Bay of Plenty District Health Board Annual Report 2016 · Output Classifications ... Combined Community and Public Health and Disability Services Advisory Committee ... The process

Bay of Plenty District Health BoardAnnual Report 2016

The Bay of Plenty District Health Board Annual Report 2016

Produced in 2016by the Bay of Plenty District Health BoardPO Box 12024, Tauranga 3143www.bopdhb.govt.nz

ISSN: 2230-6447 (Print)ISSN: 2230-6455 (Electronic)

Photos courtesy of Owen Wallace - cover Brian Scantlebury - www.brianscantlebury.com

and Stephen Barker of Barker Photography.

Bay of Plenty District Health BoardAnnual Report 2016

Contents

A Year in Review ....................................................................................................................................................... 1

Chair and CEO’s Year in Review ..................................................................................................................................... 3

Māori Health Rūnanga Year in Review ......................................................................................................................... 7

Statement of Performance for the year ended 30 June 2016................................................................................ 13

What are we trying to achieve? .......................................................................................................................... 15

How are we performing? .................................................................................................................................... 19

This year we have achieved ................................................................................................................................ 25

Output Classifications ......................................................................................................................................... 26

Health Target: Summary of Performance ........................................................................................................... 27

Output Class 1: Prevention ................................................................................................................................. 28

Output Class 2: Early Detection and Management ............................................................................................. 35

Output Class 3: Intensive Assessment and Treatment Services ......................................................................... 45

Output Class 4: Rehabilitation and Support ........................................................................................................ 55

Statement of Financial Performance by Output Class ........................................................................................ 59

Statement of Responsibility for the year ended 30 June 2016 ............................................................................. 61

Auditor’s Report for the year ended 30 June 2016 ................................................................................................. 65

Financial Statements for the year ended 30 June 2016 ......................................................................................... 71

Statement of Comprehensive Revenue and Expense ........................................................................................ 73

Statement of Financial Position ......................................................................................................................... 74

Statement of Changes in Equity ......................................................................................................................... 75

Statement of Cashflow ....................................................................................................................................... 76

Statement of Contingent Liabilities .................................................................................................................... 77

Statement of Accounting Policies ....................................................................................................................... 78

Notes to the Financial Statements for the year ended 30 June 2016 ................................................................. 87

Our People for the year ended 30 June 2016 ........................................................................................................ 107

Employment Policies and Procedures ............................................................................................................... 109

Staff Engagement and Partnership .................................................................................................................... 111

Learning Environment ....................................................................................................................................... 112

Scholarships and Study Funding ......................................................................................................................... 112

Innovation Awards ............................................................................................................................................ 112

Staff Status ........................................................................................................................................................ 113

Termination Payments ...................................................................................................................................... 117

Salaries over $100,000 ...................................................................................................................................... 118

Directors’ and Officers’ Insurance ..................................................................................................................... 119

Donations .......................................................................................................................................................... 119

Contents

Board and Committee Report for the year ended 30 June 2016 ........................................................................ 121

Introduction........................................................................................................................................................ 123

Board .................................................................................................................................................................. 123

Combined Community and Public Health and Disability Services Advisory Committee ................................... 124

Bay of Plenty Hospital Advisory Committee ...................................................................................................... 125

Audit, Finance and Risk Management Committee ............................................................................................ 125

Remuneration Committee ................................................................................................................................. 126

Delegations ........................................................................................................................................................ 126

A Year in ReviewA Year in Review

Statement of Performancefor the year ended 30 June 2016

Statement of Responsibility for the year ended 30 June 2016

Auditor’s Report for the year ended 30 June 2016

Financial Statementsfor the year ended 30 June 2016

Notes to the Financial Statementsfor the year ended 30 June 2016

Our Peoplefor the year ended 30 June 2016

Board and Committee Reportfor the year ended 30 June 2016

Chair and CEO’s Year in Review

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It has been a year of change for the Bay of Plenty District Health Board (DHB). An era ended in January 2016 with the retirement of our Chief Executive Phil Cammish. Phil made an enormous contribution to the development of the DHB during his 10 years at the helm. His significant contributions include:

• the triumvirate leadership model which significantly enhances clinical leadership, • our union relationships which provide a strong basis for all our operations, • the development of the Clinical School, including the Innovation and Research Awards and the Rural

Immersion Scheme, • the completion of Project LEO (the redevelopment of Tauranga Hospital) and the approval and

completion of Project WAKA (the redevelopment of Whakatane Hospital) the onsite provision of Radiotherapy Services in the new Kathleen Kilgour Centre, the location of Pathlab on-site in new facilities and the provision of Cardiology Services.

The initiatives which Phil led have had a significant impact on the health of our population. We wish Phil all the very best in his retirement. Helen Mason was appointed as Chief Executive in February 2016. Helen has worked for the DHB for over 17 years, starting as a Registered Nurse in the flexipool and including stints as General Manager Planning and Funding and Chief Operating Officer. Reflecting on 2015/16

The year was dominated by high increases in demand for our services. This was fuelled by strong population growth, particularly in the Western Bay of Plenty. This is now our continuing reality and the DHB needs to be equipped to understand and respond to it, operationally and financially. Whole-of-system demand has seen Emergency Department activity increase to 77,233 presentations (17% above expectation), elective services discharges to 11,113 (9.6% increase), Primary Health enrolment to 221,619 (3.7% increase) along with growth in support services such as dispensing 3.57 million pharmaceutical prescriptions (3.3% increase) and conducting 1.35 million community laboratory tests (5.5% increase).

We anticipate that this demand for services will continue into the future. We know that to be able to service our population well, we need to think about how we deliver services most appropriately to meet this growing demand. Work on this specific issue is ongoing and the DHB is also currently engaging with a wide-ranging list of stakeholders to develop a 10 year Bay of Plenty Health Services Plan. This will give us a real understanding of how we expect our population to develop and therefore what the DHB needs in both prevention and treatment in both community and hospital settings over that period. Our staff are incredibly important to us in the delivery of high quality services to our population. The DHB continues to invest strongly in its staff, supporting them

to stay healthy and develop professionally. Our achievement of a WorkWell Gold award in 2016 reflects this investment in our people including the provision of on-site wellness facilities at both our main hospital sites. We began a conversation with staff in the second half of the year, raising the question of what is important to them? This culminated in a workshop held during May with over 80 staff from a range of professions and departments across the DHB attending. This work is ongoing. The DHB received a certificate of achievement during the year for being the first DHB over-the-line in New Zealand to implement all of the Care Capacity Demand Management Programme tools and processes in our medical, surgical and paediatric inpatient services. By achieving this we have met our objective of providing safe staffing, healthy workplaces in conjunction with our union partners. The enactment of the Health and Safety at Work Act 2015 during the year prompted the DHB to review all health and safety activities and ensure that staff and leaders are aware of, and supported in their responsibilities. This work will ensure that we continue to put health and safety at the centre of all that we do.

“for the duration of my stay I encountered nothing but courtesy, professionalism, positive attitudes and a can-do approach from a staff who attended to my care and recovery”.


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At the Bay of Plenty DHB, we aim to create an environment that empowers healthcare professionals to improve the way they work and to improve patient care, not only within their departments but across the healthcare setting and within our communities. Over the last three years hundreds of hours of training have been completed by staff providing practical skills and access to a range of tools on quality improvement and patient safety. The training adopts the Institute for Healthcare Improvement (IHI) Model for Improvement, an approach that uses a simple way of identifying areas for improvement and then testing innovative ideas on a small scale. The development of a dedicated Quality Improvement (QI) Residency for junior doctors is an example of our future work force focus and we intend to extend it across other healthcare staff groups. This initiative gives junior doctors dedicated time to learn quality improvement leadership skills and explore new ways of delivering patient care. Our population’s health is influenced by a wide range of factors beyond the delivery of health services. Health is not simply about the treatment people receive in hospital or from their GP. The prevention of illness and staying healthy is largely determined by the way we live our lives. The factors that determine how healthy we are include warm appropriate housing, safe neighbourhoods, clean air and water, diet, and easy access to transport, recreation, education and employment. Many of the organisations responsible for these key factors lie outside the health sector. Through its Health in All Policies (HiAP) approach, the DHB is engaging with a wide range of stakeholders and agencies to support them to take into account the health implications of their decisions, to seek synergies and avoid harmful health impacts. We recognise our responsibility to work in partnership to achieve lasting change for the health and wellbeing of the people of the Bay of Plenty. At the centre of healthcare is our patient, and this year we have received some great feedback on their experiences while in our facilities. From our patient experience feedback, two compliments were standouts and they are presented around the text in this report. We appreciate all feedback on our care, positive and negative, and are proud of our staff and their contribution to our community. Good progress has been made on the implementation of the Integrated Healthcare Strategy during the year. An example of this is that we recognise people can receive healthcare in several settings such as their GP, pharmacy, or hospital. Each, in the past, has held information about a person’s health needs and medications. Until now that information has largely been held separately by those providers. Ensuring clinicians across the system have appropriate access to patient’s information was the driver behind two major projects which now allow health professionals to access patient information more easily. ‘CHIP for GPs’ and ‘Medcheck’ were developed by the Bay of Plenty DHB in cooperation with our three Public Health Organisation partners together with other healthcare providers. This initiative links the systems, giving easy access to the health professionals, thereby enhancing patient care in any setting. A further important discussion under the Integrated Healthcare Strategy is to consider whether services are being provided in the right setting. These conversations are framed by focusing on the patient’s needs and perspectives. A good example of this is the progress made during the year on considering an integrated approach to Community Nursing and the resultant decisions will be implemented in the coming year. Another major focus for us throughout the past year and moving forward is Future Care Planning (FCP). Future Care Planning is a conversation planning for a person’s future healthcare needs. The process assists individuals to identify their personal beliefs and values to formulate and communicate their preferences for their future healthcare. It helps people understand what the future might hold and to say what treatment they would and would not want. The process may result in the person choosing to write a Future Care Plan, a document where they record those wishes. The clarity afforded by a Future Care Plan can reduce the stress both for the person concerned and their family and friends during a difficult period of life. It is an important document for people at any stage of their lives.

‘Sometimes things happen for a reason and although we didn’t want our trip to end this way, we’re grateful that it happened in Tauranga, where we received first class service by extremely competent and caring staff’


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The Year Ahead

As a result of the high level of demand we’re experiencing, meeting our financial targets will remain a significant challenge in 2016/17, one that we are determined to rise to and continue to provide high quality services to our population.

The Executive Team of the DHB sat down with the incoming Chief Executive to consider what our immediate priorities should be as a team. We will be progressing these strongly during 2016/17. They are represented as follows:

Bay of Plenty Health Services Plan – As we signalled in our commentary on 2015/16, we are engaging with a wide range of stakeholders to create a 10 year plan which will be completed and moved to implementation in 2017. Quality Review – During the first quarter of 2017, we will start a discussion on how the DHB measures its performance and better links it to improvement. Good to Great - Māori Health – Improving our Māori Health performance is incredibly important to the DHB. We are determined to improve outcomes for our Māori population through lifting performance on key measures, achieving

mainstream responsiveness and using our resources to improve implementation. Staff Engagement and Culture – The workshops held by staff in May 2016 resulted in four clear workstreams being developed by the staff representatives aimed at improving engagement and culture. These are imbedding our CARE values, improving communication, dealing with inappropriate behaviour including bullying and performance appraisals. A staff steering group is already established to oversee these work streams and significant progress on all of them is expected to be made before the end of the financial year. We will continue to invest in learning and development of our staff and investing in the future of our work force. Our Clinical School is important in that context and this year we will be receiving our first intake of 5th year medical students, an important development for the Bay of Plenty. As we embark on a year of new challenges, we gratefully thank our 3,200 staff who work hard to provide high-quality health services for our growing population. Thank you for your support in 2015/16 and all you do for the people we serve. We would like to take this opportunity to thank our Board, and community-based healthcare partners and organisations for their contribution to the delivery of health services to the population of the Bay of Plenty. Sally Webb Helen Mason Board Chair, Bay of Plenty DHB Chief Executive, Bay of Plenty DHB

Māori Health Rūnanga Year in Review

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The Māori Health Rūnanga is the Iwi Relationship Board (IRB), and works in partnership with the Bay of Plenty District Health Board (DHB). It is a sound governance Board, with all 18 of our region’s iwi represented. The IRB is focused on achieving equitable health outcomes for Māori within the Bay of Plenty DHB.

The Board continues to acknowledge the important role of iwi, and looks to the Māori Health Rūnanga and the 18 mandated iwi health representatives to provide both the strategic direction and connection to the Māori community on matters and issues important to Māori.

Both Board and Rūnanga chairs were keen to further strengthen their governance relationship by holding combined quarterly meetings. Objectives for the combined boards have been:

• To build a greater shared understanding of partnership; • Shared understanding around challenges and opportunities for the respective boards; • Facilitate shared learning especially in He Pou Oranga Tangata Whenua; • Identify, agree and progress shared priorities; and • Accelerate the achievement of health equity.

Key areas of focus for these meetings are: Māori Health Plan Dashboard Report, He Pou Oranga Tangata Whenua, CARE Values, Iwi strategic matters and Whānau Ora.

Toi Ora (ultimate health and wellbeing) is our vision for Māori in the Bay of Plenty rohe (district). To achieve Toi Ora, Te Ekenga Hou (our Māori Health Strategy) has three key themes. It is closely linked to the national Māori Health strategy He Korowai Oranga and its vision of Pae Ora (Healthy Futures).

Key achievements of the Māori Health Rūnanga in the 2015/16 year within these three key themes were:

Tino Rangatiratanga – Self-determination and empowerment • Whānau Ora Needs Assessment (WONA)

The Bay of Plenty DHB has completed the Whānau Ora Needs Assessment which was a project that drew on many sources and key stakeholders to identify key health inequities that Māori face in Bay of Plenty DHB and to provide some key recommendations. The assessment included wellbeing measures and outcomes, such as the social determinants of health and the environmental conditions which predispose those differing health outcomes.

Key recommendations included prioritising equity as a lens across all agencies which affect the social determinants of health such as housing, employment and education; to have a deliberate focus on allocating resources in proportions to the level of need; and initiatives that improve access and quality of health care for Māori in the Bay of Plenty should be encouraged and are critical in improving whānau health literacy, engagement with the health sector, and health outcomes for the whole population.

• Kaupapa Māori Nurse Practitioners The focus on building the capacity and capability of the Māori nursing workforce has resulted in an eventful year with three more Māori nurses achieving at the pinnacle of their profession. With one nurse in the Western Bay of Plenty and two in the Eastern Bay of Plenty achieving nurse practitioner status, this brings the total number of Māori Nurse Practitioners to four.


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Tuituinga Pou Hauora – Ensure responsiveness of mainstream services to Māori • Whole-of-System Approach – Pae Ora (Healthy Futures)

To accelerate our Māori health performance, the Bay of Plenty DHB has taken a whole-of-system approach and has leveraged the refreshed He Korowai Oranga vision of Pae Ora (Healthy Futures). The DHB has made conscious efforts in developing new models of care that look at health from a client/whānau centred perspective. This will be achieved through the ongoing work in co-designing and strengthening partnerships across the various sectors to move to a more integrated system that sees the achievement of equity in all programmes and services.

• Contracting for outcomes Two Kaupapa Māori providers (along with two mainstream providers) have trialled the new Ministry of Business Innovation and Employment (MBIE) contracting for outcomes framework for their adult mental health services. A feature of the contracting framework is that it uses Results Based Accountability (RBA). The contracting process involved co designing (funder and provider) performance measures that measured How much?; How well?; and Any one better off? Rather than the traditional output measures. The Providers valued the co-design process, and the shift from measuring outputs to outcomes.

He Ranga Hua Hauora – Increase capacity and capability of Māori providers and communities to meet their own toi ora. • Māori Health Plan web-based tool – www.trendly.co.nz

The launch of the web-based tool for Māori Health Plan performance monitoring, which was developed in 2014/15, has been implemented over 2015/16. This innovative tool gives all 20 District Health Boards an instant, mobile way of tracking equity, performance, and improvements in Māori health. This initiative was sponsored by Tumu Whakarae, the national Māori General Managers Group, and endorsed by the national CEO group for implementation across the sector. Over the past year there have been several refinements such as the addition of a news update; a narrative on each indicator that can convert the percentage to achieve into real numbers.

• Māori Health Excellence Seminars The Bay of Plenty DHB, in partnership with the Midland DHBs, was funded by the Ministry of Health, via the Māori Provider Development Scheme, to deliver a series of health excellence seminars. These seminars feature some of the best performing organisations in the country, enabling providers within the BOPDHB to learn effective service delivery models and to improve health outcomes for Māori and other New Zealanders. Four seminars were delivered on the topics of Improving infant health; achieving equity in health; improving cervical screening performance; and improving childhood immunisations. The seminars and the web-based monitoring tool have been integrated and the seminar presentations and supporting material have been archived and can be accessed and viewed by users in Trendly.

Māori Health Plan (MHP)

The MHP has been endorsed by the Rūnanga on behalf of the Iwi as a key vehicle for Māori health, and continues to be one of the Rūnanga’s key mechanisms for monitoring inequalities and highlighting disparities. The Rūnanga has focused on promoting and monitoring the top six (Did not attend rates; breast and cervical cancer screening; Ambulatory Sensitive Hospitalisation (ASH) Rates; rheumatic fever; and improving oral health priority areas, as this is where we will achieve the greatest health gain for Māori.

Punohu McCausland Chair, Māori Health Rūnanga


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Bay of Plenty District Health Board Māori Health Plan Performance Dashboard Quarter 4 Update (to June 2016)

Please note that the main source of data has come from the trendly website (http://trendly.co.nz) or otherwise specified in the footnotes.

Indicator Target Māori

Non-Māori

or Total1

Reducing Disparity

Disparity Gap

Data Quality

1

Ethnicity data accuracy in Primary Health Organisation (PHO) registers

Training on this tool took place over the year and has been implemented progressively over the year.

Access to Care

2

Percentage of Māori enrolled in PHOs and GP practices2 100% 97% Total 98% √ 1%

This measure is a better reflection of enrolments from registers of all PHOs, as well as BOP residents who attend the Te Whanau-a-Apanui Community Health Clinic - Te Kaha practice (1278 or 87% Māori) and Tuhoe run Taneatua practice (1097 Māori).

3

Ambulatory Sensitive Hospitalisations (ASH) Rates per 100,0003

0-4 years 111 127 Total 115 SP 12

45-64 years 106 190 Total 101

89

0-74 years 111 n/a n/a n/a

Work has been progressed to develop a range of initiatives that will assist in better managing acute demand within both primary and secondary care settings and, as a direct result, impact positively on ASH rates. There has been improvement over the year; however the disparity gap remains the same.

Maternal Health

4

Percentage of Māori infants breastfed4

6 weeks (full and exclusive breastfed) 68% 62% Total

75% 13%

3 months (full and exclusive breastfed) 60% 50% Total

62% 12%

6 months (full, exclusive and partially breast fed) 59% 61% Total

65% √ 4%

Bay of Plenty DHB has achieved its breastfeeding target for Māori. Our percentage of fully, exclusively or partially breastfed six month olds ranks us seventh of 20 DHBs.

1 The comparison population is stated for each indicator and may be the Total Population, Other, Non-Māori, or Non-Māori Non-Pacific depending on the way that ethnicity has been categorised and grouped by the relevant data supplier. 2 Data source derived from the PHO enrolment registers and the DHB clinic (Te Kaha) register - This indicator is a more accurate view of the Māori PHO enrolment rates due to two main considerations: 1. Some General Practices are domiciled to other DHBs, even though they sit within the geographic boundaries of the BOPDHB; 2. The Te Kaha clinic is a clinic operated via the BOPDHB Provider Arm. 3 Same results and source as the Statement of Performance section of this Annual Report. 4 Data source derived from Māori Health Plan Dashboard data sets.

Key to Reducing Disparity: √ Progressing well SP Some progress No progress or worsening ? Further work or info required

http://trendly.co.nz/


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Non Māori

or Total5

Reducing Disparity

Disparity Gap

Cardiovascular disease and diabetes

5

Percentage of eligible Māori who have had their cardiovascular risk assessed within the past five years6 90% 86%

Non-Māori 92%

SP 6%

There was a reduction in the disparity gap over the year. The key actions that were undertaken over the year to lift performance were:

• Improving the integrity of the data to ensure that all eligible persons could be identified and contacted. • Ongoing promotional activity (radio, events) that targeted a hard to reach subset of Māori men between the

ages 35-44 years. • Better integration and linking of services such as screening and self-management/green prescription options so

that patients were more informed about how they can better manage their conditions. • Building the workforce capability so that more staff could carry out a Cardio Vascular Risk Assessment and

utilising the roles of the Nurse Practitioners.

Cancer

6

Breast screening rate (50-69 years) 70% 60% Non-Māori 73%

13%

There has been a small reduction in inequalities, and this indicator will continue to have a focused approach in lifting performance. For the coming year, this will remain one of the top five priority areas. There will be greater ownership, monitoring and action to address this gap in the future. The DHB will need to screen 482 more Māori women (3,507 screened in total) to reach the target.

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Cervical screening rate (25-69 years)7 80% 64% Non-Māori 83%

SP 19%

Whilst we have not met the target, there has been a steady increase in coverage placing Bay of Plenty DHB within the top four DHBs nationwide. The inequity gap has reduced.

Our key actions moving forward are: • implementing plan where the Regional Co-ordinator will work alongside EBPHA to develop and test new

initiatives. • supporting practices to identify unscreened and under screened women and assist with referral to alternate ISPs

as appropriate. • developing use of data-match reports to identify practices with smaller inequality gaps and encourage sharing

learnings.

5 The comparison population is stated for each indicator and may be the Total Population, Other, Non-Māori, or Non-Māori Non-Pacific depending on the way that ethnicity has been categorised and grouped by the relevant data supplier. 6 The data is sourced from CPI reports submitted by PHOs as well as PHO enrolment datasets. 7 Māori Health Plan 2013/14 indicator specifies an eligible population of women aged 20-69 to align with national screening unit which is different to the Statement of Performance indicator which uses an age range 25-69. This measure is now consistent between the Annual Plan and Māori Health Plan.


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Non Māori

or Total8

Reducing Disparity

Disparity Gap

Smoking

8

Percentage of hospitalised smokers provided with cessation advice9 95% 96% Total

96% √ 0%

There is no inequity for Māori, with Māori receiving a higher rate of cessation advice (96.0%) compared with non-Māori (95.7%). The DHB has achieved the overall target with 95.7% of all smoking patients given cessation advice.

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Percentage of smokers presenting to primary care provided with cessation advice10 90% 76% Total

76% √ 0%

2015/16 measures were expanded to include smokers seen in the last 15 months. Data validation was an issue for this measure. Coverage within the Primary Health Organisations has gradually improved since a change to data processes reported a 66% result in Q1.

Developments in primary care reporting in the last 12 months now enables us to report progress by ethnicity. There is no inequality in reaching Māori for this measure.

There have been two main approaches to improving performance: • Contacting all enrolled patients who are known to smoke based on latest data and have not had an ABC

intervention in the past 15 months. Many of these patients will not have been into the practice in the past 15 months. Then verify their current smoking status and if still smoking deliver and record the ABC intervention. In WBOPPHO, practices have been supported and incentivised financially to lift the number of ABC interventions undertaken.

• Improve the accurate recording of ABC interventions actually given so that the data can be retrieved when the measure is calculated. Anomalies have been corrected in Q4 in many practices.

Immunisation

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Percentage of infants fully immunised by 8 months of age 95% 87% Non-Māori 86%

SP 1%

The DHB continues to work with our PHOs and key MOH personnel to understand barriers to service delivery and identify new opportunities to further improve this performance.

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Percentage of the population (>65 years) who received the seasonal influenza immunisation 75% 50%

Non Māori 66%

SP 16%

There continues to be a steady disparity throughout the year. The DHB continues to encourage kuia and kaumatua programme providers to support influenza vaccination. All kuia and kaumatua programmes are closely linked with neighbouring practices.

Rheumatic Fever

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Reduced acute Rheumatic Fever hospitalisations11 1.7 2.8 Pacific only

1 √ -

Because over 95% of first incidence cases of hospitalised Acute Rheumatic Fever are Māori, the total BOP target has been equated to Māori - there is no measure for non- Māori.

8 The comparison population is stated for each indicator and may be the Total Population, Other, Non-Māori, or Non-Māori Non-Pacific depending on the way that ethnicity has been categorised and grouped by the relevant data supplier. 9 Data is sourced through the DHB Hospital cubes and admission reports. 10 Result calculated by summing the numerators and denominators for each of the three PHOs, based on the data within the Integrated Performance Incentive Framework (IPIF) performance summary. 11 Data sourced through the Ministry of Health and verified via DHB Hospital admission data sets.


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Non Māori

or Total12

Reducing Disparity

Disparity Gap

Access to services

13

Did-Not-Attend rate (DNA) outpatient appointments13 5% 15.6% Total 6.6%

10%

This indicator continues to be a significant area of concern and has been a high priority for the current, will continue for the coming year. There are many activities that had occurred over the previous year to improve this indicator. Key activities include:

• Development of the Patient Information Centre - This team continues to provide support to additional services and has picked up text reminding – this has allowed more continuity of service and a much more reliable service;

• Establishment of the Failed Appointment Governance Group; • Improving Customer Service; • Provision of outreach clinics to places such as Kawerau; and • Improving the use of text messaging to schedule appointments and create better connectivity with clients.

Oral Health

14

Māori preschool dental clinic enrolment rates14 95%15 65% Non-

Māori 90%

SP 25%

The enrolment rate of preschool Māori children continues to show steady but slow growth each quarter, and 1.8% for January to March 2016 quarter. This has significant improvement of 40% from previous years but this will still remain a challenge and focused effort will be required again to ensure that performance can be achieved.

12 The comparison population is stated for each indicator and may be the Total Population, Other, Non-Māori, or Non-Māori Non-Pacific depending on the way that ethnicity has been categorised and grouped by the relevant data supplier. 13 Data derived from the BOPDHB Provider Balanced Scorecard as at 30 June 2016. 14 Raw data sourced via Titanium. 15 Target was 90% until December 2015 then increased to 95% from 1 January 2016 to 30 June 2016.

Statement of Performancefor the year ended 30 June 2016

Statement of Performance for year ended 30 June 2016

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What are we trying to achieve?

The Bay of Plenty District Health Board (DHB) is the largest funder and provider of health and disability services in the Bay of Plenty. The actions we take in terms of which services to fund and the level at which we invest have a significant impact on the health of our 223,000 residents. In achieving our vision of ‘healthy, thriving communities,’ it is important that we understand the level of need within our population, as well as the current and future drivers of service demand. Our intention is to deliver services that will achieve the best outcomes for our residents, a quarter of whom identify as being Māori. We take a long-term view, and shift resources to where we believe they are most needed, in order to improve the health of our population, while ensuring that the health system is sustainable.

This section provides an overview of the key elements of our outcomes framework, which is designed to align with the strategic direction and statement of intent of the Ministry of Health, and the Midland region, of which we are one of the five member DHBs. Our strategy identifies three strategic goals (which we refer to as 5-10 year outcomes). These are:

1. People take greater responsibility for their own health: The development of services that support people to stay well and take increased responsibility for their own health and wellbeing.

2. People stay well in their homes and communities: The development of integrated, primary and community services that support people in their own home or a community-based setting and provide a point of ongoing continuity of care.

3. People receive timely and appropriate care: The provision of specialist resources and services in response to episodic events in both a hospital and primary setting.

These long-term outcomes will be achieved through the combined efforts of all those people working across the Bay of Plenty health system, central and local government, other DHBs within and outside of our region, and the wider health and social services sector. Every year we commit to evidencing the state of our population’s health and our progress toward our intended outcomes. We have identified long-term outcome measures to track our performance toward our aims. Given the long-term nature of these outcomes, our goal is to make a measurable change over time, rather than achieve a specific annual target.

The intervention logic diagram on the following page visually demonstrates how these strategic goals and the outcomes we are seeking will contribute to the goals of the Midland region, and the overarching sector goals of Government. These diagrams illustrate both a framework for measuring and monitoring our performance, as well as a demonstration at a strategic level of our progress to date.


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Ministry of Health’s (MOH) Performance Story:

Midland DHBs’ Performance Story:

Health and Disability System

O

utcomes

All New Zealanders lead longer, healthier and more independent lives

New Zealand’s Health system is cost effective and supports a productive economy

Strategic Direction - Module 1

Strategic purpose and role

Improve and protect the health of New Zealanders

Ministry of Health

Intermediate

Outcom

es

New Zealanders are healthier and more independent

High quality health and disability services are

delivered in a timely and accessible manner

The future sustainability of the health system is assured

Policy Drivers

Regional Collaboration

Strong governance and clinical leadership

Integration between Primary and Secondary

Care Living within our means

Midland

Vision

All residents of Midland District Health Boards lead longer, healthier and more independent lives M

idland Regional Service Plan ( RSP) – Module 1

Regional Strategic

Outcom

es

To improve the health of our population To reduce or eliminate health inequalities

Regional O

utcome

Indicators To increase our average life

expectancy To reduce premature death rates To improve our amenable mortality rate

Regional Strategic

Objectives

To improve Māori Health

outcomes

Integrate across the continuum of

care

To improve quality across

agreed regional services

To improve clinical

information systems

To build the workforce

Efficiently allocate public health system

resources

By focusing on these objectives, we will be able to drive change that enables us to live within our means.


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Bay of Plenty District Health Board’s Performance Story:

5-10 Year Outcom

es

BAY OF PLENTY DISTRICT HEALTH BOARD Vision: Kia momoho te hāpori oranga - Healthy, thriving communities

Mission: Enabling communities to achieve good health, independence and access to quality services Values: CARE (Compassion, Attitude, Responsiveness and Excellence)

Strategic Direction

People take greater responsibility for their health

People stay well in their homes and communities

People receive timely and appropriate care

3-5 Year Impacts

Fewer people smoke

Reduction in vaccine

preventable diseases Improving Health behaviours

Children and adolescents have

better oral health Early detection of treatable

conditions People better manage their long

term conditions Fewer people are admitted to

hospital for avoidable conditions People maintain functional

independence

People are seen promptly for

acute care People have appropriate

access to elective services Improved health status for

people with a severe mental illness

More people with end stage conditions are supported

Focus Areas

Māori Health - Achieving Equity

Health of Older People

Chronic Conditions

Child and Youth

Priorities and Targets

Resources/ Inputs

People

Performance Management

Clinical Integration / Collaboration /

Partnerships

Information

Stewardship

(sample outputs listed only – for a full list see Module 3 – Statement of Performance)

Outputs

• Providing Smokers who

access Primary and Secondary services with Smoking Cessation advice and support

• Children are fully immunised at eight months

• Percentage of population enrolled with a

Primary Health Organisation

• No. of children enrolled in the Well Child/Tamariki Ora (WCTO) Programme

• No. of acute inpatient

presentations

• Elective and arranged Day of Surgery rate is achieved

• Shorter wait times for

non-urgent mental health and addiction services

Statement of perform

ance expectations


18

Our performance against our long-term framework is reported over the following pages. Overall, these outcome measures show the health of our population is improving.

