PMAANZ e-Matters Newsletter

Sent: Mar 1, 2024, 4:31 PM

A word from our Secretary | Carol Neki

Kia ora koutou katoa,

Time is flying by as we find ourselves already two months into the new year. Many of you will be gearing up to prepare financial reports for your accountants, and I wish you all the best of luck with that endeavour!

In this March Newsletter, our Chair will provide insights into the meetings she has attended and the advocacy efforts she has undertaken on behalf of our PMAANZ members. While advocacy isn't the main focus of PMAANZ, we must share our members' thoughts, values, concerns, and frustrations to keep the health industries accountable.

Jess from Collaborative Aotearoa will be sharing resourceful tips on how to run financially sustainable practices, which can be invaluable for our members. Fiona from MAS will also remind us of our obligations when implementing the 90-day trial in our agreements, ensuring that we stay compliant and fair in our employment practices.

If you still need to register, a few spots remain at our upcoming Roadshow. And for those who have registered for the Tāmaki Makaurau session, I look forward to seeing you there!

Karen will discuss the success of our PMAANZ messenger page as a resourceful tool for day-to-day communication among our members. Seeing how technology can enhance our connectivity and support network is fantastic.

Lastly, Wendy, our treasurer, is diligently reviewing our Biennial Survey, which will soon be distributed to all of you. Your feedback is invaluable in guiding the direction of our organisation, so please take the time to share your thoughts and insights.

We'll wrap up this month's newsletter with Mary's Netflix/book reviews, providing some leisurely content to enjoy outside your professional endeavours.

Until next time, take care and stay connected.

Ngā mihi

Carol Neki | PMAANZ Executive National Secretary

A word from our Chair | Mary Morrissey

Kia ora koutou katoa.

Happy New Year to all our valued members! I hope you had a chance to take a well-deserved break and enjoy quality time with your whānau and friends.

Even though my work break was brief, I managed to step away from the usual hustle and bustle of meetings. It was refreshing to recharge and gain new perspectives. Now, as we dive back into action, I'm thrilled to share some of the recent meetings I have attended, either virtual or F2F:

Primary Care Sector Engagement Group
General Practice New Zealand - GPNZ
General Practice Leaders Forum - GPLF
Royal Commission of Inquiry into COVID-19 Lessons Learned
Collaborative Aotearoa
ACC Nymbl meeting
Data & Digital working group

In the realm of healthcare, the pressing issue at the forefront of our minds during numerous meetings is none other than General Practice Sustainability—or, as I personally term it, General Practice Survivability. GPNZ and GPLF meticulously compiled BIM papers (Briefings for the incoming Minister) that delved into the intricacies of this crisis. These crucial documents were dispatched to Minister Reti in late 2023. Witnessing a united front advocating for change with the current Government is heartening.

Last year, GPNZ took a proactive step by commissioning a study on this topic and enlisting Sapere's expertise. Their findings were discussed during a working group session just before the holiday season, where we prioritized the challenges and brainstormed potential solutions. The key and interdependent themes were funding, complexity, models of care, rural workforce, integration, and primary care development. In January, the paper, 'Securing Sustainable General Practice in Aotearoa,' was formally presented to the Minister. Encouragingly, he has already engaged with its content, discussing it on RNZ and with Mike Hosking.

However, we must remain pragmatic. Relying solely on increased funding in the near future might not be a viable strategy. Instead, we need to explore ways to maximize our income streams. Here are some actionable steps:

Review Your Practice Management System (PMS):

Ensure that all services rendered have been accurately charged or claimed for. Attention to detail here can significantly impact revenue.

Explore Additional Funding Options:

Investigate avenues such as ACC, Primary Options, and flexible funding provided by your Primary Health Organizations (PHOs).

Consider Innovative Approaches:

Some practices have successfully integrated paramedics and physician assistants into their teams. These additions not only alleviate workload but also enhance patient services.

We all must try to find innovative solutions that benefit our practices and patients. Let's continue exploring new approaches as we adapt to the ever-evolving landscape of healthcare.

On a more personal note, it's been delightful to hear and see the Americana presence in New Plymouth this weekend. The rumble of engines as they cruised around the coast and through the towns of Taranaki was quite invigorating. From classic beauties to roaring roadsters, these vehicles evoke a sense of nostalgia and freedom. Whether it's the sleek lines of a vintage car or the throaty growl of a muscle machine, each passing Americana gem adds a touch of excitement to the streets.

Here's to the joy of witnessing these rolling pieces of history—may they continue to bring smiles and memories to all who encounter them!

Main St New Plymouth

My new car

Our American diner

Ngā mihi

Mary Morrissey

MAS Health Practice | 90 day trials

All employers can now include a 90-day trial period clause for new employees. The change was passed by Parliament on December 23, 2023. The trial period is for up to 90 calendar days.

