Procare

Annual Report 2016

Caring for Aucklanders through high quality general practice

Our Network

ProCare is New Zealand's largest network of primary healthcare professionals. We are a member organisation, with a shareholder base of more than 180 Auckland general practices who choose to be part of ProCare. Our practices provide family-based healthcare to more than 820,000 Aucklanders.

Clinical excellence is paramount to all we do. High-quality care is delivered across our network through high-quality general practice. ProCare works to support and empower our practices to do this. We are committed to a system that appropriately meets the needs of each individual and whanau through planned proactive care for long term conditions and disabilities; timely and accessible acute care when needed and comprehensive preventative care to promote health and wellbeing.

The Year for ProCare's Enrolled Population

Our Network

Achievements

SUPPORTING THE PROCARE NETWORK

All of our work is driven by three things we are passionate about: clinical excellence, thriving businesses and influential networks.

National Health Targets

Impact

National health targets closing the inequality gap

ProCare’s 180 Auckland general practices achieved significant success against the Government’s health targets in 2015/16.. The ProCare network exceeded the targets set for Primary Health Organisations in four out of the five key areas, only narrowly missing out on the immunisation target for two-year-olds.

  • More Heart and Diabetes Checks (target of 90% of the relevant enrolled population / coverage 93%)
  • Better Help for Smokers to Quit – Primary Care (target of 90% / coverage 92%)
  • Increased Immunisation for eight-month-olds (target of 95% / coverage 95%)
  • Increased Immunisation for two-year-olds (target of 95% / coverage 94%)
  • Cervical Screening (target of 80% / coverage of 82%).

Closing the inequality gap

ProCare general practices are reducing the cervical screening inequality gap. Between August 2015 and June 2016, our practices closed this gap for Maori, Pacific and Quintile 5 women by 2.5%.

Psychological Services

ProCare is passionate about improving health outcomes and reducing inequalities for Aucklanders. We offer a range of services that complement our practices. We also recognise the importance of a person’s mental wellbeing, which is why our practices are able to refer their patients to a dedicated psychological service made up of 28 therapists (including psychologists, counsellors, CBT specialists).

Chair Reports

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It is my privilege to write ProCare’s annual Chair report, reflecting on the highlights of the year.

182 ProCare General Practices provide valued, high quality primary care to 820,000 patients. In ProCare, we focus efforts to support our practices on the following three areas:

Clinical Excellence

We achieved four out of five of our Integrated Performance Incentive Framework (IPIF) targets, only narrowly missing children fully immunised by age two. We have also provided quarterly Outcome and Quality Framework reports to each practice, detailing their achievements on an expanded suite of clinically relevant health indicators. Our direct to patient services include psychologists, community health navigators, health promotion advisors, and dieticians. We also provide Maori, Pacific, Asian, church, and school focused health services. ProCare teams work with practices, sharing ideas to improve quality.

Thriving Businesses

Delivering high quality health care depends on sustainable businesses. ProCare continues to provide practices with advice to improve their business performance. Owner’s forums proved a valuable forum for sharing innovation, opportunities, and concerns. We allowed practices who reached their IPIF targets to receive Flexible Funding, i.e. 65-75% of the practice generated discretionary income.

Influential Network

Advocacy on behalf of our practices in the last 12 months has included presentations to three government ministers, and a growing presence in the media. We have focused on sustainable funding for our practices, both in correctly setting co-payments and advocating for improving capitation funding. We also co-authored the “Closing the Loop” report, advocating for improved community based quality mental health services.

Other milestones

Homecare Medical was awarded the contract to build and deliver New Zealand's first integrated, national telehealth service which went live 1 November 2015. Homecare Medical Ltd is jointly owned by ProCare Health Ltd and Pegasus Health (Charitable) Ltd.

Starting to populate the Clinical Intelligence System (CIS), a database of anonymised clinical information collected from our practices. This will allow us to study the health of our population at a deeper level than before, providing aggregated reports to important stakeholders, and more granular reports to our practices.

Remarkable progress was made toward implementing the corporate restructure which will see all general practitioner members as shareholders of ProCare. This is an exciting step which sees all members invested in our future.

In summary, it has been a busy, but also productive year for ProCare. I am grateful for the wise advice and direction from the ProCare Directors in leading such a successful organisation. Last year Dr Sue Clark resigned from the board, and we were very sorry to lose her input. We were also pleased to welcome Dr Craig King who was elected as her replacement at our last AGM.

Our staff, led by CEO Steve Boomert, continue to provide valuable support and advocacy, innovation and leadership. And to our practices, without you, ProCare is nothing. So the largest thanks goes to our practice teams, seeing patients every week.


