pharmacy · in a high trust system. • smart system - a system that learns and shares innovations,...

PHARMACYin MidCentral Strategy Pū Rongoā Te Pae Hauora o Ruahine o Tararua Ngā Rautaki

Pharmacy in MidCentral Pū Rongoā Te Pae Hauora o Ruahine o Tararua

He Mihi Kua hau mai te rongo he ao hou kei te waihangatia e tātou.

Arā, he ao hou e noho nei ko te tangata e tino ora ana, ko te hauora te tino aronga, ko te whai whakaaro o tētahi ki tētahi, ahakoa ko wai, ahakoa nō hea. Nau mai e hika mā ki tēnei whakaaro kua marara ki ngā tōpito katoa o Te Pae Hauora o Ruahine o Tararua whenua. Nei te mihi kau ake o Te Tīma Pū Rongoā o Te Pae Hauora o Ruahine o Tararua tā tātou aronga ki ngā kāinga katoa o Te Pae Hauora o Ruahine o Tararua Kia pai te noho, Kia ora te tangata, kia ora te hapori.

He Kupu Whakataki ForewordTo achieve Quality Living – Healthy Lives – Well Communities we need to think and work differently.

We want nothing but the best health care, and the best health and wellbeing for everyone. Every day in our communities, people face a range of challenges; some live with mental illness, some live with a chronic disease, others may become acutely unwell and need emergency care.

Thinking beyond health, some live in cold, damp houses, some may experience violence, and others struggle to afford the everyday costs of living. Health and its partners will commit to work together as one team, taking a more collaborative approach so that we can achieve better health outcomes for our communities. This also means partnering with individuals, recognising them as experts in their own health and in their own lives.

GreetingsThe word is out there a new world is being created. A new world where everyone is very healthy and health is the focus, along with being thoughtful to each other, regardless of who or where we are from. So welcome to this new perspective being dispersed to all corners of the MidCentral District. This is an unconditional greeting from the Pharmacy Team in MidCentral of Te Pae Hauora o Ruahine o Tararua sending our focus to all homes of the MidCentral District. Quality living, Healthy lives, Well communities.

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Pū Rongoā Te Pae Hauora o Ruahine o Tararua Ngā Rautaki What national strategies guide the Pharmacy in MidCentral strategy?

New Zealand Health StrategyThe New Zealand Health Strategy contains five themes that describe the future direction for the overall health system:

• People powered - Supporting people to understand and manage their care and make choices, and to have a say in service design.

• Closer to home - Providing services closer to home and in an integrated way, with a view to promoting wellness at all stages of life and preventing and managing long-term conditions.

• Value and high performance - Improving performance and the culture of performance in order to get better outcomes, equity of outcomes, experience of care and value for resources.

• One team - Strong leadership and a capable workforce working as one team in a high trust system.

• Smart system - A system that learns and shares innovations, and makes good use of new technologies, information technology, and data.

Closer to homeKa aro mai ki te

kāinga

Smart systemHe atamai te

whakaraupapaAll

New Zealanderslive well stay well get well

Value and high performance

Te whāinga hua me te tika o ngā

mahi

One teamKotahi te tīma

People-poweredMā te iwi hei kawe

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He Korowai OrangaAs New Zealand’s Māori Health Strategy, He Korowai Oranga sets the overarching framework that guides the Government and the health and disability sector to achieve the best health outcomes for Māori. Pae Ora(Healthy Futures) is the Government’s vision and aim for the refreshed strategy. It builds on the initial foundation of Whānau Ora (Healthy Families) to include Mauri Ora (Healthy Individuals) and Wai Ora (Healthy Environments).

The four pathways of the original He Korowai Oranga framework continue to tell us how to implement the strategy. These pathways are:

• supporting whānau, hapū, iwi and community development

• supporting Māori participation at all levels of the health and disability sector

• ensuring effective health service delivery• working across sectors.

04O

vera

ll ai

m

Pae Ora Healthy futures

for Māori

Elem

ents

Wai Ora Healthy

environments

Whānau Ora Healthy families

Mauri Ora Healthy individuals

Dir

ectio

ns

Māori aspirations

and contributions

Treaty of Waitangi

principles:

Partnership

Participation

Protection

Crown aspirations

and contributions

Key

thre

ads

Rangatiratanga

Knowledge

Building on the gains

Quality

improvement

Equity

Path

way

s

Whānau, hapū, iwi,

community development

Leadership

Māori participation

Planning,

resourcing

and

evaluationEffective service delivery

Outcome/

performance

and

monitoringWorking

across sectors

Pharmacy Action Plan 2016-2020The four focus areasThis Action Plan identifies four focus areas for changing models of care over the next three to five years:

1. population and personal health2. medicines management services3. minor ailments and referral4. dispensing and supply services.

Tools for changeFour essential tools for change, closely aligned to themes in the New Zealand Health Strategy, have also been identified as necessary to support this change:

1. leadership2. smart systems3. workforce4. regulation.

This Pharmacy Strategy has been developed to set out where and how pharmaceutical services can contribute to these new models of care.