Outcome Goal Outcome Measure Comment / Achievement

People take greater responsibility for their health

Fewer people smoke

Reduction in vaccine

preventable diseases

Improving health behaviours

Improvement has been recorded against this outcome measure (as evidenced by an increase in the percentage of Year 10 students who have never smoked). Bay of Plenty DHB has also made good progress against its Smokefree Health Target in secondary and primary care and continues working with Lead Maternity Carers in providing advice and support to quit for pregnant women. Bay of Plenty DHB continues to focus on improving the health literacy of its population promoting the benefits of immunisations to reduce the incidence of preventable diseases. Healthier dietary choices are evident from the latest obesity and nutritional targets within the NZ Health Survey published for 2014/15. People surveyed indicated that more vegetables were consumed than three years ago while obesity measures are improved.

People stay well in their homes and communities

Children and adolescents have better oral health

Early detection of treatable

conditions

Fewer people are admitted to

hospital for avoidable conditions

People maintain functional

independence

Oral health results have improved, particularly amongst pre-schoolers. Adolescent utilisation rates however were unfavourable. A coordinated approach between Bay of Plenty DHB and its community providers will promote performance in this area. Breast screening rates continue to improve gradually while cervical screening rates for Māori women have lifted. Cardio-Vascular Disease (CVD) assessment rates continue to increase through the concerted efforts of our Primary Health Organisations (PHOs). Our Ambulatory Sensitive Hospitalisation (ASH) rates have improved for children as a result of targeted strategies to improve performance. We have reduced the percentage of our over 65 year old population in Aged Residential Care (5.04%: 5.03% target), although the proportion that receives Home Based Support Services climbed this year (11.31%: 12.15% target). Importantly, the average age recorded for entry to aged care is rising over time. These measures indicate our over 65s are staying well in their own homes for longer.

People receive timely and appropriate care

People are seen promptly for

acute care

People have appropriate access to elective services

Improved access to mental health services


Our Emergency Department saw 5% more patients during the year than in 2015 and still ensured 94% of those patients were seen within six hours, against the Health Target of 95%. Elective surgery discharges totalled 11,113 (target: 10,136). People were seen in a timely manner, no one waited longer than four months to be seen and we continue to intervene at a rate that reflects population need Mental Health access rates were maintained at manageable levels and supporting measures such as wait times targets for both mental health and alcohol and drug treatment were achieved in 11 out of 12 categories. 823 patients receiving palliative care services is ahead of target (739 patients) and above base line (800 patients.)


19

How are we performing?

Sitting beneath our three strategic goals 16 key impact areas where we can make a measurable contribution in the medium-term to achieving these long-term outcomes. The impacts are areas where we can influence change and make a difference in improving the health and wellbeing of our population. We have set targets against these key measures in order to evaluate the effect of service delivery over a three-to-five year period. This section provides an update on our progress.

Overall, the impact indicators point to an improvement in the health status of the Bay of Plenty population this past year. To assist in reading and interpreting this report, we have colour coded our 2016 achievements. A green figure indicates performance has achieved, or exceeded the target. A red figure indicates a gap between actual and target performance.

In addition, a summary of performance against the Māori Health Plan is included within the Runanga annual review.

Outcome: People take greater responsibility for their health What difference have we made for our population?

Key Impact Measure 2015 Base

2016 Achieved

2016 Target Comment

Fewer People Smoke

Increased percentage of Year 10 students never smoked1

72%

78%

77%

Achieved. Latest year signalled a trend of higher abstinence than in previous years. BOPDHB was on par with national average for never smoked (79%) although the year on year decrease in daily smokers (1.2%) was half that of the national decline rate (2.5%).

Fewer People Smoke

Decreased percentage of people who identify as current smokers (based on our smoking prevalence data from our hospitalised patient admission system)

16%

17%

15%

The result this year reflects a less favourable result than last year with more people identifying as smokers admitted to hospital. We did not achieve our target of 15% prevalence. The DHB has a wide range of services across the BOPDHB working to reduce the prevalence of people that Smoke in our community. This is reflected in our improving health target performance offering people brief advice and support to quit as well as targeted programmes for Māori, pregnant woman and Tangata Whaiora.

1 This survey is published for the previous calendar year so 2016 achieved measure is for the year ended 31 December 2015.


20

Outcome: People take greater responsibility for their health What difference have we made for our population?


2016 Achieved

2016 Target Comment

Reduction in vaccine preventable diseases

95% of eight month olds have completed their scheduled vaccinations (6 weeks, 3 months, and 5 months) to be achieved in stages by the end of 2015

89%

89%

95%

Not Achieved. The DHB is currently reviewing all of its immunisation services to look at how we can lift the performance of the whole system, so more children are immunised.

Reduction in vaccine preventable diseases

3 Year average Crude Rate per 100,000 of vaccine preventable disease in hospitalised 0 – 14 year olds2

29.33

26.14

Decrease

Achieved.


Percentage of Obese in New Zealand 2-14 years population

• Total • Māori • Pacific

10.8% 15.5% 24.8%

10.8% 14.8% 29.7%

10.2% 14.5% 23.5%

Not achieved3. A new health target from 1 July 2016 recognises the importance of childhood referrals after Before School checks in improving the behaviours of New Zealanders.


Percentage of Obese in New Zealand 15+ years population

• Total • Māori • Pacific

29.9% 45.5% 66.7%

30.7% 46.5% 66.2%

27.0% 43.0% 64.0%

Not achieved4. A new health target from 1 July 2016 recognises this national challenge to improve the behaviours of New Zealanders.

2 Source is 3-year average to 2014/15 of aggregated hospital data using clinical codes for immunisations but excluding rubella arthritis and congenital rubella. Midland average was 25.77 while the national average was 22.88. 3 Source is Annual NZ Health Survey Update indicators published in December 2015 for 2014/15. Latest available Health Survey data updated by DHB region for the 2011/12-2013/14 period includes comparative unadjusted prevalence results for DHBs. Analysis for BOPDHB details results of 8.6% for Total, 13.0% for Māori and 5.2% for Non-Māori population groups. 4 Source is Annual NZ Health Survey Update age standardised indicators published in December 2015 for 2014/15. Latest available Health Survey data updated by DHB region for the 2011/12-2013/14 period includes comparative unadjusted prevalence results for DHBs. Analysis for BOPDHB details results of 31.7% for Total, 48.3% for Māori and 26.9% for Non-Māori population groups.


21

Outcome: People stay well in their homes and communities What difference have we made for our population?


2016 Achieved

2016 Target Comment


Increase in the percentage of children who are caries-free at age 5: • Total • Māori

46% 26%

51% 23%

64% 64%

While our result is better than base, Child and Youth will remain a focus area for the Bay of Plenty DHB Board in closing the gap and achieving target. Specific strategies to improve performance in this area include reviewing dental enrolment processes, improving information flows between Bay of Plenty DHB and providers, and recruitment of adolescent dental co-ordinators. Although we have not met the overall target a number of other oral health measures for children and adolescents have shown significant progress, including pre-school enrolments and adolescent utilisation rates, both of which are up.


Reduction in the mean decayed, missing and filled teeth (DMFT) score at Year 8: • Total • Māori

1.68 2.43

1.58 2.26

1.65 1.6

Our ratio was achieved for the total population. While the ratio was not achieved for Māori children the equity gap remained similar to last year. This is a key priority action from the Māori Health Plan.

Early detection of treatable conditions

Increased rate for breast screening for eligible women aged 45-69 years6 within a 24 month period: • Total • Māori

69% 59%

Not available

70% 70%

Actions this year included discussions with the Midland provider on how to implement best practice drawn from other providers within New Zealand where coverage rates are higher.

Early detection of treatable conditions

Cervical cancer mortality in New Zealand: • Total • Māori

1.7 3.2

Not available

Decrease

A focus by PHOs on improving engagement with screening programmes will increase population awareness of risks and the benefits of early intervention.

5 Annual Plan 2016 noted target as < 1.6 Total and < 1.6 MāoriMāori ‘Subject to Ministry of Health approval’. Subsequent confirmation from the Ministry indicated that the target for Year 1 ended 31 December 15 should remain at 1.6 for both measures and reduce to 1.55 for Year 2 – refer Module 7: Performance Measures in BOPDHB Annual Plan 2015/16. A successful outcome will be a reducing measure for decayed, missing or filled teeth over time. 6 Ministry of Health Planning Guidelines for 2015/16 indicated that DHBs should focus on eligible women in the 50-69 cohort. That cohort represents the age range of eligible women in the Māori Health Plan outcome. Achievement for MāoriMāori Health Plan measure was 59% for Māori (50-69) and 71% for Total (50-69).


22

Outcome: People stay well in their homes and communities What difference have we made for our population?


2016 Achieved

2016 Target Comment

Fewer people are admitted to hospital for avoidable conditions7

Reduced ASH rates: 0-4 years: • Total • Māori 45-64 years: • Total • Māori 0-74 years: • Total • Māori

119 161

110 228

116 191

115 127

101 190

n/a n/a

111 111

106 106

111 111

Our focus has significantly shifted over the last 12 months where unprecedented, increased acute demand was experienced across the entire system. Work has been progressed to develop a range of initiatives that will assist in better managing acute demand within both primary and secondary care settings and, as a direct result, impact positively on ASH rates.

People maintain functional independence8

No more than 5.03% of the Bay of Plenty population over 65 years of age access Aged Residential Care

5.10%

5.04%

<5.03%

While the target was just missed, more of our over 65 population are being supported in their own homes. This has a number of benefits for patients and their family/whānau, as well as containing pressure on our aged care facilities.

People maintain functional independence

Bay of Plenty population over 65 years of age receive care in their homes

11.06%

11.31%

<12.15%

Achieved. More of our over 65 population are being supported in their own homes. This has a number of benefits for patients and their family/whānau living independently in the community.

People maintain functional independence

Average age of entry to Aged Related Residential Care9:

• Rest home • Dementia • Hospital

85.63 81.39 84.46

86.47 83.75 86.05

85.63 81.39 84.46

Achieved. The health of our older population continues to improve. Rest Home services are accessed on average 10 months later than last year. Specialist care services are accessed on average 19 months later and Dementia care 28 months later.

7 Our 2015 Annual Report reported the equivalent percentile score achieved for the 12 months ended 31 March 2015 relative to the national average for the Total population. Source for 2016 is the Ministry of Health SI1 – System Integration report published in June 2016 for the 12 months ended 31 March 2016. No reporting was received for the 0-74 years population group in 2016. 8 Sourced from Client Claims Processing System for the 12 months ended 30 June 2016 for patient details received by 28 July 2016. 9 Data sourced from Client Claims Processing Systems (CCPS) of care providers.


23

Outcome: People receive timely and appropriate care What difference have we made for our population?


2016 Achieved

2016 Target Comment

People are seen promptly for acute care

Increase in the percentage of people who visit ED and are seen within 6 hours

93%

94%

95%

We did not achieve target, however performance was improved despite increasing demand on services. Initiatives in 2015 helped imbed systemic change that enabled us to improve our performance against this measure. Growth in ED attendances of 5% year on year was one of the key factors impacting on performance. 77,233 people attended ED this year compared with 73,623 last year.

People have appropriate access to elective services

Our Standardised Intervention Rates (SIRs) meet national expectations for: • Major Joint

replacement procedures

• Cataract procedures • Cardiac procedures • Coronary Angiography • Percutaneous

revascularisation

25.78

30.29 6.70

30.28 10.51

29.05

21.20 6.41

28.33 10.48

21.0

27.0 6.5

34.7 12.5

We achieved one of five intervention targets this year. The access rate improved year on year for joint procedures.10 Some other procedures planned for delivery by tertiary DHBs were not completed.

10 Activity measures relate to intervention rates per 10,000 people for elective procedures performed in the 12 months ended 31 March 2016.


24

Outcome: People receive timely and appropriate care What difference have we made for our population?


2016 Achieved

2016 Target Comment

Improved access to mental health services

Improving the health status of people with severe mental illness through improved access 0-19 years: • Total • Māori 20-64 years: • Total • Māori 65+ years: • Total • Māori

5.10% 5.79%

5.61% 9.44%

3.46% 4.32%

4.96% 5.70%

5.65% 9.50%

3.70% 5.03%

5.50% 6.50%

5.50% 9.70%

3.45% 4.00%

Access rates are growing but may have plateaued in the 0-19 age group due to the additional demands placed on services by cross-sector initiatives. We did not achieve our target for this group. Māori access rates for the 65+ have grown well above target. The Programme to Integrate Mental Health Data (PRIMHD) has resulted in greater transparency which should help identify areas for improvement. Access rates reported below are for the Total population.


Increased number of people accessing specialist palliative care11

800

823

739

Referrals have consistently exceeded the target for this measure in recent years. Work continues on accurate data capture and reporting within hospices and the hospital. Our 2016 Annual Plan includes additional quality measures.

11 At the time of reporting the quarter four return for our Eastern Bay provider had not been received. The reported number for 2016 could increase by another 50 patients based on the three-quarter average for that provider.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

25

This

yea

r we

have

ach

ieve

d…

Prev

entio

n

Heal

th T

arge

t: W

e pr

ovid

ed 7

6% o

f sm

oker

s acc

essin

g pr

imar

y ca

re (t

arge

t 90

%) a

nd 9

5% in

seco

ndar

y se

rvic

es

(targ

et 9

5%) w

ith sm

okin

g ce

ssat

ion

advi

ce a

nd su

ppor

t.

Heal

th T

arge

t: W

e fu

lly im

mun

ised

2,47

6 (8

9%: t

arge

t 95%

) eig

ht m

onth

ol

ds a

gain

st v

acci

ne p

reve

ntab

le

dise

ases

.

We

prom

oted

seas

onal

influ

enza

im

mun

isatio

n to

ens

ure

60%

of o

ur

over

65

aged

pop

ulat

ion

rece

ived

im

mun

isatio

n (ta

rget

75%

).

We

coor

dina

ted

2,37

6 pa

rtic

ipan

ts in

th

e Gr

een

Pres

crip

tion

(GRx

) pr

ogra

mm

e.

Two

out o

f eve

ry th

ree

infa

nts w

ere

still

rece

ivin

g so

me

brea

st m

ilk a

t six

m

onth

s.

Early

Det

ectio

n &

M

anag

emen

t

Heal

th T

arge

t: W

e en

sure

d 90

% o

f our

po

pula

tion

have

had

thei

r ca

rdio

vasc

ular

risk

ass

essm

ent

com

plet

ed w

ithin

a fi

ve y

ear p

erio

d (ta

rget

90%

).

We

incr

ease

d th

e pe

rcen

tage

of p

re-

scho

ol a

ged

child

ren

enro

lled

in d

enta

l se

rvic

es to

89%

(tar

get 9

0%).

We

incr

ease

d th

e nu

mbe

r of p

eopl

e en

rolle

d w

ith a

PHO

by

5,36

8 pe

ople

, an

d ou

r enr

olm

ent p

erce

ntag

e w

as

99%

(tar

get 1

00%

). M

āori

enro

lmen

t w

as 9

7% (t

arge

t 100

%).

Our

en

rolm

ent p

erce

ntag

es a

re a

bove

na

tiona

l ave

rage

.

We

mai

ntai

ned

our p

erce

ntag

e of

el

igib

le w

omen

(age

d 25

-69)

who

hav

e ha

d th

eir c

ervi

cal c

ance

r scr

eeni

ng in

a

thre

e ye

ar p

erio

d at

79%

(tar

get:

80%

). 70

% o

f elig

ible

Māo

ri w

omen

(age

d 25

-69

) hav

e ha

d th

eir t

hree

yea

r sc

reen

ing.

We

mai

ntai

ned

our p

erce

ntag

e of

re

siden

ts w

ho a

re o

ver 6

5 ye

ars a

nd

acce

ssin

g DH

B fu

nded

Age

d Re

siden

tial

Care

serv

ices

at 5

.04%

, and

mor

e pe

ople

(11.

31%

) age

d ov

er 6

5 re

ceiv

ed

care

in th

eir o

wn

hom

es fo

r lon

ger.

Inte

nsiv

e As

sess

men

t &

Trea

tmen

t Ser

vice

s

Heal

th T

arge

t: W

e im

prov

ed o

ur

perc

enta

ge o

f pat

ient

s ad

mitt

ed,

disc

harg

ed o

r tra

nsfe

rred

from

an

ED

with

in si

x ho

urs a

t 94%

(tar

get 9

5%),

whi

ch w

as a

chie

ved

desp

ite a

5%

in

crea

se in

att

enda

nces

.

Heal

th T

arge

t: W

e tr

eate

d an

d di

scha

rged

11,

113

elec

tive

patie

nts

(req

uire

d nu

mbe

r of d

ischa

rges

was

10

,136

), an

d re

cord

ed a

hea

lth ta

rget

re

sult

of 1

09%

(tar

get 1

00%

).

Heal

th T

arge

t: O

f our

pat

ient

s re

ferr

ed

for r

adio

ther

apy

or c

hem

othe

rapy

tr

eatm

ent,

73%

wer

e se

en w

ithin

62

days

of r

efer

ral (

targ

et 8

5% b

y Ju

ne

2016

).

We

man

aged

dem

and

for a

cute

car

e by

att

endi

ng to

77,

233

Emer

genc

y De

part

men

t pre

sent

atio

ns (t

arge

t 65

,588

).

We

exce

eded

one

of f

ive

Ele

ctiv

e Se

rvic

es P

atie

nt F

low

Indi

cato

rs (E

SPIs

) ta

rget

s, u

sed

to m

easu

re p

erfo

rman

ce

agai

nst p

atie

nt re

ferr

al, w

ait t

ime

and

clin

ical

ass

essm

ent c

riter

ia in

a h

ospi

tal

sett

ing.

Reha

bilit

atio

n &

Sup

port

We

disp

ense

d 3,

569,

885

phar

mac

eutic

al it

ems.

We

com

plet

ed 6

9,99

0 co

mm

unity

re

ferr

ed ra

diol

ogy

even

ts (m

easu

red

as

rela

tive

valu

e un

its).

We

unde

rtoo

k 1,

351,

553

com

mun

ity

labo

rato

ry te

sts a

nd c

ompl

eted

thes

e w

ithin

our

48

hour

targ

et 1

00%

of t

he

time.

Our

ful

l ach

ieve

men

t, ag

ains

t ou

r An

nual

Pl

an

mea

sure

s fo

llow

s.

Supp

lem

enta

ry r

epor

ting

agai

nst

Māo

ri He

alth

Pl

an

targ

ets

is av

aila

ble

in

the

Māo

ri He

alth

Rū

nang

a Ye

ar in

Rev

iew

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

26

Out

put C

lass

ifica

tions

Sect

ion

142

of t

he C

row

n En

titie

s Ac

t 20

04 r

equi

res

Dist

rict

Heal

th B

oard

s (D

HBs)

to

prov

ide

mea

sure

s an

d fo

reca

st s

tand

ards

of

outp

ut d

eliv

ery

perf

orm

ance

. O

ur re

sults

aga

inst

thes

e m

easu

res a

nd st

anda

rds f

or th

e ye

ar e

nded

30

June

201

6 ar

e se

t out

bel

ow.

DHBs

are

requ

ired

to p

rovi

de th

ese

mea

sure

s an

d st

anda

rds

of o

utpu

t del

iver

y pe

rfor

man

ce u

nder

agg

rega

ted

outp

ut c

lass

es.

Ther

e ar

e fo

ur o

utpu

t cla

sses

for 2

016.

The

se a

re:

1.

Prev

entio

n 2.

Ea

rly D

etec

tion

and

Man

agem

ent

3.

Inte

nsiv

e As

sess

men

t and

Tre

atm

ent S

ervi

ces

4.

Reha

bilit

atio

n an

d Su

ppor

t.

Out

put c

lass

es a

llow

DH

Bs to

gro

up se

rvic

es a

nd d

emon

stra

te th

e po

pula

tion

heal

th ‘

impa

cts’

of t

heir

Popu

latio

n Ba

sed

Fund

ing

(PBF

) al

loca

tion

deci

sions

, Gov

ernm

ent

prio

ritie

s an

d na

tiona

l dec

ision

-mak

ing.

Fo

r ea

ch o

utpu

t cl

ass

ther

e ar

e ag

reed

nat

iona

l out

put

perf

orm

ance

mea

sure

s an

d ta

rget

s.

Supp

lem

entin

g na

tiona

lly a

gree

d m

easu

res

are

a nu

mbe

r of

loca

l or

regi

onal

mea

sure

s th

at

repo

rt o

ur a

chie

vem

ent a

gain

st st

rate

gic

or o

pera

tiona

l goa

ls ta

rget

ed in

our

Ann

ual P

lan.

The

func

tion

of th

e St

atem

ent o

f Per

form

ance

Exp

ecta

tions

is to

sum

mar

ise h

ow th

e Ba

y of

Ple

nty

DHB

eval

uate

d an

d as

sess

ed w

hat

serv

ices

and

pro

duct

s w

e ne

eded

to d

eliv

er a

s re

flect

ed in

our

201

6 An

nual

Pla

n. It

also

dem

onst

rate

s ho

w w

e pe

rfor

med

aga

inst

the

resu

lting

targ

ets a

nd m

easu

res.

The

per

form

ance

mea

sure

s cho

sen

are

not a

com

preh

ensiv

e lis

t and

do

not c

over

all

of th

e ac

tivity

of

the

DHB,

but

they

do

refle

ct a

fund

amen

tal p

ictu

re o

f the

maj

or p

art o

f our

act

ivity

aga

inst

loca

l, re

gion

al a

nd n

atio

nal s

trat

egie

s an

d pr

iorit

ies.

Whe

re p

ossib

le, w

e ha

ve in

clud

ed p

ast p

erfo

rman

ce (b

asel

ine

data

) alo

ng w

ith e

ach

perf

orm

ance

targ

et to

giv

e th

e co

ntex

t of

wha

t w

e ar

e tr

ying

to

achi

eve.

Th

e DH

B be

lieve

s th

e ou

tput

s an

d m

easu

res

as p

rese

nted

in

this

sect

ion

prov

ide

a go

od

repr

esen

tatio

n of

the

full

rang

e of

serv

ices

that

we

prov

ide.

Our

repo

rtin

g th

is ye

ar p

rovi

des t

he re

ader

with

mor

e in

sight

into

our

per

form

ance

aga

inst

the

natio

nal H

ealth

Tar

get f

ram

ewor

k, a

nd

our a

chie

vem

ents

rela

tive

to th

e na

tiona

l per

form

ance

ave

rage

for a

ll DH

Bs th

roug

h ou

t the

cou

ntry

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

27

Heal

th T

arge

t: Su

mm

ary

of P

erfo

rman

ce

Heal

th T

arge

ts a

re a

set

of

natio

nal p

erfo

rman

ce m

easu

res

desig

ned

to im

prov

e th

e pe

rfor

man

ce o

f he

alth

ser

vice

s. T

hey

wer

e in

trod

uced

to

the

heal

th s

yste

m in

200

8 an

d ar

e re

view

ed a

nnua

lly t

o en

sure

the

y al

ign

with

gov

ernm

ent

prio

ritie

s.

This

sect

ion

prov

ides

a s

umm

ary

of o

ur p

erfo

rman

ce fo

r 201

6.

This

snap

shot

allo

ws

for c

ompa

rison

aga

inst

our

201

4 an

d 20

15 b

asel

ines

as

wel

l as

ben

chm

arki

ng a

gain

st th

e na

tiona

l DHB

ave

rage

ach

ieve

d ac

ross

all

20 D

HBs.

The

resu

lts b

elow

are

for t

he fu

ll fin

anci

al y

ear f

rom

1

July

201

5 to

30

June

201

6. F

urth

er in

form

atio

n is

publ

ished

by

the

Min

istry

of H

ealth

at w

ww

.hea

lth.g

ovt.n

z/he

alth

targ

ets.

Heal

th T

arge

t M

easu

re

2014

Bas

e 20

15 B

ase

2016

Ta

rget

20

16

Actu

al

Q4

2016

BO

PDHB

Re

sult

Q4

2016

DH

B Av

erag

e Sh

orte

r sta

ys in

em

erge

ncy

depa

rtm

ents

95%

of

patie

nts

will

be

adm

itted

, disc

harg

ed, o

r tr

ansf

erre

d fr

om a

n Em

erge

ncy

Depa

rtm

ent w

ithin

six

hour

s

92

%

93

%

95

%

94

%

94

%

94

%

Impr

oved

acc

ess t

o el

ectiv

e su

rger

y

The

volu

me

of e

lect

ive

surg

ery

will

be

incr

ease

d by

at

leas

t 4,

000

disc

harg

es n

atio

nally

per

yea

r12

10

6%

10

9%

10

0%

10

9%

11

0%

10

8%

Fast

er c

ance

r tr

eatm

ent

All

patie

nts,

re

ady-

for-

trea

tmen

t, w

ait

less

th

an

62

days

fo

r a

radi

othe

rapy

or c

hem

othe

rapy

firs

t ass

essm

ent

N

ew

Mea

sure

66

%

85

%

73

%

73

%

74

%

Incr

ease

d im

mun

isatio

n

85%

of

ei

ght

mon

th

olds

w

ill

have

th

eir

prim

ary

cour

se

of

imm

unisa

tion

(six

w

eeks

, th

ree

mon

ths,

an

d fiv

e m

onth

s im

mun

isatio

n ev

ents

) on

time

87

%

89

%

95

%

89

%

87

%

93

%

Bett

er h

elp

for s

mok

ers

to q

uit

95%

of

hosp

italis

ed p

atie

nts

who

sm

oke

and

are

seen

by

a he

alth

pr

actit

ione

r in

publ

ic h

ospi

tals

are

offe

red

brie

f adv

ice

and

supp

ort t

o qu

it sm

okin

g.

90%

of

enro

lled

patie

nts

who

sm

oke

and

are

seen

by

a he

alth

pr

actit

ione

r in

gen

eral

pra

ctic

es a

re o

ffere

d br

ief a

dvic

e an

d su

ppor

t to

qui

t sm

okin

g.

90%

of

preg

nant

wom

en w

ho i

dent

ify a

s sm

oker

s at

the

tim

e of

co

nfirm

atio

n of

pre

gnan

cy in

gen

eral

pra

ctic

e or

boo

king

with

Lea

d M

ater

nity

Car

er (L

MC)

are

offe

red

advi

ce a

nd s

uppo

rt to

qui

t 13

92

%

88

%

N

ot

Repo

rted

94

%

93

%

93

.7%

95

%

90

%

90

%

95

%

76

%

94

.7%

96

%

84

%

91

%

96

%

88

%

94

%

Mor

e he

art a

nd

diab

etes

che

cks

90%

of

the

elig

ible

pop

ulat

ion

will

hav

e ha

d th

eir

card

iova

scul

ar r

isk

asse

ssed

in th

e la

st fi

ve y

ears

83

%

89

%

90

%

90

%

91

%

91

%

12 O

ur e

lect

ive

surg

ery

disc

harg

e ta

rget

was

10,

136

disc

harg

es.

13 T

he M

inist

ry o

f Hea

lth fi

nalis

ed re

port

ing

agai

nst t

his m

easu

re in

201

5, w

hich

is n

ow ro

utin

ely

repo

rted

qua

rter

ly w

ith o

ther

hea

lth ta

rget

s for

201

6.

To a

ssist

you

read

and

inte

rpre

t th

is re

port

, we

have

col

our c

oded

ou

r 201

6 ac

hiev

emen

ts.

A gr

een

figur

e in

dica

tes t

hat o

ur

perf

orm

ance

has

ach

ieve

d, o

r ex

ceed

ed th

e ta

rget

. A

red

figur

e in

dica

tes t

hat w

e ha

ve n

ot

achi

eved

the

targ

et.

http://www.health.govt.nz/healthtargets

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

28

Out

put C

lass

1:

Prev

entio

n

Prev

enta

tive

Serv

ices

are

ser

vice

s th

at p

rote

ct a

nd p

rom

ote

heal

th f

or t

he w

hole

pop

ulat

ion

or id

entif

iabl

e su

b-po

pula

tions

. The

y co

mpr

ise s

ervi

ces

desig

ned

to e

nhan

ce t

he h

ealth

sta

tus

of t

he p

opul

atio

n as

dist

inct

from

tre

atm

ent

serv

ices

whi

ch r

epai

r/su

ppor

t he

alth

and

disa

bilit

y dy

sfun

ctio

n.

Prev

enta

tive

Serv

ices

add

ress

indi

vidu

al b

ehav

iour

s by

targ

etin

g po

pula

tion

wid

e ph

ysic

al a

nd so

cial

env

ironm

ents

to in

fluen

ce h

ealth

an

d w

ellb

eing

.

Prev

enta

tive

Serv

ices

incl

ude

heal

th p

rom

otio

n to

ens

ure

that

illn

ess

is pr

even

ted

and

uneq

ual o

utco

mes

are

red

uced

; sta

tuto

rily

man

date

d he

alth

pro

tect

ion

serv

ices

to p

rote

ct th

e pu

blic

from

toxi

c en

viro

nmen

tal r

isk a

nd c

omm

unic

able

dise

ases

; and

, pop

ulat

ion

heal

th p

rote

ctio

n se

rvic

es su

ch a

s im

mun

isatio

n an

d sc

reen

ing

serv

ices

.

Prev

enta

tive

Serv

ices

hav

e th

e fo

llow

ing

stra

tegi

c go

als:

1.

Peop

le a

re h

ealth

ier,

able

to se

lf-m

anag

e an

d liv

e lo

nger

2.

Pe

ople

are

abl

e to

par

ticip

ate

mor

e in

soci

ety

and

reta

in th

eir i

ndep

ende

nce

for l

onge

r 3.

Pe

ople

rece

ive

timel

y an

d ap

prop

riate

com

plex

car

e 4.

He

alth

ine

qual

ities

bet

wee

n po

pula

tion

grou

ps i

n ou

r co

mm

unity

will

red

uce

by i

dent

ifyin

g an

d ad

dres

sing

prev

enta

ble

cond

ition

s acr

oss t

he p

opul

atio

n ea

rly.

Prev

enta

tive

Serv

ices

are

rep

rese

nted

in o

ur r

epor

ting

as a

n ou

tcom

e ta

rget

of

‘peo

ple

take

gre

ater

res

pons

ibili

ty f

or t

heir

heal

th’

with

thre

e im

pact

goa

ls:

1.

Few

er p

eopl

e sm

oke

2.

Redu

ctio

n in

vac

cine

pre

vent

able

dise

ases

3.

Pe

ople

hav

e he

alth

ier d

iets

.

Ove

rall,

thes

e in

dica

tors

wou

ld su

gges

t tha

t we

have

impr

oved

our

per

form

ance

to o

ur p

opul

atio

n ov

er th

e pa

st y

ear.

Durin

g th

e 20

15/1

6 fin

anci

al y

ear

Bay

of P

lent

y DH

B in

vest

ed $

9.6

mill

ion

(1%

) in

Prev

enta

tive

Serv

ices

(2

014/

15: $

12.5

mill

ion

- 1%

; 20

13/1

4: $

11.9

mill

ion

- 2%

).

This

incl

uded

$2.

