Regional Public Health 2017-2018 Annual Plan [PDF]

This annual plan is for the year 1 July 2017 to 30 June 2018. It has been approved by the ... Figure 1. RPH Planning Fra

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Regional Public Health 2017-2018 Annual Plan

Vision

Equitable, sustainable and healthy futures for all Vision for Māori

Māori are healthy and enjoying equal quality lifestyles, from infants to elderly Bold Goal

Halving the rate of avoidable hospital admissions for Māori, Pacific and children by 2021 Goal for Māori

We are confident, connected and comfortable in working with Māori and our work makes a difference Values

Culturally responsive Integrity Compassion Equity Excellence Annual Priorities

Work with Māori Engage with primary care Focus on children

Contents Introduction ............................................................................................................................................. 3 Bold Goal and priorities ................................................................................................................. 6 Māori health .................................................................................................................................. 7 Population profile .......................................................................................................................... 7 Long term conditions ................................................................................................................... 12 Healthy Families Lower Hutt ....................................................................................................... 13 Finance ................................................................................................................................................... 14 How to read the Action Plan section ..................................................................................................... 16 Action plans………………………………………………………………………………………………………………………………..……..20 1.3 Building healthy social environments .................................................................................... 20 1.5 Promote the health of refugees ............................................................................................ 23 1.6 Work with schools to identify and address health needs ..................................................... 25 1.7 Improving vision and hearing ................................................................................................ 28 1.8 Support for Work and Income clients to improve their health outcomes ............................ 30 2.1 Smokefree Nation 2025 ......................................................................................................... 32 3.1 Nutrition and physical activity ............................................................................................... 34 4.1 Alcohol and other drugs ........................................................................................................ 36 4.2 CAYAD .................................................................................................................................... 39 5.1 Communicable diseases ........................................................................................................ 41 5.2 Promote and facilitate immunisation .................................................................................... 43 5.3 Deliver Year 7 and 8 Boostrix and Gardasil vaccination programmes................................... 45 5.5 Sexual health promotion ....................................................................................................... 47 5.6 Deliver neonatal BCG vaccination ......................................................................................... 48 6.1 Minimise environmental hazards promote safe drinking water sustainable resource management .......................................................................................................................... 49 6.2 Promote safe and healthy urban environments.................................................................... 68 6.4 Health Promoting Schools ..................................................................................................... 69 6.6 Border health and response to emergency events ............................................................... 70 7.1 Business support .................................................................................................................... 74 7.2 Māori action plan................................................................................................................... 75

Regional Public Health 2017-2018 Annual Plan Page 1

7.4 Public health infrastructure ................................................................................................... 77 7.6 Public health analytical services ............................................................................................ 78 7.8 Communications support and health information dissemination ........................................ 79 7.9 Central region public health advice (Schedule D).................................................................. 80 8.1 Standalone contracts ............................................................................................................. 81 List of figures Figure 1. RPH Planning Framework......................................................................................................... 4 Figure 2. RPH Organisational Chart......................................................................................................... 5 Figure 3 Wider determinants of health, Dahlgren and Whitehead, 1991 ............................................ 13 List of tables Table 1. DHB local priorities .................................................................................................................... 6 Table 2. Core public health functions mapped to MoH core contract activities .................................. 17 Table 3. MoH core contract issues mapped to MoH core contract activities ...................................... 18 Table 4. MoH non-core contracts mapped to action plans and activities ............................................ 18 Table 5. DHB contracts mapped to action plans................................................................................... 18 Table 6. Other contracts mapped to action plans ................................................................................ 19 Table 7. Action plans across all contracts ............................................................................................. 19

Regional Public Health 2017-2018 Annual Plan Page 2

Introduction This annual plan is for the year 1 July 2017 to 30 June 2018. It has been approved by the Ministry of Health and endorsed by Hutt Valley District Health Board (HVDHB). Regional Public Health (RPH) is one of twelve public health units in New Zealand and provides services as per the Ministry of Health’s (MoH) service specifications for public health services and contractual agreements with the MoH, Wairarapa, Hutt Valley and Capital & Coast DHBs, and other funders. RPH ensures statutory responsibilities are met as specified by the MoH. This plan aligns to the three DHBs’ annual plans and Ministry of Health’s annual planning guidelines for public health units. A copy is also available at www.rph.org.nz . A summary progress report will be submitted to the MoH after six months, and a full annual report after one year. RPH’s purpose is to achieve ‘better health for the greater Wellington region’ by focusing on communities and the environment, rather than at the individual level. A multidisciplinary workforce undertakes all five of New Zealand’s core public health functions: • Health assessment and surveillance • Public health capacity development • Health promotion • Health protection and • Preventive interventions. These functions are integrated into a population-based approach, meaning staff work within a variety of settings where people live, work, learn and play. RPH aims to work in collaboration with Māori, Pacific peoples, communities and providers across the health sector (primary health care in particular). Collaboration at local, sub-regional, central region and national levels is emphasised. An example is on-going active involvement in the National and Central Region Public Health Clinical Networks. To focus action on more equitable health and wellbeing outcomes, RPH links with a wide range of government, non-government and community organisations, addressing barriers and enablers such as access to health care services, housing, income, employment and education. In November 2013, RPH established the RPH Planning Framework (see figure 1). This framework is informed by the New Zealand Public Health Clinical Network’s report ‘Core Public Health Functions for New Zealand’ and the Ministry of Health’s tier one public health service specification. The reestablishment of an RPH Strategic Plan is underway to help guide our future direction.

Regional Public Health 2017-2018 Annual Plan Page 3

Figure 1. RPH Planning Framework

Regional Public Health Planning Framework Vision: Equitable, sustainable and healthy futures for all Bold Goal: Halving the rate of avoidable hospital admissions for Māori, Pacific and children by 2021 Inputs

Key principles

Core public health functions

Public health service outcomes

Health status of the population

Focusing on the health of communities rather than individuals

Health assessment and surveillance

A healthier and more productive population

Government

Influencing health determinants

Public health capacity development

Reducing health disparities, including a focus on Pacific peoples and vulnerable groups

Ministry of Health

Prioritising improvements in Māori health

Health promotion

Improving Māori health

District Health Boards

Reducing health disparities, including a focus on Pacific peoples and vulnerable groups

Health protection

Increased safeguards for the public’s health

Funding and Planning Unit

Basing practice on best available evidence

Preventive interventions

A reduced burden of acute and chronic disease

Building effective partnerships across the health sector and other sectors Remaining responsive to new and emerging health threats

Regional Public Health RPH values are integrity, excellence, equity, compassion, and being culturally responsive. Staff work in teams within groups, based on areas of focus (see figure 2): • Healthy Environments and Disease Control Group • Preventive Health and Chronic Disease Group • School Health and Immunisation Group • Business and Analytical Support Unit There is a wide range of roles: health protection officers, medical officers of health, medical officers, public health advisors, public health analysts, public health nurses, public health physicians, vision and hearing technicians, management, administration, communications, and information systems.

Regional Public Health 2017-2018 Annual Plan Page 4

Figure 2. RPH Organisational Chart

The geographical area RPH covers includes (see figure 3): • Hutt Valley DHB (Hutt City Council, Upper Hutt City Council) • Capital & Coast DHB (Wellington City Council, Porirua City Council, Kapiti Coast District Council – note health promotion services for the Otaki Ward are provided by the MidCentral DHB Public Health Service) • Wairarapa DHB (Masterton District Council, Carterton District Council, South Wairarapa District Council). Figure 3. RPH Service Area

Regional Public Health 2017-2018 Annual Plan Page 5

Bold Goal and priorities Since 2012, RPH has had a deliberate focus on aligning all activities to achieve a ‘Bold Goal’ of ‘halving the rate of avoidable hospital admissions for Māori, Pacific and children by 2021’. This is an aspirational outcome statement developed by staff to challenge and motivate them, and bring a collective purpose to their work. For 2017-2018, the annual priorities are: • Working with Māori. • Focus on children. • Engagement with primary care. The Bold Goal and annual priorities are used to prioritise services to make the best use of available resources. This annual plan takes into account the Government’s expectations as well as national, central region, sub-regional and district priorities for health. This includes alignment to the refreshed New Zealand Health Strategy. RPH contributes to many of the Government’s and DHBs’ health targets and priorities. For example, activities to increase access to healthy food choices can over time, contribute to preventing diabetes and other long term conditions. See Table 1 below. Table 1. DHB local priorities

Wairarapa DHB

Hutt Valley DHB

Capital & Coast DHB

• Living Within Our Means • Health Equity • Child and Youth Health • Long Term Conditions • System Integration • Quality • Workforce • Care Closer to Home Our overarching priority is to continue to focus on the 'triple aim plus one': • For our Patients - Improved quality, safety and experience of care and a better patient journey • For our Populations - Improved health and equity for all populations • For the Public - Best value for health system resources and living within our means • A thriving organisation, including our organisational culture, clinical leadership, engagement and workforce development. • Improve child health and child health services • Better Elder Care • Integrated Care • Empowered Self-Care • Enhanced Clinical Leadership • Continuous Outcome Evaluation and Monitoring

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NB: Relevant national level DHB annual priorities (as per the Minister’s letter of expectations to DHBs) have been included within each action plan, in the summary statement.

