Summary of Submissions from CPHAC/DISAC Agenda 25 Oct

   

Media Release

26 October 2011

Disability Support Services

Yesterday (25/10) Nelson Marlborough District Health Board considered feedback from Disability Support Services (DSS) consultation and passed recommendations that a trust be formed as a new governance model for the service.

Clients, family/friends and staff of the service were included in consultation that came from a Rutherford Review of services. Yesterday family and friends of DSS clients also took the opportunity to make a presentation to the Board and Advisory Committee.

DSS supports over 220 clients and employs over 270 full time equivalent employees in residential and day services.

NMDHB is one of only two DHBs that continue to provide residential and day support services for people with an intellectual or physical disability. In 2007 following consultation with the service the Board resolved to continue the status quo until a long term strategic view was established and agreed that will inform future direction and viability. 

NMDHB’s consultation with family and clients centred on two governance/ownership options: that an already identified existing provider takes on the residential service currently provided by NMDHB, or when it is financially sustainable a community-based trust is established to provide the service. The latter of these options was ratified by the Board yesterday (25/10).

Other aspects consulted on were the financial sustainability of the service including resolving issues with client funding, and changes to the service delivery model.

The consultation period was one month with meetings being held with ResCare an advocacy group associated with intellectual disability, service clients, client council, staff and unions.

Of the 104 people who made submissions 81 provided feedback on the financial sustainability recommendations with 60 focusing mainly on the need to resolve the client funding issue.

NMDHB Business Development Manager, Keith Rusholme said, “There were some recurring points on feedback on financial sustainability, along with general support for the initiatives.

In submissions many people expressed confidence in the current service provision and governance, most of those responses did say that if the Board chose not to provide the service in future the preferred option was to establish a local Trust.

“Regarding appropriate funding for clients, DHB Chief Executive John Peters met with Ministry of Health officials during September and from this meeting there was some agreement on a process to review the funding for some clients.

Mr Rusholme said three expressions of interest were received from other providers for the provision of services if the Board was to decide to explore the transfer of service to another provider. These were from:  NZ Care, Patients and Community Trust (PACT), and  Manawatu Accommodation and Sheltered Housing Trust (MASH).

These trusts also offered to walk alongside NMDHB to assist in developing a local trust.

ENDS

Information

The consultation covered three aspects of Disability Support Services (DSS).

Governance /Ownership structure. Two options were given; form a Trust or another organisation/s takes responsibility for the service.

Financial sustainability. This section contained a number of recommendations to ensure the future financial viability of the service.

Service delivery. This section made recommendations of developing a more person centred service delivery model.

The Board passed the following recommendations in the 25 October meeting following Community and Public Health and Disability Advisory Committee feedback from their meeting on the same day:

THAT THE WORK BE COMPLETED TO RESOLVE THE FUNDING ISSUES. THAT SUBJECT TO THIS:

1. THAT THE BOARD SEEK APPROVAL FROM THE MINISTER TO ESTABLISH A TRUST FOR THE TRANSFER OF DSS
2. THAT A REPRESENTATIVE GROUP BE ESTABLISHED OF BOARD MANAGERS, RESCARE REPRESENTATIVE, MOH REPRESENTATIVE, NASC MANAGER, AND EXTERNAL EXPERTISE TO DEVELOP AN IMPLEMENTATION PLAN FOR THE DEVELOPMENT OF THE TRUST AND TO OVERSEE THE TRANSFER OF SERVICES TO THAT TRUST
3. THAT THE BOARD CONSIDER THE ASSETS* THAT WOULD BE TRANSFERRED TO THE TRUST TO ENSURE IT IS VIABLE
4. THAT THE INITIATIVES IN REGARDS TO FINANCIAL VIABILITY AND SERVICE DEVELOPED AS OUTLINED IN THE CONSULTATION DOCUMENT BE SUPPORTED FOR IMPLEMENTATION
5. THAT THE ADDITIONAL COST SAVING MEASURES RECEIVED THROUGH THE CONSULTATION PROCESS BE FULLY EXPLORED BY DSS
6. THAT THE IMPLEMENTATION PHASE OF THE RECOMMENDATIONS INCLUDE INVOLVEMENT OF STAFF AND UNIONS SO THAT AN INCLUSIVE PROCESS IS UNDERTAKEN.

“Please note that at this stage the “assets” to be considered for transfer are not quantified but will be part of the discussion and the trust formation negotiation.

Please see the Community Public Health /Disability Support Advisory Committee (CPHAC DISAC) Agenda of 25 October 2011 for more details of the consultation submissions see Appendix 4  DSS Consultation Feedback Summary. http://www.nmdhb.govt.nz/BoardCommitteesAgendas.aspx

 

 

 

Feedback Form

 

Disability Support Service Clients, families and staff are asked to send feedback on the proposal by 5pm 23 September 2011

To:

Heather Janssen

DHB Office Manager

Disability Support Services Nelson Marlborough

District Health Board

Private Bag 18

Nelson 7042

or email heather.janssen@nmdhb.govt.nz

 

 

Media Release

23 August 2011

 

Nelson Marlborough District Health Board (NMDHB) is seeking feedback from Disability Support Service (DSS) clients, families and staff on recommendations that includes future governance/ownership of the service. More... 
Further Information

 

 

Nelson Marlborough District Health Board’s (NMDHB) consultation on how Ophthalmology services might be made more efficient to allow more patients to get their treatment now closes on January 28.

The DHB has extended the consultation timeframe to allow more time for submissions to be developed.

The consultation is based on a report from the Rutherford Initiative. The initiative looks at all services and contracts within DHB to determine whether there is a more efficient way of providing the same level of service.
The name comes from the famous Earnest Rutherford quote “We haven’t got the money, so we’ve got to think”.

Four years of Ophthalmology Service data was analysed to arrive at the proposed options for the future development of the service. One option is to outsource all or part of Ophthalmology services at no cost to patients. The second is to maintain the provision of the service in-house but with changes to models of care that would free up specialist consultants to see more patients with higher needs.

NMDHB, Medical Surgical Service Director, Dr Peter Bramley said, “Either of these options would give quicker, sooner, more convenient treatment to ophthalmology patients.

“While there are no ongoing savings made with the outsourcing option there is a one off saving of $2.5m. This represents the amount that would be saved on the redevelopment of the Surgical Outpatients Department.

“With the option of reconfiguration of in-house services there is a potential annual saving of $400,000 if fully implemented.”

The DHB would like to hear from staff and public on these options that have been generated with a view to working smarter and providing a better service. A decision on the reconfiguration of the service is expected to be made in late February.

Dr Bramley said, “Regardless of the option chosen we will continue to provide quality Ophthalmology services to Nelson Marlborough people.

“We understand that examining existing services can create uncertainty but it is important to remember that the focus is about seeking insights to find smarter ways to deliver a better  ophthalmology service.”

ENDS

 

 

FEEDBACK
We are keen to hear your views on the options presented. Please return the Feedback Form enclosed by 5pm , Friday 28 January, 2010. Download the form from: www.nmdhb.govt.nz or from karen.lindsay@nmdhb.govt.nz or phone 03 546 1998. Once feedback is received it will be collated and the proposals reviewed and adjusted if appropriate. A report on the feedback will be circulated with recommendations and a final implementation plan will be developed for the Ophthalmology service.

 

How will a decision be made between the two options?

We will wait for feedback from staff and other stakeholders in the service. Depending on this feedback a decision will be made. It may be that there is no support for outsourcing of the service or we may not be able to reach agreement on an outsourcing contract which will lead to reconfiguration of hospital-based services (or parts) with new models of care and a focus of improving processes for service delivery.

In the service redevelopment how will the new models of care be introduced?

A user group will develop the new models of care based around the model of having some parts of what is currently delivered by SMOs delivered by other trained staff. There may be further consultation in conjunction with HR processes for clinical, nursing and admin staff regarding job structures.

Is outsourcing a step toward privatisation of the public health sector?

The proposal to outsource Ophthalmology services to the private sector is in line with "Better, sooner, more convenient health care". The patient doesn't have to pay for these services and there will certainly be no co-payment. This will be the same public service provided in the private sector.

Are Ophthalmology public patients currently treated at specialists private consulting rooms?

The DHB does from time to time use private specialist capacity to carry out outpatient appointments and surgical procedures.

Is this outsourcing model of delivering a secondary public service in the private sector applied anywhere else in New Zealand?

There are several examples of DHBs who have this model working in their district. Bay of Plenty, for example, has contracted out all of its Ophthalmology services for more than five years.

Is there a danger that putting this service into the private sector will raise the price of delivery to the DHB?

There will be clear parameters in the contracts on costs. There is an expectation that outsourced services will be delivered within national pricing.

Are more hospital services likely to be recommended to be delivered in the private sector?

This is something that is not known at present. We are always considering new models of provision in an attempt to work more efficiently and provide better health outcomes to our patients. Rutherford will look at all clinical areas and may make appropriate recommendations for other services.

 

Media Release - 23 November 2010

Report on the Submissions

Questions and Answers
 

Psychogeriatric Services Consultation

The District Health Board has completed the consultation on the future of psychogeriatric services provided from Alexandra Hospital.

 

The clearest theme to emerge was the need to ensure that any changes are very well planned to
maintain/improve standards of care.

We will work to ensure that residents continue to receive the right services to meet their needs. It is expected that it will take some time for the changes to be effected and we will keep you informed.

 

The current Psychogeriatric community team becomes a specialty team of the Mental Health Service

The seven beds for the assessment of those who are acutely unwell be relocated into a specially renovated wing of the Mental Health Admissions Unit on the Nelson Hospital site;

Long term Continuing Care be provided in the community.;

A clinical leadership group be established with key clinicians from across all relevant Provider areas for Health of Older People, Mental Health, Neurology and other Surgical and Medical areas where appropriate;

The future of the Alexandra Hospital site is considered.

 

Defining the Terms

Community Team

Provide assessments support and education visits in the community to assist people to manage their conditions in their normal environments including aged residential facilities.

This team may arrange acute admission if required.

Acute Beds  

An unwell person may be  admitted to the Mental Health Unit for assessment to find the cause of their mental health issues. Then:

Continuing Care     

This is for people who have been assessed and require residential (continuing) hospital level care.   They may have physical as well as mental health concerns.  Psychogeriatric residents provide challenges to their carers due to their combination of physical and mental health conditions.

 

More information on the consultation - click here

Media Release - 22 September 2010
 

Pyramid of Care - click to Enlarge

 

 

7 September 2010

NMDHB has signed off the Proposal to Dispose of Surplus Property with the final list of properties now identified.

After public consultation community homes used by Intellectual Disability Support Services (IDSS) in Nelson on Halifax, Songer, Tasman St, and Toi Toi St have been retained and will not be declared as surplus. Tapawera Clinic and 450sqm of land will be retained, with the house and some land subdivided for disposal. 

Ministerial consent will now be sought as part of the Crown clearance process.



21 June 2010 - Summary of Submissions Received - Proposed Surplus Property Disposal
Nelson 6 submission received. 
• All six submissions oppose selling of Community Homes.
- Four clients from Community Homes expressing their concerns of selling 79 Halifax St, as it’s their home, close proximity to town, friends and family
- IDSS wishing to retain properties for future use.
- Expressing concerns of selling Clients homes as clients are marginalised enough.
Wairau 6 submission received.
• Two submissions support the disposal, however have tags attached
-  should retain trees in south east corner to protect monarch butterflies.
-  proceeds of sale to be used for further development of services, equipment
• Four submissions oppose sale, stating that land is not DHB’s to sell, should keep for future development. 

Tapawera 17 submission received.
• All seventeen submissions do not oppose the selling of house and land as long as the Clinic and parcel of land is sub-divided off.
  
Murchison 1 submission received.
• Submission supports sale of 113 & 136 Fairfax St with tag that funds should be used for building a staff flat, or accommodation (self contained flats) for elderly on hospital grounds.

