April 2022 Update
It’s been an extremely busy beginning to 2022. While reports coming from the Prime Minister and officials at Ministry of Health say NZ has peaked in this current Omicron outbreak, here in Kapiti cases are still high but appear to be steadying. We have certainly, like most businesses, not been immune to staff shortages as our team and the families have been exposed to Covid. We are thankful to have such a dedicated and hard-working team who pull together at these challenging times to ensure our community is kept safe and well.
We are seeing first hand the effects of ‘long Covid’ on our patients and their whanau. On the flipside, we know that there may be patients sitting at home, very unwell (not just with Covid related illnesses) and are either too afraid to venture out, or who feel we may be too busy to see them.
Our team works hard to clinically assess patients’ needs to ensure those that need the help, get help. If you or your family feel you need to see one of our team then please give us a call on 04 293 6005.
In previous newsletters we have highlighted the GP shortage currently facing NZ, and the strategies we have in place to provide the best patient care we can. These strategies include using the workforce we have available to deliver care –
Nurse Practitioners are experienced nurses who have firstly done a Masters in Nursing, as well as further study that enable them to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease and formulate and prescribe treatment plans. They work under the supervision of your GP. Michelle Flaws and Georgie Clareburt, while rotating in/out of our Urgent Care Unit, also support the GPs by running discharge and general medicine clinics, as well as overflow prescription requests. We are extremely fortunate to have both Michelle and Georgie working with our team.
Nurse Prescribers make it easier for you to get medicine and care you need. They have a list of medicines that they can prescribe for common and some long-term conditions, and work alongside your GP to ensure you are keeping well. Jane Clarke, who joined us in January this year has been a nurse prescriber for 5 years now, and was previously employed as a Cardiac Specialist Nurse/Charge nurse of Cardiology at Hutt Valley DHB. Jane has valuable experience in cardiac health and can offer a full individualised review of your cardiac health, develop a management plan to optimise your health outcomes, as well as prescribe medications. Jane is working as an Intern Nurse Practitioner will be joining our Nurse Practitioner’s team early 2023.
Clinical Pharmacists work alongside our doctors to review medications you may be taking to ensure they are optimally meeting your needs. Hilary Krebs has been working with our team for over 4 years now and is a key critical part of our team, and supports in the management of diabetes and other long-term conditions.
Nurses are continually undertaking more training to increase their knowledge on how to manage more chronic health conditions. We are using their skills in specialised nurse-led clinics, where they work alongside another prescribing clinician (this can be a GP, Nurse Practitioner, Nurse Prescriber of Clinical Pharmacist) to ensure you get the care you need at the time you need it.
PCPAs (Primary Care Practice Assistant) are trained by us to support our nurses. They are able to perform administrative clinical tasks and are trained to take blood pressures, and procedures like ECGs, then send these to the GPs for review – this frees up our nurses to take on other clinical work.
You can see that, while we may have lower numbers of GPs than we’d like, we have some very experienced and qualified staff who can help you.
There have been some changes to our POD structure. PODs are now as follows –
Ruru – Drs Herman van Kradenburg, Maaike Franken, Will Huang, Matt Gaston (GP Registrar)
Tui – Drs John Clark, Mark Conrad, Hanna Preston, Celine Sinclair (GP Registrar)
Kea – Drs Anouk Balster, Dermot O’Connor, Eleana Earon
Each pod is supported by at least 3 nurses, our Nurse Practitioners (Michelle Flaws, Georgie Clareburt) and Nurse Prescriber (Jane Clarke)
Increase in some of our fees
Our government contributes to the cost of your healthcare. This is in the form of a subsidy only against consultations; however, this subsidy does not cover the cost of a consultation.
While we are encouraged (by the government) to increase our fees on an annual basis, our last fees increase was in March 2018. We had scheduled to increase fees just as the Covid pandemic hit in March 2020, but decided to put this on hold due to the stress and strain put on our community at the time.
However, we find ourselves in a position that we can no longer hold our current fee structure. High costs of recruiting (and retaining) doctors, our nurses needing pay parity with the DHB (so they don’t leave to work elsewhere), an increase in the minimum wage pushing up staffing costs, and significant medical supply costs (due to supply issues relating specifically due to Covid) all contribute to this.
From Monday 11th April 2022 our standard consultation prices* are increasing as follows –
Children under 14 – no change – consultations remain free. Note however that there is a charge should your child require a prescription outside of a consultation.
CSC holders & dependents – consultations remain at the capped rate of $19.50 and $13 (dependent) as mandated by the government. Note these rates only apply to consultations in our standard opening hours*
Everyone else –
Youth 14 – 17years **
Adult 18 – 44 years **
Adult 45 – 64 years **
Adult >65 years **
*standard consultations are during the hours of 8am to 5.30pm Mon-Fri
Procedures and other costs
Some of our other costs have increased as well. Please ask our team before booking as to costs involved. We will, within the next week, publish a list of procedures and their costs, on our website. The costs of consultation fees are already on our website on the fees page.
We understand that healthcare is expensive, especially if you need to come to the doctors regularly. We are happy to discuss with you how we can help. Please make an appointment to see our Office Manager to discuss payment plans or any concerns you may have with our fees.
We are often challenged about charges that relate to accidents, including when off-work certificates need to be renewed, or when the doctor needs to refer a patient to a specialist or for more treatment. We thought it might be handy to point out a few ‘truths’ about ACC claims –
- ACC does not cover all costs associated with treatment of your injury. We may charge you a consultation fee. It is not appropriate to ask your GP for a script for your regular medications at the same time you are there for an ACC consult. If this happens you may be charged an additional consultation fee for non-ACC related issues – there is additional work for the GP in this instance.
- Other health providers (for example physiotherapists) can lodge your claim with ACC, however, they are unable to provide off-work certificates – this must be done by one of our team.
- ACC dictates treatment pathways that our team need to follow. This includes the length of time they can give you for an off-work certificate, and also the clinical care that needs to happen prior to being referred to a specialist and/or for surgery. For example, you may need to go to physio for a period of time before you can be referred.
- To determine if an off-work certificate can be extended involves a consultation with you – it is not just a matter of ‘rolling over’ the certificate, the clinician is legally obligated (by ACC) to review you. In most situations we can do this by telephone – there may be a charge for this. Our team are now pro-actively booking a further consultation for you closer to the time the certificate is due to expire – this way you will not get to stage of urgently needing a new certificate as this does add a layer of work for the GP.
- Our Nurse Practitioners, and in some instances our nurses, can do a lot of the follow-up work around ACC injuries.
- If you are hospitalised for your injury, you may be discharged back to our team for after-hospital care, in particular if you need continuing pain management.
- ACC claims can be declined. This may be as soon as we process your claim, or it may be after weeks and/or months of treatments (if ACC actions a review that determines the injury was not caused by an ‘external force’ (accident)). If this happens we will need to recoup the cost of our services from you.
ACC’s website has a lot of great information on it around what can/cannot be claimed, and what they ‘may’ pay for (note their use of the word ‘may’) – Treatment we can help pay for (acc.co.nz)
We are working with our team to provide much better transparency and understanding of your ACC injury and treatment options.
3rd Party Consents
The Privacy Commissioner protects your health information under the Health Information Privacy Code 1994. This means that we have rules to follow, not just in how we collect health information about you, but how we release information to third parties.
A third party includes your parent/guardian/caregiver (if you are over 16*), spouse or other family member.
On a daily basis we receive requests for information from family members about their loved one’s care. In most of these situations we are unable to disclose that information because we do not have permission to do so, which often leads to frustration.
Many of our patients have designated an Enduring Power of Attorney (EPOA) but this only acts as third party consent once this legal document has been activated (at a time the patient no longer has the ability to act for themselves).
We encourage you to consider having a third party consent lodged with us. It’s very simple –
- Complete the form (either by emailing firstname.lastname@example.org or dropping it in to our team here at Marae Lane or at the Beach clinic); or
- When you are next in the clinic ask our team for one of these forms
We then add an alert to the file, which is accessible to all of our team. This certainly speeds up the process of finding out how your loved one is, at the time you most need it.
If you are on MyIndici, we can also give you permission to access your loved one’s MyIndici for seeing clinical notes, future appointments etc.
*special guidelines apply for children under the age of 16 should they request that their health information not be shared with their parent/guardian.
Yes! It’s that time of the year again! Given the NZ borders are opening up, and that NZ has essentially been in lockdown for the last two years, the Ministry of Health are anticipating higher rates of seasonal flu, and have increased the eligibility for funded flu jabs to ensure more people are jabbed against influenza this year.
Have you booked your flu shot yet?
We are running flu clinics Mondays to Fridays and while demand lasts these will run all day – our focus is to get as many of our patients vaccinated as quickly as possible. The clinic is being run in the carpark on the corner of Marae Lane and Ngaio Road (opposite the entrance to the Countdown carpark). While we can take a small number of walk-ins, booking is preferred. With 250+ appointments available each day there is plenty of capacity.
To book –
- If you registered on MyIndici, book via the appointments tab, select Flu Clinic from the provider;
- Send an enquiry on our website for who you wish to book for – our team will give you a call to secure your booking; OR
- Call our team on 04 293 6005 (option 1) – its best to call after 2pm to avoid our peak periods
Please do not come into the clinic to book an appointment, as we are still limiting numbers of patients due to the current Covid Omicron outbreak.
Every day we are receiving requests from our community to enrol at Waikanae Health. This includes family members of our registered patients who are registered elsewhere. Nearly two years ago we made the decision to not take on new enrolments as we wanted to focus on providing the best care to our existing patients. We have an extremely complex patient base that takes more GPs to manage their care – where most other practices assign 1600-2000 patients per full time GP, the ideal for our practice is approximately 1200 patients per full time GP. While there are certain exemptions, our books for enrolment remain closed at this time.