The Eastern locality geographical area includes urban areas of Howick, Pakuranga, Dannemora, East Tamaki and Flat Bush and extends to the rural areas of Beachlands, Maraetai, Clevedon, Kawakawa Bay and Orere Point. General practices in the Eastern Locality are part of EastHealth Trust PHO, ProCare PHO and National Hauora Coalition PHO.
An estimated 145,000 people (28.5%) of the Counties Manukau population live within the Eastern Locality (resident population). Just over 112,000 people were enrolled in the primary care practices of the Eastern Locality in April 2015 (24% of the population enrolled in primary care practices in Counties Manukau). The overall locality population is expected to grow up by 50% by 2034.
Demographic trends in the Eastern Locality include:
In the Eastern Locality there is a highly skilled team of health professionals who are well placed to support general practice to optimize the health outcomes of the enrolled population. The team are based at East Health Trust PHO.
The team has a strong focus on self-management for long term conditions which complements the self-management programmes offered by East Health Trust PHO and philosophy of the PHO. An overview of the specific Eastern Locality services includes the following:
A physiotherapist leads the implementation of an evidence based strength and balance retraining programme. This programme targets people age 75 years and older living in the community and at high risk of falls and fall related injuries. The programme has been very well received by patients and general practice alike. We can report significant improvement in strength and balance consistent with the published research.
This programme targets those who are newly diagnosed with osteoarthritis hip and/or knee. Group exercise classes delivered by a physiotherapist are held over 7 weeks with a strong focus on education and self-management. Upon completion of the programme most report they will incorporate a structured exercise programme into their daily life. Our analysis shows significant improvement in the timed up and go, 8 metres walking test and self-reported ADLs, quality of life and pain.
A physiotherapist runs the Joint Replacement Alternative Pathway (JRAP) programme – this is the most recent of the musculoskeletal work underway in Eastern Locality. A multi-disciplinary team coordinated by the physiotherapist works to support individuals to self-manage their osteoarthritis. Programme components include self-management, exercise, medicines review, healthy eating and disease management. Patients enrolled with Eastern Locality general practices who are referred for a hip or knee joint replacement and are declined or elect not to have the surgery are offered the programme. The programme is well integrated with secondary care.
The Eastern Locality Integrated Care Coordinator provides a highly responsive service designed to support people to remain in the community and thereby reduce admissions or readmissions to hospital. The Integrated Care Coordinator provides support, coordination and education directly to the patient and their family as well as to Primary Health, secondary and community care teams. A key role is to provide a rapid response (home visit) for those people the General Practitioner considers to be at risk of hospital admission but for whom timely community responses may prevent an admission.
The Eastern Locality Clinical Advisory Pharmacist works in a wide range of settings – general practices, rest homes as well as virtually, to review medications and provide recommendations to general practitioners. The target group are those on the At Risk Individual programme; those prescribed more than 5 medications; confusion and those with a poor understanding of why they are have been prescribed certain medicines. There is strong evidence for the benefit of clinical medication reviews and the role of a Clinical Advisory Pharmacist.
In the Eastern Locality the multi-disciplinary team includes the Eastern Locality Senior Medical Officer, Nurse Lead, Integrated Care Coordinator, Mental Health & Addictions Coordinator and Clinical Advisory Pharmacist. The team meets every Monday to review people who have been hospitalised and to provide recommendations back to general practice.