| | | | | | | | Hauora Taiwhenua Newsletter August 2024____ | | | | | | Welcome from Dr Grant Davidson,
Chief Executive | Kia ora tātou
As I write this message, the staff and Board of Hauora Taiwhenua are still in deep mourning for the loss of our friend, colleague, mentor and leader Rhoena Davis. We all feel a huge void has been left in our personal and professional lives that Rhoena filled with her quiet grace, knowledge and giving. We send our thoughts to Patrick and other members of Rhoena’s extended whānau at this time. Nā koutou i tangi, nā tatau katoa
| | Dr Grant Davidson Hauora Taiwhenua Chief Executive | | | |
Recently I have been travelling around the motu visiting rural hospitals to discuss the new service we are developing to provide workforce support to those hospitals – both providing locums and international doctors for full-time positions. As a team we have visited almost all of the 26 rural hospitals and talked to their staff. We often visited general practices nearby or linked to the Hospital at the same time. The overwhelming theme was the shortage of staff and therefore the withdrawal from services. Many weren’t able to staff weekend shifts and afterhours clinics. The staff were picking up extra shifts and doing long hours, all at the personal expense of family time and burn out. The feeling of commitment to the community was an over-riding drive which kept them pushing to, and beyond, acceptable limits. It was no surprise to me to see the recent media attention on Dargaville Hospital unable to staff weekend shifts, and quickly after, the same pressures on Kawakawa and Kaitaia Hospitals. When contacted by the media I was asked if Dargaville was “a canary in a coalmine”, being symbolic of larger issues in the rural workforce. My immediate response was, ‘no – the canary is dead, along with many others up and down the country. They have all been on the floor of their cages for some time! It’s just that people are starting to talk publicly about them being dead.” For those of you of my vintage, and willing to take a lighter-hearted view of a very serious topic, I refer you to the classic Monty Python Dead Parrot Skit. It seems to me that we have a classic situation of a “Norwegian Blue pining for the Fiords!” This week the West Coast PHO also realised they had a problem with their canary. They don’t have the staff to provide weekend cover at Buller Hospital, let alone urgent care and after-hours services in their satellite services spanning from Karamea to Haast. The workforce doesn’t exist and there isn’t adequate funding to bring in expensive temporary staff on a continuing basis. The group were brave enough to step up and say, “Look, my lad, I know a dead parrot when I see one, and I'm looking at one right now.” They concluded that they need to find an alternative model of care, because if they don’t they will push their remaining workforce beyond sustainability and the whole health system will collapse on the Coast. My understanding is what they are proposing for the Coast is a greater reliance on Ka Ora telehealth services for after-hours triage and management of low acuity patients. Te Nikau Hospital at Greymouth will still be open for afterhours care. There may be Hatu Hone St John’s staff or PRIME trained nurses that could be mobilised if the Ka Ora telehealth service dictates that hands-on assistance is required. Those planning afterhours care on the Coast are in an unenviable situation. They have to act with the resources they have at hand, and yet the only viable option is implementing a telehealth solution in a region with some of the worst connectivity issues in New Zealand, and the greatest geographical spread of any region (drive times from Karamea to Greymouth Hospital is 3 hours, and Haast to Greymouth Hospital is 4 hours. All assuming the roads are open). The Coast is also the area of the South Island with the highest levels of socioeconomic deprivation, further restricting access to connectivity and transport to medical care. I think the West Coast PHO are doing the sensible thing by investigating all options. We need to gather around and support them at this stage. All of this is symptomatic of much bigger systemic issues in the NZ health system related to training and funding in primary care, and specifically in rural primary care, that we need to keep seeking long term solutions for. We must do better as a country that having the longterm solution for rural healthcare being a voice on the end of a phone that may not connect when you need it most! Which brings me back to reflecting on Rhoena Davis. She would have accepted all of the above with empathy and kindness, told me that the important thing is whānau, and that we all just had to get on and do what we could in our own way to provide care, and provide support for others doing the same. Aroha mai nui Rhoena.
Ngā mihi nui, Dr Grant Davidson Chief Executive Hauora Taiwhenua Rural Health Network
| | | | Distinguished Fellowships for Rural
| | Field Insights
"A tool not a panacea: telehealth is overhyped as a solution to New Zealand’s rural health-care crisis" | | | | | | Honouring Rhoena Davis: Celebrating a Life of Dedication and Service | | It is with deep sadness and heavy hearts that Hauora Taiwhenua announces the passing of Rhoena Davis, a cherished member of our Board and a passionate advocate for rural health and Māori healthcare in Aotearoa.
Her unwavering dedication and exemplary service have left an indelible mark on our organisation and the healthcare landscape of Aotearoa.