Māori health RPH recognises and respects the Treaty of Waitangi, and the principles of partnership, participation and protection, acknowledging the special relationship between the Crown and tangata whenua. The national Māori Health Strategy: He Korowai Oranga (2014) provides the strategic direction that guides health sector contributions to pae ora – healthy futures. The vision for RPH in contributing to improving Māori health outcomes and reducing inequities is “Māori are healthy and enjoying equal quality lifestyles, from infants to elderly” (RPH Māori Strategic Plan 2014 – 2017). There are four pathways identified in the RPH Māori Strategic Plan, to support and challenge staff to “think Māori first”: • Te Ara Tuatahi - Pathway One - Relationships. • Te Ara Tuarua - Pathway Two - Workforce development. • Te Ara Tuatoru - Pathway Three - Accountability. • Te Ara Tuawha - Pathway Four - Communications. To move forward along each pathway, actions and measures are woven into all the annual operational actions plans that are summarised to produce the annual plan. Additionally, the Māori Action Plan provides a mechanism to implement organisation-wide actions. RPH contributes directly and indirectly to many of the specified national, central region, sub-regional and local targets and priorities for Māori health. For example, RPH activities to reduce the supply of tobacco products can, over time, contribute to the reduction in smoking prevalence which in turn can contribute to reductions in cancers, respiratory disease and heart disease.

Population profile1 Geography and population The DHBs in the greater Wellington area, Wairarapa, Hutt Valley and Capital & Coast (i.e. Wellington sub-region), represent three of the twenty DHBs in New Zealand. They comprise urban, rural and coastal settings. Capital & Coast CDHB is the largest DHB of the sub-region, followed by Hutt Valley and Wairarapa. The population for the three DHBs was 463,230 at the last census (2013), which represented ten percent of New Zealand’s total population of approximately 4.2 million. The map in figure 4 shows the deprivation distribution by quintile across the greater Wellington area.

1

2015 Health Needs Assessment For Wairarapa, Hutt Valley and Capital & Coast District Health Boards, 2015.

Regional Public Health 2017-2018 Annual Plan Page 7

Figure 4. Map of 3DHB sub-region by deprivation quintile

Census Area Unit mapping is based on Statistics New Zealand’s data which are licensed by Statistics New Zealand for re-use under the Creative Commons Attribution -Non commercia 3.0 New Zealand license. Deprivation data was sourced from Department of Public Health, University of Otago.

The Wairarapa is a diverse rural area, separated from the rest of the Wellington region by the Rimutaka ranges. The Wairarapa DHB (41,109 people, 9% of the sub-region) includes three territorial authorities (TAs), Masterton, Carterton and South Wairarapa, covering a total land area of 5,936 square kilometres. Masterton, with a population of around 23,000, is Wairarapa’s one large urban town. The land area of Hutt Valley DHB is 916 square kilometres. The area is predominantly flat in the Hutt River valley, bordered by mountainous ranges in the east (Rimutakas) and north (Akatarawas and Tararuas) and a coastal southern edge. Lower Hutt City and Upper Hutt City are the Hutt Valley’s two TAs, with a combined population of 138,417 people (30% of the sub-region). The Capital & Coast district has a land area of 739 square kilometres. It is made up of three TAs: Wellington City, Porirua City and Kapiti Coast District, with a combined population of 283,704 people (61% of the sub-region). The Kapiti Coast District includes some territory which is part of the Midcentral DHB (Otaki and near surrounds). The Capital & Coast area has relatively high density residential living (by New Zealand standards), with on-going expansion of urban areas.

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Population growth The Wellington sub-region population is growing and ageing. In 2013, the census ‘usually resident population’ 2 for the Wellington sub-region was estimated to be 463,230, a five percent increase from the last census in 2006 (441,387). The largest percentage change was seen in Wairarapa DHB (6.5%) and CCDHB (6.4%). Population growth is expected to continue and by 2033 the sub-region is expected to be home to over half a million people. In all three DHBs, numbers of older people (65+) are projected to increase while the population under 25 years stays about the same or declines. Socioeconomic deprivation Over the last few decades there have been major changes in the way New Zealand society is organised and in the ways in which we view our communities. The New Zealand Index of Deprivation 2013 (NZDep2013) is a summary measure derived from the 2013 Census of Population and Dwellings. The index, constructed from nine Census 2013 variables, provides a summary deprivation score from 1 to 10 for small areas. A score of 1 is allocated to the least deprived ten percent of areas, and 10 is allocated to the most deprived ten percent of areas across New Zealand. NZDep2013 is sometimes presented as quintiles, with 1 being the least deprived and 5 the most deprived. The NZDep2013 index of deprivation reflects eight dimensions of material and social deprivation. These dimensions reflect lack of income, employment, communication, transport, support, qualifications, owned home and living space. In the Wairarapa DHB the most deprived areas are found in central Masterton and Featherston, but overall the population is spread over all deprivation indices. The Hutt Valley DHB population is distributed reasonably evenly across the deprivation index. The most deprived areas are in Lower Hutt City, around the areas of Taita, Naenae and Wainuiomata. The territorial authorities of Capital & Coast DHB have contrasting socioeconomic profiles. Porirua City is a city of two halves; about 35% of the population live in highly deprived areas (deciles 9 and 10) and about 40% live in the areas of least deprivation (deciles 1 and 2). The most deprived areas are concentrated in eastern Porirua and areas to the west of State Highway 1. In contrast, Wellington City population predominantly lives in the least deprived areas. There are small pockets of deprived areas in the corridor from Te Aro to Berhampore, and around Miramar and Strathmore in the south. In Kapiti district the majority of people live in the mid-range of the deprivation index.

2

The census ‘usually resident population’ count of an area in New Zealand is a count of all people who usually live in that area and were present in New Zealand on census night. Excluded are: visitors from overseas, visitors from elsewhere in New Zealand, and residents temporarily overseas on census night.

Regional Public Health 2017-2018 Annual Plan Page 9

Figure 5. Wairarapa population distribution across deprivation deciles, 2013

Figure 6. Hutt Valley population distribution across deprivation deciles, 2013

Figure 7. Capital & Coast population distribution across deprivation deciles, 2013

Within the sub-region, 48% of Pacific people were living in the most deprived neighbourhoods. Nearly a third were living in a decile 10 area. Māori were also over-represented in the most deprived areas, with 29% living in decile 9 or 10. In comparison, 16% of Asian and 19% of Other 3 lived in a decile 1 neighbourhood.

3

Other ethnicity includes Other, European, MELLA – Middle Eastern, Latin American or African ethnicities, and ethnicities which have not been included elsewhere

Regional Public Health 2017-2018 Annual Plan Page 10

Figure 8. Sub-regional population distribution across deprivation deciles by ethnicity, 2013

Age profile The age profile differs markedly across the sub-region. Wairarapa DHB is noted for a proportionately larger older population compared to Capital & Coast DHB and Hutt Valley DHB. Hutt Valley DHB has a similar age distribution to Capital & Coast DHB, but has slightly larger population under 15 years than the other two DHBs. The age distribution of CCDHB is characterised by a large proportion of adults of working age. The age profile of the TAs in the Wairarapa, and Kapiti District areas are similar with lower proportions of youth and an aging population. Lower Hutt City and Upper Hutt City are similar in their age group distribution, with higher proportions of children and middle aged people. Wellington City TA is noted for the highest population of young working age, whereas Porirua City has the highest proportion of children aged under 15 years. Figure 9. Sub-regional age group distribution, 2013 35

Wairarapa DHB Hutt Valley DHB CCDHB

30

Percent

25 20 15 10 5 0 0-14

15-24

25-44

45-64

65+

Ethnic profile Māori and Pacific peoples make up 12% and 10% respectively of the sub-region’s population and both are young populations. The ethnic groups are distributed differently across the sub-region; the TAs with the largest numbers of both Māori and Pacific peoples are Wellington City, Lower Hutt City, and Porirua City (36% of Pacific peoples in the sub-region live in Porirua City).

Regional Public Health 2017-2018 Annual Plan Page 11

Overall, the ‘Other’ ethnic group makes up around 70% of the sub-region’s population, and is the dominant ethnic group in all three DHBs. Across the sub-region, the people in this ethnic group tend to be in the older working age group. Asians make up 10% of the population, with the greatest proportions being in the 25-35 year age group. Figure 10. Ethnic composition by territorial authority, 2013

The ethnic composition of the sub region is likely to change in the next 20 years. Growth is expected in the Māori population, most noticeably in Capital & Coast DHB where it is expected to be about 20% larger than in 2013. The Asian population by 2033 is expected to have grown by at least 50% from 2013, in all three DHBs. Pacific peoples and Other populations are expected to grow much more slowly and even decline in some younger age groups.

Long term conditions RPH has recently completed a plan for the prevention of long term conditions (LTCs). Actions are based on the Ottawa Charter for Health Promotion, a well as the socioeconomic determinants of health. The Ottawa Charter actions are: advocacy for health; enabling people to take control of the things that determine their health; mediating between differing interest in society, for coordinated action; building healthy public policy; creating supportive environments; strengthening community action; developing personal skills; and reorienting the health sector. Actions are also focused on the broader influences on health, as set out by Dahlgren and Whitehead in ‘Policies and strategies to promote social equity in health’, 1991.

Regional Public Health 2017-2018 Annual Plan Page 12

Figure 3 Main determinants of health, Dahlgren and Whitehead, 1991

RPH is actively engaged in work on the risk factors for long term conditions: tobacco use; alcohol related harm; poor nutrition and physical inactivity. Complementing this work, RPH has a Community Action Neighbourhood approach (CANA), initially with three communities (Wainuiomata, Titahi Bay and Wairarapa). The result of this approach will inform other RPH work on what matters to people, in their communities. Additionally, there is a national focus on obesity both as a condition and as a risk factor for other conditions. Focusing on obesity prevention for children and youth is part of our work in preventing LTCs.

Healthy Families Lower Hutt RPH continues to work closely with Healthy Families Lower Hutt. Representatives from Healthy Families Lower Hutt, Te Awakairangi Health Network (a PHO in the HVDHB area) and RPH meet bimonthly for joint planning, sharing information and discussing progress on common work areas. Since December 2016, the three organisations began jointly delivering WorkWell in the Hutt Valley. All three organisations have trained WorkWell Advisors; RPH has signed an agreement with Toi te Ora Public Health Unit; and RPH also has a representative on Healthy Families Lower Hutt Workplace Special Interest Group. We continue to work jointly with Healthy Families Lower Hutt to encourage Hutt City Council to increase Smokefree outdoor spaces and to provide community water fountains, physical activity opportunities and healthy food and beverages. Within education settings, the focus is water only in schools. We work jointly to encourage communities to have a say in matters that impact on them, for example, in the liquor licensing process. The 2017-18 shared work programme is likely to include collective action in Wainuiomata, pro water initiatives, increasing smokefree areas and the WorkWell programme (which is likely to be a significant work area as the programme gets established).

