Healthy Ageing - Integrated Support

Canterbury DHB Older People’s Health Services Strategy

2006 - 2010Dr Karleen Edwards

General Manager, Planning & Funding

Recent History of Aged Care Planning in Canterbury

• Strong foundations - Elder Care Canterbury• Devolution of Aged Care Contracts October

2003• NZ Positive Ageing Strategy• Health of Older People Strategy 2002

(Ministry of Health)• Healthy Ageing Integrated Support (CDHB)

Challenges

• Increasing demand to services

• Resources - Population Based Funding Formula (PBFF)

• Workforce

• Changing expectations/models of care

Canterbury’s Aged Population

CDHB Population Projections 2001 - 2021

Canterbury’s Aged Population

• 13% of Canterbury DHB population is aged 65 years and over

• By 2021 this group will represent 20% of our population. Nationally the annual expenditure on health and support services for over 65’s for last year was:

- $2000 per person for 65-69 year olds - $7,800 per person for 80-84 year olds - $12,000 per person for 85 and over

• In Canterbury, this year we will spend $195 million on Aged Care Health Services

Canterbury’s Aged Population cont….

Each Year:• 5% of people over 65 years in Canterbury are in

residential care (Rest Homes, Private Hospitals, Dementia Care) costing $97 million

• 15% of people over 65 years in Canterbury receive Home Support (house cleaning, personal care) costing $22 million

• 20% of people over 65 years in Canterbury receive inpatient hospital services costing $76 million

But Local Context - Population Based Funding (PBF)

Determines our share of health funding basedon:• our population• weightings for unmet need• rural adjuster• overseas visitor adjuster

Tertiary Adjuster• Inter District Flows

Advantages of PBF

Almost all funding at a local level to enable:

• innovative models of care and service delivery• optimising use of resources and future

investment• integration of services and funding• systems approach across services• focus on health outcomes• innovative contracting

Disadvantages of PBF

• Canterbury DHB ‘overfunded’

• Prices paid for inter district flows

• Prioritisation and targeting of resources

• Doesn’t determine the size of the pool - just relative shares

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Older Persons Health Strategy Development Process

• Sector Expert Group

• Older Persons Health Needs Assessment

• National and international research

• Best practice, literature reviews

• Consultation

Underlying Principles

• Older person centred• ‘Ageing in Place’• Preventative• Integrated planning and delivery• Participation and collaboration• Best use of resources• Building capacity• Holistic model focused on wellness• Flexible Funding / Evidenced based

What will we do?

8 Workstreams: • Underpinning foundation issues• Health Promotion• Effective primary health services• Improved coordination• Enhance home and community based services• Improving the Patient Journey through the

hospital• Improving long term services• Palliative and ‘end of life’ care

Aged Care - Safety Nets

1) Helping people stay fit and healthy2) Good primary care and support (catching problems before they worsen)3) A smooth path in, through and out of specialist services4) Slowing the progression of deteriorating health and dependence5) Appropriate ‘end-of-life’ care