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Rautaki Tiro Whānui The wider strategic context

Implementing Medicines New Zealand 2015 to 2020In 2015 the Ministry of Health released a new action plan, Implementing Medicines New Zealand 2015 to 2020 (Ministry of Health 2015a). It identifies the following seven impact areas to achieve the three core outcomes set out in the Government’s Medicines Strategy:

• making the most of every point of care• enabling shared care through an

integrated health care team• optimal use of antimicrobials• empowering individuals, families and

whānau to manage their own medicines and health

• optimal medicines use in older people and those with long-term conditions

• competent and responsive prescribers• removing barriers to access.

Te Wao nui a Tāne Integrated Service ModelThe MDHB integrated service model (ISM) focuses on strategies that link different levels of healthcare within all provided services so a patient’s journey between primary, specialist and hospital care is simple and seamless. The clinical services and budgets are managed in such a way to avoid delays and double-ups in care. The focus for MidCentral DHB is to ensure a greater range of healthcare services are delivered in the community in a manner that integrates with general practice and primary, secondary and specialist services.Achieving integration in a complex sector such as health requires all system participants to work together to achieve the best possible outcomes with patients, family/whānau and the community. In recognition of this goal, Pae Ora has gifted MidCentral DHB the concept of Te Wao nui a Tāne to represent the ISM.

The overarching philosophy of Te Wao nui a Tāne relates to the great forest of Tāne, which symbolises the ecology of a forest where all elements are co-dependant on each other for the outcome of growth and to enable the forest to flourish -Te Pū Rongoā.

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LIVES WELLHEALTHYLIVINGQUALITY

Kia pai te noho Kia ora te tangata Kia ora te hapori COMMUNITIES

THINK Hauora Connecting Communities for Wellbeing 2019-2025 Strategy

THINK Hauora Vision“Tūhonotia te Hapori ki te Ora

Connecting Communities for Wellbeing”

This will be enabled through the core values:

• Trust• Respect• Unity• Accountability• Courage

THINK Hauora will achieve success through its Strategic Aims:

• Whānau Ora• Equity• Access• Value• Innovation• Networking• Growth

MidCentral DHB – our strategy for successOur Vision...

As a DHB, the purpose is summarised as

“Better health outcomes, better health care for all”.

This is enabled through the core values:

• Compassionate• Courageous• Respectful• Accountable

The DHB will achieve success through its Strategic Imperatives:

• Partner with people to support health and wellbeing

• Connect and transform primary, community and specialist care

• Achieve quality and excellence by design • Achieve equity of outcomes across

communities

COMMUNITIES HOROWHENUA MANAWATŪ

ŌTAKI PALMERSTON NORTH TARARUA

STRATEGY AT A GLANCE 2019–2025 Tūhonotia te Hapori ki te Ora Connecting Communities for Wellbeing

Affordable care

Excellent outcom

esExcellent experience

for providersExcellent experience

for those we serve

QU

AD

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PLE A

IM

STRATEGIC AIMS WHĀNAU ORA OUTCOMES

COM

MIT

MEN

T T

O T

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IRIT

I O W

AIT

AN

GI

Whānau Ora Achieving wellbeing

Rangatiratanga Self-Managing

Equity People, community voice and data-driven

Kōtahitanga Whānau Cohesion

Access Easy, available, cross-sectors

Hauoranga Living Healthy Lifestyles

Value Teams, technology, performance

Tuakiritanga Participating in Te Ao Māori

Innovation Quality improvement, excellence, engagement

Tiaki Taiao Responsible Stewards of Living & Natural Environments

Networking Relationships, partnerships, collective impact

Pāporitanga Participating in Society

Growth Sustainability, system and alignment focus

Pukenga Rawa Economic Security & Wealth Creation

WEAVING

Pū Rongoā Te Pae Hauora o Ruahine o Tararua Ngā Rautaki Pharmacy in MidCentral Strategy The Pharmacy in MidCentral Strategy has two parts:

Development of our WHY: This outlines the approach taken, what we did and how we did it. It highlights the key findings of why it is we do what we do.

Development of How and What: This section looks at how this Strategy will be used to develop the future of pharmacy services in the MidCentral District.

The Pharmacy in MidCentral Strategy aims to make a positive contribution to the health outcomes of the MidCentral District. It will be used to make changes necessary to continuously improve our health system, as part of the wider heath sector and social service network. The Strategy places MidCentral District residents and their families/whānau at the centre of planning decisions and system design to best meet the needs of our communities.

The framework of the Pharmacy in MidCentral Strategy is based on the ‘Hospital to Community Care Continuum’.

It identifies three patient contact points within pharmacy services:

1. The Hospital2. The Primary Care environment3. Community Pharmacies

It is important that everyone contributing to pharmacy services in the MidCentral district work as one team towards implementing the Strategy. This will ensure that our WHY is at the forefront of each decision made for the future of services in Pharmacy in MidCentral.

Mahere Mahi Framework for Pharmacy in MidCentral Strategy 07

Hospital to Community Pharmacist

Community Pharmacist

Primary Care Support Pharmacist

Referral

Referral

Referral

Referral

Development of our WHYEvery organisation – and every person’s career – operates on three levels. The golden circle identifies these levels: What we do, how we do it, and why we do it.

