SERVICE SPECIFICATION – KAUPAPA MAORI MEDICAL …



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|KAUPAPA MAORI MEDICAL SUPPORT SERVICES |

|SERVICE SPECIFICATION |

|(Te Hauora O Te Hiku O Te Ika services) |

|STATUS: These service specifications may be amended to meet local agreement needs. |NON-MANDATORY ( |

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|Review History |Date |

|Published on NSFL |July 2002 |

|Amendments |July 2012 |

|changed to non-mandatory status by agreement with DHB GMs Planning and Funding. MAOR0117 , | |

|MAOR0118 , MAOR0120 MAOR0121 | |

Note: Contact the Service Specification Programme Manager, National Health Board Business Unit, Ministry of Health to discuss the process and guidance available in developing new or updating and revising existing service specifications.

Web site address of the Nationwide Service Framework Library:

KAUPAPA MAORI MEDICAL SUPPORT SERVICES

SERVICE SPECIFICATION

MAOR0117, MAOR0118, MAOR0120, MAOR0121

1.0 Definition

The Provider will provide medical services complimentary to and in association with all other services of (insert name of provider). The services provided by you are primarily for Mäori but do not exclude people of other cultures. The services delivered will specifically focus on the holistic needs of Mäori, and be prioritised to those with the greatest acuity of need and capacity to benefit. The purpose of this service is to:

1.1 Provide medical advice and support to all services of (insert name of provider) by way of staff training, participation in clinical quality improvement systems and processes such as clinical policy and procedure development

1.2 Provide medical supervision to support extension of the Nurses scope of practice within National Nursing standards and regulations, for example provision of immunisations, cervical screening, and chronic disease management.

1.3 Provide clinical medical services, on referral from another health professional, which are complimentary to, and in association with, all other services of (insert name of provider).

2. Maori Health

The service is expected to contribute to the reduction in health inequalities, the 13 priority Population Health Objectives, as well as the Maori health gain objectives, in particular, targeting services to impact on asthma, diabetes, injury prevention, smoking, hearing, mental health, oral health and immunisation, including violence prevention.

The Maori Health Strategy: He Korowai Oranga is referred to and Maori Health requirements are outlined in the General Terms and Conditions and Provider Quality Specifications. In addition the provider arm of the DHB is to develop and implement a Maori Health Plan that outlines how it will contribute to improving outcomes for Maori for the services contained in this service specification.

The Plan should include the following objectives as a minimum:

• How you will ensure that Maori utilisation is at least equal to the Maori population in the provider's catchment.

• How you will ensure your effectiveness and the acceptability and accessibility of services to Maori

• How links with primary care - general practice, community providers and Maori providers will be effective for improved outcomes in Maori health

• How discharge planning and rehabilitation processes will meet the needs of Maori;

• Links with the DHB provider arm's Maori Health Plan and other contractual quality specifications, especially consultation with Maori.

• How these objectives will be monitored and measured for Maori health outcomes.

3. Outcomes Sought

The key outcomes sought through this service are:

3.1 Effective co-ordination and integration of the services of (insert name of provider) with all other health and disability services

3.2 Clinical development and clinical quality improvement of Nursing and other (insert name of provider) services through training and medical support

3.3 Contribution to the ongoing development of (insert name of provider) as an Integrated Primary Health Organisation

3.4 Contribute Medical input to ensure timely access to culturally appropriate primary medical services for all clients of (insert name of provider) complimentary to and in association with other services of (insert name of provider)

4. Service Users

People who are enrolled with (insert name of provider) and who live within the following boundaries:

The area (insert all boundary areas)

The services provided by you are primarily for Maori but do not exclude people of other cultures. However, and as a priority, the services delivered will focus specifically on the needs of Maori in the service boundaries.