2 m

illio

n on

Im

mun

isatio

ns a

nd $

1.4

mill

ion

on

the

Wel

l Chi

ld /

Tam

arik

i Ora

pr

ogra

mm

es.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

29

Out

put C

lass

1: P

reve

ntio

n

Out

com

e: P

eopl

e ta

ke g

reat

er re

spon

sibi

lity

for t

heir

heal

th

Impa

ct: F

ewer

peo

ple

smok

e Th

e M

inist

ry o

f Hea

lth re

port

s th

at if

no

one

in N

ew Z

eala

nd s

mok

ed, t

he li

ves

of a

lmos

t 5,0

00 N

ew Z

eala

nder

s w

ould

be

save

d ev

ery

year

. Si

mpl

y pu

t, qu

ittin

g sm

okin

g is

one

of t

he b

est

thin

gs y

ou c

an d

o fo

r yo

ur h

ealth

, and

for

the

heal

th o

f you

r fa

mily

and

tho

se

arou

nd y

ou.

The

heal

th e

ffect

s of s

mok

ing

are

deva

stat

ing:

1.

Smok

ing

harm

s nea

rly e

very

org

an a

nd sy

stem

in th

e bo

dy;

2.

It’s t

he c

ause

of 8

0% o

f lun

g ca

ncer

cas

es, a

nd is

link

ed to

man

y ot

her c

ance

rs;

3.

It’s a

maj

or c

ause

of h

eart

att

acks

, hea

rt d

iseas

e, st

roke

, and

resp

irato

ry d

iseas

es su

ch a

s em

phys

ema

and

chro

nic

bron

chiti

s;

4.

Smok

ing

can

also

cau

se b

lindn

ess,

impo

tenc

e an

d in

fert

ility

; 5.

Sm

okin

g al

so h

urts

you

r chi

ldre

n, th

roug

h th

e da

mag

e do

ne b

y sm

okin

g w

hen

preg

nant

or t

he e

ffect

s of s

econ

d-ha

nd sm

oke.

In M

arch

201

1 th

e N

ew Z

eala

nd G

over

nmen

t com

mitt

ed t

o a

goal

of N

ew Z

eala

nd b

ecom

ing

smok

efre

e by

202

5. T

he B

ay o

f Ple

nty

Dist

rict H

ealth

Boa

rd (D

HB)

is c

omm

itted

to o

ur ro

le in

ach

ievi

ng th

is ta

rget

, and

our

pro

ud o

f our

per

form

ance

in th

is ar

ea.

Follo

win

g th

ree

year

s of

con

siste

nt im

prov

emen

t, ou

r sec

onda

ry s

ervi

ces

team

hav

e no

w s

ucce

ssfu

lly e

mbe

dded

sm

okin

g ce

ssat

ion

‘ABC

s’ (A

sk

and

docu

men

t if

smok

er, B

rief

advi

ce o

n qu

ittin

g, C

essa

tion

supp

ort)

into

sta

ndar

d op

erat

ing

proc

edur

es.

We

have

ach

ieve

d th

e He

alth

Tar

get m

easu

re, w

hich

is th

at 9

5% o

f hos

pita

lised

pat

ient

s w

ho s

mok

e an

d ar

e se

en b

y a

heal

th p

ract

ition

er in

pub

lic h

ospi

tals

are

offe

red

brie

f adv

ice

and

supp

ort t

o qu

it sm

okin

g.

The

ongo

ing

focu

s of

our

Prim

ary

Heal

th O

rgan

isatio

ns (

PHO

s) o

n AB

Cs in

a p

rimar

y ca

re s

ettin

g ha

s en

able

d st

eady

impr

ovem

ent

durin

g th

e la

st y

ear.

The

Hea

lth T

arge

t is t

hat b

rief a

dvic

e is

offe

red

and

supp

ort t

o qu

it sm

okin

g gi

ven

to 9

0% o

f elig

ible

pat

ient

s who

sm

oke

and

wer

e se

en w

ithin

the

last

15

mon

ths

by a

hea

lth p

ract

ition

er in

gen

eral

pra

ctic

es.

We

finish

ed b

elow

our

targ

et th

is ye

ar

with

a re

sult

for t

he y

ear o

f 76%

. Th

is re

sult

refle

cts

sust

aine

d im

prov

emen

t in

our p

erfo

rman

ce fr

om 6

7% in

the

first

qua

rter

of t

he

year

.

Expe

ctan

t mot

hers

who

regi

ster

with

Lea

d M

ater

nity

Car

ers

are

also

offe

red

supp

ort t

o qu

it if

they

are

sm

oker

s. W

e ha

ve m

aint

aine

d ou

r ach

ieve

men

t of s

uppo

rt o

ffere

d to

95%

of s

mok

ers

for t

his

prim

ary

care

mea

sure

in 2

016.

Sm

okin

g pr

eval

ence

is m

ore

com

mon

in

Māo

ri w

omen

with

tw

o in

eve

ry fi

ve w

omen

iden

tifyi

ng a

s sm

oker

s.

This

is hi

gher

tha

n fo

r al

l wom

en w

here

one

in s

ix w

omen

id

entif

y as

cur

rent

or p

revi

ous s

mok

ers,

whi

ch il

lust

rate

s cle

ar h

ealth

ineq

uity

in sm

okin

g ra

tes.

The

se s

ober

ing

smok

ing

rate

s sig

nal a

sig

nific

ant c

halle

nge

in a

chie

ving

the

natio

nal g

oal o

f a sm

okef

ree

New

Zea

land

by

2025

.

Sim

ply

put,

quitt

ing

smok

ing

is on

e of

the

best

thin

gs y

ou c

an

do fo

r you

r hea

lth.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

30

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Prov

idin

g Sm

oker

s who

acc

ess

Prim

ary

and

Seco

ndar

y se

rvic

es

with

Sm

okin

g Ce

ssat

ion

advi

ce

and

supp

ort

Seco

ndar

y Se

rvic

es:

Tota

l M

āori

92

%

91

%

94

%

92

%

95

%

95

%

95

%

96

%

96

%

96

%

Achi

eved

.

Und

er-r

ecor

ding

of

ad

vice

be

ing

give

n w

as

addr

esse

d th

is ye

ar.

Emer

genc

y De

part

men

ts a

nd A

sses

smen

t U

nits

req

uire

the

mos

t su

stai

ned

effo

rts

to a

chie

ve c

ontr

olle

d ch

ange

.

Prim

ary

Care

: To

tal

Māo

ri

88

%

N

ot

Repo

rted

93

%

N

ot

Repo

rted

90

%

90

%

76

%

76

%

86

%

N

ot

Repo

rted

Not

Ach

ieve

d.

2015

/16

mea

sure

s w

ere

expa

nded

to

incl

ude

smok

ers

seen

in t

he

last

15

mon

ths.

Da

ta v

alid

atio

n w

as a

n iss

ue f

or t

his

mea

sure

. C

over

age

with

in

the

PHO

s ha

s gr

adua

lly im

prov

ed s

ince

a

chan

ge t

o da

ta p

roce

sses

rep

orte

d a

66%

re

sult

in Q

1.

Deve

lopm

ents

in

prim

ary

care

rep

ortin

g in

the

last

12

mon

ths

now

ena

ble

us t

o re

port

pro

gres

s by

eth

nici

ty.

Ther

e is

no

ineq

ualit

y in

re

achi

ng

Māo

ri fo

r th

is m

easu

re.

Pe

rcen

tage

of p

regn

ant w

omen

w

ho id

entif

y as

smok

ers a

t the

tim

e of

con

firm

atio

n of

pr

egna

ncy

in g

ener

al p

ract

ice

or

book

ing

with

Lea

d M

ater

nity

Ca

rer a

re o

ffere

d ad

vice

and

su

ppor

t to

quit

Tota

l M

āori

N

ew

Mea

sure

New

M

easu

re

94

%

94

%

90

%

90

%

95

%

94

%

95

%

94

%

Achi

eved

. Th

e DH

B ra

nks

12th

for

thi

s m

easu

re n

atio

nally

. Th

e av

erag

e nu

mbe

r of

w

eeks

be

fore

re

gist

ratio

n w

ith

an

LMC

was

15

.3

com

pare

d w

ith

the

14

wee

k de

sired

m

axim

um.

Māo

ri w

omen

reg

ister

ed a

t 16

.5

wee

ks

gest

atio

n.

Sm

okin

g pr

eval

ence

rate

s ill

ustr

ate

heal

th d

ispar

ity

with

M

āori

wom

en

thre

e tim

es

mor

e lik

ely

to

be

smok

ers

at

time

of

regi

stra

tion.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

31

Out

put C

lass

1: P

reve

ntio

n

Out

com

e: P

eopl

e ta

ke g

reat

er re

spon

sibi

lity

for t

heir

heal

th

Impa

ct: R

educ

tion

in v

acci

ne p

reve

ntab

le d

isea

ses

The

natio

nal

imm

unisa

tion

goal

was

tha

t 95

% o

f ch

ildre

n ar

e fu

lly i

mm

unise

d at

eig

ht m

onth

s of

age

by

Dece

mbe

r 20

14.

Imm

unisa

tion

can

prev

ent

a nu

mbe

r of

vac

cine

pre

vent

able

dise

ases

. It

not

only

pro

vide

s in

divi

dual

pro

tect

ion

but

also

pop

ulat

ion-

wid

e pr

otec

tion

by r

educ

ing

the

inci

denc

e of

inf

ectio

us d

iseas

es a

nd p

reve

ntin

g sp

read

to

vuln

erab

le p

eopl

e.

Som

e of

the

se

popu

latio

n-w

ide

bene

fits

only

aris

e w

ith h

igh

imm

unis

atio

n ra

tes,

dep

endi

ng o

n th

e in

fect

ious

ness

of

the

dise

ase

and

the

effe

ctiv

enes

s of t

he v

acci

ne.

In 2

015,

our

per

form

ance

for

cove

rage

of e

ight

mon

th o

lds

by Ju

ne 3

0 pl

atea

ued

with

the

prio

r ye

ar a

t 87%

(2,4

63 c

hild

ren)

. In

the

late

st y

ear

to J

une

2016

we

lifte

d co

vera

ge a

gain

to

89%

(2,

476

child

ren)

, inc

ludi

ng 9

71 M

āori

child

ren.

Pr

ogre

ss in

thi

s se

rvic

e is

mad

e m

ore

chal

leng

ing

by a

con

siste

nt d

eclin

e ra

te, w

hich

repr

esen

ts th

e pr

opor

tion

of p

aren

ts w

ho h

ave

not g

iven

con

sent

for t

heir

child

ren

to b

e im

mun

ised.

Th

e nu

mbe

r of

dec

lined

imm

unisa

tions

for

elig

ible

chi

ldre

n de

crea

sed

by e

ight

dur

ing

the

curr

ent

year

fr

om 1

94 c

hild

ren

(6.9

%)

to 1

86 c

hild

ren

(6.7

%).

A f

urth

er 1

59 c

hild

ren

reac

hed

thei

r ei

ght-

mon

th m

ilest

one

age

befo

re

imm

unisa

tions

wer

e fu

lly c

ompl

eted

. I

nitia

tives

suc

h as

pub

lic h

ealth

mes

sagi

ng a

roun

d th

e be

nefit

s of

im

mun

isatio

n, c

linic

im

mun

isatio

n co

-ord

inat

ors

mak

ing

dire

ct c

onta

ct w

ith p

aren

ts a

nd p

eer

revi

ews

by s

ucce

ssfu

l DH

Bs in

thi

s m

easu

re c

ontin

ue t

o pr

ovid

e th

e ba

sis fo

r gre

ater

ach

ieve

men

t in

this

serv

ice.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

M

idla

nd

Aver

age

2016

N

atio

nal

Aver

age

14

Child

ren

are

fully

imm

unise

d at

ei

ght m

onth

s15

Tota

l M

āori

87

%

87

%

95

%

95

%

89

%

87

%

90

%

87

%

93

%

91

%

Not

Ach

ieve

d.

Not

Ach

ieve

d.

Resu

lts r

emai

n ah

ead

of l

ast

year

but

be

hind

targ

et. T

he D

HB c

ontin

ues

to w

ork

with

our

PHO

s an

d ke

y M

OH

pers

onne

l to

unde

rsta

nd b

arrie

rs t

o se

rvic

e de

liver

y an

d id

entif

y ne

w o

ppor

tuni

ties

to fu

rthe

r im

prov

e th

is pe

rfor

man

ce.

14 N

atio

nal A

vera

ge so

urce

is th

e la

test

pub

lishe

d he

alth

targ

et re

sult

from

Min

istry

of H

ealth

; 201

5/16

Qua

rter

Fou

r (Ap

ril-Ju

ne) r

esul

ts.

15 Im

mun

isatio

n re

sult

repo

rted

is th

e an

nual

cov

erag

e fo

r 12

mon

ths e

nded

30

June

201

6, w

hich

diff

ers f

rom

qua

rter

4 h

ealth

targ

et re

port

ed re

sults

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

32

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

M

idla

nd

Aver

age

2016

N

atio

nal

Aver

age

Child

ren

are

fully

imm

unise

d at

tw

o ye

ars16

Tota

l M

āori

88

%

90

%

95

%

95

%

89

%

89

%

92

%

92

%

93

%

92

%

Not

Ach

ieve

d.

Cons

isten

t w

ith t

he s

low

pro

gres

s m

ade

agai

nst

the

8 m

onth

ta

rget

, a

sligh

t in

crea

se

is re

flect

ed

for

2016

. Sl

ight

ly

high

er a

chie

vem

ent

than

for

eigh

t m

onth

ol

ds r

efle

cts

mom

entu

m m

ade

whe

n th

is w

as t

he p

revi

ous

heal

th t

arge

t. Th

ere

is no

disp

arity

gap

bet

wee

n M

āori

and

non-

Māo

ri ch

ildre

n. C

olle

ctiv

e w

ork

betw

een

the

DHB

and

its k

ey p

rimar

y ca

re p

artn

ers

and

MO

H co

ntin

ues

in a

n at

tem

pt t

o lif

t ov

eral

l pe

rfor

man

ce.

A se

rvic

e re

view

is

curr

ently

und

erw

ay.

Pe

rcen

tage

of t

he p

opul

atio

n (>

65 y

ears

) who

hav

e ha

d th

e se

ason

al in

fluen

za

imm

unisa

tion17

Tota

l Pop

ulat

ion

Māo

ri

70

%

62

%

75

%

75

%

60

%

50

%

N

ot

Repo

rted

Not

Re

port

ed

N

ot

Repo

rted

Not

Re

port

ed

Not

Ach

ieve

d.

Not

Ach

ieve

d.

16 M

easu

re fo

r the

num

ber o

f chi

ldho

od im

mun

isatio

ns c

ompl

eted

by

24 m

onth

s w

as re

mov

ed fr

om th

e 20

15/1

6 An

nual

Pla

n bu

t is

refe

renc

ed h

ere

for c

ompa

rison

. M

āori

base

line

was

not

repo

rted

in 2

015;

90%

is so

urce

d fr

om th

e N

atio

nal I

mm

unisa

tions

Reg

ister

for 2

4 m

onth

old

s. T

arge

t alig

ns w

ith th

e To

tal p

opul

atio

n m

easu

re.

17 B

asel

ine

seas

onal

influ

enza

imm

unisa

tion

mea

sure

of H

igh

Nee

ds 6

4% in

Ann

ual P

lan

2015

/16

has

been

cha

nged

to M

āori

mea

sure

dev

elop

ed in

the

2016

yea

r and

re

port

ed in

the

Māo

ri He

alth

Pla

n. B

asel

ine

mea

sure

per

the

2015

/16

Māo

ri He

alth

Pla

n fo

r Māo

ri on

ly w

as 6

2%.

Imm

unisa

tions

beg

in w

hen

your

ch

ild is

six

wee

ks o

ld.

Get

ting

your

ba

by v

acci

nate

d at

the

reco

mm

ende

d tim

es w

ill g

ive

them

th

e be

st p

rote

ctio

n ag

ains

t dise

ase.

For m

ore

info

rmat

ion

see

ww

w.h

ealth

.gov

t.nz/

your

-hea

lth

or a

sk y

our G

P.

http://www.health.govt.nz/your-health

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

33

Out

put C

lass

1: P

reve

ntio

n

Out

com

e: P

eopl

e ta

ke g

reat

er re

spon

sibi

lity

for t

heir

heal

th

Impa

ct: P

eopl

e ha

ve h

ealth

ier d

iets

Brea

stfe

edin

g he

lps

lay

the

foun

datio

ns o

f a h

ealth

y lif

e fo

r a

baby

and

also

mak

es a

pos

itive

con

trib

utio

n to

the

hea

lth a

nd w

ider

w

ellb

eing

of m

othe

rs a

nd w

hāna

u/fa

mili

es.

Excl

usiv

e br

east

feed

ing

is re

com

men

ded

by th

e M

inist

ry o

f Hea

lth u

ntil

babi

es a

re a

roun

d six

mon

ths.

A nu

mbe

r of h

ealth

ben

efits

for b

oth

baby

and

mot

her a

re li

sted

. Fo

r the

bab

y, th

ese

incl

ude:

• Br

east

milk

is e

asily

dig

este

d. It

’s im

med

iate

ly a

vaila

ble

and

alw

ays f

resh

; •

If yo

u ea

t a

heal

thy

diet

, the

n yo

ur b

reas

t m

ilk p

rovi

des

baby

with

a p

erfe

ct b

lend

of

nutr

ient

s an

d pr

otec

tive

antib

odie

s (a

lthou

gh it

doe

sn’t

repl

ace

the

need

for i

mm

unisa

tions

); •

Brea

stfe

edin

g he

lps y

our b

aby

grow

and

dev

elop

phy

sical

ly a

nd e

mot

iona

lly;

• Br

east

feed

ing

and

brea

st m

ilk h

elp

prot

ect y

our b

aby

from

che

st in

fect

ions

, men

ingi

tis, e

ar in

fect

ions

and

urin

e in

fect

ions

; •

Brea

stfe

edin

g de

crea

ses

the

risk

of s

udde

n un

expe

cted

dea

th in

infa

ncy

(SU

DI, a

lso k

now

n as

sud

den

infa

nt d

eath

syn

drom

e or

SID

S). I

t’s a

lso li

nked

to lo

wer

hos

pita

lisat

ion

rate

s;

• Br

east

feed

ing

and

brea

st m

ilk m

ay p

rote

ct y

our b

aby

from

chr

onic

tum

my

prob

lem

s an

d so

me

child

hood

can

cers

. The

y m

ay

also

be

less

like

ly to

get

alle

rgie

s, e

czem

a or

ast

hma.

Bene

fits f

or th

e m

othe

r inc

lude

:

• Sk

in-t

o-sk

in c

onta

ct is

a w

onde

rful

way

to st

art i

ntim

atel

y co

nnec

ting

with

you

r bab

y;

• Br

east

feed

ing

help

s red

uce

the

risk

of o

besit

y an

d m

ay h

elp

redu

ce th

e ris

k of

dia

bete

s in

late

r life

; •

Brea

stfe

edin

g re

duce

s you

r risk

of p

re-m

enop

ausa

l bre

ast c

ance

r; •

Brea

stfe

edin

g m

ay re

duce

you

r risk

of o

varia

n ca

ncer

, ost

eopo

rosis

and

hip

frac

ture

late

r in

life;

•

Brea

stfe

edin

g m

ay h

elp

you

lose

wei

ght g

aine

d du

ring

preg

nanc

y;

• Br

east

feed

ing

can

be y

our m

otiv

atio

n to

star

t liv

ing

a he

alth

ier l

ifest

yle,

and

cut

dow

n on

smok

ing

or d

rinki

ng.

Bay

of P

lent

y DH

B ha

s ac

hiev

ed it

s br

east

feed

ing

targ

et f

or M

āori

infa

nts

aged

six

mon

ths

whi

le t

he t

otal

pop

ulat

ion

finish

ed ju

st

shor

t of

the

tar

get

(tha

t six

out

of

10 b

abie

s re

ceiv

e so

me

brea

st m

ilk in

the

ir 26

th w

eek)

. O

ur p

erce

ntag

e of

ful

ly, e

xclu

sivel

y or

pa

rtia

lly b

reas

tfed

six

mon

th o

lds r

anks

us s

even

th o

f 20

DHBs

.

Brea

stfe

edin

g he

lps l

ay th

e fo

unda

tions

of a

hea

lthy

life

fo

r a b

aby.

We

are

still

pro

gres

sing

tow

ard

achi

evin

g ou

r asp

iratio

nal t

arge

ts.

Bay

of P

lent

y ac

hiev

ed fu

ll,

excl

usiv

e an

d pa

rtia

lly b

reas

tfed

pe

rcen

tage

s abo

ve n

atio

nal

benc

hmar

ks fo

r all

age

coho

rts.

Bay

of

Ple

nty

rank

s in

the

top

half

of

DHBs

for b

reas

t fee

ding

serv

ices

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

34

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Num

ber o

f sch

ools

enga

ged

in

the

Heal

th P

rom

otin

g Sc

hool

s pr

ogra

mm

e

43

44

48

44

Not

Av

aila

ble

Amal

gam

atio

ns o

f sc

hool

s on

the

Eas

t Ca

pe h

as r

educ

ed th

e ph

ysic

al n

umbe

r of

sc

hool

s en

gage

d in

HPS

with

out

redu

cing

th

e nu

mbe

r of

ch

ildre

n be

nefit

ting.

Ta

rget

ing

of l

ow-d

ecile

sch

ools

did

not

deliv

er th

e ta

rget

48

scho

ols.

The

num

ber o

f peo

ple

part

icip

atin

g in

the

Gre

en

Pres

crip

tion

(GRx

) pro

gram

mes

Tota

l M

āori

Non

-Māo

ri

2,

248

95

0 1,

298

2,

185

90

5 1,

280

2,

233

95

3 12

80

2,

376

1,

068

1,

308

N

ot

Avai

labl

e

Not

Av

aila

ble

N

ot

Avai

labl

e

Achi

eved

.

Prim

ary

Care

pa

rtne

rs

and

Spor

t Ba

y of

Pl

enty

re

mai

n st

rong

ad

voca

tes

for

the

prog

ram

me

and

its

bene

fits t

o cl

ient

s.

Achi

eved

. Ac

hiev

ed.

Perc

enta

ge o

f inf

ants

rece

ivin

g br

east

milk

at s

ix m

onth

s18

Tota

l M

āori

64

%

55

%

66

%

60

%

59

%

59

%

67

%

61

%

N

ot

Avai

labl

e

Not

Av

aila

ble

Achi

eved

. Pa

cific

wom

en a

re t

he lo

wes

t gr

oup

whi

le n

on-M

āori/

Paci

fic c

over

age

is w

ell a

bove

targ

et.

Achi

eved

. R

emai

ns a

foc

us a

rea

of t

he

Māo

ri He

alth

Pl

an

oper

atio

nal

grou

p.

Bett

er

data

ca

ptur

e an

d in

form

atio

n sy

stem

s im

prov

emen

ts w

ithin

the

Wel

l Ch

ild T

amar

iki O

ra p

rovi

ders

con

trib

ute

to

impr

oved

mon

itorin

g.

18 A

nnua

l Pla

n 20

16 s

peci

fies

this

targ

et a

s Pe

rcen

tage

of i

nfan

ts fu

lly a

nd e

xclu

sivel

y br

east

fed

at s

ix m

onth

s. T

his

mea

sure

was

cha

nged

in 2

015

to in

clud

e pa

rtia

l br

east

feed

ing

as w

ell s

o th

at th

e ne

w ta

rget

onl

y ex

clud

es b

abie

s fe

d ex

clus

ivel

y by

art

ifici

al m

ilk.

Base

line

for 2

015

is 64

% T

otal

and

55%

for M

āori

infa

nts

in q

uart

er

two

2013

/14.

Thi

s mea

sure

is p

ublis

hed

twic

e ye

arly

by

the

min

istry

for D

ecem

ber a

nd Ju

ne p

erio

ds in

clud

ing

activ

ity o

f the

Wel

l Chi

ld T

amar

iki O

ra p

rovi

ders

.

Th

e M

inist

ry o

f Hea

lth su

ppor

ts

fam

ilies

with

hea

lthy

feed

ing

guid

elin

es a

t all

ages

.

For m

ore

info

rmat

ion

see

ww

w.h

ealth

.gov

t.nz/

your

-hea

lth

/hea

lthy-

livin

g/ba

bies

-and

-to

ddle

rs/f

eedi

ng-g

uide

lines

http://www.health.govt.nz/your-health%20/healthy-living/babies-and-toddlers/feeding-guidelines



Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

35

Out

put C

lass

2:

Early

Det

ectio

n an

d M

anag

emen

t

Early

Det

ectio

n an

d M

anag

emen

t Se

rvic

es a

re d

eliv

ered

by

a ra

nge

of h

ealth

and

alli

ed h

ealth

pro

fess

iona

ls in

bot

h th

e co

mm

unity

an

d ho

spita

l se

ttin

gs.

The

se s

ervi

ces

are

deliv

ered

by

priv

ate

clin

icia

ns,

not-

for-

prof

it ag

enci

es a

nd g

over

nmen

tal

orga

nisa

tions

in

clud

ing

gene

ral

prac

tice,

co

mm

unity

and

wha

nau-

cent

red

grou

ps,

phar

mac

ists,

lab

orat

orat

orie

s, r

adio

grap

hy s

ervi

ces

and

com

mun

ity d

entis

ts.

Thes

e se

rvic

es a

re b

y th

eir

natu

re m

ore

gene

ral i

n de

sign,

usu

ally

acc

essib

le fr

om m

ultip

le h

ealth

pro

vide

rs a

nd f

rom

a n

umbe

r of

di

ffere

nt lo

catio

ns w

ithin

Bay

of P

lent

y DH

B.

On

a co

ntin

uum

of

care

the

se s

ervi

ces

are

prev

enta

tive

and

trea

tmen

t se

rvic

es f

ocus

on

indi

vidu

als

and

smal

ler

fam

ily/w

hana

u gr

oups

. M

ore

rece

ntly

, hea

lth p

rofe

ssio

nals

have

sou

ght t

o em

pow

er in

divi

dual

s to

bet

ter u

nder

stan

d th

eir s

peci

fic h

ealth

nee

ds a

nd

cont

inue

self-

man

agem

ent o

f life

-long

con

ditio

ns.

By d

etec

ting

heal

th n

eeds

and

impl

emen

ting

man

agem

ent

stra

tegi

es a

cros

s th

e po

pula

tion

befo

re a

cute

or

chro

nic

dise

ase

occu

rs,

thes

e se

rvic

es w

ill a

ssist

in a

chie

ving

the

follo

win

g st

rate

gic

goal

s:

1.

Peop

le a

re h

ealth

ier,

able

to se

lf-m

anag

e an

d liv

e lo

nger

. 2.

Pe

ople

are

abl

e to

par

ticip

ate

mor

e in

soci

ety

and

reta

in th

eir i

ndep

ende

nce

for l

onge

r. 3.

Pe

ople

rece

ive

timel

y an

d ap

prop

riate

com

plex

car

e.

4.

Heal

th in

equa

litie

s bet

wee

n po

pula

tion

grou

ps in

our

com

mun

ity w

ill re

duce

.

Early

Det

ectio

n an

d M

anag

emen

t ser

vice

s ar

e re

pres

ente

d in

our

repo

rtin

g by

an

outc

ome

targ

et o

f ‘pe

ople

sta

y w

ell i

n th

eir h

omes

an

d co

mm

uniti

es’ w

ith th

ree

impa

ct g

oals:

1.

Child

ren

and

Adol

esce

nts h

ave

bett

er o

ral h

ealth

. 2.

Tr

eata

ble

cond

ition

s are

det

ecte

d ea

rly a

nd p

eopl

e ar

e be

tter

at m

anag

ing

thei

r lon

g te

rm c

ondi

tions

. 3.

Fe

wer

peo

ple

are

adm

itted

to h

ospi

tal f

or a

void

able

con

ditio

ns.

4.

Mor

e pe

ople

mai

ntai

n th

eir f

unct

iona

l ind

epen

denc

e.

Ove

rall,

the

resu

lts fo

r the

se in

dica

tors

wou

ld su

gges

t tha

t we

have

impr

oved

per

form

ance

for o

ur p

opul

atio

n th

an la

st y

ear.

Durin

g th

e 20

15/1

6 fin

anci

al y

ear

Bay

of P

lent

y DH

B in

vest

ed $

180.

4 m

illio

n (2

5%) i

n Ea

rly D

etec

tion

and

Man

agem

ent (

2014

/15:

$18

7.8

mill

ion

- 26%

; 201

3/14

: $17

9.2

mill

ion

- 27%

).

Thi

s inc

lude

d $4

5.7

mill

ion

on

Prim

ary

Heal

th c

apita

tion

paym

ents

(fo

r enr

olm

ent w

ith a

GP)

and

$56

.5

mill

ion

on P

harm

aceu

tical

Ser

vice

s.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

36

Out

put C

lass

2: E

arly

Det

ectio

n an

d M

anag

emen

t O

utco

me:

Peo

ple

stay

wel

l in

thei

r hom

es a

nd c

omm

uniti

es

Impa

ct: C

hild

ren

and

Adol

esce

nts h

ave

bett

er o

ral h

ealth

M

ain

mea

sure

s of p

erfo

rman

ce

Volu

mes

Co

mm

ents

20

14

Base

20

15

Base

20

16

Targ

et

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e19

Redu

ctio

n in

Dec

ay M

issin

g an

d Fi

lled

Teet

h (D

MFT

) sco

re a

t Ye

ar 8

To

tal

Māo

ri

1.

54

2.

35

1.

68

2.

43

<1

.60

<1.6

0

1.

58

2.

26

N

ot

Repo

rted

Achi

eved

. O

ral

heal

th

of

child

ren

star

ting

seco

ndar

y sc

hool

is im

prov

ing.

N

ot a

chie

ved.

The

equ

ity g

ap b

etw

een

Māo

ri an

d no

n-M

āori

rem

ains

a k

ey

focu

s are

a to

be

addr

esse

d.

Perc

enta

ge o

f chi

ldre

n w

ho a

re

carie

s fre

e at

age

five

To

tal

Māo

ri

44

%

23

%

46

%

26

%

64

%

64

%

51

%

27

%

N

ot

Repo

rted

Not

ach

ieve

d.

Publ

ic h

ealth

cam

paig

ns

and

deba

te o

n ef

fect

s of

sug

ary

drin

ks

raise

pro

file

for g

ood

oral

hea

lth.

Not

ach

ieve

d.

Perc

enta

ge o

f ado

lesc

ent

utili

satio

n of

DHB

fund

ed d

enta

l se

rvic

es

To

tal

74

%

68

%

85

%

70

%

N

ot

Repo

rted

Not

ach

ieve

d. A

dditi

onal

edu

cato

rs a

re

empl

oyed

to e

nsur

e ro

bust

tran

sitio

n of

pa

tient

s an

d m

edic

al r

ecor

ds f

rom

Bay

of

Ple

nty

DHB

prov

ider

to

com

mun

ity

dent

ists a

t Yea

r 8.

Perc

enta

ge o

f Chi

ldre

n (0

-4)

enro

lled

in D

HB fu

nded

den

tal

serv

ice

To

tal

Māo

ri20

Non

-Māo

ri

84

%

N

ot

Repo

rted

Not

Re

port

ed

84

%

63

%

99

%

90

%

90

%

90

%

89

%

65

%

95

%

N

ot

Repo

rted

Not

Re

port

ed

Not

Ac

hiev

ed.