We all know what we do: the services we provide or the jobs we do. Some of us know how we do it: the things that we think make us stand out from the rest of the healthcare sector. But very few of us can clearly articulate why we do what we do. Why goes much deeper to understanding what motivates and inspires us, and our patients. It is the purpose, cause and beliefs that drive the Pharmacy community (Pharmacists, Pharmacy Technicians and Assistants). Why does the Pharmacy community exist? Why did you get out of bed this morning? And why should our patients care?

This simple idea, when expanded, perfectly correlates with the biology of the human brain. The outer section of the Golden Circle – the What corresponds to the outer section of the brain – the neocortex.

08

This is the part of the brain responsible for the rational and analytical thought. It helps us understand the facts and figures, features and benefits. The neocortex is also responsible for language. The middle two sections of the Golden Circle – the Why and How – correspond to the middle section of the brain, the limbic system. This is the part of the brain responsible for all our behaviour and decision making. It’s also responsible for all our feelings, like trust and loyalty. But unlike the neocortex, the limbic system has no capacity for language. This is where ‘gut feelings’ come from. It’s not our stomach. It’s a feeling we get about a decision we have to make that we struggle to explain.

NEOCORTEX

WHAT

HOW

WHY

LIMBIC BRAIN

We can learn, however, to put words to those feelings. And those who do are the ones who are better able to inspire action in themselves, their colleagues, their patients and their communities. Once we understand our WHY, we will be able to clearly articulate what make us feel fulfilled and to better understand what drives our behaviour when we are at our natural best. When we can do that, we will have a point of reference for everything we do going forward – development of services, workforce development etc. We will be able to make intentional choices for Pharmacy in MidCentral. We will be able to inspire patients to see, appreciate and utilise the value that Pharmacy in MidCentral provides.

In order to be able to clearly articulate our why, it was important to start with listening to the pharmacy community.

Listening was imperative to better understand what we held as important as part of the healthcare industry. Understanding our pharmacy community will enable us to work in partnership together to design and develop services that align to our WHY and that meet our populations health care needs.

Through the development of our why, it was important to ensure that we had the following principles in mind:

• It encourages our community to be actively involved in the development of pharmaceutical services within the MidCentral district.

• It places the patient at the centre of the design and development of services.

• It targets and addresses inequities across our communities.

• It ensures that the development of future services must align to our WHY.

• It enables workforce development decisions to be made to align to our WHY – through ensuring that those coming into MidCentral support our vision and values.

• It will be used to help inform investment decisions and provides focus for future planning.

09

Vision is a destination- A fixed point to which we focus all effort.Strategy is a route- An adaptable path to get us where we want to go.

- Simon Sinek

“

“

Our WHY – our voices unitedSixty five people from across the MidCentral Pharmacy Community undertook a workshop to develop our WHY.

It involved a presentation around Locality Planning and how knowing our population will guide decision making in the future.

We had a presentation about how we need to ensure that everything we do addresses inequities in our community.

The conversation about WHY was started with a video presentation by Simon Sinek, followed up with a group discussion about why it is that we do what we do.

With over 90 pieces of feedback, we were able to identify a number of important themes. With these, we have been able to clearly articulate our WHY.

Ngā Rautaki Strategic ImperativesFollowing the feedback, three important strategic imperatives were identified as the WHY of Pharmacy in MidCentral to move us from an illness model to a wellness model.

• Everything we do is for the benefit of our people in MidCentral.

• We maintain best practice in everything we do.

• The services we provide must address inequities to ensure our people achieve better health outcomes.

From these strategic imperatives, three guiding objectives have been identified. • People Centric• Best Practice• Better Health Outcomes

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100% of patients are people. 100% of employees and co-workers are people. If we don’t understand people, we will not understand healthcare.

He tangata People Centric For Pharmacy in MidCentral, creating a system that is truly ‘People Centric’ is characterised by the combination of patient centricity and a workplace people centric culture.

• Patient centricity focuses on health care that establishes a partnership between clinicians, patients, and their whanau to ensure that decisions respect patients’ wants, needs and preferences. It emphasises that information and interactions focus on the patient and solicit their input on the education and support they need to make decisions and participate in their own care.

• People are at the core of every organisation, and an organisation’s employees – its people – are the most important investment it will make. Even as technology advances and funding shifts, it is the leadership and personal contributions of the individual employees who comprise an organisation’s workforce that ultimately make the difference. Great workplaces foster an environment of communication, fairness, respect, and trust - while creating opportunities for people to grow as employees, and as individuals.

Ngā tikanga papai Best Practice A focus on best practice is how we will put a ‘People Centric’ system into action. It refers to the practice of pharmacy that responds to the needs of the people who use pharmacist services, to provide optimal, evidence-based care. FIP and WHO advise that best practice will be achieved through:

• a pharmacist’s first concern in all settings is the welfare of their patients.

