience, Compliance & Measurement Dashboard

4.3 Sub-Committee Reporting on Performance Exceptions and Covid-19 Preparedness 4.3.1 Community & Public Health (Aroha Haggie) 4.3.2 HAC (Mary Burr & Dr Peter Watson) 4.3.3 DiSAC (Sanjoy Nand)

032 040

046 049 064

10.55am 5. RESOLUTION TO EXCLUDE THE PUBLIC (Short Break) 066

https://cmhealth.zoom.us/j/325747147

Counties Manukau District Health Board – Combined HAC/CPHAC/DiSAC Meeting 8 April 2020

BOARD MEMBER ATTENDANCE SCHEDULE – HAC 2020

Name Jan 26 Feb Mar 08 Apr

27 May Jun 01 Jul 12 Aug 09 Sep Oct 04 Nov 16 Dec

Catherine Abel-Pattinson

No

Me

etin

g

No

Me

etin

g

No

Me

etin

g

No

Me

etin

g

Colleen Brown

Dianne Glenn

Garry Boles x

Katrina Bungard

Lana Perese

Paul Young

Reece Autagavaia

Tipa Mahuta

* Via conference call

002


HOSPITAL ADVISORY COMMITTEE DISCLOSURE OF INTERESTS

8 April 2020

Member Disclosure of Interest

Catherine Abel-Pattinson (Chair) Board Member, healthAlliance NZ Ltd.

Member, NZNO

Member, Directors Institute

Husband (John Abel-Pattinson): o Director, Blackstone Group Ltd o Director and Shareholder, Blackstone Partners Ltd o Director and Shareholder, Blackstone Treasury Ltd o Director and Shareholder, Bspoke Group Ltd o Director, Barclay Management (2013) Ltd o Director, AZNAC (JAP) Ltd o Director and Shareholder, Chatham Management Ltd o Director and Shareholder, GCA Trustee Ltd o Director, MAFV Ltd o Director and Shareholder, Manaia No. 4 Trustees Ltd o Director and Shareholder, Wolfe No. 1 Ltd o Director, Greenstone Motels Ltd o Director and Shareholder, Silverstone Property Group Ltd o Director, various single purpose property owning companies o Director and Shareholder, Abel-Pattinson Trustee Ltd

Lana Perese (Deputy Chair) Director & Shareholder, Malatest International & Consulting

Director, Emerge Aotearoa Limited Trust

Trustee, Emerge Aotearoa Housing Turst

Director, Vaka Tautua

Director, Malologa Trust

Colleen Brown Chair, Disability Connect (Auckland Metropolitan Area)

Member, Advisory Committee for Disability Programme Manukau Institute of Technology

Member, NZ Down Syndrome Association

Husband, Determination Referee for Department of Building and Housing

Director, Charlie Starling Production Ltd

District Representative, Neighbourhood Support NZ Board

Chair, Rawiri Residents Association

Director and Shareholder, Travers Brown Trustee Limited

003


Dianne Glenn Member, NZ Institute of Directors

Life Member, Business and Professional Women Franklin

Member, UN Women Aotearoa/NZ

Past President, Friends of Auckland Botanic Gardens and Chair of the Friends Trust

Life Member, Ambury Park Centre for Riding Therapy Inc.

Member, National Council of Women of New Zealand

Justice of the Peace

Member, Pacific Women’s Watch (NZ)

Member, Auckland Disabled Women’s Group

Life Member of Business and Professional Women NZ

Interviewer, The Donald Beasley Research Institute for the monitoring of the United Nations Convention on the Rights of Persons with Disabilities

Garry Boles Member, C and R

NZ Police Constable

Katrina Bungard

Chairperson MECOSS – Manukau East Council of Social Services.

Deputy Chair Howick Local Board

Member of Amputee Society

Member of Parafed disability sports

Member of NZ National Party

Paul Young TBC

Reece Autagavaia Member, Pacific Lawyers’ Association

Member, Labour Party

Trustee, Epiphany Pacific Trust

Trustee, The Good The Bad Trust

Member, Otara-Papatoetoe Local Board

Member, District Licensing Committee of Auckland Council

Member, Pacific Advisory Group for Mapu Maia – Problem Gambling Foundation

Board of Trustees Member, Holy Cross School

Member of the Cadastral Surveyors Board

Assessor of the Creative Communities Scheme South & East Auckland

Tipa Mahuta Deputy Chair, Te Whakakitenga o Waikato

Councillor, Waikato Regional Council

004


HOSPITAL ADVISORY COMMITTEE MEMBERS’ REGISTER OF DISCLOSURE OF SPECIFIC INTERESTS

Specific disclosures (to be regarded as having a specific interest in the following transactions) as at 26 February 2020

Director having interest Interest in Particulars of interest Disclosure date Board Action Catherine Abel-Pattinson Whaanau Accommodation

Options at MMH Catherine’s husband owns a business that has hotel/motels in the Counties Manukau catchment area that are from time to time used for CM Health or WINZ clients.

4 April 2018 That Catherine Abel-Pattinson’s specific interest be noted and that the Board agree that she may remain in the room and participate in any deliberations, but be excluded from any voting.

005


Minutes of Counties Manukau District Health Board Hospital Advisory Committee Held on 26 February 2020 at 1.20pm

Ko Awatea Room 101, Middlemore Hospital 100 Hospital Road, Otahuhu, Auckland

PART I – Items Considered in Public Meeting

BOARD MEMBERS PRESENT

Catherine Abel-Pattinson (Chair) Dr Lana Perese (Deputy Chair) Colleen Brown Dianne Glenn Katrina Bungard Paul Young Apulu Reece Autagavaia Tipa Mahuta

ALSO PRESENT

Avinesh Anand (Deputy CFO, Provider) Dr Kate Yang (Executive Advisor, CEO’s Office) Margie Apa (Chief Executive) Mary Burr (General Manager Women’s Health) Dr Peter Watson (Chief Medical Officer) Sanjoy Nand (Chief of Allied Health, Scientific & Technical Professions) Teresa Opai (Secretariat) (Staff members who attended for a particular item are named at the start of their item)

APOLOGIES

Garry Boles Chris Mallon (Chief Midwife) Dr Jenny Parr (Chief Nurse and Director of Patient and Whaanau Experience) Dr Mary Seddon (Director Ko Awatea)

WELCOME The tour of Ward 17 commenced at 1.20pm. The meeting commenced at 2.10pm. Ms Abel-Pattinson opened the meeting and welcomed the new Committee, reminding them that the first session is Public and as such the media are often in attendance. If there is an item that would be more suitably discussed in the Public Excluded session, please observe this. Ms Abel-Pattinson advised that she has had some discussions with management to change the reporting style going forward to better meet the needs of HAC, the Ministry’s expectations and the DHBs strategic plan. This is an ongoing conversation where the DHB isn’t looking to change the board paper, but rather to have a cover sheet that summarises the information for the Board up front. The senior management team introduced themselves to the new Committee members. No items for General Business were noted.

006


DISCLOSURE OF INTEREST/SPECIFIC INTERESTS There were no Disclosures of Interest to note requiring update. There were no Specific Interests to note regarding the agenda for this meeting. 1. AGENDA ORDER AND TIMING

Agenda items were taken in the same order as listed on the agenda. 2. BOARD COMMITTEE MINUTES 2.1 Minutes of the Hospital Advisory Committee 20 November 2019

Ms Glenn referred to item 4.5 Equitable Health Outcomes and asked that the discussion points be saved and taken forward for a future discussion on Equity. Action: Secretariat to add Equity discussion points noted under item 4.5 to action register. Resolution (Moved: Ms Glenn/Seconded: Ms Brown) That the Minutes of the Hospital Advisory Committee meeting held on 20 November 2019 be approved.

Carried

2.2 Action Items Register – Public

Noted. Ms Apa noted that the first item, a report on the birthing units in the context of our strategy for Women’s Health, should be moved to the Public Excluded Action Items register. Ms Burr confirmed that the Women’s Health team would be able to provide the information at the 27 May HAC meeting. Action: Secretariat to move the above item from Public to Public Excluded Action Items Register.

3. PROVIDER ARM PERFORMANCE REPORT 3.1 Executive Summary (Margie Apa)

The report was taken as read. Mary Burr provided key points:

The White Island experience displayed incredible teamwork and cooperation. Of the 47 people involved in the incident, 31 were injured and the DHB treated 11 of the injured at any one time.

The national targets for Colonoscopy and Gastroscopy are continuing to be met.

Planned care (elective) results for November 2019 was 112.3% of planned production, which will provide a good buffer going forward. Indicative planned care result for December is 111%.

Kidz First ED attendances are down 6% compared to last year.

An Ocular plastic surgeon is joining the team in March 2020.

Current maternity bed capacity has increased to 54 (from 45 this time last year).

Recruitment around the post-natal ward is progressing, with nursing covering some of the midwifery shortfall.

‘Our People’ were acknowledged including appointment of Dr Peter Watson as CMO, the pharmacy team who reacted swiftly around the White Island response, the Tamaki Oranga service who celebrated 20 years of operation and the stroke team who are finalists in the Vodafone Innovation Fund.

007


National Bowel Screening programme has identified 76 cancers to date. For the benefit of the new Committee members, Ms Abel-Pattinson explained the rationale behind the Board’s request for an update at each meeting.

The number of Ophthalmology overdue follow-up appointments has increased in December due to the reduction in outpatient services over the Christmas period, but recovery to previous levels is expected by March 2020.

Pressure on Gynaecology assessment is based on volume and theatre access. Business cases are being worked through to identify how the DHB can better manage the volume.

Radiology ongoing strikes are over with the collective agreement now settled. New graduates joining the DHB at the beginning of this year are assisting vacancy rates.

Mental Health acute services community training to police and ambulance has been very successful.

The simulated emergency event was worthwhile and was held two days before the White Island event.

ED continues to experience very high volumes but achieved its 6-hour turnaround target across four days in December.

The number of Measles cases has significantly reduced.

There are challenges around Faster Cancer Treatment time due to impact of radiology strike action, slow diagnostic testing process and access to theatre by the While Island event.

Surgical services are returning to normality after the White Island event.

ARHOP has achieved a reduction in the use of beds due to successful community programmes.

Overall, most national health targets are on track. Ms Apa noted that the DHBs investment in outsourcing is making a real difference in getting through the lists. Ms Glenn noted the efforts of Women’s Health to recruit registered nurses to work alongside midwives and has discussed with Chris Mallon (Chief Midwife), the monetary impact on nurses having to do a further 2-years training and asked whether the DHB could offer to assist financially. Ms Abel-Pattinson acknowledged the concept and advised that a further discussion on Workforce is planned for a later meeting. Ms Apa advised that Elizabeth Jeffs is working on a workforce development plan refresh alongside the strategy plan and Mr Nand can work with Elizabeth on this.

3.2 Hospital Services Project Portfolio Overview (Margie Apa) The report was noted and taken as read. Ms Apa provided key points:

Every $ counts is not quite where the DHB would like it to be.

Every Hour Counts is a major cross-hospital work-flow project, which has exposed that the DHBs flow challenges are not independent problems. A cross-organisation task force is to be formed, led by Dana Ralph-Smith, to work with the services and review how the DHB is organising ambulatory care, how it can better use its workforce, and look at the area parallel to the DHBs facilities.

Ms Mahuta commented that she would like to gain an understanding of non-financial indicators in the sector. It was agreed that this would be best covered in a separate workshop session. Action: Dr Yang to arrange to include a non-financial performance workshop as part of the induction of new board members, subject to approval of the Board Chair.

008


3.3 Finance Results – CMDHB Provider Arm (Avinesh Anand) The report was taken as read. Mr Anand provided points:

The content of the finance report compared to other DHBs is under review.

Deficit $2.4m largely impacted by White Island with direct costs of $2.124m. The DHB has incurred an estimated $9.8m of costs related to White Island and discussions are underway with ACC regarding funding.

ED numbers are down 6.4% in December compared to last year.

Plan care volumes were impacted by White Island, but overall are still on target.

Vacancies continue in hard to recruit areas.

