Urgent Medical Care, including After Hours GP - November 2015
Urgent general practice care in Central Otago is provided by the local medical centres in each community. The way to access this service 24hrs a day is by calling any of the medical centres.
After hours care (6pm till 8am every day):
After hours care in Wanaka is provided by Lakes After Hours from the medical centre on Cardrona Valley Rd.
For the communities of Cromwell, Alexandra and Roxburgh, after hours care is provided by the Central Otago After Hours Inc. duty GP based at the After Hours GP clinic at Dunstan Hospital. This is a GP owned service, not a free public hospital service.
It is essential that patients contact the GP - phone your nearest medical centre, your call will be answered by a nurse. In an emergency, phone 111 for an ambulance. The ambulance staff may then contact the duty GP for you to be seen if hospital care is not required.
Dunstan Hospital does not provide a free walk-in emergency department service. Patients who present to Dunstan Hospital will be assessed by a nurse, and referred to the duty GP. In the case of a life threatening emergency patients will be seen in Dunstan Hospital.
Charges will apply in most cases for the GP service, regardless of where this is delivered, including the after hours clinic at Dunstan Hospital.
Occupational Therapy Week 26-31 October 2015
Occupational Therapy week is a nationwide event occurring from the 26th-30th October 2015.
Occupational Therapists at Dunstan Hospital are planning various activities to align with this year’s theme of “raising the profile”.
Our wonderful student OT’s are planning an eye catching interactive display at the hospital front entrance which will outline the occupational therapy role and how we can assist people to engage in meaningful and satisfying everyday activities. We have also provided a reminder to local GP’s outlining the Occupational Therapy role and how to access our service.
Many of us take aspects of life for granted. What would you do if you could no longer complete your usual everyday activities? Things like getting dressed, following a bus timetable, driving, working, walking up your stairs at home, or socialising with friends?
The things that you do (we call them your "occupations"), help to express who you are, how you feel about yourself and how you connect with others. Occupational Therapists work alongside you and your family/community to identify the occupations that may be difficult for you and to set goals for what you want to achieve. For example we may work with you to learn new ways of dressing after a stroke, adapt your home, work or school, develop new skills or interests or access community supports.
We have a very experienced team of ward, community and paediatric Occupational Therapists based at Dunstan Hospital.
If you know of anyone that might benefit from our service, please feel free to contact our team on (03) 440 4302.
“National Certificate in Health, Disability and Aged Support, Level 3 Rehabilitation Assistants”
Sandra Booth, our full time Allied Health Therapy Assistant successfully completed the requirements for the “National Certificate in Health, Disability and Aged Support, Level 3 Rehabilitation Assistants” Sandra and several other assistants working at Dunedin Public Hospital were the first therapy assistants in this region to undertake and complete this national qualification. The course lasted a year and covered skill development in occupational therapy, physiotherapy and speech language therapy. We congratulate Sandra on achieving this qualification and believe our patients in both the ward and the community will benefit from her hard work and increased knowledge and skills.
HOSPITAL GROUNDS TO HAVE FREE CARE
They may be unlikely fairy godmothers, but Dunstan Hospital is not complaining.
Fulton Hogan Central staff have come to the rescue of the hospital.
Terminating its grounds maintenance contract was one of the cost cutting measures taken by Central Otago Health Services Ltd (COHSL), which runs the hospital, when its budget was pruned by 2% in June by the Southern District Health Board.
COHSL manager Karyn Penno said the priority was to maintain the hospital's outpatient services and ward capacity but stopping the grounds contract was ''a bit of a blow''.
''Not only have the gardens largely been developed and planted with the assistance of local service groups since the [hospital] rebuild in 2005, they are also a welcome distraction and an important part of patient recovery,'' Ms Penno said.
''We constantly get comments from patients and visitors on the wonderful outlook and it is important to us that we keep the grounds at the same high standard.''
So it was a welcome surprise to have the regional manager for Fulton Hogan Central, Alan Peacock, offer to cover all the grounds maintenance free of charge for the next 12 months, she said.
''It's humbling to live and work in a community where local business and people offer to their local hospital their time and money to ensure that we continue to offer the same level of service and where possible, enhance the services to the community,'' Ms Penno said.
Mr Peacock said he made the offer after reading about the hospital's critical funding situation.
''Fulton Hogan likes to support things that support the community and the hospital is critical to everyone. We thought we could support it in a way that could keep it running and give something back to the community at the same time.
''It's not something we'd have done if we were taking work away from any other provider but the hospital had withdrawn from its grounds contract.''
He declined to be drawn on the value of Fulton Hogan's gesture but said it represented a ''significant'' saving for the hospital.