Regional Public Health 2017-2018 Annual Plan Page 13

Finance

Regional Public Health 2017-2018 Annual Plan Page 14

Regional Public Health 2017-2018 Annual Plan Page 15

How to read the Action Plan section The services that RPH delivers are collated into annual operational ‘action plans’ (also known as service areas). These incorporate services from one or more contracts. Each action plan contains a number of ‘activities’. Within each activity there is a number of ‘tasks’ which break the work down further into manageable elements. These tasks are not included in the annual plan as they are for operational planning and monitoring. Each action plan begins with a high-level summary statement, which includes the relevant planning priorities for DHB 2017-18 annual plans. Results Based AccountabilityTM (RBA) is used for performance accountability measures, as per the MoH guidelines for PHU annual planning. These measures cover the three dimensions of performance accountability: • How many did we do? (quantity of effort): # (number) • How well did we do it? (quality of effort): % (percentage) • Is anyone better off? (quantity and quality of effect): # and %. From the MoH guidelines: “ In public health, direct ‘clients’ are people, organisations, settings, partners who engage directly with or receive benefit/services directly from working with a public health service provider…. Indirect ‘clients’ are those that the provider does not directly engage with but may receive a benefit from what the provider delivers.” Four categories are required to identify the direct/indirect ‘client’ outcome or ‘effect’ of the activities provided – i.e. ‘is anyone better off’: • SK: change in skills/ knowledge • AO: change in attitude/opinion • BC: behavioural change • CC: circumstance change Also required is: • S: subjective data • O: objective data It should be noted that measures for activities that do not form part of the core public health contract, are based on the reporting requirements agreed with the particular funder and, therefore, may not be based on the RBA format.

Regional Public Health 2017-2018 Annual Plan Page 16

Activity categories To assist the reader, the following tables show the activities sorted into a several categories: Table 2 Activities funded from the MoH core public health contract, sorted by the five core public health functions as per the tier one and tier two public health service specifications. Table 3 Activities funded from the MoH core public health contract, sorted by MoH issue (also known as public health funding categories) Table 4 Other contracts with the MoH Table 5 Activities funded from one, two or three DHBs Table 6 Activities funded from other contracts Table 7 Activities across all contracts Table 2. Core public health functions mapped to MoH core contract activities

Core public health function

Action Plan

Activities

Health Assessment and Surveillance

4.1

3,4,7

Public Health Capacity Development

1.5

2,5

5.1

5

7.4

1-4

7.6

1,2

7.8

1,2,3

1.3

1-9

1.5

1,4

2.1

2-4

3.1

1-8

4.1

5,6

5.5

1-3

6.2

1,2

1.5

3

2.1

1

4.1

1,2

5.1

1-4,6-8

5.2

5

6.1

1-21

6.6

1-5

Health Promotion

Health Protection

Preventive Interventions

-

Regional Public Health 2017-2018 Annual Plan Page 17

-

Table 3. MoH core contract issues mapped to MoH core contract activities

MoH Issue

Action Plan

Activities

Alcohol and other drugs

4.1

1-7

Communicable disease

5.1

1-8

5.2

5

Mental health

1.3

2,3

Nutrition and physical activity

3.1

1-8

Physical environments

1.3

4,6

6.1

1-21

6.2

1,2

6.6

1-5

7.4

1-4

7.6

1,2

7.8

1-3

Sexual and reproductive health

5.5

1-3

Social environments

1.3

1,5,7,8

Tobacco control

2.1

1-3

Schedules B and C: Refugee and other asylum seekers

1.5

1-5

Schedule D: Central region public health advice

7.9

1-5

Generic/Public health infrastructure

Table 4. MoH non-core contracts mapped to action plans and activities

Contract

Action Plan

Activities

Community Action on Youth and Drugs (CAYAD)

4.2

1-4

Drinking Water Assistance Programme Facilitation

6.1

5

Health Promoting Schools

6.4

1

Public Health Clinical Network Secretariat

8.1

1

Table 5. DHB contracts mapped to action plans

Service

WDHB

HVDHB

CCDHB

Action Plan

Porirua Mobile Ear Nursing Service



1.7

Primary Healthcare Nursing Innovation – Public Health Nurse in WINZ, Porirua



1.8

DHB NIR Administration Services



5.2

Outreach Immunisation Coordination



5.2

Public Health Nurse - Healthy Housing



6.2

Hutt Valley DHB Tobacco Control



2.1

Wairarapa DHB Tobacco Control

2.1



BCG Nurse Services





5.6

Healthy Housing Programme







6.2

HPV and Boostrix Immunisation Programme







5.3

Vision and Hearing Technicians







1.7

School Based Public Health Nursing







1.6

Regional Public Health 2017-2018 Annual Plan Page 18

Table 6. Other contracts mapped to action plans

Other Contracts

Action Plan

Central Region Registrar Supervision

8.1

MidCentral Medical Officer of Health

8.1

Table 7. Action plans across all contracts

Across all contracts

Action Plan

Business support

7.1

Māori action plan

7.2

Regional Public Health 2017-2018 Annual Plan Page 19

Action Plans 1.3 Building healthy social environments The components of this healthy social environments action plan are: a Community Action Neighbourhood (CAN) approach to service delivery to empower specific communities; wider community liaison work; health promotion in early childhood settings; WorkWell (in collaboration with Healthy Families Lower Hutt and Te Awakairangi Health Network) and suicide postvention. All of these components relate to the social environments where people live, learn, work and play. Working across settings helps coordinate the messages and messaging. All of these activities relate to the Ministry of Health Tier 2 specifications for Health Promotion and Health Protection (regulatory activities are in action plan 6.1). Regional Public Health has developed a Community Action Neighbourhood (CAN) approach in three areas: Titahi Bay, Wainuiomata and Wairarapa. The framework for this approach involves the accommodation of community empowerment in core public health programmes identified by the community that address harm from tobacco, alcohol and obesity (nutrition and physical activity). The relationships RPH builds in these communities will influence what the Service does to support communities to address their issues of concern. In the wider greater Wellington region, RPH has a community liaison approach and focuses on the more deprived areas, and areas with high Māori and Pacific communities to identify and address their issues relating to health. Working in early childhood and workplace settings address the health promoting qualities of these social environments. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Living Well with Diabetes, Child Health, Childhodd Obesity Plan, Mental Health, Better Health for Smoker to Quit. Suicide postvention activities contribute to the following planning priorities for DHB 2017-18 annual plans: Prime Minister's Mental Health Project, Mental Health. Activities in this plan contribute to the following DHB priorities: Healthy Families Lower Hutt (HVDHB only).

Performance measures #

Core function

Issue

Activity

How many = #

How well = %

# community groups or individuals engaged with that identify an issue of public health significance.

% identified community issues driven by Māori or Pacific.

1.3.1

Health Promotion

Social environments

Lead and coordinate work across RPH to strengthen community led action as a means to improving the delivery of service to Māori, Pacific and low socio-economic families.

1.3.2

Health Promotion

Mental health

Lead coordinated multi-disciplinary # RPH responses to completed response to all suicides in the suicides in the Hutt Valley DHB HVDHB and CCDHB areas. and CCDHB areas.

Regional Public Health 2017-2018 Annual Plan Page 20

% completed suicides responded to according to protocol (target: 100%)

Is anyone better off = #/%

#/% community involved in initiatives of public health significance (BC,O).

1.3.3

Health Promotion

Mental health

Attend meetings on suicides for HVDHB and CCDHB, for the Child and Youth Mortality Review Committees.

# deaths RPH responds to that are reviewed by the Child and Youth Mortality Review Committees.

1.3.4

Health Promotion

Physical environments

Increase wellness in early childhood centres.

# hits on the RPH website when outbreaks of illness arise.

1.3.5

Health Promotion

Social environments

Strengthen partnerships and communication with external stakeholders and communities on community identified issues of public health significance.

# stakeholders engaged.

1.3.6

Health Promotion

Physical environments

Support kohanga reo kaimahi to build a healthier environment for mokopuna.

# kohanga reo RPH engages with for the purpose of building healthier environments for mokopuna.

% kohanga reo who participate in workshops report satisfaction about the advice they receive (ie a rating of 4 or 5 on Likert scale 1 to 5).

#/% kohanga reo reporting a change of practice or behaviour as a result of RPH engagement (BC,O).

1.3.7

Health Promotion

Social environments

Coordinate organisational involvement in community-led events with high Māori and Pacific attendance.

# community events with high Māori and Pacific attendance supported by RPH.

% organising committees where RPH is a member.

#/% event organising committees that report being better informed on public health issues through RPH involvement.

1.3.8

Health Promotion

Social environments

Implement the Workwell programme in the sub-region, initially working with Healthy Families Lower Hutt and Te Awakairangi Health Network (PHO) in the Hutt Valley.

# new workplaces registered for WorkWell. # registered workplaces supported to implement and achieve WorkWell accreditation.

% workplaces that have high numbers of Māori and/or Pacific workers.

#/% workplaces that report positive behaviour change in relation to priority wellbeing areas (BC,S).

Regional Public Health 2017-2018 Annual Plan Page 21

Brief narrative report on RPHs contribution to the committees (AO,S).

% feedback received from early childhood services provided with advice and support for an outbreak indicates satisfaction with RPH input (ie rating of 4 or 5 for Likert 1 to 5).

#/% early childhood services that report changing their practice/behaviour based on the advice they are given by RPH (BC,O).

