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Welcome to the Spring edition of Connect. I would like to take this opportunity to express

my sincere thanks to all staff who have worked so hard to deliver services to an unprecedented number of patients in the last few weeks. We all hope the impending warmer weather will give some well-deserved respite.

For some time now I have talking about the need for some fundamental changes in how we deliver health services to our population in order to cope with the increasing demand from an expanding an aging population. The work done by Dr Gary Jackson has clearly signalled to us that we have no time to waste and that the need for change is being thrust upon us sooner than we initially believed.

How to deal with this change? Well, we cannot keep building new hospitals ad infinitum. So, how can we thrive in this environment – remember we have the population equivalent of Hamilton moving into our DHB area over the few years. We can look towards primary care as the ‘engine room’ of the new health model. We can invest in programmes that keep patients well and keep them in the community. Secondary care should

be focus on that which is truly hospital based. Hospitals are very expensive way of providing community and chronic care.

We need clinicians to lead this change as it is about changing how we work and practice. We need to invest in training and improving capability and to ensure that it is well managed to achieved the best gains are to be made. We need to work much better with our partners, primary care, NGOs and other DHBs. And we need to be bold. The challenge is so significant that we cannot manage by becoming more efficient plus doing some small scale change alone. Indeed this will lead to change for all of us, but by not changing we are running a much greater risk for our staff and patients.

The major strategic projects are linked together as a whole, but are very focussed on delivering changes to key areas.

To ensure “business as usual” is made as safe and as viable ,as possible, we have already set up Middlemore Central to co-ordinate hospital care as effectively as possible. To this we will add a second phase of our programme to improve quality and reduce waste. Last year, through “Thriving in difficult times” we set a target of $10m, but you delivered $22m - this was critical in ensuring finances without cutting jobs or services. This year our aim through “T2” is to save $20m through working smarter. Already senior managers and clinicians have begun to identify the work streams and opportunities. In addition we are identifying the top “wicked issues” which we need to address - changes to the way we work - which will make working easier and better for you and patients. An early focus will be on seeing how we can better design the system for managing emergency surgery.

There will two major projects which will

focus on building the capacity needed to manage patients better and at home so they need hospital care less than in the past. The first is to divide Counties into six specific localities, each with there own particular health needs, we will work through partnerships of primary and secondary clinicians to ensure services are developed to keep people well and at home. The second, is to ensure that over the next two years the equivalent of 20,000 bed days - about 5% of our total, take place in the community, not hospital.

Taken together this whole initiative is called “Achieving a balance”. A balanced health system designed to do the right thing at the right place at the right time in the right way. But also one designed to ensure a balanced working life for staff - where you have the time and the support to practice at your best, with time to spare.

I need you, to be leaders and implementers of change, to fully understand what your part in this will be and how you can contribute to our success in the coming months. A major part will be ensuring we engage you not just in being part of the change, but the people who drive it. I have often said it is those on the frontline who know the answers, and the task of the management team to ensure we find out what they are and empower you to deliver them. The capacity we have built through Ko Awatea will be used to do much of this redesign work. We are not alone in feeling the need to change, but we are in the forefront of in addressing it. It is the start of another chapter in South Auckland’s history of innovation and leadership in health in New Zealand.

I look forward to writing it with you, and thank you in advance for your support and dedication as we move into the next phase of health delivery in South Auckland.

Best wishesGeraint A Martin CEO, CMDHB

From the CEO

September 2011

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CALD – cultural & linguistic diversity Can you greet a patient in Korean? Do you know which languages are covered by our interpreting services? How would you show respect for a young Muslim woman in your care? If someone asked you to “bring a plate” to a function, what would you do?

If you were able to answer the questions above confidently, you are demonstrating “cultural competence” – the ability to recognise, understand, and empathise with a number of different cultural groups in the workplace. And in our multi-cultural environment, that’s an important skill. Communi-cating effectively with your colleagues, providing excellent health care to individuals and families from diverse backgrounds, minimising cross-cultural conflict and improving job satisfaction are all positive outcomes of this competency.

In fact, this competency is vital throughout the health sector in New Zealand, as evidenced by the Health Practitioners Competence Assurance Act 2003 (HPCAA) which requires registration authorities to set standards of clinical competence and cultural competence. The Medical Council NZ, The Royal NZ College of GPs, Nursing Council of

NZ, The Aotearoa NZ Association of Social Workers, and other professional bodies require members to undertake training in cultural competence, and hours can be credited towards your CME (Continu-ing Medical Education).

Learning & Development is pleased to provide all staff with the opportunity to learn more about diver-sity, with a range of modules called CALD. (Cultural And Linguistic Diversity) Most modules are available on-line or Face to Face so you chose which style of learning suits your needs.