''Our aim is the keep the hospital grounds and car parks looking smart and tidy.''
• There are about 100 rose bushes in gardens around the hospital and COHSL hopes individuals or a service group might offer to look after them.
This would include pruning and general maintenance for the next year. Anyone interested can contact Maree Leitch at the hospital
New Ambulance for Dunstan Hospital
Dunstan Hospital is very pleased with the new hospital transport ambulance recently purchased with support from a number of community organisations and businesses. The new Mercedes Sprinter ambulance will replace the aging and well-travelled Nissan Ambulance we have been using since 2010. The previous ambulance has racked up around 350,000 km, almost all of this has been between Dunstan Hospital and Dunedin Hospital. We are hoping that the new vehicle will last us for up to 10 years based on the current mileage, but with our growing population, and increasing hospital activity this might be a little optimistic. The new ambulance has been custom built to our specifications by Otago Auto Trimmers in Dunedin, and one of the key features is the new Stryker electric patient stretcher. This will be a first for Central Otago, and allows even bariatric patients (up to 325kg) to be safely loaded using our hospital loading platform, without the need to lift the stretcher. Additional features include 2 dedicated attendant seats, and 2 stretcher patient capacity. The following organisations and businesses have generously supported this project:
Central Lakes Trust – vehicle purchase
NZ Community Trust
The Lion Foundation
Jamies Jewelers (Alexandra)
Aerotrack Medical Ltd.
Mercedes Benz (NZ) also provided us with a generous discount on the vehicle.
Access to Playground
If you have a child on Vincent Ward or are visiting a patient on the ward with children, remember to utilise our playground. Please ensure you supervise your child at all times and please note that you are using this facility at your own risk.
There will also be times when the playground is needed by our therapists and their clients and therefore not available to the public. The playground is situated by the visitors car park - staff can provide you with directions.
Dunstan Hospital – CT Scanner
Dunstan Hospital’s CT scanner which is operated by Otago Radiology (the radiology service provider at Dunstan Hospital) is now operating five days a week – Monday to Friday. Since the opening of the CT scanner 640 scans have been provided to people who live in the Central Otago and Lakes region. We look forward to welcoming more patients from the Wakatipu Basin to utilise the expanded service at Dunstan and benefit from the convenience of having CT scans available only an hour away from Queenstown.
This project was generously supported by the Central Otago and Upper Clutha Communities, the Central Lakes Trust, and the Southern District Health Board, to provide access to high tech imaging close to home. The CT scan services offered at Dunstan Hospital include:
● Public Outpatient CT scans – requested by a Specialist and funded by the SDHB
● ACC approved and funded CT scans
● Private CT scan services – patient fees or health insurance
● Urgent or emergency CT scans
We have worked closely with the SDHB and Otago Radiology to make sure that we can provide equitable access to CT services for the whole Southern DHB population.
All public funded CT scan referrals are managed through exactly the same systems as before, starting with referral for a scan by a Specialist on the standard blue SDHB CT referral form, sent to the radiology departments at Dunedin or Southland Hospitals. Patients who live in Central Otago and Queenstown Lakes are then given priority for scans at Dunstan Hospital. Additional publicly funded outpatient scans will also be made available to patients from other nearby locations such as Maniototo and Southland.
GP’s can discuss patients who may require an urgent or emergency CT scan with one of the hospital doctors at either Dunstan Hospital or Lakes District Hospital.
Inland Population Growth Fuels big increases in Dunstan Hospital caseload, but the SDHB is signalling a funding reduction
The continuing strong growth in the inland Otago population is driving strong increases in the use of Dunstan Hospital and its associated community services.
Between the 2006 and 2013 censuses, the population of the communities served by Dunstan Hospital grew by 19% overall, with the Upper Clutha district growing by some 29%. Much of this unprecedented growth has been in the 65 years and older age groups, who are the highest users of healthcare services.
Karyn Penno, General Manager at Dunstan Hospital reports that during the past three years
inpatient admissions to the Hospital have grown by 28%,
the use of the High Dependency Unit for patients in critical conditions has grown by 20%
the overall average ward occupancy has risen by 20%.
This strong growth in demand for the Hospital’s inpatient service has been matched by strong growth in the demand for its community services.
The increase in patient numbers can be attributed to a combination of factors in addition to the population growth. These include the CT scanner has enabled more patients to be kept at Dunstan Hospital for definitive care instead of being transferred to Dunedin, and advances in the level and complexity of care provided at Dunstan. All of these factors are helping to achieve the Ministry of Health and SDHB’s strategic aims of delivering quality care closer to home and in the community away from specialist hospitals.