• the core of the pharmacy activity is to help patients make the best use of medicines. Fundamental functions include the supply of medication and other health-care products of assured quality, the provision of appropriate information and advice to the patient, administration of medication, when required, and the monitoring of the effects of medication use.

• an integral part of the pharmacist’s contribution is the promotion of rational and economic prescribing, as well as dispensing.

• the objective of each element of pharmacy services is relevant to the patient, is clearly defined and is effectively communicated to all those involved. Connections among health-care professionals is the key factor for successfully improving patient safety.

11

He whakapai ake I te hauoraBetter Health Outcomes Pharmacy in MidCentral is committed to delivering Better Health Outcomes to the population of MidCentral. Better Health Outcomes will be achieved through the culmination of a people centric system that is focused on best practice. Through the Care Continuum, Pharmacy in MidCentral will target:

• inappropriate medication prescribing and dispensing;

• increasing the health literacy of the population in terms of medications;

• polypharmacy – in particular for the elderly and mental health patients;

• reducing medication errors and medication related harm;

• reducing medication wastage in the hospital and in the community; and

• developing local services to address health inequities and increase medication concordance.

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Better Health Outcomes are the gradual result of always striving to do things better for our population.

The strategic imperatives and objectives were aligned to create Pharmacy in MidCentral

To provide best practice advice & service

so the people of MidCentral achieve better health outcomes.

Meatia ngā mea ka taeaAs a health system we cannot address all of the causes of health inequity however we have a responsibility to take action in the areas over which we have some control or influence.

Addressing InequitiesAchieving equity requires us to acknowledge that different groups of people may benefit from different approaches to clinical problems in order to get comparable outcomes. “Standard” or “single ways” of dealing with clinical problems do offer equal care for all, but they become inequitable and unfair as soon as there are differences between groups. By contrast, equitable approaches are very rarely equal because they are deliberately designed to respond to problems in ways that minimise the impact of important differences between groups.

We will contribute to addressing inequities in region through ensuring:

Health equity for Maori and priority populations• Increase on time immunisation coverage

rates (including influenza)• Improved engagement with culturally

relevant whānau based health services• Reduced prevalence of tobacco smoking• Increased timely access to local primary

health care services

Our people live longer in good Health• Increased coverage of enrolled population

seen by clinical pharmacy for medicines assessment check.

• Reduced health literacy demands on individuals and whānau

Best value from public health system and resources. • Improved patient experience of Care• Increased ratio of people with a disability

and aged under 65 years who have a service coordination outcome of individualised funding.

• Reduced variation in clinical practices (pathways/standards).

Pharmacy in MidCentral Pū Rongoā Te Pae Hauora o Ruahine o Tararua

Pharmacy in MidCentralTo align with the strategic imperatives, we identified the three pharmacy ‘sectors’ – Hospital, Primary Care and Community Pharmacy. We are moving forward together in order to provide a care continuum for our patients. This will enable them to achieve better health outcomes, through best practice and teamwork.

14Three people

interconnected represents the three sectors of pharmacy

working together.

The health cross represents the patient and the

striving towards better patient health

outcomes.

The name acknowledges all

three sectors and is all encompassing.

The circle represents the

patient care continuum and

how the local action plan encompasses

all pharmacy services.

The three people at the head of the

circle represent the three objectives

of our WHY.

16Mahere ki Anamata Our Roadmap ForwardThe future direction and WHY of Pharmacy in MidCentral has been produced into a infographic format. It demonstrates that our path forward is based on the foundations of the New Zealand Health Strategy and the Pharmacy Action Plan 2016-2020. Our path has been laid through the MidCentral DHB and THINK Hauora strategies which enable us to focus on our WHY and future vision of – People Centric, Best Practice, Better Health Outcomes. Through this, we are paving our way towards providing best practice advice & service so the people of MidCentral achieve better health outcomes.

The three objectives of our

WHY

Paving stones based on the

DHB Strategy

The pillars on which we pave our future:

• NZ Health Strategy

• Pharmacy Action Plan 2016-2020

River & weave relates back to

our commitment to Te Wao Nui a

Tane

Horizon representing

MidCentral District

DHB & THINK Hauora Strategy

documents

To provide best practice advice & service so the people of MidCentral achieve better health outcomes.

Development of How and WhatIn November 2018, 63 members of the Pharmacy in MidCentral community came together to discuss how we can put our WHY into action. The purpose was to provide the structure to help guide the day-to-day decisions that align with our WHY and pave our way forward for Pharmacy in MidCentral.

The Pharmacy in MidCentral community developed how they will put the WHY into action on a 1-3, 3-5 and 5+ year timeframe. Three significant focus areas were identified relating to:

1. Systems2. Services3. Workforce

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Ngā Pūnaha Systems Better and more integrated health care systems that enable access to patient record systems will assist pharmacists with professional decision-making in providing patient-centric services. As pharmacists deliver more patient-centric services in future, they will increasingly use patient management systems to do so. However, ‘systems’ extend further than simply access to PMS systems or harm reducing medication software programmes.

It includes funding mechanisms and systems linked to prescribing and dispensing. Effective systems will enable better patient experiences, address issues of inequity, encourage integrated communication between physicians and pharmacists and help contribute to safe and efficient patient care.