There are still criteria for the trial period to be valid.

A trial period may be used for new employees only, meaning employees who have not previously been employed by you.
A new employee is not automatically subject to a trial period. A trial period should be discussed during the recruitment process and must be agreed in writing. A clause must be included in the employee's individual employment agreement (IEA) and in the letter of offer.
If you want to employ a new employee on a trial period where a collective agreement (between a union and multiple employees) is in place, you will need to agree this with the employee separately in writing, in the letter of offer. This needs to be done even if a trial period is included in the collective agreement. You will also need to make sure that if you agree to a trial period, your agreement is not inconsistent with any of the terms of the collective employment agreement.
The IEA containing the trial period must be signed by the employee before the employee commences work.
If you decide to terminate an employee's employment under a trial period clause, notice of termination must be given within the trial period (which can be up to 90 days). However, the notice period itself can extend outside the trial period.
Notice must be provided in accordance with the employee's employment agreement. The parties may agree that a shorter notice period will apply during the trial period (e.g. one week instead of four weeks), but that notice period must be recorded in the employment agreement (ideally in the trial period clause).
A trial period is a one-off – it cannot be rolled over or extended.
The employer's overriding obligation to act fairly and reasonably in its dealings with the employee, remains during a trial period. It is also recommended that any decision to dismiss still be preceded by a fair process.

During the trial period the duty of good faith still applies for both parties. The employer should, where possible, provide:

a thorough induction process
buddying with an existing employee
training needs analysis, that identifies areas where further specific training might be required
regular meetings to discuss how things are going for the employee and giving feedback
managing areas that need improvement and giving appropriate support.

The recruitment process is expensive to undertake so you want your new recruits to succeed. This means providing appropriate support and learning opportunities to enable them to become confident employees who are productive and quickly become valued team members.

But even with the best recruitment and induction process, sometimes the recruit doesn’t meet your expectations, either in performance or team fit or sometimes both. Before doing anything, check:

the employment agreement and offer include the 90-day trial period
that the agreement was signed before the employee started work, and
that they hadn’t worked for you before.

If you find yourself in this position you should still, follow a fair dismissal process. Ideally you will have been providing feedback through the trial period, but even if you haven’t, you should meet with the employee to provide feedback and ask for their feedback. State that you are considering invoking the trial period clause, and that you will make your decision in, for example, 5 days. This allows the employee time to act on your feedback and/or prepare themselves.

If you see no improvement and you decide to give notice of termination under the 90-day trial, then this should be done in writing. This notice of termination must be given within the trial period, although the notice period can take you outside the 90 days. If included in the employment agreement, you could make payment in lieu of notice. We would expect the notice period under a ‘trial clause’ to be shorter than the notice period in the ‘termination on notice clause’. There should be a valid reason for the dismissal, although under legislation you do not need to provide this.

Employees can still bring a personal grievance for sexual or racial harassment, unjustified disadvantage, discrimination, or failure to comply with the continuity provisions where there is a sale or transfer of business.

If you have any questions on recruitment or the 90-day trial provisions, you can email the HealthyPractice team at business@mas.co.nz or call us on 0800 800 627.

Fiona Mines

HealthyPractice Adviser/Administrator

This article is of a general nature and is not a substitute for professional and individually tailored business or legal advice. © Medical Assurance Society New Zealand Limited 2024.

Collaborative Aotearoa | Healthcare Home Resources to Support General Practice

Amidst escalating workloads and diminishing staffing levels in general practice, the imperative to adopt innovative approaches for survival is becoming increasingly crucial. The inception of the Healthcare Home model of care dates back to 2016. It underwent enhancements in 2019 to align with the Pae Ora health reforms and is currently undergoing a comprehensive revamp. This process involves updating, refreshing, changing, and enhancing all resources based on the insights garnered from the past seven years of implementation. This article delves into five of the 38 indicators that hold the potential to prompt transformative changes in your general practice, offering actionable insights to improve and fortify your healthcare environment.

Let's address the prominent issue at hand - the insufficient funding in capitation and general practice. A commendation is due to our colleagues at GPNZ for their recent report on the sustainability of general practice, shedding light on the persistent deficit in primary care funding. In the realm of financial planning, Collaborative Aotearoa (Collab) offers a financial modelling spreadsheet designed to assist practices in comprehending their financial landscape and evaluating the potential of healthcare home implementation. It is evident that implementing these changes necessitates an initial financial investment, and we acknowledge that access to such funding continues to vary across the country. Regardless of sector support, it is worthwhile to explore this resource and discern the opportunities embedded in the model to bolster the financial sustainability of your practices. The Collaborative is currently in the process of reviewing and refining this modelling tool to ensure it reflects the realities of 2024, including considerations for inflation. Should you require assistance in utilising or understanding the tool, please do not hesitate to reach out to your Primary Health Organisation (PHO).