While such unprecedented growth in the demand for clinical services has its challenges, the matter is exacerbated by the fact that funding from the SDHB has not matched the growth in delivery of services. The Hospital has been able to meet the challenges through the willingness of our dedicated staff to shoulder additional workloads and through limited funding from sources other than the SDHB.
The SDHB funding increases received by Dunstan Hospital during the growth periods referenced above, has been at or below the level of inflation (of the order of 2% on average). For the current financial year, the Hospital’s SDHB funding was in fact slightly reduced from the previous year, a situation that the Board of the Hospital reluctantly agreed to, to help the SDHB manage its deficit.
The SDHB has recently advised that they will be aiming for further economies including a reduction in funding of the order of 5% for the next financial year. Russell McGeorge, Chairman of the Hospital’s operating company advises that this situation is clearly not sustainable for Dunstan Hospital, and that the Board and Management of the Hospital are monitoring the situation closely. Without a funding increase to match the increased population related health demands, the level of services provided by Dunstan Hospital cannot be maintained.
COHSL PRESS RELEASE - 5 May 2015
DUNSTAN HOSPITAL WILL BE HEAVILY IMPACTED BY SDHB FUNDING CUTS - PUBLIC MEETINGS TO BE HELD TO ADVISE THE COMMUNITY
The SDHB has confirmed to COHSL that:
We will receive no additional SDHB funding for the 2015-16 financial year to cover increased services resulting from the strong inland population growth
Our SDHB funding for the 2015-16 financial year will be cut by 5% from the funding provided for the current financial year.
Further economy measures are likely later in the year.
These decisions by the SDHB mean that Dunstan must remove approximately $1 million (10%) from its budget for the 2015-16 financial year. This is double the impact of the SDHB’s economy measures on the other rural hospitals in the Southern district.
To operate within this reduced funding level :
We will have to substantially reduce the level of services provided
We will likely have to close 25 to 50% of the inpatient beds
We will have to make corresponding staff reductions
These reductions to our services will have a strong impact on the communities we serve. Significant numbers of overflow patients from Dunstan will have to be transferred on a daily basis to Dunedin, Invercargill, or other rural hospitals in the Southern District. Outpatient services are likely to be affected in the later additional economy measures.
The Board and management of COHSL have made strong representations both to the SDHB’s senior management and to the Chairman of the SDHB on the unique situation that Dunstan Hospital faces, but the SDHB has not changed its position on our funding. It has recently confirmed the first round of economy measures in writing to us.
The cuts to services we will have to make are not a one off-event, but will permanently reset the services available from Dunstan to a new lower level.
The COHSL Board is particularly concerned that the SDHB’s funding cuts are arbitrary and do not address the areas of the SDHB’s operations causing the organisations persistent deficits, and future additional funding cuts could be required.
Given the heavy impact of the SDHB’s decisions on Dunstan, and as a consequence on the Central Otago and Upper Clutha communities, COHSL’s Board has arranged public meetings to inform the communities and hold discussions on the funding cuts, as follows:
7:30pm May 20, Alexandra Community Theatre, Skird St
7:30pm May 21, Cromwell Presbyterian Church, Elspeth St
7:30pm May 26, Main Auditorium, Lake Wanaka Centre
COHSL’s reactions to the SDHB’s intentions are strongly supported by COHInc, the community elected group that represents the communities as the shareholder in COHSL.
The SDHB have been invited to participate in the public meetings to cover the background to, and details of the planned funding cuts. COHSL will discuss the strong growth in inpatient numbers at the Hospital and the impact of the funding cuts. A petition to the SDHB will be available for signing at the meetings.
We strongly urge the residents in the communities served by Dunstan Hospital to attend one of the public meetings to understand what the SDHB’s funding cuts will mean for the Hospital and the community, and to provide feedback to both the SDHB and COHSL.
DUNSTAN HOSPITAL PUBLIC MEETINGS - COHSL FUNDING AGREEMENT WITH SDHB
24 June 2015
Central Otago Health Services Limited (COHSL) reached agreement last week with the Southern DHB for the 2015/16 year. As a result of this agreement and the significant contributions by our staff and shareholder we are able to confirm that outpatients and therefore ward capacity can be maintained at current capacity for another 12 months. This will provide us with the time to develop a new service purchase and delivery model with the SDHB and the Ministry of Health, and secure a longer-term contract.
In summary, the 12-month agreement provides the following:
rollover of our existing contracts with the SDHB for another 12 months
$200,000 reduction to our current SDHB funding
no change to COHSL’s outpatient clinics or their funding, regardless of the outcome of the outpatient services review
adopting an entirely new contract approach for 2016/17, which will include the SDHB making an annual contribution to inflationary pressures and recognising Dunstan’s population growth in our funding contract
“As with every difficult negotiation, compromises from both the SDHB and COHSL means there is a mixture of good and not-so-good in our agreement. It is really disappointing that we weren’t able to secure funding for the increasing demand for health services in our region. The funding reduction of $200,000 for this year is less than the SDHB wanted, but we didn’t want any reduction at all,” says Ms Penno, General Manager, COHSL.