Over the next few weeks, we’ll be telling you more about the CMDHB CALD Programme – what you can learn, how it will benefit you, and success stories from across the region.

Frequently Asked QuestionsQ. What can I hope to gain from participating in the CALD Programme?You’ll see many benefits from attending the suite of courses. Here are a few:· An improvement in the quality of the patient/

practitioner relationship· Increased patient safety

· Better compliance with treatment plans and medications

· Fewer misunderstandings between you and your patients

· Reduced health risks due to better understand-ing

· Greater engagement with other staff · Enhanced job satisfaction· Credits towards your CME

Q. How do I enrol?A. The CALD Programme has many components, so it’s important you choose the course or courses that are right for you. Check out the information at the Learning & Development page on SouthNet or talk to your manager about the place to start your journey.

Q. Do I have to participate in the CALD Pro-gramme?A. Your professional body (the Medical Council, the Nursing Council, and so on) and New Zealand leg-islation requires you to be culturally competent, and there are credits linked with all the courses on offer. We strongly encourage you to learn more about the people who are your patients and your colleagues as they represent the most diverse population in New Zealand.

Q. When can I do the courses?A. Many of the courses are already available on the Learning & Development calendar, and you can book through SouthNet. We will also be offering some courses on-line – watch this space!

Mick Hubbard was tragically killed in a car accident on Tuesday 23rd August on his way to work. Mick was Manager of Emergency Response and Security and had worked with CMDHB since 1999. He was an easily recognised member of staff with his ex-police upright bearing as he strode through the campus. For those who worked closely with Mick, they knew that he was a very focussed individual who lived and breathed Emergency Response. He represented CMDHB both locally, regionally and nationally and over the last 4 years became very involved with the Ministry of Health as New Zealand planned and managed SARS and H1N1 outbreaks and was widely respected around New Zealand for his contribution..

He had recently undergone major surgery which would have challenged the most stalwart of people and despite having some later complications, in his own inimitable style, refused to let his illness get the better of him and returned to work earlier than expected as he enjoyed the challenges of his job and the people with whom he worked.

He could be a very determined man, used to get-ting his own way in things in which he strongly be-lieved but was still open to a good lively debate with other experts in the field of emergency response!

He was a good man who enjoyed a good joke and was looking forward to putting his illness behind him and getting on with life. Sadly, this was not to be – he will be sadly missed by his friends and colleagues.

Obituary: Mick HubbardMick’s Final word on RWCWell, as I am sure you all know, it’s the start of the RWC – The Rugby World Cup. Whether you are a fan or not, this event will have some impact on your time between September 9th and October 23rd

There will be a total of 15 games played in Auckland and with visitors from overseas, now thought to number in excess of 95,000, NZ will be a very busy place.

At CMDHB, we have been planning with the Ministry of Health, the two other DHB’s in Auckland and also with Northland for some time now, as to how we will cope with the extra patients that this may mean to us in Health. Regardless of what happens as a result of this high geographical mix of people at games and visiting other activities, such as Pubs and Fan Zones, there will still be normal health related issues which happen day in and day out – heart attacks, broken bones and general illness to mention a few.

We have made plans to have extra staff available both here and on call, in case any of these problems arrive directly on our doorstep. We have spoken to St John, all the Emergency Services, Civil Defence and other health provid-

ers as to how best we deal with these situations. While there is considered to be a very low threat of extreme violence or terror attacks, we have of course, factored this into our planning as well.

If anyone has any specific questions regarding CMDHB’s part in this planning, I am happy for you to e mail Geraldine Cunningham and we will try to answer for you. This of course does not include giving odds on the teams in the final!! Mick HubbardSecurity Manager/Emergency Response Manager

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Dental clinic openingsMajor milestones in children’s oral healthcare have been reached recently, with the opening of two children’s community dental clinics at Shelly Park School and Manurewa Intermediate.

The sun shone as people and students gathered to bless and open the new clinic at Shelly Park School. Principal Brian Rolfe marked the occasion by planting a Lancewood, a native New Zealand tree, outside the clinic’s entrance. He also returned to the ground a sample of soil and leaves that were taken from the land before construction began. This signified the past four years of planning coming together with the present, and the journey yet to come.

The following day the Honourable Peter Dunne, Associate Minister of Health, opened the clinic at Manurewa Intermediate. He commended all involved in the project on their efforts and said he looked forward to better oral health outcomes for children in Manurewa who would benefit from the excellent standard of care the new clinic will provide. The school’s kapa haka group also performed during the opening, delighting the large crowd with their energy and singing.