The second crucial factor for enhancing general practice workflow is telehealth. Despite becoming proficient in this during the COVID-19 pandemic, many general practices have reverted to traditional models post-COVID-19. Telehealth and telephone triage can aid your practice in ensuring it attends to the necessary patients each day, prioritising based on need and acuity through clinical phone assessments. Phone triage is an evolving practice with various effective approaches. Utilising efficient telephone triage and telehealth appointments can increase access to your practice for your patients, enhancing their wellbeing and health outcomes. The Collaborative has many resources to support the implementation of successful telephone triage. Resources include suggested appointment templates for adoption and adaptation by practices, webinars, and guides on implementing changes from provider and patient perspectives.

Most importantly, there's support and coaching available to set you and your practice up for success. You don't have to do this alone.

An integral element of the highly valued tradition of spring cleaning in any professional setting, especially within healthcare home practices, revolves around our third top indicator, known as standardisation. This strategic approach entails establishing consistent and uniform processes, protocols, and systems, significantly contributing to improved working conditions, and streamlined workflows. Adopting standardisation not only nurtures a more organised and efficient work environment but also creates a structured framework within a practice. This framework serves as a cornerstone for saving valuable time, optimising resources, and fostering a top-tier working environment. The positive repercussions of standardisation extend beyond internal operations, ultimately leading to enhanced patient outcomes. Ensuring that procedures are standardised empowers healthcare professionals to deliver more consistent and high-quality care, positively impacting patient experiences and overall health outcomes. Embracing standardisation as part of the spring-cleaning process in a healthcare practice is undeniably a wise choice, offering multifaceted benefits that resonate throughout the entire organisation. The beauty of this indicator is that it can be implemented on a scale that aligns with the available capacity, making it adaptable to small and large initiatives. Starting with something as simple as clinical correspondence trays (where they still exist) is a perfect entry point.

Patient portals emerge as our fourth operational ally. Over the years, these portals have received varied reviews, some being game-changers while others are less supportive. What persists in evidence within the healthcare home model is the capacity of portals to enhance the patient experience and improve access to healthcare. Not every patient interaction requires a face-to-face encounter; sometimes, a simple administrative interaction suffices. Portals are crucial in supporting patients in ordering prescriptions, booking appointments, and asking straightforward questions. The most impactful aspect of a portal is affording patients access to their notes. By providing this access, we uphold the principles of Tino rangatiratanga, offer options, support self-management, and empower patients to share their clinical diagnosis with their care team at home. It's truly a transformative element. Contact your Primary Health Organisation (PHO) for support if you encounter clinicians resistant to this change. Seek resources to aid in this transition on the Collaborative website or directly contact the Collaborative team.

The final hint of help is supporting our general practice workforce. Our general practice teams are facing a workforce crisis, with staff pay equity issues and the complexity of patient care creating a stressful and busy work environment. Supporting and connecting our practice teams during this testing phase is essential. The Healthcare Home model of care endorses daily morning huddles to connect the team with a

common goal and purpose and inject much-needed energy into the team. Start with a team board overhaul to bring structure to your huddles, and then spend 5 minutes each day reviewing key activities, notices, and announcements. Then, for the next month, try to end the huddle with a quick-fire activity that gets the team connected and laughing. This could simply be a minute-to-win-it challenge, a speed quiz from the daily newspaper, or a joke from a favourite joke book. Keep your eyes on the Collaborative Aotearoa social media platforms for huddle inspiration over the coming months.

Jess Morgan-French, Interim CEO Collaborative Aotearoa

Welcome to our newest members

December new members:

Yvette Hansen
George Ngatai
Claire Hill

January new members:

Rachel hope
Dinah Rea
Sudha Pratyusha Thati
Callie Foster

February new members:

Phil Batchelor
Andrea Nicholas-Gallagher

Welcome to PMAANZ!

PMAANZ Roadshow | March 2024

Don’t miss out on our Roadshow, where you can learn from Gary Smith, the “guru” of Practice Management in Australia. Register now before it’s too late!

Gary manages a large and reputable General Practice in Penrith, NSW. He has devoted his career to improving practice management in Australia and beyond. He has been featured in a leading medical magazine as an expert in his field.

Gary is also a life member of the AAPM and a strong supporter of UNE Partnerships, the top provider of general practice and practice management education in Australia.

Gary cares deeply about the education and empowerment of First Nations people and frontline workers. He has travelled to remote and rural areas to conduct workshops on medical reception, administration, and management, in partnership with UNE Partnerships and QAIHC, for the last 12 years.

Gary has been a leader and a pioneer in the primary healthcare sector and the practice management profession for over 30 years.

