PEGASUS
A SNAPSHOT 2021
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Introduction Who we are Pegasus Health is a charitable organisation committed to improving the health outcomes for the people of Canterbury through innovation in service design and delivery, collaboration with partners and continuous improvement. Our vision is to support ‘all Cantabrians leading healthy lives’, and our mission
is to ‘together make Canterbury the best place to receive and provide Primary Health care’. Our values of inclusive, connected, strive and integrity, underpinned by our guiding principle of Manaakitanga, create the fabric of our ways of being as an organisation. Pegasus Health has a commitment to ensure that we overtly, purposefully and strategically thread equity and Te Tiriti o Waitangi through all we do and how we operate. We ensure equity is prioritised in our considerations, structures, decisions and processes so that we are able to improve the health outcomes of all of our people and communities in Canterbury. In particular: •
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The reduction of disparities between the health of Māori and other identified groups within the population of Canterbury and the reduction of barriers to the timely access to appropriate health services; The greater participation of the population of Canterbury in healthrelated issues through proactive consultation and communication with Communities and in keeping with the spirit of the Treaty of Waitangi; and, The improvement of integration and liaison between healthcare providers and others in Canterbury to ensure that health care services are coordinated around the needs of the population of Canterbury.
What we do We support general practices and community-based health providers within Canterbury to deliver quality health care, to more than 445,000 enrolled patients. We are an essential part of the Canterbury health system, delivering community care health services, supporting general practice, and coordinating and linking parts of the system together. We have primary care teams that are responsive to the wellbeing needs of our patients and communities. Prioritising Māori, Pasifika and people with mental health needs, is important to our work. We deliver health care and we are proud of our approach with 47% of the Pegasus Team delivering a diverse range of care directly to patients. Close to 80,000 people attended our 24-hour surgery in 2020. This enables the Christchurch Hospital Emergency Department to concentrate on emergencies. You can see the effect we have on reducing ED patient attendance when you consider that the ED team saw approximately 100,000 people last year. Cantabrians have been through a lot in the last decade and we have responded by growing our community-based mental health services. When COVID-19 arrived, we responded by establishing communitybased assessment centres to ensure people could get assessed and tested quickly.
Acute Demand service We provide an acute care service that supports around 34,000 people in the community annually. As a result there are more hospital beds available for people needing surgical care, and patients don’t face repeat general practice visit fees - yet still have access to radiology, ultrasound, ECG and blood tests. Patients received these results just as quickly as if they were in hospital. Our whānau-friendly observation unit at the Pegasus 24 Hour Surgery provides a place for people needing to be closely monitored. This also provides significant savings across the Canterbury Health System. Community health care costs around $140 per visit, compared to $1,180, for an overnight stay in hospital. A comprehensive register of our services is provided on pages 4-8.
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Why we do it We believe that, for most people, their general practice is the place where they will receive care most of the time. We recognise that general practice cannot do it all, but has a lead role in supporting patients' access to the health and social services they need. Our role is to work across the health system so that people are in control of their own health and can readily navigate access to the services they need.
Where we do it While we are primarily based in Canterbury, we operate a number of services throughout the South Island and share part ownership in the nationwide Healthline service, through Whakarongorau Aotearoa (formerly HealthCare Home).
How we do it We network and collaborate with other health providers. A key initiative is our participation in and hosting of the Canterbury Clinical Network. We work closely with a range of organisations, including the Canterbury District Health Board and other alliance partners, to enable the delivery of primary health care to the community and to assist in the continuous improvement of our wider health care system. We make connections, for example: • We connect with our diverse communities to build understanding (Māori; Pacific and Culturally and Linguistically Diverse (CALD) Health Managers) • We connect with people on a benefit to recognise their potential, help them get well and find meaningful work; (Here Toitū) • We connect communities with the support they need to work through the tragedy of suicide. We focus on clinical quality, ensuring excellent and safe primary care services that are evidence-informed and free from commercial bias. We pragmatically find ways to make things work within a complex system.
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We provide strong clinical leadership. We have a model of clinical quality improvement that is based on peer developed and delivered education. Programmes address variations in practice and equity of outcomes, help to reduce waste, and aim for excellence and safety. Underlying this is our understanding that health systems are complex and distributed leadership is needed if we are to effect positive change.
We bring together information from across the health system to help us understand what we need to do better and demonstrate change.
We help keep people healthy in their own community through the delivery of healthy eating and living programmes. We help integrate the health system: • In Canterbury, we provide a place to meet and work in partnership to redesign the health system to make it a better place for patients and health care providers • We work with general practice teams to enable them to work in ways that best use their skills and enable patients to receive the best care. We use technology to digitally connect healthcare providers and patients across the whole health system (Whakarongorau Aotearoa, Electronic Request Management System, HealthOne)
While this is who we are, it is important to remember where we came from. Pegasus was begun 28 years ago by Canterbury GPs, who had a vision for what primary care could achieve in Canterbury. Over that time, we have evolved into the charitable organisation you see today. Pegasus has been shepherded on this journey by its GP membership, who see a role for primary care in underpinning a health system that makes a positive difference in health and in people’s lives.
We advocate for what is right for the people and health care providers in our community.
Acknowledging our roots
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A snapshot of Pegasus Health Leadership / Alliancing There are many, varied services and activities we provide to support the delivery of primary care in Canterbury.
Pegasus Practice Partners Primary care is made up of an interconnected network of private businesses which are mostly interdependent. Their practice, and business, often share the same core needs. Pegasus is a practice support organisation, working in smart ways to get economies of scale across the clinical and business services that nearly all primary care providers need. We have a core IT function that today provides the backbone of IT systems for the Pegasus network of practices across Canterbury. Our immunisation, mental health, nursing, population health and other teams work with practices to support them to deliver the best possible care to their patients.
Pegasus Community Partners We work closely with a range of community organisations to deliver services that assist people to navigate and access primary care. The Clinical Quality Advisory Board and various advisory groups provide valuable input into strengthening the links between primary care and the community. The services we deliver are based on a philosophy of shared care with our key partners – Canterbury Clinical Network, Canterbury Community Pharmacy Group, the Canterbury District Health Board and the wider health and social sectors.
Canterbury Clinical Network The Canterbury Clinical Network (CCN) is a collective alliance of healthcare leaders, professionals and providers from across the Canterbury health system. CCN is New Zealand’s largest district alliance, with 12 alliance partners working together to improve the health and wellbeing of our communities. Established in 2010, CCN brings people together from across the health system to design and improve health services to ensure people get the care they need as close to their homes as possible. This service transformation is led by people who live and breathe health – doctors, nurses, pharmacists and health managers – alongside the people who use health services every day.
Canterbury Community Pharmacy Group The Canterbury Community Pharmacy Group (CCPG) works to ensure that community pharmacy is an integral part of the primary health care team in Canterbury and that community pharmacists are able to deliver an enhanced range of evidencebased health services to improve patient outcomes. CCPG is engaged at all levels in the planning and development of new health care services for patients and communities in Canterbury.
24 Hour Surgery We are the only Urgent Care Clinic in Canterbury that operates 24 hours a day, 7 days a week and have been caring for the people of Canterbury for more than 20 years. We work closely with over 320 GPs and NPs (a total of 92 practices) in Canterbury who are affiliated with the 24 Hour Surgery to ensure their patients have access to urgent care after hours. All patients are assessed, treated, and then referred back to their regular practitioner for ongoing care. We also welcome patients who are visitors to Christchurch and can provide them with the care they require whilst they are here.
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Our doctors are a mix of Pegasus Health member GPs (out of hours) and our permanent Medical Officers who are specially trained to provide general practice and accident related medical care. Our doctors are supported by highly skilled nurses and administrative staff. We are an ACC accredited accident and medical service provider, with a fracture clinic and radiology services onsite. This services takes pressure off the wider Canterbury Health system and the Christchurch Hospital Emergency Department.
Acute demand It has been 20 years since Pegasus Health set up its Community Care programme, allowing people needing acute health care to safely remain or recover at home. In 2000, general practice doctors and nurses were trained and supported to care for people in their own home, offering all the monitoring and treatment options they would have received in hospital. The programme evolved into the Acute Demand Management Service (ADMS). In 2004, the service was extended across Canterbury, with extra funding received from the Canterbury District Health Board. Today, the ADMS supports around 34,000 people in the community. As a result, there are more hospital beds available for people needing surgical care. Patients don’t face repeat general practice visit fees, yet still have access to radiology, ultrasound, ECG and blood tests. They receive the results just as fast as if they were in hospital. Additionally, a family- friendly observation unit at the 24 Hour Surgery provides a place for people needing to be closely monitored. There are also significant savings across the Canterbury Health System. Community health care costs around $140 per visit, compared to $1,180 for an overnight stay in hospital. When the Canterbury earthquakes damaged hospital buildings in 2010/11, and the number of people needing acute care grew instantly, the ADMS helped fill the gaps. The service has proved particularly helpful for patients with Chronic Obstructive Pulmonary Disorder (COPD). In 2013, people with COPD complication attending the Emergency Department at
Christchurch Hospital would automatically be admitted to hospital for care. ADMS nurses were placed inside the department to work with staff on alternative care in the community and by 2016, more than 160 hospital bed days had been saved.