#/% external stakeholders and/or community report being well supported by RPH teams (AO,O).

1.3.9

Health Promotion

Not MoH core contract

A health promotion, education and prevention focus in the Wairarapa early childhood sector, particularly in high need centres and their respective communities.

% early childhood centres # high-medium need centres RPH is actively working with (15). indicate satisfaction (Likert Scale) with RPH service provision.

Regional Public Health 2017-2018 Annual Plan Page 22

#/% early childhood centres report having changed practice/behaviour as a result of RPH engagement (BC,O).

1.5 Promote the health of refugees (includes Schedules B & C) This action plan delivers refugee health services to quota refugees, refugee family support category (RFSC) and asylum seekers settling in the greater Wellington region. The plan involves clinical services which facilitate refugees transitioning into the New Zealand health system, training and education that builds health sector capacity (i.e. GP services) and health promotion activities for both refugee communities and volunteer support organisations who work with refugee communities (i.e. Red Cross Refugee Services). Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Primary Care Integration.

Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

1.5.1

Health Promotion

Refugees/Other Asylum seekers

Active involvement in the planning # intersectorial meetings of regional and national health attended by RPH staff. services for refugees, in collaboration with partner agencies.

1.5.2

Public Health Capacity Development

Refugees/Other Asylum seekers

Build capacity across health and social services to respond to identified refugee health needs.

# training opportunities facilitated by RPH. # meetings facilitated by RPH.

1.5.3

Health Protection

Refugees/Other Asylum seekers

Assess and plan health care services for refugee populations (quota, asylum and family support category refugees).

# refugee families and/or individuals supported by RPH.

% quota refugees who receive at least one home transition visit from RPH. Internal audit to assess visits completed within 610 weeks.

#/% refugee clients connected and engaged with health services within the region and with health needs addressed (BC,O).

1.5.4

Health Promotion

Refugees/Other Asylum seekers

Promote good health messaging to refugee populations, including teaching sessions and refugee community workshops in collaboration with other providers.

# collaborative workshops facilitated with our stakeholders.

#/% identified key public health concerns covered in the workshop, these include: diet/nutrition/obesity; dental and oral health; food storage; immunisation; smoking; and navigating the NZ health system.

This population group have english as a second language, therefore a workshop evaulation can not be administered.

Regional Public Health 2017-2018 Annual Plan Page 23

% actions assigned to RPH within regional and national refugee plans completed.

#/% training participants who report an increase in skills and knowledge (SK,S).

1.5.5

Public Health Capacity Development

Refugees/Other Asylum seekers

Enhancing RPHs capacity and capability to improve and deliver refugee population health services (staff professional development).

# public health nurses within the Disease Control team identified for staff development.

Regional Public Health 2017-2018 Annual Plan Page 24

% staff who have completed identified training.

1.6 Work with schools to identify and address health needs This action plan summarises the work carried out by public health nurses in primary and intermediate schools. In Wairarapa this includes early childhood centres and te kohanga reo. Public health nurses work to identify and manage health concerns that arise from the underlying wider social determinants of health. A broad range of services are provided to all primary schools, with a focus on improving the health and wellbeing of children and their whānau. The provision of a targeted model of service delivery means the high deprivation areas and lower decile schools receive a more intensive service. Public health nurses receive referrals from parents, schools and other community providers for children with unmet health needs. Public health nurses work collaboratively with a wide range of services, agencies and organisations. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Supporting Vulnerable Children; Reducing Rheumatic Fever; Raising Healthy Kids; Childhood Obesity Plan; Child Health; Primary Care Integration.

Performance measures #

Core function

Issue

Activity

How many = #

How well = %

1.6.1

Preventive Interventions

Not MoH core contract

Personal health referrals received and health concerns addressed.

# personal health referrals that support education learning and developmental and behaviour concerns. # personal health referrals are documented and reported monthly. # referrals out to specialised services including community, NGOs and hospital.

Timely intervention occurs and continuity of care is provided. Feedback annually from selected schools on the quality of the service received.

1.6.2

Health Promotion

Not MoH core contract

Rheumatic fever awareness raising activity in the Hutt Valley and Porirua involving working with primary and secondary services to support education and information.

# education sessions provided to primary and secondary services. # school PHN rheumatic fever sessions to classes or newsletters.

% Hutt and Porirua public health nurses skilled to deliver rheumatic fever messages (target: 100%).

Regional Public Health 2017-2018 Annual Plan Page 25

Is anyone better off = #/%

#/% students have their health needs met with timely intervention, and continuity of care and appropriate referrals (BC,S).

1.6.3

Preventive Interventions

Not MoH core contract

New entrant assessments offered to children in decile 1-3 schools who do not complete a B4SC, and to other identified vulnerable children in decile 4-10 schools.

# new entrant assessments completed will be recorded in monthly reports. # referrals from the assessment.

% children in decile 1-3 schools who have not received a B4SC, offered a new entrant assessment (target: 90%).

1.6.4

Health Promotion

Not MoH core contract

Health education, health promotion and population health focused activities support and address public health priorities.

# quarterly communication of health messages to schools with a population health focus. # selected hauora (health) events in the community, attended. # internal and external stakeholder meetings with a population health focus, attended.

Feedback from schools, families and stakeholders reflect equitable healthcare for students. % decile 1-3 schools that received health support and education from a PHN (target: 100%).

1.6.5

Preventive Interventions

Not MoH core contract

Integration and collaboration with Māori, Pacific and through liaison with Māori and Pacific community providers and iwi. Develop refugee support by building connections with Government and community agencies. Use of interpreters and appropriate health literacy tools for clients and staff.

# personal health referrals that support education learning and developmental and behaviour concerns. # engagements recorded in monthly reports. # regular meetings with Disease Control team clinical nurse specialist regarding status of refugee health.

Referrals support education learning and developmental and behaviour concerns. Annual audits to demonstrate health literacy actions to support care planning. % referrals resolved by the PHN, or referrals to specialist and culturally appropriate agencies.

1.6.6

Preventive Interventions

Not MoH core contract

Early identification and treatment of children with poor skin integrity and skin infections in decile 1-6 schools and other children referred from higher decile schools.

# referrals treated per skin standing orders. # skin infections referred to other services. # referrals receiving preventive care.

% skin standing orders audited.

Regional Public Health 2017-2018 Annual Plan Page 26

All children receiving a new entrant check have health needs identified and referred.

#/% CCDHB and HVDHB PHNs who have completed the Massey University on-line skin education modules (SK,O). #/% PHNs signed off to work under standing orders (SK,O). #/% children better off after treatment under standing orders (BC,S).

1.6.7

Preventive Interventions

Not MoH core contract

Child advocacy and protection. # child protection referrals PHNs respond and support child responded to. where child protection identified as issue.

% referrals with correct DHB procedures followed.

1.6.8

Health Promotion

Not MoH core contract

The clinical nurse specialist (CNS) to oversee workforce development in liaison with team leaders. This will encompass planning continuing professional development, supporting student nurse progress, supporting E3, PDRP, CASP. Supporting Māori, Pacific staff and students as well as promoting a public health focus for the School Health and Immunisation Group (SHIG).

Evaluation forms collated and reviewed following training.

# training sessions delivered to PHNs and SHIG staff. Workforce development for Māori and Pacific nurses and students.

Regional Public Health 2017-2018 Annual Plan Page 27

Clients benefit from a well trained quality workforce.

1.7 Improving vision and hearing This action plan works towards improving the vision and hearing of children in the greater Wellington region, and will improve health outcomes for children and youth through the following streams of activity: - The provision of a mobile ear van for children and youth in Porirua (CCDHB) - Routine vision and hearing screening at B4SC, following enrolment at school, and screening on request. - Both services have a focus on reaching Māori tamariki with priority screening in quintile 5 B4SC areas, and prioritising screening in decile 1-4 schools. - Providing ear health education and training to public health nurses to enable a high level of competence. - Appropriate referral system to the ear van clinic, primary or secondary care when needed. RPH will target services to Māori and Pacific children and youth as these groups have higher hearing failure rates (source: B4SC MoH Monthly Report and Quality Letter). Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Primary Care Integration, Child Health. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

1.7.1

Preventive Interventions

Not MoH core contract

Provide free mobile ear van service, located in identified high needs communities in Porirua.

# ear nurse clinics per week.

% booked clinic appointments attended.

#/% children with improvement to their ear health or appropriate referral made (CC,O).

1.7.2

Health Promotion

Not MoH core contract

Establish strong links with kohanga reo and aoga amata Pacific language nests in Porirua.

# kohanga reo and Pacific language nests (aoga amata) early childhood centres visited.

% children seen by the ear nurse that also receive ear health education.

#/% centres who promote the ear van service with a whanau ora approach evidenced by family appointments (BC,O).

1.7.3

Health Promotion

Not MoH core contract

Ear nurses to establish closer working relationships with B4SC and Well Child Tamariki Ora services in Porirua.

# drop-in clinics held at Cannons Creek Plunket rooms, and Waitangirua Health Centre concurrently with B4SC clinics. # meetings with B4SC and Well Child Tamariki ora services.

% children who received access to the Ear Van service on the B4SC clinic days.

#/% children with improvement to their ear health or appropriate referral made (CC,O).

Regional Public Health 2017-2018 Annual Plan Page 28

1.7.4

Health Assessment and Surveillance

Not MoH core contract

Investigate the viability of a 3 year old tymping programme in kohanga reo in the Hutt Valley (pending budget).

# engagements with key stakeholders in monthly reports.

100% stakeholders are receptive to the establishment of a 3 year old tymping programme in the Hutt Valley.

#/% specialist and GP services report the value of a 3 year tymping programme in the Hutt Valley (AO,S). #/% kohanga reo receptive to implementation of a 3 year old tymping programme (AO,S).

1.7.5

Preventive Interventions

Not MoH core contract

Deliver National Vision Hearing Screening Programme.