Focus Areas: Population and Personal Health, Medicines Management Services, Minor ailments and referral and dispensing and supply services.

Strategic imperatives: Achieve quality and excellence by design, Connect and transform, primary, community and specialist care, Partner with people and whanau to support health and wellbeing and Achieve equity of outcomes across communities.

Enablers: Information, Partners, Stewardship and Innovation.

Strategic Focuses: Partner with people, community and providers to collectively meet needs of population, Quality Foundation for Success and Activate smart systems to support GPT/IFHCs (health home) to thrive through effective relationships.

Systems and our WHY:People Centric• We will work collaboratively to target

areas of inequities. • Continue to engage with the Ministry

of Health and Ministry of Social Development about the funding of co-payments for prescriptions.

• Continue conversations with the Ministry of Social Development about how WINZ funds patients co-payments and how these can be more efficient in the future.

• We will enable systems to send alerts to community pharmacies when patients are admitted into hospital.

• Engage with the Ministry of Health with respect to special authority numbers and how these are administered.

• We will initiate conversations with external stakeholders around funding based on service weighting, DAMHs and real time claiming.

Best Practice • We will work collaboratively with

healthcare teams and THINK Hauora to enable pharmacist access to PMS systems for critical clinical information.

• We will work collaboratively with stakeholders to enable more efficient pharmacist to clinician communication systems including timely access to clinically relevant information.

Better Health Outcomes• We will work collaboratively with IT

enablers and automation to enhance services provided to our population (including electronic registers and robotics).

• We will encourage wider uptake of NZePS with healthcare teams.

• We will continue to engage with the Ministry of Health about moving towards paperless prescriptions.

• We will enable the implementation of medication monitoring, ordering, and reconciliation programmes.

What does success look like against the Pharmacy Action Plan 2016-2020:Well-designed IT solutions give people better, safer treatment, while enabling more efficient and cost-effective services. People and their treatment providers have access to a core set of personal health information, regardless of the health service setting. New technologies play a significant role in influencing what, how, where and when health services are provided and who provides them. Supporting this approach are fully integrated information technology (IT) systems that enable health professionals to share relevant patient information.

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Services must be delivered in ways that meet people’s needs, take account of their preferences lifestyles and desired health outcomes and make the best use of every point of care. Valuing and respecting people’s time by making access to health services easy and responsive ensures a more positive experience with the health system. Patient access increases when services are closer to home, and impacts positively on the patient experience.

The unique and complementary skillsets of Pharmacists will enable them to deliver services that are responsive to the changing health and equity needs of the MidCentral population, as part of the wider health care team, which supports our population to achieve better health outcomes.



Enablers: People, Information, Partners, Stewardship and Innovation.

Strategic Focuses: Improve access and equity, Co-design integrated care for priority populations, Partner with people, community and providers to collectively meet needs of population, Quality Foundation for Success and Activate smart systems to support GPT/IFHCs (health care home) to thrive through effective relationships.

Ngā Ratonga Services

Services and our WHYPeople Centric• We will promote the services provided

by pharmacy in our community to all stakeholders.

• We will deliver services through connected health care teams, making the most of every contact.

• We will deliver services that target addressing inequities and barriers to access• Develop services that address inequities

for our priority populations

• Work collaboratively with iwi to provide services on Marae

• Develop services to target remote populations• We will provide face-to-face services where

possible. • Pharmacist provision of pharmaceutical care

services that enhance health and wellbeing.• We will ensure that all non-hospital medications

are dispensed by the patients preferred community pharmacy.

Best Practice • We will develop services that enable qualified

Pharmacists to treat minor ailments and reduce the daily pressures on healthcare teams.

• We will work with general practice to enable pharmacists to refer patients to healthcare teams.

• We will work with healthcare teams to develop a service for identified long term conditions.• For example: for stable Gout and diabetes

patientsBetter Health Outcomes• We will review the existing services and

investigate to how these can be improved• For example: LTC programme, reporting

metrics for primary care support pharmacists, the number of clinical pharmacists in the hospital.

• We will work with prescribers to reduce medicine waste.

• We will deliver services in environments that do not adversely affect a person’s health or wellbeing.

• We will work collaboratively across sector to enable connected pharmacy services that ensure better health outcomes for our patients and are closer to home.

What does success look like against the Pharmacy Action Plan 2016-2020:Pharmacists are working in a broader range of settings. These settings may include (for example) community pharmacy, Whānau Ora, primary care, aged residential care and hospitals; new business models may also be developed to suit these more diverse settings. The medicines management expertise of pharmacists and pharmacist prescribers is fully used across the health and social sectors, as part of health care teams who may be working virtually or in the same physical location. In particular, these pharmacists play an important role in managing the care of people with complex medicine regimens. Contracts are aligned across the sector to identify and manage high-risk groups. The services are cost-effective to the whole system, materially reducing daily pressure on healthcare teams and other acute care settings so that clinicians can prioritise people with more complex needs.