Education Our Clinical Quality and Education (CQE) Programme provides continuing education to general practitioners, practice nurses, nurse practitioners and community pharmacists throughout Canterbury. Educational messages are tailored to each professional group, with a strong focus on teamwork. The programmes are provided via: • Small Group meetings (peer-led, interactive, case-based) • Large Group Meetings (lecture-style) • Workshops and Modules (e.g. recurring diabetes modules) • Bulletins (e.g. new medicines, safety alerts). The CQE team consists of experienced registered health professionals, most of whom also work in clinical practice. All are skilled in literature searching, critical appraisal, and interpreting and presenting information as evidence-informed educational material. A Qualitative Analyst helps with survey design and reporting, and a Data Analyst scrutinizes prescribing and laboratory test ordering to provide local datasets for discussion. Themes repeatedly threaded through the Small Group programme include: addressing polypharmacy, over-diagnosis, and over-treatment; understanding variation and uncertainty in practice; encouraging shared decision making; and considering health literacy, equity, and diversity. The Small Group sessions aim to present new evidence to health professionals, asking them to compare what they do in relation to their peers, facilitating discussion about challenging issues, and encouraging behaviour change. The information provided in the education sessions is evidence-informed, and free from commercial bias. Each education meeting is facilitated by a Small Group Leader, from a team of health professionals who undergo training specifically for this role. Pegasus Health is a registered RNZCGP Continuing Medical Education (CME) Provider. The Nursing Council of NZ
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recognises professional development hours awarded to practice nurses for participation in the Education Programme. The CQE programme is also recognised by the Pharmaceutical Society of NZ and is suitable to be included as part of the ENHANCE recertification programme for pharmacists.
Whakarongorau Aotearoa Whakarongorau Aotearoa (formerly Homecare Medical) is owned by Pegasus Health and ProCare. It has been providing clinical support for general practices after hours for more than 20 years. Since November 2015, it has also been operating digital telehealth services, which offer free health, mental health and addictions support across digital channels. Events of the last 18 months have disrupted and reshaped Aotearoa and the health landscape. The work of Whakarongorau Aotearoa has been central to supporting the response to some of those events - from the ongoing effects of the tragic events in Christchurch in March 2019, through to the measles epidemic and the Whakaari eruption, and the impacts of COVID-19. With over 4,000 contacts received each day, Whakarongorau Aotearoa’s role is to ensure that every New Zealander has access to free, high-quality health and social care, 24 hours a day, seven days a week, over seven digital channels. In addition to providing National Telehealth Services, Whakarongorau Aotearoa also independently delivers clinical support through several other services, including Employer Advice Line, Mental Health After Hours, Safe to talk, Puāwaitanga and of course general practice out-of hours support. Eight clinical teams work around the clock to provide people with the best quality telehealth advice and care, delivered by registered nurses, mental health nurses, psychologists, psychotherapists, psychiatrists, counsellors, doctors, paramedics, poisons officers, health advisors, sexual harm professionals, and emergency triage nurses. In the 2019/20 year (ending 30 June 2020) 825,582 contacts were answered by the National Telehealth Service - those contacts came from 556,933 people (1 in 10 people in Aotearoa New Zealand).
Key Services In the last 12 months (ending 30 June 2020) over 825,582 contacts were made to the National Telehealth Service - those contacts came from 556,933 people (1 in 10 people in NZ). A further 207,325 COVID-19 contacts were answered in the four months between 1 February and 30 June 2020, taking the total contacts answered through NTS services during FY20 to over 1 million contacts.* *Figures have been rounded to nearest 100; these are ‘answered’ contacts.
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Strengthening Family Practice Last year we introduced Hikitia, our Strengthening Family Practice programme, which builds on the improvements many practices have already made, and is aligned with the Health Care Home philosophy. Hikitia aims to make practices more resilient, through helping improve business efficiency and sustainability, while focusing on delivering patient care in a variety of new ways that value clinical and patient time, and improve the experience for both. Pegasus staff, across a range of teams, support general practices to overcome the challenges and changes faced in delivering care for their patients. An essential initiative is the provision of technology and guidance to provide virtual consults for patients.
Pastoral Care Our Pastoral Care Programme began in 2009. Designed to detect problems at an early stage and support doctors on an individual basis through times of increased stress, burn out or personal problems, the programme has proved its worth through Canterbury’s pattern of crisis, change and progression. The programme offers a combination of peer support counselling and education, covering such areas as prescribing habits and business sustainability. Referrals often come from nurses, pharmacists and doctors with concerns for their clinical colleagues. It’s a safe environment to share concerns and a step before the involvement of the Medical Council.
Advocacy Pegasus Health is a strong advocate for public policy and environments that make the healthy choice the easy choice. Pegasus supports a ‘Health in All Policies’ approach - integrating health considerations into policymaking to improve health, whether it be at a local or national policy level. Pegasus holds position statements on a variety of health topics, including: Equity of Health Care for Māori, Equally Well (addressing physical health inequity for people experiencing serious mental illness
and addiction), Tobacco Control, Healthy Weight, Alcohol and Drinking Water Fluoridation. Our positions align with those taken by the Canterbury District Health Board (DHB), Royal New Zealand College of General Practitioners, and other local and national health organisations.
Mental Health Pegasus is embracing the opportunity to support the roll-out of a new, holistic way of delivering mental health, addiction and wellbeing care through general practice. We are working towards a longer-term solution to provide an integrated model of primary healthcare – Te Tumu Waiora. Te Tumu Waiora Canterbury is a joint initiative, led by the Canterbury Clinical Network in partnership with Pegasus Health, Waitaha Primary Health, Christchurch PHO, Canterbury DHB and NGO partners. It puts wellbeing and mental health at the heart of general practice, with the introduction of new focused roles working as part of the general practice team – the Health Improvement Practitioner (HIP) and Health Coaches (HCs). The aim is to make wellbeing and mental health support services more accessible for high priority groups such as Māori, Pasifika, youth, and people with other equity issues. The programme is currently operational in six practices within Canterbury, with more planned for this year. These practices provide immediate brief intervention to patients, reducing the need for people to be referred for lengthier interventions.
Here Toitū Here Toitū is a national programme launched in 2019 and designed to support people living with a health condition or disability (including mental health), helping them to set their own goals and aspirations, and where they can, return to earning, learning, caring or volunteering in a workplace. The programme is jointly run by the Ministry for Social Development (MSD) and Primary Health Organisations across New Zealand. Pegasus Health has been working with the programme’s predecessor, Step Up, since 2017. This has now evolved into Here Toitū after a successful pilot and trials. The new programme has taken the best aspects of Step Up, combined them with elements from similar programmes - Mana Taimahi (Auckland and Whanganui
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based programme) and Well Plan (Auckland-based) - and scaled up the service to more general practices in their regions, making it available to more people. We’ve already seen through our work with Step Up that it’s about more than just returning to work. We’ve heard great stories from our general practices about patients with complex mental health needs feeling really satisfied through volunteering, and their families say it’s great to see them doing something they wouldn’t have thought possible in the past. A team of health navigators work individually with people to meet the specific health needs affecting their wellbeing and ability to work. There is collaboration between general practice, Ministry of Social Development and the health navigators. A participant who has re-entered the workforce through the Step Up Programme says the health navigator helped her with interview confidence and pointers on how to approach and talk about her illness with future employers.
Suicide Prevention Our Suicide Prevention team leads, coordinates and puts into place suicide prevention activities in efforts to reduce the number of suicides and attempted suicides in Canterbury. It also steps in, as requested, after a death by suicide to support affected communities. Canterbury communities affected by suicide are benefiting from a newly formalised collaboration between Pegasus Health and He Waka Tapu’s Kia Piki Te Ora team (Māori Suicide Prevention Coordinators). The He Waka Tapu team provides suicide prevention activities by addressing the risk factors most relevant for Māori and by building strong communities. The team works closely together to share resources and experiences to strengthen the support they offer communities within the shared kaupapa (programme) of suicide prevention. The data shows that Māori are disproportionately affected by suicide. Provisional suicide data for 2019/2020 indicates Māori suicide rates were 1.7 times higher than non-Māori rates, and so it is vital that suicide prevention activities are heavily informed by Te Ao Māori.
Help For Youth Most of the youth offenders at Te Puna Wai ō Tuhinapo need some form of mental health support. The Youth Justice Residential Facility located just outside Rolleston is operated by the Ministry for Vulnerable Children, Oranga Tamariki. It can house up to 40 residents. Their length of stay varies from one week to several months and lasts while they are on remand, until sentenced by the court. Pegasus Health provides primary health care services to Oranga Tamariki. This includes services at Te Puna Wai Youth Justice Facility and Te Oranga – Care and Protection Facility in Burwood.
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Supporting Change and Systems Improvement Pegasus is working with other partners in the Canterbury health system, to bring about significant improvements for the health of all Cantabrians through System Level Measures (SLMs). SLMs focus on how health systems improve outcomes at a population level, increasing access to health services and reducing inequity in the health outcomes of our communities.
Improved access to cervical cancer screening
There are six key areas of focus that are recognised nationally. Canterbury has a set of locally-selected contributory measures (circling the SLMs on the chart). Of particular significance to Pegasus are four areas: • Improved cervical cancer prevention with increased access to cervical cancer screening • Improved physical health for people with mental illness – also known as ‘equally well’
In-hospital Patient Experience Survey engagement
Primary Care Patient Experience Survey implementation
• Improved oral health • Addressing ‘family harm’ - though not identified as a contributory measure - has been identified as an area where primary care can have a significant impact. We recognise that general practice and primary care can make a big impact in these areas. In a sense, this is where we believe we can make some of the biggest differences in people’s lives, in particular, to reduce disparities in outcomes. At the centre of addressing the System Level Measures is our primary care workforce. As part of strengthening this, a locally-designed skills development course on motivational interviewing was started in 2017, called “Motivating Conversations.” This supports health professionals to bring about positive behavioural change through their interactions with patients. More than 720 GPs, practice nurses, pharmacists and other primary health care professionals have been trained in conducting motivational conversations. Feedback on the course has been positive, particularly with the easy transferability of the skills to their practice.
Understand ethnic variation in Ambulatory Sensitive Hospitalisation (ASH) rates
Improved physical health for people with mental illness
Health promoting lifestyle to support reduced regular smokers.
