Highlights and predictions

17 July 2017

CE Jim Green


Each July, I provide a summary of the year (financial) and make a prediction for the year ahead. This is in the Hospital Advisory and Board papers that are freely available on our website, I'm sure most staff aren’t regular readers of those papers.

So to keep you up with what I have said I am including my thoughts here. I am interested in your feedback. Please give me a call (ext 8100) or respond to this e-mail.

One of the hardest parts is to narrow down a few highlights from the year. Inevitably so many good things have happened in health in Tairāwhiti over the year.

Thank you all for what has been achieved. More of our highlights will be identified in the “20 Good Things in Health in Tairāwhiti” edition for 16/17.

2016/17 In Review

Starting this summary off I invariably return to my predictions for the year ahead made at the equivalent summary in July 2016. I said: "My prediction is for even more troubled waters for our waka. However, our crew are determined, innovative and strong. So I am predicting we will go a longer distance in 2016/17 with way less shipped water." I believe that was remarkably accurate.

As our crew on the Hauora Tairāwhiti waka you have been determined, innovative and strong as have been the wider crew in health services across the district. The WAKA values have propelled us forward with record amounts of care provided for the community, new services and new service innovations.

Huge Growth

There has been an inexorable growth in the numbers presenting for care at Gisborne Hospital. The acute services load has at times meant elective services have had to be curbed in order to make sure people are treated in acceptable time frames. We have seen a small reduction in elective services but still surpassed our targets. Services have been challenged at times to have the key staff to provide care. Many of you have had to be nimble to make sure people have the care they require.

Health Targets

Despite this we have done well for Health Targets, once again meeting the hospital based targets for Emergency Department patient flow and elective discharges. The cancer treatment target performance has fluctuated during the year despite working very closely with tertiary service providers to ensure our people had the diagnostics and treatments required as quickly as possible. We have perfected the local service delivery within the target time frames but are still not achieving the overall target where we require services from out of the district. Our Primary Health Organisation (PHO) partners have done well on the Smoking Advice target. Returning our childhood immunisation rate to over 95% has been slow to rebuild; although it did improve late in the year. Our comprehensive approach to the Childhood Obesity target will pay dividends in a forward-looking focus to not only respond to the needs of children who are obese, with their families, but to also reduce the impact of obesity on our community.

Service developments

Service developments throughout the year have been based on our Hauora Tairāwhiti values and aspirations. For example, how do we support people earlier so that the impact of ill health is prevented and the next generation has a step wise change in health outcomes? We have worked with our iwi provider partners to design a service to support women who are pregnant or who have young children, to maximise their own health potential and that of their children. The approach utilises Māori models of care to increase effectiveness. A similar design process is in place to radically improve early access to mental health services. We have planned with PHO, iwi provider and consumer advocacy to work with tangata whaiora and their whānau to promote earlier recovery and to reduce the need for hospital based services.

Social determinants of health

We have also used the spirit of the WAKA values to move outside our health boundaries to add our weight to modifying the determinants of health in Tairāwhiti. Through Manaaki Tairāwhiti, the local social investment pilot, we have worked with iwi, government agencies and the council to begin the better lining up of care so that the inter-connections in health and social services can be used to advance outcomes, not hold people back.

Possibly better financials

At present it looks like we may have turned a corner on the financials for Hauora Tairāwhiti as well. Our current consolidated deficit of ($5.3m) is $1.4m better than the final result for 2015/16. However, it is early days and our increased throughput has made us more vulnerable to the vagaries of inter-district flows.

2017/18 prediction.

So to my 2017/18 prediction. That will, unfortunately, be for more troubled waters for our waka, especially as we grapple with the increased acute load, but with the support of our primary care partners. We will be installing some cyclers on our waka so we will be going faster.

Another thanks...

Thanks for the continuing work to respond to the surge in people needing health care in Tairāwhiti.

The media has highlighted strained hospital services across the North Island. However, I think the increases here in Tairāwhiti are possibly higher.

Thanks for ensuring people get the care - here and in the community.