Benefits of a PHO increasing its outreach activities to achieve health targets
The national result for the Better help for smokers to quit and More heart and diabetes checks health targets are now approaching the target threshold among DHBs. Although PHOs/DHBs have made great progress, we recognise that reaching the last few percentage points of the target can be difficult. Part of the problem is that not all of the enrolled population attend general practice in a given period and that some of the enrolled population is very mobile and can be difficult to contact. Alternative approaches such as outreach activities and sector intelligence/IT tools can improve patient reach and has already been evidenced by some DHBs.
From 1 July 2015 PHOs are tasked with ensuring that all their enrolled population who smoke are provided with an offer of help to quit including those who do not visit general practice. A similar eligible population also exists for the CVD target.
Benefits of using occupational health nurses to reach the Better help for smokers to quit and More heart and diabetes checks health targets
Occupational health nurses are an important part of primary health care and bring a specific set of professional skills to the health sector. They provide advice and care to a population (e.g. young working men) who many not visit their GP routinely. Many of these men, for example, are important to both health targets because of their high smoking rate and increased CVD/diabetes risk. In addition, involving occupational health nurses may contribute to continuity of care for smoking cessation interventions and CVD risk and diabetes management. Overall, improving access to these populations will result in greater health gains and contribute to a reduction in health inequities.
Occupational health nurses deliver smoking cessation advice and CVD risk assessments
Screening for tobacco use and offering to support smokers to quit is already a key part of the occupational health nurses' work.
Blood pressure, blood glucose, blood cholesterol, BMI and waist circumference measurement (components required for by the CVD target) are a key part of services already provided by many occupational health nurses/services providers.
Challenges a PHO should be aware of
Ensuring smoking cessation interventions (including the simple offer of support and more intensive interventions) and cardiovascular disease risk assessments are consistent with activities undertaken in primary care and follow Ministry guidelines. This requires collaboration between PHOs and occupational health nurses and may include tool/IT changes to ensure that any interventions provided in the occupational health setting are captured within the primary care IT systems.
Solutions to the challenges
A Memorandum of Understanding may be a useful method of formalising the relationship with occupational health nurses. PHOs may wish to commit to providing support, for example, resources, training, data capturing processes, referral tools to stop smoking services, and access to follow-up CVD and diabetes risk management services.
For more information on the Better help for smokers to quit and the More heart and diabetes checks health targets please see the Health Targets section of our website.
For a series of educational videos answering common questions and offering support to general practice for the More heart and diabetes checks and Better help for smokers to quit health targets see the General Practice Toolkits.
Better help for smokers to quit
If you are unsure whether any initiative within primary care that you are proposing meets the health target requirements, or have any further questions, please contact the tobacco control team at the Ministry of Health: firstname.lastname@example.org
Please also see the New Zealand Guidelines for Helping People to Stop Smoking.
More heart and diabetes checks
For questions about the health target reassessment window please contact the CVD Diabetes and Long Term Conditions team at the Ministry of Health: email@example.com
Also, please refer to the New Zealand Primary Care Handbook 2012 (updated 2013) for the reassessment criterion.