Amenable mortality rates under 75 years
Reduced acute admissions following a fall
Patient experience of care ASH rates for 0–4 year olds
Improved oral health
Increased newborn enrolments
Reduced length of stay and monitor readmissions
Acute hospital bed days Babies in smokefree households at 6 weeks post birth
Access & utilisation of youth-appropriate health services
Accessible and youth-friendly oral health services
Reduced inappropriate polypharmacy
Increased number of pregnant women are smokefree
Referrals of pregnant women to stop smoking services
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Pegasus In Action Reducing Wait Times and Empowering GPs
Dr Robyn Barnes, Clinical GP Lead, looks forward to sharing the initiative with her colleagues. In September 2018, Pegasus teamed up with ACC and Pacific Radiology in a High Tech Imaging (HTI) pilot project that removed the need for patients with specific, non- acute pain to get a specialist referral for Magnetic Resonance Imaging (MRI). Traditionally, patients with non-acute knee, shoulder or spinal pain had to visit a specialist in order to get an MRI which may or may not have resulted in a return visit to the specialist. Under the pilot project, general practitioners who have received training can now refer these patients directly for an MRI. Following this, the General Practitioner can refer the patient to a specialist for potential surgery, or a physiotherapist, saving time and money for the patient and providing peace of mind. Feedback from GPs has been outstanding, and ultimately, patients have benefited from reduced waiting time, peace of mind and ease of process regarding a potentially worrying situation. This project prevents worsening health anxiety, as the patient can be reassured that the injury will resolve and is not
anything sinister. A long wait time for a specialist referral can result in a lot of suffering. The HTI pilot is being rolled out nationally and Pegasus Health Project Lead, Dr Akshay Shukla, says it has been a collaborative effort. “This initiative is a success story of ACC building partnerships across the sector to deliver care,” Akshay says. “It’s led to an improvement in the waiting time from two to three months, down to 35 to 40 days.” Clinical GP Lead, Dr Robyn Barnes presented the first twoday workshop where doctors were trained in musculoskeletal assessment, and the processing of MRI reports. To date, 264 general practitioners have upskilled themselves in musculoskeletal injury assessment. “We offer training and support for all practices wanting to introduce the HTI programme, and I look forward to being able to work with colleagues to share the benefits of this great initiative," says Akshay.
COVID-19 Response When COVID-19 emerged as a pandemic, Pegasus staff connected with their colleagues throughout the Canterbury health system to respond. The system worked well as we coordinated through the Canterbury Primary Response Group (CPRG) with the Canterbury District Health Board, our fellow PHOs and the Ministry of Health. The Community Based Assessment Centres (CBACs), along with general practice, have become the public face of the response, especially with the Government’s focus on testing. At the height of the pandemic, ten CBACs were operating across urban and rural areas in Canterbury, with a mobile unit providing testing facilities for frontline and at-risk workers such as the Police and staff at hotels, rest homes and supermarkets. CBACs are staffed by doctors, nurses and administration staff and provide clinical assessment, testing, advice, triage, and referrals to other services. Pegasus staff are involved in many aspects of the CBAC through the CPRG operation, including sourcing facilities, setting up and supporting technology and patient management systems, rostering and staffing, communication of referrals, finance and accounts, as well as general management and operational oversight.
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Summary
Pegasus FTE Summary
FTE
Supporting Practices
48.2
Direct to Patient Total
158.1
Direct to Patient – 24 Hour
94.8
Direct to Patient - Primary Mental Health
34.4
Direct to Patient - Here Toitū
11.1
Direct to Patient - COVID
7.3
Direct to Patient - Other
10.6
445, 000
Data, Analysis and IT
76.8
Business Services (Back Office)
53.4
Grand Total
336.5
Total Funded Population (1 Jan 2021)
Māori Pacific Peoples Asian MELAA* European Other
41,357 (8.9%) 13,063 (2.8%) 48,373 (10.4%) 6,515 (1.4%) 350,988 (75.5%) 4,517 (0.9%)
* Middle Eastern, Latin American and African
Enrolled Patients
at Pegasus general practices and affiliated community health providers
464,813
80, 000 Patients
attended our 24 Hour Surgery in 2020
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PHO and Network Governance
Pegasus Health (Charitable) Ltd is governed by a Board made up of ten members and one advisor. Our Board members and advisor are made up as follows:
Pegasus Health roles of Directors and Board Advisor Current at 27 January 2021
Dr Sharon ASHMORE (GP Director)
Ben KEPES (Independent/Community Director)
Director, Pegasus Health (Charitable) Limited Director, Pegasus Health Membership Limited Member, Pegasus Digital Advisory Group Member, Pegasus GPVu Steering Committee Member, Pegasus Health Membership Ltd Membership Committee Member, Sirius Clinical User Group
Director, Pegasus Health (Charitable) Ltd Member, Assurance and Risk Committee, Pegasus Health
Brett CHAMBERS (Advisor)
Nicola SCOTT (Nurse Director)
Chair, Assurance and Risk Committee, Pegasus Health Member, Assurance and Risk Committee, Pegasus Health
Director, Pegasus Health (Charitable) Limited Director, Pegasus Health Nurse Membership Ltd Member, Pegasus Leadership Development and Governance Group
Dr Caroline CHRISTIE (GP Director)
Dr Andrew RAWSTRON (GP Director) Director, Pegasus Health (Charitable) Ltd Director, Pegasus Health Membership Ltd
Deputy Chair, Pegasus Health (Charitable) Limited Director, Pegasus Health (Charitable) Limited Director, Pegasus Health Membership Limited Director, Pegasus Health Nurse Membership Limited Pegasus Health Small Group Education Leader Clinical Support GP, Pastoral Care Programme, Pegasus Health Clinical Leader Representative for Pegasus Health, Medical Council New Zealand Member, Assurance and Risk Committee, Pegasus Health Member, Board Composition Committee, Pegasus Health Member, Remuneration Committee, Pegasus Health
Peter TOWNSEND (Independent/Community Director)
Dr Ben HUDSON (GP Director)
Dr Simon WYNN THOMAS (GP Director)
Director, Pegasus Health (Charitable) Ltd Director, Pegasus Health Membership Ltd Chair, Clinical Quality Advisory Board – CQAB Member, Pegasus Population Health Advisory Board (PHAB)
Deputy Chair, Pegasus Health (Charitable) Limited Chair, Pegasus Health Membership Ltd Director, Pegasus Health (Charitable) Ltd Director, Pegasus Health Membership Ltd Member, Remuneration Committee, Pegasus Health
Jane HURIA (Maori Director) Director, Pegasus Health (Charitable) Limited Member, Pegasus Leadership Development and Governance Group Member, Board Composition Committee, Pegasus Health
Chair, Pegasus Health (Charitable) Limited Director, Pegasus Health (Charitable) Limited Chair, Board Composition Committee, Pegasus Health Chair, Remuneration Committee, Pegasus Health
Dr Vanessa WEENINK (GP Director) Director, Pegasus Health (Charitable) Limited Director, Pegasus Health Membership Limited Member, Clinical Governance Committee (Pegasus representative) for Whakarongorau Aotearoa (formerly HomeCare Medical)
Community-based advisory groups to Pegasus Our Population Health Advisory Board (PHAB) advises the CEO on matters relating to population and community health, and equity. Board membership includes the three Canterbury-wide reference groups (Te Kāhui o Papaki Kā Tai, the Pacific Reference Group, and the Culturally and Linguistically Diverse (CALD) Health Advisory Group), a community mental health expert and other local population health experts: • Te Kāhui o Papaki Kā Tai is a Pegasus funded and administratively supported Canterbury-wide Māori health reference group of primary care organisations, clinicians, community organisations, Manawhenua ki Waitaha (local iwi representation), Māori community providers and the Canterbury District Health Board, including Community and Public Health, formed in 2009. • The Pacific Reference Group is a Pegasus funded and administratively supported advisory group that was formed in 2000 (known then as the Pacific Health Meeting) in recognition of the health inequalities of our Pasifika population. The Pacific Reference Group is a Canterbury-wide combined group of primary care organisations, clinicians, community organisations, Pasifika health providers, Government and District Health Board. •The Culturally and Linguistically Diverse (CALD) Health Advisory Group is a Pegasus funded and administratively supported Canterbury-wide health reference group, consisting of representatives of primary care organisations, clinicians, community members, and the Canterbury District Health Board.
Clinical, Data / Digital and other specific Governance Pegasus’s Clinical Quality Advisory Board (CQAB) is our highestlevel clinical governance body. It has membership from primary care professionals (GPs, PNs, NP, pharmacist, social work) and consumer representation. The purpose of the
group is to provide leadership in clinical quality for Pegasus’s direct-to-patient services and the GP network for clinical quality. CQAB has 2 sub-committees: • The Research Committee provides leadership for Pegasus Health’s primary care research activities. This includes managing frequent requests by researchers seeking support for their research. A common request is for supply of data to address research questions. Comprehensive data-sharing policy and procedures have been developed to guide this work. The committee has active, collaborative relationships with researchers to address research questions of mutual use to the population and communities, of not only Canterbury but New Zealand. The committee includes a consumer representative.
• The Pegasus Digital Advisory Group (PDAG) provides advice to Pegasus on matters relating to IT, electronic technology and digital platforms. The Group: • Advises and supports the CIO and Clinical Leader for IT in considering organisational and broader IT issues • Identifies emergent risks in a ‘clearing house’ capacity and escalates for consideration and decision, if necessary • Acts as a conduit for General Practice to identify potential technology, systems or service opportunities that will improve service delivery to patients and efficiency within General Practice • Is a point of reference for existing and new programmes within Canterbury and South Island.
System Governance - Canterbury Clinical Network (CCN) District Alliance Pegasus is a founding member of the Canterbury Clinical Network District Alliance (CCN) and worked jointly with the Canterbury DHB to establish the Alliance as a truly clinically-led body for the district in 2010. The Alliance is largely based on the decision-making and relationships that existed in Canterbury prior to the national health policies of the day.