Dr Harley Aish, Chair
ProCare Health Limited

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Malo e lelei and greetings;

In a year where we’ve seen a growing number of stories about homelessness in Auckland and a spotlight put on child poverty, it’s served as a reminder that the purpose of a PHO is to increase access and reduce inequities-to primary healthcare. During 2015/16 the ProCare Networks Limited Board focused on commissioning those programmes, systems and tools that would enable the Network to deliver quality healthcare to our communities at the right time, in the right way.

Two areas where we’ve made inroads for our at risk population is through an increase in immunisation rates for 8 month old babies to 95% , and cervical screening rates for high needs women – Maori, Pacific and Quintile 5, reducing the inequity gap by 2.5%.

Front of mind always for the PNL Board is how we can make a meaningful difference to people’s health and wellbeing. For example, ProCare’s Manakidz work and the Rapid Response clinics provided by some ProCare practices has contributed to a real and recognised reduction in Rheumatic Fever rates in South Auckland. Being present and making services accessible has also been a successful ingredient in the mental health and wellbeing in the 19,000 health contact interactions we have had with our young people, with the Enhanced School-based Health Services, providing access to onsite school based psychologists, doctors and nurses, being available to nearly 10,000 students in 11 decile 1-3 schools in Auckland.

And through developing smarter tools and systems, we are better at knowing our patient population. The Clinical Intelligence System has helped us identify where our at risk population live and provided richer data about patient groups. One pilot within a practice showed how 60% of their ‘non-screened’ patients, actually had data recorded that enabled them to be ‘screened’. Not only did this provide the practice with greater efficiencies around their records, but gave a more complete and up to date picture of a large amount of patients. The smoking status / brief advice programme is another example of when provided with the right tools, practice teams can identify and then support their patients to give up smoking – this is going beyond screening, into helping pinpoint the appropriate intervention and as a result the network population of smokers reduced by over 8000 people in the last 12 months.

While treating patients is always going to be a key part of primary care, the PNL Board has also focused this year on programmes that will support and empower patients to self-manage. For the At Risk Individuals (ARI) programme in Counties/Manukau region, we know that there are more than 12,000 patients with long-term conditions now have goal-based care plans and 36.2% of patients that have now left the ARI programme and are considered to be confident self-managers, and are optimally managed.

Supporting and strengthening the wellness of our high needs communities is always paramount for the PNL Board and I’d like to acknowledge my board colleagues for their work throughout the year. I’d also like to thank Steve Boomert and the team at ProCare for their endless commitment to the needs of our patient population and network.


Tevita Funaki, Chair
ProCare Networks Limited

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Understanding the impact we make

Practices tell us that having dedicated psychological services for their patients is one of ProCare’s greatest offerings and points of difference. This was reiterated by an independent evaluation undertaken this year, which showed that GPs hold the service in high regard and see it as filling a significant gap in the mental health spectrum. It was pleasing to see excellent levels of patient/client satisfaction with average scores of 4.6 out of 5 from more than 1,000 clients surveyed. The evaluation also indicated that the packages of care are making a real difference, as Kessler scores showed a marked reduction in their distress levels – a positive impact given PPS is a service intended to support mild to moderate distress levels.

Performance & improvements

While the evaluation revealed a lot of positives for PPS, it also provided GP and patient insights into how we can improve and enhance our service. We’re already making progress in some of those areas, such as improving access through practice-based psychologists, as well as working with the DHBs to ensure patients are appropriately triaged and there is a clear referral pathway for GPs encountering increasingly severe and complex cases.

Our outreach work has continued and increased this year in the support we provide to the Enhanced School-based Health Services. We now have psychologists based in 10 decile 1-3 schools in the ADHB region, which provided services for almost 10,000 pupils. Our participation in Triple P (Positive Parenting Programme) also saw us deliver more than 1,200 parenting interventions - 52% of parents or caregivers were Maori or Pacific.

National advocacy

Trying to ‘close the loop’ along those pathways and between service users, referrers and providers in the primary mental health and addictions space has been an initiative that PPS staff, and our colleagues from Midlands, Compass and Pegasus have gained great traction on this year. The vision of primary care-based mental health services discussed in Closing the Loop, would not only benefit ProCare patients, but across the country and health system as a whole. I commend the work undertaken by Johnny O’Connell who has spear-headed Closing the Loop and led discussions with the sector and the Ministry of Health. As the recently appointed Patient Services Manager, Johnny O’Connell is well-placed to take forward the strategic development and operations of both PPS and those complementary services that support practices’ patients, such as self-management education.

Growing our capability

We’ve expanded our capability in identifying and supporting the range of social and cultural needs that can impact a person’s mental and physical wellbeing, for example, strengthening our health psychology expertise. Using our Health Navigators we’ve been looking at access barriers to understand why some people, particularly high priority groups like Maori and Pacific, have higher rates of not attending scheduled sessions. We’ve improved access by extending hours across our sites in Manukau and Epsom, which has been well-received. We have been working with the NGO sector to see how we can extend PPS into the community by contracting their expertise and facilities. In Counties/Manukau we have increased our resources to help address the prevalence of mental health and addiction issues in low socio-economic areas in the south.