Rhoena Davis was recently honoured with the prestigious Peter Snow Memorial Award for 2023, announced at the National Rural Health Conference 2024. This recognition was a testament to her outstanding contributions to Māori health, rural healthcare delivery, and nursing leadership. Her commitment to these causes was evident in every aspect of her work, reflecting a deep-seated passion for improving health outcomes for vulnerable populations.
Beyond her more clinical-focused roles, Rhoena served as Deputy Chair on the Hauora Taiwhenua Board and Deputy Chair of Hauora Taiwhenua’s Tiriti Partner, Te Rōpū Ārahi. Her expertise was instrumental in shaping Hauora Taiwhenua’s bicultural foundation: helping to ensure the principles of Te Tiriti o Waitangi – partnership, protection, and participation – were enshrined in our Constitution. Rhoena will be remembered for her warmth, wisdom, and the genuine care she extended to everyone she encountered. Her leadership was guided by a deep sense of purpose and a heartfelt connection to the communities she served.
Rhoena’s legacy will continue to inspire and guide us as we strive to uphold the values and principles she championed. Her exemplary service reflects a deep commitment to fostering equitable healthcare delivery and improving patient outcomes. She will be deeply missed by all who had the privilege of knowing and working with her.
As we grieve the loss of Rhoena, we also celebrate her life and the profound difference she made to so many. We extend our deepest sympathies to Rhoena's whānau and friends. We join those who were inspired by her and guided by her in life in saying farewell and thank you.
Hauora Taiwhenua will continue to honour Rhoena’s memory, ensuring her legacy lives on through our ongoing work and future initiatives. | | | | | | University of Otago’s Rural Health Research Day | | | | Waking up to a crisp and chilly Christchurch winter’s morning is always a shock to us North Islanders but was quickly warmed by the enthusiasm of the rural health enthusiasts who came together for the University of Otago’s inaugural Rural Health Research Day held on 1st August.
The animated room of academics who double as health professionals, health professionals who double as academics, Health NZ rural health commissioning and Ministry of Health rural health policy and system leads, and Hauora Taiwhenua advocacy team talked, listened, laughed and chatted about the research that the team, led by Professor Garry Nixon, have been doing over the past 2 to 3 years.
The mission for the day? To bridge the gap between their research and its real-world impact; to convert data into policies and realistic actions; and convert those policies and actions into improved rural health outcomes. Throughout the day, the group identified areas in which Health NZ, the Ministry of Health, the University of Otago and Hauora Taiwhenua could collaborate: - Increase collaboration on research.
- Establish a governance structure for the GCH.
- Research to identify and evaluate high-performing rural services in NZ.
- Generate joint policy briefs based on research findings.
- Build rurally based Māori and Pacific research capacity.
- Apply an equity lens to rural health policy and research
- Socialise rural health research findings more broadly within Health NZ, ACC, MoH.
- Collaborate on the rural hospital sustainability project including resolving the catchment problem.
Making sense of what the research tells us While I eagerly latch onto every rural health research paper that comes my way, I admit to finding research statistics a real challenge, and staying focussed through the details of an academic paper is almost beyond me! This sorted itself out through the tightly packed programme for the day that gave researchers the opportunity to use their tightly allocated 5 minutes to talk about their work, what they learned, and explain its implication for rural communities.
It demonstrated that applying the Geographic Classification for Health to understanding the relationship between rurality and health outcomes, is a game changer. It also connected the success of UoO’s rural health research to the fact that their team lives and works in rural areas across all corners of our country. We saw that this means that they understand the questions that need to be asked, and they know where to look for the answers. The day we spent together drew a pathway to applying research findings to on-the-ground solutions.
Hauora Taiwhenua Rural Health Snapshot The Rural Health Snapshot incorporates key points out of the research we heard about during the day, but it is as the title says, just a snapshot. I’d encourage you to follow the links in the Snapshot to the research papers and think about what the findings mean for you, and the rural communities you care about. Thanks to Garry and the University of Otago Rural Health Researchers, the day was a huge success towards bridging the gap between research and reality. We look forward to working with you to make this a regular event! | | Inaugurating the University of Otago’s new virtual Centre for Rural Health. Opened at an event in Ashburton on 31st of July, the virtual Centre brings the highly dispersed rural staff and students of the Department of General Practice and Rural Health and the Rural Health Academic Centre, Ashburton (RHACA) under one umbrella.
The Centre will act as the University of Otago’s rural health unit, with the primary purpose of supporting teaching and research across rural New Zealand. It will incorporate 46 staff, who straddle clinical and academic roles, based in 21 rural communities from the Hokianga to Balclutha. Alongside post graduate medical and nursing professional development and training, undergraduate medical students are undertaking their studies in rural sites between Wairoa and Queenstown.