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CCN is a highly functioning health system alliance that has made great gains in patient-centred integrated care, aimed at reducing health inequities across the district. It recognises that a complex system requires distributed leadership – and our staff take an active role in this leadership. We provide a complete hosting service to enable the CCN District Alliance to operate, including employment of key CCN programme office staff and leadership, use of Pegasus facilities, infrastructure and office equipment. CCN is New Zealand’s largest district alliance, representing 12 alliance partners who work together to improve the health and wellbeing of more than 550,000 people from Kaikōura to Ashburton. This involves extensive alliancing initiatives to improve the health outcomes of our communities and proactive partnership between health service professionals and community members. CCN brings people from across the health system together to design and improve health services collaboratively, ensuring that communities get the services they need – in the right place and at the right time. We are involved at all levels of the Alliance, from the Alliance Leadership Group to the Alliance Support Team and all the work streams and relationships under the Alliance. Our role includes chairing three of the alliancing groups (Child and Youth, System Outcome Steering Group and Population Health and Access Service Level Alliance).
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Governance Roles in related entities Pegasus is involved with the following organisations: • Canterbury Community Care Trust – shareholder and director appointment • bpacnz Limited – shareholder and director appointment and current Chair • Whakarongorau Aotearoa (HomeCare Medical) – shareholder and director appointments • Whakarongorau Aotearoa (HomeCare Medical) – Clinical Governance Committee (Chair) • HealthOne Fusion – part owner and leadership team member/chair appointment • Screen South Ltd – shareholder and director appointments, one of which has held the Chair role • Early Start Project Limited – shareholder and director appointment.
Sector Leadership Pegasus directors, clinical leaders and senior staff are broadly involved in leadership roles across the sector: • University of Otago, Professor of General Practice, Head of Department of General Practice • Health Quality and Safety Commission – Primary Care IAG RNZCGP Rural Chapter • Pharmac - various sub-committee memberships • Medical Council New Zealand - representative • Canterbury Clinical Network - Alliance Leadership team and Alliance Support team • General Practice New Zealand - Executive • General Practice New Zealand CEO Group (Chair) • Health Care Home Collaborative – appointments (Chair) • South Island Electronic Request Management System (ERMS) – Joint leadership with Canterbury District Health Board. • Canterbury PHO CEO Group • Primary Health Organisation Service Agreement Amendment Protocol (PSAAP) - Member • Te Tumu Waiora Sponsors Group • Canterbury COVID Vaccination Task Force • Canterbury Primary Response Group • System Level Measures Regional System Outcomes Steering Group (Chair) • Trustee Christchurch Early Intervention Trust (The Champion Centre) • New Zealand Family Planning (Deputy President).
Contribution to Programme and Activities Within the Canterbury Clinical Network District Alliance there are 24 groups – of which eight are Service Level Alliances, four are Work Streams, and four are Service Development Groups. The Alliance includes the System Level Management (SLM) oversight group. The Canterbury Clinical Network Work Programme 2020-22 describes the work carried out by these groups. We actively participate in most of these groups. The examples below highlight our involvement: Programme Office system development work • Review and redesign of the alliancing co-design approach and process. Population Health and Access Service Level Alliance initiatives (Chaired by Pegasus Health Public Physician) • Co-design of the Canterbury Health Systems approach to promoting and supporting healthy lifestyles • Research to understand issues of people who are unenrolled and to identify the number unenrolled – a Pegasus funded project • Initiative to improve access to, and quality of, interpreter services across Canterbury • Initiative to improve pathways for people identifying as transgender. Child and Youth Workstream (Co-chaired by Pegasus Health Director of Nursing) • Oversight of B4SchoolCheck programme • Project to review youth access to sexual health services with a focus on high risk populations. Community Services Service Level Alliance • Work to identify women under 65 at risk of osteoporosis and develop strategies towards early intervention. Co-ordinated Access on Release Group • Implement HealthOne into prison health units in Canterbury • Reintegration services and linking with primary care on release.
Health of Older People Workstream • Early diagnosis of dementia initiative • Deprescribing in older adults initiative. Immunisation Service Level Alliance • Improving pertussis coverage in pregnant women • Outreach programme to reach children missing out on immunisations • Immunisation Conversation Programme. Mana Ake Service Level Alliance • Mana Ake provides support to children in Canterbury, in years 1-8 at school, promoting wellbeing and positive mental health • Canterbury’s primary and intermediate schools are able to access dedicated wellbeing and mental health support in schools • A successful collaboration between Health and Education. Mental Health Workstream • Implementation of the new integrated primary care mental health service Te Tumu Waiora • Cross-agency Canterbury Suicide Prevention Action plan implemented. Oral Health Service Development Group • Advocacy for improved Oral Health, including water fluoridation and reduced sugar/ sugar free policies.
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Pharmacy Service Level Alliance • Addressing gaps in the current patient transfer process, focusing on management of medications during admission from and discharge back to the community • General Practices polypharmacy audit capability. Rural Health Workstream • Rural workforce gaps analysis • General Practice and St John access to after-hours urgent care and emergency responses in rural Canterbury communities, including PRIME3 • Project to understand inequities in access in rural areas • Model of care development in 3 rural areas – Hurunui, Oxford and Ashburton • Telehealth development. System Outcomes Steering Group (see Quality Improvement Initiatives section) Urgent Care Service Level Alliance • Proactively plan for coordinated system responses for periods of exceptional demand, particularly during winter or infectious disease outbreaks.
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Workforce Development Initiatives Pegasus Small Group Education Programme Pegasus has had a long tradition in the development and delivery of high quality, innovative training and education. Our Clinical Quality and Education Team develops and coordinates the delivery of this programme. Our Small Group Education Programme’s overarching philosophy is ‘the promotion of best clinical practice through optimal and ethical use of finite resources and addressing health inequity’. The programme promotes clinical quality and aims to reduce variance in practice. It is a key approach to quality improvement for the primary care network under Pegasus Health and other PHOs. The programme’s approach shows clinicians what they are doing in comparison to their peers, presenting summaries of new evidence (including the controversies within it), and allowing peer to peer discussion. It aims to: • ensure the optimal use of public money for pharmaceutical prescribing and laboratory testing • promote of evidence based, peer reviewed quality use of medicines; and • reduce in unnecessary testing which can have negative health outcomes, such as patient anxiety and false positive test results. The structure and approach of the Pegasus Small Group Education Programme incorporates over 27 years of experience in providing education services to General Practitioners. The effectiveness of the programme is directly related to the quality of the evidence-based education material, localised data (where appropriate) and active leadership of the peer support learning environment by trained facilitators.
The last ten topics the small group education programme covered were1: • Family Harm Prevention • Smoke and Mirrors – a topic covering aspects of smoking cessation and vaping • Testing Times – a topic covering the principles, concepts, benefits and harms of testing • Child and Youth Mental Health • Medicinal Cannabis • Ageing Well • 1st 1000 days • Health in the digital age • Refugee and Migrant Health • Live and let liver.
We run two scholarship programmes, both of which are funded by Pegasus Health Charitable Ltd and award $30,000 annually to approximately 20 students who are studying medicine, nursing and allied health profession studies: • Pegasus scholarship awards for Māori, Pasifika and CALD health undergraduate students • Summer scholarships / studentships.
Outside of Canterbury, the Pegasus Small Group Education Programme partners with six primary care networks to provide access to the programme. These include Comprehensive Care, Mahitahi Hauora, Pinnacle MHN, ProCare and South Canterbury DHB. The Pegasus Education Programme also provides Large Group sessions on a variety of clinical and non-clinical education topics, such as the COVID vaccination programme.
In Partnership with the CDHB, we have created two permanent and ongoing positions for new graduate registered nurses within the existing New Entrant to Practice Programme (NetP).
Scholarship Programmes We are committed to improving health outcomes and reducing health inequities for the people of Canterbury, so a large part of our focus is the development of an effective and engaged primary health care workforce. We see that having a diverse primary health care workforce is critical to meeting the health care needs of the people of Canterbury. In 2001, we established the Scholarship Awards to encourage a wider diversity of health professionals to enter the primary health care workforce in Canterbury. The awards are also an opportunity to celebrate and promote a diverse workforce.
New Entrant to Practice Programme (NetP) The Canterbury District Health Board (CDHB) and Pegasus Health are both strategically focused on equitable access to health care and equitable outcomes for all. Within this, we are focused on developing an equitable workforce that meets the needs and demographics of our target population.
The Korimako and Toloa initiatives place a new graduate Māori and a new graduate Pasifika registered nurse in a primary health care setting where there are significant Māori and Pasifika populations. Each position runs over a twelve-month period and the nurse is placed in an identified General Practice, and either a Primary Care based Pasifika PHO or Māori PHO. The programme was developed in partnership with providers, utilising a co-design model. Both salaries and associated expenses are funded as a joint venture between Pegasus and the CDHB, with no cost to the General Practices or NGOs.
Professional Training Programmes • •
Pegasus hosts the RNZCGP Registrar Training Programme Pegasus is an approved training site for the NZ Public Health Medicine training programme with one Public Health Medicine Registrar in placement undertaking equity related projects.
1 Please contact Pegasus for a detailed synopsis of each topic if required
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Motivating Conversations
CME
Allied health education
One of our ongoing Pegasus education initiatives is the Motivating Conversations training, providing skills development in the area of motivational interviewing for all primary health care professionals across Canterbury.
Our Clinical Quality and Education team is an approved agent, acting on behalf of RNZCGP to approve education for CME points for professional development programmes.
Pharmacists from across Canterbury participate in the Pegasus Small Group Education Programme. We facilitate Large Group education sessions for all Allied Health staff, including social workers and mental health practitioners. Our Social Work lead provides support to social workers working in general practices and NGOs.
Pegasus Pastoral Care Programme Our Pastoral Care Programme began in 2009. Designed to detect problems at an early stage and support doctors on an individual basis through times of increased stress, burn out or personal problems, the programme has provide its worth through Canterbury’s pattern of crisis, change and progression. The programme offers a combination of peer support counselling and education, covering such areas as prescribing habits and business sustainability. Referrals come from nurses, pharmacists and doctors with concerns for their clinical colleagues. It is a safe environment to share concerns before the possible involvement of the Medical Council. The programme has been running successfully for twelve years and has helped many GPs. The number of practitioners is small, so the programme is individualised. It is always confidential.