# children from B4SC, new entrant and Year 7 screened as part of the national vision hearing screening programme. # HealthScape entries.

100% of children who have a B4SC will be screened by the VHT. Plunket report regular VHT attendance to planning meetings and B4SC clinics. Monthly reports show B4SC are completed and closed. Plunket, parents and schools report positive engagements.

#/% B4SC, new entrant and Year 7 referrals are actioned by specialist or GP services (BC,O). #/% RPH VHT staff value close working partnership with Plunket (AO,S). #/% parents and schools are aware of VHT programme through feedback to stakeholders (SK,S).

1.7.6

Health Promotion

Not MoH core contract

Closer links with integrated care partners i.e. public health nurses, Plunket, PHOs, Tamariki Ora, Porirua Children's Ear Van, early childhood centres (ECCs) and schools.

# B4SC area meetings with coordinators. # VHT/ear nurse clinics in Porirua. # combined VHT and school PHN meetings. # ECC and school VHT visits.

Feedback is received from B4SC, ear nurses, school PHNs, ECCs and schools. Minutes show VHT attendance at meetings.

#/% partners report increase knowledge of the role of the RPH VHTs through referral numbers and types (SK,S).

1.7.7

Public Health Capacity Development

Not MoH core contract

All RPH VHTs will complete a biennial competency assessment by the end of 2016.

# VHTs have undertaken a peer review of their practice using the competency assessment tool.

% VHTs have completed an assessment of their practice.

#/% VHTs have increased knowledge and skills through identification of professional development needs (SK,S).

1.7.8

Preventive Interventions

Not MoH core contract

Investigate the establishment of static ear nurse clinics in the Hutt Valley (pending budget).

# stakeholder engagements.

100% stakeholders are receptive to the establishment of static ear nurse clinics in the Hutt Valley.

#/% specialist and GP services report the value having static ear nurse clinics. #/% with identified poor ear health are seen.

Regional Public Health 2017-2018 Annual Plan Page 29

1.8 Support for Work and Income clients to improve their health outcomes Public health nursing to improve the health outcomes of the Porirua Work and Income client population. These activities connect Work and Income clients to services, and connects Porirua health and social services to relevant information regarding Work and Income. The nurse also connects health and social services together with the aim of providing a smooth service for the client. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Primary Care Integration (CCDHB) only, Performance measures #

1.8.1

Core function

Health Promotion

Issue

Not MoH core contract

Activity

Established links with Porirua marae and Māori health providers support positive health outcomes for clients and the community. Support the annual Work and Income Health Expo. Developed relationships with specialist services, e.g. diabetes nurse specialist, assist clients to make lifestyle changes and better manage long term condition outcomes, disability and palliative care.

1.8.2

Health Promotion

Not MoH core contract

Develop and maintain links with Work and Income staff, management and clients. Work with Work and income staff to reduce the number of job seekers by providing health input for clients. Attend weekly site meetings.

How many = #

How well = %

# referrals to other services, GP health specialties and NGOs. # marae with on-going links to Work and Income PHN. # Māori health providers with on-going links to Work and Income PHN. # presenters at the annual Work and Income health expo.

% local marae with on-going links to Work and Income PHN (target 60). % Māori health providers with on-going links to Work and Income PHN.

#/% clients, who have previously not accessed healthcare, have been linked and supported back to primary care (target 80) (BC,O).

# referrals from Work and Income case managers.

% site meetings attended (target 70). Narrative reporting from feedback from Work and Income manager, case managers and clients.

#/% referrals to health worker from case managers have needs addressed and appropriate referrals made (target 80). Narrative report on client outcomes (case study) (BC,O).

Regional Public Health 2017-2018 Annual Plan Page 30

Is anyone better off = #/%

1.8.3

Health Promotion

Not MoH core contract

Maintain a monthly calendar of health events for the Work and Income Porirua Links office. Annual review of health calendar.

# providers of screening programmes, e.g. cervical, breast and cardiac, are invited to Porirua Links office.

Regional Public Health 2017-2018 Annual Plan Page 31

% providers satisfied with health calendar opportunities at Work and Income.

#/% clients that engage with providers at health event are more informed (target 90) (SK,S).

2.1 Smokefree Nation 2025 This action plan focuses on a range of regulatory and health promoting activities. The regulatory and health promoting activities relate to the service specifications for Health Promotion and Health Protection. Activities include: - Increasing compliance and awareness of the Smokefree Environments Act 1990. - Increasing public support for the overall goal of a Smokefree Aotearoa by 2025. - Increasing successful smoking cessation. - Strengthening operational alliances and interagency networks. - Supporting the 'Better Health for Smokers to Quit' target within primary and secondary care settings. - Reducing health inequities for Māori, Pacific peoples, and those in lower socioeconomic groups who have much higher rates of smoking and higher rates of ill-health and death from both smoking and passive smoking. Tobacco use is recognised as a major contributor to health inequities. The health burden attributable to tobacco smoking prevalence is higher amongst Māori communities. To carry out this work RPH networks with Ministry agencies, territorial authorities, retailers, licensed premise operators, the regional Stop Smoking Service (Takiri Mai Te Ata), Wellington Smoke Free Network, community event organisers, communities, as well as primary and secondary health service providers to influence and enforce policies and practices, to achieve Smoke Free Aotearoa 2025. Tobacco control activities contribute to the following planning priorities for DHB 2017-18 annual plans: Living Well with Diabetes, Better Help for Smokers to Quit. Smoking cessation activities contribute to the following planning priorities for DHB 2017-18 annual plans: Primary Care Integration (HVDHB, WDHB only),Living Well with Diabetes, Better Help for Smokers to Quit and Child Health; and reduced disparities. The tobacco plan overall contributes to the following Ministry priorities: tobacco national health target; environmental health regulatory environments; maternal and child health and wellbeing promotion; and social environments. Performance measures #

2.1.1

Core function

Health Protection

Issue

Tobacco control

Activity

Increased compliance and awareness of the Smokefree Environments Act 1990 with a key focus in Māori and Pacific communities.

How many = #

How well = %

# retailer education visits completed (Note: one visit equals one visit to one retailer). # controlled purchase operations (CPOs) completed (Note: one CPO equals one total operation that targets a number of premises).

% tobacco retailers included in CPOs.

Regional Public Health 2017-2018 Annual Plan Page 32

Is anyone better off = #/%

#/% tobacco retailers that are compliant at time of CPO (BC,O).

2.1.2

Health Promotion

Tobacco control

Increase public support for Smokefree Aotearoa 2025.

# organisations supported to develop or review SmokefreeAuahi Kore policies.

2.1.3

Health Promotion

Tobacco control

Strengthen operational alliances and interagency networks to support achieving Smokefree Aotearoa 2025.

# alliances and networks engaged with for the purpose of achieving Smokefree Aotearoa 2025. # Smokefree project/programmes introduced together with other alliances and networks.

% projects/programmes targeted at Māori and Pacific communities.

#/% alliances and networks that report positive feedback on RPH involvement and input.

2.1.4

Health Promotion

Not MoH core contract

Meet the 'Better Help for Smokers to Quit' target within secondary care at HVDHB and WDHB.

# quarterly reports that indicate the 95% target was achieved.

% Māori and Pacific patients given ABCs through the programme.

#/% participants in ABC training report an increased level of knowledge (SK,S).

Regional Public Health 2017-2018 Annual Plan Page 33

#/% smokefree te kohanga reo in RPH area (BC,O). #/% smokefree workplaces reporting fully implementing their Smokefree-Auahi Kore Policy (BC,O).

3.1 Nutrition and physical activity Poor nutrition and physical inactivity are two significant risk factors in the development of long term conditions. RPH takes a systems approach to prevention through building healthy nutrition and physical activity related public policy, creating supportive environments and strengthening community action by focusing on the communities of highest need. The aim is to achieve sustained improvements in health and wellbeing through improving the health opportunities for good nutrition and physical activity in environments where people live, learn, work and play, across the lifecourse. The plan relates to the MoH Health Promotion service specifications. This action plan aligns with the Healthy Families NZ approach which suggests that concentrated community-led health promotion, tailored to specific community need can be successful in addressing the underlying causes of chronic diseases. While Healthy Families Lower Hutt broadly has responsibility for this work for the Lower Hutt area, RPH's area of influence includes the areas of Upper Hutt, the Wairarapa, Central, Southern and East Wellington, Porirua and Kapiti. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Childhood Obesity Plan, Child Health, Living Well with Diabetes. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

3.1.1

Health Promotion

Nutrition and physical activity

Build healthy public policy to address obesogenic environments.

# organisations that agree to provide us with baseline data for the purpose of implementing a food and beverage policy.

3.1.2

Health Promotion

Nutrition and physical activity

Strengthen community action to improve the availability of healthy food in areas of high Māori and Pacific populations.

# and location of newly established fruit and vegetable packing and distribution hubs.

% growth of hubs over 20172018.

3.1.3

Health Promotion

Nutrition and physical activity

Maintain relationships and interagency networks that aim to reduce the impact of obesogenic environments.

# collaborative meetings organised and attended.

% network members surveyed report satisfaction with the Wellington NPA Network meetings, (ie rating of 4 or 5 for Likert scale of 1 to 5).

Regional Public Health 2017-2018 Annual Plan Page 34

Is anyone better off = #/%

#/% organisations who report adopting a policy.

#/% reported increase in volumes of fresh fruit and vegetables through the fruit and vegetable co-ops over the level in 2016-2017 (BC,O). #/% reported increase in orders of fresh fruit and vegetables through the co-ops during 20172018 across each distribution hub (BC,O).

3.1.4

Health Promotion

Nutrition and physical activity

Increase access to physical activity for children.

# schools who receive recycled sports equipment.

3.1.5

Health Promotion

Nutrition and physical activity

Facilitate the implementation of the Wairarapa Breastfeeding Plan 2016-2019.

