Northland Long Term Conditions Clinical Governance Group

Northland Faculty Board member Mark Lankshear sits on the Northland Long Term Conditions Clinical Governance Group his report from its latest meeting is below:

Dear all,

I attended the Northland Long Term Conditions Clinical Governance Group on 5th May 2015 as a GP representative.

This was an interesting and at times quite lively meeting chaired by Aniva Lawrence. We were a little low on numbers but did achieve a quorum. We heard updates from a number of work streams, specifically the respiratory, CVD, ACP, gout and dementia work.

One piece of good news is that the spirometry equipment guidance for Northland has now been approved and training is being undertaken for practice nurses – we were told 60 nurses have now been through this approved training and that the guidance re equipment and training will be circulated shortly to practices. The cost / finances and access issues have yet to be worked out.

The CVD rehab and dementia pathways are both going to go through a co-design process which will be beginning soon with Lyn Rostern newly appointed to take a lead on these – probably in Kaikohe to start with. The respiratory rehab programme still seems stalled and there was some frustration expressed around this and Lyn will be looking at any commonalities that could be useful here.

The gout project has had a redesign to try to ensure wide access and equity – we were told that all of Northland's pharmacists have signed up for this and although there will be two pilot sites initially it's hoped this scheme will be available Northland wide in the near future.

A number of other issues came up for discussion including the ongoing structure of rehab services in general. One of the work streams reported their concern that the MoH had issued a statement that they wanted to see rehab programmes based in primary care and with a generic flavour. The workstream felt this had risks of lack of expertise and focus and were going to write to the minister expressing this.

This has been a common discussion theme within the group and I (and some others) expressed the view that, although the key to successful rehabilitation is clearly good partnership working between patient, primary and secondary services, that these services should be based in the community and be patient rather than disease focussed. My feeling is that the key task is engagement (which is a primary care strength) and ensuring people with chronic diseases are ultimately well connected to primary care is essential to their long term management and well being. I think this is a key issue for this group which will continue to be a subject of debate.

As ever any feedback is very welcome and will be taken back to the groups next meeting which will be in early June.