SERV

ICES

SERV

ICES •

We

will

pro

mot

e th

e se

rvic

es p

rovi

ded

by p

harm

acy

in o

ur

com

mun

ity

to a

ll st

akeh

olde

rs.

• W

e w

ill d

eliv

er se

rvic

es th

roug

h co

nnec

ted

heal

th c

are

team

s,

mak

ing

the

mos

t of e

very

cont

act.

•

We

will

del

iver

serv

ices

that

targ

et a

ddre

ssin

g in

equi

ties

and

ba

rrie

rs to

acc

ess

• W

e w

ill re

view

the

exis

ting

serv

ices

and

inve

stig

ate

to h

ow

thes

e ca

n be

impr

oved

• W

e w

ill w

ork

colla

bora

tive

ly a

cros

s sec

tor t

o en

able

conn

ecte

d ph

arm

acy

serv

ices

that

ens

ure

bett

er h

ealt

h ou

tcom

es fo

r our

pa

tien

ts a

nd a

re c

lose

r to

hom

e.

• W

e w

ill e

nsur

e th

at a

ll no

n-ho

spit

al m

edic

atio

ns a

re d

ispe

nsed

by

the

pati

ents

pre

ferr

ed co

mm

unit

y ph

arm

acy.

•

We

will

dev

elop

serv

ices

that

ena

ble

qual

ified

Pha

rmac

ists

to

trea

t min

or a

ilmen

ts a

nd re

duce

the

daily

pre

ssur

es o

n he

alth

care

team

s.

• W

e w

ill w

ork

wit

h pr

escr

iber

s to

redu

ce m

edic

ine

was

te.

• W

e w

ill d

eliv

er se

rvic

es in

env

iron

men

ts th

at d

o no

t adv

erse

ly

affec

t a p

erso

n’s h

ealt

h or

wel

lbei

ng.

• W

e w

ill w

ork

wit

h he

alth

care

team

s to

deve

lop

a se

rvic

e fo

r id

enti

fied

long

term

cond

itio

ns.

• W

e w

ill w

ork

wit

h ge

nera

l pra

ctic

e to

ena

ble

phar

mac

ists

to

refe

r pat

ient

s to

heal

thca

re te

ams.

Present to 2022 2022-2025 2025+“P

eopl

e do

nt b

uy w

hat y

ou d

o.Th

ey b

uy w

hy yo

u do

it.”

- S

imon

Sin

ek

Ohu Kaimahi WorkforceCurrent models of care do not make the best use of pharmacists’ capacity and unique skill set or promote a ‘one team’ approach to providing health care. To respond to the changing burden of disease, the health and disability workforce needs to be structured differently. Workforce planning is important as it makes everyone in the team look to the future, for themselves, the business and the industry.

It helps aspiring team members push themselves forward, it helps to reorganise people into roles that their skills are more suited to and it helps to anticipate the future, so there are no surprises. It requires the team to design a plan that considers all business and industry eventualities.

Effective workforce planning is, in essence, an integrated talent management system that can help our industry build and grow, always looking to the future and anticipating the next step. Workforce planning is particularly relevant during times of industry change, helping to enable us to be resilient to change as well as face the challenges ahead in a positive and proactive way.



22

Enablers: People, Partners and Innovation.

Strategic Focuses: Partner with people, community and providers to collectively meet needs of population and Quality Foundation for Success.

Workforce and our WHYPeople Centric• We will invest in developing a sustainable

workforce for Pharmacy in MidCentral• Develop a workforce plan that outlines

skills required in the future and how we will meet the need.

• We will work with key stakeholders to ensure unrivalled recruitment strategies and high levels of retention in MidCentral.

• Enable career development opportunities across the industry for those that seek to upskill.

• Review the current professional skill levels across the district to maximize patient benefit across the population – integrate this into the workforce plan.

• When making hiring decisions, ensure that those hired align to our WHY.

• We will ensure that new providers in the area add value to MidCentral and align to our WHY • Services are provided from within

MidCentral• They add value to the workforce (people

and skills)Best Practice • We will ensure that our teams have the

knowledge and skills to operate in a best practice manner. • Use of technical workforce for technical

tasks – i.e. PACTs• Development of more online training

modules to enable further upskilling• We will continue to develop relationships

with our medical peers to increase interprofessional trust. • Development of best practice

prescribing advice.Better Health Outcomes• We will encourage pharmacists to

participate in medical Multi-Disciplinary Teams. • Participation in the LTC review and MDT

teams.• Participation in Healthcare Teams.• Increase pharmacy workforce skill base

to enable pharmacists to spend more time with their patients.

• We will identify new ways to provide better health outcomes to our population.• PACTs in rural communities.• Prescribing pharmacists managing LTC

patients.• Primary Care Support Pharmacists

employed as part of the healthcare teams.

Wor

kfor

ce 2025

+20

22 - 2

025

pres

ent

to 20

22

A w

orkf

orce

pla

n th

at o

utlin

es

skill

s req

uire

d in

the

futu

re

and

how

we

will

m

eet t

he n

eed.

We

will

inve

st

in d

evel

opin

g a

sust

aina

ble

wor

kfor

ce fo

r Ph

arm

acy

in

Mid

Cent

ral.

