At the November 2007 Board meeting, members of the Waitemata DHB board had the opportunity to discuss and decide upon the outcomes from it's recent public consultation on the:

• Primary Health Organisation (PHO) configuration policy options (preferred number and geographic boundaries of PHOs)
• Proposals for improved "after hours" primary health care provision.

The consultation period ran from 20 August to 12 October during which time a number of meetings, hui and fono were held. A total of 78 submissions or feedback communications were received by the Waitemata DHB. 

A final copy of the report is available to download.

PHO configuration

Waitemata DHB board decides to retain status quo
There are currently six PHOs that are geographically aligned to North Shore and Waitakere City Councils and the Rodney district. The feedback from the consultation was strongly in favour of either retaining the status quo (40%) or having a reduced number of PHOs (one per Council area) (28%). Only one of the six PHOs had wanted to remove the geographical boundaries or extend the number of PHOs.

Board members agreed with the feedback and have decided to retain the status quo. As part of this decision they have also indicated that they are going to engage with the current PHOs and communities to develop a five-ten year primary health care implementation plan for Waitemata district that will further inform the PHO configuration policy and ongoing primary health care development.

After hours access to primary care and emergency services

The Waitemata DHB board is keen for plans to be finalised and implementation of new/extended services to commence to address current gaps.

After hours primary health care is important for ensuring the health and wellbeing of all communities. It is important that there is equity of access to care across all communities to the level expected by national guidelines. After hours primary health care includes patient services that cannot be safely deferred until regular general practice services are next available.

It was clear from the consultation process that there are gaps in after hours primary care provision across the district. Members of the board stressed the need to press ahead with the board taking a stronger leadership role in determining how services would best be developed to address current access issues and to progress implementation as rapidly as possible.

It was recognised that there are three different services that need to be considered together in formulating the most effective and efficient solutions:

• Access to "emergency" care (this is a secondary care service) with issues that need to be addressed at North Shore Hospital (relating to quality and facilities) and at Waitakere Hospital (restricted hours of opening)
• Urgent access to primary care outside normal hours of provision (with the most pressing needs being Wellsford/Warkworth and South Kaipara)
• The need for extended hours for primary care to make services more accessible for people who find it difficult to attend during normal working hours (more flexibility needed across the district).

As a result the Waitemata DHB board have said they are committed to ensuring that the process and detail to complete the After Hours Plan is carried out in a collaborative manner involving PHO, general practice, emergency care, Maori, Pacific and general community representation, and includes appropriate economic modelling of after hours primary care service needs and resources.