# meetings held (4).

% stakeholder/partner attendance at Breastfeeding Wairarapa meetings and activities.

3.1.6

Health Promotion

Nutrition and physical activity

Increase consumption of fruit and vegetables by developing personal skills through community led cooking lessons.

# fruit and vegetable co-op communities engaged with, for the purpose of adopting community led cooking lessons.

#/% fruit and vegetable co-op communities who report implementing cooking lessons.

3.1.7

Health Promotion

Nutrition and physical activity

Review the role that food charity plays in the school environment.

# public health nurses receive the environmental scan recommendations.

3.1.8

Health Promotion

Nutrition and physical activity

Support public health and primary health nurses by providing nutrition and physical activity updates via a newsletter.

# newsletters produced.

Regional Public Health 2017-2018 Annual Plan Page 35

#/% schools who report that the recycled equipment received is useful. % agencies reporting they are actively working towards the Wairarapa Breastfeeding Plan (BC).

#/% public health nurses who report finding the recommendations useful. % public health nurses surveyed who report satisfaction with the newsletters (ie, a rating of 4 to 5 on a Likert scale 1 to 5).

#/% public health nurses report using the information provided in the newsletter.

4.1 Alcohol and other drugs These public health actions are aimed at reducing the levels of harm from alcohol and other drug use in the greater Wellington region. Activity is divided into three main areas: supply control; demand reduction; and, problem limitation. The approaches include both regulatory (Health Protection service specification) and health promoting (Health Promotion service specification) approaches. The work is informed by analysis of sub-regional data and audits of tasks such as license applications and compliance visits (Health Assessment and Surveillance service specification). RPH works with police, territorial authorities and community agencies, using regulatory and health promotion approaches, to understand and address the issues driving the harmful consumption of alcohol and drug use. Communities will be empowered to address their concerns using the RPH Community Action Neighbourhood approach. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Supporting Vulnerable Children, Reducing Unintended Teenage Pregnancy, Mental Health, Child Health, Living Well with Diabetes. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

4.1.1

Health Protection

Alcohol and other drugs

Inquire, report on and prepare briefs of evidence/submissions for all alcohol licensing matters.

# applications received for all licence types (on, off, club, special). # applications inquired into. # applications that had matters in opposition or recommendations made.

% application inquiries completed in the required 15 working days.

#/% matters in opposition made by RPH that are accepted by the receiving authority (DLC and/or ARLA). Numerator: # matters in opposition that are accepted by the receiving authority. Denominator: # matters in opposition made by RPH. #/% matters in opposition negotiated with the applicant that resulted in the withdrawal of the opposition.

4.1.2

Health Protection

Alcohol and other drugs

Collaborate in police led controlled purchase operations (CPOs) to reduce the sale of alcohol to minors.

# CPO events conducted (i.e. 1 event equals 1 evening). # premises visited specifying # of - on, off, club visited. (Reported in Vital Few RBA report).

% CPOs focused on communities with high Māori populations or areas of high deprivation. (Reported in Vital Few RBA report).

#/% premises that are compliant at the time of the CPO (BC,O). (Reported in Vital Few RBA report).

Regional Public Health 2017-2018 Annual Plan Page 36

4.1.3

Health Alcohol and other Assessment and drugs Surveillance

Undertake sub-regional and local analysis of alcohol related health data (Wellington ED, hospital health data) along with other relevant information e.g. demographics and use the analysis/reports to influence other parties at a local and sub-regional level.

# occasions data presented to agencies/services.

% peer reviewed reports as per RPH protocols.

Narrative report on anecdotal feedback regarding usefulness of the health data.

4.1.4

Health Alcohol and other Assessment and drugs Surveillance

Conduct yearly audit of alcohol licence applications, CPOs, and compliance visits from RPH database HealthScape. Complete a report to inform strategic direction and workload planning.

# audit reports completed.

% reports completed to internal specifications, including peer review.

#/% team leaders and medical officers of health report the data analysis is of value i.e. useful for planning work load and strategy internally (AO,S).

4.1.5

Health Promotion

Alcohol and other drugs

Strengthen alliances and interagency networks to reduce alcohol and other drug related harm.

# alliances and networks engaged with. # collaborative activities/projects.

% alliances and networks whose activities support communities with high Māori, Pacific peoples or young persons. % projects that support communities with high populations of Māori, Pacific peoples and young persons.

#/% alliances and networks that exhibit a stronger commitment to addressing alcohol and other drug related harm or risk factors associated with that harm (BC,S).

4.1.6

Health Promotion

Alcohol and other drugs

Work with territorial authorities (TAs) and other agencies to develop policies that support reducing alcohol and other drug related harm.

# policy submissions. # policies developed.

% RPH submissions or policy reviews that are peer reviewed.

Narrative report on the outcome of the submissions (BC,S).

Regional Public Health 2017-2018 Annual Plan Page 37

4.1.7

Health Alcohol and other Assessment and drugs Surveillance

Work with communities and other stakeholders to develop evidencebased public health action which supports the reduction of alcoholrelated harm, including providing up to date evidence-based information.

# community and other stakeholders groups supported to reduce alcohol related harm. # key activities facilitated or delivered (e.g. presentations, training sessions).

Regional Public Health 2017-2018 Annual Plan Page 38

% community and other stakeholder groups supported, that are in areas of high alcohol related harm. This may include areas with low socioeconomic status/high Māori population . Numerator: # community and other stakeholder groups supported, that are in areas of high alcohol related harm. Denominator: # community and other stakeholder groups supported.

4.2 CAYAD (Community Action on Youth and Drugs) This Action Plan aims to enhance, promote and strengthen the supports provided to rangitahi in the Hutt Valley to improve outcomes related to drugs and alcohol. Activities in this plan support the six national CAYAD strategic action areas: - Communities have greater capacity to shape their own wellbeing and prevent harm from alcohol and other drugs. - Community contributions to alcohol and other drug policy are more effective and well informed. - More cross sector collaboration. - Community capacity to support young people in education, employment and recreation is improved. - Wider support for action on alcohol and other drug related harm. - Continue to develop and grow the CAYAD programme by. Enhancing collaboration between CAYAD sites. Providing focused workforce development for CAYAD coordinators and the community. Maintaining and enhancing support for CAYAD sites. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Prime Minister's Youth Mental Health Project, Mental Health (HVDHB only) Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

4.2.1

Health Promotion

Not MoH core contract

Support organisations and community groups to develop healthy and sustainable policy and practices to enhance environments to reduce AOD related harm.

# organisations/community groups supported to develop healthy policies and practices.

% organisations/community groups engaged with who have started the policy development/review process.

#/% organisations/community groups who report having new or improved AOD policies in place as a result of the provider’s activity (BC,O).

4.2.2

Health Promotion

Not MoH core contract

Engage with and support organisations and community groups to plan and deliver community action initiatives to reduce alcohol and other drug related harm affecting young people.

# organisations/community groups supported.

% organisations/community groups report they are satisfied or very satisfied with provider’s support (i.e. rating of 4 or 5 for Likert scale of 1 to 5).

#/% reported outcomes achieved in community action initiatives (CC,O).

Regional Public Health 2017-2018 Annual Plan Page 39

4.2.3

Health Promotion

Not MoH core contract

Design, deliver and support awareness-raising activities that provide opportunity for informed discussion and debate, to increase knowledge and/or create behaviour change around the use of alcohol and other drugs.

4.2.4

Health Promotion

Not MoH core contract

Support organisations and # organisations/community community groups to increase groups supported to develop a input into local, regional and submission. national decision-making, including engaging in policy development processes.

# participants.

Regional Public Health 2017-2018 Annual Plan Page 40

% awareness-raising messages are aligned with Government, Ministry of Health and other evidenced based policies/strategies.

#/% participants report an increased knowledge of topic and/or increased understanding of key strategies to reducing AOD related harm (SK,S).

% organisations/community groups that have involved youth in the submission development process.

#/% organisations/community groups report they have put in a written/oral submission including licensing objections, as a result of provider’s support (BC,S).

5.1 Communicable diseases The aim of this action plan is to prevent illness and effectively respond to notifiable diseases and outbreaks of public health concern. Through effective public health disease surveillance, investigation and control, the impacts of communicable, waterborne and foodborne diseases can be minimised, reducing the incidence of cases from further spread. Robust collection of ethnicity data and review of surveillance data by ethnicity will help direct response activities to the most vulnerable communities where the burden of disease is higher. These include Māori, Pacific and children. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Reducing Rheumatic Fever, Primary Care Integration. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

5.1.1

Health Protection

Communicable disease

Respond promptly to cases and outbreaks of communicable, waterborne and foodborne diseases.

# disease notifications and outbreaks reported by disease.

% significant disease investigations initiated within 24 hours of notification.

#/% case and outbreak investigations successfully completed and audited on EpiSurv/Concerto (CC,O).

5.1.2

Health Protection

Communicable disease

Facilitate successful completion of drug regimens for tuberculosis (TB), latent tuberculosis infected (LTBI) and leprosy clients.

# notified TB, LTBI and leprosy cases.

#/% clients that report via a client satisfaction survey their clinical support was of a high standard and they were supported to complete their treatment.

#/% clients who completed their treatment in the reporting year (BC,O). Complementary narrative on identified treatment success stories.

5.1.3

Health Protection

Communicable disease

Work collaboratively with primary # active rheumatic fever clients care to improve secondary on the rheumatic fever register prophylaxis treatment for supported by RPH. rheumatic fever clients. Respond to and manage notifications of rheumatic fever from DHBs and primary care.

% bicillin non-compliant rheumatic fever clients followed up by RPH to encourage and facilitate bicillin compliance and regular health reviews by their specialist.

#/% rheumatic clients compliant with bicillin timeliness and compliance (BC,O).

Regional Public Health 2017-2018 Annual Plan Page 41

5.1.4

Health Protection

Communicable disease

Work collaboratively with health professionals to achieve a reduction in the incidence of acute and/or recurrent rheumatic fever, particularly in Māori and Pacific communities.