The new clinics are two of many nationwide which are being reconfigured as part of the Government’s ‘Good Oral Health, For All, For Life’ strategy which is aimed at improving the oral health of every child in New Zealand. In Counties Manukau alone, CMDHB is refurbishing or replacing 18 clinics and introducing a fleet of mobile and transportable dental facilities to take oral health to the community and marae throughout our district. Progress on the next 16 clinics is well underway, with the site for the Botany Downs Children’s Dental Clinic also recently blessed. All 18 clinics will be up and running by July next year.

Top: Peter Dunne opening ManurewaLeft: Manurewa Intermediate kapa haka group performed during the opening.Below left: Brian Rolfe planting the Lancewood. Below: Brian Rolfe with CMDHB Oral Health Programme Man-ager, Christine McKay.

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Dolly Hillman has spent the last few weeks learning how to cook - for the second time.

But this time she’s learnt how to cook meals which are healthy and affordable.

The 52-year-old woman from Mangere has recently finished the new healthy lifestyles course being offered by the Mangere Budgeting Services Trust (MBST) with the support of the Counties Manukau District Health Board (CMDHB). And though she already knew how to cook a range of meals, she says the classes have given her a whole new set of skills and knowledge to use in the kitchen.

“I did know how to cook but I didn’t know how to cook healthy meals. The things I’ve learned here are going to stay with me.”

Dolly has been cooking for years and regularly prepares meals for at least three people, or more

when her grandchildren come to visit. Her family couldn’t understand why she wanted to attend the new classes, which she found out about when seeking budgeting advice from MBST.

But Dolly persevered. She wanted to learn about healthy recipes, how to make her money stretch further and how to read food labels in the supermarket.

“I wanted to know what the big long words they have on the packets in the supermarket mean. I didn’t know how to read labels. But now I go to the supermarket, pick up the packets and look at the back for the contents.”

The classes cover all aspects of meal preparation and planning. Participants get to cook and taste healthy dishes themselves, and also tour a supermarket to learn about reading labels and stretching their food budgets further.

Cooking up a Storm

MBST Healthy Lifestyles Coordinator Julie Ash says many participants are experienced at cooking but still enjoy learning about healthy variations using everyday ingredients such as noodle fritters or potato and corned beef wedge.

Dolly says she’s now cooking without salt, planning her meals and her budget before she goes to the supermarket, and trying the tasty dishes from class at home.

“You can read all the recipes you want but it’s not until you see the dish made in front of you that you realise it does look delicious and tastes delicious too. After doing it here, I had a try making pumpkin soup at home. It was good.

“I do actually go home and try the recipes because I have seen it made and tried it. I want to show off to my family and they love it. They’re quite surprised by what they see!”

Dolly, who has type 2 diabetes and has had health problems which have led to a stay in hospital, is also hoping she can use what she has learnt to improve her health and the health of her family.

“I’m learning to cook healthy for my grandchildren. I want to be there as they grow up and be able to teach them things. Teach them not to be unhealthy, the way I’ve been eating most of my life.

“What’s happened here is going to be embedded in my memory. It might not be much to some other people but it’s a lot to me.”

The healthy lifestyles courses are offered by MBST and supported by CMDHB’s Creating a Better Future strategy. Creating a Better Future promotes healthy eating, physical activity, being smokefree and the safe use of alcohol in order to prevent or delay the onset of diabetes, cardiovascular disease, chronic respiratory diseases and many cancers in our community. For more information visit www.betterfuture.co.nz

Each course consists of eight classes, run over four weeks. To register, call (09) 275 2266.

Dine and DanceSpring

TelstraClear Pacific Events Centre in the Wolfe Fisher Arena

Pre Dinner Drinks: 7:00Dinner: 7:30Dance: 8:30 - 12:00Band: Union

Dress: FormalFree Soft DrinksCash BarFree Parking

Tickets $40 per personAvailable from the reception desks at MSC, DHB, Middlemore Central, Car Pool Office and Executive Management Level 5 Galbraith Block

November 26th 2011 Val McCulloughClinical Governance Executive OfficerRoom 308 Staff Support BuildingMiddlemore HospitalPhone (09) 276 0044 Ext 2822

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Healthy Lungs Study“We have been watched enough, please do something” (quote from Maori parent whilst consenting to be part of the respiratory study that led to Healthy lungs).

Admission rates to hospital for lower respiratory infection (LRI) in children under one in CMDHB are extremely high, with poverty being a key driver.

Supported by a project grant from the Health Research Council the Healthy Lungs Study is a collaboration between primary care, community services and secondary and tertiary services. Leading the study is Dr Adrian Trenholme, Paediatrician at Kidz First and Dr Cass Byrnes, Paediatric Respiratory Specialist, Starship.