Looking ahead – model of care development

For the year ahead a big focus is on developing an evidence-based, fit-for-the-future clinical model to ensue we’re delivering high quality outcomes with and for your patients. There will be several opportunities for GPs and practices to shape that model and we look forward to engaging on how our psychological services can better support you, your practice, your patients and their whanau.


Steve Boomert, Chair
ProCare Psychological Services Limited

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Clinical Assessments Ltd [CAL] shareholding is owned 2/3 by ProCare Health Ltd and 1/3 by East Health Ltd. CAL administers the Primary Options for Acute Care [POAC] service which provides responsive coordinated acute care in the community, with an aim to reduce acute demand on hospital services and allowing patient care to be managed closer to home. Funded by the three Metro Auckland DHBs, POAC offers a safe and effective alternative to a hospital presentation or admission. Clinical pathways and policies support consistent practice and drive greater safety and quality of care. There is a Clinical reference group and Clinical Director –to ensure excellent clinical governance of all aspects of the service. About 85% of POAC interventions will successfully and safely avoid the patient needing to go to hospital.

The annual target of Primary Options for Acute Care Services (POAC) referrals is 6,042 for Auckland DHB, 6,519 for Waitemata DHB and 12,320 for Counties Manukau Health. Overall, the total referrals received increased slightly compared with the same period in the previous year.

The average cost per referral remains consistent across WDHB and ADHB. CMDHB average cost was slightly higher this year. This can be attributed to the increase in the more complex nature of cases being managed, as well as the increase in requests for some more costly urgent investigations (CT, MRI) to assist in early discharge or to avoid referral to Emergency Department; and community based Iron Infusions. The Synergia led review of the POAC and Access to Diagnostics services and recommendations are still pending, as are DHB board level decisions around an expansion of the service – possibly to 12000 cases pa for the Waitemata area.

There are exciting moves towards expanding the coordination function of the service including ‘Community Central’ - whereby all referrals for community based services provided by Counties Manukau Health and their strategic partners are received, triaged and coordinated in conjunction with POAC staff.


Dr Neil Hefford, Chair
Clinical Assessments Limited

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ProCare Charitable Foundation grants to six charities

The ProCare Charitable Foundation (the Foundation) was made possible through the generosity of General/Medical Practitioners (shareholding members) of the ProCare Provider network. As Chairman of the Foundation I am proud to be associated with such passionate healthcare professionals that are committed to reducing health inequalities in our Auckland communities.

In 2013 – 2014 shareholding members gifted to the Foundation over 90% of their shares enabling the Foundation to secure a strong capital base for the future. The Public Trust was appointed as the sole – Trustee to create independence for the Foundation and take care of the day to day strategic operations including the annual granting process. Craig Investment Partners were appointed as the Foundations investment managers.

The other Foundation board members include Tom Marshall who was the founding Chairman of Procare Health Limited (PHL) in 1993-2008, Trevor Janes and James Sclater who are along with me are independent board members of PHL.

We are appreciative of the support of the Public Trust and the customer service they provide to our grant applicants and recipients. There ‘SmartyGrants’ system completely automates the grant applications process and allows for efficient administration end to end.

I am able to report in our inaugural granting year of 2015 we received close to 40 applications and approved grants for six registered charities awarding combined funding of more than $250,000.

We were very impressed by the quality of all of the applications received which made the task of selection challenging. It also served to highlight how many registered charities there are in Auckland’s health sector doing good works to reduce health inequalities, improve population health outcomes and improve through education the health and well-being of individuals and communities. The Foundations final grant decisions were based on an assessment of applicant’s capacity to deliver and the expected outcomes of the project.

The six registered charities to benefit from the 2015 ProCare Charitable Foundation funding allocation were:

  • Anxiety New Zealand: community education programme for Maori and Pacific in lower socio-economic areas
  • Stroke Foundation NZ: Pacific Stroke Prevention Programme
  • Starship Foundation: health promotion resources to improve skin health and infections for children living in deprived areas
  • Well Foundation: mobile health clinic to deliver services to children at risk in Rodney and Waitakere
  • Children’s Autism Foundation: direct services and programmes for families of autistic children living in hardship
  • Men’s Health Trust: education programme and resources for men’s health.

The new financial year will see the second round of grants by the Foundation to build on its inaugural year success. We will also look at ways to grow our donations to further build our capital base which will serve to increase annual grants in years and years to follow.

To the shareholders of PHL a huge thank you for your contribution to date – we trust you are as pleased with the results as we are and of course we welcome any further shares and/or financial contributions you may wish to make.

