Brief report on the ongoing processes related to revising the recommendations of
Investing in Health (Moh, 2003)
As reported in the last edition of Te Puawai, a strategy group comprised of representatives from both NZNO and the College of Nurses, Aotearoa CNA(NZ) met on March 6th 2007 to review the recommendations arising from:
- MoH evaluation of the Care Plus Programme;
- The Management of Lifelong Conditions workshop hosted by CNA(NZ) and College of Practice Nurses, NZNO;
- The report of the National Health Committee on ”Meeting the needs of people with chronic illness “
- The original goals and recommendations of the document Investing in Health (2003). We wished to use these documents as a basis for our deliberations.
We asked the question as to what change and development is required to realise the full potential of nursing services in the primary health care arena. In reviewing the goals and directions as outlined in Next Steps (MoH, 2006) and considering the implications for nursing, it is clear that significant obstacles remain. The strategy group determined that it was important to review the process for developing primary health nursing as outlined in Investing in Health (2003) through the creation of renewed recommendations to the MoH, PHOs and to DHBNZ.
A draft document was produced by the initial strategy group and circulated widely for submission. It is acknowledged that the time frame for submissions was short and processes for dissemination of the document were not as clear as they could be. However 81 submissions were received (many from large groups) and they were independently analysed by a skilled submission analyst.
Overall the submissions largely supported the revised recommendations. Concerns raised in the submissions centred around three areas including: the cessation of GP employment of practice nurses in favour of salaried employment to PHOs / DHBs; the reframing of Care Plus as a nurse-led service; and patients enrolling with PHOs rather than with specific GPs.
On July 20th representatives of many nursing groups concerned with primary health care met to progress work on the initial document entitled "A revision of recommendations from Investing in Health (2007)". The group included nurse leaders from PHOs, DHBs, College of Nurses, College of Practice Nurses, NZNO and the General Practice Nurse Alliance Group. The day was jointly hosted by NZNO PHC Nurses Council and the College of Nurses and independently facilitated by Annette Milligan. The 30 nurses present reviewed the comprehensive independent analysis of the 81 submissions and agreed that, with the exception of some very minor adjustments, all but three of the recommendations had been well supported. The group then turned its attention to revising those three areas which as predicted had generated the most division of opinion. Those three recommendations now reflect the outcome of that post submission review process and very minor adjustments have been made to some other recommendations.
In addition three new recommendations to the Ministry of Health have been added as follows:
- That the Ministry of Health Expert Nursing Advisory Group on primary health care be urgently reconvened;
- That the resource devoted to nursing in the MoH be increased;
- That in order to ensure succession planning, a senior nurse advisor position is created to support the Chief Advisor.
The revised document is now being reconsidered by an enlarged strategy group and will then be presented to the respective Boards of the College and NZNO for formal sign off before being presented to the Chief Advisor Nursing. After that it will be available on the relevant websites including our own. The report of the submissions has already been placed on the College website for your interest.
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