St

rate

gies

in

clud

ing

mul

tiple

enr

olm

ent i

n he

alth

ser

vice

s at

bi

rth

rem

ain

a ke

y ar

ea

of

focu

s.

Grea

ter

enga

gem

ent

with

ka

upap

a pr

imar

y he

alth

org

anisa

tion

aim

s to

lift

en

rolm

ents

of u

nder

5s.

Perc

enta

ge o

f enr

olle

d pr

e-sc

hool

and

prim

ary

scho

ol

child

ren

(0-1

2) o

verd

ue fo

r the

ir sc

hedu

led

dent

al e

xam

inat

ion

To

tal

Māo

ri

14

%

N

ot

Repo

rted

N

ot

Repo

rted

10

%

10

%

10

%

10

%

N

ot

Repo

rted

Achi

eved

. Re

port

ing

deve

lopm

ents

du

ring

the

year

ena

ble

us t

o re

port

a

Māo

ri re

sult.

19 O

ral h

ealth

repo

rtin

g is

by c

alen

dar y

ear t

o al

ign

with

scho

ol c

linic

s. P

ublis

hed

resu

lts fr

om th

e M

inist

ry o

f Hea

lth fo

r the

12

mon

ths

ende

d 31

Dec

embe

r 201

5 w

ere

not c

onfir

med

at t

he ti

me

of re

port

ing.

20

Enr

olm

ent

of M

āori

child

ren

(0-4

) in

Ora

l hea

lth s

ervi

ces

is a

prio

rity

in t

he M

āori

Heal

th P

lan

(ref

er 2

015/

16 A

nnua

l Pla

n 2.

4) w

ith a

tar

get

of 9

5% e

ngag

emen

t.

Targ

et w

as li

fted

from

85%

in th

e 20

15 c

alen

dar y

ear.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

37

Out

put C

lass

2: E

arly

Det

ectio

n an

d M

anag

emen

t O

utco

me:

Peo

ple

stay

wel

l in

thei

r hom

es a

nd c

omm

uniti

es

Impa

ct: E

arly

det

ectio

n of

trea

tabl

e co

nditi

ons a

nd p

eopl

e ar

e be

tter

at m

anag

ing

thei

r lon

g te

rm c

ondi

tions

The

perc

enta

ge o

f po

pula

tion

enro

lled

with

a P

rimar

y He

alth

Org

anisa

tion

(PHO

) is

an i

mpo

rtan

t m

easu

re a

s it

indi

cate

s th

e pr

opor

tion

of o

ur re

siden

ts w

ho h

ave

acce

ss to

prim

ary

care

, and

hav

e vi

sited

a g

ener

al p

ract

ition

er w

ithin

a tw

o ye

ar p

erio

d, w

hich

is

a re

quire

men

t in

ord

er t

o be

rec

ogni

sed

as a

ctiv

e on

the

PHO

reg

ister

. Ac

cess

to

prim

ary

care

has

bee

n sh

own

to h

ave

posit

ive

bene

fits

in m

aint

aini

ng g

ood

heal

th, i

nclu

ding

ear

ly d

etec

tion

and

man

agin

g lo

ng te

rm c

ondi

tions

. It

also

redu

ces

the

econ

omic

cos

t of

ill h

ealth

and

is a

key

fact

or in

redu

cing

hea

lth d

ispar

ities

.

In th

e 20

16 fi

nanc

ial y

ear,

Bay

of P

lent

y DH

B re

cord

ed a

n in

crea

se o

f 5,3

68 p

erso

ns e

nrol

led

with

PHO

s, fr

om 2

13,6

92 to

221

,619

. Th

e to

tal p

opul

atio

n fo

r Ba

y of

Ple

nty

DHB

incr

ease

d at

a c

ompa

rabl

e ra

te t

o en

rolm

ents

, whi

ch m

eans

tha

t ou

r en

rolm

ent

rate

lift

ed

mar

gina

lly to

99%

of o

ur to

tal p

opul

atio

n, h

owev

er o

ur ta

rget

lift

ed to

100

%. T

he in

crea

se in

tota

l pop

ulat

ion

saw

the

prop

ortio

n of

M

āori

enro

lled

incr

ease

fro

m 9

3% t

o 97

%.

In

real

ter

ms

how

ever

, an

add

ition

al 3

,485

Māo

ri pe

ople

enr

olle

d w

ith a

gen

eral

pr

actit

ione

r, in

dica

ting

that

real

pro

gres

s is b

eing

mad

e to

war

d ou

r tar

get o

f ful

l enr

olm

ent.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

38

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

21

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e Pe

rcen

tage

of p

opul

atio

n en

rolle

d w

ith a

Prim

ary

Heal

th

Org

anisa

tion

(PHO

)

Tota

l M

āori

98

%

94

%

98

%

93

%

10

0%

10

0%

99

%

97

%

95

%

90

%

Not

ach

ieve

d. T

here

are

219

,060

peo

ple

dom

icile

d w

ithin

th

e BO

P th

at

are

enro

lled

with

a

Prim

ary

Heal

th

Org

anisa

tion.

O

f th

at

tota

l, 51

,842

id

entif

y as

Māo

ri. T

he B

OP

popu

latio

n is

223,

420

of

whi

ch

56,0

20

iden

tify

as

Māo

ri.

Not

ach

ieve

d. S

tead

y pr

ogre

ss h

as b

een

mad

e sin

ce 2

015.

Ack

now

ledg

emen

t of

the

patie

nts

with

in T

e Ka

ha c

linic

and

Ta

neat

ua

prac

tice

has

impr

oved

th

is re

sult

for M

āori.

Long

term

con

ditio

ns a

re a

maj

or h

ealth

bur

den

for N

ew Z

eala

nd n

ow a

nd in

to th

e fo

rese

eabl

e fu

ture

. Thi

s gr

oup

of c

ondi

tions

is th

e le

adin

g ca

use

of m

orbi

dity

in N

ew Z

eala

nd, a

nd d

ispro

port

iona

tely

affe

cts

Māo

ri, P

acifi

c an

d So

uth

Asia

n pe

ople

s. A

s th

e po

pula

tion

ages

, and

life

styl

es c

hang

e, t

hese

con

ditio

ns a

re li

kely

to

incr

ease

sig

nific

antly

. Ca

rdio

vasc

ular

dise

ase

(CVD

) inc

lude

s he

art

atta

cks

and

stro

kes

– w

hich

are

bot

h su

bsta

ntia

lly p

reve

ntab

le w

ith li

fest

yle

advi

ce a

nd tr

eatm

ent f

or th

ose

at m

oder

ate

or h

ighe

r risk

. Th

is in

dica

tor

mon

itors

the

pro

port

ion

of t

he e

ligib

le p

opul

atio

n w

ho h

ave

had

the

bloo

d te

sts

for

CVD

risk

asse

ssm

ent

(incl

udin

g th

e bl

ood

test

s to

scre

en fo

r dia

bete

s) in

the

prec

edin

g fiv

e ye

ar p

erio

d.

Our

hea

lth t

arge

t re

sult

for

the

perc

enta

ge o

f elig

ible

pop

ulat

ion

who

hav

e th

eir

card

iova

scul

ar d

iseas

e ch

eck

com

plet

ed w

ithin

the

la

st fi

ve y

ears

fell

shor

t of a

chie

ving

the

targ

et.

At 9

0% o

ur re

sult

(201

5: 8

9%) i

s ju

st b

elow

with

the

natio

nal a

vera

ge o

f 91%

(201

5:

80%

). A

ctiv

ity n

atio

nally

ach

ieve

d no

min

al g

ains

in e

ach

quar

ter

of 2

015/

16 s

o th

e na

tiona

l tar

get

was

rea

ched

by

the

end

of Ju

ne

2016

. O

ur c

heck

s for

Māo

ri im

prov

ed a

t a h

ighe

r rat

e th

an fo

r non

-Māo

ri pa

tient

s so

heal

th d

ispar

ity im

prov

ed d

urin

g th

e ye

ar.

21 T

he e

nrol

men

t ta

rget

lift

ed in

201

6 fr

om 9

8% t

o a

targ

et o

f ful

l enr

olm

ent

for

Bay

of P

lent

y Re

siden

ts in

Gen

eral

Pra

ctic

e, D

HB r

un c

linic

s or

the

Tuh

oe c

linic

in

Tane

atua

.

PHO

s are

one

veh

icle

thro

ugh

whi

ch

the

Gove

rnm

ent’s

prim

ary

heal

th

care

obj

ectiv

es a

rtic

ulat

ed th

roug

h Be

tter

, Soo

ner,

Mor

e Co

nven

ient

Pr

imar

y He

alth

Car

e ar

e im

plem

ente

d in

loca

l com

mun

ities

.

http://www.health.govt.nz/our-work/primary-health-care/better-sooner-more-convenient-primary-health-care

http://www.health.govt.nz/our-work/primary-health-care/better-sooner-more-convenient-primary-health-care

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

39

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Perc

enta

ge o

f elig

ible

pop

ulat

ion

who

hav

e th

eir c

ardi

ovas

cula

r di

seas

e (C

VD) c

heck

com

plet

ed

with

in th

e la

st 5

yea

rs22

Tota

l M

āori

Non

-Māo

ri

83

%

81

%

88

%

89

%

83

%

90

%

90

%

90

%

90

%

90

%

86

%

92

%

90

%

86

%

91

%

Achi

eved

. N

ot a

chie

ved.

M

onito

ring

has

shift

ed t

o th

e hi

gh ri

sk p

atie

nt g

roup

of M

āori

mal

es

aged

35-

44 y

ears

old

. Ac

hiev

ed.

Elig

ible

wom

en (2

5-69

) hav

e a

cerv

ical

can

cer s

cree

n ev

ery

thre

e ye

ars23

Tota

l M

āori

Non

- Māo

ri

80

%

64

%

84

%

79

%

64

%

83

%

80

%

80

%

80

%

79

%

70

%

82

%

77

%

66

%

78

%

Not

Ach

ieve

d. H

owev

er t

here

has

bee

n a

signi

fican

t in

crea

se i

n ce

rvic

al s

cree

ning

pe

rfor

man

ce

ther

efor

e a

redu

ctio

n in

in

equa

litie

s.

In

Febr

uary

20

16

the

Nat

iona

l Scr

eeni

ng U

nit

chan

ged

the

way

it

repo

rted

cov

erag

e us

ing

ethn

icity

and

do

mic

ile

reco

rded

on

th

e M

inist

ry

of

Heal

th

Nat

iona

l He

alth

In

dex

(NHI

) in

stea

d of

et

hnic

ity

and

dom

icile

in

form

atio

n fr

om t

he N

atio

nal

Scre

enin

g Re

gist

er. C

hang

ing

to N

HI e

thni

city

mea

nt

mor

e M

āori,

Pa

cific

an

d As

ian

who

pa

rtic

ipat

ed i

n ce

rvic

al s

cree

ning

wer

e co

unte

d.

The

incr

ease

in

pe

rfor

man

ce

also

coi

ncid

es w

ith a

dditi

onal

fun

ding

to

GPs

to p

rovi

de f

ree

scre

enin

g fo

r pr

iorit

y w

omen

.

Elig

ible

wom

en (2

0-69

) hav

e a

cerv

ical

can

cer s

cree

n ev

ery

thre

e ye

ars

Tota

l M

āori

Non

-Māo

ri

80

%

64

%

84

%

N

ot

repo

rted

Not

re

port

ed

N

ot

repo

rted

80

%

80

%

80

%

N

ot

repo

rted

Not

re

port

ed

N

ot

repo

rted

N

ot

repo

rted

Not

re

port

ed

N

ot

repo

rted

No

long

er re

port

ed.

22 C

VD H

ealth

Tar

get w

as re

vise

d to

90%

from

75%

sinc

e th

e pu

blic

atio

n of

the

Annu

al P

lan

2014

. 23

Pre

viou

sly t

he e

ligib

le p

opul

atio

n of

wom

en a

ged

20 t

o 69

yea

rs w

as u

sed.

It

was

cha

nged

in t

he 2

015

Annu

al P

lan

to a

lign

with

the

pop

ulat

ion

used

for

Māo

ri He

alth

Pla

n m

onito

ring.

Thi

s ser

vice

is a

prio

rity

area

in th

e M

āori

Heal

th P

lan.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

40

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Elig

ible

wom

en (5

0-69

) hav

e a

brea

st sc

reen

exa

min

atio

n ev

ery

3 ye

ars24

Tota

l M

āori

Non

-Māo

ri

67

%

58

%

69

%

69

%

59

%

71

%

70

%

70

%

70

%

71

%

60

%

73

%

71

%

65

%

72

%

Achi

eved

. Br

east

scr

eeni

ng P

erfo

rman

ce

is be

ing

clos

ely

mon

itore

d w

ith a

n Ac

tion

Plan

rec

ently

dev

elop

ed b

etw

een

the

key

stak

ehol

ders

and

add

ition

al fu

ndin

g be

ing

allo

cate

d fr

om B

reas

tscr

een

Mid

land

to

im

plem

ent

actio

ns

outli

ned

with

in

the

Plan

.

Focu

s Are

a 2

- Dia

bete

s M

anag

emen

t (Hb

A1c)

: Im

prov

e or

, whe

re h

igh,

mai

ntai

n th

e pr

opor

tion

of p

atie

nts w

ith g

ood

or a

ccep

tabl

e gl

ycae

mic

con

trol

Not

Re

port

ed

N

ot

Repo

rted

85

%

75

%

N

ot

Avai

labl

e

Not

ach

ieve

d.

Focu

s Are

a 3

- Dia

bete

s M

anag

emen

t: M

aint

ain

or

impr

ove

appr

opria

te

man

agem

ent o

f Mic

ro-

albu

min

uria

or o

vert

ne

phro

path

y in

pat

ient

s with

di

abet

es

Not

Re

port

ed

N

ot

Repo

rted

N

ew

Mea

sure

N

ot

Repo

rted

N

ot

Avai

labl

e

Deve

lopm

enta

l m

easu

res

have

not

bee

n co

nsol

idat

ed

into

a

natio

nal

aver

age

resu

lt.

Focu

s Are

a 4

- Str

oke

Serv

ices

: Pe

rcen

tage

of p

oten

tially

elig

ible

st

roke

pat

ient

s thr

ombo

lyse

d

New

M

easu

re

N

ot

Repo

rted

6%

9%

N

ot

Avai

labl

e

Achi

eved

.

Focu

s Are

a 4

- Str

oke

Serv

ices

: 80

% o

f str

oke

patie

nts a

dmitt

ed

to a

stro

ke u

nit o

r org

anise

d st

roke

serv

ice

with

de

mon

stra

ted

stro

ke p

athw

ay

89%

96%

80%

81%

Not

Av

aila

ble

Achi

eved

.

24 A

nnua

l Rep

ort

2014

indi

cato

r sp

ecifi

ed a

n el

igib

le p

opul

atio

n of

wom

en a

ged

45 t

o 69

to

alig

n w

ith n

atio

nal c

over

age

and

2014

Bay

of P

lent

y DH

B An

nual

Pla

n.

Mea

sure

am

ende

d to

the

50-

69 e

ligib

le p

opul

atio

n in

the

Ann

ual P

lan

2015

to

alig

n w

ith B

reas

t Sc

reen

Aot

earo

a’s

targ

et fo

r th

at p

opul

atio

n an

d M

āori

Heal

th P

lan

mea

sure

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

41

Out

put C

lass

2: E

arly

Det

ectio

n an

d M

anag

emen

t O

utco

me:

Peo

ple

stay

wel

l in

thei

r hom

es a

nd c

omm

uniti

es

Impa

ct: F

ewer

peo

ple

are

adm

itted

to h

ospi

tal f

or a

void

able

con

ditio

ns

Rheu

mat

ic f

ever

is a

con

ditio

n th

at a

ffect

s pa

tient

s fo

r th

eir

entir

e lif

e.

Prov

idin

g de

tect

ion

and

trea

tmen

t fo

r th

is co

nditi

on is

a

natio

nal p

riorit

y in

ord

er to

giv

e th

e be

st q

ualit

y of

life

pos

sible

. Th

roat

sw

abbi

ng s

ervi

ces

in s

choo

ls fo

r Str

epto

cocc

al A

hel

p id

entif

y th

e po

tent

ial p

atie

nts

who

mig

ht d

evel

op R

heum

atic

feve

r in

late

r yea

rs.

Early

det

ectio

n al

low

s fo

r tim

ely

refe

rral

to a

n ap

prop

riate

he

alth

pro

fess

iona

l who

can

pre

scrib

e a

cour

se o

f tr

eatm

ent

that

kee

ps p

atie

nts

out

of h

ospi

tal.

Onc

e pa

tient

s ar

e ad

mitt

ed t

o ho

spita

l with

firs

t ins

tanc

e of

Rhe

umat

ic fe

ver t

hey

will

like

ly re

quire

regu

lar i

nter

vent

ion

durin

g th

eir l

ives

. O

ur a

im is

to re

duce

the

inci

denc

e of

repo

rted

firs

t cas

es o

f rhe

umat

ic fe

ver o

ver t

ime.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Perc

enta

ge o

f elig

ible

pop

ulat

ion

who

hav

e ha

d th

eir B

efor

e Sc

hool

Che

cks c

ompl

eted

Tota

l Pop

ulat

ion

High

Nee

ds

92

%

90

%

88

%

78

%

90

%

90

%

90

%

90

%

92

%

93

%

Achi

eved

. Pr

oces

s ch

ange

s im

prov

ed

perf

orm

ance

. Ac

hiev

ed. P

rovi

der n

oted

som

e ch

alle

nges

in

rea

chin

g at

risk

chi

ldre

n fr

om m

obile

fa

mili

es.

Inci

denc

e nu

mbe

r of a

cute

rh

eum

atic

feve

r cas

es25

14

7

4 6

10

2

case

s

Not

Ac

hiev

ed.

A co

mpr

ehen

sive

prog

ram

me

of in

terv

entio

ns is

in p

lace

for

the

2016

/17

year

to a

chie

ve th

e ta

rget

as

at 3

0 Ju

ne 2

017.

Hosp

italis

atio

n ra

tes p

er 1

00,0

00

for a

cute

rheu

mat

ic fe

ver

6.5

3.2

1.7

2.

8 2.2

Not

Ac

hiev

ed.

Esta

blish

men

t of

ra

pid

resp

onse

se

rvic

e an

d th

e ex

tend

ed

heal

thy

hom

es

initi

ativ

e,

alon

g w

ith

furt

her

qual

ity im

prov

emen

t in

itiat

ives

in

the

sore

thr

oat

scho

ol-b

ased

sw

abbi

ng

prog

ram

me

shou

ld p

rogr

essiv

ely

redu

ce

hosp

italis

atio

n ra

tes.

Pe

rcen

tage

of R

est H

ome

resid

ents

rece

ivin

g vi

tam

in D

su

pple

men

t fro

m th

eir G

P

67%

74%

70%

73%

Not

av

aila

ble

Achi

eved

.

25 B

ay o

f Ple

nty

DHB

Rheu

mat

ic fe

ver r

ates

are

for t

he fi

nanc

ial y

ear e

ndin

g 30

June

201

6. C

ompa

rato

rs fo

r the

Nat

iona

l Ave

rage

rate

s are

for t

he c

alen

dar y

ear e

nded

31

Dec

embe

r 201

5 as

pub

lishe

d by

the

Min

istry

of H

ealth

, whi

ch c

onfir

med

102

Rhe

umat

ic F

ever

cas

es n

atio

nally

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

42

Out

put C

lass

2: E

arly

Det

ectio

n an

d M

anag

emen

t O

utco

me:

Peo

ple

stay

wel

l in

thei

r hom

es a

nd c

omm

uniti

es

Impa

ct: F

ewer

peo

ple

are

adm

itted

to h

ospi

tal f

or a

void

able

con

ditio

ns

The

proc

ess

of a

sses

sing

the

urge

ncy

of p

atie

nts’

nee

d fo

r int

erve

ntio

ns is

cal

led

tria

ging

. Tr

iagi

ng a

ims

to e

nsur

e th

at th

ose

patie

nts

asse

ssed

as

havi

ng th

e m

ost u

rgen

t nee

d ar

e tr

eate

d m

ore

quic

kly

than

thos

e pa

tient

s w

ith a

less

urg

ent n

eed.

The

re a

re fi

ve tr

iage

ca

tego

ries;

tria

ge c

ateg

ory

1 pa

tient

s ar

e ve

ry u

rgen

t, w

hile

tria

ge c

ateg

ory

5 pa

tient

s ar

e le

ss u

rgen

t. B

ay o

f Pl

enty

DHB

rem

ains

co

mm

itted

to se

rvin

g al

l pat

ient

s in

an e

ffect

ive

and

effic

ient

man

ner,

and

as a

resu

lt is

plan

ning

for r

educ

tions

in th

e nu

mbe

r of t

riage

le

vel 4

and

5 p

atie

nts

atte

ndin

g in

an

Emer

genc

y De

part

men

t. T

hose

pat

ient

s w

ho m

ay b

e se

en s

oone

r and

mor

e co

nven

ient

ly in

a

prim

ary

care

set

ting

will

be

enco

urag

ed t

o se

ek c

are

optio

ns c

lose

r to

hom

e ra

ther

tha

n in

a s

peci

alist

hos

pita

l Em

erge

ncy

Depa

rtm

ent.

Our

non

-urg

ent

(leve

l 4 a

nd 5

) res

ult

of 5

0% a

chie

ved

in t

he y

ear

ende

d 30

June

201

6 re

pres

ents

an

impr

ovem

ent

on

the

unfa

vour

able

incr

ease

in th

e 20

14-1

5 ye

ar to

67%

of a

ll at

tend

ance

s. I

ncre

asin

g de

man

d on

em

erge

ncy

serv

ices

put

s pr

essu

re o

n ho

spita

l se

rvic

es h

owev

er i

nitia

tives

put

in

plac

e to

im

prov

e pa

tient

flo

w t

hrou

gh t

he e

mer

genc

y de

part

men

ts e

nabl

ed t

his

impr

ovem

ent.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Perc

enta

ge o

f tria

ge le

vel 4

& 5

s pr

esen

ting

to th

e Em

erge

ncy

Depa

rtm

ent (

ED)

50%

67%

<65%

50%

Not

Av

aila

ble

Achi

eved

.

Num

ber o

f pre

sent

atio

ns to

Em

erge

ncy

Depa

rtm

ent –

Tria

ge

Leve

l 4 a

nd 5

as a

per

cent

age

of

the

tota

l pop

ulat

ion

15%

22%

12%

19%

Not

Av

aila

ble

Not

ach

ieve

d.

Impa

cted

by

a sig

nific

ant

year

on

year

gro

wth

in

ED a

tten

danc

e nu

mbe

rs (

5%).

Im

prov

ed o

n 20

15 w

ith

low

er y

ear o

n ye

ar g

row

th.

In

crea

sed

num

bers

of Y

ear 9

st

uden

ts re

ceiv

ing

HEEA

DSSS

as

sess

men

t in

deci

le 1

-3

scho

ols26

198

28

1

250

19

8

Not

Av

aila

ble

Not

ach

ieve

d.

Repo

rtin

g ch

ange

s du

ring

the

year

req

uire

fur

ther

disc

ussio

n w

ith

prov

ider

s to

en

sure

co

nsist

ent

data

co

llect

ion

acro

ss sc

hool

s.

26 N

ote,

HEE

ADSS

S =

Hom

e Ed

ucat

ion

Empl

oym

ent A

ctiv

ities

Dru

gs a

nd A

lcoh

ol S

exua

lity

Suic

ide

Spiri

tual

ity.

Spec

ial E

duca

tion

Scho

ols,

alte

rnat

ive

educ

atio

n ce

ntre

s an

d Te

en P

regn

ancy

Uni

ts a

re in

clud

ed a

s wel

l as Y

ear 9

leve

ls of

stat

e-fu

nded

seco

ndar

y sc

hool

s.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

43

Out

put C

lass

2: E

arly

Det

ectio

n an

d M

anag

emen

t O

utco

me:

Peo

ple

stay

wel

l in

thei

r hom

es a

nd c

omm

uniti

es

Impa

ct: P

eopl

e m

aint

ain

func

tiona

l ind

epen

denc

e

The

Bay

of P

lent

y DH

B vi

sion

for

olde

r pe

ople

is: '

Hea

lthy,

inde

pend

ent

and

dign

ified

age

ing'

. O

ur B

oard

hav

e id

entif

ied

heal

th o

f ol

der

peop

le a

s a

prio

rity

and

aim

s to

be

proa

ctiv

e in

the

man

agem

ent

of s

ervi

ces

for

the

futu

re g

iven

the

pre

dict

ed p

opul

atio

n in

crea

se a

nd th

e as

soci

ated

hig

h co

st o

f car

e fo

r thi

s gr

oup.

The

Bay

of P

lent

y's p

opul

atio

n is

agei

ng, w

ith th

e nu

mbe

r of p

eopl

e ag

ed

75 y

ears

or o

lder

pre

dict

ed to

gro

w a

t an

aver

age

annu

al g

row

th ra

te o

f 3.5

% b

y 20

20.

Heal

th p

rofe

ssio

nals

ackn

owle

dge

that

Māo

ri of

ten

deve

lop

age-

rela

ted

cond

ition

s at

an

earli

er a

ge t

han

othe

r su

b-po

pula

tions

and

tha

t di

spar

ities

and

ineq

ualit

ies

exist

whe

n M

āori

acce

ss s

uppo

rt a

nd h

ealth

ser

vice

s.

Pro

gram

mes

suc

h as

wha

nau

ora

serv

ices

, kor

oua

and

kuia

pro

gram

mes

and

kau

papa

M

āori

nurs

ing

serv

ices

tha

t ex

hibi

t st

rong

cul

tura

l va

lues

are

del

vere

d by

Māo

ri se

rvic

e pr

ovid

ers

in t

he c

omm

unity

. C

utur

ally

re

spon

sive

serv

ices

are

nec

essa

ry w

ithin

mai

nstr

eam

hos

pita

l an

d pr

imar

y ca

re s

ettin

gs t

o en

sure

tha

t M

āori

are

appr

opria

tely

ac

cess

ing

heal

th se

rvic

es.

Bay

of P

lent

y DH

B de

velo

ped

a He

alth

of O

lder

Peo

ple

Stra

tegi

c Pl

an in

201

2. T

he a

im o

f thi

s St

rate

gy is

to

prov

ide

dire

ctio

n to

the

he

alth

and

disa

bilit

y se

ctor

by

iden

tifyi

ng a

reas

whe

re B

ay o

f Pl

enty

DHB

int

ends

to

focu

s its

tim

e, e

nerg

y an

d re

sour

ces

in

colla

bora

tion

with

our

stak

ehol

ders

.

The

obje

ctiv

es o

f the

Str

ateg

y ar

e to

pro

vide

qua

lity

heal

th a

nd d

isabi

lity

serv

ices

for o

ur g

row

ing

olde

r pop

ulat

ion

that

:

1.

Prom

ote,

impr

ove,

and

supp

ort h

ealth

y, in

depe

nden

t and

dig

nifie

d ag

eing

. 2.

Ha

ve a

n in

tegr

ated

app

roac

h ac

ross

the

cont

inuu

m o

f car

e.

3.

Redu

ce th

e de

man

d on

rela

ted

high

cos

t ser

vice

exp

endi

ture

to le

vels

that

can

be

sust

aine

d w

ithin

fina

ncia

l con

stra

ints

. 4.

Re

duce

dup

licat

ion

in th

e he

alth

syst

em.

5.

Are

simpl

e, st

ream

lined

and

effi

cien

t.

We

mon

itor o

ur p

rogr

ess i

n im

plem

entin

g th

is St

rate

gy w

ith a

suite

of k

ey p

erfo

rman

ce in

dica

tors

. M

aint

aini

ng th

e pe

rcen

tage

of o

ur

over

65

popu

latio

n w

ho a

cces

s DH

B fu

nded

Age

d Re

siden

tial C

are

faci

litie

s an

d m

anag

ing

the

grow

th in

dem

and

for

Hom

e Ba

sed

Supp

ort S

ervi

ces a

re tw

o of

our

lead

mea

sure

s. B

ay o

f Ple

nty

DHB

did

not a

chie

ve it

s 5.0

3% 2

016

Resid

entia

l Car

e ac

cess

targ

et w

ith a

pe

rcen

tage

of 5

.04%

of o

ver

65s

in fu

nded

age

d ca

re (5

.1%

in 2

015)

. Our

Sup

port

Ser

vice

s fig

ure

of 1

1.31

% w

as h

ighe

r tha

n la

st y

ear

(11.

08%

) but

with

in o

ur t

arge

t of

less

tha

n 12

.15%

. W

hilst

we

fund

ed c

omm

unity

car

e in

exc

ess

of o

ur p

lann

ed a

mou

nt fo

r 20

16,

thes

e re

sults

sug

gest

that

we

are

incr

easin

g th

e le

vel o

f sup

port

to re

siden

ts w

ho re

mai

n in

thei

r ow

n ho

me,

whi

ch k

eeps

them

out

of

an a

ged

resid

entia

l car

e fa

cilit

y fo

r lon

ger.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

44

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se27

20

15

Base

20

16

Targ

et

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e M

aint

ain

curr

ent p

erce

ntag

e of

po

pula

tion

over

65

year

s tha

t ac

cess

age

d re

siden

tial c

are

5.03

%

5.

10%

5.03

%

5.

04%

Not

Av

aila

ble

Not

ach

ieve

d.

Perc

enta

ge o

f the

pop

ulat

ion

65+

year

s tha

t acc

ess H

ome

Base

d Su

ppor

t Ser

vice

s (HB

SS)

11.6

6%

11

.08%

<12.

15%

11.3

1%

N

ot

Avai

labl

e

Achi

eved

. Th

is is

refle

ctiv

e of

the

DHB

’s Ag

ing

In P

lace

str

ateg

y to

sup

port

peo

ple

to li

ve w

ell i

n th

eir

own

hom

es a

s lo

ng a

s pr

actic

able

.

Incr

ease

in o

ccup

ancy

rate

for

Resid

entia

l Res

pite

Bed

Day

s28

68%

73%

82%

75%

Not

Av

aila

ble

Not

Ach

ieve

d. O

ccup

ancy

dro

pped

in th

e w

inte

r mon

ths t

o tw

o be

ds o

f thr

ee (5

0%

for t

he d

emen

tia le

vel b

ed).

Hos

pita

l le

vel c

are

is be

st u

tilise

d at

88%

.

Incr

ease

d nu

mbe

r of d

emen

tia

spec

ific

day

prog

ram

me

atte

ndan

ces f

or c

lient

s with

de

men

tia29

3,08

9

3,10

5

2,69

2

3,13

3

Not

Av

aila

ble

Achi

eved

. Th

ere

is in

crea

sing

dem

and

from

clie

nts a

nd fa

mili

es fo

r day

pr

ogra

mm

es. R

evise

d re

port

ing

now

di

stin

guish

es a

ctiv

ity fo

r dem

entia

clie

nts

livin

g w

ithin

car

e fa

cilit

ies.