An update of submissions will be given at the Board meeting Wednesday 7th July.  A public meeting is to be held in Blenheim on Friday 9th July, 1pm.  A full paper will be then given to Board outlining options and recommendations for approval at the August meeting.


20 April 2010 - Nelson Surplus Land Identified
Consultation: Proposed Disposal of Surplus Property: Nelson Marlborough District Health Board
Pursuant to clause 43, Schedule 3 of the New Zealand Public Health and Disability Act 2000 (“Act”), the Nelson Marlborough District Health Board (NMDHB) proposes to dispose of the following surplus properties.
32 Tipahi St, Nelson: This land is described as Lot 3 DP 4682 INT IN & SUBJ to R/W, area of land 0.0986 hectares
32A Tipahi St, Nelson: This land is described as Lot 4 DP 4682 INT IN & SUBJ to R/W, area of land 0.1991 hectares
113 Kawai St, Nelson: This land is described as Lot 1 DP 20300 INT IN & SUBJ to R/W, area of land 0.1349 hectares
115 Kawai St, Nelson: This land is described as Lot 2 DP 20300 INT IN & SUBJ to R/W, area of land 0.1048 hectares
117 Kawai St, Nelson: This land is described as Lot 2 DP 141, area of land 0.1037 hectares
110 Toi Toi St, Nelson: This land is described as Lot 5 DP 2545, area of land 0.0736 hectares
110A Toi Toi St, Nelson: This land is described as Lot 1 DP 8888, 2 flats, area of land 0.0769 hectares
79 Halifax St, Nelson: This land is described as Lot 5 DP 7787, area of land 0.0607 hectares
271 The Ridgeway, Stoke, Nelson: This land is described as Sec 1 SO 15129 BLK VII Waimea SD, area of land 0.1768 hectares
387 Main Road, Stoke, Nelson: This land is described as Lot 1 DP 6310, area of land 0.0759 hectares
659 Main Road, Stoke, Nelson: This land is described as Lot 4 DP 5220, area of land 0.0809 hectares
67 Songer St, Stoke, Nelson: This land is described as Lot 8 DP 6370 SUBJ to & with INT IN R/W, area of land 0.0850 hectares
125-127 Waimea Rd, Nelson: This land is described as Lots 3 4 DP 4124, area of land 0.2438 hectares
110 Main Road, Tapawera This land is described as PT Lot 5 DP 2610 BLK IX Wai-iti SD, area of land 0.2587 hectares
113 Fairfax St, Murchison: This land is described as PT Sec 49 Town of Murchison, area of land 0.1012 hectares
136 Fairfax St, Murchison: This land is described as Lot1 DP 6531 BLK 1 Tutaki SD, area of land 0.1012 hectares
The Act requires District Health Boards to consult with their communities before disposing of surplus property.
Accordingly, submissions in writing are invited from members of the community served by the Nelson Marlborough District Health Board.
Submissions must be dated, signed and include the following information:
1. Your name, postal address, telephone and fax number and email address (if applicable).
A copy of the submission must be received by NMDHB by 5.00pm Friday 11th June 2010 at the address below:
Marlborough Surplus Land Identified Consultation: Proposed Disposal of Surplus Property: Nelson Marlborough District Health Board
Pursuant to clause 43, Schedule 3 of the New Zealand Public Health and Disability Act 2000 (“Act”), the Nelson Marlborough District Health Board (NMDHB) proposes to dispose of the following surplus properties
Wairau Hospital East Block, including houses 30 – 46 Hospital Rd, Blenheim: Part of Pt Lot 2 Sec 27 OMAKA DIST, area of land is approximately 5.580 hectares This land is yet to be sub-divided off main Hospital block.The Act requires District Health Boards to consult with their communities before disposing of surplus property.
Accordingly, submissions in writing are invited from members of the community served by the Nelson Marlborough District Health Board.
Submissions must be dated, signed and include the following information:
5. Your name, postal address, telephone and fax number and email address (if applicable).
Donna Wiley