Avon Medical Centre in Stratford has expanded the range of services offered and is now accepting new patients as well as offering an acute care walk-in clinic on weekdays. Photo / Ilona Hanne
Avon Medical Centre in Stratford has expanded the range of services offered and is now accepting new patients as well as offering an acute care walk-in clinic on weekdays. Photo / Ilona Hanne
A new model of care at a Stratford medical centre is reducing wait times and increasing the services offered.
“Where we are now, is a fully staffed GP, acute care and subspeciality clinic staffed by a team of highly qualified and skilled healthcare professionals dedicated to providing a high-quality health service to the people of Stratford. The teams-based care model we are working with means patients are able to see the most appropriate health professional for their specific condition in the timely manner in our local community.”
Dr Nick says the system, known as a “comprehensive care team approach”, is internationally seen as best practice across primary and secondary healthcare and is a critical solution to ensuring sustainable, high-quality healthcare provision is possible, with ageing populations suffering more-complex medical conditions and staffing resource issues affecting the entire healthcare industry.
“We are lucky enough to have a high-skilled team of nurse practitioners, physician associates, clinical pharmacists, prescribing nurses, extended care paramedics, healthcare assistants and administrators as well as specialist GPs, so when you call for an appointment, or come in through our walk-in clinic, you will be able to be seen by the right person to treat your specific needs in a timely manner.”
Erin James, nurse lead at Avon Medical, says the collaborative team approach means not only are patients seen by “the right person at the right time”, but staff can call on their colleagues for a second opinion or to utilise their skills when needed.
“Any of our clinicians can consult with on-site specialist GPs when needed, no matter who the patient is booked in to see. This means we can all work at the top of our scopes in a safe and effective manner.”
Some of the team at Avon Medical Centre in Stratford. Photo / Ilona Hanne
Erin says when someone calls to book a routine appointment, they will be booked in to see “the most appropriate and available clinician, whilst also considering who the patient normally sees”, to ensure wait times are minimal and continuity of care is achieved where possible.
“We don’t want people waiting for two weeks for a routine appointment, and under this system, they won’t have to.”
The newly launched walk-in acute clinic uses the same model, she says.
“Whether people are patients of ours or not, they can use our acute care clinic, which is open Mondays to Fridays between 8.30am and 5pm. They will be triaged by a triage nurse and treated in order of urgency. This service saves people a trip out of town and also helps reduce the load on Base Hospital and Hāwera Hospital’s ED departments where wait times can be really long.”
Through the increased availability of clinicians, Avon Medical is also now available to accept new patient enrolments, says Erin.
“We are able to deliver an accessible, high-quality service to the community, reducing the need for patients to travel out of town where possible.”
“We also have x-ray on site three days a week, which speeds up the process of diagnosis and treatment.”
Patients can also manage some of their care themselves, requesting repeat prescriptions and viewing test results online through the MyIndici app, she says.
“If patients need help registering for that or accessing it, they can call in and our reception team can help them set it up ready to use.”
Among the many clinicians now seeing patients at Avon Medical Centre are extended care paramedics (ECPs) Sandra Holliday and Jesse Walmsley.
To become an ECP takes many years of training and on-the job-learning, says Jesse.
“We do postgraduate training, making about five years, with significant ongoing professional development requirements.”
Sandra, who has a master’s in health, says working as an ECP offers the best of both worlds for paramedics.
“We can, and do, work in the ambulance still, but also work from the medical centre and are able to see patients through more of the process. For example, this morning we had a kid come in with a sore foot. We were able to see them, assess them, send them for an x-ray on site, then diagnose a break, put them in a cast and send them home. All of that in one place, saving them a trip to New Plymouth which costs petrol as well as time.”
Being able to do so much on site makes a real difference, says Jesse.
“By having us ECPs here means we can treat people in their community as much as possible.”
That doesn’t just mean working from rooms at Avon Medical either, says Sandra.
“We can also go to patients in their homes to assess and even treat them if they aren’t able to come to us.”
Of the patients they see in their homes, Jesse estimates about 60 per cent are treated there, with the rest needing to be taken to hospital.
“So that is quite a large percentage of patients who don’t have to go to hospital, reducing wait times in the emergency department as well.”
Working from a medical centre staffed with a range of clinicians makes it easy to take a collaborative approach to patient care, says Sandra.
“If one of our patients needs a GP, we have one on call effectively, we have x-ray here, we can call on the other staff here at any point to assist or help, and we can do the same for them.”
From a personal level, the job is really rewarding, says Sandra.
“We have had some really interesting cases come through, and we get to see them right through the process. Some cases take a while, which is why it’s great having a large number of staff working there.
“It’s all about making sure every patient can be seen in the right time frame, by the right person to treat them.”
Every day is different, she says, but she estimates she and Jesse can see about 18 patients a day.
“And each of those patients is getting the care they need, without having to wait for long.”
The biggest barrier to patient care can be the patient themselves, says Dr Nick.
“People are used to the idea of seeing a GP for everything, so sometimes it takes a while for people to understand the change in this system. Realistically, the old model was not sustainable with two-thirds of GPs planning on retiring in the next 10 years, New Zealand does not have enough GPs to continue with GP-focused primary healthcare.
“We are so lucky in Avon to have such a selection of highly skilled healthcare professionals each with their own special interest and skills to bring to the clinic. This model of care ensures every patient is seen in a timely manner, and by the most appropriate clinician. By freeing up our GPs through the use of clinicians like ECPs, prescribing nurses and clinical pharmacists, we are able to provide other services from here such as minor surgery including skin cancer surgery, vasectomies, and varicose vein management and other things people used to have to go out of town for.”
Dr Nick says he has been really impressed with the Stratford community’s willingness to try the new model of care and new clinicians.
“The number of patients who now request Berta, our physicians assistant, or Will, our clinical pharmacist, is testament to how quickly the community is seeing their value and respecting their incredible clinical skills.”
Things have changed over the years in healthcare, he says.
“It’s no longer a case of patients seeing the GP who may have delivered them when they were born for every medical condition. Instead, we are aiming to ensure our community can see the right clinician for their needs at the right time right here in our community.
“The positive feedback has been really motivating for the whole team who have really been through tough times over the past five years and are finally almost able to take a breath and be proud of what they have created in their own community.
“From the receptionists to the nurses and beyond, they are the true heroes in this story, as without their dedication and hard work we would not be where we are today.”
