build knowledge about various service options including optimum skill-mixes, client focus and cost effectiveness;

INTRODUCTION

The Coordinated Primary Options (CPO) project recognises that people may often be admitted to hospital because of financial and/or other barriers in gaining access to services in the community. Therefore, CPO’s purpose is to:

 enable Primary Care teams to access community based services, offering alternatives to acute hospital admission;

 build knowledge about various service options including optimum skill-mixes, client focus and cost effectiveness;

 identify and where appropriate, address communication and service gaps that contribute to hospital admissions;

 encourage general practice insights into issues and general practice support for reducing hospital admission;

 support practice changes required to achieve the goals of reducing the level of acute admissions and achieving integrated services.

A range of community diagnostic, therapeutic and logistic services are available at no cost (excluding the initial GP consultation) to the patient. Examples of these include:

 Diagnostic tests – X rays, ultrasound

 Home visits by GP and/or practice nurse;

 Follow up and return visits to GP locations;

 Transportation;

 Rest Homes

 Community IV therapy

Coordinated Primary Options is flexible and easy to use – accessing the services requires forwarding completed referral and invoice forms, either electronically through Medtech or manually through paper based forms.

CPO PATHWAY

Patient presents and pays for Initial Consultation with GP

Would you normally refer

this patient to hospital? NO

Manage patient in usual way.

Can you safely manage this patient with $300 funding for up to 5 days?

Refer patient to hospital.

Can you take clinical responsibility for this

patient’s care?

Can a colleague or A&M doctor take clinical responsibility for this

episode? NO NO Contact CPO coordinator on 027 245 4015, if required

Provide services within your own practice or refer to another GP provider as required (for

certain pathways)

Complete Referral Form and submit or fax to 8734960

Yes

Attach CPO number to all correspondence relating to patients episode of care including prescriptions, X-ray requests etc.

Submit electronically or Fax a referral form to the Service Coordinator

After Completion of Care: 1. Complete Outcome/Invoice Form-electronic or manual

2. Submit or Post forms to CPO Coordinator: P O Box 11141 Hastings or Fax to 06 8734960.

Yes

Yes

NO

REFERRING A PATIENT TO CPO

Which patients are eligible to access CPO services?

Any patient who resides in Hawkes Bay (including Wairoa, Waipukurau, Waipawa), and would have otherwise been referred acutely to hospital.

How are services accessed for the patient?

Complete an electronic referral form and submit, OR fax a manual form to 8734960. If the Service Coordinator assistance is required, phone (027) 245 4015.

Electronic referrals are installed on MedTech and My Practice as advanced forms

Who has clinical responsibility for the patient while receiving CPO services?

By accessing CPO, the referring GP agrees to take clinical responsibility and ongoing care for the patient in the community.

What happens if a patient requires admission after all?

Refer to hospital services in the usual way. It is essential that patients receive the safest and clinically appropriate treatment and be admitted when necessary – risks should never be taken to avoid an admission. CPO will pay for services already provided within primary care.

How much is allocated per patient per episode of care?

$300 (incl GST) is allocated per episode (GP visits, scans, medications, etc included). Discuss with the Service Coordinator if the episode of care may exceed $300.

How much can be charged for services?

A schedule of fees is on the outcome/ invoice form.

How many days can a patient be under CPO?

The episode of care should be likely to have completely resolved in five days.

Can the Practice team provide CPO services?

Yes. Some examples of practice based services are:

 Practice nurse consultation or observation;

 IV therapy

 GP/PN home visits

When should the Referral form be faxed to CPO?

The referral form should be received by the Service Coordinator within 24 hours of the patient’s initial consultation or the next normal working day.

How are Practice-based services claimed back?

Complete an Outcome form and submit electronically.

Or Post the manual outcome form to the Service Coordinator when the episode of care is complete. For manual forms send the original referral form as well.

You will receive payment for your care by the 20th of the month if all documentation is in order.

Does the patient have to pay for CPO?

No. Their initial GP consultation incurs the usual practice charge and thereafter, all services are provided at no cost to the patient.

Can CPO services be accessed for the same patient for more than one episode of care?

Yes, funding is allocated per patient, per episode of care.

