Disability and Support Advisory Committee

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1 Disability and Support Advisory Committee Health Priorities for 2007/08 November 2006

2 Purpose of Workshop The what the health priority areas of Minister of Health CCDHB, as identified in the District Strategic Plan and the Health Needs Assessment within individual Mental Health, Disability and Older Person s services portfolios The how the factors influencing implementation of priorities Develop key principles for CPHAC to apply to prioritisation of health area priorities

3 Resource Allocation and Prioritisation Process Board DSP Board/CPHAC/DSAC/Community/ HAC/P&F/other Initiative s P&F drafts list for EMT endorsement Under the New Zealand Public & Disability Act (2000), CPHAC has responsibility for recommending the best way to achieve health outcomes for our community CPHAC Sets Priorities: Recommends to Board DAP Recommends to Board Management sorts out how

4 Current Spending on Health Services Detail for planned expenditure 2006/07 (to be added)

5 Minister of Health s Priority Areas (2007/08) Framework to achieve 4 high-level outcomes 1. Better health 2. Better participation and independence 3. Reduced inequalities 4. Trust and security Outcomes to be achieved through Progressing the New Zealand Disability Strategy He Korowai Oranga Improving Mental Health Implementing the Health of Older People Strategy by 2010 Progressing the Primary Health Care Strategy Reducing Inequalities Quality and Safety Implementing Healthy Eating Healthy Action Implementing the New Zealand Cancer Control Strategy Immunisation Additional child and Youth focus Significantly progressing the Health Information Strategy Progressing the Future Workforce Cost effectiveness, efficiency and value for money

6 Capital and Coast DHB s Priority Areas Health Needs Assessment (2004) 12 areas identified as priority areas Include Disability Health of Older People Mental Health Service Development District Strategic Plan ( ) Reducing disparities in health status Reducing incidence and impact of chronic conditions

7 Intervention Framework to Improve Health and Reduce Inequalities (source: Ministry of Health, Reducing Inequalities in Health (2002 ) 1. Structural 2. Intermediate Pathways Impact of social, economic, cultural and historical factors on health status is mediated by various factors including: - behaviour/lifestyle - environmental: physical and social Social, economic, cultural and historical factors fundamentally determine health. - Economic and social policies: education, housing, labour market) - Power relationships: racism, discrimination - Treaty of Waitangi 3. Health and Disability - access to material resources - control: internal, empowerment Specifically, health and disability services can: - improve access-distribution, availability, acceptability and affordability - improve pathways through care - take a pop health approach by: - identifying pop health needs - matching services to identified pops - health education 4. Impact The impact of disability and illness on socio-economic position can be minimised through - income support - antidiscrimination legislation - deinstitutionalisation/community support - respite care/carer support

8 Reducing Impact of Chronic Conditions If these (modifiable) risk factors were eliminated, at least 80% of all heart disease, stroke and type-2 diabetes would be prevented; over 40% of cancer would be prevented (source: WHO, Preventing Chronic Disease: A Vital Investment)

9 Chronic Care Management Framework Inequalities focus Health Promotion & Prevention Early Identification Integrated Information Systems Support for self management Optimal Treatment Primary care orientation Workforce Redesign healthy public policy social marketing HEHA tobacco control healthy housing screening programmes opportunistic testing at-risk case finding approaches expert patient programmes whanau ora approaches education and support peer based programmes encourage use of cost effective therapies evidence-based guidelines across providers use of risk stratification to identify high-risk individuals/whanau proactive follow-up using alerts/

10 Mental Health Priority Areas Developed through A combination of existing priorities (continuing initiatives from 2006/07 DAP) Regional service priorities developed through the Central Region Mental Health and Addictions Net work The Journey Forward Implementation Programme, overseen by The Journey Forward Leadership Group Te Kōkiri The National Mental Health and Addiction Action Plan

11 Mental Health Services Planning Process Generic Health Mental Health Specific NZ Health and Disability Strategy Te Tahuhu Service Coverage Te Kōkiri District Strategic Plan District Annual Plan Regional Service Plan The Journey Forward P r i o r i t i s a t i o n Re-prioritise Re-configure New Money New Initiatives Blueprint One-off Tagged or Underspend

12 Mental Health Priority Areas Resourcing The Journey Forward infrastructure engagement and information Improve alignment of primary care and mental health services improve access and effectiveness Developing peer support approaches Reducing gaps in the continuum of alcohol and drug services Increase in access to child and youth services Regional forensic services

13 New Zealand Disability Strategy Implementation Developed through Discussion with people with disabilities to understand the barriers that most affect their ability to participate and are, therefore, the earliest priority for change Promoting Participation sets out CCDHB s objectives and priorities for implementing the New Zealand Disability Strategy at every level of the DHB

14 New Zealand Disability Strategy Implementation Providing disability competence training Improving physical access Improving communication and access to information Enhancing employment opportunities Improving community/consumer engagement

15 Health of Older Person s Priority Areas Developed through A combination of existing priorities (continuing initiatives from 2006/07 DAP) Response to MOH Health of Older People Strategy Ongoing implementation of approved DHB level strategies (e.g. Integrated Home & Community Care Programme, Palliative Care Review) Ongoing developmental work with contracted providers (Packages of Care, Restorative Home Support) Consultation/collaboration with Quality & Integrated Care team

16 Health of Older Person s Priority Areas Ongoing integration of home and community care (community nursing and allied health) Restorative home support Supporting carers Workforce support and development Better utilisation of aged residential care Palliative care - access, integration and coordination Improving access Maori and Pacific 45 years plus Other 65 years plus

17 Factors Influencing Implementation of Health Priorities Opportunity cost the cost of pursuing one alternative versus another Regional economies of scale Intersectoral leverage Building on existing strategies NGO sustainability Urgency

18 CPHAC s Role: Health Priority Resource Allocation Consider the health priorities of the health portfolios Mental Health Disability Pacific Health Secondary/Tertiary Older Person s Health Maori Health Primary Care Assess priorities within the strategic frameworks to address the DSP priorities reducing disparities and reducing the incidence and impact of chronic conditions Based on assessment, develop recommendations to the Board regarding balance of allocation of resources within the two DSP strategic priority areas

19 DSAC s Recommendations to CPHAC DSAC supports the health priority areas for Mental health Disability HOP Other recommendations from DSAC to CPHAC

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