APEX We host an annual education event for practice managers and administrative staff.
GPVu Reporting Portal Through the GPVu portal, we provide access to RNZCGPapproved audit templates for CPD credits.
Our education programme attracts 700 - 800 Primary Care Clinician participants (GPs, Practice Nurses and Pharmacists) across the Canterbury health system.
CNE Registered Nurses and Nurse Practitioners from across Canterbury participate in the Pegasus Small Group Education Programme. In addition, we run a range of nursing workforce support and training initiatives, including: • Financial support to attend conferences, professional supervision, counselling, courses, and PG education • Pasifika and Māori NetP positions in partnership with CDHB • Management of career development through Nursing Workforce Development Coordinator for all General Practice nurses • Student summer scholarships • Locum nurse (General Practice) hui • Nursing team leader (General Practice) hui • PDRP oversight and coordination by Nursing workforce development coordinator • Professional supervision oversight/guidance by Nurse Advisor • Facilitated Nurse Advisory forum • Sponsorships of nursing conferences, for example the College of Primary Health Care Nurses.
Cultural competency We provide training to support cultural competency, including: • Te Tiriti and other cultural competency education to general practice and allied health staff on a regular basis • Training to lift capability in health care for Muslim communities.
Equity We run regular seminars and training sessions on the Treaty of Waitangi and its application to healthcare.
Digital literacy We offer individualised and group training in Medtech32 for General Practice teams, in a specialist training facility and at both intermediate and advanced levels.
Other Practice Managers and Practice Staff • New Practice Manager Induction programmes • Hosting and delivery of APEX seminars for administration staff include: Health and Disability, Privacy, Enrolment, and Best practice.
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General Practice Support Activities Clinical support services
Cornerstone and Foundation Standard support
We support general practice teams to deliver first level and extended services, including: • Immunisation co-ordination - training and advice on delivery of the immunisation programme, including cold chain • B4SC (Before School Checks) - training of nurses, co-ordination, and outreach • Smoking Cessation - ABC and cessation support to individuals on behalf of practices • Refugee support services • GPVu Reporting Portal • Fracture Clinic service delivered at the 24 Hour Surgery • Acute Demand Management Services • ACC GP access to High Tech Imaging programme – clinical training, programme management and referral management.
We support general practices to achieve and maintain both the minimum Foundation Standard and Cornerstone accreditations (RNZCGPs quality framework’s two key programmes). This mature programme provides: • A Pegasus Quality Programme Manager with further support from the Practice Support Liaison roles • General templates and guideline resources centrally developed and made available to practice teams through an online portal • Foundation Standard assessments for practices (at no cost) • Cornerstone assessors available to practices as required.
Health Care Home Support The Health Care Home (HCH) integrated care management model helps general practice improve how it deals with unplanned and urgent care, deliver more proactive care for patients with long-term health needs, and lift business efficiency. We have endorsed the Health Care Home model as the model we use for driving change and continuous improvement within our general practices. We actively promote and support the Health Care Home initiative through: • Rolling out the Hikitia (Health Care Home Fundamentals) initiative to general practices: pegasus.health.nz/health- professionals/hikitia • Being a Health Care Home Collaborative member: healthcarehome.org.nz • Canterbury-wide hosting of the IFHS/HCH programme, supporting all three Canterbury PHOs to deliver the Health Care Home Model of Care work.
Health system change support Practice Support Liaisons actively support Ministry of Health & CDHB led projects. They support practices to implement new programmes, such as the National Enrolment Scheme and Primary Care Ethnicity Data Audit toolkits (EDAT).
Technical support We provide IT, phone system, and Patient Management System support to practices. Our Pegasus Service Desk provides: • Hardware, software, and user support for all key general practice technologies • Provision of hosted telephony solutions • IT and Medical hardware procurement - configuration, installation, loan equipment, repair, and maintenance • Medtech32 incident, service and problem management including upgrade, hosting, database maintenance, patient record extraction and merging between practices, new practice implementation, third party integration e.g. Gp2Gp, Healthlink, ACC, PMS advocacy on behalf of practices with the vendor, and SQL report creation • Secure internet access including mail and web filtering; anti-virus protection, tuned firewall protection, 4G failover, and load balancing
• Security services including Active Directory authentication to shared resources, HISO compliance assistance, application security reviews, secure and encrypted file transfer, and database and file backup and restoration • New practice assistance including cabling advice, fibre connection assistance, hardware and software requirements, PMS advice and implementation assistance • Practice IT environment monitoring and management • Emergency and disaster assistance with IT, power and connectivity solutions e.g. Christchurch earthquakes and Covid19 • Application hosting and provision e.g. domain registration, web hosting, Office 365, email, and instant messenger • Claims and payment (management) support via Pegasus developed systems e.g. Helicon.
Administration We help practices achieve health system compliance, such as enrolment and friendly audits. • Our Practice Support Liaison team supports practices in their health system compliance processes, data integrity and clinical coding. • The Pegasus-developed GPVu portal provides reports reconciling PMS enrolments against the NES, to ensure patient information (such as ethnicity) is accurately recorded and needs are highlighted, such as patients whose enrolment or Community Services Card card is expiring.
Communications We have developed an integrated system of communicating to Canterbury general practices to ensure timely and relevant updates, through: • Peg E Post – a weekly digital newsletter sent to our membership network, the CDHB, and contacts across the Canterbury health sector • Pegasus World – a dedicated website for information relevant to Canterbury primary care.
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District service claiming & econciliation We provide claiming services for Canterbury general practices across a range of district-wide programmes, including: • Acute Demand packages of care • Planned care • Subsidised procedures, for example spirometry, sleep assessments, and lesions.
Mentoring and training We deliver accredited Advanced Clinical Life Support Training (ACLS) for general practitioners and Practice Nurses at our dedicated training facility. Allied health, Nursing and General Practice Liaisons provide communication and facilitation between general practice and Christchurch Hospital clinicians across acute, elective, chronic and allied health services. The liaison service: • Aims to improve patient access to services and patient outcomes • Can be contacted for advice on referral criteria or when issues arise around specific referrals.
Performance reporting We provide reports to general practice teams to support improvement in clinical and business quality. Reporting utilises data collected in near real-time (daily update) incorporating data from general practice PMS, hospital discharges, ED attendances, 24 Hour Surgery attendances and community delivered retinal screening. Reports are accessed by practices via a secure webbased portal.
Procurement We provide general practices with a bulk vaccine purchasing, storage, ordering and distribution service.
Recruitment support directly, including locums Our corporate HR function provides a full-service recruitment offering for general practice, including GP, PN and Practice Manager roles. This includes advertising and promotion to attract domestic and international candidates to consider working in Canterbury.
Workforce provided directly to practices Our GP Plus Service provides fixed term placement of Pegasus employed Medical Officers and general practitioners into general practice. Our Health Improvement Practitioners are embedded in general practice and work alongside general practice teams as part of the Te Tumu Waiora programme (also refer to Clinical Services section>Mental health).
Other services Organised afterhours care for patients enrolled in Canterbury general practices is provided by the Pegasus 24HS Urgent Care clinic. Most general practices across Canterbury utilise the afterhours nurse-led telephone triage service delivered by the Pegasus subsidiary, Whakarongorau Aotearoa (formerly HomeCare Medical). When Canterbury general practices are unavailable to provide care to their patients, the Pegasus 24HS Urgent Care clinic provides planned cover, such as at Christmas and on other public holidays.
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Other Provider Support Activities Technical support
Administration
(e.g. IT, phone system, PMS) HR / recruitment / training
Our facilities and infrastructure is leveraged by the Canterbury health system to host several key initiatives, including use of Pegasus corporate support services and direct employment of team members. Hosted groups include: • Canterbury Community Pharmacy Group • Canterbury Clinical Network • Canterbury Primary Response Group • Canterbury Community Care Trust (CCCT).
We provide: • Secure WAN internet connections and service desk support for Pharmacy • MedTech licensing and support free of charge to The Cambridge Clinic, a specialist medical service for anybody over the age of 12 who has been sexually assaulted or abused
Health System Communications A key outcome of our communications strategy is to assist teams across Pegasus in improving health care access and equity, and community wellbeing.
We use multiple channels to communicate, build and maintain relationships with the wider health sector, community and patients, including: • Pegasus 2025 – a fortnightly digital newsletter sent to key stakeholders • Peg E Post – a weekly, digital newsletter sent to Canterbury GPs • Pegasus World – a dedicated website for the Canterbury Primary care sector • Dedicated social media – including Facebook and LinkedIn • Dedicated websites – Support Plus (supportplus.co.nz), Beefound (beefound.co.nz), 24HS (24hoursurgery.co.nz), and our flagship Pegasus Health website (pegasus.health.nz) • Pulse Surveys with practice partners. Pegasus 2025 is our new electronic multimedia newsletter, which focuses on stories where Pegasus teams and initiatives improve the lives of patients and communities. Our stories showcase the role of general practice and our leadership in innovation within the Canterbury Health System. To support these initiatives, we are developing a reservoir of stories that are told from a human – rather than a system – point of view. We communicate with our members via seminars and meetings, through our liaison team, and with various email bulletins. In the next six months we will refresh our websites, our member intranet (Pegasus World), and our internal SharePoint site as part of an increased focus on quality communication and increased digital engagement.
Other services We provide additional clinical and support services under contract to a range of organisations, including: • Nova Trust (Detox centre) - provision of medical services • Department of Corrections - Medtech 32 support and maintenance • Oranga Tamariki Youth Justice Facilities – provision of Medical services • MSD Here Toitū Programme management and delivery • Whakarongorau Aotearoa – National Quitcard services.