June McCabe, Chair
ProCare Charitable Foundation

PROCARE'S YEAR IN REVIEW

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A Letter from Our CEO

Looking back, it was this year in which the ProCare network started to gather momentum and begin to forge the way through dynamic partnerships to meet the changing demands of primary care in New Zealand. We are building strong relationships with a range of funders, NGOs and other PHO partners.

The journey towards more patient centred care through the Health Care Home model was launched with four practices. Together we partnered with Pegasus, Compass Health, Midlands Health Network (Network 4) to craft the Closing the Loop initiative for primary care mental health and addiction services. Partnering with Pegasus, Homecare Medical now delivers a new national telehealth service. A corporate restructure was also undertaken to position ProCare for the future and it was also a year that saw a 9% increase in our member satisfaction. Thanks to all the staff who contributed to this outcome.

Looking forward, we want to build on this progress, continue to listen to, respond and act on behalf of our members and to again see the success of our work evidenced through increases in our member satisfaction.

The world is changing rapidly, and our health system (particularly primary care) will undoubtedly be at the forefront of issues as we head toward the next general election. The result of which may well see some big shifts in New Zealand’s primary care and wider health systems. We face challenges of unprecedented demands on our health system, changing demographics and advances in technology that enable people to interact with health services differently.

With great challenges and in times of rapid change come both opportunities and threats. Primary care can choose how to respond to these various issues all of which are pressing for attention and solutions.

Our vision at ProCare is not to be reactive but rather to be a proactive network, aligning tightly with our members to enable us to effectively contribute to setting the agenda on their behalf and also on behalf of the population we serve.

While not losing the advantages of scale, we will be more nimble. Grounded in our commitment to members to deliver Clinical Excellence, Thriving Businesses and Influential Network, we will stretch to better serve primary care. The coming year will see us run an innovative education pilot, strengthen our community based services to be more cohesive and strongly aligned, progress the vision outlined in Closing the Loop to see those with mental health issues adequately served, build on the successful practice owners forums and continue to deliver a range of services to help with the day to day running of general practice, for example through ICT initiatives.

As the government drives toward improved health system integration we will also continue to support this direction and develop our advocacy work, both at a ProCare level and in collaboration with colleagues across general practice. This will be based on the themes of improving access; increasing capacity; and improving outcomes. These themes provide a framework for activities in the 12 months leading up to the next general election, in which we will be seeking to promote the value of general practice and the potential of our network to protect and enhance the health of Aucklanders.

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Steve Boomert
Chief Executive

ProCare Health Limited

Highlights

Ambitious Mental Health Plan Launched

ProCare joined forces with New Zealand’s four largest Primary Health Organisations (PHOs) to develop an ambitious plan for the future of mental health and addiction services.

Launching the plan, Closing the Loop, ProCare CEO Steve Boomert said: ‘We know we have the potential to improve outcomes and change lives. We can transform the provision of mental health services and the experience of service-users by drawing together the skills and resources of all the relevant agencies. ‘Given the opportunity and the funding, primary care can be a more comprehensive, effective and efficient provider of mental health services.’

The model is underpinned by the concept of the ‘Health Care Home’ and principles of partnership, continuity and integration between primary, community, non-government organisations and specialist services.

The document sets out recommendations based on five key themes:

  • Having a person-centred mental health and addictions system that achieves meaningful outcomes tailored to the needs of the population
  • Having a place-based model of support that supports self-determination and wellness
  • Ensuring the right enablers are in place including having a suitably skilled workforce; making good use of technology; and having appropriate funding models
  • Having well-resourced research and evaluation
  • Having the right leadership at all levels

Closing the Loop was developed by ‘Network 4’ a collaboration between New Zealand’s four largest PHOs: Compass Health, Pinnacle Midlands Health Network, Pegasus Health and ProCare Health. Collectively, Network 4 is responsible for the primary care needs of almost 2 million New Zealanders. Closing the Loop is available at www.closingtheloop.org.nz

Stop Smoking Service – Auckland & Waitemata

To help Aotearoa become smokefree by 2025, the Ministry of Health introduced new, regional stop smoking services throughout New Zealand.

In the Auckland and Waitemata DHB regions, the Stop Smoking Service is being delivered collaboratively by ProCare, The Fono and Ngāti Whātua Ōrākei Whai Maia Limited.

The service is available to those people wanting to stop smoking who live, work or play in the Auckland or Waitemata regions, which includes Central, East and West Auckland, as well as the North Shore and up to Wellsford.

The journey to stop smoking can be tough, so the service aims to make it as easy as possible by being accessible and focused on the individual’s needs – whether those are cultural, health and wellbeing, whanau or social. For example, providing Pacific church-based sessions that support people to stop smoking, or a home-based coaching session where a mum wanting to quit doesn’t have access to transport or childcare.