5. Access

Client/whanau access to the medical services will generally be by way of referral from other services of (insert name of provider) and primarily through referral from the primary mobile nursing and health promotion service. Referral from other health professionals outside the (insert name of provider) services will also be accepted for clients already enrolled with (insert name of provider)

6. Service Components

The service will be delivered by a medical practitioner(s) and quality Service Coordinator. The medical services provided under this schedule are not general practitioner services. Rather, they are complimentary to the other services of (insert name of provider).

|SERVICE COMPONENTS |DESCRIPTION |

|Tapuhi Service |Quality Management & Workforce Development |

| |Contribution to ongoing training and upskilling |

|Mobile Primary Nursing and Health Promotion|Provision of a clinical resource for information or case discussion |

|Tamariki Ora |Development of clinical quality improvement systems and processes such as clinical policy and |

|Smoking Cessation |procedure development and clinical audits. |

|Breast Screening Promotion |Development and operation of clinical/delegated authority protocols for nurses to provide some |

|Chronic Disease State Management |treatment services, e.g. emergency contraception. |

|Maternity Support |Staff Occupational health |

| | |

| |Medical Clinical Input to Service: |

| |Medical input to assessment of client or family health needs that are of complex nature |

| |Contribution to specific health promotion projects |

| |Contribution to provision of outreach clinics |

| |Medical input to community health projects, e.g. Hep B Free, Diabetes Management, Immunisation |

| |catch-up |

|Oral Health |Quality Management & Workforce Development |

| |Contribution to ongoing training and upskilling of dental health assistants. |

| |Resourcing dental assistance to provide appropriate response to broader tai tamariki health request |

| |Staff Occupational Health |

| | |

| |Medical Clinical Input to Service |

| |Prescribing treatments for dental infections and pain. |

| |Contribution to specific health promotion projects |

|Mental Health |Quality Management & Workforce Development |

| |Contribution to ongoing training and upskilling of mental health support workers. |

| |Staff Occupational Health |

| | |

| |Medical Clinical Input to Service |

| |Medical input to development of health maintenance plans for individual residential clients. |

| |Development of medication monitoring systems for residential clients |

| |Medical liaison on behalf of clients. |

| |Contribution to specific health promotion projects |

|Disability Support |Quality Management & Workforce Development |

| |Contribution to ongoing training and upskilling of disability support workers. |

| |Staff Occupational Health |

| | |

| |Medical Clinical Input to Service |

| |Occupational health and support for home support service. |

| |Medical liaison on behalf of clients. |

| |Contribution to specific health promotion projects |

6.1 Medical input will be provided in the manner of Quality Management, Workforce Development and Clinical Support to any additional services that (insert name of provider) may provide in the future.

6.2 The Medical Practitioner(s) will facilitate collaboration and integration of other health and disability support services with (insert name of provider) services.

The provider will ensure that the services provided under this Service Contract are integrated and co-ordinated with services provided by other health and disability providers in the region

7. Settings

The medical services will be provided in association with other (insert name of provider) services. The majority of (insert name of provider) services are taken to clients/whanau, wherever is most appropriate to meet the needs of the clients/whanau. Typically these services are provided in the client’s home, at Marae, schools, or other community facilities. In addition the Provider will have available, an appropriate clinic facility at the Kaitaia base of (insert name of provider)

7.1 Staff Training – Disability, Violence and Abuse

Disability

Staff training must be given specifically in:

• disability awareness to ensure disability children/adults and disabled carers are given appropriate access and support

• specific issues in the patterns and identification of abuse and interpersonal violence for these groups.

Violence/Abuse

Staff must have training in how to identify, support and refer victims of child/adult abuse and interpersonal violence. The agency must have protocols in place to support staff in this intervention.

8. Quality Requirements

The service is required to comply with Sections A & B of Part 1 of this Agreement.

9. Additional Clauses

9.1 For this service schedule the funding should be allocated according to 70% medical clinical input and 30 % quality management and workforce development.