5.1.5

Public Health Capacity Development

Communicable disease

Refer actvitiy 6.6.5

5.1.6

Health Protection

Communicable disease

Reduce the burden of disease outbreaks in institutional settings.

5.1.7

Health Protection

Communicable disease

5.1.8

Health Protection

Communicable disease

# health professional groups supported by RPH to notify acute and/or recurrent rheumatic fever cases within seven working days.

#/% health professional groups who report they will implement a process to improve their RF notification.

#/% health professionals that report they have implemented processes to ensure timely notification of acute rheumatic fever as a result of RPH engagement (BC,S).

# early childhood centres (ECCs) and aged residential care facilities (ARC) invited to a disease outbreak workshop.

% invited ECEs and ARCs who participated in a disease outbreak workshop.

#/% ECCs and ARCs who have changed their outbreak management practice/behaviour as a result of RPH engagement (BC,O). #/% ECCs and ARCs who reported they have an increased knowledge about how to identify, notify and manage an outbreak (SK,O).

Maintain a working relationship # visits/reviews of needle with managers of needle exchange exchange facilities. services within our health district to facilitate an annual review of their service, ensuring the service is operating in accordance with their authorisation documentation.

% needle exchange facilities that receive an annual review of their facility.

#/% needle exchange facilities that have their annual authorisation approved by the medical officer of health (CC,O).

Legionnaire's disease awareness programme - promote safer and healthier gardening in the community.

% attendees rate the education sessions as 'good' or 'very good'.

#% attendees acknowledge an increase in their knowledge of legionellosis disease and a change in gardening practice/behaviours at the completion of the educational session (BC,O).

# legionellosis longbeachae cases notified. # education sessions facilitated by RPH/or provided by RPH.

Regional Public Health 2017-2018 Annual Plan Page 42

5.2 Promote and facilitate immunisation This action plan outlines the safe delivery of all immunisation programmes in the greater Wellington region and focuses on education, training, delivery, data collection and promotion of immunisation in the community. Health professionals and community agencies are supported to provide positive immunisation messages. Successful implementation of all of these components will ensure the Ministry of Health targets for childhood vaccination is achieved. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Increased Immunisation, Primary Care Integration. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

5.2.1

Preventive Interventions

Not MoH core contract

Promote national immunisation targets through collaboration with key HVDHB stakeholders.

Record number of quarterly meetings with stakeholders. Monitor monthly reports on immunisation targets.

MOH targets are met.

National targets are met and children receive immunisation.

5.2.2

Preventive Interventions

Not MoH core contract

National Immunisation Register (NIR) database and messaging for HVDHB is maintained in line with national protocols and reporting requirements.

# babies on register referred to practice or outreach services. All babies on NIR register.

% babies referred to practice and followed up.

Meet and exceed MoH immunisation targets.

5.2.3

Preventive Interventions

Not MoH core contract

Maintain cold chain accreditation checks for all HVDHB and those within the Hutt Valley that provide immunisation.

Monthly, quarterly and annual reporting to identified stakeholders.

Low or no reports of cold chain failures.

All vaccinations given are valid and not compromised.

5.2.4

Preventive Interventions

Not MoH core contract

Maintain infrastructure for immunisation delivery including HVDHB Local Immunisation Programme (LIP).

Record and report on the number of education sessions (at least 4 annually).

% providers will be recorded on a list of authorised vaccinators and ensure that those who have not attended an update be required to do so (target 90%).

Regional Public Health 2017-2018 Annual Plan Page 43

5.2.5

Health Protection

Communicable disease

Maintain infrastructure for immunisation delivery including participation in the Regional Immunisation Committee; authorisation of vaccinators by the Medical Officer of Health; and workforce development, advice and support for Local Immunisation Programmes (LIPs).

# of education sessions (at least 4 annually). # of vaccinators authorised by MOoH.

Regional Public Health 2017-2018 Annual Plan Page 44

% currently authorised vaccinators who have attended a vaccinator training update in the last 2 years.

5.3 Deliver Year 7 and 8 Boostrix and Gardasil vaccination programmes School based immunisation programmes have been shown to be an effective means of delivering immunisation to the school population. Vulnerable communities in particular, benefit from a service that provides students with vaccinations at school therefore reducing potential issues for families who face barriers to access. The Year 7 Boostrix programme delivered to all boys and girls affords protection from three diseases - diphtheria, tetanus and pertussis (whooping cough). Pertussis is still a frequently notified disease, and continues to be prevalent in some communities. The Year 8 Gardasil programme provides immunisation against the nine common human papillomavirus viruses, seven that can lead to cancer including cervical, genital area, throat or mouth. Two viruses included in the vaccine are to prevent genital warts. The regime of immunisation has reduced, from three doses of Gardasil 4 to two doses of Gardasil 9. The Ministry of Health have also extended the time that individuals can be immunised to 26 years of age for both male and females, the vaccine is free up until that age. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Increased Immunisation, Primary Care Integration. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

5.3.1

Preventive Interventions

Not MoH core contract

Ensure that data entered is correct and transferred to appropriate databases: SBVS, Wairarapa Excel spreadsheets and NIR. Work collaboratively with key stakeholders in order to get the best outcome for these immunisations.

Immunisation clinics and catchup clinics at schools enrolled in the programme will be recorded and reported as per contract.

% eligible children will be recorded correctly on the databases (target 100). All targets are met and/or exceeded.

All vaccinations are recorded accurately.

5.3.2

Preventive Interventions

Not MoH core contract

Promotion of the Year 7 Boostrix and Year 8 Gardasil vaccinations through schools and community settings.

# education sessions to all schools in the programme. # quarterly newsletters to schools from the School Health and Immunisation Group. # attendance at stakeholder meetings.

% schools enrolled in the school based programme.

#/% eligible population who receive appropriate immunisation via school based programme (BC,O).

Regional Public Health 2017-2018 Annual Plan Page 45

5.3.3

Preventive Interventions

Not MoH core contract

Deliver Year 7 Boostrix and Year 8 Gardasil vaccinations in schools.

# immunisations given are recorded and reported on. # those who have declined or have not completed all doses referred to their GP.

% schools enrolled in the school based programme.

#/% eligible population who receive appropriate immunisation via school based programme (BC,O).

5.3.4

Preventive Interventions

Not MoH core contract

Cold chain monitoring of all vaccines to be done on a daily basis as per RPH immunisation policy and procedures manual. Cold chain maintenance will be recorded on chilly bins that are used for transporting vaccines to venues.

Daily recordings of vaccination fridge temperatures. Daily recording from data logger on chilly bin.

% daily temperatures of the immunisation fridge monitored (target 100). % chilly bins used to transport vaccines have data loggers (target 100). % data logger reports stored electronically (target 100).

All patients receive valid vaccination.

Regional Public Health 2017-2018 Annual Plan Page 46

5.5 Sexual health promotion The intent of this action plan is to provide sexual health advice, primarily to young Māori and Pacific peoples and those that work with these groups to improve awareness, prevention and management of sexually transmitted infections and reproductive health. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Reducing Unintended Teenage Pregnancy. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

% youth feed back that they learnt new information from the session.

5.5.1

Health Promotion

Sexual and reproductive health

Deliver sexual health education sessions that support youth of Māori and Pacific descent with their decision making for sexual and reproductive health related issues.

# sexual health education sessions provided to youth of Māori and Pacific descent.

5.5.2

Health Promotion

Sexual and reproductive health

Provide sexual health information sessions for influential community people to increase knowledge and capacity of communities of high Māori and Pacific populations.

# sexual health information sessions delivered to communities with high Māori and Pacific populations.

5.5.3

Health Promotion

Sexual and reproductive health

Provide sexual health education sessions to youth of Māori and Pacific descent to raise awareness of available services to support their decision making.

# sexual health education sessions including information on available services provided to youth of Māori and Pacific descent.

Regional Public Health 2017-2018 Annual Plan Page 47

Is anyone better off = #/%

Narrative report on anecdotal feedback following sexual health education sessions.

#/% participants from sexual health information sessions report that the information helps them in their work with the wider community (AO,S). % youth of Māori and Pacific descent more aware of services that can support them with sexual health related issues.

Narrative report on anecdotal feedback indicating Māori and Pacific youth are more confident to use services that provide support for sexual health related issues.

5.6 Deliver neonatal BCG vaccination Tuberculosis infection continues to occur in New Zealand. At risk groups in New Zealand are offered a BCG immunisation in a timely manner. The neonatal BCG nurse provides education to caregivers before and after delivery of the immunisation. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Increased Immunisation. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

5.6.1

Preventive Interventions

Not MoH core contract

Promotion of BCG service to # quarterly meetings with Lead maternal and child health providers. Maternity Carers (LMC). # six monthly meetings with primary health and community health providers. # quarterly meetings with DHB immunisation stakeholders.

% LMCs aware of the referral process.

#/% identified eligible population who received appropriate vaccination (target: 90%) (BC,O).

5.6.2

Preventive Interventions

Not MoH core contract

Deliver the BCG programme to eligible children 0-5 years.

% eligible clients who attend booked clinics.

#/% identified eligible population who received appropriate vaccination (target: 90%) (BC,O).