As Professor Garry Nixon commented: “Part of our success is thanks to our large geographic footprint, with staff and students living and working in communities across New Zealand – it is fantastic to be able to unify everyone under one entity… Not only will a dedicated Centre make it easier for us to support our rurally based students, teachers and researchers, it will make us more visible, and it will be easier for us to engage with rural communities.” | | | | | | | | | |
Consultation on Rural Funding Principles
Hauora Taiwhenua recently convened a working group to put together a document for those involved in planning rural health programmes and funding for these, that would provide them with key principles to consider when designing initiatives impacting rural primary care delivery. The aim being that programme design, and accompanying funding, will help ensure that rural health outcomes can be more equitable to those that are achieved in urban areas. To achieve that goal of equal outcomes for all, design needs to be different and funding is often required to be greater. Contemporary examples of where these principles are relevant include: funding of child vaccinations in rural areas, funding rural contracts for ACC, funding rural afterhours and PRIME, etc. The attached document is the result of the efforts of the working group. We would appreciate feedback from you on this final document. We are open to constructive feedback for change, or endorsement of the work. Following final agreement across our Chapters, the plan is to work with our colleagues in the Rural Desk at Health NZ to run a series of workshops to help convey these concepts to programme designers and funders within Govt Agencies. These workshops would include sessions on how to utilise the Geographical Classification for Health (GCH) and the attached principles in their work. We hope that along with increased understanding, the workshops will result in a number of case studies being documented that will show implementation of these principles, along with some design checklists.
If you have any feedback and questions about this, please don’t hesitate to get in touch at enquiries@htrhn.org.nz.
We look forward to receiving your feedback over the next four weeks. We will close off feedback on Monday September 30. | | | | | | | | The Healthcare Highway: 'Share Mobile’ initiative to rural wellness
| The ‘Share Mobile’ initiative has been a bold stride towards dismantling the barriers that have long hindered access to quality healthcare in rural communities. It is a pragmatic and innovative approach that delivers essential healthcare services right where it’s needed most.
As a proud board member of Hauora Taiwhenua, I have seen the triumphs and challenges of rural healthcare delivery and the crucial need for such services. It has not been a smooth journey – it has been a bumpy ride! | | Mark Eager Chief Executive, Mobile Health Group | | | |
Rural health facilities are often underfunded and understaffed, which can lead to a lack of access to advanced medical technologies and a struggle to attract skilled professionals. There is a shortage of healthcare professionals willing to plant their roots in these areas. Without adequate funding, rural health facilities struggle to provide competitive salaries and benefits, making it difficult to entice professionals to work in these areas.
The result is a cycle of disadvantage for rural health professionals. They often feel isolated and unsupported, lacking the resources available to their urban counterparts. This not only affects their ability to provide quality care but also limits their professional development and career progression. Health professionals in rural areas miss out on opportunities to work with advanced equipment and technologies, which are readily available in urban areas. The concept of ‘Share Mobile’ is an innovative solution that is making a difference, and a testament to what can be achieved when we dare to think differently. The introduction of the original Mobile Surgical Unit 23 years ago, and more recently, Mobile Imaging - our PET-CT unit is a step in the right direction. Mobile Imaging provides advanced PET-CT scanning to regional areas. This service is knocking down barriers - be it travel costs or the sheer inconvenience for patients who are not up to travel, and making imaging more accessible to rural communities. The potential for expansion is clear. By including equipment like Ultrasound, Echocardiography, and ECG machines in mobile units, and rotating them between rural locations, we can ensure that these communities have access to advanced diagnostic tools. By sharing and rotating these resources, we can maximise their usage and we are bringing medical technology to the doorsteps of those in rural areas who have been overlooked for too long. As well as keeping patients treated closer to home and reducing the burden on secondary hospitals. So, what’s the plan? It is about rallying together - rolling up our sleeves and doing the hard work necessary to ensure that every New Zealander, regardless of their postcode, has access to the best possible healthcare. It is not just promising a healthier, more connected rural world - it is delivering it. Let us continue to advocate for this change! | | | | | | | | | | | | | | NZLocums & NZMedJobs - What we've been up to! | This time of year is always bustling for the NZLocums & NZMedJobs team, with conference season in full swing.