Join us at the Roadshow and learn from Gary Smith about:

How to apply business ethics to your leadership role.
How to choose and use the best leadership style for your organisation’s goals and values.
How to comply with and benefit from the relevant legislation in your organisation.
How to understand and communicate your organisation’s mission, purpose and values.
How to understand and communicate your organisation’s objectives, plans and strategies.
How to understand and communicate the organisational change processes

Click this link to for more information.

A special “Thank you” to our sponsors for this road show, Tū Ora Compass Health, Pegasus Health Pinnacle and Procare.

Membership Update | Karen Greer

Kia ora koutou katoa

Well, Christmas and New Year have been and gone. Undoubtedly, we are all back to work and getting back into the swing of things.

There are a lot of discussions going on out there in PMAANZ land. There are a lot of variations of roles within our staffing throughout the Motu. Who does what to help each other out? There is no right or wrong way to utilise staff if it is in their scope of practice. The most important thing is how we treat and look after our patients. I know patients appreciate the hard mahi we do.

As a manager, it is a tough role, but I must admit the messenger comments earlier in the month were classic. The conversation was about the Titles and job descriptions of our positions. Titles ranged from general managers, practice managers, mothers to all, IT specialists, grocery shoppers, goddesses, and then there was the best "da bomb." Isn't it great even though we are all under a lot of pressure, we still have a sense of humour?

As the Membership portfolio liaison, I may ring you or pop in to see how you are doing throughout the year. If you have a problem with something, feel free to contact me at membership@pmaanz.org.nz, and I can help you out, or if I don't know, I can point you to the right person.

On a different note. Tonight, I watched the NETFLIX documentary "What Happens in the Greatest Night in Pop." It was an eye-opener if you like music and want to see how they made the song "We Are the World," USA raising funds for Africa. I will not tell you anymore, but it is worth a watch. On a funny note, I could hear my lovely Toni laughing, watching the bloopers of The Chase on TV1.

Well, you amazing PMAANZ members, take care and look after yourselves until next time.

Ngā mihi

Karen Greer |PMAANZ Membership

Treasurer Update | Wendy Harris

PMAANZ looks forward to providing the Biennial Survey to members and other interested parties in the health sector later in the year. The survey has been held every two years since 2004, so we are pleased to be conducting the tenth edition in 2024.

The primary purposes of this survey are to gather information on the changing nature of our workplaces and to provide PMAANZ and other interested groups with a current market remuneration guide for practice managers and administrators within the health sector. This is aligned with the Scope of Practice. This survey has also created the opportunity for the Executive to find out what PMAANZ members may expect from their membership, conference, and means of communication, i.e., PMAANZ Website, Newsletter, and Facebook Page.

It is essential to minimise changes to the survey to provide year-on-year comparable data to inform practice managers and administrators; however, we are currently reviewing the questions included in the survey, so if there were areas you would like us to consider, please let us know.

I look forward to engaging with you all on this.

Wendy Harris | PMAANZ Treasurer

NZ Doctor Reads | Newsletters and Publications

We are always adding to the page of NZ Doctor articles, click the link.

We also have publications that might be of interest to you, click the link.

To read our Partner newsletters which might be of interest, click the link.

GenPro NZNO Primary Practice Pay Equity Claim Representation - click here to read.

Books / Movies / Shows - recommended by members

Book / Netflix Show - Fool Me Once

Former special ops pilot Maya, home from the war, sees an unthinkable image captured by her nanny cam while she is at work: her two-year-old daughter playing with Maya's husband, Joe—who was brutally murdered two weeks earlier. The provocative question at the heart of the mystery: Can you believe everything you see with your own eyes, even when you desperately want to? To find the answer, Maya must finally come to terms with her past's deep secrets and deceit before she can face the unbelievable truth about her husband—and herself.

I thoroughly enjoyed this show, twists & turns to keep you guessing. Recommend any of the Harlan Coben books and shows.

Book - The Chalet - Catherine Cooper

French Alps, 1998: Two young men ski into a blizzard… but only one returns. Twenty years later, four people connected to the missing man find themselves in that same resort. Each has a secret. Two may have blood on their hands ...

**The Sunday Times Top 5 bestseller**

Longlisted for the CWA New Blood Award

‘Pure adrenaline’ ERIN KELLY

‘An intense thriller’ HEAT ‘Agatha Christie meets the glamour of après-ski’ SUNDAY TIMES.

It is a great light read with some surprising twists.

Netflix Movie - Action Thriller - King Arthur

Robbed of his birthright, Arthur comes up the hard way in the back alleys of the city. But once he pulls the sword from the stone, he is forced to acknowledge his true legacy - whether he likes it or not.

Netflix movie – Psychological, apocalyptic thriller - Leave the World Behind

A family's getaway to a luxurious rental home takes an ominous turn when a cyberattack knocks out their devices, and two strangers appear at their door.