“However, our big win is that because of the efforts and personal sacrifices of our staff, and reductions in some of the community services we provide (notably physiotherapy and community radiology) we will largely be able to continue with our current service levels, including outpatient clinics, CT scans and inpatient services. Our community has been very clear that keeping our acute inpatient capacity was an absolute priority, and that is what we have focused on. Agreement from the SDHB that they won’t change our outpatient funding for this year is a huge relief and means that we won’t have to make the drastic reductions that would otherwise have been required. However we still needed make some significant savings in our budget to make it all fit.”
Savings made for the 2015/16 year include:
capital expenditure for 2015-16 will be kept to an absolute minimum, and in return COHInc have agreed to a one-year ‘holiday’ on the rent that we pay to use the community-owned assets
with the support of the Central Lakes Trust, ceasing the depreciation payments for the CT scanner (ie the money we are paying to COHInc to put aside to buy a replacement scanner when the time comes)
staff training will be pretty much mandatory-only for the next 12 months
medical staff have agreed to continue with their current roster for another six months
grounds maintenance will be done by volunteers rather than contracted out
numerous efficiency measures designed by staff, including significant changes to the stock management system, a complete revamp of the patient records filing system, savings in linen costs, moving to generic business cards
Although many of the savings are short-term, over the coming 12 months COHSL will be working directly with the Ministry of Health and the SDHB to develop a new service purchase and delivery model. The whole health system is under tremendous pressure at the moment, trying to cope with rising cost of service delivery, aging population, consumer demands, pressure to reduce costs, etc. Dunstan, given our position – rapidly growing and aging population, high rurality, distance from base hospital services, the “Dunstan model” with no ED, and an unstable DHB that doesn’t have the confidence of the Minister – finds itself at the leading edge of these pressures.
The SDHB has agreed to work with us to come up with a new contracting model for next year. Conversations with the Ministry about how we might evolve to become part of an integrated network across this region are already underway, with a visit to Dunstan planned in early July. “We will need to work hard to pull this new model together within 12 months, but I know that we can do it – we have already proven that we are innovative, resilient and committed to delivering the best care possible,” says Chair Russell McGeorge.
“We would like to express our sincere thanks to our staff and community for their support during the last few months, and a particular thank you for the personal sacrifices our staff will be making during this next year. It is buying us the opportunity to plan a new, better future for Dunstan and our community.”
021 454 897
New Community Services Van for Dunstan Hospital
Thanks to the generosity of the Rotary Clubs of Alexandra, Cromwell, Wanaka and Roxburgh, we are now the proud owners of a new van which has been fitted out to meet the needs of our equipment delivery service throughout Central Otago and Wanaka. We are fortunate to have also received financial support from the Friends of Dunstan Hospital who covered the costs of the installation of a hoist in the van so that staff are no longer required to lift heavy pieces of equipment. Staff have already reported back on how much they enjoy using the new vehicle and hoist.
We are very grateful to the Rotary Clubs in our region for their on-going support of our delivery of health services. We are well aware of the hours of volunteer work that have gone in to the raising of this considerable sum of money, in particular the very successful book sales in a number of areas.
The District Nurses moved to the Wanaka Lakes Health Centre, from their Tenby Street premises on 1st December. They are located in the newly completed extension on the northwest side of the building. There will be advantages in the District Nursing team being part of the ‘Health Hub’ – with opportunities to enhance communication about patient care, between the relevant teams co-located there.
Wanaka District Nursing weekend hours have increased, hours are now: Monday to Sunday 0830 – 1700.
New Contact details for Wanaka District Nursing team:
Phone: 443- 0750 Fax: 443-0751
COHSL also have an office in the Wanaka Lakes Health Centre that will be used by visiting Allied Health team members throughout the week. We hope to have a shed built on site soon, to house some of the equipment that the Occupational Therapists provide for people in the Upper Clutha area.
Diabetes clinics with the Diabetes Nurse Specialist and Dietitian will continue to be held in the Community Rooms at the Wanaka Lakes Health Centre.
Research into rural health professionals’ skills
Congratulations to our physiotherapist Sarah Walker who has been awarded a Clinical Research Training Fellowship from the Health Research Council of New Zealand (HRC) to investigate the scope of practice, challenges and complexities experienced by rural allied health professionals.
read more here: