Care Plus
Care Plus is a PHO initiative aimed at assisting people who need to visit their family GP or nurse often for reasons such as chronic illness (such as diabetes or heart disease) acute mental health needs or a terminal illness.
The Ministry of Health released a review of Care Plus in December 2006.
College of Practice Nurses committee member Nga Kay attended a Care Plus workshop in 2006 and reported her impressions below.
Management of Lifelong Conditions (Care Plus) Workshop
Palmerston North, 27th October 2006
Report by Nga Kay
Care Plus, a nationwide initiative by the MOH was rolled out on 1 July 2004, to provide primary health care to people with high health needs due to chronic conditions such as diabetes or heart disease, have medical or mental health needs, or a terminal illness.
Since its inception, nurses providing this service have raised concerns regarding the implementation of the Care Plus programme, especially with the intended philosophy and its practical implementation. NZNO Primary Health Care members met with the MOH’s representative, Chief nursing Advisor, Mark Jones, to discuss concerns that patients may not be receiving full benefits of the programme and to collaboratively make decisions that would ultimately improve patient health.
A workshop organised by the College of Nurses Aotearoa and the New Zealand College of Practice Nurses, NZNO for ‘Management of Lifelong Conditions’, currently known as ‘Care Plus’, was attended by approximately 80 nurses at the Convention Centre in Palmerston North. As one of five nurses awarded an NZNO scholarship to participate in the workshop, I would like to thank NZNO for giving me the opportunity to attend.
Excellent presentations by various providers described how the Care Plus programme was implemented in their area. Noticeably from these presentations, there was a Care Plus Co-ordinator with a nursing background, driving the programme and therefore resulting in beneficial outcomes for patients and the clinical team.
Break out group sessions identified that the majority of Care Plus programmes are nurse-led, nurses are integral to the efficiency and outcomes of the programme and not all programmes were working successfully.
Some of the reasons submitted were lack of consistency of resources, IT support, poor workforce development, access to high need patients, time, competing workload and work projects, lack of employer support, remuneration, recruitment and retention, and data analysis of patient outcomes.
Patient focused, improved access for enrolled patients, clinical career pathways for nurses, improved outcomes of patient self-management, increased job satisfaction, collaboration between service providers and employment of a Care Plus Co-ordinator were reasons why Care Plus was working well.
Discussion of what nurses believed needed to happen for a successful programme included influencing at PHO/MOH level, formation of a national steering/leadership group, co-ordinated education, knowledge of and access to local resources, maintaing a resource directory, funding to follow the patient, utilise current funding in different ways, national approach to outcome measurements that go beyond clinical and non-clinical, development of tools, nationally consistent guidelines and sharing of models/guidelines of successful Care Plus programmes.