Curr

ent

prof

essi

onal

skill

le

vels

acr

oss

the

dist

rict t

o m

axim

ize

patie

nt

bene

fit a

cros

s the

po

pula

tion

We

will

ens

ure

that

ou

r tea

ms h

ave

the

know

ledg

e an

d sk

ills t

o op

erat

e in

a b

est p

ract

ice

man

ner.

Cont

inue

to d

evel

op

rela

tions

hips

w

ith o

ur m

edic

al

peer

s to

incr

ease

in

terp

rofe

ssio

nal

trus

t.

Iden

tify

new

w

ays t

o pr

ovid

e be

tter

hea

lth

outc

omes

to o

ur

popu

latio

n.

Ensu

ring

that

th

ose

bein

g hi

red

alig

n to

ou

r WH

Y.

Valu

e is

add

ed

to th

e w

orkf

orce

th

roug

h pe

ople

an

d sk

ills.

Ensu

re th

at n

ew

prov

ider

s in

the

area

add

val

ue to

M

idCe

ntra

l and

al

ign

to o

ur W

HY.

Enco

urag

e ph

arm

acis

ts to

pa

rtic

ipat

e in

m

edic

al M

ulti-

Disc

iplin

ary

Team

s.

Care

er

deve

lopm

ent

oppo

rtun

ities

ac

ross

the

indu

stry

for

thos

e th

at se

ek

to u

pski

ll.

Serv

ices

pr

ovid

ed h

ave

a fo

otpr

int

with

in

Mid

Cent

ral.

Incr

ease

d us

e of

tech

nica

l w

orkf

orce

for

tech

nica

l tas

ks.

Incr

ease

pha

rmac

y w

orkf

orce

skill

ba

se to

ena

ble

phar

mac

ists

to

spen

d m

ore

time

with

thei

r pat

ient

s. Pr

imar

y Ca

re

Supp

ort

Phar

mac

ists

em

ploy

ed a

s par

t of

the

gene

ral

prac

tice

team

s.

Pres

crib

ing

phar

mac

ists

m

anag

ing

LTC

patie

nts.

PA

CTs i

n ru

ral

com

mun

ities

.

Deve

lopm

ent

of m

ore

onlin

e tr

aini

ng m

odul

es

to e

nabl

e fu

rthe

r up

skill

ing.

A te

am is

not

a

grou

p of

peo

ple

that

wor

k

toge

ther

. A te

am

is a

gro

up o

f pe

ople

that

tr

ust e

ach

othe

r.

- Sim

on S

inek

W

orkf

orce

pla

n th

at o

utlin

es sk

ills r

equi

red

in th

e fut

ure

En

able

care

er d

evel

opm

ent o

ppor

tuni

ties

Inc

reas

e ph

arm

acy

wor

kfor

ce sk

ill b

ase

S

ervi

ces a

re p

rovi

ded

from

with

in

24

For The Golden Circle to work properly, we must have: 1. Clarity of Why,2. Discipline of How, and 3. Consistency of What. No one section of The Golden Circle is more important than the other. The most important thing is to achieve a balance across all three. WHY:If we don’t know WHY we do What we do, how can we expect anyone else to know? For others to know our WHY, we must first have clarity of our own Pharmacy in MidCentral WHY.

To provide best practice advice and services so the people of MidCentral achieve better

health outcomes.People Centric - Best Practice - Better

Health OutcomesHOW:These are the actions that we will take to bring our cause to life must be aligned with our WHY. WHAT:Everything we say and everything we do must be consistent with what we believe. The only way people will know what we believe is if we say and do the things we actually believe.

What does success look like against the Pharmacy Action Plan 2016-2020:Following a ‘one team’ approach, all health professionals are using each other’s complementary skill sets and working collaboratively to improve health outcomes. The workforce is culturally competent and, in particular, pharmacy practice acknowledges the special relationship with Māori and the commitment to partnership, protection and participation under the Treaty of Waitangi. The health system uses the capability and capacity of the pharmacy workforce to achieve the greatest benefits. Pharmacy technicians, including PACTs, take on some of the non-clinical tasks that pharmacists previously carried out. Pharmacists are less involved in the technical aspects of medicines supply and provide people-centred care across a wide range of practice settings. People interested in a career in health see pharmacy as a viable long-term option that offers a range of practice opportunities. Pharmacists have a structured professional development pathway that attracts and retains people with the right skill mix to support new models of care. Development of the pharmacy workforce is aligned with development strategies for the broader health workforce.

25

WhyLegend:

HowWhat

SYSTEMSW

ORKF

ORCE

SERVICES

To provide best practice advice & service

so the people of MidCentral achieve better health outcomes.

People Centric. Best Practice.Better Health Outcomes.

W

orkf

orce

pla

n th

at o

utlin

es sk

ills r

equi

red

in th

e fut

ure

En

able

care

er d

evel

opm

ent o

ppor

tuni

ties

Inc

reas

e ph

arm

acy

wor

kfor

ce sk

ill b

ase

S

ervi

ces a

re p

rovi

ded

from

with

in

T

he c

urre

nt p

rofe

ssio

nal s

kill

leve

ls m

axim

ise

p

atie

nt b

enef

it ac

ross

the

popu

latio

n

Te Awheo Atamai – the Golden circle

We will promote the services provided by

pharmacy in our community to all

stakeholders.