Perc

enta

ge o

f old

er p

eopl

e re

ceiv

ing

hom

e su

ppor

t who

ha

ve h

ad a

com

preh

ensiv

e cl

inic

al a

sses

smen

t and

a

com

plet

ed c

are

plan

in th

e la

st

twel

ve m

onth

s30

100%

100%

100%

100%

Not

Av

aila

ble

Achi

eved

. Ca

re

plan

s ar

e ac

tivel

y m

anag

ed b

y Su

ppor

t Net

.

27 B

asel

ine

resu

lts a

re a

s re

port

ed a

t tim

e of

pub

lishi

ng o

f 201

4 an

d 20

15 A

nnua

l Rep

orts

. Cl

aim

s pr

oces

sed

afte

r ye

ar e

nd h

ave

incr

ease

d th

e hi

stor

ical

pop

ulat

ion

rate

s in

the

grap

hs fo

r res

iden

tial c

are

and

hom

e su

ppor

t ser

vice

s res

ults

. 28

Thi

s m

easu

re r

epre

sent

s re

spite

nig

hts

whe

re c

arer

s ar

e af

ford

ed r

est

oppo

rtun

ities

, whi

ch e

nabl

es t

he p

erso

n be

ing

care

d fo

r to

rem

ain

in t

heir

own

hom

es fo

r lo

nger

. Re

sult

is fo

r the

12

mon

ths e

nded

30

Sept

embe

r 201

5 ba

sed

on th

e la

st c

ompl

ete

perf

orm

ance

mon

itorin

g re

turn

subm

itted

by

the

serv

ice

prov

ider

. 20

14 B

ase

was

inco

rrec

tly st

ated

as 6

8% in

the

2014

Ann

ual R

epor

t – th

e ac

tual

occ

upan

cy ra

te fo

r 201

4 fr

om p

rovi

der r

etur

ns w

as 6

9%.

29 A

tten

danc

es a

re d

eriv

ed fr

om p

rovi

der m

onito

ring

retu

rns

rece

ived

dur

ing

the

year

. At

tend

ance

s pr

evio

usly

repo

rted

for b

ase

mea

sure

s w

ere

for a

ll at

tend

ance

s to

da

y pr

ogra

mm

es.

This

mea

sure

is d

esig

ned

spec

ifica

lly fo

r act

ivity

with

dem

entia

clie

nts

in c

are

faci

litie

s. D

emen

tia c

lient

s av

erag

e 27

% o

f all

clie

nts

atte

ndin

g th

ese

prog

ram

mes

dur

ing

the

last

two

year

s. A

djus

ted

base

num

bers

wou

ld b

e 98

5 in

201

4, 8

32 in

201

5 an

d 84

7 in

201

6 ag

ains

t a ta

rget

of 9

90 u

sing

this

met

hodo

logy

. 30

Sou

rce

is ca

re p

lans

reco

rded

in th

e ve

rifie

d as

sess

men

t too

l Int

erRA

I.

19%

of t

he B

ay o

f Ple

nty

DHB

popu

latio

n is

aged

65

or o

lder

(4

3,16

0 re

siden

ts),

high

er th

an th

e na

tiona

l ave

rage

of

15%

.

The

over

65s

are

fore

cast

to b

e 24

%

of o

ur p

opul

atio

n in

202

5 (5

7,52

0 re

siden

ts).

Tha

t mak

es th

is gr

oup

our f

aste

st g

row

ing

age

dem

ogra

phic

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

45

Out

put C

lass

3: I

nten

sive

Ass

essm

ent a

nd T

reat

men

t Ser

vice

s

Inte

nsiv

e As

sess

men

t and

Tre

atm

ent S

ervi

ces

are

deliv

ered

by

a ra

nge

of s

econ

dary

and

tert

iary

pro

vide

rs u

sing

publ

ic fu

nds.

The

se

serv

ices

are

usu

ally

inte

grat

ed in

to fa

cilit

ies t

hat e

nabl

e co

-loca

tion

of c

linic

al e

xper

tise

and

spec

ialis

ed e

quip

men

t suc

h as

a ‘h

ospi

tal’.

Th

ese

serv

ices

are

gen

eral

ly c

ompl

ex a

nd p

rovi

ded

by h

ealth

car

e pr

ofes

siona

ls th

at w

ork

clos

ely

toge

ther

.

They

incl

ude:

1.

Ambu

lato

ry s

ervi

ces

(incl

udin

g ou

tpat

ient

, di

stric

t nu

rsin

g an

d da

y se

rvic

es a

cros

s th

e ra

nge

of s

econ

dary

pre

vent

ive,

di

agno

stic

, th

erap

eutic

, and

reha

bilit

ativ

e se

rvic

es).

2.

Inpa

tient

serv

ices

(acu

te a

nd e

lect

ive

stre

ams)

incl

udin

g di

agno

stic

, the

rape

utic

and

reha

bilit

ativ

e se

rvic

es.

3.

Emer

genc

y De

part

men

t ser

vice

s inc

ludi

ng tr

iage

, dia

gnos

tic, t

hera

peut

ic a

nd d

ispos

ition

serv

ices

.

On

a co

ntin

uum

of c

are

thes

e se

rvic

es a

re a

t the

com

plex

end

of t

reat

men

t ser

vice

s and

are

focu

sed

on in

divi

dual

s.

Inte

nsiv

e As

sess

men

t and

Tre

atm

ent s

ervi

ces w

ill a

ssist

in a

chie

ving

the

follo

win

g st

rate

gic

goal

s:

1.

Peop

le a

re h

ealth

ier,

able

to se

lf-m

anag

e an

d liv

e lo

nger

. 2.

Pe

ople

are

abl

e to

par

ticip

ate

mor

e in

soci

ety

and

reta

in th

eir i

ndep

ende

nce

for l

onge

r. 3.

Pe

ople

rece

ive

timel

y an

d ap

prop

riate

com

plex

car

e.

4.

Heal

th in

equa

litie

s bet

wee

n po

pula

tion

grou

ps in

our

com

mun

ity w

ill re

duce

.

Thes

e go

als w

ill b

e re

ache

d by

ens

urin

g ac

cess

to ti

mel

y ac

ute

and

elec

tive

serv

ices

to th

e Ba

y of

Ple

nty

popu

latio

n be

fore

the

burd

en

of d

iseas

e sig

nific

antly

impa

cts o

n in

divi

dual

s and

thei

r abi

lity

to p

artic

ipat

e in

soci

ety.

Inte

nsiv

e As

sess

men

t an

d Tr

eatm

ent

serv

ices

are

rep

rese

nted

in o

ur r

epor

ting

as a

n ou

tcom

e ta

rget

of

‘peo

ple

rece

ive

timel

y an

d ap

prop

riate

car

e’ w

ith fo

ur im

pact

goa

ls:

1.

Peop

le a

re se

en p

rom

ptly

for a

cute

and

arr

ange

d ca

re.

2.

Peop

le h

ave

appr

opria

te a

cces

s to

elec

tive

serv

ices

. 3.

Im

prov

ed h

ealth

stat

us fo

r peo

ple

with

a se

vere

men

tal i

llnes

s or a

ddic

tions

. 4.

Pe

ople

with

end

-sta

ge c

ondi

tions

are

supp

orte

d.

Ove

rall,

thes

e in

dica

tors

wou

ld su

gges

t tha

t we

have

impr

oved

our

per

form

ance

to o

ur p

opul

atio

n ov

er th

e pa

st y

ear.

Durin

g th

e 20

15/1

6 fin

anci

al y

ear

Bay

of P

lent

y DH

B in

vest

ed $

415.

6 m

illio

n (5

8%) i

n In

tens

ive

Asse

ssm

ent a

nd T

reat

men

t Ser

vice

s (2

014/

15: $

395.

4 m

illio

n - 5

6%;

2013

/14:

$37

7.2

mill

ion

- 57%

).

This

incl

uded

fund

ing

for E

mer

genc

y De

part

men

ts, A

cute

serv

ices

and

El

ectiv

e de

liver

y.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

46

Out

put C

lass

3: I

nten

sive

Ass

essm

ent a

nd T

reat

men

t Ser

vice

s O

utco

me:

Peo

ple

rece

ive

timel

y an

d ap

prop

riate

car

e Im

pact

: Peo

ple

are

seen

pro

mpt

ly fo

r acu

te c

are

Emer

genc

y De

part

men

t (ED

) len

gth

of s

tay

is an

impo

rtan

t mea

sure

of t

he q

ualit

y of

acu

te (e

mer

genc

y an

d ur

gent

) car

e in

our

pub

lic

hosp

itals,

bec

ause

:

1.

Emer

genc

y de

part

men

ts a

re d

esig

ned

to p

rovi

de a

cute

(urg

ent)

hea

lth c

are;

the

timel

ines

s of t

reat

men

t del

iver

y is

impo

rtan

t fo

r pat

ient

s.

2.

Long

stay

s in

emer

genc

y de

part

men

ts a

re li

nked

to o

verc

row

ding

of t

he E

D.

3.

The

med

ical

lite

ratu

re h

as li

nked

bot

h lo

ng s

tays

and

ove

rcro

wdi

ng in

EDs

to n

egat

ive

clin

ical

out

com

es fo

r pat

ient

s su

ch a

s in

crea

sed

mor

talit

y an

d lo

nger

inpa

tient

leng

ths o

f sta

y.

4.

Ove

rcro

wdi

ng c

an a

lso le

ad to

com

prom

ised

stan

dard

s of p

rivac

y an

d di

gnity

for p

atie

nts.

Bay

of P

lent

y DH

B w

as c

lose

to

achi

evin

g th

e ED

hea

lth t

arge

t of

95%

of

patie

nts

adm

itted

, disc

harg

ed o

r tr

ansf

erre

d fr

om a

n ED

w

ithin

six

hou

rs.

This

resu

lt re

flect

s a

sust

aine

d ef

fort

to

atte

nd t

o th

e ne

eds

of t

he 7

7,23

3 pe

ople

who

att

ende

d ED

thi

s ye

ar in

a

timel

y fa

shio

n (w

hich

refle

cts

a 5%

incr

ease

on

the

73,6

23 p

rese

ntat

ions

in th

e 20

15 y

ear)

. Th

e ta

rget

is a

mea

sure

of t

he e

ffici

ency

of

flow

of a

cute

pat

ient

s th

roug

h pu

blic

hos

pita

ls an

d ho

me

agai

n. B

ay o

f Ple

nty

DHB

reac

hed

94%

in 2

016

afte

r ach

ievi

ng 9

3% fo

r 201

5.

We

are

prou

d of

thi

s ac

hiev

emen

t in

ligh

t of

the

5%

incr

ease

yea

r on

yea

r in

the

tot

al n

umbe

r of

ED

atte

ndan

ces

qual

ifyin

g fo

r th

e he

alth

tar

get

mea

sure

. Hi

stor

ical

tre

nds

of s

easo

nal f

luct

uatio

ns d

urin

g th

e w

inte

r m

onth

s w

ere

less

evi

dent

thi

s ye

ar w

ith a

mor

e su

stai

ned

leve

l of d

eman

d pr

esen

ting

to T

aura

nga

Emer

genc

y De

part

men

t ear

lier i

n th

e ye

ar.

M

ain

mea

sure

s of p

erfo

rman

ce

Volu

mes

Co

mm

ents

20

14

Base

20

15

Base

20

16

Targ

et

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e Pe

rcen

tage

of p

atie

nts a

dmitt

ed,

disc

harg

ed o

r tra

nsfe

rred

from

an

ED

with

in si

x ho

urs

92%

93%

95%

94%

94%

N

ot

Achi

eved

.

Proc

ess

impr

ovem

ents

w

ithin

Em

erge

ncy

Depa

rtm

ents

ena

bled

st

aff

to m

anag

e a

signi

fican

t gr

owth

in

atte

ndan

ce

num

bers

w

hile

lif

ting

the

prop

ortio

n se

en w

ithin

the

des

ired

six

hour

tim

efra

me.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

47

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Focu

s are

a 3

– Ac

ute

coro

nary

sy

ndro

me

serv

ices

: >7

0% o

f hi

gh ri

sk A

cute

Cor

onar

y Sy

ndro

me

patie

nts a

ccep

ted

for

coro

nary

ang

iogr

aphy

hav

ing

it w

ithin

3 d

ays o

f adm

issio

n (D

ay

of a

dmiss

ion=

Day

0)

83%

77%

70%

87%

Not

av

aila

ble

Achi

eved

.

Focu

s are

a 3

– Ac

ute

coro

nary

sy

ndro

me

serv

ices

: >95

% o

f pa

tient

s pre

sent

ing

with

ACS

w

ho u

nder

go c

oron

ary

angi

ogra

phy

have

com

plet

ion

of

ANZA

CS Q

I ACS

and

Cat

h/PC

I re

gist

ry d

ata

colle

ctio

n w

ithin

30

days

- PP

20

New

M

easu

re

N

ew

Mea

sure

≥9

5%

98

%

N

ot

avai

labl

e

Achi

eved

.

Acut

e re

adm

issio

n ra

te31

To

tal P

opul

atio

n 75

yea

rs a

nd o

lder

7.

80%

10.2

5%

11

.4%

15.4

%

10

%

10

%

11

.9%

15.7

%

N

ot

avai

labl

e

Not

av

aila

ble

Not

ac

hiev

ed.

Ba

y of

Pl

enty

DH

B is

impl

emen

ting

a ra

nge

of a

cute

dem

and

man

agem

ent

initi

ativ

es

incl

udin

g ne

w

mod

els

of c

are

to p

ositi

vely

im

pact

on

acut

e de

man

d.

Not

ach

ieve

d.

As a

bove

, a

cont

inue

d fo

cus a

rea

for 2

016.

Elec

tive

Inpa

tient

ave

rage

leng

th

of st

ay (L

OS)

redu

ced

(day

s)32

3.21

3.20

1.59

3.19

New

M

easu

re

Not

ach

ieve

d bu

t a

redu

ctio

n ov

er t

ime

signa

ls be

tter

pat

ient

out

com

es.

Acut

e In

patie

nt le

ngth

of s

tay

(LO

S) r

educ

ed (d

ays)

4.09

3.91

<2.9

3.95

New

M

easu

re

Not

ach

ieve

d.

High

er r

atio

tha

n in

201

5 re

flect

s acu

te p

ress

ures

this

year

.

31 T

he m

etho

dolo

gy o

f cal

cula

tion

has b

een

amen

ded

betw

een

repo

rtin

g ye

ars.

32

The

met

hodo

logy

for c

alcu

latin

g le

ngth

of s

tay

for t

arge

t in

the

2015

/16

Annu

al P

lan

base

d on

Min

istry

def

initi

ons d

iffer

s to

inte

rnal

mon

itorin

g fo

r thi

s mea

sure

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

48

Spec

ialis

t can

cer t

reat

men

t and

sym

ptom

con

trol

is e

ssen

tial i

n re

duci

ng th

e im

pact

of c

ance

r. In

201

4, D

HBs

bega

n to

gat

her d

ata

to

mea

sure

thr

ee n

ew F

aste

r Ca

ncer

Tre

atm

ent

Indi

cato

rs.

Two

of t

hese

indi

cato

rs a

re n

ow u

sed

to m

easu

re t

he t

imel

ines

s of

can

cer

trea

tmen

t ac

ross

the

who

le p

atie

nt jo

urne

y, w

hich

onc

e av

aila

ble

will

form

par

t of

a m

ore

effe

ctiv

e su

ite o

f qua

lity

mea

sure

s. T

he

first

is a

ref

erra

l tar

get

of 6

2 da

ys b

etw

een

diag

nosis

of a

sus

pici

on o

f can

cer

to fi

rst

appo

intm

ent

for

disc

ussio

n of

tre

atm

ent.

It is

ex

pect

ed th

at 8

5% o

f ref

erre

d pa

tient

s be

seen

with

in th

is tim

efra

me

by Ju

ly 2

016.

The

sec

ond

is a

targ

et o

f 31

days

from

the

poin

t a

patie

nt is

read

y fo

r the

ir ra

diat

ion

or c

hem

othe

rapy

unt

il de

liver

y of

that

trea

tmen

t.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

33

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e Pa

rt A

Fas

ter C

ance

r Tre

atm

ent

– 62

day

hea

lth ta

rget

– 8

5% o

f pa

tient

s ref

erre

d w

ith a

hig

h su

spic

ion

of c

ance

r wai

t 62

days

or

less

to re

ceiv

e th

eir f

irst

trea

tmen

t (or

man

agem

ent)

to

be a

chie

ved

by Ju

ly 2

016

New

M

easu

re

66

%

85

%

73

%

73

%

Not

Ach

ieve

d.

Valid

atio

n of

dat

a an

d re

port

ing

proc

esse

s w

as

com

plet

ed

durin

g th

e ye

ar.

Mar

ch q

uart

er re

sults

of

70%

wer

e lo

wer

tha

n fir

st h

alf

follo

win

g va

lidat

ion.

Gap

s in

dat

a co

llect

ion

mea

n th

at w

hile

wor

k w

as b

eing

don

e w

ithin

ta

rget

it

was

not

bei

ng r

ecor

ded.

The

se

gaps

are

in th

e pr

oces

s of b

eing

clo

sed.

Part

B F

aste

r Can

cer T

reat

men

t –

31 d

ay in

dica

tor -

Pro

port

ion

of

patie

nts w

ho re

quire

radi

atio

n or

che

mot

hera

py a

nd a

re re

ady

for t

reat

men

t rec

eive

thei

r firs

t ca

ncer

trea

tmen

t with

in 3

1 da

ys

New

M

easu

re

76

%

10

0%

81

%

86

%

Not

Ach

ieve

d.

Deve

lopm

ent

of r

epor

ting

that

en

able

s ac

cura

te

mon

itorin

g of

pe

rfor

man

ce

is on

goin

g.

Gaps

in

da

ta

colle

ctio

n m

ean

that

w

hile

w

ork

was

be

ing

done

with

in ta

rget

it w

as n

ot b

eing

re

cord

ed. T

hese

gap

s are

in th

e pr

oces

s of

bein

g cl

osed

.

33 A

nnua

l Pla

n ta

rget

for m

easu

re P

P30

was

inco

rrec

tly p

ublis

hed

as <

10%

. Th

e in

tent

ion

is fo

r eve

ry p

atie

nt to

rece

ive

trea

tmen

t with

in 3

1 da

ys.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

49

Out

put C

lass

3: I

nten

sive

Ass

essm

ent a

nd T

reat

men

t Ser

vice

s O

utco

me:

Peo

ple

rece

ive

timel

y an

d ap

prop

riate

car

e Im

pact

: Peo

ple

have

app

ropr

iate

acc

ess t

o el

ectiv

e se

rvic

es

The

Gove

rnm

ent

wan

ts t

he p

ublic

hea

lth s

yste

m t

o de

liver

bet

ter,

soon

er,

mor

e co

nven

ient

hea

lthca

re f

or a

ll N

ew Z

eala

nder

s.

Elec

tive

surg

ery

oper

atio

ns i

mpr

ove

qual

ity o

f lif

e fo

r pa

tient

s su

fferin

g fr

om s

igni

fican

t m

edic

al c

ondi

tions

but

can

be

dela

yed

beca

use

surg

ery

is no

t re

quire

d im

med

iate

ly.

For

exam

ple,

a h

ip r

epla

cem

ent

can

redu

ce p

ain

and

incr

ease

fun

ctio

n, a

llow

ing

a pe

rson

to g

et b

ack

to p

artic

ipat

ing

in p

hysic

al w

ork

or o

ther

impo

rtan

t act

iviti

es.

A ca

tara

ct o

pera

tion

may

ens

ure

som

eone

is a

ble

to

see

wel

l eno

ugh

to r

ead

or t

o dr

ive

thei

r ca

r, w

hile

a g

rom

met

ope

ratio

n m

ight

res

tore

pro

per

hear

ing

to a

you

ng p

erso

n w

ith ‘g

lue

ear’.

Bay

of P

lent

y DH

B, w

ith a

tota

l of 1

1,11

3 el

ectiv

e su

rger

y di

scha

rges

(201

5: 9

,388

), ha

s exc

eede

d ou

r pla

n an

d re

cord

ed a

hea

lth

targ

et re

sult

of 1

09%

.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Num

ber o

f ele

ctiv

e (in

clud

ing

card

ioth

orac

ic) d

ischa

rges

8,97

1

9,38

8

10,1

36

11

,113

Not

Av

aila

ble

Achi

eved

.

Stan

dard

ised

Inte

rven

tion

Rate

s (S

IRs)

as p

er 1

0,00

0 of

po

pula

tion34

Card

iac

Perc

utan

eous

re

vasc

ular

isatio

n Co

rona

ry

Angi

ogra

phy

Cata

ract

Jo

int

6.

73

13

.91

30

.37

21

.31

25

.71

6.

70

10

.51

30

.28

30

.29

25

.78

6.5

12.5

34.7

27

21

6.

41

10

.48

28

.33

21

.2

29

.05

6.

13

12

.35

33

.76

33

.72

23

.17

Not

ach

ieve

d. E

xcee

ds n

atio

nal

aver

age.

Re

gion

al

activ

ity

to

expl

ore

how

to

im

prov

e ca

rdia

c in

terv

entio

n.

Not

ach

ieve

d. N

o sig

nific

ant w

aitin

g lis

ts.

Not

ach

ieve

d bu

t no

sig

nific

ant

wai

ting

lists

. N

ot a

chie

ved,

how

ever

ref

lect

s in

cide

nce

of

elig

ible

ca

tara

ct

case

s m

ore

than

un

derp

erfo

rman

ce.

Achi

eved

.

Did-

not A

tten

d (D

NA)

rate

for

outp

atie

nt se

rvic

es

Tota

l M

āori

Non

-Māo

ri

6.

9%

15

.6%

4.13

%

6.

6%

15

.4%

4.12

%

5% 5% 5%

6.

6%

15

.6%

4.02

%

N

ot

Avai

labl

e

A se

ries

of c

ontr

olle

d ch

ange

ini

tiativ

es

and

clos

er m

onito

ring

are

unde

rway

but

no

t ref

lect

ed b

y th

is re

sult.

N

ot a

chie

ved.

Ini

tiativ

es a

re u

nder

way

to

addr

ess r

espo

nsiv

enes

s to

Māo

ri.

34 SI

Rs a

re a

ratio

of d

ischa

rges

per

pop

ulat

ion

for e

lect

ive

proc

edur

es; a

stan

dard

ised

mea

sure

is a

com

paris

on a

gain

st a

nat

iona

l ben

chm

ark.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

50

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

ESPI

s (El

ectiv

e Se

rvic

es

Perf

orm

ance

Indi

cato

rs)

ESPI

1

- tim

ely

proc

essin

g of

re

ferr

als

ESPI

2 –

per

cent

age

of p

atie

nts

wai

ting

long

er

than

fo

ur

mon

ths

for

thei

r fir

st

spec

ialis

t as

sess

men

t ES

PI

3 -

patie

nts

wai

ting

with

out

a co

mm

itmen

t to

tr

eatm

ent

ESPI

5

- pa

tient

s gi

ven

a co

mm

itmen

t to

tr

eatm

ent

but

not

trea

ted

with

in

four

mon

ths

ESPI

6 -

pat

ient

s in

ac

tive

revi

ew

who

ha

ve

not

rece

ived

as

sess

men

t w

ithin

6

mon

ths

ESPI

8 -

pro

port

ion

of p

atie

nts

trea

ted

who

w

ere

prio

ritise

d us

ing

a re

cogn

ised

tool

10

0%

0% 0% 0% 0%

100%

10

0%

0% 0% 0% 0%

100%

10

0%

0% 0% 0% 0%

100%

10

0%

0% 0%

0.8%

0%

10

0%

98

.15%

0.60

%

0.

10%

1.4%

2.65

%

98

.33%

Achi

eved

. Ac

hiev

ed.

Achi

eved

. N

ot a

chie

ved.

Ac

hiev

ed.

Achi

eved

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

51

Out

put C

lass

3: I

nten

sive

Ass

essm

ent a

nd T

reat

men

t Ser

vice

s O

utco

me:

Peo

ple

rece

ive

timel

y an

d ap

prop

riate

car

e Im

pact

: Im

prov

ed h

ealth

stat

us fo

r peo

ple

with

a se

vere

men

tal i

llnes

s

For s

ever

al y

ears

, Men

tal H

ealth

has

bee

n a

prio

rity

heal

th a

rea

for t

he G

over

nmen

t, an

d fo

r Bay

of P

lent

y DH

B. T

he fo

cus o

n, in

tere

st

in a

nd e

ngag

emen

t w

ith m

enta

l hea

lth a

nd a

ddic

tion

serv

ices

is in

line

with

res

earc

h (T

e Ra

u Hi

neng

aro:

The

New

Zea

land

Men

tal

Heal

th S

urve

y, 2

006,

Min

istry

of H

ealth

) whi

ch s

how

s th

at a

bout

47%

of N

ew Z

eala

nder

s w

ill e

xper

ienc

e a

men

tal i

llnes

s an

d/or

an

addi

ctio

n at

som

e tim

e in

thei

r liv

es.

The

Bay

of P

lent

y DH

B m

enta

l hea

lth a

nd a

ddic

tion

sect

or c

ontin

ues

to w

ork

tow

ards

mee

t th

e se

rvic

e ex

pect

atio

ns a

nd t

arge

ts

cont

aine

d w

ithin

Risi

ng t

o th

e Ch

alle

nge:

The

Men

tal H

ealth

and

Add

ictio

n Se

rvic

e De

velo

pmen

t Pl

an 2

012

– 20

17 (

SDP)

. Th

e SD

P cl

early

art

icul

ates

prio

ritise

d se

rvic

e de

velo

pmen

ts fo

r th

is p

erio

d. It

aim

s to

ens

ure

that

acr

oss

the

spec

trum

of h

ealth

pro

mot

ion,

pr

imar

y, s

peci

alist

trea

tmen

t and

sup

port

ser

vice

s ac

cess

and

resp

onsiv

enes

s w

ill b

e en

hanc

ed, t

hat r

ealis

ing

the

visio

n an

d ac

hiev

ing

the

goal

s of

the

Pla

n w

ill r

equi

re t

he c

ombi

ned

effo

rt o

f th

e he

alth

and

soc

ial

serv

ice

wor

kfor

ce,

incl

usiv

e co

mm

uniti

es,

fam

ily/w

hana

u w

ho s

uppo

rt o

ne a

noth

er a

nd a

ll N

ew Z

eala

nder

s w

ith m

enta

l hea

lth a

nd a

ddic

tion

issue

s le

adin

g th

eir o

wn

reco

very

. To

ach

ieve

thi

s, s

ervi

ce i

nteg

ratio

n w

ill b

e st

reng

then

ed,

with

val

ue f

or m

oney

and

ser

vice

del

iver

y ou

tcom

es i

mpr

oved

for

our

po

pula

tion.

Mee

ting

the

SDP

will

resu

lt in

us:

• Ac

tivel

y us

ing

our r

esou

rces

mor

e ef

fect

ivel

y.

• Bu

ildin

g in

fras

truc

ture

for i

nteg

ratio

n be

twee

n pr

imar

y an

d sp

ecia

list s

ervi

ces.

•

Cem

entin

g an

d bu

ildin

g on

gai

ns in

resil

ienc

e an

d re

cove

ry.

• U

nder

taki

ng a

gap

ana

lysis

bet

wee

n th

e ac

tions

iden

tifie

d in

the

SDP

and

curr

ent s

ervi

ce p

rovi

sion

mod

el.

We

are

prou

d of

our

ach

ieve

men

ts i

n im

prov

ing

the

heal

th s

tatu

s fo

r pe

ople

with

men

tal

heal

th a

nd a

dditi

on n

eeds

. O

ur

perf

orm

ance

aga

inst

our

targ

ets i

s tab

led

on th

e fo

llow

ing

page

.

Bay

of P

lent

y DH

B in

vest

ed

$62.

7 m

illio

n in

Men

tal H

ealth

an

d Ad

dict

ion

serv

ices

in

2015

/16.

(201

4/15

: $62

.0 m

illio

n)

(201

3/14

: $59

.4 m

illio

n)

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

52

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Impr

ovin

g m

enta

l hea

lth se

rvic

es

usin

g tr

ansit

ion

(disc

harg

e)

plan

ning

for c

hild

and

you

th –

PP

735

Tota

l M

āori

N

ew

Mea

sure

Not

av

aila

ble

66

%

N

ot

avai

labl

e

95

%

95

%

10

0%

N

ot

repo

rted

N

ot

avai

labl

e

Achi

eved

. Se

rvic

e ha

s w

ell

imbe

dded

pr

oces

ses i

n pl

ace

to e

nsur

e yo

ung

peop

le

have

cle

ar tr

ansit

ion

plan

s in

plac

e.

We

have

22

of 1

65 c

lient

s i

n

paid

em

ploy

men

ts, 1

4 of

who

m a

re M

āori.

Aver

age

leng

th o

f acu

te a

dult

(18+

yea

rs) i

npat

ient

stay

(day

s)

17 d

ays

17

day

s

14 -

21

14

day

s

17 d

ays

Achi

eved

.

Rate

s of 7

day

follo

w-u

p in

the

com

mun

ity p

ost d

ischa

rge

74%

69%

90%

64%

64%

N

ot

achi

eved

.

Rate

s ar

e af

fect

ed

by

clie

nts

not

enga

ging

po

st

disc

harg

e,

mov

ing

out

of a

rea

and

bein

g un

able

to

cont

act.

A re

ferr

al o

f a y

oung

per

son

(0

-19

year

s) is

seen

by

Alco

hol

and

Oth

er D

rug

heal

th

prof

essio

nal w

ithin

3 w

eeks

of

refe

rral

bei

ng re

ceiv

ed

78%

83%

80%

80%

Not

av

aila

ble

Data

was

not

ava

ilabl

e fo

r qu

arte

r fo

ur

repo

rtin

g.

35 R

elap

se/p

reve

ntio

n pl

an m

easu

re is

a n

ew m

easu

re f

or 2

014/

15 A

nnua

l Pla

n.

Men

tal H

ealth

rep

orts

are

for

12

mon

ths

rolli

ng d

ata

how

ever

dat

a ca

ptur

e on

ly

rela

tes t

o pe

riods

aft

er F

ebru

ary

2015

.

47%

of N

ew Z

eala

nder

s will

ex

perie

nce

a m

enta

l illn

ess o

r ad

dict

ion

at so

me

time

in th

eir l

ives

.

(Te

Rau

Hine

ngar

o: T

he N

ew Z

eala

nd

Men

tal H

ealth

Sur

vey,

200

6,

Min

istry

of H

ealth

).

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

53

36 Ta

rget

s are

set o

nly

for 0

-19

year

s in

2015

/16

Annu

al P

lan.

Ach

ieve

men

t is e

xpec

ted

to m

atch

thes

e le

vels

for a

ll ag

e gr

oups

. 37

Nat

iona

l ave

rage

resu

lts a

re fo

r the

12

mon

th p

erio

d en

ded

31 M

arch

201

6 an

d so

urce

d fr

om M

inist

ry o

f Hea

lth P

RIM

HD W

ait T

imes

repo

rtin

g da

ta.