ProCare Practices Achieve Health Target Success

ProCare’s general practices achieved significant success against the Government’s health targets.

‘We made tremendous improvements in how many people we are reaching with crucial health promotion advice and screening activity,’ said Dr Harley Aish, ProCare Chairman. ‘This isn’t about numbers, but about making a difference to people’s lives, keeping them well and promoting better health outcomes.’

The ProCare network exceeded the targets set for Primary Health Organisations in four out of the five key areas, only narrowly missing out on the immunisation target for two-year-olds.

Over the last five years 93% of ProCare practice’s eligible population have had a heart and diabetes check - meaning 224,000 people have had their risk of having a heart attack or stroke assessed, and, where appropriate, having a treatment programme developed.

And 7,000 Aucklanders were supported to quit smoking over the 12 months to 30 June 2016 through brief advice in ProCare practices.

Dr Aish said : ‘The efforts of practice clinical teams in supporting people to quit smoking combined with our new stop smoking service for Auckland and Waitemata means that we are having a real impact on the health of our population.’

‘We’re particularly pleased with the progress ProCare practices are making in cardiovascular screening and smoking advice for high needs populations, where we achieved the same impressive performance as with the overall population.’

Across our network, 82% or 178,000 women have had a cervical smear within the previous three years. ‘ProCare is proud that we are reducing the cervical screening inequality gap. Between August 2015 and June 2016 our practices closed this gap for Maori, Pacific and Quintile 5 women by 2.5%,’ said Harley.

ProCare at Polyfest

The ProCare team took the opportunity to engage with the community at Polyfest, raising awareness of the broad range of services which ProCare provides.

There was a variety of information on offer covering self-management education, ProCare psychological services, Triple P parenting group programmes, Manakidz immunisation awareness, health, nutrition, and smoking cessation.

Highlights included the ProCare team meeting families, individuals and performing groups from a variety of cultures who visited the display.

ASB Polyfest is the largest Māori and Pacific Island festival in the world, showcasing culture, with more than 9,000 students from 64 schools who took part in the four-day festival.

The festival was a great way for ProCare to celebrate cultural identity, diversity and to share in local community spirit.

ProCare Practices: first Three to Receive Foundation Standard Certification

Dr Nicholas Cooper, Onehunga Doctors and Royal Oak Medical Centre were the first three practices in New Zealand to receive their Foundation Standard certification.

At a breakfast celebration in April, Helen Morgan-Banda, CEO of the Royal New Zealand College of General Practitioners (RNZCGP), along with ProCare CEO Steve Boomert, presented the certificates to the practices and were joined by the ProCare team who have supported practices to get ready for their assessments, and those who have carried out the assessments.

ProCare CEO Steve Boomert said: “We recognise that practices are really busy, so going through a process like Foundation Standard is another thing they’ve had to work through on top of the day-to-day. We congratulate these practices for their commitment and what they’ve achieved – they’ve gone above and beyond what’s required.”

By June 2017, all practices are required to meet Foundation Standard (unless already Cornerstone accredited), as it represents compliance with the key safety and regulatory components that apply to general practice.

ProCare also continued to maintain a level of CORNERSTONE accredited practices above the national level of 62%.

Network 4

Network 4 is a collaboration of New Zealand’s four largest PHOs: Compass Health, Midland Health Network, Pegasus Health and ProCare – together covering a population of more than two million people.

Network 4 has been relatively active in the last year.

  • Completing and releasing our mental health position paper (Closing the Loop) which has been well received and supported by major NGO groups
  • Establishing the National Health Care Home Collaborative and working on standards for the Health Care Home with other sector stakeholders including the RNZCGP
  • Sharing skills, knowledge and resources around Quality Improvement issues for PHOs
  • Commissioning an evaluation of the established Health Care Home practices
  • Sharing findings of the various reviews of Practice Management Systems undertaken by N4 members
  • Commissioning a piece of work to understand the value of a national primary care data repository
  • Providing a forum for the N4 CEOs and Chairs to discuss issues, learn each other’s perspectives and develop cohesive positions from our organisations to support strong progressive general practice

Working with District Health Boards

ProCare’s relationship with the two major district health board alliances has focused on annual plans. In the Counties Manukau health region, this means the ongoing implementation of the ARI programme. In the Auckland / Waitemata DHB region, it means the continued focus on CVD and diabetes.

In Waitemata, ProCare worked extensively with the Waitemata PHO and Waitemata District Health Board on a Community Health Services Plan for the next five to 10 years. This will complement the draft Hospital Services Plan.

In Auckland, ProCare worked with the DHB to develop the locality strategy and hope to see material progress on the integration of DHB community services with primary care in the future.the locality strategy and hope to see material progress on the integration of DHB community services with primary care in the future.

