Primary, community care the key
Whichever way you look at it, the Southern District Health Board covers a vast and challenging area. Encompassing 64,000 kilometres, the area spans from the Waitaki Bridge just north of Oamaru on the East Coast, across to Wanaka then down the rest of the South Island including Stewart Island.
Funded from the Government purse to just over $1 billion dollars, SDHB’s diverse geographic area is home to a population base of 335,000 and presents some unique challenges.
“Around the Coast we have a stable and often aging population,” says Chris Fleming, SDHB’s CEO. “Then you look at Central Otago and we have a much younger but booming population.
“That poses a huge challenge because most of our health infrastructure is in Dunedin and Invercar-gill and the growing population is about as far away from those services as is they could possibly be.”
With an aging population not only do the health demands increase but as that age group increasingly makes up a larger percentage of the overall population the workforce contracts relative to size, posing the challenge of how you support the needs of the greater community moving forward.
“One of the things we’re driving is our primary and community care strategy. “How do we get people more engaged in their own healthcare and get more services into the community, providing care at the earlier stages focused on prevention – prevention is far better than finding a cure.”
Chris is also lead CEO for Aged Care and says a key consideration with an aging population is how to better support older people to live independently.
“I’ve never met an older person who does not want to live as long as they can, as comfortably as they can and as independently as they can, and then when they do need more care it is provided in a high quality service near family and whanau.”
Turning to the question of mental health, Chris says that for a long time New Zealand has under invested in lower complexity/primary mental health.“We now need to invest more on that front because the more we can deal with lower level mental health needs the less likely people are to develop more complex needs.”
Despite the challenges, he says the future out-look for Southern District Health Board is promising and exciting as a diverse range of initiatives are launched to meet the area’s health and well-being needs.
The core facility development includes the $1.4 billion rebuild of Dunedin Hospital, the biggest rebuild of health infrastructure that New Zealand has ever seen, and a new Emergency Department recently opened at Queenstown’s Lakes District Hospital.
General Practice is being enhanced with the roll out of Health Care Homes, an initiative now covering 40% of the Southern population.
“That’s about re-engineering primary care, enabling GP’s to deliver more timely and appropriate care. “Included in that will be GP telephone triaging enabling doctors to provide advice to patients phoning in who don’t need to visit, freeing up a whole lot of capacity to work with patients who do need face-to-face care.”
Community health hubs are being developed, extending services into the community that might historically have be found in a hospital setting, such as urgent care, radiology and visiting specialists.
“Digitizing health information will enable fast access to information across the health system so that healthcare professionals are well informed about the care needed. “It also means people have better access to their own records, reinforcing that you can take responsibility for your own care.”
Passionate about the district’s healthcare, Chris says one of the reasons he works in health is that he can never go home at the end of the day and say I have done enough.“There will always be unmet needs to address – that is the challenge.”
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