The study aim is to reduce respiratory morbidity

in South Auckland children by adapting the Cystic Fibrosis model of care following hospital admission with LRI under the age of two years to determine if this decreases the presence of Chronic Suppurative Lung Disease at age two-four years.

The study is a 24 month randomised control trial enrolling 400 children under two admitted to hospital with severe LRI to either an ‘intervention’ or ‘control’ group. All children will receive initial and final outcome assessments.

The cystic fibrosis model advocates regular review for deviation from normal health and early treatment/preventative care with a focus on respiratory health. The intervention group will attend one of three community respiratory clinics every three months,

SUPPORTING OUR TEAMS

We are extremely pleased to have received funding from Counties Manukau District Health Board to deliver a Healthy Lifestyles Programme, which delivers cooking demonstrations, offers advice on good nutrition and also supermarket tours, where individuals and families learn how to shop smarter, buy healthier food and make the dollars stretch further; thereby Creating Better Futures.

“A large number of people simply don’t know how to cook, bottom line. They certainly don’t know how to cook on a budget and putting good healthy and nutritious food on the table is often out of the reach of many families” says Darryl Evans, Chief Executive of Budgeting & Family Support Services, Mangere. “But people do want to come and learn. They want to acquire the skills needed to self-manage and provide better futures for their children”.

The goal of the Healthy Lifestyles Programme is that families learn to live healthier lives and also go on to teach their children how to make better choices regarding what it is they buy from the supermarket and how to make tasty and affordable meals.

We teach people how to look for bargains in the supermarket. How to make healthier choices when buying food and how to plan your meals for the week ahead. Shopping smarter teaches people how to make wiser choices and stretch each dollar further. We also teach people how to read food labels, so you know what you’re buying, what salt content or fat content is in each item you purchase.

What we do know is that many families currently struggle with the ever-rising cost of living as and putting healthy food on the table can be extremely expensive. What we are hoping

to show people is that it doesn’t have to be too expensive if you plan your meals, take time when shopping, make healthier decisions around what you eat and put into practice everything you learn from our Healthy Lifestyles Coordinator and Nutritionist, Julie Ash. Healthy living can be affordable!

Healthy Lifestyles Programme

staffed by a research study GP/Nurse Practitioner, study clinic nurse and community health worker. Children with ongoing respiratory problems will be referred to secondary or tertiary care for further management as needed.

The control group will receive ‘usual’ care i.e. GP review for family directed health concerns.

Kirstin Davey and Jo Smith are two of the Kidz First Research Nurses who are recruiting patients, Kirstin comments “I am very excited to be part of the study team as we feel it may make a change for the health of our children in the community”. “We are really pleased to be involved in collaborative and innovative research to improve child health in South Auckland.” Says Jo.

Lyndsay Le Comte,

Healthy Lungs Project Manager, CCRep

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THE RECENT media frenzy about the undiscovered death of an elderly Wellington man may come as no surprise to those who work in aged care.

Sadly the media spotlight is seldom cast upon the needs of those who have completed their working years unless something goes horribly wrong.

Similarly, few in the community are prepared to toss a coin in a collection bucket to support older citizens.

When it comes to getting donations out of deep pockets – kids, kittens and cancer have the Midas touch.

However, Buddhist Compassion Tzu Chi Foundation is dedicated to helping older people as well as relieving the suffering of people struck down by disasters and hardship.

A few months ago charge nurse manager Vicki Rawiri met with Tzu Chi members and discussed the current needs of Assessment, Treatment and Rehabilitation (A, T and R) wards where elderly patients are cared for following strokes or falls.

There was hot demand for quality wheelchairs that improve mobility, independence and

GO TEAM: Buddhist Compassion Relief Tzu Chi Foundation members surround Vicki Rawiri with their gifts to A, T and R.

Compassion & caring for seniors

TOUGH economic times continue to push many companies to cut expenditure in order to remain profitable and as a result the charity sector is also feeling the pinch.

However, Visy New Zealand has challenged staff to adopt a philanthropic culture – giving all employ-ees ownership of fundraising ventures.

The packaging and recycling company went to

the staff and asked them what important cause did they want to support?

Children’s health came out tops and it seemed fitting to build a relationship with Kidz First Children’s Hospital, which is in the heart of Visy’s Auckland-based plants.

Looking for a win-win plan that benefitted staff and Kidz First a biggest loser programme was launched.

Employees could improve their health, gain support from workmates, have some fun and raise money with sponsorship.

Sandy Davie from Visy Packaging – Fibre Board at Wiri jumped into the support role training shoes and all.

Sandy helped fellow workers with their nutrition, encouraged them to pound the pavements in preparation for Round the Bays and kept a discreet tally of weekly weight loss.

Fifty-five employees joined the campaign and as the kilos dropped off the dollars rolled in.