38 2

016

Annu

al R

epor

t ind

icat

ors a

re so

urce

d fr

om P

RIM

HD d

ata

and

rela

te to

wai

t tim

es fo

r the

per

iod

1 Ap

ril 2

015

to 3

1 M

arch

201

6.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

36

2016

Ac

tual

20

16

Nat

iona

l Av

erag

e37

Sh

orte

r wai

t tim

es fo

r no

n-ur

gent

men

tal h

ealth

and

ad

dict

ion

serv

ices

Prov

ider

Ar

m

– M

enta

l Hea

lth:

· % p

eopl

e se

en ≤

3 w

eeks

38

0

-19

year

s

20-

64 y

ears

65+

yea

rs

· % p

eopl

e se

en ≤

8 w

eeks

0-1

9 ye

ars

2

0-64

yea

rs

6

5+ y

ears

Pr

ovid

er

Arm

&

N

GO

– Al

coho

l &

Dr

ug:

· % p

eopl

e se

en ≤

3 w

eeks

0-1

9 ye

ars

2

0-64

yea

rs

6

5+ y

ears

· %

peo

ple

seen

≤8

wee

ks

0

-19

year

s

20-

64 y

ears

65+

yea

rs

77

%

76%

83

%

96

%

94%

96

%

84

%

58

%

89%

95%

85

%

89%

86

%

75%

89

%

98

%

95%

98

%

83

%

80

%

88%

96%

95

%

97%

80

%

80%

80

%

95

%

95%

95

%

80

%

80

%

80%

95%

95

%

95%

81

%

82%

86

%

98

%

96%

97

%

79

.6%

81%

91

%

89

%

90%

10

0%

70

%

84.2

%

81.3

%

91

%

95%

94

%

86

.9%

81.7

%

86.2

%

96

.1%

93

.4%

95

.1%

Achi

eved

. Ac

hiev

ed.

Achi

eved

. Ac

hiev

ed.

Achi

eved

. Ac

hiev

ed.

Not

ach

ieve

d.

Data

val

idat

ion

chal

leng

es

cont

inue

with

res

ults

for

key

pro

vide

rs

not r

efle

ctin

g na

rrat

ive

repo

rtin

g.

Achi

eved

. Ac

hiev

ed.

Not

ach

ieve

d. D

ata

valid

atio

n is

ongo

ing.

N

ot a

chie

ved.

Dat

a va

lidat

ion

is on

goin

g.

Achi

eved

.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

54

Out

put C

lass

3: I

nten

sive

Ass

essm

ent a

nd T

reat

men

t Ser

vice

s O

utco

me:

Peo

ple

rece

ive

timel

y an

d ap

prop

riate

car

e Im

pact

: Peo

ple

with

end

stag

e co

nditi

ons a

re su

ppor

ted

Palli

ativ

e ca

re i

s an

are

a of

hea

lthca

re t

hat

focu

ses

on r

elie

ving

and

pre

vent

ing

the

suffe

ring

of p

atie

nts.

U

nlik

e ho

spic

e ca

re,

palli

ativ

e m

edic

ine

is ap

prop

riate

for

pat

ient

s in

all

dise

ase

stag

es, i

nclu

ding

tho

se u

nder

goin

g tr

eatm

ent

for

cura

ble

illne

sses

and

th

ose

livin

g w

ith c

hron

ic d

iseas

es, a

s w

ell a

s pa

tient

s w

ho a

re n

earin

g th

e en

d of

life

. Pa

lliat

ive

med

icin

e ut

ilise

s a

mul

tidisc

iplin

ary

appr

oach

to

patie

nt c

are,

rel

ying

on

inpu

t fr

om p

hysic

ians

, pha

rmac

ists,

nur

ses,

cha

plai

ns, s

ocia

l wor

kers

, psy

chol

ogist

s, a

nd o

ther

al

lied

heal

th p

rofe

ssio

nals

in f

orm

ulat

ing

a pl

an o

f ca

re t

o re

lieve

suf

ferin

g in

all

area

s of

a p

atie

nt's

life.

Th

is m

ultid

iscip

linar

y ap

proa

ch a

llow

s the

pal

liativ

e ca

re te

am to

add

ress

phy

sical

, em

otio

nal,

spiri

tual

, and

soci

al c

once

rns t

hat a

rise

with

adv

ance

d ill

ness

. Pa

lliat

ive

care

is a

n im

port

ant s

ervi

ce p

rovi

ded

to th

e pa

tient

and

for t

he fa

mili

es/w

hāna

u.

Bay

of P

lent

y DH

B re

mai

ns f

ocus

ed o

n m

eetin

g th

e on

goin

g an

d in

crea

sing

dem

and

for

this

serv

ice,

whi

ch i

s pr

ovid

ed i

n th

e co

mm

unity

by

two

serv

ice

prov

ider

s in

the

Bay

of P

lent

y. D

eman

d fo

r pal

liativ

e se

rvic

es c

ontin

ues

to g

row

abo

ve th

e ra

te o

f gen

eral

po

pula

tion

grow

th a

nd in

crea

sed

fund

ing

was

allo

cate

d in

the

last

yea

r to

refle

ct th

is. O

ur ta

rget

was

aga

in e

xcee

ded

for t

he n

umbe

r of

pat

ient

s sup

port

ed b

y pa

lliat

ive

care

serv

ices

(823

ach

ieve

d ag

ains

t 739

targ

et).

The

re w

as a

n in

crea

sed

prop

ortio

n of

pat

ient

s who

re

ceiv

e sp

ecia

list p

allia

tive

care

sup

port

for c

ance

r or e

nd s

tage

rena

l fai

lure

, with

rate

s fo

r oth

er c

ondi

tions

bei

ng a

bove

targ

et in

the

East

ern

Bay

of P

lent

y.

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Ba

se

2015

Ba

se

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Num

ber o

f clie

nts s

uppo

rted

by

spec

ialis

t pal

liativ

e ca

re39

723

80

0

739

82

3

Not

Av

aila

ble

Achi

eved

.

Perc

enta

ge o

f peo

ple

supp

orte

d by

spec

ialis

t pal

liativ

e ca

re,

othe

r tha

n ca

ncer

or e

nd st

age

rena

l fai

lure

23%

29%

23%

22%

N

ot

Avai

labl

e

Not

ach

ieve

d.

39 A

nnua

l Pla

n 20

15/1

6 w

as p

ublis

hed

with

an

erro

r in

the

tar

gets

for

palli

ativ

e ca

re m

easu

res.

Tar

gets

for

2013

/14

wer

e re

cord

ed in

sec

tion

3.6.

4 ra

ther

tha

n th

e in

tend

ed 2

016

targ

et o

f 739

clie

nts s

uppo

rted

as r

epor

ted

in se

ctio

n 1.

8.11

of t

he 2

016

Annu

al P

lan.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

55

Out

put C

lass

4: R

ehab

ilita

tion

and

Supp

ort

Reha

bilit

atio

n an

d Su

ppor

t Ser

vice

s ar

e ai

med

at s

uppo

rtin

g pe

ople

to m

axim

ise th

eir

inde

pend

ence

and

incr

ease

thei

r abi

lity

to li

ve

in t

he c

omm

unity

. Ac

cess

to

a ra

nge

of s

hort

or

long

-ter

m c

omm

unity

bas

ed s

ervi

ces

is ar

rang

ed b

y N

eeds

Ass

essm

ent

Serv

ice

Coor

dina

tion

serv

ices

follo

win

g a

‘nee

ds a

sses

smen

t’ an

d se

rvic

e co

-ord

inat

ion

proc

ess.

The

rang

e of

ser

vice

s in

clud

es p

allia

tive

care

se

rvic

es, h

ome-

base

d su

ppor

t ser

vice

s, d

ay p

rogr

amm

es, r

espi

te a

nd re

siden

tial c

are

serv

ices

.

On

a co

ntin

uum

of c

are

thes

e se

rvic

es p

rovi

de s

uppo

rt fo

r in

divi

dual

s an

d th

eir

care

rs w

hile

pre

dom

inan

tly b

eing

pro

vide

d w

ithin

a

com

mun

ity se

ttin

g or

in th

e pa

tient

’s h

ome.

Reha

bilit

atio

n an

d su

ppor

t ser

vice

s ass

ist in

ach

ievi

ng th

e fo

llow

ing

stra

tegi

c go

als:

1.

Peop

le a

re h

ealth

ier,

able

to se

lf-m

anag

e an

d liv

e lo

nger

. 2.

Pe

ople

are

abl

e to

par

ticip

ate

mor

e in

soci

ety

and

reta

in th

eir i

ndep

ende

nce

for l

onge

r.

By e

nsur

ing

the

prov

ision

of

timel

y an

d ap

prop

riate

reh

abili

tatio

n an

d su

ppor

t se

rvic

es, i

ndiv

idua

ls ca

n re

turn

to

the

best

pos

sible

le

vel o

f par

ticip

atio

n in

soci

ety

as q

uick

ly a

s pos

sible

.

Ove

rall

resu

lts su

gges

t tha

t we

have

impr

oved

our

per

form

ance

for o

ur p

opul

atio

n ov

er th

e pa

st y

ear.

Durin

g th

e 20

15/1

6 fin

anci

al y

ear

Bay

of P

lent

y DH

B in

vest

ed

$117

.6 m

illio

n (1

6%) i

n Re

habi

litat

ion

and

Supp

ort

Serv

ices

(201

4/15

: $10

2.7

mill

ion

- 17%

; 201

3/14

: $98

.0 m

illio

n -

15%

). T

his i

nclu

ded

$28.

3 m

illio

n fo

r Hom

e-Ba

sed

Supp

ort S

ervi

ces

and

$53.

2 m

illio

n fo

r Ag

ed R

esid

entia

l Car

e.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

56

Out

put C

lass

4: R

ehab

ilita

tion

and

Supp

ort

Out

com

e: P

eopl

e re

ceiv

e tim

ely

and

appr

opria

te su

ppor

t ser

vice

s Im

pact

: We

will

del

iver

serv

ices

whi

ch c

ontr

ibut

e to

war

ds a

rang

e of

the

impa

cts a

bove

Phar

mac

eutic

al,

Radi

olog

y an

d La

bora

tory

Ser

vice

s al

l ha

ve a

n im

port

ant

role

in

heal

th s

ervi

ces

in t

he i

dent

ifica

tion,

tre

atm

ent,

cont

rol a

nd o

ngoi

ng m

anag

emen

t of

the

hea

lth n

eeds

of

our

popu

latio

n.

Bay

of P

lent

y DH

B re

port

s bo

th q

uant

ity (t

he n

umbe

r of

te

sts

or it

ems

requ

ired

by o

ur p

opul

atio

n) a

nd q

ualit

y (r

espo

nsiv

enes

s, t

imel

ines

s, e

ffect

iven

ess

and

satis

fact

ion)

mea

sure

s.

Th

is he

lps t

o in

form

the

curr

ent a

nd fu

ture

nee

ds o

f our

resid

ents

, alo

ng w

ith v

alua

ble

qual

ity m

easu

res

whe

re ti

mel

ines

s ca

n im

prov

e th

e lik

elih

ood

of p

ositi

ve h

ealth

out

com

es.

Bay

of

Plen

ty D

HB h

as a

lso d

evel

oped

a P

atie

nt E

xper

ienc

e Su

rvey

tha

t m

easu

res

the

qual

itativ

e as

pect

s of a

pat

ient

’s jo

urne

y th

roug

h th

e ho

spita

l.

Grow

th in

Rad

iolo

gy a

nd L

abor

ator

y te

sts

and

in P

harm

aceu

tical

disp

ense

d ite

ms

is pl

anne

d fo

r w

ithin

the

par

amet

ers

of o

vera

ll po

pula

tion

incr

ease

s ea

ch y

ear.

Pha

rmac

eutic

al d

ispen

sing

fee

grow

th w

as in

line

with

exp

ecta

tions

in t

he la

st y

ear.

The

rat

io o

f di

spen

sed

item

s pe

r per

son

livin

g w

ithin

the

DHB

serv

ice

area

lift

ed a

gain

in 2

015/

16 to

alm

ost 1

6 pe

r per

son

(from

15.

85 p

er p

erso

n in

201

4/15

) whi

ch is

indi

cativ

e of

hig

her

disp

ensin

g ac

tivity

aft

er fi

ve y

ears

of r

educ

ed p

resc

ribin

g ac

tivity

and

impr

ovin

g po

pula

tion

heal

th.

Lab

orat

ory

test

s pe

r ca

pita

incr

ease

d th

is ye

ar a

t a

low

er r

ate

than

the

2.5

% in

crea

se in

the

res

iden

t po

pula

tion,

whi

ch

repr

esen

ts a

favo

urab

le re

sult

(com

para

ble

with

201

4/15

) in

term

s of t

he n

umbe

r of b

lood

test

s del

iver

ed.

Bay

of P

lent

y DH

B in

vest

ed $

56.5

m

illio

n in

Pha

rmac

eutic

al se

rvic

es

in 2

015/

16 (2

014/

15: $

56.8

m

illio

n; 2

013/

14: $

56.2

mill

ion)

, an

d ho

ld c

ontr

acts

and

fund

49

diffe

rent

Pha

rmac

ies l

ocat

ed a

ll ar

ound

the

regi

on.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

57

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Bas

e 20

15 B

ase

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Num

ber o

f com

mun

ity

phar

mac

y pr

escr

iptio

ns 40

3,33

1,34

1

3,45

7,58

9

3,40

8,11

8

3,56

9,88

5

Not

Av

aila

ble

Achi

eved

. W

e ex

pect

ed t

his

to g

row

in

line

with

pop

ulat

ion

grow

th,

whi

ch w

as

2.5%

on

the

prev

ious

yea

r.

Impr

oved

wai

t tim

es fo

r di

agno

stic

serv

ices

41 –

ac

cept

ed re

ferr

als r

ecei

ve

thei

r sca

n w

ithin

6 w

eeks

fo

r:

Coro

nary

An

giog

raph

y Di

agno

stic

Co

lono

scop

y Su

rvei

llanc

e Co

lono

scop

y Co

mpu

ting

Tom

ogra

phy

(CT)

M

agne

tic

Resp

onse

Im

agin

g (M

RI)

94

%

36

%

28

%

80

%

70

%

90

%

38

%

12

%

82

%

78

%

95

%

60

%

60

%

95

%

85

%

99

%

39

%

12

%

96

%

92

%

96

%

56

%

58

%

87

%

63

%

Achi

eved

. N

ot a

chie

ved.

A r

emed

ial p

lan

is in

pla

ce

to a

ddre

ss t

he d

eliv

ery

of C

olon

osco

py

serv

ices

w

hich

ha

s be

en

impa

cted

by

st

affin

g va

canc

ies.

N

ot a

chie

ved.

As a

bove

. Ac

hiev

ed.

Ac

hiev

ed.

Tota

l num

ber o

f co

mm

unity

refe

rred

ra

diol

ogy

Rela

tive

Valu

e U

nits

(RVU

s)42

67,6

60

73

,560

73,6

80

69

,990

Not

Av

aila

ble

Radi

olog

y nu

mbe

r re

flect

s lo

wer

act

ivity

de

liver

ed b

y DH

B se

rvic

e th

is ye

ar.

PHO

pr

oced

ures

wer

e lo

wer

tha

n co

ntra

cted

al

thou

gh m

ore

accu

rate

ly r

efle

ct d

eman

d in

the

com

mun

ity.

40

Thi

s out

put i

s mea

sure

d by

the

tota

l num

ber o

f pha

rmac

eutic

al it

ems d

ispen

sed

in th

e co

mm

unity

for B

ay o

f Ple

nty

resid

ents

41 A

ctiv

ity is

for a

ll pa

tient

s w

ho re

ceiv

ed a

dia

gnos

tic s

ervi

ce in

the

12 m

onth

s en

ded

30 Ju

ne 2

015

and

the

perc

enta

ge re

flect

s th

ose

who

had

thei

r pro

cedu

re d

one

with

in th

e ta

rget

tim

efra

me

for e

ach

indi

cato

r . 42

Thi

s m

easu

re is

bas

ed o

n cl

aim

s pr

oces

sed

at t

he t

ime

of p

ublis

hing

whe

re th

e DH

B Se

nt =

Bay

of P

lent

y DH

B. R

adio

logy

ser

vice

s w

ere

prov

ided

by

the

DHB

and

Prim

ary

Heal

th O

rgan

isatio

ns fo

r the

cur

rent

fina

ncia

l yea

r. T

he D

HB d

eliv

ered

50,

926

RVU

s whi

le P

HOs d

eliv

ered

17,

851

RVU

s.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

58

Mai

n m

easu

res o

f per

form

ance

Vo

lum

es

Com

men

ts

2014

Bas

e 20

15 B

ase

2016

Ta

rget

20

16

Actu

al

2016

N

atio

nal

Aver

age

Tota

l num

ber o

f com

mun

ity

labo

rato

ry te

sts43

1,27

9,10

1

1,32

5,30

7

1,28

0,00

0

1,35

1,55

3

Not

Av

aila

ble

Achi

eved

.

Test

s pe

r pe

rson

ha

ve

rem

aine

d at

sim

ilar l

evel

s to

201

5 de

spite

an

incr

ease

in p

opul

atio

n gr

owth

.

Non

-urg

ent c

omm

unity

la

bora

tory

test

s are

co

mpl

eted

and

co

mm

unic

ated

to

prac

titio

ners

with

in th

e re

leva

nt c

ateg

ory

timef

ram

es

Cate

gory

1:

With

in 2

4 ho

urs44

Ca

tego

ry 2

: W

ithin

96

hour

s Ca

tego

ry 3

: W

ithin

72

hour

s

N

ew

mea

sure

New

m

easu

re

N

ew

mea

sure

N

ot

Avai

labl

e

Not

Av

aila

ble

N

ot

Avai

labl

e

95

%

10

0%

10

0%

N

ot

Avai

labl

e

Not

Av

aila

ble

N

ot

avai

labl

e

N

ot

Avai

labl

e

Not

Av

aila

ble

N

ot

Avai

labl

e

Mea

sure

s are

not

repo

rted

by

prov

ider

. Th

ese

mea

sure

s at

tem

pt t

o ca

ptur

e th

e ef

ficie

ncy

of

the

info

rmat

ion

flow

be

twee

n he

alth

pr

actit

ione

r an

d di

agno

stic

pro

vide

r.

Perc

enta

ge o

f com

mun

ity

labo

rato

ry te

sts c

ompl

eted

w

ithin

des

igna

ted

timef

ram

e fr

om re

ceip

t of

the

spec

imen

at t

he

labo

rato

ry

With

in 4

8 ho

urs

(rou

tine

test

) W

ithin

3 h

ours

(u

rgen

t tes

t)

10

0%

99

%

N

ot

Repo

rted

Not

Re

port

ed

90

%

80

%

10

0%

99

.5%

N

ot

Avai

labl

e

Not

Av

aila

ble

Our

lab

pro

vide

r ha

s in

vest

ed i

n ne

w

faci

litie

s th

is ye

ar.

Adv

ance

s in

tes

ting

and

timel

ines

s is e

xpec

ted

for 2

017.

Patie

nt E

xper

ienc

e Su

rvey

Not

Av

aila

ble

N

ot

Avai

labl

e

80

%

N

ot

Avai

labl

e

N

ot

Avai

labl

e

Mon

itorin

g is

in d

evel

opm

ent.

Our

qua

lity

acco

unts

re

port

on

ot

her

mea

sure

s ca

ptur

ed w

ithin

the

surv

ey.

43 T

he 2

015

base

line

of 1

,255

,637

test

s rep

orte

d in

the

2016

Ann

ual P

lan

is ba

sed

on a

pro

visio

nal c

ount

of a

ctua

l tes

ts d

eliv

ered

. Th

e fin

al p

ublis

hed

resu

lt fo

r 201

5 of

1,

279,

101

was

1.8

5% h

ighe

r. O

ur la

bora

tory

test

s com

plet

ed th

is ye

ar re

pres

ent a

2.0

% li

ft o

ver l

ast y

ear.

44 Ta

rget

repo

rt re

fere

nces

a 1

2 ho

ur ta

rget

of 9

5% w

ith 9

9.5%

ach

ieve

d fo

r Hos

pita

l Rou

tine

test

s and

100

% a

chie

ved

for o

ther

Rou

tine

test

s.

Stat

emen

t of P

erfo

rman

ce fo

r yea

r end

ed 3

0 Ju

ne 2

016

59

Stat

emen

t of F

inan

cial

Per

form

ance

by

Out

put C

lass

Th

e fo

llow

ing

tabl

e di

sclo

ses

the

actu

al f

inan

cial

per

form

ance

by

outp

ut c

lass

aga

inst

the

Ann

ual P

lan

for

the

year

end

ed 3

0 Ju

ne

2016

.

Sum

mar

y of

Rev

enue

s and

Exp

ense

s by

Out

put C

lass

20

15/1

6 $0

00s

Actu

al

2015

/16

$000

s Pl

an

2014

/15

$000

s Ac

tual

2014

/15

$000

s Pl

an

Early

Det

ectio

n

Tota

l Rev

enue

18

0,09

7 18

1,16

9 18

7,55

6 17

7,35

9

Tota

l Exp

endi

ture

18

0,41

5 18

0,87

3 18

7,82

2 17

7,27

2

Net

Sur

plus

/ (D

efic

it)

(318

) 29

6 (2

66)

87

Reha

bilit

atio

n &

Sup

port

Tota

l Rev

enue

11

7,43

0 10

8,14

1 10

2,56

8 10

5,93

5

Tota

l Exp

endi

ture

11

7,63

7 10

7,94

4 10

2,71

4 10

5,94

3

Net

Sur

plus

/ (D

efic

it)

(207

) 19

8 (1

46)

(8)

Prev

entio

n

Tota

l Rev

enue

9,

583

15,0

06

12,4

59

14,3

05

Tota

l Exp

endi

ture

9,

600

14,9

06

12,4

76

14,3

06

Net

Sur

plus

/ (D

efic

it)

(17)

10

0 (1

7)

(1)

Inte

nsiv

e As

sess

men

t & T

reat

men

t

Tota

l Rev

enue

41

4,90

6 40

3,25

4 39

4,80

8 38

8,03

0

Tota

l Exp

endi

ture

41

5,63

8 40

2,46

2 39

5,36

9 38

7,85

7

Net

Sur

plus

/ (D

efic

it)

(732

) 79

2 (5

61)

173

Tota

ls

Tota

l Rev

enue

72

2,01

6 70

7,57

1 69

7,39

1 68

5,62

9

Tota

l Exp

endi

ture

72

3,29

0 70

6,18

5 69

8,38

1 68

5,37

8

Net

Sur

plus

/ (D

efic

it)

(1,2

74)

1,38

6 (9

90)

251



63

The Board and Management of the Bay of Plenty District Health Board (DHB) accept responsibility for the preparation of the financial statements and the judgements used in them.

The Board and Management of the Bay of Plenty DHB accepts responsibility for establishing and maintaining a system of internal control designed to provide reasonable assurance as to the integrity and reliability of the financial reporting and non-financial reporting.

In the opinion of the Board and Management of the Bay of Plenty DHB, the financial statements for the year ended 30 June 2016 fairly reflect the financial position and operations of the Bay of Plenty DHB.

Sally Webb Helen Mason Letham White Board Chair Chief Executive Officer General Manager Corporate Services

Auditor’s Report for the year ended 30 June 2016

67

68

69

Financial Statements for the year ended 30 June 2016

Statement of Comprehensive Revenue and Expense for the year ended 30 June 2016

The accompanying notes form part of and are to be read in conjunction with these financial statements 73

Note

2016 Actual $000's

2016

Budget $000's

2015

Actual $000's

Crown revenue 1 710,970 701,034 687,662 Other revenue 2 9,735 5,517 7,644 Finance revenue 1,311 1,020 2,084 Employee benefit costs 4 (232,803) (224,528) (222,340) Outsourced costs (31,778) (23,269) (29,963) Clinical expenses (51,941) (53,702) (51,519) Infrastructure and non-clinical expenses 5 (35,773) (34,587) (31,127) Payments to providers (336,109) (336,878) (330,031) Finance costs (6,337) (6,522) (7,058) Capital charge 6 (9,239) (6,612) (6,636) Depreciation 10 (18,046) (20,087) (19,254) Amortisation on intangible assets 11 (1,232) - (575) Share of joint venture surplus/(deficit) 13 (32) - 123 (Deficit) / Surplus for the year (1,274) 1,386 (990) Other comprehensive revenue and expense Revaluation of Land and Buildings - - 33,683

Total comprehensive revenue and expense (1,274) 1,386 32,693

Statement of Financial Position as at 30 June 2016

74 The accompanying notes form part of and are to be read in conjunction with these financial statements.

Note

2016 Actual $000's

2016

Budget $000's

2015

Actual $000's

Assets Current Assets:

Cash and cash equivalents 7 7,252 16,047 20,052 Trade and other receivables – Exchange 8 10,004 7,185 11,170 Trade and other receivables – Non Exchange 8 13,266 6,820 10,271 Inventories 9 2,846 2,575 3,700 Total Current Assets: 33,368 32,627 45,193 Non-current Assets: Property, plant and equipment 10 295,138 273,703 294,713 Intangible assets 11 4,041 - 4,329 Investments in associates 12 51 - 49 Investments in joint ventures 13 247 - 279 Other investments 316 176 374 Total Non-current Assets: 299,793 273,879 299,744 Total Assets 333,161 306,506 344,937 Liabilities Current Liabilities: Employee entitlements 14 (28,608) (25,640) (30,015) Trade and other payables - Exchange 15 (28,148) (34,825) (36,278) Trade and other payables - Non Exchange 15 (5,799) (6,260) (6,521) Borrowings 16 (19,500) - (19,500) Total Current Liabilities: (82,055) (66,725) (92,314) Non Current Liabilities: Employee entitlements 14 (547) (878) (770) Borrowings 16 (132,700) (152,200) (132,720) Total Non Current Liabilities: (133,247) (153,078) (133,490) Equity:

Crown equity (71,071) (72,322) (71,071) Retained Earnings (3,420) (4,694) (4,694) Other reserves (43,368) (9,687) (43,368) Total Equity: (117,859) (86,703) (119,133) Total Equity and Liabilities (333,161) (306,506) (344,937)

For and on behalf of the Bay of Plenty DHB:

Sally Webb Ron Scott Board Chair Deputy Chair 31 October 2016 31 October 2016

Statement of Changes in Equity for the year ended 30 June 2016

The accompanying notes form part of and are to be read in conjunction with these financial statements 75

Equity Reserves Total

Crown equity

$000's

Retained earnings

$000's

Property revaluation

$000's Total equity

$000's

Balance at 1 July 2015 71,071

4,694

43,368

119,133 Total recognised revenue and expense - (1,274) - (1,274) Contribution from the Crown - - - - Movement in revaluation of land and buildings - - - -

Balance at 30 June 2016 71,071

3,420

43,368

117,859

Balance at 1 July 2014 71,071

5,684 9,685

86,440 Total recognised revenue and expense - (990) - (990) Contribution from the Crown - - - -

Movement in revaluation of land and buildings - -

33,683

33,683

Balance at 30 June 2015 71,071

4,694

43,368

119,133

Statement of Cashflow for the year ended 30 June 2016

76 The accompanying notes form part of and are to be read in conjunction with these financial statements.

Note

2016 Actual $000's

2016

Budget $000's

2015

Actual $000's

Cash flows from operating activities Cash receipts from Crown and patients 719,388 706,174 686,347 Cash paid to suppliers (431,668) (424,990) (412,157) Cash paid to employees (266,962) (247,636) (250,831) Cash generated from operations 20,758 33,548 23,359 Interest received 1,362 1,020 2,045 Interest paid (6,506) (6,495) (6,809) Net taxes refunded/(paid) (goods and services tax) 446 21 (123) Capital charge paid (9,239) (6,612) (6,636) Net cash flows from operating activities 6,821 21,482 11,836 Cash flows from investing activities Proceeds from sale of investments - - - Acquisition of investments 17 - (470) Acquisition of property, plant and equipment (19,638) (24,081) (20,925) Net cash flows from investing activities (19,621) (24,081) (21,395) Cash flows from financing activities Proceeds from equity injections - - - Borrowings raised - - 8,500 Net cash flows from financing activities - - 8,500 Net increase/(decrease) in cash and cash equivalents (12,800) (2,599) (1,059) Cash and cash equivalents at beginning of year 20,052 20,052 21,111 Cash and cash equivalents at end of year 7,252 17,453 20,052

Statement of Contingent Liabilities as at 30 June 2016

77

Bay of Plenty DHB has been notified of no potential claims as at 30 June 2016 (2015: No claims).

Statement of Accounting Policies for the year ended 30 June 2016

78

Reporting entity

Bay of Plenty District Health Board (DHB) is a District Health Board established by the New Zealand Public Health and Disability Act 2000. Bay of Plenty DHB is a crown entity in terms of the Crown Entities Act 2004, owned by the Crown and domiciled in New Zealand. Bay of Plenty DHB is a reporting entity for the purposes of the New Zealand Public Health and Disability Act 2000 (NZ PHD), the Financial Reporting Act 2013, the Public Finance Act 1989 and the Crown Entities Act 2004 (CEA).

Bay of Plenty DHB is a public sector, public benefit entity (PS PBE), as defined under External Reporting Board (XRB) Standard A1. PS PBEs are reporting entities whose primary objective is to provide goods or services for community or social benefit and where any equity has been provided with a view to supporting that primary objective rather than for a financial return to equity holders.

The financial statements of Bay of Plenty DHB for the year ended 30 June 2016 incorporate Bay of Plenty DHB and Bay of Plenty DHB’s interest in associates and joint ventures. Bay of Plenty DHB is required under the CEA to prepare consolidated financial statements in relation to the economic entity for each financial year.

Consolidated financial statements for the economic entity have not been prepared due to the small size of the controlled entities which means that the controlling entity and economic entity amounts are not materially different. The following are the Bay of Plenty DHB controlled entities which have not been consolidated in the financial statements:

Tauranga Community Health Trust (Inc.) and Whakatane Community Health Trust (Inc.) are charitable trusts which administer donations received which are tagged for specific use within the Bay of Plenty DHB. The Bay of Plenty DHB has no financial interest in either of these trusts. The trusts are controlled by the Bay of Plenty DHB in accordance with PS PBE IPSAS 6 as the Bay of Plenty DHB is able to appoint the majority of the Trustees of the Charitable Trusts. The objective for which the Charitable Trusts are established is entirely charitable. Bay of Plenty DHB’s activities involve funding and delivering health and disability services and mental health services in a variety of ways to the community.

The financial statements were authorised for issue by the Board on 31 October 2016.

Statement of compliance

These financial statements, including the comparatives, have been prepared in accordance with Public Sector PBE Accounting Standards (PS PBE IPSAS) – Tier 1. These standards are based on International Public Sector Accounting Standards (IPSAS).

Basis of preparation

The XRB issued PS PBE IPSAS that apply to the financial statements of PS PBEs for the financial years beginning on or after 1 July 2014. These financial statements have been prepared in accordance with Tier 1 PS PBE IPSAS and are prepared on a going concern basis.