Procare Charitable Foundation

The ProCare Charitable Foundation was created through the generosity of its shareholding members for the purpose of improving the health and wellbeing of Auckland communities. In 2015 grants were made to the six charities featured here. Hear from our recipient charities in their own words:

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Men’s Health Trust NZ

The ProCare Foundation grant has enabled the Men’s Health Trust NZ to write and launch a website full of information and real life stories on men’s health and wellbeing - menshealthnz.org.nz. Written in everyday conversational language, the website is a go-to for information about signs, symptoms, causes, tests and treatments for health conditions that commonly affect men.

The grant also contributed to the development of an interactive Men’s Health talk for workplaces. Launched in March, the talk is taken by volunteer health professionals along with Unitec health students. The talk covers living healthier, early signs of common health conditions, annual health check-ups and mental health. It also includes blood pressure and “healthy size” checks. The aim of the talk is to inspire men to get interested in their health and vital stats.

Over the past few months, the Men’s Health Trust have presented their talk all around Auckland, including Oji Mill, Samsung NZ, Healthy Families Manukau, Deaf Aotearoa, nib Health Insurance and Traffic Management.

"Many thanks for coming out tonight to see us at the start of our shift. Staff all enjoyed the preso & have identified the small changes we all need to make for the future." - Paul, Shift Foreman, OJI Paper Recycling Mill

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IMAGE: Happy days - some of the Waitemata DHB Child & Family West team with new clinic

The Well Foundation

A new mobile health clinic is now on the road providing healthcare to children and families in need across the Waitemata region. The Well Foundation fundraised for the $210,000 clinic and a grant from the ProCare Charitable Foundation in November 2015 helped significantly.

“ProCare’s grant took us considerably closer to our target for the clinic, which was a top priority for us given the impact it’s expected to have on the health of our community, particularly the thousands of children from deprived areas,” says Well Foundation CEO Andrew Young.

The clinic will be taken by public health nurses into schools, early childhood centres, and other public spaces like community centres, to provide ear health check-ups and treatment, throat swabbing as part of the Rheumatic Fever Prevention Programme and general health advice, treatment and referrals when required.

The mobile health service was previously run using two modified motorhomes, both of which are almost 18 years old and are cramped, inefficient and mechanically unreliable. The new mobile health clinic takes the place of the older clinic and along with being comfortable, spacious and able to stand up to the growing demands on the service, it has a self-sufficient power supply. No longer needing to run a lead to power means nurses can take the clinic to new areas and locations in the community to reach new patients for assessment and treatment.

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IMAGE: 2016 Pacific Stroke Prevention Champions (left to right): Sione Tupou, Losi Harford, Mark Anaki, Tai Faalogo (Stroke Foundation), Jo Jarden (Stroke Foundation) and Pelenatete Lam Sam.

Pacific Stroke Prevention Project Removes Barriers to Good Health

Pacific communities in Auckland are now more aware of the importance of regular blood pressure checks, the signs of stroke and the need to dial 111 for suspected cases. They are also more empowered to reduce their risk of stroke which is great news given Pacific communities are up to three times more likely to have a stroke when compared to New Zealand Europeans.

With a ProCare Foundation grant, the Stroke Foundation trained five Pacific Community Champions to weave their stroke experiences into a structured presentation on stroke prevention. Through 25 presentations to more than 1000 pacific community members, the Champions used storytelling to add relevance and weight to stroke prevention messages.

The Champions also attracted media interest with Tagata Pasifika, TV1 and TV3 news all running stories on stroke prevention. From June-July 2016, their work was also complemented by a national campaign, designed to raise awareness of the key signs of stroke and the need to dial 111 for suspected cases.

As part of the grant, a free blood pressure test was offered in Otara on the 10 October 2015 and again on 1 October 2016. In total, 272 people had their blood pressure tested, many of them identified as Pasifika. Those with concerning readings were referred to their general practice for further support.

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IMAGE: Matthew and his family are one of many that the Children’s Autism Foundation has provided support to, through the Outreach service.

Empowering Families with an Understanding of the Autism

Funding from ProCare Charitable Foundation has enabled the Children’s Autism Foundation (CAF) to increase overall services to meet a growing demand for quality support services.

CAF provides individualised support, guidance and strategies through home visits, workshops, social skills groups and email/phone consultations. The following are quotes from families who have received CAF services:

"We've implemented a number of strategies to encourage good behaviour. Over six months now and we are much more positive in our parenting and our boy's behaviour has improved, meltdowns are much less frequent, and our boy gets out of meltdowns much quicker."

"Our family consultant is so relaxed, insightful and understanding, we could not have moved forward without her. Many thanks."