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Quality Improvement Initiatives Equity based QI initiatives Our System Level Measures plan contains several Continuous Quality Improvement initiatives with a focus on equity, including: • Addressing family harm and risk of family harm - A major piece of work has started to enhance our approach to addressing family harm and risk of family harm. This is a multi-pronged approach through general practice teams, that includes surveys and peer-led education. We are developing expertise and resources within Pegasus to support the GP network, and establishing communication channels that support clear, timely and accurate transmission of information about people who are experiencing, or are at risk of, family harm. • Cultural competency – Our equity team works directly with general practice teams who have high Māori, Pasifika and CALD population to address cultural competency and community engagement, and outcomes for their enrolled population. • Motivating Conversations development programme – After running an improvement project to address low levels of motivational interviewing confidence and skills in primary health care health professionals, we established an innovative skills development education programme called Motivating Conversations. This is critical to supporting ABC and other person-centred preventive work in primary care. We identified that no education was available in Canterbury (or New Zealand) to effectively develop these skills. Since developing this programme, over 700 primary health care professionals have undertaken the programme. The initiative was instigated by Pegasus, but has been a collaborative endeavour, involving the three Canterbury PHOs. The programme is also available across other regions.
Priority Areas
Health targets Te Ha Waitaha – Stop Smoking Canterbury We provide two Stop Smoking Practitioners to work with patients across the network under the wider Te Ha Waitaha framework. ABC Smoking Cessation Our Stop Smoking Support Advisors undertake: • Recalls contacting target populations on behalf of Pegasus practices offering stop smoking advice/interventions and linking patients in with appropriate programmes or services. • Education, advice and support is provided to practices re: processes for ABC coding; using GPVu to create Recall lists; ABC delivery best practice and referrals. • Information and news updates to practices on current Tobacco control related matters. Vape to Quit is a current new tool / topic and Heated Tobacco Products is an emerging topic.
System Level Measures (SLMs) Advocacy We have actively advocated at a national level for meaningful ways to promote clinical quality. We have been instrumental in informing the System Level Measures (SLM) Framework and are a key partner in the Canterbury SLM Plan. The System Outcomes Steering Group is Chaired by Pegasus Health’s Public Health Physician. Pegasus places a high priority on implementing the System Level Measures (SLM) Framework to support system change, to meet health care needs and address inequity of outcomes. The plan is an important part of our commitment to our Equity Strategy and to meeting our Te Tiriti o Waitangi obligations. Each continuous quality improvement initiative identified in the SLM plan has an equity focus, and the majority involve our teams working closely with other Canterbury PHOs.
To further embed SLM improvement work at Pegasus, we have identified SLM priority areas to put additional focus and resources in. These include: • An Equally Well primary care-based initiative that aims to improve health of people who experience severe mental health and/or addiction. This has identified the need for better navigation and follow-up for clients. Enhancements are being planned to navigation roles within Pegasus. • The SLM ASH Rates focus is on oral health for Māori and Pasifika children. Pegasus is identifying ways in which general practice teams can promote oral health and enrolment in dental services. • Cervical cancer prevention is a focus that recognises the need to improve cervical screening and HPV rates. We have formed a close relationship with ScreenSouth and are making progress at increasing dropping cervical screening rates, particularly for Māori. This improvement initiative will be extended in 2021 as capacity is available. Other SLM contributory measure improvement initiatives with the Pegasus team’s active involvement includes: • Smoking cessation services – we have undertaken major restructure and improvement in how enrolled smokers are supported to stop smoking. This includes innovations in how the Pegasus-based ABC team focus on supporting practices with high Māori and Pasifika populations. Pegasus has also reviewed the general practice-based programme (PEGS) and instead now employ two Stop Smoking Practitioners who work with the Te Hā - Waitaha smoking cessation programme. This has contributed to the now more efficient, effective, and equitable smoking cessation services across Canterbury • Polypharmacy - a joint primary-secondary improvement initiative that we have been a key partner in, is focusing on reduced inappropriate polypharmacy • Findings of the Patient Experience Survey are contributing to quality improvement initiatives within general practice team supported by the Hikitia programme.
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Targeted programmes
GPVu
We have established important quality improvement programmes, including: • Hikitia (Health Care Home Fundamentals) initiative. We support and roll-out the Hikitia / Strengthening Family Practice (SFP) programme for general practices. It is based on a collection of ideas from the Health Care Home approach, which have proven valuable to Canterbury practices. This continuous quality improvement programme aims to support practices to become more resilient with delivering services in a dynamic environment and more flexible in meeting patient needs. Read more about Hikitia: pegasus.health.nz/health-professionals/hikitia/ • Pegasus Small Group Education Programme (refer to Workforce Development Section).
The GPVu reporting portal can be used by general practice teams to understand their enrolled population and improve clinical and business quality. GPVu utilises data extracted from Practice Management Systems, the Canterbury DHB and the National Enrolment Services. It supports the work of Hikitia.
Research Initiatives Pegasus Health Research Programme We are actively involved in conducting and supporting health research that addresses matters of regional and national interest. All research is undertaken in partnership with tertiary institutions. We have particularly strong research partnerships with the University of Otago in Christchurch and the University of Canterbury.
Examples of research activities include: • Hosting 4-5 students each year on small research projects. These summer studentships are hosted at Pegasus with co-supervision from Pegasus and the University involved in the project • Supply of quantitative data for regional and national research projects • A range of other collaborative research with tertiary institutions. Our Research Projects include: • Estimating the level of interpreter use in general practice. Though this has generally thought to be low, this was a world first in attempting to numerate the usage. • Identifying barriers for Pasifika to access general practice. Though this has been described before, this was in fact the first time that novel research has been published on this issue. • Understanding of health literacy with practice nurses. • Currently underway - a research project to numerate the numbers of people unenrolled in Canterbury. This project is using the IDI to determine this and will be a New Zealand first, as currently reported unenrolled numbers are based on estimates using census data projections. This is part of a Public Health Medicine training programme registrar project.
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Clinical Programmes Coordinated Primary Options (CPO) / Primary Options for Acute Care (POAC) • General Practice packages of care - Where GP teams provide care to patients, specifically to avoid hospital admissions where additional care in the community can enable this. There were 79,384 packages of care provided in 2020. • Imaging- Such as scans of kidneys, ureters, and bladder (CTKUB), ultrasound and x-ray • Hospital-based liaison nurses working with clinicians to support the discharge of patients to the relevant services, e.g. to GP for care or to Acute Demand Community Nursing • Acute Demand Community Nursing (ADCN): Provision of community-based care for COPD, heart failure, skin infections etc. In home or in clinic care provided for up to a week. The nursing team have supported 11,848 cases in 2020 • Observation Unit - Located within the 24 Hour Surgery, 5,343 patients were observed in 2020 • Clinical governance to support General Practitioners in their care of patients and oversight for the ADCN team.
Where clinical care is delivered by the Acute Demand Community Nursing (ADCN) service, the GP team are kept collaboratively informed and the care of the patient is returned to the GP team at the conclusion of the episode.
Pegasus was instrumental in the establishment of the Canterbury Acute Demand service and continues to provide significant support to the leadership, delivery and hosting of the programme including: • Representation on the Canterbury Community Care Trust which oversees the delivery of the services to the Canterbury population • Employing and hosting the service delivery teams, i.e. coordination team, community nursing team, liaison nurses • Clinical Services and observation capacity at the Pegasus 24 Hour Surgery • Claims and payment agency services for packages of care claims across Canterbury • Service governance and management.
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24 Hour Surgery Pegasus Health 24 Hour Urgent Care Services The service provides care to patients when their primary care team are at capacity or closed. Additionally, the service provides care to patients who can safely avoid an Emergency Department (ED) or hospital admission with the provision of appropriate care in the community. In line with its system-focused role in Canterbury, the Pegasus Health 24 Hour Surgery is a non-enrolling practice, returning care of patients to their GP team. Key facts about our 24HS: • Approximately 80,000 attendances per year (a similar volume to the Canterbury DHB Emergency Department) • Patients who must attend for hospital-level care are differentiated and referred to the appropriate specialty which minimises the impact on ED and is better for the patient • Our service includes an Observation Unit where patients can be observed and managed for up to 24 hours. In 2020, 5,343 patients were observed • The 24 Hour Surgery can receive patients brought in by ambulance • The 24 Hour Surgery’s role in the system is well understood by Cantabrians and this is illustrated by attendance. Over Christmas 2020 / 2021 ED saw 53% and 24HS saw 47% of presentations to both facilities. On two days, presentations to 24HS exceeded those to ED, leaving ED for emergencies as is appropriate • The 24 Hour Surgery provides afterhours medical services to Aged Residential Care residents to prevent unnecessary ED or hospital admissions. An ACC specialist services contract is held by 24HS and an Orthopaedic Surgeon is available for fracture clinics, with a second surgeon as backup. There were 1,634 visits in 2020. We are also contracted to provide ACC Urgent Care. This is staffed by ED physicians and 24HS Medical Officers and enables patients to be treated in the community, by appropriately qualified staff in an appointment-based system. There were 4,159 visits in 2020.
In addition, the 24HS has been instrumental in our COVID response: • Streaming and swabbing made available; with more than 10,000 red / orange stream presentations and 4,700 swabs completed • Provision of 24/7 clinical care to guests of Canterbury MIQ (including COVID care). This includes a daily ward round with MIQ staff, Community Public Health (CPH) and relevant respiratory and infectious diseases clinicians to ensure coordinated care for these patients. In 2020, 1,059 consultations were completed.