One staff member at Visy Glama raised a phe-nomenal $1,300.

The winners of the greatest percentage of weight loss were awarded Westfield shopping centre vouchers, which some donated to Kidz First to purchase toys.

At the shopping spree Westfield Manukau kindly added to the donation, as did Farmers Manukau.

New corporate package

SHOPPING SPREE: Buying toys for Kidz First Children’s Hospital. From left, Sandy Davie and Justin Thompson (Visy), Monique Matthews (Westfield Manukau), Michelle Kidd (South Auckland Health Foundation) and Meredith Graham (Visy).

ON BOARD: Michelle Kidd (left) from South Auckland Health Foundation was thrilled to receive a donation from Kate An-gus and Andrew Gleason general manager Visy New Zealand.

rehabilitation so Tzu Chi did their research and donated wheelchairs and blankets to A, T and R at Middlemore Hospital.

The blankets are made from recycled plastic bottles and the donation was a kind hearted way for Tzu Chi to spread their warmth.

Patients were treated to a chat with Tzu Chi members and some had the opportunity to test

drive the new wheelchairs.Tzu Chi has worked with South Auckland Health

Foundation for more than a decade.As well as supporting Middlemore they give

their time to elderly people in the community, have established a Chinese school in East Tamaki, engage in environmental projects and have donated almost 7000 blankets to earthquake relief in Christchurch.

Visy was established in Australia and the company’s philanthropic culture is endorsed by the Pratt Foundation.

The money raised by staff was matched dollar for dollar by the Pratt Foundation – resulting in a generous $13, 449 donation to Kidz First.

Thanks to the Visy team there will soon be a spirometer for Kidz First intensive care and a new ECG machine for rheumatic fever and paediatric cardiology clinics.

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LIFE actually is all fun and games for some of New Zealand’s most talented sportspeople and fortunately many superstars will happily share their stardom for good causes.

It’s not unusual for a bus load of Vodafone Warriors to arrive at the doors of Kidz First Children’s Hospital armed with souvenirs and smiles.

The lads have also been known to test their trivia brain power joining CMDHB staff and supporters in a fundraising quiz night.

There are also plenty of smiles when the Blues pop into the intensive care unit to cheer up a fellow rugby player who’s coping with a serious injury.

And, the captain’s run at Eden Park is always a treat for youngsters who may face chronic health conditions or teenagers who have few positive influences in their lives.

Auckland Rugby has been well represented by Joe Rokocoko who is always a welcome visitor at Kidz First and Middlemore Hospital.

Joe has even been known to pick up knitting needles – all for a good cause.

As an ambassador for South Auckland Health Foundation the humble rugby star will be greatly missed by the Foundation team when he heads to France after the Rugby World Cup.

Then there is cruiserweight boxer Shane Cameron who is always willing to down his gloves to visit CMDHB facilities.

The staff and patients at Auckland Spinal Rehabilitation Unit were stoked to hang out with the Mountain Warrior when he took time out of his training schedule to share a few boxing tips.

Sport may not be what’s hot for everyone but it is hard to deny the passion for hard fought games in the South Auckland community.

The sports stars inspire youngsters to reach their dreams and make a difference to patients when they need it the most.

Below left: Mountain Warrior Shane Cameron takes time out to chat with a patient at Auckland Spinal Rehabilitation Unit.Right: Joe Rokocoko learns some knitting skills for a good cause.

Good sports

HERO: Ali William makes the day for a couple of young fans at a Blues’ captain’s run.

DOLLARS: Vodafone Warriors quiz night was a fun fundraiser for Kidz First.

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After-hours healthcare

Accident and medical clinics in the after hours networkSuburb A&M clinic Phone Opening hours

SOUTH and EAST

Pukekohe Pukekohe Family Healthcare, 10 West Street. Ph 237 0280 Closes 10pm

Takanini/Papakura Takanini Care, 106 Great South Road. Ph 299 7670 Closes 10pm

Otara East Tamaki Healthcare (Bairds Road), 160 Bairds Road Ph 274 3414 Closes 11pm

Otahuhu Whitecross Otahuhu, 15-23 Station Road Ph 0800 611 111 Closes 10pm

Botany East Care, 260 Botany Road Ph 277 1516 24 Hours

WEST

Henderson Westcare Whitecross Henderson, 131 Lincoln Road Ph 0800 611 111 24 Hours

New Lynn Westcare Whitecross New Lynn, 2140 Great North Road Ph 0800 611 111 Closes 10pm

CENTRAL

Remuera Whitecross Ascot, 90 Greenlane Road East Ph 0800 611 111 24 Hours

Three Kings Accident and Medical Centre Three Kings Plaza, 536 Mt Albert Road Ph 625 2999 Closes 10pm

NORTH

Takapuna Shorecare, Ground Floor, Sovereign House, Smales Farm Ph 486 7777 24 Hours

Glenfield Whitecross Glenfield, 436-440 Glenfield Road Ph 0800 611 111 Closes 10pm

Note: In rural areas, such as Kumeu, Waiheke, Warkworth and Wellsford a 24 hour on call service is provided. If medical care is required after hours in these areas, patients should ring the local GP practice to access these services.

more accessible and affordable health care after hours in AucklandThe three District Health Boards across Auckland announced a landmark change for those needing urgent health care after hours.