REPORTING REQUIREMENTS PART 1

ESTABLISHMENT PHASE

A report on activity for the period (insert dates) to include:

1.1 Staff employed to-date

2. Establishment of Information systems

3. Resources purchased during establishment phase

4. Establishment of appropriate premises

5. (insert name of provider) Strategic plan

REPORTING REQUIREMENTS PART 2

ONGOING OPERATION OF KAUPAPA MAORI MEDICAL SUPPORT SERVICE

2.1 The reporting requirements for this service schedule should be read in conjunction with the reporting requirements of the other services of (insert name of provider) as the outcomes of those other services of (insert name of provider) should reflect the inputs of this service schedule. The reporting requirements of this service schedule should describe how this service has enhanced and complimented the other services of (insert name of provider)

2.2 QUARTERLY QUANTITATIVE REPORTING

2.2.1 Number of Consultations

The number of consultations shall be reported by the following:

• Total consults

• Consults by age group in the following categories:

Tamariki

Tai Tamariki

Pakeke

Kaumatua/Kuia

• An ongoing Client Register showing the following information:

• Total number of clients by ethnicity*

• Total number of clients exiting the service per quarter

• Total number of new clients entering the service per quarter

*Ethnicity is recorded as perceived by the family/whanau. People may therefore perceive themselves as belonging to more than one ethnic group. Ethnicity is to be reported according to the following priority system: if perceived ethnicity includes:

• Maori, report as Maori

• Pacific, report as Pacific

• otherwise, report as Other.

2.2.2 Location of Consultations

Consultations shall be reported by the following locations:

• Client’s home

• Marae

• (insert name of provider) base

• School

• Other community setting

2.2.3 Outcome of consultations

The outcome of consultations will be recorded according to the following:

• A = Management recommended without referral

• B = Referral to GP

• C = Referral for acute admission

• D = Referral for outpatient type assessment

2.2.4 Format of Quarterly Quantitative Report

| |Number of consults |Location of consults |Outcome of consults |

|Tamariki e.g. |24 |6 Marae, 6 school, 12 kura kaupapa |20A, 0B, 4C, 0D |

|Rangatahi | | | |

|Pakeke | | | |

|Kaumatua/Kuia | | | |

|Total Consults e.g. |600 |576 Client’s Home, 6 Marae, 6 |596A, 0B, 4C, 0D |

| | |School, 12 kura kaupapa | |

2.3 QUARTERLY NARRATIVE REPORTING

2.3.1 Medical Clinical Input To Service

2.3.2 A narrative report will be provided quarterly describing the nature of medical clinical input to (insert name of provider) services. The report will include the following information:

• A summary of the nature of conditions seen by medical practitioner

• Health Issues, concerns raised by KMMS service

• Planning considerations as a result of issues, concerns raised

• Evaluation of responsiveness to trends seen

• Comments on health outcomes observed as a result of the above

2.3.3 Quality Management and Workforce Development

2.3.4 The narrative report on quality management and workforce development will include the following information:

• CQI plans

• CQI activity implemented

• Workforce development needs

• Workforce development provided to whom

• Outcomes of workforce development

2.4 ANNUAL REPORTING

2.4.1 In addition to the above quarterly reporting requirements, this service is required to submit an annual report. The annual report should include, but not be limited to the following:

• Trends in incidence of illness and injury

• The current disease prevalence in the client population

• Immunisation rates

• Cervical screening rates

• Breast screening rates

• Hep B screening rates

• Smoking cessation rates

• Diabetes annual review numbers

• The status of effective co-ordination and integration of Te Hauora O Te Hiku O Te Ika services with other health and disability support services.

• The status of your continuous quality improvement programme

• Organisational development achievements

• Key issues and risks should be identified

DUE DATES FOR SERVICES REPORTING

SERVICE REPORTS

The provider will report on service delivery and programme development progress using the performance indicators specified in the Schedules.

|REPORT – ESTABLISHMENT |REPORT DUE DATE |

|Report on Activity 1 July 2001 to 30 June 2002 |20 July 2002 |

|QUARTERLY REPORT |REPORT DUE DATE |

|1st quarter ended 30 June |20 July |

|2nd quarter ended 30 September |20 October |

|3rd quarter ended 31 December |20 January |

|4th quarter ended 31 March |20 April |

|5th quarter ended 30 June |20 July |

|ANNUAL REPORT |REPORT DUE DATE |

|Annual report on service activities, as stated above in clause 2.4 |20 April each successive year, (2003, 2004) |

Monthly payments will be suspended if reports are not received by the due date.

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