Te Tumu Waiora Fifteen of our general practices have the Te Tumu Waiora model operating within their practice. Our HIPs are seeing over 600 patients per month and the Health Coaches are meeting with over 300. We provide programme leadership and directly employ HIPs. Brief Intervention Talking Therapies Trained mental health professionals use the FACT (Focused Acceptance Commitment Therapy) model to deliver up to five sessions of talking therapies with patients referred from general practice. Based on need, the level of access to the programme for the Canterbury population is significantly higher than in other parts of the country. Over 8,000 patient referrals are received every year to this service. We provide 20 FTE of social work and counselling across an enrolled population of 453,000 (8.7% Maori; 2.8% Pacific; 9.7% Asian; 1.3% MELAA and 76.7% European). Referrals for this service increased by 16.5% in the last 12 months.
Here Toitū This programme supports unemployed patients on Jobseekers – Health Deferred Benefit to return to work. Case navigators work with individuals for up to a year supporting them to overcome the health barrier that is preventing them from working, and then supporting them in finding employment and/or education. The predominate presenting issues are anxiety, depression and AOD. Suicide Prevention Coordination Programme Canterbury DHB’s Suicide Post-vention Team, hosted at Pegasus, provide communities where there has been a suicide with support around resources, and facilitates community development to enable the community to heal.
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Radiology / Diagnostics GP-Referred MRI Pegasus has worked closely with ACC to trial increased general practitioner access to GPs to hi-tech imaging such as MRI. The trial has been successful in improving patients’ access to diagnostics and care. We have been actively involved in GP training, clinical triage of referrals (CQI), developing referral pathways, and managing relationships with imaging providers and radiologists in the community and hospital. ACC is now looking to roll out a similar service nationally using PHOs as their delivery partners.
Other services Child Health Support We work with families referred from general practice and needing mental health, behavioural or social support. Partnership Community Workers (PCW) This Pegasus-provided health navigation and linking service specifically meets the needs of Māori, Pacific, CALD and lowincome people. The PCW team form a diverse network, funded and supported by Pegasus and employed by community organisations across Canterbury. Team members are from our Māori and Pacific communities, and some come from a CALD background. They work in collaboration with Pegasus PHO-affiliated General Practice Teams and their local communities to reduce barriers that an individual or family / whānau may experience in accessing health care. PCWs focus on people who are not enrolled with a general practice – or who are enrolled but are not visiting their general practice teams as often as needed. Policy development and influence We have a long-standing policy on avoiding commercial bias in clinical decision making. This has meant that all Pegasus-related events and education do not receive funding or any type of support from organisations that could influence clinical decision making, such as pharmaceutical companies.
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Other Contracts / Services External Contracts held including MoH, MSD, MoE etc. We work closely with the Canterbury District Health Board, the CCN District Alliance and the South Island Alliance to manage, fund and deliver a broad range of health services and initiatives including: • 24 Hour Accident and Medical Services • Refugee, Palliative, Youth Sexual Health Services • Canterbury Acute Demand Management Service including coordination, community nursing, observation, packages of care via general practice • Pegasus Canterbury Education Programme for GPs, Practice Nurses and Pharmacists • Before School Check Programme • South Island Electronic Referrals Management System • South Island HealthOne System – shared electronic health record • Health Promotion programmes including Puāwai Family Programmes and Support services (Appetite for Life and Senior Chef) • Here Toitū (previously Step Up) • Canterbury Immunisation Coordination programme • Integrated Family Health Services – HealthCare Home (Hikitia) • Primary Mental Health and Addition • Health Services for Children and young people in Care and Protection Facilities (OT) • Rheumatic Fever • Rural Phlebotomy subsidies • Canterbury Suicide Prevention and Coordination services • Low-cost access to Contraception and long-term reversible contraception • Free consults for prisoners on release.
Other Government Agencies: • ACC - High Tech Imaging, provision of GP Training, clinical triage and relationship management to enable GPs direct access to Hi tech imaging (MRI) • ACC – Urgent Care services including fracture management • Department of Corrections – Medtech32 Practice Management System support services • MSD Here Toitū. Other Contracted Services: • Nova Trust Limited – Medical Services • Urgent Care Specialist Services Fracture Clinic • Vaccine and Medical Supplies.
Subcontracted services and management We subcontract with a broad range of providers to deliver health service and support: • 20 Appetite for Life – Health Promotion Facilitators • 48 Before School Check general practice providers • 26 High Risk Foot Podiatry providers • 3 Senior Chef health promotion facilitators • 11 Partnership Community Worker providers • 30 Community Spirometry general practice providers.
Regional Contract Service Delivery cross PHOs • Acute Demand Management Service –Coordination, claims and payment Agency Services • BeeFoundNZ Locum Placement • Canterbury Primary Response Group • Various central claims and payment services canterbury wide programmes.
MOUs with PHOs, NGOs and other community / health organisations Formal relationships to facilitate clinical workforce training, support and ongoing development: • University of Otago – Master of Nursing Programme, Vocational Education and Training • University of Otago - Summer Studentship Programme • University of Otago – GP Registrar Training Programme • New Zealand College of Public Health Medicine – Public Health Medicine Training Programme • Ara Institute of Canterbury – MOU to Facilitate and Promote Collaboration • CDHB - Support for first year registered nurses (NetP) • MOU Maori and Pasifika NetP placement in targeted General Practices.
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Population Health Population / Community level Health Needs Analysis Health Intelligence We provide data analysis to support population health, using information captured via our health intelligence programme. The health intelligence programme collects data from across the Canterbury Health system (General Practice PMS; 24hour Surgery; Primary Mental Health and Hospital Services) enabling analysis of population health issues across a range of dimensions including Age, Gender, Ethnicity, Deprivation and Localities. Longitudinal performance data is updated regularly and is used to evaluate the impact of population health intervention. Leadership We ensure that population and community-level health needs are understood through the advice of the Pegasus Population Health Advisory Board, and the roles of the Pegasus Director of Hauora Māori and Equity, Hauora Health Manager, Pacific Health Manager and the Culturally and Linguistically Diverse (including Refugee and New Migrant, and Gender Diverse) Health Manager.
Health promotion programmes not already mentioned We manage, coordinate and deliver a broad range of Health Promotion programmes, including: • Puāwai Family Programmes and Support Service includes: Appetite for Life, Senior Chef, Tutupu (Pacific Church Champions) and the Healthy Lifestyle Coordination Services • Green Prescription (provided by Sport Canterbury) • Active Canterbury • Healthy Heart Award (provided by New Zealand Heart Foundation - Christchurch Branch) • Young Parents Breastfeeding Support Service (provided by Early Start) • Suicide Prevention Coordination team for Canterbury
• Reading in Mind Book Scheme for Mental Health and Wellbeing (provided in partnership with Christchurch City Libraries and the Canterbury Mental Health Education Resource Centre). Te Hā-Waitaha Stop Smoking Canterbury Te Hā-Waitaha Stop Smoking Canterbury service, launched in October 2016, was developed with input from multiple key organisations within the Canterbury Health System, including Pegasus, with the view to provide a comprehensive, quality service that meets the needs of priority populations in Canterbury. The service can be described as a ‘hub and spoke’ model whereby Community & Public Health (the hub) receive referrals and redirect them to Stop Smoking Practitioners based in multiple community organisations. These include kaupapa Māori organisations - He Waka Tapu, Te Puawaitanga Ki Ōtautahi Trust and Purapura Whetu. Referrals can also be generated and received via the community organisations themselves, increasing the ‘reach’ or ‘engagement’ directly from priority communities. We became a partner to the service in July 2019 and have a strategy to run smokefree clinics based in Pegasus general practices with high numbers of enrolled patients identifying as Māori. The service offers a Pregnancy Incentive Programme for pregnant women to stop smoking throughout, and ideally, beyond their pregnancy. This programme has exceeded its target for enrolments and has achieved equity with regards to Māori women successfully quitting, relative to non-Māori.
Self-management education / support Health promotion programmes include a strong educational component to encourage and support patient self-management, particularly the services provided through the Puāwai Family Programmes and Support Service, Te Hā-Waitaha Stop Smoking Canterbury and Reading in Mind.
Other proactive / wellbeing-based initiatives Health and Wellbeing advice and support The Partnership Community Worker (PCW), Child Health Support and Here Toitū (previously Step Up) services provide health and wellbeing advice and support for their clients, along with their navigation role. Health and Wellbeing initiatives We are an active participant in a variety of Christchurch / Canterbury health and wellbeing initiatives. Examples include: Children’s Day, Older Persons Health Expo, Polyfest, Suicide Prevention Hui, Strengthening Youth Sector Hui, and World Refugee Day.
Other Advocacy for Health in all Policies We recognise that the wider determinants of health have a profound impact on health. Consequently, Pegasus has several positions on specific health areas / issues / determinants of health, for example equity, healthy weight, mental health, tobacco control, climate change and water fluoridation, and at times advocates on its positions to improve health equity and health outcomes. Pegasus regularly and proactively advocates for health in all policies through submissions and other activities. We are a founding member of Healthy Christchurch and a signatory to the Healthy Christchurch Charter – a charter that recognises the wider determinants of health.
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Data and Digital Patient Portal We advocate that our practices adopt patient portals. Practice accreditation to our Hikitia (Health Care Home) programme requires the adoption of a patient portal. Portal adoption is proactively supported through a structured change manage process designed to ensure both patients and practice teams benefit through increased portal utilisation.
Development of telehealth services • Rural General Practice – We are currently trialling after hours back up support to rural general practices in North Canterbury via telehealth virtual consultations. • Aged Care – We provide telehealth after hours support to Aged Residential Care facilities via the 24Hour Surgery. • Capability – We provide all practices within our network with webcams and a virtual consultation tool kit to enable practices to offer telehealth as part of its service offerings as required. • Future Telehealth Platform - We are currently working with a group of PHOs around NZ to identify and formalise a consistent telehealth service delivery model and PMS agnostic virtual consult platform. This is a current strategic priority.