Are there any conditions or situations where patients should be admitted straight to hospital rather than CPO?

The clinical judgment rests with the GP. Examples include:

 Patients with chest pain of cardiac origin;

 Patients who suffer a stroke;

 Older, frail adult with multiple medical problems.

Are there some conditions not covered by CPO?

 Only conditions specified as pathways are funded under CPO

Who can help with medical advice?  Dr Alan Wright

CPO Medical Advisor Telephone: 873-8999 Mobile 021 2544145

 Appropriate Registrar

 Physician of the Day

How can further information be obtained if the need arises?

SERVICE PROVIDERS

Radiology

Address Telephone Fax

Hawkes Bay Radiology Prospect Road

HASTINGS

873-1166 873-1167

Hawkes Bay Radiology Kennedy Road Greenmeadows NAPIER 845-3306 845-3307 Onsite Ultrasound Unit 3 62 Munroe Street NAPIER 080 991119 835-1705 Onsite Ultrasound Canning Road Hastings 0800 991119 870-4403

 Send patient by taxi if necessary (using Hastings Taxis). Please ensure the taxi driver knows not to wait while the procedure is performed.

 All referrals must have a completed referral form with the CPO reference number included.

Pharmacy

Provider Contact Phone/Fax

The Pharmacy

The Hasting Health Centre 101 Queen Street East HASTINGS

Paul Messerschmidt Phone 873-8585 Fax: 873-8586

Radius Care Pharmacy 32 Munroe Street NAPIER

Fraser Smith Phone 834-0884 Fax: 873-8586

Taradale Medical Pharmacy Taradale Medical Centre Puketapu Road Taradale Richard Barley Rachael McNeil Phone 845-2790 Fax: 845-1583

1. All medications that are prescribed under CPO can only be supplied by the above pharmacies. These are IV cefazolin, moxifloxicin, gentamycin, clexane.

2. This does not include those medications available on the MPSO or prescriptions given at the completion of the episode of care ie: oral antiobiotics, dexamethasone, intravenous saline (1L).

Transport

The Coordinated Primary Options taxi service may be used to transport patients to and from any of the CPO Service Providers.

Provider Contact Phone/Fax

Hastings Taxis 303 Railway Road HASTINGS

Phone 878-5055

When ordering a taxi you must:

1. State that it is a Coordinated Primary Options pick-up and should be charged to the CPO account. Also give the reference number and name of the patient.

Community IV Therapy Provider

For patients requiring IV therapy, who are unable to come into the surgery and are suitable to receive IV Cefazolin in their home or rest home.

The responsibility of care remains with the referring General Practitioner

Provider Contact Phone/Fax

Health Care NZ Hawkes Bay P O Box 953

21 Browning Street NAPIER

Dianne Sharplin Phone 834-4214 Fax: 834-4215

For this service to commence, please contact Dianne Sharplin on 027 449 1803. The GP needs to complete the Community IV Referral Form (found in outbox in Medtech, or paper based) and fax to 834 4215 before 2pm.

 The original referral form must be posted to: IV Community Nurse,

PO Box 953, Napier. Key points for Referral Form:

 The prescription component of the form must be written in legible writing and signed by the prescribing doctor

 The first dose of the drug must be given within the general practice/ Afterhours Medical Centre

 The referral form must be faxed to 834 4215 before 2pm Monday to Friday, if you wish the nurse to commence IV therapy on that day.

 For queries regarding this referral contact IV Community Nurse on 027 4491803

 The practice will be contacted via phone to confirm acceptance

 The GP is able to utilise the nurses am, pm or both. (You need to specify this on the referral form.)

 A contact number of the prescribing GP must be available for the nurse, including an afterhours number.

 GP’s will be contacted if the patient’s condition deteriorates; the IV tissues or the nurse has concerns with the patient’s condition.

 Patients are advised to visit their GP at the completion of treatment

 There is weekend and public holiday cover if the patient has commenced treatment prior to the weekend or public holiday. No new referrals are able to be accepted over a weekend or a public holiday.

NB: The cost for this service will be included as part of the package of care with an anticipated value of $300.

Any queries please contact Sonya Harwood, CPO Coordinator on 027 2454015