Ms Glenn referred to the ED presentations graph and asked if the info desk in ED has been successful in directing patients to other areas of the hospital. Dr Watson advised that while it appears that ED volumes are plateauing, those with EMQ vouchers are not included. If they were added, numbers are larger than last year. Another significant change has been putting an after-hours clinic into Otara, where a large proportion of the DHBs volume comes from.

3.3.1 Non Resident Bad Debt Summary (Avinesh Anand)

The report was taken as read. Mr Anand advised, for the benefit of the new Committee members, that there is a detailed process for non-resident debt. Ms Abel-Pattinson reassured new members that non-resident debt is actively pursued.

Resolution (Moved: Ms Glenn/Seconded: Ms Mahuta) That the Hospital Advisory Committee: Note and receive the reports.

Carried

4. CORPORATE REPORTS 4.1 General Medicine Deep Dive Presentation (Catherine Tracy, Chris Luey)

Ms Tracy provided a presentation to the meeting. Key points:

General Medicine provides a range of non-surgical healthcare to adults without limit to any one organ or system/area of knowledge. Permanent inpatient beds 144, SMO FTE~24 (40 physicians), RMO FTE65, Nursing FTE239.

Acute admissions 1400-1600/month, impatient medicine, ambulatory care 1400 FSA, 1500 follow-up/year.

12 ward general medicine teams with 3 teams per ward, to expand to 15 teams with the addition of ward 17.

New roster implemented 9 December 2019, reverting to 1:3 pattern and is more ward-based and efficient system with improved utilisation of RMOs to provide more out of hours coverage without additional positions.

Ms Apa asked what roster is used by the DHBs colleagues at ADHB and WDHB. Dr Luey advised that the demands are quite different, so it was not possible to compare directly.

009


Ms Mahuta asked that when the workforce conversation is held, that the information identifies where there are multipliers, ie: a General Medicine staff member who is also a specialist.

Action: Secretariat to advise Ms Jeffs of Ms Mahuta’s request to identify any multipliers in the upcoming workforce presentation.

Workload is measured in three traditional ways – discharge numbers, acuity and length of stay. The DHBs discharges are 36% higher than ADHB with a similar number of doctors. Acuity is similar to other regional DHBs.

Measuring of complexity is challenging and shows the DHBs complexity is the highest of regional DHBs with the trend and rate of increase also far higher.

WEIS (used by MoH) doesn’t reflex complexity or socio-economic impact.

Length of stay has starting trending downward.

Bed capacity constantly exceeded, forcing acute areas to be used to house patients. Business case to open Ward 17 permanently approved by ELT but not budgeted.

Vulnerabilities: vacancies in SMOs, RMOs and nursing, training threatened as service demands eclipse training opportunities, workload is unsustainable, inadequate capacity, provider of last resort.

Strengths: outstanding staff, active recruitment programme, patient flow improvements and innovation.

Immediate term: Fully and permanently open Ward 17 and facilitate recruitment. Short term: need for organisational support for services depended on by General Medicine, ie: cardiology, respiratory, ED. Medium term need for sixth ward with three associated teams.

Dr Luey noted that there was some concern that the flu season and corona virus may hit at the same time.

Ms Mahuta asked that Ms Tracy’s presentation be added to Diligent. Action: Secretariat to add Ms Tracy’s powerpoint presentation to Diligent. Ms Bungard left the meeting at 3.06 pm. A quorum remained present.

4.2 Bowel Screening Programme Update (Catherine Tracy) The report was taken as read. Ms Brown asked if the DHB was able to treat all patients that are being screened in the bowel screening programme in a timely fashion. Ms Tracy confirmed that the DHB was able to, but that Fast Cancer Treatment is impacting on the theatre times of other surgeries. Ms Apa advised that access to theatres and diagnostics are the DHBs limiting factors. Apulu Autagavaia asked whether a breakdown of cancers was available for those that were positive. Ms Tracy advised that the DHB has a report available that can be sent through. Action: Ms Tracy to provide Secretariat with a breakdown of cancers that were positive so that these can be included with the Minutes. (Refer Appendix 1). Ms Mahuta asked what the likelihood was of the Ministry acting to meet its Maaori and Pasifika targets. Ms Tracy advised that a letter to the Ministry has been prepared as the DHB has concerns around its ability to increase that capacity.

010


Resolution (Moved: Ms Brown/Seconded: Ms Glenn) That the Hospital Advisory Committee: Note and receive the report.

Carried

4.3 Fast Cancer Treatment Quarterly Update (Catherine Tracy)

The report was taken as read. Resolution (Moved: Ms Mahuta/Seconded: Dr Perese) That the Hospital Advisory Committee:

Note and receive the report.

Carried

4.4 Patient Flow – Every Hour Counts Update and Presentation (Dr Mary Seddon) The report was taken as read. Resolution (Moved: Ms Brown/Seconded: Ms Glenn) That the Hospital Advisory Committee:

Note and receive the report.

Carried Dr Seddon provided a presentation to the meeting. Key points:

Demand is outstripping capacity. Working to reduce/shape demand to match capacity with demand, redesign the system.

MRI waitlist reduced from 2129 to 631 between Feb-Sep 2019, however not sustained, increasing to 910 in February, due to reduction in number of outsourced MRIs plus impact of industrial action.

Trial of senior clinician-led triage of ED patients on Monday’s 11am-11pm achieved success on 2 of 4 trial days.

Cardiac investigation unit change to electronic booking process, introduction of morning orderly, introduction of walk in clinic for DNAs, clinics using same pacemakers and creation of electronic reported for cardiology testing have all improved flow.

Transformational change is required with clear mandate that senior leaders and clinicians will drive change. However, sufficient capacity in clinical teams is needed in order to achieve effective engagement and involvement.

Ms Glenn asked when the bed numbering system would be available. Dr Seddon advised access to bed numbers but not who is in the bed should be available around September.

011


Dr Perese asked if decreases in time had impacted patient experience, both hospital and ambulatory. Dr Seddon advised that pre-work has been done in ambulatory and a small amount has been done in hospital. Ms Abel-Pattinson asked what methods were available to recognise innovation. Dr Seddon advised she can provide the names of those at the frontline so that a letter of thanks can be provided from the Committee. Mr Nand advised that some recognition had taken place, such as morning teas, emails of thanks, articles in the Daily Dose, but agreed a letter from the Committee would be appropriate. Action: Dr Seddon to provide names of frontline innovators to Secretariat, who will prepare letters of thanks from the Committee.

4.5 Patient Experience and Safety Report (Dr David Hughes) The report was taken as read.

4.5.1 Safety, Experience, Compliance and Measurement Dashboard

The report was taken as read. Dr Hughes provided key points:

The reports reflect updates to some of the charts, in particular, the review of falls due to concerns that the data was not particularly reliable, and work on hospital associated infections.

Ms Abel-Pattinson advised the Committee that an induction would be running for new board members, to explain the terms, why the DHB measures them and the different methods of showing the data.

There have been some issues around electronic medication reconciliation. The implementation of MedChart has significantly changed workflows for pharmacists, who are not getting to complete reconciliations as quickly as previously. The positive is the volume of scripts reviewed daily, which has doubled to 61,000 every month.

Ms Abel-Pattinson asked how many sentinel events have been stopped by MedChart. Mr Nand advised that a review has been completed and the data could be provided at a future deep dive. Action: Mr Nand to provide data relating to MedChart sentinel events, once a deep dive has been scheduled for a future meeting

4.5.2 Safety, Experience, Compliance and Measurement Dashboard Variance Report

The report was taken as read.

4.5.3 QSM Local Report The report was taken as read.

Dr Hughes provided key points:

Additional reporting added relating to opioid related harm at very early stages, looking at how many patients are affected by this, eg: constipation, breathing, nausea and vomiting.

012


Resolution (Moved: Ms Brown/Seconded: Ms Glenn) That the Hospital Advisory Committee: Note and receive the reports.

Carried

4.6 Vaping Workshop Ms Abel-Pattinson advised the meeting that the DHB had a no smoking policy over the entire campus. The consensus of a previous board discussion was that not enough was known about vaping and not all board members agreed about using it as part of a quit programme. It was determined that a workshop be held to review more recent evidence and to look at the needs of the DHBs population, particularly in Mental Health, where there are some additional needs that may not be necessary for the rest of our hospital population. Action: Dr Yang and Secretariat to organise a date for the Vaping workshop and extend the invitation to all Board members.

Resolution (Moved: Dr Perese/Ms Glenn) That the Hospital Advisory Committee: Agree that a workshop be scheduled to further discuss the DHBs position on Vaping.

Carried

5. INFORMATION PAPERS 5.1 Emergency Department and Middlemore Central (John Cartwright)

The report was noted and taken as read. 5.2 Medicine and Integrated Care (Catherine Tracy)

The report was noted and taken as read.

5.3 Surgery, Anaesthesia and Perioperative Services (Pauline McGrath) The report was noted and taken as read.

5.4 Central Clinic Services (Ian Dodson)

The report was noted and taken as read. 5.5 Women’s Health (Mary Burr)

The report was noted and taken as read. 5.6 Kidz First (Nettie Knetsch)


5.7 Adult Rehabilitation and Health of Older People (Dana Ralph-Smith) The report was noted and taken as read.

5.8 Mental Health and Addictions (Tess Ahern)


013


Resolution (Moved: Ms Brown/Seconded: Ms Glenn) That the Hospital Advisory Committee: Note and receive the reports.

Carried

6. RESOLUTION TO EXCLUDE THE PUBLIC

Resolution (Moved: Ms Mahuta/Seconded: Dr Perese)

That the Hospital Advisory Committee in accordance with the provisions of Schedule 3, Clause 32 and Sections 6, 7 and 9 of the NZ Public Health and Disability Act 2000:

The public now be excluded from the meeting for consideration of the following items, for the reasons and grounds set out below:

General subject of items to be considered

Reason for passing this resolution

in relation to each item

Ground(s) under Clause 32 for passing this resolution

Public Excluded Minutes of 20 November 2019 and Actions

That the public conduct of the whole or the relevant part of the proceedings of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist, under section 6, 7 or 9 (except section 9(3)(g)(i))of the Official Information Act 1982.

[NZPH&D Act 2000 Schedule 3, S32(a)]

Confirmation of Minutes As per the resolution from the public section of the minutes, as per the NZPH&D Act.

Workshop 2020 Work Plan including Site Visits and Reports



Commercial Activities

The disclosure of information would not be in the public interest because of the greater need to enable the Committee to carry out, without prejudice or disadvantage, commercial activities.

014


General subject of items to be considered

Reason for passing this resolution

in relation to each item


Facilities, Engineering and Asset Management Report



Commercial Activities

The disclosure of information would not be in the public interest because of the greater need to enable the Committee to carry out, without prejudice or disadvantage, commercial activities.

Carried

The Public Meeting closed at 3.43 pm.

The next meeting of the Hospital Advisory Committee will be held on Wednesday, 8 April 2020.

Signed as a true and correct record of Counties Manukau District Health Board’s Hospital Advisory Committee meeting held on 26 February 2020.

Catherine Abel-Pattinson Chair

Date

015


Appendix 1

Report on Positivity Rate by Ethnicity

016


BSP Colonoscopy Rate Due to Positive Kit Broken Down by Ethnicity

2019 2020

Ethnicity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Total %

Asian 6 10 7 12 10 13 9 11 10 19 13 10 10 140 18.6%

European 18 21 38 34 35 32 27 25 29 37 35 22 32 385 51.2%

Maaori 4 8 10 7 4 5 8 9 10 10 7 8 5 95 12.6%

Middle Eastern/ Latin American/ African

1 1 5 3 3 2 1 16 2.1%

Pacific Peoples 6 14 7 6 4 8 8 8 10 10 7 7 10 105 14.0%

Not Stated 1 1 2 2 2 3 11 1.5%

Grand Total 35 53 62 60 53 59 53 58 64 79 66 50 60 752 100.0%

017


Number of Cancers Detected (positive colonoscopy) by Ethnicity “Cancer Detection Rate”

Maaori have a much higher Kit positivity rate, but cancer detection is similar, be it a bit higher, than other ethnicities at the moment.

018

Note: Items ticked (other than Standing Action Items) and completed are included on the Register for the next meetings review and can then be removed the following month.


Hospital Advisory Committee Meeting – Public Action Items Register – 08 April 2020

DATE ITEM ACTION DUE DATE RESPONSIBILITY COMMENTS/UPDATES COMPLETE

5 June 2019 3.1 Executive Summary

Provide a report on the birthing units including details of utilisation, population growth projects and cost comparison across all CM Health birth units.

08 April 2020

Mary Burr

Deferred to May meeting and moved to Public Excluded Action Items Register

20 November 2019 2.4 Hospital Advisory Committee Draft Work Plan 2020

Deferred to first 2020 meeting for approval by the new Committee.

26 February 2020

Mary Burr/ Dr Peter Watson

Deferred to April meeting and moved to Public Excluded Action Items Register

26 February 2020 2.1 Minutes of HAC 20 November 2019

Item 4.5 Equitable Health Outcomes

Future Meeting

Discussion points to be saved and taken forward for a future discussion on Equity

26 February 2020 3.2 Hospital Services Project Portfolio Overview

Dr Yang to arrange to include a non-financial performance workshop as part of the induction of new board members

Pending Board Approval

Dr Yang

26 February 2020 4.1 General Medicine Deep Dive Presentation

Secretariat to advise Ms Jeffs of need to identify any multipliers in the upcoming workforce presentation

8 April 2020

Ms Jeffs

26 February 2020 4.1 General Medicine Deep Dive Presentation

Secretariat to add Ms Tracy’s powerpoint presentation to Diligent

8 April 2020

Secretariat

26 February 2020 4.2 Bowel Screening Programme Update

Ms Tracy to provide Secretariat with a breakdown of cancers that were positive so that these can be included with the Minutes

8 April 2020

Ms Tracy/ Secretariat

26 February 2020 4.4 Patient Flow – Every Hour Counts Update

Dr Seddon to provide names of frontline innovators to Secretariat, who will prepare letters of thanks from the Committee

8 April 2020

Dr Seddon/ Secretariat

019





26 February 2020 4.5.1 Safety, Experience, Compliance and Measurement Dashboard

Mr Nand to provide data relating to MedChart sentinel events, once a deep dive has been scheduled for a future meeting

Future Meeting

Mr Nand


Standing Action Items

31 January 2018 2 Patient Experience and Safety Report

Provide a regular update at each meeting on response rates to the patient survey and the complaints review process

8 April 2020

David Hughes

Include in Corporate Reports

18 August 2018 3 Chronic Conditions

Provide a regular update at each meeting as part of the Executive Summary.

8 April 2020

Penny Magud to provide update to

Mary Burr

Include in Executive Summary

19 February 2019 Email from M Apa

28 August 2019

4.3

Patient Flow – Every Hour Counts

Provide a regular update at each meeting.

Track KPI progress and provide a regular update at each meeting.

8 April 2020

Mary Seddon


31 January 2018 6.1 Hospital Services 2018/19 Project Initiatives

Provide a regular update at each meeting on current projects.

8 April 2020

Mary Burr

Include in Provider Arm Performance Reports

31 January 2018 6.11 Bowel Screening Programme

Provide a regular update at each meeting.

8 April 2020

Catherine Tracy


020




Quarterly Standing Action Items (Every Alternate Meeting)

4 October 2017 2.4 Human Resources Report

Provide a quarterly report for those staff that have had annual leave paid out, their current leave balance, leave accrual and leave taken. This report will not specifically identify particular individuals due to privacy issues.

8 April 2020

Elizabeth Jeffs


15 November 2011 5.1 Certification

Provide a quarterly report showing progress being made against each corrective action.

8 April 2020

Jenny Parr


9 April 2019 CM Health Board Meeting

Fast Cancer Treatment

Regularly monitor and provide a quarterly report for these actions:

Service-led action plans for each of the 4 tumour streams.

Gynaecology, Head & Neck, Lower GI (Bowel) and Lung Cancer team to take a more detailed look at hot spots and stream-specific issues.

Cancer Nurse Coordinators and Cancer Trackers meetings to be held to review and discuss hotspots.

27 May 2020

Catherine Tracy


14 March 2018 3 Finance – Non Resident Bad Debt Summary

Provide a quarterly report to HAC.

27 May 2020

Avinesh Anand

Include in Provider Arm Performance Reports

021


CPHAC BOARD MEMBER ATTENDANCE SCHEDULE 2020

Name 26 Feb Mar 8 Apr 27 May June 1 Jul 12 Aug 9 Sept Oct 4 Nov 16 Dec

Colleen Brown (Co-Chair)

No

Mee

tin

g

No

Mee

tin

g

No

Mee

tin

g

Pierre Tohe (Co-Chair)

Barry Bublitz

Dianne Glenn

Katrina Bungard

Lana Perese

Paul Young

Apulu Reece Autagavaia

Robert Clark

Tipa Mahuta

022


CPHAC MEMBERS

DISCLOSURE OF INTERESTS

8 April 2020

Member Disclosure of Interest

Colleen Brown

(CPHAC Co-Chair)

Chair, Disability Connect (Auckland Metropolitan Area)

Member, Advisory Committee for Disability Programme Manukau Institute of Technology

Member, NZ Down Syndrome Association

Husband, Determination Referee for Department of Building and Housing

Director, Charlie Starling Production Ltd

District Representative, Neighbourhood Support NZ Board

Chair, Rawiri Residents Association

Director and Shareholder, Travers Brown Trustee Limited

Pierre Tohe

(CPHAC Co-Chair)

Senior Executive, Tainui Group Holdings

Trustee, Taniwha Marae

Barry Bublitz Director, International Indigenous Council for Healing Our Spirits Worldwide

Patron - Management Team, Te Mauri Pimatisiwin (A Journal of Aboriginal and Indigenous Community Health)

Chair - Māori Research Review Committee

Chair, Wikitoria King Whānau Trust

Chair, Eva Newa Wallace Whānau Trust

Secretary, Mataitai Farm Trust

Turuki Health Care – Employee

Co – Chair Mana Whenua Kei Tamaki Makaurau Board

Co-Chair Kaitiaki Roopu: Whakangako te Mauri o te Tangata

Dianne Glenn Member, NZ Institute of Directors

Life Member, Business and Professional Women Franklin

Member, UN Women Aotearoa/NZ

Past President, Friends of Auckland Botanic Gardens and Chair of the Friends Trust

Life Member, Ambury Park Centre for Riding Therapy Inc.

Member, National Council of Women of New Zealand

Justice of the Peace

Member, Pacific Women’s Watch (NZ)

Member, Auckland Disabled Women’s Group

Life Member of Business and Professional Women NZ

023


Interviewer, The Donald Beasley Research Institute for the monitoring of the United Nations Convention on the Rights of Persons with Disabilities.

Katrina Bungard Chairperson MECOSS – Manukau East Council of Social Services.

Deputy Chair Howick Local Board

Member of Amputee Society

Member of Parafed Disability Sports

Member of NZ National Party

Lana Perese Director & Shareholder, Malatest International & Consulting

Director, Emerge Aotearoa Limited Trust

Trustee, Emerge Aotearoa Housing Turst

Director, Vaka Tautua

Director, Malologa Trust

Paul Young TBC

Apulu Reece Autagavaia Member, Pacific Lawyers’ Association

Member, Labour Party

Trustee, Epiphany Pacific Trust

Trustee, The Good The Bad Trust

Member, Otara-Papatoetoe Local Board

Member, District Licensing Committee of Auckland Council

Member, Pacific Advisory Group for Mapu Maia – Problem Gambling Foundation

Board of Trustees Member, Holy Cross School

Member of the Cadastral Surveyors Board

Assessor of the Creative Communities Scheme South & East Auckland

Robert Clark TBC

Tipa Mahuta Deputy Chair, Te Whakakitenga o Waikato

Councillor, Waikato Regional Council

024


COMMUNITY and PUBLIC HEALTH ADVISORY COMMITTEE MEMBERS’ REGISTER OF DISCLOSURE OF SPECIFIC INTERESTS

Specific disclosures (to be regarded as having a specific interest in the following transactions) as at 26 February 2020

Director having interest Interest in Particulars of interest Disclosure date Board Action Apulu Reece Autagavaia Agenda of 26 February

2020 Mr Autagavia is a member of the District Licensing Committee of Auckland Council

26 February 2020 That Apulu Reece Autagavaia’s specific interest is noted and the Committee agreed that he may remain in the room and participate in any deliberations of the Committee but is not permitted to participate in any decision making, if applicable.

025


Minutes of Counties Manukau District Health Board Community and Public Health Advisory Committee

Held on Wednesday, 26 February, 2020 at 9.00am – 12.00pm Ko Awatea, Room 101, Middlemore Hospital, 100 Hospital Road, Otahuhu, Auckland

PART I – Items considered in Public Meeting

BOARD MEMBERS PRESENT

Colleen Brown (Co-Chair) Pierre Tohe (Co-Chair) Barry Bublitz Dianne Glenn Katrina Bungard Lana Perese Paul Young Apulu Reece Autagavaia Robert Clark Tipa Mahuta

ALSO PRESENT

Fepulea’i Margie Apa, Chief Executive Dr Gary Jackson (Director, Population Health) Aroha Haggie (Director, Funding & Health Equity) Dr Kate Yang (Executive Advisor to the CE) Vicky Tafau (Secretariat) (Staff members who attended for a particular item are named at the start of the minute for that item)

PUBLIC AND MEDIA REPRESENTATIVES PRESENT

A reporter from NZ Doctor was present at this meeting. WELCOME

The meeting commenced at 9.00am with a mihi and karakia from Pierre Tohe and Robert Clark.

1. AGENDA ORDER AND TIMING Items were taken in the same order as listed on the agenda.

026


2. GOVERNANCE

2.1 Apologies

Apologies were received and accepted from Campbell Brebner and Tipa Mahuta (lateness).

2.2 Register of Interests

The amendments to the Disclosures of Interest were noted and will be actioned by Ms Tafau (add Barry Bublitz and Robert Clark as Mana Whenua Representatives). The amendment to the Disclosure of Specific Interests was noted by Ms Tafau.

2.3 Confirmation of the Minutes of the Community and Public Health Advisory Committee meeting held on 6 November 2019. Resolution (Moved: Dianne Glenn/Seconded: Reece Autagavaia) That the minutes of the Community and Public Health Advisory Committee meeting held on 6 November 2019 be approved. Carried

2.4 Action Items Register/Response to Action Items Action Items are to be discussed as part of the Workplan 2020 discussion in the Public Excluded section of this meeting.

3. BRIEFING 3.1 Auckland Regional Public Health Service Briefing (William Rainger, Medical Officer of Health, ARPHS)

Report was taken as read. As a new board is in session, Dr Rainger gave an overview of ARPHS and their functions; health protection, health promotion and disease prevention. In response to the measles outbreak and the Covid event, ARPHS works in conjunction with the DHB around strategies to address immunisation issues. The Northern Region Health Coordination centre has been activated. Currently ARPHS staff are at the airport meeting patients and providing information to them. The first stage is to keep Covid 19 out of New Zealand and this sits within ARPHS area of responsibility. The second stage requires DHB assistance as ARPHS don’t have capacity to manage the scale of that response. Customs are currently monitoring people seeking entry to NZ and determining where they have been in the last 14 days. Ms Brown mentioned the catch up campaign for measles immunisations and was advised that money will be allocated from Government, but the amount is yet to be determined. In regard to Mumps and countries that don’t immunise for it, we can monitor those coming in and catch them up. Ultimately a policy change would be required to ensure, for example, seasonal workers coming in to New Zealand are denied entry until fully immunised. A policy change can be an expensive exercise.

027


Recommendation to the Board CPHAC would like the Board to consider advocating, both regionally and with ARPHS/intersectorally, for stronger immunisation policies for those wishing to enter New Zealand, in particular for education/work. Moved: Dianne Glenn/Seconded: Robert Clark Carried: Unanimously Measles is a good story to show how, in order to prevent these types of outbreaks, we need to understand and support communities with their issues. The Metro DHBS work closely with Northland DHB, but CPHAC was wondering if there could be a closer working relationship between the four DHBs in order for there to be better coordinated responses to certain events? The Northland Public Health Service and ARPHS meet monthly to discuss issues where they may work together. Dr Rainger is interested to to see if the Health & Disability Review will strengthen this area of focus. How could we have worked better with Asian/Maori/Pacific Communities very early on to mitigate the spread of the disease is a question that ARPHS has been looking at. Reducing inequities is part of the ARPHS overarching objectives. From an organisation perspective, for long term development, ARPHS will reinvigorate the Treaty of Waitangi perspective and also have a structured organisational approach to inequities. Action ARPHS will come back to CPHAC with details around the make up of their staff in relation to the population they are representative of. In regard to vaping, ARPHS is currently waiting for Government direction. CM Health is planning a workshop regarding Vaping and this is to be discussed today at HAC. CPHAC wants to make sure there is a strong submission from the Metro DHBs with a regional input (ARPHS). Ms Apa will circulate the submission to Board for their feedback. Dr Rainger reiterated that Vaping should be advertised as a Quit Smoking Tool, however, that is not the approach that the Government is taking. ARPHS will suggest ensuring tobacco retailers, like alcohol retailers, must be licenced. ARPHS will return in six months’ time (12 August 2020).

6. RESOLUTION TO EXCLUDE THE PUBLIC

Resolution (Moved: Colleen Brown/Seconded: Dianne Glenn) That in accordance with the provisions of Schedule 3, Clause 32 and Sections 6, 7 and 9 of the NZ Public Health and Disability Act 2000:

028


The public now be excluded from the meeting for consideration of the following items, for the reasons and grounds set out below:

General Subject of items to be considered

Reason for passing this resolution in relation to each item


2.1 Confirmation of Public Excluded Minutes 6.11.19

That the public conduct of the whole or the relevant part of the proceedings of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist, under section 6, 7 or 9 (except section 9(3)(g)(i)) of the Official Information Act 1982. [NZPH&D Act 2000 Schedule 3, S32(a)]


3.1 & 3.2 CPHAC TOR and Work Plan 2020 Discussion.

That the public conduct of the whole or the relevant part of the proceedings of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist, under section 6, 7 or 9 (except section 9(3)(g)(i)) of the Official Information Act 1982. [NZPH&D Act 2000 Schedule 3, S32(a)]

Commercial Activities The disclosure of information would not be in the public interest because of the greater need to enable the Board to carry out, without prejudice or disadvantage, commercial activities. [Official Information Act 1982 S9(2)(i)]

Carried This first part of the meeting concluded at 11.00am.

SIGNED AS A CORRECT RECORD OF THE COUNTIES MANUKAU DISTRICT HEALTH BOARD COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE MEETING OF 26 FEBRUARY 2020.

__________________________________ Colleen Brown Pierre Tohe Committee Co-Chair Committee Co-Chair

029

Items once ticked complete and included on the Register for the next meeting, can then be removed the following month.


Community & Public Health Advisory Committee Meeting – Action Items/Resolution Register – 26 February 2019


Standing Items

Locality Updates: Provide updates for Locality Hubs in general until established enough to provide individual deep dives.

2020 Alan Greenslade, Matt Hannant and Penny Magud

On hold due to the Covid-19 response.

ARPHS – six-monthly update. 12 August Doone Winnard ARPHS will come back to CPHAC with details around the make-up of their staff in relation to the population they are representative of.

Quarterly Non-Financial Summary: Quarterly report. 8 April 2020 Parekawhia McLean On hold due to the Covid-19 response.

17/18 Metro Auckland SLM Improvement Plan – quarterly report.

8 April 2020 Robin van Ausdell On hold due to the Covid-19 response.

21.2.2018 3.1 Green Prescriptions in Counties Manukau - Green Prescription is currently undergoing a re-procurement process and will update once this process has concluded.

TBC Ryan Stangroom and Matt Hannant

Work still underway to finalise the service.

19.9.2018 Board 4.3 MoH Letter – Strengthening the DHB Healthy Food & Drink Policy - Doone Winnard and Stella Welsh are looking at what the DHB is currently doing and what this letter means and will report back via HAC and CPHAC.

TBC Doone Winnard Doone Winnard will notify Ms Tafau when there is updated information to report to the committee.

26.9.2018 3.1 4.4 Healthy Families New Zealand: Update to CPHAC in 6 months’ time.

TBC Carmel Ellis Deferred until a suitable date can be confirmed. HFNZ have issued an invitation to host CPHAC at Amersham Way, Manukau.

3.07.2019 5.2 Youth Health: Post the update from Ms Burgess-Shaw, the CPHAC committee would like to have a list of

13 December Carmel Ellis The requested data has been provided as an information

030

Items once ticked complete and included on the Register for the next meeting, can then be removed the following month.



schools that CM Health support.

CPHAC enquired about the spread of students accessing mental health services across our schools. Sexual and Mental health are the biggest areas of access for students. Information will be provided for a future CPHAC.

paper in the Public Excluded Agenda.

6.11.2019 3.1 Ms Ellis was asked to bring Startwell to a subsequent CPHAC – early 2020 in order to provide CPHAC with an overview of the services they offer to the community.

26 February Carmel Ellis On hold due to the Covid-19 response.

031

Patientexperiencesurveyresults

ThisreportisintendedforcomparisonofDHBresultswithnationalaverages.ItisnotintendedforcomparisonbetweenDHBs.

November2019

PleaseselectoneDHBandkeepNewZealandasthedefaultselectionforcomparisonMultiplevalues

032

CountiesManukauHealthQ3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Responserate

0

20

40

1714

2024

2724 23

29

22

27 27 2826

2325 24 24

27

15

2123

1517

26

19

13

2017 18

22

1612

22 2117 18

13

Responserate(%)

Districthealthboard(DHB)CountiesManukauHealth

NewZealand

033

CountiesManukauHealth

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Communication

Coordination

Partnership

Physicalandemotionalneeds

8.5

7.78.1

8.58.18.3

7.88.38.2

8.8 9.0

8.28.7

8.28.07.88.18.5

8.28.37.8

8.2

7.8

8.98.4

7.7

8.78.38.38.0

8.37.7

7.2

8.28.7

8.28.48.58.0

8.47.9

8.78.3 8.4

8.1

9.08.38.68.48.28.08.18.3

9.08.38.5

8.98.48.18.28.2

8.68.58.68.2

8.5

8.57.8

9.18.38.6

8.38.27.98.68.5

9.38.58.78.7

8.08.08.18.88.68.8

8.48.9

Scoreoutof10

Districthealthboard(DHB)CountiesManukauHealthNewZealand

ComparedwithNZaverageAboutthesame

Higher

Lower

Nocomparisonduetolowresp..

034

Rateyourexperienceofcommunicationoutof10

Q2,2014

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

7

8

9

10

8.5

7.78.1

8.58.18.3

7.88.38.2

8.8 9.0

8.28.7

8.28.07.88.18.5

8.28.37.8

8.2


Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Whenyouhadimportantquestionstoaskadoctor,didyougetanswersthatyouco..Wasyourconditionexplainedtoyouinawaythatyoucouldunderstand?(Yes,complete..Didyoufeeldoctorslistenedtowhatyouhadtosay?(Yes,always/yes,sometimes/no)Didyoufeelnurseslistenedtowhatyouhadtosay?(Yes,always/yes,sometimes/no)Didyoufeelotherstafflistenedtowhatyouhadtosay?(Yes,always/yes,som..

Didamemberofstafftellyouaboutmedicationsideeffect..

77788770817579757281

6275806967727672777177 79

73706872707661747380 88

75766370677772746873 74

9292 817381727580807963

77896873687784717375 83

65677970667370706874

6072

867368697986757478 74

5367

857461

797064718260727680

67666679717980 68

56595257485544565159 5947584749524652475348 47

Percentageinhighestcategory(excl.N/A)


NewZealand

Communication

035


Rateyourexperienceofpartnershipoutof10

Q2,2014

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

7

8

9

8.1

9.0

8.38.68.48.28.08.18.3

9.0

8.38.58.9

8.48.18.28.2

8.68.58.68.2

8.5

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Wereyouinvolvedasmuchasyouwantedtobeindecisionsaboutyourcareandtreatment?(Yes,definitely/yes,tosomeextent/no)

Didthehospitalstaffincludeyourfamily/whānauorsomeoneclosetoyouindiscussionsaboutyourcare?(Yes,always/yes,sometimes/no)

60

7869677072

576460

73

636473

5865

60

72767072

6069

5662616157

4748585658

53

64

51565755

45

5751

5860 57


Partnership


NewZealand

036


Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Wereyougivenconflictinginformationbydifferentstaffmembers,eg,onestaffmemberwouldtellyouonethingandthenanotherwouldtellyousomethingdifferent?(No/yes,sometimes/yes,always)

Doyoufeelyoureceivedenoughinformationfromthehospitalonhowtomanageyourconditionafteryourdischarge?(Yes,definitely/yes,tosomeextent/no)

717775

596268

58

717375

55

7168

555860

717674

656672

76

61646066

6064

45

6663

4657

656760

525959575355 55


Rateyourexperienceofcoordinationoutof10

Q2,2014

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

7

8

9

7.8

8.98.4

7.7

8.78.38.3

8.08.3

7.77.2

8.2

8.78.28.48.5

8.08.4

7.9

8.78.3 8.4

Coordination A.


NewZealand

037


Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Ifyouneededhelpfromthestaffgettingtothetoiletorusingabedpan,didyougetit..

Doyouthinkthehospitalstaffdideverythingtheycouldtohelpcontrolyourpain?(Yes,..

Overall,didyoufeelstafftreatedyouwithrespectanddignitywhileyouwereintheh..

Overall,didyoufeelstafftreatedyouwithkindnessandunderstandingwhileyouwere..

Wasculturalsupportavailablewhenyouneededit?(Yes,always/yes,sometimes/no)

56788078

65717067747860

8179656572

8385877877 70

79837785737471

8471

82 8781897973737981828183 79

73727672839289798083

7191928594828593898586 84

69708475

90828275828972

91918282768189878783 82

808079676053

67758279 696387

5747

5878

67817567

78


Rateyourexperienceofhavingphysicalandemotionalneedsmetoutof10

Q2,2014

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

7

8

98.5

7.8

9.1

8.38.6

8.38.27.9

8.68.5

9.3

8.58.78.7

8.08.08.1

8.88.68.8

8.48.9

Physicalandemotionalneeds A.


NewZealand

038



NewZealand

Q3,2014

Q4,2014

Q1,2015

Q2,2015

Q3,2015

Q4,2015

Q1,2016

Q2,2016

Q3,2016

Q4,2016

Q1,2017

Q2,2017

Q3,2017

Q4,2017

Q1,2018

Q2,2018

Q3,2018

Q4,2018

Q1,2019

Q2,2019

Q3,2019

Q4,2019

Q1,2020

Beforetheoperationdidstaffexplaintherisksandbenefitsinawayyoucouldunderstand?(Yes,completely/yes,tosomeextent/no)

Didstafftellyouhowtheoperationwentinawayyoucouldunderstand?(Yes,completely/yes,tosomeextent/no)

Didyouhaveconfidenceandtrustinthedoctorstreatingyou?(Yes,always/yes,sometimes/no)

Didyouhaveconfidenceandtrustinthenursestreatingyou?(Yes,always/yes,sometimes/no)

Didyouhaveconfidenceandtrustintheothermembersoftheteamtreatingyou?(Yes,always/yes,sometimes/no)

94 86 85 85 81 82 769497

7466 69 71 71 71

6076 8371

9077

79 82 79 81 85 8571

80 86

83 86 81 77 82 8472 7967 65

82 8490

6982 75 74

8467 67 73 75


Additionalquestions A.

039

Safety, experience, compliance and measurement dashboard 1. Monthly divisional summary of serious incidents – AEB As sent during February 2020

2. Health Roundtable - Insights

Target Latest month

0 non-falls serious adverse events

2

This table shows the incidents by Division reviewed by the Adverse Events Operational Group and reported to the Health Quality & Safety Commission as potentially meeting Severity Assessment Code (SAC) 1 or 2 criteria. The incidents do not necessarily occur in the month reported due to delays in identifying the severity of the harm.

Action: Both cases have been reported to the Serious Adverse Event Committee and it is recommended that a multidisciplinary group focuses on reducing IVL lines, improving aseptic insertion, reviewing sites daily and removing lines no longer needed.

Target Latest month

< 2.2% (baseline) 2.2%

Health Roundtable (Insights) provides data based on coded discharge data. This shows percentage of admissions affected by any Classification of Hospital Acquired Diagnoses (CHADx) codes.

Data is quarterly and provided three months in arrears due to clinical coding requirements after discharge.

1

Division Description

Surgery 1) Peripheral IV line bacteraemia

Locality Services

1) Bacteraemia CLAB

1.1 Non-falls serious adverse events

Target Latest month

0 falls serious adverse events 2

Division Description

ARHOP 1) Fall resulting in fractured pubic rami

Medicine 1) Fall resulting in head injury

1.2 Falls serious adverse events

The incidents do not necessarily occur in the month reported due to delays in identifying the severity of the harm.

Action: Reported to the Serious Adverse Event Committee . Up-date requested from the falls prevention group

040

3. National Quality and Safety Markers (QSM)

3.1 Falls

3.3 Medication Safety

Target Latest month

< 0.09 falls with major harm per month per 1000 bed days

0

This chart shows the inpatient rate of Staphylococcus aureus bacteraemia (SAB) per 1000 bed days. Common causes of SAB in hospital include infected peripheral and central lines.

Action: Consider separate chart for peripheral IVL infection to monitor progress of activities to reduce peripheral IV line associated bacteraemia.

Target Latest month

<0.06 SAB per 1000 bed days 0.08

3.2 Hospital Associated Infections – Staph. aureus bacteraemia

This chart shows the number of falls with major harm per 1000 bed days. This data is sourced from the incident management system. A review has been undertaken of falls data in the system to ensure the chart is as accurate as possible.

All falls with rated SAC 1 or 2 are included. The data is reported by date of fall rather than the date incident was reported to HQSC (item 1.2).

2

Target Latest month

80% 59.1%

This chart shows the high risk patients with electronic medication reconciliation (eMR) completed within 48 hours of admission. The reduction in completion rate relates to change in workflow and workload for pharmacy services since the implementation of MedChart and concerns about the reliability and validity of the risk tool.

Action: Re-develop the risk tool using Qlik and MedChart. Consideration of clinical pharmacy resources and prioritisation of effort given significant change in pharmacy workload and workflow since electronic prescribing has been implemented.

041

4.1 Pressure injuries

Target Latest month

0 Stage 3, 4 or unstageable pressure injuries

0

4. Excellent, high quality care

This chart shows the severe pressure injuries (Stage 3, 4 or unstageable) per 100 patients on ward based monthly audits. Note that these audits do not aim to identify all such cases as it is a random sample, however because it is standardised it does allow comparison over time. For the last 6 months this audit has not identified any of these cases.

This chart shows the Intensive Care Unit (ICU) central line associated bacteraemia (CLAB) rate per 1000 line days. The actual line days in ICU average 100 per month.

Target Latest month

<1 CLAB per 1000 line days 0

4.2 Central line associated bacteraemia (CLAB) - ICU

3

Target Latest month

0 Stage 2 pressure injuries 25

This chart shows stage 2 pressure injuries per 100 patient admissions. This data is from Incident Reporting System. This relies on self report of stage 2 pressure injuries.

There is a special cause that is being investigated however it may correlate with the effect of urinary incontinence on skin integrity.

Action: Pressure injury prevention group to review risk assessment and prevention plans to consider improvements focussed on mild to moderate pressure injury.

042

4

4.3 Venous thromboembolism (VTE)

This chart shows the number of elective orthopaedic provoked venous thromboembolism (VTE) cases per 1000 bed days. The target of <2.3 per 1000 bed days has been set following a review of the current evidence and Health Roundtable benchmarking with similar hospitals in Australasia.

Target Latest month

<2.3 per 1000 bed days 0

043

5

5. Improve consumer engagement

5.1 Internal inpatient experience survey

Target Latest month

> 450 completed surveys per month

486

There are three ways for patients to complete the CM Health internal inpatient experience survey: email, text or tablet. This chart shows the number of patients who completed the survey.

Special cause variation due to shorter surveys from 2019.

This chart shows the percentage of patients in our internal inpatient experience survey who rated their care as very good or excellent. The average is 80%.

The target of 80% was established by ELT in April 2017.

Target Latest month

80% 82%

5.2 Net Promoter Score

Target Latest month

TBC 41%

This chart displays Net Promoter Score as a percentage. The score reflects the response to the Friends & Family question from the internal inpatient experience survey: How likely are you to recommend our service to friends and family if they needed similar care or treatment?.

044

6. Feedback central

6

Target Latest month

80% 61%

This chart shows the ratio of cases resolved within 20 days of submission.

In consultation with other DHBs, it was identified that the average performance nationally is approximately 50%. 80% (aspirational) target has been set based on the feedback for CM Health.

Action: Feedback Central will continue to work with services to ensure that those straightforward complaints are managed efficiently as close to the consumer as possible. Feedback Central to review the pattern of time to resolution for those complaints taking longer than 20 working days.

This chart shows that the number of complaints is a stable with a mean of 80 per month. The highest number of complaints are received from our busiest areas: Surgery/anaesthetic and peri-operative (SAPs), Medicine, the Emergency Care Department, Women’s Health and Mental Health.

045


Counties Manukau District Health Board Combined HAC, CPHAC, DiSAC Meeting

Covid-19 Response in the Community

Recommendation It is recommended that the combined subcommittees (HAC, CPHAC and DiSAC): Receive this update on the District Health Board’s community and public health response to the Covid-19 pandemic.

Prepared and submitted by: Aroha Haggie, Director of Funding and Health Equity

Purpose The purpose of this paper is to provide the Board subcommittees an update on the work to manage the Covid-19 pandemic in the community. Community response Much work has gone into Covid-19 preparedness and response in the community. We recognize this is a worrying time for our population, many of whom are already battling with pre-existing medical conditions and impacts of socioeconomic deprivation. CM Health has been working hard to provide additional support and information, especially to Maaori, Pacific, Asian populations as well as those who are elderly, disabled or otherwise vulnerable. We have also made sure to engage with key stakeholders, including service providers in the community. As of 1st April, there are now 7 CBACs (Community based assessment clinics) in our catchment area including a Maaori-led one in Manukau and Pacific-led one in Otara. Work is being done to assess the number of crowded homes in our catchment area, and the possibility of using mobile units. Communications We have increased local, outgoing communications in different languages spoken by our community. In particular, we have had good responses from advertisements in local free newspapers and videos uploaded onto social media platforms. Communications team is cognisant that people may feel overwhelmed by the many sources of information available, some which may conflict. We are keeping our messaging simple, local and in the languages spoken by our communities. We are especially keen to inform and support our vulnerable communities to continue to seek necessary medical care, including flu vaccinations for those eligible, during this lockdown period.

046


Above: A video in Samoan explaining our visitor policy on CM Health’s Instagram account Support for Maaori CM Health has stood up an incident management team (IMT) ‘Ngaa Amokura Haumaru’ to support Maaori people living in CM Health rohe. This IMT will be liaising closely with the regional Maaori Health IMT and mana whenua to ensure Maaori have access to information and resources during the lockdown. Ngaa Amokura Haumaru is supporting several initiatives, including the Whaanau Guide and Ngaa Kaimanaaki – a new community champion workforce for Covid-19 which will augment current health and social service workforces. The Whaanau guide has two parts: the first is a series of daily Facebook Live videos, with information to help Maaori whaanau deal with the day to day effects of what they will be facing in the upcoming weeks to months. In addition to health information, the show will discusses other aspects that may be impacted including managing daily household expenses, mortgage repayments and rent options, how to access government services, how to keep children calm and active at home. The second part is a series of text message (2 x a week) to whaanau registered with a Primary Health Organisation (PHO). It also provides for additional support for Paerangi; a Maaori-led collaborative designed to meet the communication needs of whaanau hauaa (Maaori with a disability). This combination of activities will ensure up-to-date advice, information and virtual support is provided to regional whaanau for Covid-19.

047


Above: One of the Whaanau Guide daily videos for getting through Covid-19 Support for providers and other key stakeholders The Funder arm have reached out to providers to provide support to assess what contracted work is essential and what could be deferred, including what could be redeployed. This assessment includes analysis of where the gaps in services are. Communications collateral has been drafted to give providers further support, clarity and direction about our expectations in relation to their contracts. CM Health is also looking to support organisations with whom we have no formal relationship with (contract or reporting lines) such as Age Concern, as they provide important services to our community. Further details will be provided in the verbal report.

048



Hospital Services Report – March 2020

Recommendation It is recommended that the Hospital Advisory Committee: Receive the Hospital Services Report covering activity in January/February 2020. Please note shortened format due to Covid-19 activity.

Prepared and submitted by Mary Burr, General Manager, Division of Women’s Health on behalf the Hospital Services Directorate.

Executive Summary Glossary EWS Early Warning Score ESPI Elective Service Productivity Indicator FCT Faster Cancer Treatment FSA First Specialist Appointment LOS Length of stay MECA Multi-Employer Collective Agreement MERAS Midwifery Employment Relations Advisory Service (union) MOH Ministry of Health NHI National Health Index NZNO New Zealand Nurse Organisation (union) PSA Public Service Association (union) SMO Senior Medical Officer WIES Weighted Inlier Equivalent Separations (MOH activity based funding methodology) Overview This report provides an overview of the performance of all CM Health Hospital Services Divisions and includes finance and divisional highlight reports which provide a consolidated view of organisational performance in these areas. It is important to note that this report was compiled during the Covid-19 pandemic and therefore this dominates most of the reporting. COVID-19 A pandemic called coronavirus is causing a respiratory illness called COVID-19 disease in New Zealand (and the world) at growing levels and is evolving and escalating each day. The disease can be severe or life-threatening and community transmission has the potential to overwhelm healthcare services in this country. Preparedness for COVID-19 Pandemic All CM Health Services began planning for a Covid-19 response early in the year, supported by emergency planning work that is always ongoing. By the end of January and into February 2020, the team was working with the regional emergency response and Auckland Regional Public Health (ARPHs) teams to develop an overarching plan. By February 2020 it became clear that CM Health required comprehensive Covid-19 related and business as usual management plans for service delivery during Covid-19 and work stepped up to a new level on this.

049


By 1 March 2020, an Incident Management Team (IMT) under the Co-ordinated Incident Management System (CIMS) structure was established. Explanation of the operationalising of CIMS The CIMS IMT provides a central command and control centre for all coordination and decision making during an event, outbreak or pandemic. CIMS achieves effective coordinated incident management across responding services and agencies and establishes common structures, functions and terminology in incident management within a framework that is flexible, modular and scalable so that it can be tailored to circumstances specific to any level or type of incident. During an event with the size and scale we are currently experiencing, CIMS is critical to gaining order and appropriate responses to escalating challenges. Current State At the time of writing this report, the hospital has no Covid-19 positive patients (this is expected to change and hospital admissions will become a factor in this response). There are 33 community patients who have tested positive. Actions to date

Planning and Information

CM Health IMT established controlling the CM Health response.

Daily IMT Briefing attended (by Zoom) by managers, CEO, ELT members and Board Chair.

Daily update to all staff from the IMT.

Regional alignment of all activities on a daily basis.

National alignment and guidance on New Zealand’s response to Covid-19.

BAU planning in place to ensure all other acute and urgent care can be maintained.

Planned Care (electives) cessation of non urgent cases, plan for urgent cases in place.

Extra capex and workforce approval processes streamlined through the IMT.

Community Response

Community Testing stations (CBACs) set up in the CM Region.

Workforce enablers

IT systems enabled to allow staff to work from home.

IT systems enabled to provide tele health consultations to patients in need of assessment, advice, plan for care.

Any non-essential staff are working from home.

High uptake of influenza vaccine by staff.

Spiritual Role and Chaplains roles and availability established for staff and patients.

Vulnerable Worker Policy/process underway.

Car Parking- no cost parking landed for all.

Workforce and Wellness team stood up and are working towards best care for staff.

Retail space business attrition managed to secured private food provided on site as well as staff café.

Management of Infection Control

Personal Protective Equipment (PPE) is available and instructions for use are highlighted daily.

Instructions around uniform cleaning given.

Ongoing uniform supply confirmed.

Visitor Policy confirmed to national level instruction- “no visitors, with some exceptions”.

Scott Building Negative Pressure Project approved. This will increase our negative pressure room stock.

050


Hospital Services Report for Activity Prior to Covid-19 - January February 2020 Key Highlights for January/February 2020

All national targets for CM Health colonoscopy and gastroscopy were achieved in January and February 2020.

Total Planned Care delivery (Electives) for January was confirmed by the MOH at 112.1% of planned production for the month. Indicative Planned Care result for February 2020 is 112%.

Kidz First ED attendances for February 2020 are down 3% on last year to date and Paediatric Medicine discharges are also down 3% for the year to date.

Very successful recruitment of new graduate midwives with 34 in core and LMC roles to start in April 2020.

Our Wellness Support team won the NZ Primary Healthcare Award for Best Mental Health Programme. Dr Sophie Ball, lead for Primary Mental Health, CM Health and Pam Hewlett, Portfolio Manager for Mental Health developed and implemented the Wellness Support model for Primary Mental Health at CM Health.

Finance Overview- February

The Provider Arm produced a $(77) k unfavourable result against budget for the month of February 2020, YTD $(3.14) M unfavourable to budget. A level of vacancies continues across the system that has been offset by cover provided by locums, bureau, overtime, casual staff and additional outsourced clinical services. Added pressure on services during the Whakaari/White Island incident, the measles epidemic, as well as the ongoing impact of Apex Strikes have led to further YTD clinical outsourcing to meet planned care volumes. The Covid-19 Pandemic financial impact will be monitored and reported in the coming months. The February result has been driven by:

- Continuing costs relating to Whakaari/White Island incident of the 9th December,

- Approved additional capacity (Ward 17, Ward 34 and Ophthalmology),

- Additional outsourcing to meet planned care volumes.

The estimated costs incurred by CMH for the White Island/Whakaari incident is estimated at $11.2M (including ~$1m for capital) for direct patient care (theatre time, clinical supplies including skins) and those incurred as a result of the incident (incident management costs, diversion of acute etc). Three patients are currently being treated and are expected to be discharged in the next few months. Delayed implementation of savings programmes and YTD overspends for unbudgeted additional capacity has reflected unfavourably on the YTD result. Key Updates to the Hospital Advisory Committee (The Committee requested regular update on the following items). National Bowel Screening Programme (NBSP)

As of the end of February 2020, there have been 64,525 kits have been distributed, 1,435 positive FIT tests; 980 colonoscopies completed, out of which 816 of those patients had biopsies. 89 cancers have been diagnosed since the start of the programme. Ophthalmology Overdue Follow up Appointments The number of people waiting for surgery at the end of February (785 patients) is similar to the previous month. There were 23 patients waiting longer than 120 days at the end of February 2020 but 12 were booked to have their surgery in early March 2020. The increase in patients waiting is due to the effect of the mega-clinics particularly the very large clinics held in November 2019 with patients now falling into the more than

051


90 days late group. The majority of the overdue patients are for minor oculo-plastic procedures; access to which will be managed by a new oculo-plastic surgeon who commenced on 2 March 2020. Divisional Highlights for January/February 2020 Women’s Health Maternity There were 543 births at Middlemore and 49 at the community units making a total of 592 births for February 2020. This is down 4% compared to February 2019 but year to date births are almost at the same level as last year. Recruitment of midwifery staff continues through internal and external web-based advertising, agencies and universities. We have had great success this year recruiting 20 Auckland graduate midwives and all have been recruited to start employment at end April 2020. Fourteen further graduate midwives will start as Lead Maternity Carers in our community; a further 9 registered nurse have been offered positions in February, to start March/April. Current maternity bed capacity remains 54 bed (up from 45 this time last year). Stage Three of the 2018 Workforce and Bed Capacity Plan will be implemented by end June 2020, with 6 further transitional beds on level 4, and 5 gynaecology beds opening on Ward 21 with the potential to flex to 10 further gynaecology beds once full midwifery/nursing recruitment is achieved. Experienced registered nurses on Maternity South/Ward 21 have undertaken rotation to up skilled in gynaecology care ready for opening additional beds on Ward 21. Kidz First Kidz First volumes For the month of February 2020, ED attendances were 1,706 (prior year 1,757) – a 3% reduction; year to date attendances were 15,777 (prior year 16,614) – a 5% reduction. Year to date Paediatric Medicine discharges were 3,422 (a 3% decrease on the prior year) and total WIES were 1,867 (also a 3% reduction on prior year). Neonatal volumes For year to date February 2020, the total Neonatal WIES (i.e. Neonatal Unit and those babies graduating from Neonatal Unit to Postnatal ward and then discharged) are at 103% of the contract level, and 110% of the prior year. Discharges for Neonates from the postnatal area and the Neonatal Unit combined are at 106% of prior year. Occupancy and acuity in February in the Neonatal Unit has dropped compared to the previous months with an average of 89% (midnight count) occupancy, i.e. an average of 30 cots for the whole month against the 34 resourced cots. From March 2019 the region has continued to experience high demand. Daily liaison between all 4 units continues to ensure that all mothers and babies can remain in the northern region. Central Clinical Services Pharmacy All clinical teams have completed (or have plans to complete) an intervention snapshot day.

The team are working with existing stakeholders and collating feedback to make improvements to MedChart configuration and workflow to improve user experience.

Prescribing of MSC Gynaecology patients and fluids and balances successfully transferred onto MedChart.

Laboratory The Regional Laboratory Network development is progressing well with an initial focus on asset management and usage, the aim is to drive consistent testing quality, efficiency and value. Radiology The general x-ray waiting list is dropping rapidly through the outsourcing of 300 patients a week from November 2019 till mid-February 2020. Additionally, the new staff are also making a big impact. The list dropped from 4731 on 30th December to 2228 on 3rd February, and it continues to drop.

Coronavirus is on the increase. There is a shortage of swabs due to shipments from China and Italy being delayed. There may also be risks with obtaining reagents for coronavirus tests.

052


Mental Health Congratulations to our Wellness Support team on winning the NZ Primary Healthcare Award for Best Mental Health Programme. Dr Sophie Ball, lead for Primary Mental Health, CM Health and Pam Hewlett, Portfolio Manager for Mental Health and Addiction developed and implemented the Wellness Support model for Primary Mental Health at CM Health. They won the Habit Group Best Mental Health Programme at the NZ Primary Healthcare Awards on 29th February 2020. In February the Counties Manukau Board received an update on the Ministry of Health, Metro-Auckland, and CM Health response to-date to He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction. A copy of this report is available through the Diligent Resource Centre to keep HAC informed. Expanding the access to and choice of primary mental health and addiction support was a key need identified in the report. The Mental Health and Addiction Directorate within the Ministry of Health is currently implementing a programme to deliver on the Wellbeing Budget 2019 initiative: Expanding access to and choice of primary mental health and addiction services. The programme includes targeted funding for priority groups, including Maori, Pacific and Youth. The CMH Mental Health team is working actively to enhance every opportunity to increase and improve services for our community. Middlemore Central and Emergency Care COVID-19 – organisational planning and responding to the ever-changing case definitions and country classifications continues. Work is being done at a National, Regional and DHB level. The Northern Region Health Coordination Centre (NRHCC) has been set up to coordinate the northern region response in conjunction with the DHBs (Northland, Waitemata, Auckland and Counties Manukau). Staff from all sectors have been requested to assist by providing appropriate staff to be based out of the EOC at Auckland City Hospital Grafton Road. Industrial Action – APEX Laboratory strike action has been withdrawn.

Medicine & Integrated Care Faster Cancer Times FCT performance remains unachieved at 82%. On-going capacity constraints are access to theatre, outpatient clinics and oncology services. Tumour stream focus areas are on the gynaecology tumour stream, particularly the endometrial cancer pathway. The gynaecology service will be presenting further information to the board in April. ORL service for head and neck cancers are undertaking a deep dive review of their cancer pathway to understand the impact of changes already made and further areas for improvement opportunity and the associated resourcing requirements.

Average Length of Stay Average length of stay marginally reduced to 3.4 days during February from a material increase of 3.7 days in January 2020. The increase remains attributable primarily to an ongoing extended social admission of 151 days resulting from residential placement failure transferring into General Medicine following a medical event. The Corona virus outbreak may further adversely affect length of stay across Medicine in the coming months as a result of the impact of illness on already vulnerable patients and self-isolation measures that may be required for critical staffing groups such as medical staff. Nursing Recruitment February activity consolidated nursing recruitment to the FTE and skill mix required to support the transition to an acute medical model of care at 15 beds with capability to flex up to 20 as demand requires. One medical team continues to be home based in Ward 17 while ongoing recruitment progresses. Pandemic planning for Covid19 is underway incorporating options involving Ward 17 and more detailed planning continues to develop. Surgery, Anaesthesia and Perioperative Services (SAPS) The SAPS Division continues to recover from the White Island Eruption and are managing the remaining three patients, one New Zealand and two overseas patients. They are still not medically fit to be repatriated and

053

https://ministryofhealthnewzealand.createsend1.com/t/i-l-xlicit-l-i/

https://ministryofhealthnewzealand.createsend1.com/t/i-l-xlicit-l-i/


COVID-19 may also impact on their repatriation. All patients whose elective surgery was cancelled have had their surgery performed or have dates for their surgery. The division are also working cohesively in preparedness for COVID-19 management if / when spread occurs. Planned Care The impact of White Island had had a knock on effect on ESPI 2 and 5 patients who would have had surgery but were displaced by the rescheduling of cases cancelled during incident. The predication had been to recover by end of June / July, however the COVID-19 pandemic will most likely to impact this and if the virus becomes widespread there will be ongoing cancellations of surgeries. A number of services are ESPI 2 and or ESPI 5 compliant. Plastic and Gynaecology are doing well with ESPI 2 compliance followed closely by ORL with only the one breach this month. Urology remains the only service ESPI 5 compliant for February albeit ORL and Gynaecology only have single figure levels of breach. Positive variances continued for total planned care production. A higher than phased level of volumes completed in January helped recoup some of the December shortfall. The recovery from COVID-19 is unpredictable at this stage and will depend on the extent of the outbreak within New Zealand. For some months to come it is expected CM Health will still have red level of breaches with the continuing need to be balancing between those that need to be treated and addressing previous month’s breaches. The White Island disaster and the need to cancel significant amounts of elective surgery contributed to higher breach levels in many services but to some extent this was offset with the Mobile Surgical Bus availability around the same time, albeit for a different level of casemix. CM Health has now had 25 consecutive months with red ESPI. We however remain in a better position relative to many other DHBs around the country. Post Covid-19 restriction, Planned Care activities will require extensive review and management. Many services have long waiting lists which have not yet recovered from the White Island impact. Adult Rehabilitation and Health of Older People Acute Allied Health services went fax free in February 2020. Electronic referral forms are now being used. Early development of the Atrial Fibrillation (AF) smartphone app has begun. This will be a patient-facing education and information application for people who have started on anticoagulation medication to prevent strokes.

National Health Targets Planned Care Measures (Elective Access) SS07: Planned Care Measures has in 19/20 replaced PP45.