Procurement of services and equipment We provide technology procurement functions to practices through our Business Information Service Team (detailed in our General Practice Support Activities section).
analysis and the delivery of clinical education. ERMS also provides invaluable data for DHB planning and funding departments, allowing them to see where services and resources are required. The recent COVID-19 lockdown in New Zealand provides two good examples of where the ERMS team provided solutions to deliver GP prescriptions and lab orders to pharmacies and labs electronically. Pegasus plays a vital role in the delivery of ERMS including: • Product Development • Product Support (all levels) • Application hosting and general maintenance, including ensuring that data in ERMS is always up to date with the relevant services and Service Providers. We also provide strategic leadership to the programme through the Regional Programme Manager role and a small Regional Implementation Team. This team is responsible for the management of the wider South Island (SI) Referrals Programme which encompasses ERMS and other referral platforms (for example, Orion Clinical Referrals). The mainstay of this programme is managing the implementation of electronic triaging of Clinical Referrals within the DHBs, and the migration of DHBs from faxed / paper referrals to electronic referrals in general.
Data services to general practice Electronic Request Management Service (ERMS) Since 2010, ERMS has been playing an integral role in how patients are referred between primary and secondary care. What started out as a CDHB initiative soon expanded to the other South IslandI DHBS and by 2013, ERMS was delivering 160,000 referrals a year. The number has now risen to over 800,000 a year. Through structured forms and alignment to Health Pathways, ERMS ensures that the right referral is delivered to the right person in a timely manner.
Data sharing with DHB / other CDHB We have a formal data sharing process between Pegasus and the CDHB, which sees near real time (daily) bi-directional data flows of information. Ministry of Health Formal agreements are also in place with the MoH for the utilisation of data collected to support population health
Data analysis services
Pegasus Health Intelligence Programme The programme is delivered through the automation of data extraction, transformation and loading of data from almost 100 source systems daily. It delivers reporting to general practice to support clinical and business quality, including the identification of patients requiring care (for example, due for CVD risk assessment), service-based performance measurement and comparative practice level performance, population based performance and identification of inequities. We have adopted a role in data stewardship which has provided the ability to use system-wide data in near real-time. We collect data sets from primary and secondary care. These patient level data sets include: General Practice Patient Management Systems: • Enrolment and demographics • Classification/problem lists • Measures (weight, height BMI etc.) • Laboratory test results • Prescribed medications • Immunisations/Vaccinations • General Practitioner and Nurse consultations Pegasus Health Systems • 24Hour Surgery • Primary Mental Health Services • Acute Demand Services Canterbury Health System (for Pegasus Enrolled Patients) • Summary inpatient discharge data • Emergency department attendances • Retinal Screening Activity Ministry of Health: • National Enrolment Service (twice week updates) All National Collections (on an ad hoc basis.)
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HealthOne HealthOne gathers and presents key parts of a patient’s primary healthcare record (general practice, pharmacy, district nursing) and presents this alongside secondary care information (public hospitals). This creates a shared electronic health record for the South Island. HealthOne is engaged with a large number of Healthcare organisations in New Zealand wanting to both access and contribute to the shared health record. This presents exciting opportunities to further enhance the quality of patient care by making key information available in a timely fashion to the treating Healthcare provider. Pegasus is a 50% owner of HealthOne and has significant role in the development and delivery of the service including: • Investment in the initial and ongoing development of the HealthOne solution (software development, testing security, privacy etc.) • Joint programme leadership in partnership with Canterbury DHB • South Island HealthOne Programme Management • Product Management • HealthOne service delivery including hosting, support and onboarding. GPVu is a web-based reporting portal designed to deliver general practice insights to support clinical and business improvements. This portal is the General Practice facing component of our Health Intelligence Programme. We provide Advisory services and some support relating to technology adoption and change management including Patient Management Systems, digital claiming services and the health network (for example, Healthlink, GP2P, Connected Health, secure data transmission and data security).
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Community Liason, Engagement and Partnership The Pegasus Board has approved a strategic initiative to develop our processes and expectations as an organisation in relation to how we engage with communities. We have a strategic anchor based around responding to the needs of our communities. We undertake work, in particular, localities and prioritize the voice and leadership from within communities and from key stakeholders in those communities.
Iwi and hapū We have established partnership with Mana Whenua, including: • A Pegasus board member nominated by Ngāi Tuahūriri • Mana Whēnua ki Waitaha (CDHB treaty partner) established relationship • High involvement with Te Tiriti and Equity group (includes a member from Mana Whenua ki Waitaha) We host the Canterbury cross-PHO Māori reference group (TKOP) which includes a member from Mana Whenua ki Waitaha.
Consumer groups A number of Pegasus leadership groups and reference groups have consumer representatives or youth representatives appointed including: • Clinical Quality Advisory Board • Population Health Advisory board • HealthOne Product and Programme Steering Group.
Children and young people We fund and provide governance membership for the Right Service Right Time (RSRT) service. RSRT is a child and family / whānau-centred entry point to a range of services for children, young people and their families / whānau. RSRT enables client choice for services and provides service navigation across multiple non-governmental organisations across Canterbury.
The Child Health Support Service refers families to an array of providers across health, social services and education – nongovernmental and private organisations.
Department of Corrections – For the provision of Medtech 32 support services and to enable integration with a range of regional programmes, such as HealthOne / ERMS.
Intersectoral groups
Ministry of Education – Engagement with Education to enable the first referral pathway via ERMS between Education and Health.
Pegasus is a founding partner and signatory of Healthy Christchurch – a WHO-styled intersectoral collaborative initiative: healthychristchurch.org.nz
Work with specific agencies outside of health (MBIE, Justice, Corrections, Education, local government etc) We partner with 200+ Canterbury-based NGOs and community organisations, including Māori Health providers, Pacific churches and services for new migrants and refugees. Local Government – Pegasus works with local councils, rural communities and rural general practices to support the health of our rural communities. We continue to work in partnership with a variety of local government organisations, including Christchurch City Council Libraries to support the mental health initiative, Reading in Mind. The Reading in Mind book scheme promotes the benefits of reading for mental health and wellbeing, through encouraging people to access books and other resources available at Christchurch City Libraries and Mental Health Education Resource Centre. The scheme also supports people to better self-manage their health and well-being. This is undertaken in strong partnership with Christchurch’s Mental Health and Education Resource Centre, the Christchurch City Libraries and the rural district libraries. Ministry of Social Development – Collaboration through the Here Toitū (previously Step Up) Service.
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Sustainability and Infrastructure: Whakarongorau Aotearoa Whakarongorau Aotearoa (formerly HomeCare Medical) has been providing clinical support for general practices after hours for more than 20 years. Since November 2015, it has also been operating digital telehealth services, which offer free health, mental health, and addictions support across digital channels.
Screen South ScreenSouth Ltd (SSL) is a non-profit organisation that administers BreastScreen Aotearoa (the national breast screening programme) for the upper and lower South Island through BreastScreen South and BreastScreen Otago Southland. ScreenSouth Ltd also provides regional programme coordination, health promotion and support for invitation and recall services for the National Cervical Screening Programme for the Canterbury and South Canterbury regions. Pegasus is 50% owner of SSL.
Early Start Project Early Start Project is a home visiting support service for families / whānau with newborn babies where social and family circumstances may challenge the health and well-being of their child(ren). Their programmes are designed to assist families as their child(ren) development with programmes such as Listen Love Play for children under 3 years old, Triple P Parenting programme and the Incredible Years Toddler programme. Pegasus is an 11% owner of Early Start alongside Plunket and a number of local practitioners.
Service Development Change
New Zealand Medicines Formulary Limited partner in New Zealand Medicines Formulary. The NZF is an independent resource providing healthcare professionals with clinically validated medicines information and guidance on best practice, enabling healthcare professionals to select safe and effective medicines for individual patients. The NZF builds on the New Zealand Universal List of Medicines and incorporates information from the British National Formulary (BNF). It is adapted for the New Zealand context and covers medicines used in New Zealand. Content and coverage will be continually updated. Pegasus is 20% owner of New Zealand Medicines Formulary Limited alongside four other health sector participants.
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COVID-19 Contribution CPRG We host and support the Canterbury Primary Response Group (CPRG) which is tasked with ensuring emergency prevention and readiness of primary care across Canterbury in general practice, community pharmacy and urgent care.
Primary Care Response Leadership We provide key staff to support the response and Emergency Operations Centre (EOC) within the broader CIMs structure, including: • Primary Care Response Controller • EOC Manager • Operations management • Communications function • Intelligence • Logistics and HR.
COVID Testing We hold an agreement with Canterbury DHB to deliver a broad range of primary care activities, including: • CBAC testing services and testing of border workers (airport and Port) • Establishment and management of community based CBACs, and General practice based CBACS across Canterbury • Set up and deliver pop up testing stations at extremely short notice in response and Ministry’s requests • Establishment and management of the community COVID testing referral call centre, and appointment booking for all patients in Canterbury wanting to access testing via a CBAC. • Establishment of a centralized Patient Management System and hardware for operating the referral centre, Community CBACs, pop up testing station messaging /results and records back to the enrolling general practice. • Reporting directly to CDHB and MoH and providing advisory services.
• Delivery of COVID testing kits to Canterbury General practices on behalf of the central labs provider. • Clinical workforce planning, sourcing and rostering to support CBACs.
COVID Vaccination We have set up and run the COVID vaccination programme for border workers and close contacts of border workers and MIQ or health workers.
Response Funding Under contract with the CDHB, Pegasus manages a number of community-based initiatives, including: • Setting up general practice claims process for all Canterbury general practice testing claims • Payment of all Canterbury general practice testing claims within 7-10 days • Funding of CBAC operations including clinical teams.
MIQ Support • Supporting testing services within MIQ • Clinical support for MIQ patients requiring care and not enrolled with general practice • Urgent Care support for patients needing face to face care from managed isolation.
Virtualisation of General Practice • Supply and delivery of web cameras to general practice • Supply of licensing for Doxy.me secure telehealth solution • Advice and best practice support for implementing virtual consults within general practice • Implementation of initial e-prescribing capability via the ERMS platform for all general practices in South Island.