Aucklanders will now be able to access a network of Accident and Medical (A&M) clinics that will be open in evenings, weekends and public holidays until at least 10pm.

Four clinics will be operating overnight covering North, West, South and East Auckland. Many will also have better access to health advice over the phone after hours. For those who need it most, their care will now be more affordable.

The initiative was developed through a taskforce representing the three Auckland DHBs, the region’s Primary Health Care Organisations, and Auckland’s A&M clinics, which came together to address inconsistencies in opening hours and costs, as well as reduce the pressures on public hospital emergency departments.

Counties Manukau DHB CEO Geraint Martin, on behalf of the three DHBs, says “These clinics will offer reduced charges for patients who have traditionally used hospital emergency

departments as their after hours solution because of cost. This, along with the telephone advice, will help stem the growth of patients visiting the hospital emergency departments who could be cared for equally as well or better in the community. This is particularly the case for patients on low incomes.”

Nearly half of Auckland’s population will get access to these reduced charges. This group includes:•undersixyearolds,•those65andover,•communityservicescardholders•highuserhealthcardholders,•thosewholiveinalowincomearea.

For example, in Henderson, under 6 year olds are usually being charged $31 and up to $36 on a public holiday and this will now be free after hours. Seven of the 11 clinics will see under six year olds for free.

“All hospitals in the region have been hit hard with high numbers of ED patients this winter, and only recently Middlemore Hospital saw a record-breaking 356 patients in its ED in a single day. More telephone advice and affordable after hours care at A&M clinics will address the growth of people going to hospital emergency departments. It will also ensure that people are aware, that

even in the middle of the night, they can get expert advice and go to an A&M,” said Mr Martin.

The three DHBs have committed $7.5 million to the project, while the region’s PHOs and A&Ms have invested $1.7 million to the project.

“This project is a positive new way of working across the region, with DHBs, PHOs and the primary care sector all coming together to make this initiative a reality.” said Mr Martin.

Chair of the Taskforce, Dr Ian Scott says, “During normal working hours people should contact their doctor. However, now, if you need medical attention after hours your first port-of-call should be to phone your regular doctor who will be able to provide advice and may direct you to your closest network A&M. As part of the initiative many of the doctors are operating an after hours telephone service that will be staffed by registered nurses.”

Patients going through an after hours A&M clinic can also expect to be seen sooner than those attending a hospital emergency department. For parents this is great news, as they will now have confidence that in the rare event they need medical treatment after hours, they can take their under 6 year old to a local A&M clinic and be seen sooner than at an ED and, in many cases, for free.

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Matatika Koiora

Matatika means to be right, straight, ethical, fair, equitable, honest, impartial, unbiased or upright.

Koiora is an expression referring to wellbeing and life. It draws upon a lament from the second Maori King, Kiingi Taawhio about the Waikato River – “Tooku awa koiora me oona pikonga he kura tangihia o te maataamuri” – “The river of life, each curve more beautiful than the last”.

The Waikato River and Tainui are inextricably linked physically, emotionally and spiritually – in our words they are one with each other. This is why it is such a privilege to have this name for the Middlemore Tissue Bank.

Matatika Koiora is also used to describe bioethics - the study of issues arising from advances in the biological (including medical) sciences.

Poukai

Poukai is an annual series of visits by the Maaori King to Kiingitanga marae around and beyond the Waikato region, a tradition that dates back to the 19th century.

Middlemore Tissue Bank presented to Maaori KingAt the Whatapaka Poukai held on August 31st at the Whatapaka Marae in Karaka, South Auckland Dr Stuart Ryan (CCRep General Manager) and Dr Samar Issa (Founding Clinical Director) presented the Middlemore Tissue Bank/Matatika Koiora – to the Maaori King, Kingi Tuheitia.

Kaumaatua from CMDHB, Matua Te Hira and Matua Whitiora Cooper, supported the presentations along with members of the Middlemore Tissue Bank Governance Committee, including Sir Bruce Slane (Chair), Gillian Cossey (CMDHB) and Pru Etcheverry (Leukaemia and Blood Foundation).