Result January (actual)

Result

February (indicative)

SS07 Measure 1

Total Planned Care Interventions

Achieved

112.1 Variance from Plan 2099

Achieved

112.0%

SS07 Measure 2

Elective Service Patient Flow Indicators (ESPI)

ESPI 2 (FSA) and ESPI 5 (Treatment) wait time targets

FSA: 1407 breaches

Treatment: 132 breaches

FSA: 1494 breaches

Treatment: 153 breaches

054


SS07 Measure 4

Ophthalmology Follow-up Waiting Times

Overdue: 4548

Overdue 50%: 1760

Overdue 100%: 781

Overdue: 4562

Overdue 50%: 1790

Overdue 100%: 812

Commentary: By February we had still achieved good Measure 1 results but have serious levels of breaching in Measure 2 (FSAs) - elective assessment and treatment- this is mostly related to the White Island Response. Again we will be severely impacted by Covid-19 in this space. Commentary: Ophthalmology The number of people waiting for surgery at the end of February (785 patients) is similar to the previous month. There were 23 patients waiting longer than 120 days at the end of February 2020 but 12 were booked to have their surgery in early March 2020. The increase in patients waiting is due to the effect of the mega-clinics particularly very large clinics held in November 2019 with patients now falling into the more than 90 days late group. The majority of the overdue patients are for minor oculo-plastic procedures. A new oculo-plastic surgeon commenced on 2 March 2020. Cancer Treatment

Description

90% of patients receive their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks.

February

Achieved

85%

Commentary:

February Performance: FCT 82% (22/27 patients) Overall performance 60% (22/37 patients) There is a widening gap between the patients that are excluded from the target due to comorbidity and patient choice reasons and those that remain included in the target. This may be due to patients choosing to delay treatment over the Christmas and summer period. Of the 4 breaches:

2 gynae, 1 lung, 1 urology

055


3 patients breached by 19 days or more

1 patient breached by one day – delays to grading is the largest contributing factor.

2 patients delayed due to sonographer strike

Gynae tumour stream has presented to the CMH Cancer steering group and further presentation is planned for the Board and the regional gynae tumour stream group.

Cardiology Angiography

Description

Cardiology - 95% elective angiograms within 90 days

February

Achieved

98%

Commentary:

The waiting time target has been achieved as outsourcing continues.

Colonoscopy

Colonoscopy Targets

Description

90% urgent (P1) colonoscopies done within 14 days

70% non-urgent (P2) colonoscopies done within 42 days

70% of Surveillance colonoscopies done with 84 day

February 100% 84% 100%

Gastroscopy

Gastroscopy Targets (CM Health Targets)

Description

85% urgent (P1) gastroscopies done within 14 days

70% non-urgent (P2) gastroscopies done within 42 days

70% of Surveillance gastroscopies done with 84 days

February 100% 85% 100%

Commentary: All MOH targets for colonoscopy were achieved again in Jan/Feb All CM Health targets for gastroscopy were achieved again in Jan/Feb. Diagnostic Access The Radiology Service is responsible for the National Health Targets- Diagnostic Access Targets. Radiology

Dec Jan Feb

% MRI scans completed within 6 weeks from acceptance of referral (average weekly)

49% 43% 50%

% CT scans completed within 6 weeks from acceptance of referral (average weekly)

68% 51% 54%

CT

Month Dec Jan Feb

Target achieved (average weekly) 68% 51% 54%

Acute demand 480 405 448

OP/GP demand (average weekly) 342 230 311

Comment: Acute demand has an average weekly increase of 11%.

OP average has an average weekly increase of 35%.

CT continues to do weekend and evening sessions. Trainees nearing completion, new one to commence April.

The waiting list is decreasing accordingly.

056


MRI

Month Dec Jan Feb

Target achieved (average weekly) 49% 43% 50%

Acute demand 65 50 69

OP/GP demand (average weekly) 164 96 148

Comment: Acute demand has an average weekly increase of 38%.

OP/GP demand has an average weekly increase of 54%.

Alternate weekend sessions have reduced the waiting list. We continue to outsource 15 a week.

MRTs now working 12 hour days Monday – Friday.

Staff member who was on LWOP has returned.

MRI Improvement Project run by Ko Awatea still in progress.

Staffing is much improved.

We are anticipating ongoing improvements in the MRI waitlist despite significant demand increases Shorter Stays in the Emergency Department

Description

95% of patients will be admitted, discharged, or transferred from an emergency department within six hours

February

Not Achieved

84.5%

Finance and Corporate February 2020 Provider Performance Note: 29 days in February 2020 compared with 31 in January and 28 in February 2019 ED ED presentations for February 2020 are higher than for February 2019. There were only 29 days in February compared with 31 the previous month but the average daily presentations are higher at 308 compared with 302 in January 2020. When adding in the Emergency Q issued vouchers the February volumes are 9414.

The number of presentations to Emergency Medicine has decreased both in number and as a percentage of the total presentations.

Paediatric Medicine presentations have decreased compared with December 2019 and General Surgery presentations have increased compared to the previous month.

Both GP presentations to Medical Services and discharges by Medical Services initially referred to Emergency Medicine have decreased as a percent of total activity in February 2020 compared with January 2020 and February 2019.

32.73% of events admitted to inpatient wards which is lower than for January 2020 and similar to

February 2019.

% of Medical service discharges admitted to inpatient wards was 75.11%, 1% lower than for January

2020. Absolute number of patients was over 200 less than January 2020.

Acute Medical Activity February

Acute WIES for Medical Services in February 2020 is lower compared with January 2020 and is higher than February 2019.

Average February 2020 WIES is 0.926, lower than for January 2020 and lower than for February 2019.

January discharges are slightly higher than for the same month in 2019 and lower than for January 2020.

o Average discharges per day are similar to January 2020 at 71 and higher than for February 2019.

ALOS for February 2020 is 3.96 compared with 4.0 in January 2020 and 3.93 in February 2019.

057


YTD

July to February 2020 total WIES for Medical Services is 224 WIES higher than for the same periods in the last financial year.

o General Medicine YTD WIES and discharges are both higher than for the same 8-month period in the previous financial year.

o Cardiology, Endocrinology and Renal Medicine YTD also have higher total WIES. Discharges for Renal Medicine, Endocrinology and Haematology are correspondingly higher YTD and continue to be lower for Cardiology

o ALOS is very slightly higher YTD this financial year compared with the previous financial year with average WIES following the same trend.

Acute Surgical Activity February

Acute WIES for Surgical Services is lower than for January 2020 and lower than February 2019. o The decrease in WIES is a reflection of the 2 less days in the month compared with the previous

month. There is also a decrease in the number of patients presenting to EC who are ultimately discharged by Surgical Services.

All surgical specialties apart from Burns have had a decrease in WIES in February compared with the previous month, along with a decrease in discharges.

Average WIES is lower than for the previous month and lower than February 2019.

All specialties apart from the Hand Service have had a decrease in discharges when comparing to the same month in 2019.

February ALOS is 3.64 compared with 3.7 in January and 3.77 in February 2019. YTD

YTD WIES volumes are lower than for the same 8 months in the previous financial year. o General Surgery and Orthopaedics have lower WIES volumes compared with the previous year

and are contributing to the overall decrease for the service.

YTD discharges are 76.5% lower than for the same 8 months in the previous financial year.

YTD average WIES is slightly higher at 1.29 compared with 1.25 for July to February the previous financial year.

YTD ALOS is 3.75 compared with 3.63 for the previous financial year periods, influenced by the longer than normal LOS of the Burns patients in the last 2 months.

Elective Activity February

February elective WIES is higher than for January 2020. o Orthopaedics, General Surgery and Plastics have had an increase in WIES and discharges this

month compared with January 2020.

ALOS is 1.21 compared with 1.13 in January 2020.

Average WIES for February is 1.09 compared with 1.07 in January 2020 reflecting an increase in WIES and discharges for the February month.

YTD

YTD WIES is less than for the same 8 month period in the previous financial year. The YTD WIES volumes for the first 5 months had been higher this financial year than for the previous financial year but were then impacted on by the White Island event in December that resulted in deferred surgery for both December and January.

o Medical Services YTD elective WIES remains higher than for the same periods in the last financial year but has little impact on the results due to the small contribution the service makes to the overall elective WIES and discharge volumes.

YTD average WIES is 1.3 compared with 1.32 for the same periods the previous financial year.

YTD discharges are higher than for the same months the previous financial year however this has been influenced by the extra day in February this year.

YTD ALOS is 1.14, similar to the previous financial year at 1.15.

058


Planned Care YTD CMDHB and ADHB make up over 99% of the total planned care WIES volumes for the CMH population and therefore can be used to understand the actual delivery against target.

February YTD WIES volumes for the CMH population are 2.9% above target.

o This result is due to an over production by ADHB in ENT, Ophthalmology, Orthopaedics and

Urology services.

o CMDHB under delivered in Cardiology, ENT, Ophthalmology, and Plastics & Burns

February YTD WIES Discharges are 0.79% under target.

059


Hospital Services Directorate – Challenges reported to HAC in March 2020 (Jan/Feb 2019 Activity) NON COVID-19 Related .

This table provides a snapshot of current challenges - For more detail, see individual services reports attached.

Division Challenges Reported Update March 2020 (Jan/Feb activity) Mitigation Strategies

Hospital Directorate

Acute Demand –Beds and TBS

Jan 16 Acute bed availability is inadequate in times of peak demand. Patient volumes, surges and times taken to be seen mean we have been unable to meet the ED Waiting Time target.

Current volumes and bed capacity are matched however ED is still struggling with To Be Seen (TBS) by times. Work continues to mitigate.

Outpatient Demand

Jan 18 Increased referral inflow for outpatient care is challenging many services. Patient Flow- Every Hour Counts Project is addressing this beginning with the establishment of a Manukau site planning group.

The Ambulatory Flow work continues.

Theatre Access

Dec 2017 Shortage of Anaesthetists has impacted upon our ability to increase theatre access to run all theatres.

Recruitment is ongoing. Theatre cancellations related to the recruitment shortage are reducing.


Kidz First Neonatal Unit capacity

Apl 16 Average occupancy for February 2020 was 89% of the resourced capacity of 34 cots.

The ongoing neonatal unit demand and capacity issues remains on the organisation’s risk register, with monthly reviews in place.

Initiation of Neonatal paper for SLT, ELT has been completed – resourcing to 38 cots and provisional plan for additional cots (building).

Recruitment of nurses continues to be a focus. We have been very successful in recruiting 22 NETP nurses who will start across the Kidz First services (including Neonatal Unit) between January and April 2020. At the beginning of January 2020 we reached the budgeted FTE for the 19/20 year.

Regional Neonatal capacity continues to be under pressure

but generally a better month in February for ADHB and CMDHB. Weekly updates on capacity remain in place. Transitional care work i.e. graduates from the neonatal unit being reunited on the postnatal floor alongside mothers returning to facility prior to infants discharge is underway

Planned Appointments

May 19 Planned Expired Appointments increased by 12 to 861 in February (January was 849).

As part of the overall Ambulatory Flow project we have started the work with Ko Awatea on reviewing the Planned Expired Appointment data and processes.


Women’s Health

Caesarean Rate

Jan 17 YTD Caesarean (CS) rate is 29% (prior year 29.0%)

YTD Induction of Labour (IOL) rate is 31% (average 19/20 year was 28%).

No capacity to commence review of CS or IOL currently. Visit in May 20 planned from MCDHB experts to explore use of Misoprostol for IOL

Continue to monitor.

Midwifery workforce

Jan 17 Current midwifery vacancies sit at 39.34FTE is required to fill current vacancies with no opening of additional beds. These figures can be partially offset by 15.58 RN/RM FTE bureau staff.

The largest intake of midwives likely by end April 2020 34 new graduates).

060


We have commenced filling some RM vacancies with RNs. However we remain chronically understaff.

Continuing to try to recruit registered nurses alongside midwives to enable opening of further beds at Middlemore Hospital.

MCIS Apl 17 Roll out of Maternity Early Warning System completed.

Planning underway for change management in 2020 to Badgernet Global Platform. Project commencement planned for April 20; service currently delivering Trendcare to users

Vendor workshops planned x 4 leading up to Oct 2020. Regional planning underway in partnership with vendor for clinical portal interface to provide snapshot view for non-maternity practitioners

Planning underway for change management in 2020 to Badgernet Global Platform. Project commencement planned for April 2020.

Gynaecology Apl 17 Due to the on-going reduced theatre capacity issues we have needed to decrease FSA volumes with more women now being placed on the GP residual list (P3 patients). To manage in the interim we have outsourced patients to wet lease theatre (our staff, private facility). This is being reviewed regularly.