In July, John Ferguson, our GP Relationship Manager, and Amanda Ellorey, our RH Relationship Manager, attended GP24 in Wellington. It was a fantastic opportunity to reconnect with some of our locums, celebrate the RNZCGP’s 50th anniversary, and enjoy a conference right here in our hometown! | | | | Most recently, Luke Baddington, our GM Workforce, and Amanda attended the GPCME South Conference at Te Pae in Christchurch, 16th to 18th August. Now in its 15th year, this conference continues to grow, nearly rivaling its North edition in terms of attendance. We had a great time catching up with our current locums, meeting those considering a new direction, and reconnecting with friends who have made New Zealand their home. The conference featured a strong program with notable speakers, including former PM Bill English and current Minister of Health Dr Shane Reti. There was also significant discussion about the potential regulation of physician associates in primary care. A special congratulations to Dr. John Fernando, who stylishly won the draw for our Swandri satchel!
| | | | Next up, we’re heading to Auckland for the Practice Managers and Administrators of New Zealand conference on the 12th and 13th of September. We look forward to seeing some of you there!
Looking to recruit? Finding the right fit for your team is like choosing the perfect pair of jandals – it needs to be comfortable, dependable, and built to last. The key is connecting with individuals, understanding their unique talents, and ensuring they are well-matched with both the role and your company’s culture. Let's start the search for that exceptional candidate who’s ready to make a meaningful impact! Give us a call at 04 472 3901, send us an email at enquiries@nzlocums.com, or visit our website. | | | | | | Rural Communities - From the Field | | The Importance of Rural Socializing for Mental Health: A Winter Focus | Mental health continues to be a pressing concern worldwide, with anxiety and depression frequently cited as prevalent issues. Various factors influence mental well-being, and one often overlooked aspect is the impact of seasonal changes, particularly winter, on rural communities. While winter can paint a picturesque scene of snow-covered landscapes and cozy fireside gatherings, the reality for many in rural areas is often less idyllic. The harsh weather conditions, ongoing farm work, and seasonal illnesses can contribute to a sense of isolation and strain. In this context, socializing becomes not just a leisure activity but a vital component of mental health management. This article explores how rural socializing, especially during the winter months, plays a crucial role in maintaining mental health and highlights two successful initiatives that exemplify the benefits of community engagement. | | An Amazing example of Communities pulling together | Rural communities pull together in the tough times. The story below illustrates this. At approximately 8.38 am on 18th July at Lake Pukaki, near Twizel, two buses were travelling in convoy, as they transported a group of Chinese tourists to their next destination. Both buses rolled on black ice and tipped over. The fog that morning was heavy, resulting in low visibility. This section of the road is notorious for its occasionally dangerous road conditions. Many accidents have occurred with drivers either not aware of the treacherous conditions or not paying close attention to the conditions. There were both adults and children on the buses. The group had come over to attend the World Choir Games in Auckland As a rural community, everyone knew their roles and the response kicked into gear like a well-oiled machine. | | | | | | | | | | | | Exclusive Discount for Hauora Taiwhenua Members: Attend the Innovation & Excellence in Primary & Community Care Conference | | | | We're delighted to be a supporting organisation for the upcoming Innovation & Excellence in Primary & Community Care Conference. This event is a key opportunity to explore transformative approaches, integration, and redesign within our healthcare system, offering insights into new care models that can ease the pressure on current services.
As a valued member of Hauora Taiwhenua, you can secure a $200 discount on your registration (Masterclass Tickets excluded) by using the promo code "SupportingCare200." Don’t miss out on this chance to engage with cutting-edge innovations in primary and community care. | | | | | |
Funding round opens for research benefitting general practice | Applications for the College’s final research funding round for 2024 have opened this morning and will be open until Tuesday 24 September. Applications are welcomed from anyone who is undertaking research in this field. You do not have to be a doctor or a member of the College to apply. Grants are typically in the range of $5,000 - $20,000 for individual applications although up to $40,000 can be awarded.
The College’s Research and Education Committee (REC) provides financial support to those conducting research or education projects and is looking for applications that reflect the five key areas of the College’s Statement of Strategic intent (Te Rautaki): - Supporting our members
- Becoming a contemporary and sustainable organisation
- Improving health equity in New Zealand
- Education excellence
- Quality general practices.
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Rural Health Career Promotion Programme Webinars
Do you have a secondary student interested in pursuing a career in health? Or perhaps someone who's still uncertain about their path after secondary school?
We warmly invite secondary school students to join our Rural Health Career Promotion Programme webinars!
We're hosting 11 webinars each spotlighting a different health career, led by current tertiary students who are studying in those fields - covering Medicine, Physiotherapy, Paramedicine, Midwifery, and more!
These informal webinars are an excellent way to explore various health careers, ask questions, and get quick, insightful answers.
For more information and to register interest, please visit: https://forms.gle/3VKJh3xp6jEH9Dcr6
If you have any questions or concerns, please don't hesitate to contact Samantha at samantha.hill@htrhn.org.nz.
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