Attending the Whatapaka Poukai was an important step in the journey towards partnership between Maaori and Matatika Koiora as the Tissue Bank endeavours to grow its collection of Maaori patients’ tumour samples. By strengthening this partnership it is hoped that we can establish a centre for Maaori tumour tissue research based at Middlemore Hospital. Such a centre could attract researchers to work with the samples to improve our understanding of cancer in both Maaori and non-Maaori. And it will encourage collaborative projects with international researchers and contribute to the development of new diagnostics and treatments. That’s why we worked hard to establish Matatika Koiora to become a regional collection of human tumour-related biospecimens for research.

Representatives of the Middlemore Tissue Bank at the Whatapaka Poukai. L-R Daphne Mason (Curator), Matua Te Hira (Kaumatua), Sir Bruce Slane (Chair – Governance Committee), Gillian Cossey (Governance Committee), Pru Etcheverry (Governance Committee), Dr Samar Issa (Clinical Director).

Dr Samar Issa addresses the Maaori King, Kingi Tuheitia, at the Whatapaka Poukai in Karaka, South Auckland.

Our aim is for Matatika Koiora to become a truly regional resource maximising the potential for research outcomes, academic publications and discoveries which will improve the health and well being of our diverse and unique people.

The Middlemore Tissue Bank/Matatika Koiora continues to grow its collection. As at September 6, 2011, there are 1450 samples from 85 donors stored in the tissue bank facility at Middlemore Hospital.

Matua Te Hira introduces Dr Stuart Ryan and Dr Samar Issa to Kingi Tuheitia.

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Buying “small clothes in normal shops” has never been as satisfying as it is for Richard Cooper.

The 48-year-old Manukau resident and CMDHB staff member has recently had bariatric surgery in which a sleeve was fitted to his stomach. Combined with the weight loss he achieved himself prior to the operation, he has shed almost 70 kilograms from his 188kg frame.

It is a result he is celebrating by buying new clothes, which regularly need to be replaced to keep up with his rapid weight loss and ever-decreasing figure.

“It’s like a reward when you buy clothes and give all your old clothes away to friends. Instead of spending money on food, I now spend it on clothes and I really enjoy that, especially being able to shop in The Warehouse or a normal store where they have jeans on the shelf I can fit.

“But I can’t buy too many at one time because in just a short time, they’re too big again,” he adds.

Richard is a Self Management Education Facili-tator and Master Trainer with CMDHB. Five years ago he weighed 188kg and was the only one of his 10 siblings to be diagnosed with type 2 diabetes. Support from friends and getting a job with CMDHB encouraged him to make some changes and start working towards a healthier lifestyle.

“When I started working at CMDHB, I felt that if this is what I was going to be doing, I needed to walk the talk. That helped motivate me to self manage a lot better.”

Over the past five years, Richard has lost 38kg by making changes to his lifestyle, such as doing regular exercise sessions at the gym. He swapped dark blue milk to light blue, butter to cholesterol-free spread and white bread to wholegrain bread. He started drinking only diet fizzy drinks and stopped eating pies.

A new lease on life

“They were huge changes. I just loved my fizzy drink and I was eating heaps of pies. They were only $1 each so I could eat four to six a day.”

Then, following discussions with his doctor, he had bariatric surgery funded through CMDHB in June this year. He says it was a challenge which required spiritual, mental and physical preparation. He lost a further 8kg through a prescribed diet in the weeks leading up to the operation, bringing his weight down to 142kg.

Less than two months on, Richard now weighs 122kg.

“They reckon I’m going to keep going down for the next five to six months to 90kg or 100kg. I’m just hoping for 110kg. Even talking about that is

strange as it wasn’t even possible in my dreams before.”

Richard is still recovering from the surgery but is continuing with sessions at the gym and adjusting to his significantly smaller appetite. One scrambled egg fills him up and his mind boggles when he remembers how much he used to eat.

As well as being able to buy smaller clothes, the biggest satisfaction for Richard is that his diabetes is now under control. Before the operation he was taking 16 tablets every day for his condition. Now he is pill-free.

“I still have to manage my health by eating well and being active but I’ve started fresh. It feels really worthwhile and I have a new lease on life.”

Steve Colling R/N was seconded to Whirinaki (CAMHS) to join a small team of clinicians form a new service; Assertive Outreach for Youth.

They have succeeded in doing so and are doing wonderful work with difficult to engage young people and their Whanau or those whose needs are complex. They operate a capped caseload so they can engage assertively, with fidelity to the Assertive Outreach Model, and spend quality time engaging, assessing and treating young people in need.

Steve’s time for this secondment is almost up he thought more people should know about the team.

Staff are sought, too, as Steve will be going back to his original place of work.

Assertive Outreach for Youth

The assertive outreach team: Annie, Steve, Avril, Malakai, Nerissa and Laura.