Many families are experiencing hardship which results in children not getting the start in life they deserve. Concerns include:

  • A lack of accessible support services
  • A lack of understanding about autism in schools and in the community
  • Experiencing isolation from their communities
  • Breakdown in family relationships
  • Anxiety and depression concerns for our families and children
  • Children being bullied and lacking social engagement

The Children’s Autism Foundation support services address the above concerns, helping families in hardship and their communities. The staff at CAF see the benefits of empowering families with an understanding of the autism, along with tools and strategies which help them with their child’s diagnosis. The services offered by CAF reduce the stresses on families in hardship.

The Children’s Autism Foundation are very thankful for the financial support from ProCare Charitable Foundation. A total of 2326 services were provided for families in the past year, double that of the previous year.

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IMAGE: Our Community Education Intern Krista, Helpline Manager Goldie and Community Education Liaison Jay with our therapy cat who lives at the clinic. Between them they visited hundreds of community groups and individuals with the support of ProCare Charitable Foundation.

Raising Awareness and Understanding of Anxiety and Depression

With the support of Procare Charitable Foundation, Anxiety New Zealand Trust developed and delivered a Community Education Project to encourage supportive relationships between health providers and the community, to encourage earlier access to mental health support & engage in healthy wellbeing practices, increase awareness and understanding of anxiety and depression, and reduce stigma and discrimination around mental illness with a focus on lower-socio economic groups and youth.

We employed a fixed term Community Education Liaison (CEL) and recruited two fulltime unpaid interns (from the USA and Mandarin speaking) to support the CEL and project. The Community Education Project has reached hundreds of healthcare professionals and provided face to face meeting with GP practices, dental practices, pharmacies and counsellors at both Auckland University and AUT University. The CEL provided education and advice sessions with parents of children who experienced anxiety, provided resources surrounding anxiety including information packs and brief intervention strategies for young people and their caregivers.

Another facet of the Community Education Project, was the Ni Hao Initiative, which sought to reduce the stigma and discrimination involved in Mandarin communities when seeking support for psychological services. We met or spoke with 107 GP Practices and their staff and sent resources in Mandarin to 52 Chinese Community Groups and Organisations and Businesses (supplying information on wellness strategies, access to services and to reduce stigma and discrimination).

The third tier of the Community Education Project, was to educate health practitioners who in turn had contact with low income and ethnically diverse populations. A highlight was two members of our clinical team provided training at an event held for GP’s within the ADHB locality, on the topic of anxiety, its presentations and treatment in both a psychological and medical model. Over 70 GP’s attended, all of whom were offered clinical information and resources for their clinicians and their clients.

The project also promoted organisational learning for our 50 help line volunteers who field 800 calls per month and 12 staff who support 3000 1:1 appointments per year. The CEL offered additional training for all staff on support for Maori and Pacific Island communities and youth and this opened conversations about how we as an organisation can continue to develop and support the community in a sustainable way.

The response has been overwhelming and Anxiety New Zealand Trust is experiencing a high demand for education in the community. We would like to sincerely thank everyone at ProCare Charitable Foundation for their support, generosity and vision in supporting the project.

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Tackling one of leading causes of hospitalisation for children in New Zealand

Tackling one of the leading causes of hospitalisation for children in New Zealand was the goal of a Starship project funded through the generosity of the Procare Charitable Foundation.

Skin infections place a huge burden on hospitals and primary care, yet such infections do not strike children equally. Children living in deprived neighbourhoods are 4-5 times more likely to develop cellulitis than their more privileged counterparts, while Pacific children are 4-5 times and Māori 2-3 times more likely, to develop cellulitis, than children of NZ European decent.

With early treatment in the community, hospital admissions can be prevented. But with many families lacking the basic knowledge to treat these common communicable illnesses, the availability of effective educational resources is key.

The project, under the leadership of Dr Alison Leversha a community paediatrician with Starship Child Health, set out to fill an identified gap in existing skin infection resources; developing a simple skin care health promotion resource to prevent infection, targeting at-risk families across the greater Auckland community.

As Dr Leversha notes, “We desperately want to keep children healthy and out of hospital and promoting skin health and first-aid makes a huge difference. Having financial support to develop and test new resources was invaluable. It identified issues we never expected.”

The multi-lingual teaching packs are now ready to be distributed through educational centres in communities with high Pacifica and Maori populations.

Homecare Medical's continued success

Homecare Medical, which is a partnership between Pegasus Health and ProCare, was selected in June 2015 by the Ministry of Health to design and deliver an enhanced, integrated national telehealth service.

Since then Homecare Medical has provided free health advice and support, 24 x 7 to more than 430,000 Kiwis across phone, text and online channels. There have been more than 550,000 contacts to the service. That’s more than one contact every minute, with 81 per cent of calls answered within 20 seconds.

Homecare Medical's staff have grown to support this. Now, more than 250 staff from Kaitaia to Bluff and in four contact centres across the country provide an integrated service.