We w

ill ensure

that our teams

have the

knowledge and skills

to operate in a best

practice manner.

We will work collaboratively with general

practice teams and THINK Hauora to enable

pharmacist access to PMS systems for

critical clinical information.

We w

ill enable the implem

entation of

medication m

onitoring, ordering, and

reconciliation programm

es.

We w

ill continue to engage with the

Ministry of Health about moving

towards paperless prescriptions.

We w

ill work collaboratively with IT

enablers and automation to enhance

services provided to our population

We w

ill encourage wider

uptake of NZePS with

healthcare

teams.

We will work collaboratively to

target areas of inequities.

We will encourage

pharmacists to

participate in

medical Multi-

Disciplinary Teams.

We w

ill continue to

develop relationships

with our m

edical peers

to increase

interprofessional trust. We will identify

new ways to provide

better health outcomes

to our population.

We will work

collaboratively across sector

to enable connected pharmacy

services that ensure better

health outcomes for our

patients and are closer to home.

We

will

inve

st in

dev

elop

ing

a su

stai

nabl

e w

orkf

orce

for

Phar

mac

y in

Mid

Cent

ral

We

will

wor

k w

ith k

ey

stak

ehol

ders

to e

nsur

e

unriv

alle

d re

crui

tmen

t

stra

tegi

es a

nd h

igh

leve

ls o

f

rete

ntio

n in

Mid

Cent

ral.

We will deliver

services that ta

rget

addressing inequities

and barriers to

access

We

will

wor

k w

ith

heal

thca

re te

ams t

o

deve

lop

a se

rvic

e fo

r

iden

tifie

d lo

ng te

rm

cond

ition

s.

We will ensure th

at all

non-hospital

medications are dispensed

by the patie

nts

preferred community

pharmacy.

We will develop services th

at

enable qualified

Pharmacists to

treat m

inor ailm

ents

and reduce the daily pressures on

healthcare teams.

We

will

del

iver

serv

ices

in

envi

ronm

ents

that

do n

ot a

dver

sely

affe

ct a

per

son’

s

heal

th o

r wel

lbei

ng.

We

will

revi

ew th

e ex

istin

g

serv

ices

and

inve

stig

ate

to h

ow

thes

e ca

n be

impr

oved

We

will

wor

k w

ith p

resc

riber

s

to re

duce

med

icin

e w

aste

.

We will deliver services through connected health

care teams, making the most of every

contact.

We

will

ens

ure

that

ne

w p

rovi

ders

in th

ear

ea a

dd va

lue

to

Mid

Cent

ral a

nd a

lign

to

our

WHY

We will initiate conversations with

external stakeholders around funding

based on service weighting, DAMHs and

real time claiming. We will e

nable systems to send alerts to

community pharmacies when patients are

admitted into hospital.

Engage with the Ministry

of Health with respect to

special authority

numbers and how

these are administered.

We will work collaboratively with

stakeholders to enable more

efficient pharmacist to clinician

communication systems

including timely access to

clinically relevant information.

Develop services that address inequities

When making hiring decisions, ensure that

Phar

mac

ist p

rovi

sion

of p

harm

aceu

tical

D

evelop services to ta

rget

We will p

rovide face-to-fa

ce services

for our priority populations

those hired align to our WHY

car

e se

rvic

es

remote populations

where possible

Work collaboratively with iwi to provide

They add value to the workforce

Review

exist

ing

serv

ices

such

as C

PAM

S

services on Marae

Use of technical workforce for technical

tasks - i.e. PACTS

and

long

term

cond

ition

s

Development of m

ore online modules

Development of best practice advice

Participation in district reviews and MDTs

Participation in Healthcare teams

PACTS and prescribing pharmacists

PCSPs employed by Healthcare team

s

Continue conversatio

ns with the Ministry of Social Development Initiate conversations with Ministry of Social Development Wider im

plementation of NZePS

a

bout how WINZ funds patients co-payments and how with respect to how WINZ funded patients pay

Eff icient real time claim

ing and DAMHs paym

ents

these can be more eff icient in the future. co-payments and how these can be more eff icient

Increase comm

unication and collaboration

between clinicians

DAMH – Drug, Alcohol and Mental Health Patients under the Mental Health Act.

DHB – MidCentral District Health Board

FIP - International Pharmaceutical Federation

GPT – General Practice Teams

IFHC – Integrated Family Health Centres

ISM - Integrate Service Model

IT – Information Technology

LTC – Long Term Conditions

MDT – Multidisciplinary Team

MOH – Ministry of Health

NZePS – New Zealand Electronic Prescription Service

PACTS – Pharmacy Accuracy Checking Technician

PMS – Patient Management System

WHO – World Health Organisation

WINZ – World and Income New Zealand

Glossary

LIVES WELLHEALTHYLIVINGQUALITY

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