New service to improve Kāpiti residents’ access to after-hours and urgent care earns leadership award

10 Dec 2019 | Building Leadership & Capability

A new service that gives Kāpiti residents improved access to after-hours and urgent health care closer to home has received an Open for leadership award from the Health Quality & Safety Commission.

Kapiti paramedic partnership photo of steering group

The steering group: (from left) Vanessa Simpson (WFA), Nicky McGeorge (CCDHB), Mabli Jones (GM, Tū Ora Compass Health), Sarah Duncan (Tū Ora Compass Health), Dr Herman Van Kradenburg (Waikanae Health).

The Kāpiti ambulance redirection service is a collaboration between Capital & Coast District Health Board (DHB), Wellington Free Ambulance, Tū Ora Compass Health primary health organisation (PHO) and Kāpiti general practitioners (GPs).

The service means that following clinical assessment by a paramedic, certain conditions can be managed in the community by a patient’s GP or urgent care centre. The DHB now funds the treatment of a number of urgent conditions locally, saving the patient a trip to Wellington Hospital.

Previously, more than 6,000 patients a year travelled from Kāpiti to Wellington emergency department (ED) for treatment outside normal consulting hours. Half of them travelled by ambulance, but fewer than half needed to be admitted to hospital.

Waikanae Health GP and Tū Ora Compass Health PHO’s clinical lead for the service, Dr Herman van Kradenburg, says this happened for a number of reasons.

‘Analysis showed the Kāpiti patients putting a strain on Wellington ED were often not enrolled with a GP or were unable to afford self-funded after-hours care. The fact that an ambulance to ED was free and the constraints of ambulance protocols around when patients should be transported to hospital all added to the ED’s workload.

‘The situation was also adding to the stress of patients, their families and whānau, the hospital and the ambulance service. And, because ambulances take people to hospital, but not home again, patients were often stranded in Wellington, adding more stress.’

More than 100 patients were managed in the service’s first three months of operation, more than 70 percent of whom didn’t need to go to Wellington ED.

‘Kāpiti GPs have a lot of experience in urgent and emergency medicine,’ says Dr van Kradenburg. ‘Between them they were already managing around 3,000 urgent cases a year.

‘Seeing patients at their local practice or in our community means greater convenience for patients and their families and whānau, improved continuity of care and reduced travel and wait times. Transporting patients locally has reduced the average travel time for ambulance paramedic staff by nearly 80 percent compared to transporting patients to Wellington ED.’

Commission deputy chief executive Karen Orsborn recently presented representatives of the new service’s collaboration team with the award. She said the new service was an excellent example of what can be achieved when health services work collaboratively to co-design solutions that better meet the needs of their communities.

The award is part of the Commission’s work to build capability and leadership in the health sector. They recognise and celebrate health professionals who demonstrate excellent practice, quality improvement and leadership skills.

Dr van Kradenburg says a presentation on the Kāpiti ambulance redirection service model of care at a recent symposium attracted a lot of interest from health professionals from around the country.

‘It’s a true win/win for everyone involved, saving patients time, reducing the load on the ambulance service and Wellington Hospital, and fairly recompensing Kāpiti GPs for their work.

‘Every health professional needs to be working at the top of their scope of practice, and Capital & Coast DHB is leading the way in acknowledging the skills of GPs in their communities.’

More information on the Open for leadership awards, including other recipients, is available here.

Last updated 11/12/2019