The financial statements are presented in New Zealand Dollars (NZD), rounded to the nearest thousand. The financial statements are prepared on the historical cost basis except that land and buildings are stated at their fair value.

The following accounting policies have been applied consistently to all periods presented in these financial statements.

The preparation of financial statements in conformity with PS PBE IPSAS requires management to make judgements, estimates and assumptions that affect the application of policies and reported amounts of assets and liabilities, revenue and expenses. The estimates and associated assumptions are based on historical


79

experience and various other factors that are believed to be reasonable under the circumstances, the results of which form the basis of making the judgements about carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

Judgements made by management in the application of PS PBE IPSAS that have significant effect on the financial statements and estimates with a significant risk of material adjustment in the next year are discussed in note 21.

Financial instruments

Non-derivative financial instruments

Non-derivative financial instruments comprise available for sale financial assets, instruments at fair value through the surplus or deficit, trade and other receivables, cash and cash equivalents, loans, other financial liabilities, and trade and other payables.

Non-derivative financial instruments are recognised initially at fair value plus, for instruments not at fair value through the surplus or deficit, any directly attributable transaction costs. Subsequent to initial recognition non-derivative financial instruments are measured as described below.

A financial instrument is recognised if the Bay of Plenty DHB becomes a party to the contractual provisions of the instrument. Financial assets are derecognised if the Bay of Plenty DHB’s contractual rights to the cash flows from the financial assets expire, or if the Bay of Plenty DHB transfers the financial asset to another party without retaining control or substantially all risks and rewards of the asset. Regular purchases and sales of financial assets are accounted for at trade date, i.e., the date that the Bay of Plenty DHB commits itself to purchase or sell the asset. Financial liabilities are derecognised if the Bay of Plenty DHB’s obligations specified in the contract expire or are discharged or cancelled.

Cash and cash equivalents

Cash and cash equivalents comprise cash balances and call deposits with maturity of no more than three months from the date of acquisition. Bank overdrafts that are repayable on demand and form an integral part of the Bay of Plenty DHB’s cash management are included as a component of cash and cash equivalents for the purpose of the statement of cash flows.

Trade and other receivables

Trade and other receivables are initially recognised at historical cost and subsequently assessed for an allowance for doubtful debts (if any). The carrying value of trade and other receivables that are of a short term duration is a reasonable approximation of their fair values. Bad debts are written off during the period in which they are identified.

Trade and other payables

Trade and other payables are stated at historical cost.


80

Property, plant and equipment

Classes of property, plant and equipment

The major classes of property, plant and equipment are as follows:

• freehold land • freehold buildings • plant and equipment • leasehold improvements • work in progress

Land and buildings are re-valued to fair value as determined by an independent registered valuer, with sufficient regularity to ensure the carrying amount is not materially different to fair value, and at least every three years. Any increase in value of a class of land and buildings is recognised directly to the property revaluation reserve unless it offsets a previous decrease in value recognised in the Surplus or deficit. Any decreases in value relating to a class of land and buildings are taken directly to the property revaluation reserve, to the extent that they reverse previous surpluses and are otherwise recognised as an expense in the surplus or deficit. Additions to property, plant and equipment between valuations are recorded at cost.

Where material parts of an item of property, plant and equipment have different useful lives, they are accounted for as separate components of property, plant and equipment.

Property, Plant and Equipment Vested from the Hospital and Health Service

Under section 95(3) of the NZ PHD, the assets of Pacific Health Limited (a hospital and health service company) vested in Bay of Plenty DHB on 1 January 2001. Accordingly, assets were transferred to Bay of Plenty DHB at their net book values as recorded in the books of the hospital and health service. In effecting this transfer, the Health Board has recognised the cost and accumulated depreciation amounts from the records of the hospital and health service. The vested assets will continue to be depreciated over their remaining useful lives.

Disposal of Property, Plant and Equipment

Where an item of property, plant and equipment is disposed of, the gain or loss recognised in the surplus or deficit is calculated as the difference between the net sales price and the carrying amount of the asset.

On the sale or retirement of a re-valued property, the attributed revaluation surplus remaining in the property revaluation reserve is transferred directly to retained earnings. No transfer is made from the revaluation reserve to retained earnings except when an asset is derecognised.

Subsequent costs

Subsequent costs are added to the carrying amount of an item of property, plant and equipment when that cost is incurred if it is probable that the service potential or future economic benefits embodied within the new item will flow to Bay of Plenty DHB. All other costs are recognised in the surplus or deficit as an expense as incurred.


81

Depreciation

Depreciation is charged to the surplus or deficit using the straight line method. Land is not depreciated.

Depreciation is set at rates that will write off the cost or fair value of the assets, less their estimated residual values, over their useful lives. The estimated useful lives of major classes of assets and resulting rates are as follows:

Class of asset Estimated life Depreciation rate • Buildings 15 to 50 years 2 - 6.67% • Plant and equipment 5 to 10 years 10 - 20.0% • Vehicles 5 to 10 years 10 - 20.0% • Fixture and fittings 3 to 25 years 4 - 33.0%

The residual value and useful lives of assets is reassessed annually.

Freehold land and work in progress are not depreciated.

The total cost of a project is transferred to the appropriate class of asset on its completion and then depreciated.

Intangible assets

Intangibles

Intangible assets that are acquired by Bay of Plenty DHB are stated at cost less accumulated amortisation and impairment losses.

NZ Health Partnerships Limited (NZHPL) Finance Procurement Supply Chain rights (FPSC) is an intangible asset recognised at the cost of capital invested by the Bay of Plenty DHB in the FPSC programme being a national initiative undertaken by NZHPL to deliver sector wide benefits. This represents the DHB’s right to access, under a service level agreement, shared FPSC services provided using assets funded by DHB’s. NZHPL are the lead agency for this work, following a transition from Health Benefits Limited (HBL) on 15 June 2015.

The rights are considered to have an indefinite life as DHB’s have the ability and intention to review the service level agreement indefinitely and the fund established by HBL through the on-charging of depreciation on the FPSC assets to the DHB’s will be used to, and is sufficient to, maintain the FPSC assets standard of performance or service potential indefinitely.

As the FPSC rights are considered to have an indefinite life, the intangible asset is not amortised and will be tested for impairment annually.

Subsequent expenditure on intangible assets is capitalised only when it increases the service potential or future economic benefits embodied in the specific asset to which it relates.

Amortisation

Amortisation is charged to the surplus or deficit on a straight-line basis over the estimated useful lives of intangible assets unless such lives are indefinite. Intangible assets with an indefinite useful life are tested for impairment at each statement of financial position date. Intangible assets with a definite useful life are amortised from the date they are available for use. The estimated useful lives are as follows:

Type of asset Estimated life Amortisation rate • Software 2 to 3 years 33 - 50%


82

Inventories

Inventories are stated at the lower of cost and net realisable value. Net realisable value is the estimated selling price in the ordinary course of business, less the estimated costs of completion and selling expenses. Cost is based on weighted average cost.

Impairment

The carrying amounts of Bay of Plenty DHB’s assets are reviewed at each balance date to determine whether there is any indication of impairment. If any such indication exists, the assets’ recoverable amounts are estimated.

If the estimated recoverable amount of an asset is less than its carrying amount, the asset is written down to its estimated recoverable amount and an impairment loss is recognised in the surplus or deficit.

For intangible assets that have an indefinite useful life and intangible assets that are not yet available for use, the recoverable amount is estimated at each statement of financial position date and was estimated at the date of transition.

An impairment loss on property, plant and equipment re-valued on a class of asset basis is recognised directly against any revaluation reserve in respect of the same class of asset to the extent that the impairment loss does not exceed the amount in the revaluation reserve for the same class of asset.

Impairment losses on an individual basis are determined by an evaluation of the exposures on an instrument by instrument basis. All individual trade receivables that are considered significant are subject to this approach. For trade receivables which are not significant on an individual basis, collective impairment is assessed on a portfolio basis based on number of days overdue, and taking into account the historical loss experience in portfolios with a similar amount of days overdue.

Calculation of recoverable amount

Estimated recoverable amount of other assets is the greater of their fair value less costs to sell and value in use. Value in use is calculated differently depending on whether an asset generates cash or not. For an asset that does not generate largely independent cash inflows, the recoverable amount is determined for the cash-generating unit to which the asset belongs.

For non-cash generating assets that are not part of a cash generating unit, value in use is based on depreciated replacement cost (DRC). For cash generating assets value in use is determined by estimating future cash flows from the use and ultimate disposal of the asset and discounting these to their present value using a pre-tax discount rate that reflects current market rates and the risks specific to the asset.

Impairment gains and losses, for items of property, plant and equipment that are re-valued on a class of assets basis, are also recognised on a class basis.

Reversals of impairment

Impairment losses are reversed when there is a change in the estimates used to determine the recoverable amount.

An impairment loss is reversed through the surplus or deficit, unless the relevant asset is carried at a re-valued amount, in which case the reversal of the impairment loss is reversed through the relevant reserve.

All other impairment losses are reversed through the surplus or deficit.

An impairment loss is reversed only to the extent that the asset’s carrying amount does not exceed the carrying amount that would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised.


83

Interest-bearing borrowings

Interest-bearing loans and borrowings are classified as other non-derivative financial instruments.

Interest-bearing borrowings are recognised initially at fair value less attributed transaction costs. Subsequent to initial recognition, interest-bearing borrowings are stated at amortised cost with any difference between cost and redemption value being recognised in the surplus or deficit over the period of the borrowings on an effective interest basis.

Employee Benefits

Defined contribution schemes

Employer contributions to KiwiSaver, the Government Superannuation Fund, and the State Sector Retirement Savings Scheme are accounted for as defined contribution plans and are recognised as an expense in the surplus or deficit during the period as they arise. The Bay of Plenty DHB has no legal or constructive obligation to pay future benefits, the Crown guarantees these benefits, and as a result the plans are accounted for as a defined contribution plan.

Long service leave, sabbatical leave and retirement gratuities

Bay of Plenty DHB’s net obligation in respect of long service leave, sabbatical leave and retirement gratuities is the amount of future benefit that employees have earned in return for their service in the current and prior periods. The obligation is calculated using the projected unit credit method and is discounted to its present value. The discount rate is the market yield on relevant New Zealand government bonds at the statement of financial position date.

Annual leave, sick leave and medical education leave

Annual leave, sick leave and medical education leave are short-term obligations and are calculated on an actual basis at the amount Bay of Plenty DHB expects to pay. Bay of Plenty DHB accrues the obligation for paid absences when the obligation both relates to employees’ past services and it accumulates.

Other Liabilities

Provisions

A provision is recognised when Bay of Plenty DHB has a present legal or constructive obligation as a result of a past event, and it is probable that an outflow of economic benefits will be required to settle the obligation. If the effect is material, provisions are determined by discounting the expected future cash flows at a pre-tax rate that reflects current market rates and, where appropriate, the risks specific to the liability.

Onerous contracts

A provision for onerous contracts is recognised when the expected benefits to be derived by Bay of Plenty DHB from a contract are lower than the unavoidable cost of meeting its obligations under the contract.

Income tax

Bay of Plenty DHB is a crown entity under the NZ PHD and is exempt from income tax under section CW38 of the Income Tax Act 2007.

Goods and services tax

All amounts are shown exclusive of Goods and Services Tax (GST), except for receivables and payables that are stated inclusive of GST. Where GST is irrecoverable as an input tax, it is recognised as part of the related asset or expense.


84

Revenue

Crown funding

The majority of revenue is provided through an appropriation in association with a Crown Funding Agreement. Revenue is recognised monthly in accordance with the Crown Funding Agreement payment schedule, which allocates the appropriation equally throughout the year.

ACC Contracted revenue

ACC contract revenue is recognised when eligible services are provided and any contract conditions have been fulfilled.

Goods sold and services rendered

Revenue from goods sold is recognised when Bay of Plenty DHB has transferred to the buyer the significant risks and rewards of ownership of the goods and Bay of Plenty DHB does not retain either continuing managerial involvement to the degree usually associated with ownership nor effective control over the goods sold.

Revenue from services is recognised, to the proportion that a transaction is complete, when it is probable that the payment associated with the transaction will flow to Bay of Plenty DHB and that payment can be measured or estimated reliably, and to the extent that any obligations and all conditions have been satisfied by Bay of Plenty DHB.

Revenue relating to service contracts

Bay of Plenty DHB receives revenue for service contracts on an invoice or payment schedule basis. Bay of Plenty DHB is required to expend all monies appropriated within certain contracts during the year in which it is appropriated. Should this not be done, the contract may require repayment of the money or Bay of Plenty DHB, with the agreement of the Ministry of Health, may be required to expend it on specific services in subsequent years. The amount unexpended is recognised as a liability.

Financing Revenue

Interest received and receivable on funds invested are calculated using the effective interest rate method and are recognised in the surplus or deficit.

Inter-District Flow Revenue

Inter-District Flow revenue is received for activity undertaken by Bay of Plenty DHB for patients domiciled in other DHB regions. Receipts are based on an agreed level of production and are subject to wash-up rules if actual volumes are different to agreed volumes.


85

Expenses

Operating lease payments

Payments made under operating leases are recognised in the surplus or deficit a straight-line basis over the term of the lease. Lease incentives received are recognised in the surplus or deficit over the lease term as an integral part of the total lease expense.

Financing costs

Financing costs comprise interest paid and payable on borrowings calculated using the effective interest rate method, are recognised in the surplus or deficit.

The interest expense component of finance lease payments is recognised in the surplus or deficit using the effective interest rate method.

Standards, Amendments and Interpretations Effective in the Current Period

All mandatory Standards, Amendments and Interpretations have been adopted in the current year. None had a material impact on these financial statements, although minor disclosure changes are made to accommodate for PS PBE requirements. This has resulted in further componentisation of receivables and payables in the Statement of Financial Position and revenue in the notes to financial statements for the exchange and non-exchange portions of each reported item.

New Standards Adopted

The External Reporting Board (XRB) has established a new Accounting Standards Framework based on a multi-sector, reporting tiers approach. The new accounting standards framework consists of two sets of accounting standards, one to be applied by entities with a for-profit objective and the other to be applied by public benefit entities (PBE’s). The Public Sector PBE standards (PS PBE IPSAS) are based largely on International Public Sector Accounting Standards (IPSAS), and apply from 1 July 2014. BOPDHB have adopted all PS PBE IPSAS and interpretations issued to date for the 30 June 2016 financial statements.

Comparatives

When presentation or classification of items in the financial statements is amended or accounting policies are changed voluntarily, comparative figures have been restated to ensure consistency with the current period unless it is impracticable to do so.

Statement of Performance Expectations by Output Class

The statement of performance expectations by output class, as reported in the statement of performance expectations, report the net cost of services for the outputs of Bay of Plenty DHB and are represented by the cost of providing the output less all the revenue that can be allocated to these activities.

Cost Allocation and Policy

Bay of Plenty DHB has arrived at the net cost of service for each significant activity using the cost allocation system outlined below.

Direct costs are charged directly to output classes. Direct costs are those costs directly attributable to an output class. Indirect costs are charged to output classes based on cost drivers and related activity and usage information. Indirect costs are those costs that cannot be identified in an economically feasible manner with a specific output class. The cost of internal services not directly charged to outputs is allocated as overheads using appropriate cost drivers such as actual usage, staff numbers and floor area.

Notes to the Financial Statements for the year ended 30 June 2016


89

1 Crown revenue

2016 Actual $000's

2015 Actual $000's

Health and disability services (Crown appropriation revenue) 634,662 614,392 Other Ministry of Health revenue 53,876 49,484 ACC (Crown non appropriated revenue) 5,508 6,022 Other Revenue (Crown non appropriated revenue) 941 1,323 Inter-District patient inflows 15,983 16,441 710,970 687,662

The appropriation revenue received by the DHB equals the Government’s actual expenses incurred in relation to the appropriation, which is a required disclosure from the Public Finance Act. Performance against this appropriation is reported in the Statement of Performance on pages 13 to 59.

2 Other revenue

2016 Actual $000's

2015 Actual $000's

Gain on sale of property, plant and equipment 180 93 Donations and bequests received 302 262 Other 9,253 7,289 9,735 7,644

3 Exchange versus Non Exchange Revenue

The Bay of Plenty DHB has reviewed its revenue streams to determine whether it is Exchange and Non-Exchange based.

2016 Actual $000's

2015 Actual $000's

Exchange Revenue 37,366 38,861 Non-Exchange Revenue 684,650 658,652 722,016 697,513

4 Employee benefit costs

2016 Actual $000's

2015 Actual $000's

Wages and salaries 227,752 214,613 Contributions to Defined Contribution Plans 6,681 6,049 Increase / (Decrease) in employee benefits provisions (1,630) 1,678 232,803 222,340


90

5 Infrastructure and non-clinical expenses

2016 Actual $000's

2015 Actual $000's

Auditor fees • Audit of financial statements 180 176

• Other assurance related services (probity & due diligence review) - - • Other related services – (FMIS hosting costs)* - 34 Directors fees and expenses 270 291 Impairment of trade receivables (bad and doubtful debts) 298 143 Infrastructure servicing costs 32,818 28,421 Koha 7 12 Loss on sale of property, plant and equipment - - Operating lease expenses 2,200 2,045 35,773 31,127

6 Capital charge

2016 Actual $000's

2015 Actual $000's

Capital charge expense 9,239 6,636 9,239 6,636

Bay of Plenty DHB pays a monthly capital charge to the Crown based on the greater of its actual or budgeted closing equity balance for the month. The capital charge rate for the period ended 30 June 2016 was 8 per cent (2015: 8 per cent).

7 Cash and cash equivalents

2016 Actual $000's

2015 Actual $000's

Bank Balance (Overdraft) (8) - Call deposits 7,260 20,052 Cash and cash equivalents 7,252 20,052

Reconciliation of surplus for the period with net cash flows operating activities

2016 Actual $000's

2015 Actual $000's

Net Surplus from operating activities (1,274) (990) Addback non-cash items Depreciation and amortisation expense 19,278 19,829 Non-perpetual inventory write-down - - Bad Debt write-off 280 181

Goods received not invoiced (50)

(819) Donated Assets - (46) Addback items classified as investing activity: Net (gain)/loss on disposal of property, plant and equipment (180) (93) Movements in working capital: (Increase)/decrease in trade and other receivables (1,829) (7,821) (Increase)/decrease in inventories 855 (1,201) Increase/(decrease) in trade payables (10,259) 2,796 Net movement in working capital (11,233) (6,226) Net cash inflow from operating activities 6,821 11,836

* Other fees relate to FMIS (Finance Management Information System) hosting costs which were paid to Waikato DHB for IT services provided by Asparona until November 2014, an entity owned by Deloitte.


91

Working capital facility

Bay of Plenty DHB is a party to the DHB Treasury Services Agreement between New Zealand Health Partnerships Limited (NZ HPL) and the participating DHBs. This agreement enables NZ HPL to sweep DHB bank accounts and invest surplus funds on their behalf. The DHB Treasury Services Agreement provides for individual DHBs to have a credit facility with NZ HPL, which will incur interest at on-call interest rates received by NZ HPL plus an administrative margin. The maximum credit facility that is available to any DHB is the value of one month’s planned Provider Arm Crown funding, inclusive of GST.

8 Trade and other receivables

2016 Actual $000's

2015 Actual $000's

Trade receivables from non-related parties 2,806 5,725 Trade receivables from related parties 163 11 Crown and Ministry of Health receivables 15,136 10,414 Accrued Income 3,447 3,460 Prepayments 1,718 1,831 23,270 21,441 Receivables from Exchange transactions 10,004 11,170 Receivables from Non-Exchange transactions 13,266 10,271 23,270 21,441 Provision for doubtful debts

Opening Balance (245) (283) Impairment losses recognised on receivables (18) 38 Additional provisions made during the year (280) (181) Receivables written off during the year 280 181 Closing Balance (263) (245)

9 Inventories

2016 Actual $000's

2015 Actual $000's

Central stores - at cost 1,938 2,354 Pharmaceuticals - at cost 541 980 Other supplies - at cost 367 367 2,846 3,700

Inventories recognised in the profit or loss amounted to $22,988,024 (2015: $20,011,240).

No inventories are pledged as security for liabilities but some inventories are subject to retention of title clauses (Romalpa clauses). The value of stocks subject to such clauses cannot be quantified due to the inherent difficulties in identifying the specific inventories affected at year-end.

Not

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93

10 Property, plant and equipment cont.

Leasehold improvement assets have been split out this year from the Buildings asset category in order to provide a more accurate class categorisation. Prior year comparatives have been restated.

Impairment

At year end 30 June 2016, there was no impairment provided for against any Property, Plant and Equipment.

Revaluation

The most recent valuation of land and buildings was performed by an independent registered valuer, Peter Todd of Darroch Limited and a member of the New Zealand Institute of Valuers. The valuation is effective as at 30 June 2015.

Land is valued at fair value using market-based evidence based on its highest and best use with reference to comparable land values. Adjustments have been made for specific market factors such as nature, location and condition of the land.

Non-specialised buildings (such as houses and medical clinics) are valued at fair value using market-based evidence with reference to standard lease terms or comparable property.

Specialised buildings are valued at fair value using optimised depreciated replacement cost because no reliable market data is available for such buildings. Optimised depreciated replacement cost is determined using a number of significant assumptions. Significant assumptions include:

• The optimised replacement cost of the asset is based on the modern equivalent asset cost (‘MEA’) with adjustments where appropriate due to technical obsolescence and over design or surplus capacity.

• The remaining useful life of assets has been estimated based on actual records and site inspections, adjusted for utilisation, refurbishments and condition of the asset.

• Straight-line depreciation has been applied to reflect the consumption of the asset.

The next valuation is expected to be completed as at 30 June 2018.

The total carrying values due to valuation are deemed to be equivalent to the fair value of the assets as at 30 June 2016.

Restrictions

Bay of Plenty DHB does not have full title to crown land it occupies but transfer is arranged if and when land is sold.

Some of the land is subject to Waitangi Tribunal claims. Titles to land transferred from the Crown to Bay of Plenty DHB are subject to a memorial in terms of the Treaty of Waitangi Act 1975 (as amended by the Treaty of Waitangi (State Enterprises) Act 1988). The effect on the value of assets resulting from potential claims under the Treaty of Waitangi Act 1975 cannot be quantified.

The disposal of certain properties may also be subject to the provision of section 40 of the Public Works Act 1981.


94

11 Intangible assets

Cost

Software Actual $000’s

NZHPL (FPSC / NOS )

Actual $000's

Total $000's

Balance at 1 July 2015 9,467 3,021 12,488 Additions 944 - 944 Disposals - - - Reclassifications - - - Balance at 30 June 2016 10,411 3,021 13,432 Balance at 1 July 2014 8,862 2,551 11,413 Additions 605 470 1,075 Disposals - - - Reclassifications - - - Balance at 30 June 2015 9,467 3,021 12,488 Amortisation and impairment losses Balance at 1 July 2015 (8,159) - (8,159) Amortisation charge for the year (1,232) - (1,232) Disposals - - - Reclassification - - - Balance at 30 June 2016 (9,391) - (9,391) Balance at 1 July 2014 (7,584) - (7,584) Amortisation charge for the year (575) - (575) Disposals - - - Reclassification - - - Balance at 30 June 2015 (8,159) - (8,159) Carrying amounts At 30 June 2016 1,020 3,021 4,041 At 1 July 2015 1,308 3,021 4,329

At 30 June 2016, Bay of Plenty DHB had made payments totalling $3,021,399 (2015: $3,021,399) in relation to the Finance, Procurement and Supply Chain (FPSC) programme. This is a national initiative. This programme was managed by Health Benefits Limited (HBL) until 15 June 2015, at which time the FPSC programme and its’ net assets were transferred to a new company, NZ Health Partnerships Limited (NZHPL). In return for these payments to HBL, Bay of Plenty DHB gained FPSC rights. These rights remain with Bay of Plenty DHB under NZHPL, and are now referred to as the National Oracle Solution (NOS) programme. In the event of liquidation or dissolution of NZHPL, Bay of Plenty DHB shall be entitled to be paid from the surplus assets, an amount equal to their proportionate share of the liquidation value based on its proportional share of the total FPSC/NOS rights that have been issues. The FPSC/NOS rights have been tested for impairment by comparing the carrying amount of the intangible asset to its depreciated replacement cost (DRC), which is considered to equate to Bay of Plenty DHB’s share of the DRC of the underlying FPSC/NOS assets. The current expectation of the Board is that the FPSC/NOS programme will proceed as planned. In this scenario, the DRC of the FPSC/NOS rights is consider to equate to, in all material respects, to the costs capitalised to date such that the FPSC/NOS rights are not impaired.


95

12 Investments in associates Bay of Plenty DHB has the following investments in associates: a) General information

Name of entity Principal

activities Interest held at

30 June Balance

date

2016 2015

Venturo Limited

Provision of urology services

50% 50% 30-Jun

Bay Imaging Group Limited

Provision of CT scanning services

50% 50% 30-Jun b) Summary of financial information on associate entities (100 per cent)

2016 Actual Assets $000's

Liabilities $000's

Equity $000's

Revenues

$000's

Profit/ (loss)

$000's

Venturo Limited 723 693 30

5,177

2

Bay Imaging Group Limited 16 20 (4)

-

-

2015 Actual

Venturo Limited 831 803 28

5,181

3

Bay Imaging Group Limited 16 20 (4)

-

- c) Share of profit of associate entities

2016 Actual $000's

2015 Actual $000's

Share of profit/(loss) before tax 4 4 Less: tax expense 2 1 Share of profit/(loss) after tax 2 3 d) Investment in associate entities

2016 Actual $000's

2015 Actual $000's

Carrying amount at beginning of year

49 46 Share of total recognised revenue and expenses 2 3

Equity adjustments - - Carrying amount at end of year 51 49

The equity method is used to account for investments in associates.

e) Share of associates’ contingent liabilities and commitments

There are no contingent liabilities and commitments at year end. Bay of Plenty DHB is not jointly or severally liable for the contingent liabilities owing at balance date by the associates.


96

13 Investments in joint ventures Bay of Plenty DHB has the following investments in joint ventures

a) General information

Name of entity Principal

activities Interest held at 30 June Balance date

2016 2015 Healthshare Limited Provision of

health contracting services

20% 20% 30 June

b) Summary of financial information on joint ventures (100 per cent)

2016 Actual Assets $000's

Liabilities $000's

Equity $000's

Revenues $000's

Profit/ (loss)

$000's Healthshare Limited 14,962 13,688 1,274 11,979 (161)

2015 Actual Healthshare Limited 14,516 13,083 1,433 10,996 614 c) Share of profit of joint venture

2016 Actual $000's

2015 Actual $000's

Share of profit/(loss) before tax (32) 123

Less: tax expense

-

- Share of profit/(loss) after tax (32) 123

d) Investment in joint venture

2016 Actual $000's

2015 Actual $000's

Carrying amount at beginning of year 279

156

Share of total recognised revenue and expenses (32)

123

Carrying amount at end of year 247

279

The equity method is used to account for investments in joint ventures.

e) Share of joint ventures' contingent liabilities and commitments

There are no contingent liabilities and commitments at year end. Bay of Plenty DHB is not jointly or severally liable for the contingent liabilities owing at balance date by the joint venture.


97

14 Employee entitlements

2016 Actual $000's

2015 Actual $000's

Non-current liabilities Liability for long service leave 547 770 Liability for sabbatical leave - - Liability for retirement gratuities - - 547 770 Current liabilities

Liability for long service leave 1,335 1,311 Liability for sabbatical leave - - Liability for retirement gratuities 74 80 Liability for annual leave 22,461 21,649 Liability for sick leave 5 45 Liability for continuing medical education leave 20 20 Salary and wages accrual 4,713 6,910 28,608 30,015 Total 29,155 30,785

2016 Actual $000's

2015 Actual $000's

Balance at 1 July 30,785 29,106 Additional provisions recognised 26,800 27,878

Reductions arising from payments/other sacrifices of future economic benefits (28,430) (26,200)

Balance 30 June 29,155 30,785

Defined Contribution Plan

Bay of Plenty DHB operate a defined contribution retirement plan for all qualifying employees. The assets of the plan are held separately from those of the DHB in funds under the control of trustees. Where employees leave the plan prior to vesting fully in the contributions, the contributions payable by the DHB are reduced by the amount of forfeited contributions.

As at 30 June 2016 there were no contributions that had not been paid over to the plans.


98

15 Trade and other payables

2016 Actual $000's

2015 Actual $000's

Trade payables to non-related parties 8,057

10,402 Trade payables to related parties 118

209

ACC levy payable 852

800 GST and PAYE payable 4,947 5,721 Income in advance for contracts with specific obligations 408 404 Other non-trade payables and accrued expenses 19,565 25,263 33,947 42,799 Payables from Exchange transactions 28,148 36,278 Payables from Non-Exchange transactions 5,799 6,521 33,947 42,799

16 Borrowings

2016 Actual $000's

2015 Actual $000's

Non-current Unsecured loans (National Health Board) 132,700 132,720 Current Unsecured loans (National Health Board) 19,500 19,500

Interest rate summary

2016 Actual $000's

2015 Actual $000's

National Health Board 4.27% 4.27%

Repayable as follows:

2016 Actual $000's

2015 Actual $000's

Within one year 19,500 19,500 One to two years 25,000 - Two to three years 49,200 25,000 Three to four years 40,000 49,220 Four to five years 8,500 40,000 Later than five years 10,000 18,500 152,200 152,220

Term loan facility limits National Health Board:

2016 Actual $000's

2015 Actual $000's

Term loan facility 15,000 15,000 Term loan (payment in month of service) standby facility 12,000 12,000 Term loan (Tauranga campus) standby facility 70,200 70,220 Term loan (Whakatane campus) standby facility 55,000 55,000 152,200 152,220


99

16 Borrowings cont.

Unsecured loans

Bay of Plenty DHB has unsecured loans with the National Health Board.

The details of terms and conditions are as follows:

Security and terms

The term loan is unsecured. Continued use of this facility is subject to normal commercial loan covenants such as interest cover.

The loan facility is provided by the National Health Board, which is part of the Ministry of Health.

The National Health Board’s term liabilities are secured by a negative pledge. Without the National Health Board’s prior written consent Bay of Plenty DHB cannot perform the following actions:

• create any security over its assets except in certain circumstances; • lend money to another person or entity (except in the ordinary course of business and then only on

commercial terms) or give a guarantee; • make a substantial change in the nature or scope of its business as presently conducted or undertake

any business or activity unrelated to health; • dispose of any of its assets except disposals in certain circumstances in the ordinary course of

business; and • provide services to or accept services from a person other than for proper value and reasonable

commercial items.

The covenants have been complied with at all times since the facility was established. The Government of New Zealand does not guarantee term loans.

17 Operating and Capital Commitments

Non-cancellable operating lease rentals are payable as follows:

2016 Actual $000's

2015 Actual $000's

Less than one year 923 1,304 Between one and five years 1,365 1,062 More than five years 67 217 2,355 2,583

Bay of Plenty DHB leases a number of buildings, vehicles and office equipment (mainly photocopiers and computers) under operating leases. The leases typically run for a period of 3 or 5 years (for office space) and 3 years (for vehicles and office equipment), with an option to renew the lease after that date. In the case of leased buildings, lease payments are increased every five years to reflect market rentals. None of the leases includes contingent rentals.