On-going work in close partnership with SAPs on the production plan for electives continues as well as maximising the opportunities for Acute Arranged volumes on the MMH site.


Medicine and Integrated Care

Bowel Screening Programme

Jul 17 As of the end of February 2020, there have been 64,525 kits have been distributed, 1,435 positive FIT tests; 980 colonoscopies completed, out of which 816 of those patients had biopsies. 89 cancers have been diagnosed since the start of the programme.

The funding review with the MoH will be arranged in early 2020.

Bronchoscopy Oct 18 The number of patients waiting for bronchoscopy procedures has begun to rise again with fortnightly Saturday lists continuing to operate from the Endoscopy unit.

To maintain and create capacity for Bronchoscopy, fortnightly bronchoscopy lists have continued operating from the Gastroenterology Unit and will be increased to weekly Saturday lists (every second month) starting in March 2020. From April 2020 Respiratory locum sabbatical cover will provide some additional short-term SMO capacity for these Saturday Bronchoscopy lists.

Increased numbers patients requiring In-Centre Dialysis

The Renal Service has completed the change of self-care Satellite (MSC) patients with Rito 2 (MMH) dependent patients and associated staff. This was done primarily to create more in-centre capacity at the Satellite unit, but it also enables the lower dependency/self-care patients to co-locate with the home therapies area on the Western Campus by being dialysed in Rito 2.

Phase 2 recruitment for in-centre dialysis is well underway with a total of 3.3 FTE. The paperwork for a 0.9 FTE HCA position has just been completed. There is a 2.3 FTE for the RN position. Planning for a Home Therapies Hub at MSC continues, as part of the 5-10 year plan as a way to mitigate the growth in in-centre dialysis.

Local Delivery Medical Oncology

May 19 The regional Cancer Services Group (NRICS) has approved in principle the next stage for local delivery of medical oncology. This is now going through a series of groups regionally and locally for further discussion and approval. If approved it will mean that CMH patients with breast cancer will receive all of their medical oncology treatment at Middlemore and lessen the burden of travel for treatment at the Auckland Regional Cancer Services at ADHB.

Work is ongoing

061


Medical Staffing

Nov 2019 SMO recruitment remains ongoing with several contracts confirmed however new appointments are not planned to come on stream until later in the year. As a result significant FTE vacancies remain in the current period. Registrar vacancies also continue to be problematic to resolve and international recruitment is ongoing.

Morale amongst both the RMOs and General Medicine SMOs continues to improve as the roster changes bed in and provide for a more appropriate workload distribution across the medical teams.

Cardiology Demand

Nov 2019 Demand continues to outstrip the capacity of the cardiology service to deliver within acceptable clinical timeframes across the following areas:

Mitigations include the following:

Outsourcing of cardiac intervention is now occurring weekly with a review of the outsourced volumes planned

Outsourcing of Echocardiograms via contracting agency sonographers is planned to continue to June 2020 as the forecast shows this is the point where clinical timeframes will be met however if further industrial action occurs this will require review.


Central Clinical Services

Radiologist FTE

Sep 16 Currently we have 2.62 FTE of staff off on parental leave which impacts the department and we have worked hard on recruiting to fill vacancies. New SMOs are commencing at beginning of 2020. This will push us slightly over our budgeted FTE however the GM and CE have agreed that this is feasible as it is for a matter of months only.

We have some of our senior RMOs joining us in 2020 as junior SMOs. The future pipeline for SMOs looks good over the next 12 months.

General X-ray/MRT FTE

Sep16 The general x-ray waiting list is climbing again due to MRT shortages and we are planning outsourcing.

We forsee this waitlist being back on target by the end of February 2020.

Histopath Lab Mar 17 The Histopathology work programme remains on track. The design phase is complete and the Registration of Interest has been held for the main construction contractor.

The IANZ audit has been completed for the new Histopathology Lab and it is now fully accredited. This risk has now been fully resolved and has been removed from the risk register.

Mental Health

Challenges Reported Update March 2020 (Jan/Feb activity) Mitigation Strategies

CAMHS Growth in Service Demand - Te Puawaitanga, the Child & Adolescent Mental health team located at Springs Road, East Tamaki are struggling to meet service demands due to continued escalating clinical demands and decreased capacity. This has impacted service delivery, with lengthy delays occurring for young people waiting for treatment and a reduction in the number of therapeutic groups offered. The areas which continue to be difficult to recruit to and remain a significant concern are nursing and psychiatry. Work continues with the Recruitment Department to strategize various approaches to assist with attracting suitable candidates. One of these strategies has been to positively promote the profile of current team members on CMH Facebook page and across other social media platforms.

Focus on recruitment – locally, nationally and internationally. In October the team had a 61.5% vacancy rate (with 16.5fte in post out of funded total 42.8fte). As of end of February 2020, the vacancy rate is 42.8%, with 24.5 fte now in post and a further 6 fte joining the team between March and June this year.

062


Workforce Recruitment

Across the CM Health MH&A division there continues to be areas with significant workforce recruitment and retention issues. Intake and assessment is another team that is experiencing high vacancies and is working to ensure an acute response is able to be provided across CM Health.

Although there has been a significant improvement in the staffing numbers, which has assisted with team morale and service delivery, it is important to acknowledge that a number of the new staff are relatively junior in their career and some are new to the Child & Youth service.


Surgery, Anaesthesia Perioperative Services

Demand for Ophthalmology Services

Jul16 The number of people waiting for surgery at the end of February (785 patients) is similar to the previous month. There were 23 patients waiting longer than 120 days at the end of February 2020 but 12 were booked to have their surgery in early March 2020. The increase in patients waiting is due to the effect of the mega-clinics particularly very large clinics held in November 2019 with patients now falling into the more than 90 days late group. The majority of the overdue patients are for minor oculo-plastic procedures. A new oculo-plastic surgeon commenced on 2 March 2020.

We continue with weekend and extra clinics to manage the volumes. Recruitment of new staff is also ongoing.

Anaesthetists’ shortage

Oct 17 Electronic rostering is running side by side with existing Excel rostering. The eRoster is now accessible remotely on mobiles in 2 formats – by week/theatre/specialty/surgeon and by week/anaesthetist/theatre/specialty/surgeon

Two Fixed term SMOs were employed to start early in 2020. These additions will off-set some of our shortfall in SMOs. An additional Fellow is commencing in October 2020 slightly outside the standard cohort but hope that this is a pre-cursor to a full time position sometime in 2021.

CSSD Staffing Nov 18 Recruitment continues Upgrade to version 15 of T-Doc occurred -no issues.

Elective performance is under threat

Oct 17 A number of services are ESPI 2 and or ESPI 5 compliant. Plastic and Gynaecology are doing well with ESPI 2 compliance followed closely by ORL with only the one breach this month. Urology remains the only service ESPI 5 compliant for February albeit ORL and Gynaecology only have single figure levels of breach.

ESPIs will be severely impacted by Covid. There will need to be a long recovery.


ARHOP Safe Patient Handling and Mobility

10/10/2019 Group 2: Provisional results for Group 2 re-audit (in August 2019)

received from Dr Mike Fray. CM Health hosted Dr Mike Fray.

Presented TROPHI tool and results. Visited Wards 4, 10, 11 and 23.

Group 2 improvements were less significant due to higher base line

scores. Improvements were seen in the following areas..

• Group 3: Re-audit of Group 3 wards (Ward 2, 5, 32North)

completed. Data collation in progress. Awaiting provisional

results from Dr Mike Fray for Group 3 re-audit (December

2019/January 2020).

• In collaboration with Research & Evaluation team, we are drafting

first stage of the programmes one year evaluation.

063



Progress Report on Disability Action Plan

Recommendation It is recommended that the combined subcommittees (HAC, CPHAC and DiSAC): Receive this progress report on the disability action plan.

Prepared and submitted by: Sanjoy Nand, Chief of Allied Health, Scientific & Technical Profession

Purpose The purpose of this paper is the provide the Board subcommittees an update on the progress made by Counties Manukau Health (CM Health) on work in the disability space. CM Health Specific Action Plan In December 2019, CM Health developed a 3 year Disability Action Plan. This plan is currently in draft and will be presented to the regional DiSAC for approval. The action plan builds on the 19-20 action plan (previously presented) and draws from the Regional Disability Strategy Implementation plan. Areas of focus include:

Staff training and development;

Increase use and awareness of Health Passport;

Improving accessibility - accessible facilities;

Using co-design and universal design principles in all new facilities and service design;

Progress Accessibility Tick programme;

Increase employment of disabled people with health care services;

Webpage for Disability;

Include disability in our equity strategy;

Improve accessibility of information for disable people. Accessibility Tick CM Health was awarded the Accessibility Tick in December 2019. The Accessibility Tick is a recognition of the commitment CM Health is making to improving employment opportunities for disabled people. There is work currently underway to develop processes and systems to support the aim of the Accessibility Tick programme. Annual Plan The draft 20-21 annual plan includes objectives that aim to deliver the actions contained in the 3 year disability action plan. These include:

Development of a disability action plan - completed in draft;

Increase disability awareness and training of staff - in place - Basic Disability Responsiveness training is now mandatory for all new staff. To date 1,330 staff have undertaken this training;

Increase training of managers - this is to enable us to support staff with disabilities and encourage and improve opportunities for employment of disabled people - see progress below.

064


Improving Systems and Processes to Support Employment of Disabled People Progress is being made on actions to improve systems and processes to support employment opportunities for disabled people. Cathy Qin, Organisation Development Consultant, was assigned to lead the employment related work for accessibility within CM Health. Recruitment: We are partnering with Workbridge to explore opportunities and have had introductory meetings. Job Advertisements: Recruitment advertising has been updated to convey we are an organisation committed to employing people with a disability. Careers Webpage: It now communicates CM Health as an organisation with the Accessibility Tick and the corresponding commitment to people with disabilities. Interviewing Template: Updated to include a question about support/accommodation. Training for Hiring Managers: Reviewed managers training for recruiting; ‘Recruiting for Results’ workshop and the e-learning module. Developed 3 disability scenarios that can be applied during interview and selection training Data: Exploring ways to collect data on number of disabled people employed COVID-19 Communications We have taken active steps to improve the ability to communicate important messages to the disability community. The CM Health external webpage includes sections for information that is readily accessible for Easy Read and Sign Language Videos. This is information created by MOH, and we have included clear links to enable people with disabilities to access this easily. We also have been providing messages in simple language and in large font. Where we have created videos to communicate messages, we are including subtitles in English and have been also exploring the translation of the messages in sign language. Ensuring Continuity of Services for People with Disabilities during the Pandemic Our planning includes business continuity for services that we currently provide to the disabled community including services that provide home-based supports. There is regional and national planning that is working to ensure the various providers of disability services have contingency plans for continued support to disabled people. Further details will be given in the verbal report.

065


Counties Manukau District Health Board 5.0 Resolution to Exclude the Public Resolution: That in accordance with the provisions of Schedule 3, Clause 32 and Sections 6, 7 and 9 of the NZ Public Health and Disability Act 2000: The public now be excluded from the meeting for consideration of the following items, for the reasons and grounds set out below:

General Subject of items to be considered

Reason for passing this resolution in relation to each item


2.1 Confirmation of Public Excl HAC Minutes of 26.2.2020

3.1 Confirmation of Public Excl CPHAC Minutes of 26.02.2020

That the public conduct of the whole or the relevant part of the proceedings of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist, under section 6, 7 or 9 (except section 9(3)(g)(i)) of the Official Information Act 1982).



4. Briefings on Covid-19 Preparedness

That the public conduct of the whole or the relevant part of the proceedings of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist, under section 6, 7 or 9 (except section 9(3)(g)(i)) of the Official Information Act 1982).


Commercial Activities The disclosure of information would not be in the public interest because of the greater need to enable the Board to carry out, without prejudice or disadvantage, commercial activities.

[Official Information Act 1982 S9(2)(i)]

066

combined meeting hospital advisory committee …...apr 08, 2020 · aroha haggie – director,...

Documents