The national telehealth service brings together seven helplines: Healthline; Quitline, the Gambling Helpline, the Alcohol Drug Helpline, the Depression Helpline (and the National Depression Initiative services) and advice for the public on poisons and immunisation.

Homecare Medical also provides after-hours support to 600 General Practices and at every opportunity directs people to enrol with a GP or connect with their existing GP for their ongoing care.

Our Board

Dr HE Aish

BHB, MB, CHB, DIPOBST, FRNZCGP

Harley Aish started his career as a general practitioner in Otara in 1997. Past roles include director of Southmed IPA and ProCare Health Ltd, and director and later chair of ProCare Networks Ltd. He served on the executive of IPAC, was part of the team for the PSAAP PHO contract negotiations and a member of the PHO Performance Programme Governance Group.

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Dr SM Clark

BMB, CHB, DIPOBST, FRNZCGP

Sue Clark has been a GP in Hobsonville for 15 years. She was also a member of the Health West PHO Board.

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Dr JEM Fox

Jonathan Fox has been in general practice in Meadowbank with his wife for 24 years, since arriving in New Zealand from the United Kingdom. Past national positions include NZMA Board member, President of the Royal New Zealand College of General Practitioners (RNZCGP) and Chair of the Council of Medical Colleges in New Zealand.

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Dr NJ Hefford

BHB, MB, CHB, FRNZCGP

Neil Hefford graduated from Auckland Medical School in 1985 and has been a GP in his own practice in Grey Lynn for 24 years. He is a director of ProCare Networks Ltd and chair of ProCare’s Clinical Governance Committee. His passion is achieving better integrated care and quality outcomes for our patient population through improved models of care, as well as improving GP work satisfaction and financial security.

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Hanne Janes

Hanne Janes has extensive commercial and legal experience, including managing start-up SMEs and strategic and economic consulting with Deloitte. Hanne's law career has spanned a diverse range of specialities including; medical and health law, professional liability, regulatory compliance, health and safety, competition, employment, civil, and relationship litigation.

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TD Janes

BCA, FCA, CFINSTD, FCFIP

Trevor Janes' career has been in investment banking and financial analysis. He is a Chartered Fellow of the Institute of Directors, a Fellow of the Institute of Financial Professionals in New Zealand and of the College of Chartered Accountants. He is currently chairman of Abano Healthcare Ltd, deputy chairman of the Accident Compensation Corporation, chairman of Certus Solutions Ltd and deputy chairman of Pulse Energy Ltd.Trevor is also a member of ProCare's Audit and Risk Assurance, and Remuneration and Governance committees.

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Dr C King

MB, CHB, FRNZCGP

Craig King has been a member of the board since November 2015. He is a GP at Health New Lynn, which was established in 2013 from an amalgamation of four local medical centres in the wider West Auckland area. He has been practicing as a GP in the area since 1990.

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Dr LEJ King

MB, CHB, DIPOBST, FRNZCGP, FNZMA

Lewis King is a Mairangi Bay GP. He is an accredited teacher for the registrar training programme of the RNZCG. He is also a former secretary of the RNZCGP and chairman of the NZMA.

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JN McCabe

MBA

June McCabe has had a diverse career in both the public and private sectors at senior levels, including 20 years of investment and banking experience. Her past and current corporate governance experience spans public, private and not-for-profit boards in the education, finance, health, housing, television and venture capital sectors.

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JM Sclater

BCOM, CA

James Sclater is a professional company director and trustee acting for a number of companies and investment trusts, including Hellaby Holdings and Damar Industries. James is a chartered accountant and a member of Chartered Accountants Australia and New Zealand and the New Zealand Institute of Directors.

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Dr JFV White

MB, CHB, FRNZCGP

Jan has been in general practice in Mt Eden for 30 years, having graduated from University Of Otago in 1973. She is currently a member of ProCare’s Pacific Heath Advisory Committee (ProPa) and the Konnect Clinical Governance Group. She is deputy chair of the New Zealand Medical Association’s General Practitioner Council.

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Our Governance Structure

ProCare Health Ltd (ProCare or PHL) is a Limited Liability Company. The great majority of its shares are held by the independent ProCare Charitable Foundation, which has a focus on giving back to the community.

The ProCare Board is responsible for setting the strategic direction of the organisation and adopting appropriate governance processes to ensure effective oversight of the organisation on behalf of shareholders, employees and other stakeholders. The Board appoints the Directors of Procare Network Limited (PNL) to act in the Primary Health Organisation (PHO).

The Board is committed to high standards of corporate governance and follows, in principle, the corporate governance guidelines and principles developed by the Financial Markets Authority and the New Zealand Institute of Directors.

The Board establishes committees to support it in its governance work. These committees do not make binding Board decisions, but make recommendations to the Board.


Our People

As at 30 June 2016.

Financial Statements

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© 2016 Company, Inc.