Primary Options
What is the Primary Options programme?
Primary Options is a programme to enable community-based treatment of some acute, short term conditions.
Each DHB in New Zealand has been set the challenge of addressing health target areas. One of these targets is reduction of ambulatory sensitive (avoidable) hospital admissions. The Primary Options programme has been set up as a means of addressing this target.
Primary options Programme Northland is overseen by a clinical governance group which has members from both the primary and secondary health sectors across Northland.
Conditions covered by the programme
The following conditions will be the priority of the Primary Options programme in its first phase:
- Cellulitis
- Deep Vein Thrombosis
- Dehydration
- Respiratory: Asthma and some forms of pneumonia
However these are not the only conditions covered by the Primary Options Programme in Northland .
The overarching criteria for a patient to be eligible for Primary Options are:
- That the patient otherwise would be referred to the hospital for management
- That the patients consents to being managed through Primary Options
- That the patient can be safely managed in the community
- That the expected duration of the event is 3-5 days
- That the patient can be managed within a budget of $350 (ultrasound additional)
To be eligible for POPN funding, where patients have the key conditions ( cellulitis, pneumonia, asthma, suspected DVT, and dehydration), they are expected to be managed as much as possible in line with a best practice pathway , acknowledging that clinical judgment remains paramount.
The POPN services that can be funded are:
- GP or Nurse consultations
- Nurse observation
- IV therapy, - either antibiotics or fluid replacement
- Private X-ray or scan
- Rest home stay – short term
- Home support
- Equipment hire services
- Transport support
Conditions not covered by the programme
- Patients with chest pain of cardiac origin should be sent to hospital by ambulance
- People who suffer a stroke
- The older/frail adult with multiple complex needs and medical problems
- People with complex conditions and needs
- People who have had an accident (ACC patients)
- People who are requiring long term palliative or terminal care
- Post Partum women with uterine tenderness and sepsis
- Appendicitis
- People who do not agree to the terms and conditions of the Primary Options programme.
- If there is any doubt contact the co-ordinator on 094381015
How will the Primary Options programme work?
Criteria and guidelines are being developed which will provide a framework for handling straight-forward cases. The referrer will send a referral form plus a photocopied relevant section of the patient’s notes through to the Primary Options Programme. This can be sent electronically or by fax. The referrer will then carry out the interventions outlined in the guidelines and invoice for work completed.
If an external provider is required this can be arranged via the programme coordinator.
It is expected that all of the information required by providers will be accessible online (eg. Manual, forms, guidelines).
The Coordinator for the Primary Options programme is Carolyn Jones, who is based at Manaia Health PHO.
Visits to stakeholders
Currently the Primary Options Programme Coordinator is visiting:
- General Practitioners and practice nurses
- Iwi Providers
- External potential referral agencies
- Relevant secondary care clinicians
The purpose of these visits is to raise awareness about the development of the programme and to identify critical success factors to make the programme work.
Mapping Resources
As part of this process, the options for the design of the services in each PHO area are being explored. Areas requiring investigation are:
- Physical space available at practices for services such as observation
- Skill base of nurses for IV therapy and interest in up-skilling
- Provision of ultrasound and lab services.
If you are a nurse who has a particular interest in participating in this programme please contact the coordinator.
Primary Options Northland Manual can be found below, either left click and open the document or right click and save target as to save to your local computer. The same document is in 3 forms pdf, word 2003, and word 2007.
To find out more about the Primary Options Programme in Northland, contact:
Primary Options Programme Coordinator, Carolyn Jones
Phone: 09 438 1015 – Fax: 09 438 3210 – Email: carolynj@manaiapho.co.nz
Postal: PO Box 1878, Whangarei 0110