During the year ended 30 June 2016 $2,199,860 was recognised as an expense in the profit or loss in respect of operating leases (2015: $2,045,173).

Bay of Plenty DHB enters into routine non-cancellable contracts for provider based services.


100

17 Operating and Capital Commitments cont.

Capital Commitments are as follows:

2016 Actual $000's

2015 Actual $000's

Less than one year 2,475 1,942 Between one and five years - - More than five years - - 2,475 1,942

18 Financial instruments

Exposure to credit and interest rate arise in the normal course of Bay of Plenty DHB's operations.

Credit risk

Financial instruments, which potentially subject the Bay of Plenty DHB to concentrations of risk, consist principally of cash, short-term deposits, trade and other receivables.

The Bay of Plenty DHB places its cash and short-term deposits with Health Benefits Limited being a counterparty without credit rating.

Concentrations of credit risk from trade and other receivables are limited due to the large number and variety of customers. ACC and the Ministry of Health are the largest debtors (approximately 65%). They are assessed to be low risk and high-quality entities due to their nature as the government funded purchaser of health and disability support services.

The status of trade receivables at the reporting date is as follows:

Trade receivables

2016 Gross Receivable

$000's

2015 Gross Receivable

$000's

2016 Impairment

$000's

2015 Impairment

$000's Not past due - - - - Past due 0-30 days 2,092 5,118 - - Past due 31-120 days 266 723 - - Past due 121-360 days 874 140 (263) (245) Total 3,232 5,981 (263) (245)

In summary, trade receivables are determined to be impaired as follows:

Trade receivables

2016 Actual $000's

2015 Actual $000's

Gross trade receivables 3,232 5,981 Individual impairment (263) (245) Net total trade receivables 2,969 5,736

At the statement of financial position date there were no significant other concentrations of credit risk. The maximum exposure to credit risk is represented by the carrying amount of each financial asset in the statement of financial position.

Not

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l Sta

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Not

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tem

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ear e

nded

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201

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103

18 F

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tal

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ths

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tal

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tes.


104

18 Financial instruments cont.

Interest-bearing loans and borrowings

Fair value is calculated based on expected future principal and interest cash flows.

Trade and other receivables / payables

For receivables / payables with a remaining life of less than one year, the notional amount is deemed to reflect the fair value.

Interest rate risk

Interest rate risk is the risk that the fair value of a financial instrument will fluctuate or, the cash flows from a financial instrument will fluctuate, due to changes in market interest rates.

Bay of Plenty DHB adopts a policy of ensuring that between 40 and 100 per cent of its exposure to changes in interest rates on borrowings is on a fixed rate basis.

Capital management

The Bay of Plenty DHB’s capital is its equity, which comprises Crown equity, reserves and retained earnings. Equity is represented by net assets. The Bay of Plenty DHB manages its revenues, expenses, assets, liabilities and general financial dealings prudently in compliance with the budgetary processes.

The Bay of Plenty DHB’s policy and objectives of managing the equity is to ensure the Bay of Plenty DHB effectively achieves its goals and objectives, whilst maintaining a strong capital base. The Bay of Plenty DHB policies in respect of capital management are reviewed regularly by the governing Board.

There have been no material changes in the Bay of Plenty DHB’s management of capital during the period.

Sensitivity analysis

In managing interest rate risks, Bay of Plenty DHB aims to reduce the impact of short-term fluctuations on Bay of Plenty DHB’s earnings. Over the longer-term, however, permanent changes in interest rates would have an impact on earnings.

At 30 June 2016, there is no interest rate sensitivity as the borrowings are at a fixed interest rate until the maturity of the borrowing(s).


105

19 Related parties

Ownership

Bay of Plenty DHB is a crown entity in terms of the Crown Entities Act 2004, and is owned by the Crown.

Identity of related parties

Bay of Plenty DHB has a related party relationship with its associates, joint ventures and with its board members, directors and executive officers. Related party disclosures have not been made for transactions with related parties that are within a normal supplier or client/recipient relationship on terms and conditions no more or less favourable than those that it is reasonable to expect the Bay of Plenty DHB would have adopted in dealing with the party at arm’s length in the same circumstances.

Further, transactions with other government agencies (for example Government departments and Crown entities) are not disclosed as related party transactions when they are consistent with the normal operating arrangements between government agencies and undertaken on the normal terms and conditions for such transactions.

Bay of Plenty DHB entered into no transactions ($0) with related parties on non-commercial terms, and as a result there are no amounts outstanding or due at balance date.

Remuneration

Total remuneration is included in “Wages and salaries” (see note 4).

2016

Actual

2015 Actual

$000’s $000’s Board members 335 291 Executive team 2,326 1,996 (There are no long term benefits) Loans to board members for the year ended 30 June 2016 amounted to $Nil (2015: $Nil). No interest is payable by the directors (2015: $Nil).

20 Subsequent event

There were no significant events subsequent to balance date.


106

21 Accounting estimates and judgments

Critical accounting judgements in applying Bay of Plenty DHB’s accounting policies

Certain critical accounting judgments in applying Bay of Plenty DHB’s accounting policies include actuarial valuations on employee entitlements, multiple employment contract agreements (MECA) negotiations, depreciation rates and useful life’s applied to property, plant and equipment.

In preparing these financial statements, estimates and assumptions may differ from the subsequent actual results. Estimates and assumptions are continually evaluated, which are based on historical and other factors, including trend analysis, expectations and future events that are reasonable and have a material effect under the circumstances.

Finance and operating leases

The inception of the office space leases of Bay of Plenty DHB took place many years ago. They are combined leases of land and buildings. It is not possible to obtain a reliable estimate of the split of the fair values of the lease interest between land and buildings at inception. Therefore, in determining lease classification Bay of Plenty DHB evaluated whether both parts are clearly operating leases or finance leases. Firstly, land title does not pass. Secondly, because the rent paid to the landlord for the building is increased to market rent at regular intervals, and Bay of Plenty DHB does not participate in the residual value of the building, it is judged that substantially all the risks and rewards of the building are with the landlord. Based on these qualitative factors it is concluded that the leases are operating leases.

Useful lives of property, plant and equipment

The Bay of Plenty DHB reviews the estimated useful lives of property, plant and equipment at the end of each annual reporting period. In addition to this, every three years the land, buildings and infrastructure are re-valued by an independent valuer, estimating the remaining life of these assets thus setting the appropriate annual depreciation to reflect this.

Fair value of land and buildings

Land and buildings are carried at fair value as determined by an independent valuer, which is based on market based evidence. The fair value of buildings is determined based on optimised depreciated replacement cost where a number of assumptions are applied in determining the fair value of land and buildings. Where a revaluation is not undertaken in a financial year, Bay of Plenty DHB undertake an assessment at each financial reporting date to ensure the fair value of property, plant and equipment does not materially differ to the carrying values of those assets.

Estimation of Employee Entitlement Accruals

The liability relating to back pay and long term employee benefits (long service leave, gratuities and sabbatical leave) is based on a number of assumptions in relation to the estimated length of service, the timing of release of the obligation and the rate at which the obligation will be paid to be applied in determining the present value. If any of these factors changed significantly, the actual outcome could be materially different to the estimate provided in the financial statements. The carrying value of the accruals has been disclosed in note 16.

22 Segment

The Bay of Plenty DHB operates in only one business segment, the funding and provision of health and disability services, throughout one geographical region (Bay of Plenty).

Our People for the year ended 30 June 2016


109

Employment Policies and Procedures

The Board has the stated intention of being a good employer. It also has an equal employment opportunities policy and is governed by human rights, health and safety in employment and employment relations legislation.

Human Resources (HR) policies and procedures are reviewed biennially in line with the Bay of Plenty District Health Board’s (DHB) commitment to good employer practices and the Bay of Plenty DHB’s values. Current employment policies include:

• Equal employment opportunity • Occupational health and safety • Recruitment and selection • Discipline and dismissal • Protected disclosures (whistle blowing) • Learning policies • Employee Assistance Programme • Performance development • Leave (annual, sick, tangihanga/bereavement, leave without pay, long service, jury service) • Orientation • Staff presentation • Position descriptions • Identity card standards • Volunteers and work experience • Shared expectations (Code of Conduct).

The Board has adopted a remuneration policy that reflects the need to set a target range for each individual employment agreement position, within the limitations of available funding. The remuneration policy is part of an overall employment relations strategy that includes defining the role of employees, performance development and appropriate reward mechanisms. Students are casual, therefore not staff. We pay above minimum wage.

Of our employees, 95% are covered by collective employment agreements. The majority of these agreements have documented “management of change” provisions, which detail the information to be provided, the communication processes to be used and the level of consultation. The Bay of Plenty DHB has comprehensive Management of Change resournces to ensure good practice is followed.

Staff engagement has continued to be an important strategy in achieving improved patient care, staff safety and delivering services as efficiently as possible.

Bay of Plenty DHB has worn very proudly the status of being a model site in New Zealand for Safe Staffing Healthy Workplace. In particular, the Bay of Plenty DHB has hosted visits from a number of DHBs across the country seeking to better understand our approach to resourcing our services based on patient acuity, and staff capability and competency. Both the areas of visually presenting the patient demand “hospital at a glance” and managing the throughput has been greatly enhanced by whole of hospital teamwork, supported by good systems.

The New Zealand Nurses Organisation (NZNO) Joint Action Group (JAG) with nursing, Association of Senior Medical Staff (ASMS) Joint Consultative Committee with senior doctors, the Public Service Association (PSA) Enterprise Committee (Mental Health Nursing, Clerical and Allied Health) and the Local Resident Medical Officer (RMO) Engagement Group (LERG), form key partnerships with unions in delivering improved levels of staff engagement, as well as taking a joint action approach to support the delivery of improved health services through strengthening clinical governance and decision making processes.


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Employment Policies and Procedures cont.

The Bay of Plenty DHB is the first DHB in New Zealand to appoint a union convenor role. This role is dedicated to enhancing the partnership approach with PSA, the Bay of Plenty DHB is proud to be part of this sector leading initiative.

A pan union forum known as the Bay of Plenty DHB Bipartite Forum enables the gains from the activity of the various union groups to be shared and monitored and the translation of the national Bipartite Action Group initiatives to something beneficial and workable at a local level.

The Staff Service Recognition Programme has grown and developed year by year as an important component of staff recognition. This has now been in place for several years with feedback from staff and other participants has been extremely positive.

The Bay of Plenty DHB has had no substantiated complaints regarding discrimination with respect to recruitment, selection and employment.

The Bay of Plenty DHB is open to applications for flexible work and considers them on a case-by-case basis. Feedback from both the Pulse Engagement Survey and Exit Survey indicate that staff believe the Bay of Plenty DHB has flexible work practices in place and that these meet the requirements of employees.

The Bay of Plenty DHB (along with the rest of the Midland Region) uses Taleo application for recruitment which enables most of the recruitment process to be undertaken on-line. A total of 596 recruitment processes including permanent and casual positions were completed through this process for the 2015/16 year (2014/15: 651). Nursing, the largest part of our workforce, representing 42% of the overall vacancies filled (2014/15: 45%).

From a Health and Safety perspective, the Bay of Plenty DHB has retained its Tertiary status within the ACC Partnership Programme, the highest level possible in this program. The audit report in 2015/16 stated that the Bay of Plenty DHB has not only met all standards within the programme but there is a positive commitment to the management of health and safety by demonstrating the following:

• Development of a Board position statement on health and safety. • Recognition of employee health and safety contribution by the Executive and Board members. • Health Living initiatives. • Extensive injury prevention initiatives coordinated by the Moving, Handling and Restraint

Minimisation Coordinator. • Extensive provision of health and safety training for EHS representatives, including approved worksafe

representative training in line with expectations contained in the Health and Safety Employment Act 1992 (and associated amendments).

• Comprehensive testing of emergency management preparedness. The overall impact of these initiatives and effective claims management has been a continuing drop in the cost of compensation claims, which on average across the last several years is around $297,000 per annum.

Bay of Plenty DHB staff have access to an Employee Assistance Programme (EAP) to assist in resolving work-related or personal issues that are impacting on their ability to work. In 2015/16 248 staff accessed EAP (compared with 205 in 2014/15), with 67% of sessions as primarily being in relation to personal rather than work issues.


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Employment Policies and Procedures cont.

As well as Health & Safety training, the Bay of Plenty DHB providers staff with Healthy Living, Working with Aggression and Restraint Minimisation and Manual Handling training. The latter course has seen a marked decrease in the number of back injuries.

The Bay of Plenty DHB offers a staff influenza vaccination programme. For 2015/16, 67% of staff (2,138 staff members) received vaccination (2014/15: 63%, 2,032 staff members).

The Bay of Plenty DHB provides two on-site staff funded gym facilities (Staff Wellness Exercise and Training - SWEAT), based at Tauranga and Whakatane campus’. SWEAT started as a voluntary staff movement with the simple objective of providing an affordable health and wellness service, at a convenient location, for all Bay of Plenty DHB staff and associated organisations to enjoy. Over a decade later, now managed by Wellness Systems Group Limited, the SWEAT membership of more than 800 have access to state-of-the-art gym equipment, weekly timetabled group fitness classes (virtual and live instruction), and a variety of annual wellness programmes and services.

As a staff initiative there is a measured and positive difference in absenteeism, ACC claims (workplace & out of work injuries) and productivity between the staff who are active members of SWEAT and those that are not.

Employees receive training on cultural issues and the Treaty of Waitangi. A total of 254 staff attended cultural awareness and Treaty of Waitangi trainings in 2015/16 (2014/15: 242). Te Reo classes are also available for Board members and staff. In addition, training is provided for managers and staff on the Human Rights Act 1993, health and disability rights, Shared Expectations (State Services Code of Conduct), and the Bay of Plenty DHB’s employment policies.

Māori make up over 23% of the Bay of Plenty working age population however only 10% of the Bay of Plenty DHB employees. There are a number of strategies in place to grow this segment of the Bay of Plenty DHB employee population.

In 2015/16 54 staff went on paid parental leave (compared to 40 staff in 2014/15). In addition to the government paid parental leave the Bay of Plenty DHB provides between six weeks and 14 weeks paid parental leave to most employees. During the year new legislation was introduced for parental leave including an increase from 14 to 18 weeks paid parental leave which came into effect 1 April 2016.

Staff Engagement and Partnership

The Staff Engagement Leader/Facilitator has continued to facilitate and monitor progress on improvement plans developed by each service in response to feedback from the 2015 Staff Engagement Survey.

Staff sick leave utilisation at has remained materially stable at 3.13%, compared to 3.02% in 2014/15. Turnover has decreased to 7.72 % in 2015/16 compared to 7.81% in 2014/15.

This year 225 staff received staff recognition awards (compared to 223 in 2014/15) and since this programme was launched in 2007 a total of 1,714 staff have received awards.


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Learning Environment

In 2015/16, 1,611 internal training events were offered with 22,034 participants completing training. (2014/15: 1,624 events and 20,701 participants). This figure includes clinical, non-clinical, leadership, fire, health and safety, IT training and mental health.

42.9% of learning was completed online (compared with 38.2% in 2014/15) with 43 on-line learning courses offered through Midland Learning. Midland Learning also includes the Mahara e-Portfolio platform which enables staff to demonstrate professional competency.

Scholarships and Study Funding

Study funding totalling $56,612 was awarded to Bay of Plenty DHB employees during the 2015/16 financial year (2014/15: $69,000).

BOP Learning Scholarships are available to staff through the generous support of businesses sponsoring the funding of the scholarships. In 2015/16 scholarships totalling $30,112 were sponsored by: NZ Institute of Safety Management, Venturo, Pure Print, Accuro, Bay of Plenty Medical Research Trust, Holland Beckett Lawyers, and Interlink Communications Ltd. Learning scholarships were awarded to 15 staff members (compared with 14 awarded in 2014/15). Recipients were from a range of roles and services including Health records, Medical Services, Clinical School, CCYHS, Nutrition Services, Pharmacy, and Anaesthesia and Surgical Services.

Mai I Nga Kuri a Wharei ki Tihirau scholarships were not offered in 2015/16. Instead the funds have been dedicated to developing a Māori Leadership programme – Leading together. This course will link to the document He Pou Oranga Tangata Whenua Determinants of Health.

Three Whakatane staff from IT, Maternity and Clinical School received awards from the Whakatane Staff Study Fund.

In 2015/16 twenty Bay of Plenty DHB employees were reimbursed a portion of their course fees for tertiary study through the Advanced Study Fund (compared to 28 employees in 2014/15). All applicants received 67% reimbursement towards their fees.

Innovation Awards

The Bay of Plenty DHB Innovation Awards were held in October 2015. Twenty applications were received from a variety of services. The eight finalists were from LINC support services, Information Management, Orthopaedics, Western Bay of Plenty PHO, Regional Māori Health Services and Communications, and Service Improvement

First place winner was an entry from the Orthopaedic team: “The pocket travel planner for the ultimate new joint experience”. This teams’ innovation was to provide a detailed handbook of information for patients and their whanau undergoing total hip and knee joint replacement surgery.

Second place and people’s choice winner was an entry entitled “Generation QI: Building tomorrows healthcare innovation and improvement leaders”. The aim of this innovation was to design and pilot a six-month QI residency for House Officers at Tauranga and Whakatane hospitals.

Third place was awarded to the cultural wall at Whakatane Hospital, “In the now is the pathway of all time”.


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Staff Status

Full Time Equivalents 3,187 permanent and temporary staff (2014/15: 3,201)

Average Age Average age is 47.8 years (2014/15: 47 years)

Disability Profile Our proportion of employees who report a disability is 0.1% (2014/15: 0.1%)

Gender Profile Women make up the majority of our workforce with 80.7% female compared with 19.3% male (2014/15: Female 80.6%, Male 19.4%)

The Bay of Plenty DHB recognises and accommodates the workplace needs of staff with stated disabilities. The Bay of Plenty DHB currently employs four disabled people covering a range of different impairments. These staff are provided with the option to park on campus in close proximity to their work area. We also encourage, staff with disabilities to utilise the in-house occupational health service as and when they require assistance. Staff with disabilities that impact on their mobility are identified and a buddy system is set up to assist them in event of emergency evacuation of buildings.

Staff with disabilities provide a valuable insight into the challenges faced by those with disabilities within our communities.

Occupational Group 2015/16 Full Time

2015/16 Part Time

2015/16 Total

2014/15 Full Time

2014/15 Part Time

2014/15 Total

Admin/Management 334 229 563 336 238 574

Allied 307 282 589 329 260 589 Medical 254 110 364 248 109 357 Nursing 271 1,268 1,539 294 1,250 1,544

Support 65 67 132 71 66 137

Total 1,231 1,956 3,187 1,278 1,923 3,201


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Staff Status cont.

Occupational Group 2015/16 Female

2015/16 Male

2014/15 Female

2014/15 Male

Admin/ Management 490 73 491 83

Allied 480 109 489 100 Medical 158 206 147 210 Nursing 1,400 139 1,407 137 Support 44 88 47 90

Total 2,572 615 2,581 620

Staff by Age Band

2015/16 Number of Staff

2014/15 Number of Staff

2015/16 Percentage

of Staff

2014/15 Percentage

of Staff

< 19 Years 2 11 0.06% 0.3%

20 - 29 Years 338 339 10.61% 10.6%

30 - 39 Years 504 506 15.81% 15.8%

40 - 49 Years 775 807 24.32% 25.2% 50 - 59 Years 959 966 30.09% 30.2% 60 - 69 Years 558 528 17.51% 16.5%

> 70 Years 51 44 1.6% 1.4%

Total 3,187 3,201 100.0% 100.0%


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Staff Status cont.

Staff by Ethnicity &

Occupational Group in 2015/16

Admin / Management Allied Medical Nursing Support Total

Asian & Indian 8 8 39 109 6 170 NZ European 339 332 130 830 61 1,712

NZ Māori 72 75 10 156 31 344 Other 20 47 89 67 4 227

Other European 75 100 75 254 24 528 Pacific Island 7 3 4 10 1 25

Unknown 22 24 17 113 5 181

Total 563 589 364 1,539 132 3,187

Staff by Ethnicity & Occupational Group in

2014/15

Admin / Management Allied Medical Nursing Support Total

Asian & Indian 8 7 35 108 4 162 NZ European 371 339 139 821 67 1,737

NZ Māori 71 66 6 145 31 319 Other 27 53 79 78 6 243

Other European 66 93 74 230 19 482 Pacific Island 7 2 3 11 2 25

Unknown 24 29 21 151 8 233

Total 574 589 357 1,544 137 3,201


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Staff Status cont.

Staff by Ethnicity & Occupational Group in

2015/16

Admin / Management

Allied Medical Nursing Support

Asian & Indian 1% 1% 11% 7% 5% NZ European 64% 56% 36% 54% 46%

NZ Māori 13% 13% 3% 10% 23% Other 4% 8% 24% 4% 3%

Other European 13% 17% 21% 17% 18% Pacific Island 1% 1% 1% 1% 1%

Unknown 4% 4% 5% 7% 4% Total

100% 100% 100% 100% 100%

Staff by Ethnicity & Occupational Group

in 2014/15

Admin / Management Allied Medical Nursing Support

Asian & Indian 1% 1% 10% 7% 3% NZ European 65% 58% 39% 53% 49%

NZ Māori 12% 11% 2% 9% 23% Other 5% 9% 22% 5% 4%

Other European 11% 16% 21% 15% 14% Pacific Island 1% 0% 1% 1% 1%

Unknown 4% 5% 6% 10% 6%

Total 100% 100% 100% 100% 100%

60% of the Board Members are female (compared to 56% in 2014/15) and 20% are Māori (compared to 17% in 2014/15). 30% of Managers in the top two tiers of the Bay of Plenty DHB are female (compared to 30% in 2014/15) and 10% are Māori (compared to 10% in 2014/15).


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Termination Payments

Raseon Number Gratuity Redundancy

Redundancy 1 $6,670.50

Redundancy 1 $31,450.50

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $7,101.65

Retire 1 $2,500.00

Retire 1 $2,500.00

Retire 1 $2,000.00

Retire 1 $1,762.79

Retire 1 $2,000.00

Total $41,364.44 $38,121.00 $79,485.44


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Salaries over $100,000

Year ended 30 June 2016 30 June 2015

Salary Bands Medical & Dental Staff Other Total Total

$100,000 - $110,000 31 35 66 64 $110,001 - $120,000 23 25 48 38 $120,001 - $130,000 16 8 24 23 $130,001 - $140,000 9 6 15 14 $140,001 - $150,000 13 4 17 19 $150,001 - $160,000 11 2 13 5 $160,001 - $170,000 10 - 10 10 $170,001 - $180,000 7 2 9 5 $180,001 - $190,000 5 2 7 8 $190,001 - $200,000 6 2 8 11 $200,001 - $210,000 11 - 11 11 $210,001 - $220,000 9 1 10 11 $220,001 - $230,000 7 1 8 6 $230,001 - $240,000 15 - 15 11 $240,001 - $250,000 8 - 8 9 $250,001 - $260,000 9 - 9 13 $260,001 - $270,000 8 1 9 8 $270,001 - $280,000 9 - 9 6 $280,001 - $290,000 5 - 5 3 $290,001 - $300,000 5 - 5 8 $300,001 - $310,000 4 - 4 1 $310,001 - $320,000 2 1 3 3 $320,001 - $330,000 2 - 2 2 $330,001 - $340,000 1 - 1 2 $340,001 - $350,000 2 - 2 1 $350,001 - $360,000 - 1 1 - $360,001 - $370,000 1 - 1 1 $370,001 - $380,000 - - - 2 $380,001 - $390,000 1 - 1 - $390,001 - $400,000 - - - 1 $400,001 - $410,000 - - - - $410,001 - $420,000 - - - - $420,001 - $430,000 1 - 1 - $430,001 - $440,000 1 - 1 - $440,001 - $450,000 - - - - $450,001 - $460,000 1 - 1 1 $460,001 - $470,000 - - - - $470,001 - $480,000 - - - - $480,001 - $490,000 - - - - $490,001 - $500,000 - - - - $500,001 - $510,000 - - - - $510,001 - $520,000 - - - - $520,001 - $530,000 - 1 1 - $530,001 - $540,000 1 - 1 - $540,001 - $550,000 - - - 1 Total over $100,000 234 92 326 298

If the remuneration of part-time employees were grossed up to a full-time equivalent basis, the total number of employees with FTE salaries of $100,000 or more would be 567 (compared to 544 in 2014/15). This comprises of medical staff 404 (compared to 393 in 2014/15), nursing staff 71 (compared to 60 in 2014/15), other clinical staff 32 (compared to 31 in 2014/15), and management 60 (compared to 60 in 2014/15).


119

Directors’ and Officers’ Insurance

Insurance premiums were paid in respect of Board Members’ and certain Officers’ Liability Insurance. The policies do not specify a premium for each individual.

The policy provides cover against costs and expenses involved in defending legal actions and any resulting payments arising from a liability to people or organisations (other than the Bay of Plenty DHB) incurred in their position as Board Members or Officers.

Donations

The Bay of Plenty DHB made no donations during the year 2015/16 (2014/15: Nil).

Board and Committee Report for the year ended 30 June 2016


123

Introduction

The Bay of Plenty District Health Board (DHB) was established pursuant to section 19 of the New Zealand Public Health and Disability Act 2000 (NZPHD).

The Bay of Plenty DHB is a Crown Entity and subject to the provisions of the Crown Entities Act 2004 (CEA), refer to http://www.legislation.govt.nz.

Board

Effective from 1 July 2013 Board Members receive a fee of $22,440 per annum, the Board Chair receives $46,200 per annum and the Deputy Chair receives $28,050 per annum.

Committee Members of the two Statutory Committees (Combined Community & Public Health Advisory and Disability Services Advisory Committee and Bay of Plenty Hospital Advisory Committee) and the Committee of the Board (Audit, Finance & Risk Management Committee) are paid $250 per meeting. The Chair of the Committee receives $312.50 per meeting.

Both Board and Committee Members are reimbursed for reasonable expenses including mileage.

Further details on Board and Committee fees can be found in Cabinet Office circular CO (12)06 Fees Framework for Members Appointed to Bodies in which the Crown has an Interest.

Actual fees paid to Board and Committee Members are listed below (dollars):

Name Board AFRM CPHAC - DSAC

BOPHAC Expenses 2015 Total

Mark ARUNDEL 22,440 2,250 - 1,250 291 26,231

Yvonne BOYES 22,440 - 750 - 1,117 24,307

Geoff ESTERMAN 22,440 - - 1,250 148 23,838

Marion GUY 22,440 - - 1,250 26 23,716

Gail MCINTOSH 22,440 2,000 - - 710 25,150

Matua PARKINSON 22,440 - 1,500 - - 23,940

Anna ROLLESTON 18,700 - - 1,000 83 19,783

Ron SCOTT 28,050 2,500 1,563 - 544 32,657

David STEWART 22,440 3,438 - 1,250 1,796 28,924

Judy TURNER 22,440 - 1,500 - 443 24,383

Sally WEBB 46,200 2,000 750 1,250 8,764 58,964

Total Board Members 272,470 12,188 6,063 7,250 13,922 311,893

Punohu MCCAUSLAND - - 1,250 - 2,750 4,000

Pauline McQuoid - - 1,500 - - 1,500

Lyall THURSTON - - 1,500 - 623 2,123

Sharon MARIU - - 1,000 - 153 1,153

Mary BURDON - - - 1,000 288 1,288

Clyde WADE - - - 1,000 320 1,320

Margaret WILLIAMS - - - - - -

Paul Curry - - 1,000 - 163 1,163

Total All Members 272,470 12,188 12,313 9,250 18,219 324,440

http://www.legislation.govt.nz/


124

Board cont.

Board Member attendance at Board meetings during the 2015/16 year was as follows:

Meetings

Name Scheduled Attended Comments

Mark ARUNDEL 11 11 Yvonne BOYES 11 10 Marion GUY 11 11 Geoff ESTERMAN 11 10 Punohu MCCAUSLAND 11 11 Rūnanga Representative Gail MCINTOSH 11 7 Matua PARKINSON 11 8 Anna ROLLESTON 9 9 Joined the Board September 2016 Ron SCOTT 11 11 Deputy Chair David STEWART 11 8 Judy TURNER 11 11 Sally WEBB 11 11 Board Chair

Combined Community & Public Health and Disability Services Advisory Committee

Committee membership and attendance during the 2015/16 year was as follows:

Meetings


Yvonne BOYES 6 3 Paul CURRY 6 4 Community Representative Pauline MCQUOID 6 6 Community Representative Matua PARKINSON 6 6 Ron SCOTT 6 5 Chair Sally WEBB 6 3 Judy TURNER 6 6 Lyall THURSTON 6 6 Community Representative Sharon MARIU 6 4 Community Representative Margaret WILLIAMS 6 2 Rūnanga Representative Punohu McCausland 6 5 Rūnanga Representative


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Bay of Plenty Hospitals Advisory Committee


Meetings


Mark ARUNDEL 5 4 Chair Geoff ESTERMAN 5 5 Marion GUY 5 5 David STEWART 5 5 Sally WEBB 5 5 Mary BURDON 5 4 Community Representative Clyde WADE 5 4 Community Representative Anna ROLLESTON 4 4 Joined the Committee in September

Audit, Finance & Risk Management Committee


Meetings


Mark ARUNDEL 11 9 Gail MCINTOSH 11 8 Ron SCOTT 11 10 David STEWART 11 11 Chair Sally WEBB 11 8

Internal Controls

To fulfil its responsibilities, management maintains adequate accounting records and has developed and continues to maintain a system of internal controls:

• The Board acknowledge that they are responsible for the systems of internal financial control. • Internal financial controls implemented by management can provide only reasonable and not

absolute assurance against material misstatement or loss. The Audit, Finance & Risk Management Committee has established certain key procedures, which are designed to provide effective internal financial control.

No major breakdowns were identified during the year in the system of internal control.

After reviewing internal financial reports and budgets the Committee Members believe that the Bay of Plenty DHB will continue to be a going concern in the foreseeable future, subject to ongoing support from the Crown. For this reason they continue to adopt the going concern basis in preparing the financial statements.


126

Remuneration Committee

Functions

The Bay of Plenty DHB employs the Chief Executive Officer in accordance with Schedule 3, clause 44 of the NZPHD.

The Remuneration Committee performs the duties of the Board in relation to the employment of the Chief Executive Officer.

Membership

The Committee meets on an as required basis for particular issues.

Committee Members during the 2015/16 year were: • Sally Webb (Board Chair) • Mark Arundel • Yvonne Boyes • Ron Scott • David Stewart

Delegations

The Board has an approved Delegation Policy in accordance with clause 39 Schedule 3 of the NZPHD Act. The NZPHD Act requires (s26(3)) and the policy allows the Board to delegate management matters of the Bay of Plenty DHB to the Chief Executive Officer.

Photos courtesy of Owen Wallace - cover Brian Scantlebury - www.brianscantlebury.com

and Stephen Barker of Barker Photography.

www.bopdhb.govt.nz

Documents

Bay of Plenty District Health Board Annual Report 2016 · Output Classifications ... Combined Community and Public Health and Disability Services Advisory Committee ... The process