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In New Zealand, as in many other countries, voluntary organisations and NGOs are providing effective mental health services. People working with Non Government Organisations (NGOs) like Community Support Workers and Community Living Services often have more time than doctors and nurses do to talk with people. Support workers have the flexibility to develop the kind of relationships that people really need – and that is often what makes the difference to people’s lives. This role will become increasingly vital as New Zealand’s approach to mental health evolves..

Listed below is a selection of NGO and voluntary services working actively in South Auckland area:

Affinity Services is a Community Based Mental Health NGO providing a suite of recovery focused services (mobile & residential) to people experiencing mental illness Phone (09) 262 1384 or (09) 261 3700 Fax (09) 263 1300 http://www.affinityservices.co.nz stephanie.abrahams@affinityservices.co.nz

Challenge Trust is a client focused and recovery oriented organisation, which is underpinned by a recovery and rehabilitation philosophy and model of service delivery. Phone (09) 265 0255 Fax (09) 265 2740http://www.challenge.co.nz, office@challenge.co.nz

Pathways Phone (09) 261 3401 Fax (09) 263 9389 http://www.pathways.co.nz, contactus@pathways.co.nz

Mahi Tahi Trust services consist of suitable housing needs, service provider needs, support needs, solution to needs of the client. Phone (09) 2765221, Fax 092765225

Te Whare Toi Aroha - Clinical Day Programme: Pathways established the Clinical Day Programme in Manukau City in partnership with the Counties Manukau District Health Board, Phone (09) 277 9263 Fax (09) 277 9264

Our community resources Frame work trust Community Living

Service and Community Support Service is a specialist mental health service within Framework - is responsible for engaging and supporting clients with a mental illness, and who have high and complex needs.... Phone (09) 299 2671 Fax (09) 299 2673 http://www.framework.org.nz, toni.ann.matara@framework.org.nz

Workwise Employment Agency supports people with experience of mental illness to choose, get, and keep jobs. They help people to secure real work, with real pay by encouraging job seekers to take responsibility if their own. Phone (09) 261 3402 Fax (09) 263 9369 http://www.workwise.org.nz, sofi.waith@workwise.org.nz

Framework Personal Focus Service is a mental health service that delivers social and recreational programmes based on a strengths-based model. Phone (09) 299 2671 Fax (09) 299 2673 personal.focus@framework.org.nz

APET provides employment training opportunity, help develop skills and positive values.Phone. 092781678. www.apet.org.nz

Raukura Hauora O Tainui is a non-profit Iwi (tribally) based organisation offering a range of cost effective Health Services to all people, including smoking cessation, D & A service etc Phone (09) 263 8040 Fax (09) 263 6631 http://www.raukura.org.nz, enquiries@raukura.com

Challenge Trust Residential Rehabilitation Service provides a real home real education and real work to make change in client’s conditions. Phone 09/2650255/ Fax-09/2652740

Christina Rest Home is a 21 bed rest home providing long and short term care, with respite care available depending on vacancies. They provide a quality, homely environment. Phone (09) 276 5640 or (021) 942 171 Fax (09) 270 0650

Priya Shahi, New Graduate Registered Nurse, Kuaka ward, Tiahomai

Career planning is now essential for anyone who wishes to apply for Health Workforce NZ (formerly CTA) funding to support their postgraduate education.

A good career plan includes both a career goal, and steps to reach it. At the same time it must be flexible enough to enable people to benefit from new opportunities.

A career plan process typically includes self assessment and career research. To make

things easy for you, CMDHB Learning and Development has developed an on-line career centre. The Counties CAREERCentre will take you through the complete career planning process and give you a one page career plan upon completion. Follow-up workshops are also available Wednesday 28 September 18.00 to 20.00 and Thursday 13 October 13.30 to 15.30.

“It really highlighted to me areas of strength

and areas for development. The reports that are produced are tangible discussion points for performance review.”

This feedback is typical of comments staff have made about the Counties CAREERCentre.

To enrol go to http://southnet/careerdevelopment/CountiesCAREERCentreLoginRequest.htm or contact Joanna Budai, Career Development Consultant at budaij@middlemore.co.nz

Career planning for you

Kuaka ward, with charge nurse Russel Murphy, RN Chummie Thompson, RN Priya Shahi, Kaumatua Joe, Ruby Martin, Cultural support group and clients.

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The Home Health Care Team along with the Awhina tia and the Public Health Nurses from the Great South Road Base in Papakura held a Mad Hatters tea Party of their own, was a great opportunity for a bit of creative expression, Whakawhanaungatanga, kai, a chat and a little bit of a laugh! Our managers wore matching Potae (Hats) hope you enjoy the photos.