# eligible referrals.

Regional Public Health 2017-2018 Annual Plan Page 48

6.1 Minimise environmental hazards promote safe drinking water sustainable resource management This action plan involves the delivery of regulatory work relating to the physical environment. Specifically it includes promoting the availability of safe drinking water to all communities, reducing adverse health effects from the use or mis-use of hazardous substances, ensuring safe recreational water and working with families in relation to disinternments and repatriation of deceased persons to their home country. It also focusses on reducing health inequalities by influencing environmental public health policy and through Resource Management Act processes. Resource Management The key objective is to promote good decision making, from a public health perspective, by regional and terriotorial authorities on applications for resource consents, and to influence the content of policy statements and plans. An important aspect of this work is ensuring that strong networks are developed with agencies involved in sustainable resource management. It is important to prioritise work by undertaking adequate risk assessments of the potential public health risks of any RMA related activity. Hazardous Substances Appropriate management of hazardous substances, including radioactive substances, throughout their life cycle, is important to avoid adverse health effects from direct or indirect exposure to hazardous substances and/or related environmental contamination. In conjunction with relevant agencies, RPH is responsible for protecting public health and minimising the burden of disease and injury from hazardous substances. Risk assessment of applications for use of Vertebrate Toxic Agents is a key role for RPH. Burial and Cremation and Other Environmental Health The sanitary storage, transport and disposal of the dead has a significant influence on both physical and social wellbeing. RPH has a role in ensuring the lawful, hygienic and dignified handling of the deceased, including disinternments, repatriations and the establishment of crematoria. Drinking Water A safe and adequate supply of drinking water is a prerequisite for good health. Many small rural New Zealand communities, including marae, do not have access to drinking-water that is known to be safe. These communities are specifically targeted through the Drinking-water Assistance Programme which provides technical assistance to help improve their water supplies. Larger water supplies are audited to ensure their risk identification and mitigation plans are adequate and being implemented, and that their operators are competent in the use of drinking water quality monitoring tools . A important aspect of this work is working with drinking water suppliers when monitoring shows microbial contamination. A good understanding of how the drinking water supply has become contaminated is essential to clearing the contamination and preventing a reoccurrence. Recreational Water Recreational water activity seeks to prevent the risk of disease associated with the public use of recreational waters and also optimise the social and physical health effects of this part of the environment. In addition, many discharges to fresh and marine waters pose a threat to health through contamination of food sources. Many of these food sources (e.g. shellfish, watercress) are collected as a traditional food source by many ethnic groups who are therefore at greater risk of illness. All activities are carried out in accordance with the Environmental Health Protection Manual, Radiation Incident Responders Handbook, National Health Emergency Plan, Microbial Water Quality Guidelines, International Accreditation New Zealand requirements relating to drinking water, and any other relevant plans, guidelines, manuals (additional), policy and advice provided by the Ministry of Health. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil.

Regional Public Health 2017-2018 Annual Plan Page 49

Performance measures #

6.1.1

Core function

Health Protection

Issue

Physical environments

Activity

Encourage and assist territorial authorities to develop and implement policies through processes, such as the review of district plans, including variations or plan changes or territorial authorities' Long Term Plans that address the wider determinants of health.

How many = #

How well = %

# applications/plans/ statements/standards assessed for public health issues. # submissions made. # hearings where evidence presented. Narrative reporting: Brief description of proactive/upstream work with stakeholders (who and what).

% submissions completed that include a public health risk assessment to ensure submission is (expected 100%): - evidence based - proportionate to the public health risk - peer reviewed.

Make timely and professional submissions on national (including national policy statements, national environmental standards and or guidelines) and regional plans and policy statements, district long term and annual plans and, where appropriate, resource consent applications to ensure that the public health effects are considered and managed of: - adverse air quality - the disposal of the dead - environmental noise - ionising radiation (in consultation with the Office of Radiation Safety) - non-ionising fields - recreational waters - gaseous, liquid and solid waste - urban design/form - sewage collection, treatment and disposal - drinking water (cross reference with the separate drinking water section) - other environmental health issues. Regional Public Health 2017-2018 Annual Plan Page 50

Is anyone better off = #/%

Narrative reporting: Public health impact (or expected impact) of submissions and/or proactive/upstream work with stakeholders (i.e. key public health gains).

6.1.2

Health Protection

Physical environments

Monitor decisions made under the Resource Management Act 1991 to ensure that the health impacts of environmental hazards have been considered. Follow up with regional councils and territorial authorities where this has not occurred.

# submissions made. # hearings where evidence presented. Narrative reporting: Brief description of proactive/upstream work with stakeholders (who and what).

Make timely and professional submissions on local government assessments of sanitary works to ensure that the public health aspects are considered. Comment, as appropriate, on territorial authority plans for sanitary works infrastructure planning. Liaise and, where appropriate, undertake joint projects with consent authorities and affected communities to ensure that public health aspects of planning and resource management are considered. Provide technical advice and information to regional councils and territorial authorities. Inform other agencies and the public on the public health aspects of matters relating to sustainable resource management.

Regional Public Health 2017-2018 Annual Plan Page 51

% submissions completed that include a public health risk assessment to ensure submission is (expected 100%): - evidence based - proportionate to the public health risk - peer reviewed.

Narrative reporting: Public health impact (or expected impact) of submissions and/or proactive/upstream work with stakeholders (ie, key public health gains).

6.1.3

Health Protection

Physical environments

Maintain accreditation of DrinkingWater Assessors and Drinking Water Assessment Unit.

# Drinking Water Assessor FTEs.

% Drinking-Water Assessors that maintain accreditation.

6.1.4

Health Protection

Physical environments

Identify and investigate incidents, complaints and notifications of adverse drinking water quality (or adequacy) of networked, tankered and temporary drinking water supplies.

# investigations related to incidents, complaints and notifications.

% networked water supplies (by class of water supply) where timely response was provided by PHU to transgressions, contamination or interruption in accordance with drinking water legislation and standards.

Report serious drinking water incidents to the Ministry of Health within 24 hours. Report suspected or confirmed waterborne disease outbreaks to the Ministry of Health within 2 hours.

Regional Public Health 2017-2018 Annual Plan Page 52

Complimentary narrative reporting.

6.1.5

Health Protection

Physical environments

Undertake all duties and functions required by the Health Act 1956, including: - Register drinking-water suppliers and water carriers as required. - Routinely go through the drinking water register each year and verify or update details of network supplies. - Promote compliance with the drinking-water requirements of the Health Act 1956 to drinking-water suppliers and water carriers. - Conduct the annual review of drinking-water supplies serving more than 100 people and report to water suppliers as required by Scope 1. - Assess water supplies’ water safety plans as required and provide a report to the water supplier within 20 working days. - Assess and process applications as required for the use of temporary drinking water supplies. - Ensure water-suppliers have plans and PHU responds in a timely manner to transgressions, water supply contamination or interruptions to the supply, including taking appropriate measures to protect and advise the community.

# water supplies surveyed in the annual review. # temporary drinking water supplies assessed and approved. Complimentary narrative reporting.

Ensure activities are integrated with the drinking water technical advice services for networked supplies serving up to 5000 people.

Regional Public Health 2017-2018 Annual Plan Page 53

% drinking water register entries (network supplies) verified or updated. % networked water supplies (by class of water supply) receiving at least one compliance inspection per annum with findings confirmed in writing.

#/% networked water supplies (broken down by class ie. large, medium, minor, small and rural agricultural) compliant with sections 69V and 69Z of the Health Act 1956 (BC,O). Complimentary narrative reporting.

6.1.6

Health Protection

Physical environments

Certify the implementation of water safety plans.

# of water safety plans assessed. # authorisations.

Authorise organisations for the purposes of ensuring compliance with the Act, drinking water standards, and water safety plans.

# assessments related to requirements of the DrinkingWater Standards.

Implement the requirements of the Complimentary narrative Drinking-Water Standards for New reporting. Zealand as required (eg, P2 assignments, catchment risk assessments, secure ground water assessments). Carry out public health grading of drinking-water supplies at the request of drinking-water suppliers.

Regional Public Health 2017-2018 Annual Plan Page 54

% water suppliers’ water safety plans reported on within 20 working days. % networked water suppliers serving more than 100 people with approved water safety plans. % of network drinking water supplies with an approved WSP that have had an implementation completed in the last 3 years (expected 100%). Narrative report: Why it isn’t 100% (if it isn’t).

Complimentary narrative reporting.

6.1.7

Health Protection

Physical environments

Undertake enforcement activities # investigations related to in consultation with, and at the enforcement (please specify in direction of, the Ministry of Health. narrative). Refer issues and concerns with selfsupplies to territorial authorities as required. Provide technical advice and information on public health aspects of drinking water supplies, including the implications of the Health Act 1956 and the Drinking Water Standards for New Zealand, to water suppliers, councils, the public and organisations on issues of public health significance in respect to drinking water supplies. Ensure that the public health effects of drinking water supplies are considered and managed by making timely submissions on: - regional and district plans and policies including giving effect to the National Environmental Standard for drinking water catchments - territorial authority assessments of drinking water supplies - resource consent applications.

Regional Public Health 2017-2018 Annual Plan Page 55

6.1.8

Health Protection

Physical environments

Provide advice on the benefits of water fluoridation when the issue becomes a significant issue in the community by: - supporting health professionals who are promoting the extension or maintenance of fluoridated water supplies - ensuring appropriate education material is available to institutions, health professionals, territorial authorities, community groups and the public - ensuring that messages on fluoridation and oral health are consistent and current, and keep all health providers well informed - making timely submissions on water fluoridation when appropriate.

Regional Public Health 2017-2018 Annual Plan Page 56

#/% water supplies serving 1000 people that are fluoridated (CC,O). Complimentary narrative reporting.

6.1.9

Health Protection

Physical environments

Report all notifications of hazardous substances injuries, including agrichemical spray-drift complaints, lead poisoning and poisoning arising from chemical contamination of the environment, to the science provider in the format required, including GP notifications.

# public health HSNO enforcement officers. # cases of hazardous substances injuries that are notified by GPs, hospitals and others.

Promote hazardous substances injury notifications by GPs. Participate in the Hazardous Substances Injury Surveillance System and other notifiable condition surveillance systems, including GP notifications via the HSDIRT system and according to Ministry of Health guidelines and direction. Investigate notifications of lead poisoning, poisoning from chemical contamination of the environment, and hazardous substances injuries as required.

Regional Public Health 2017-2018 Annual Plan Page 57

% debriefs/audits that show responses have been consistent with the Ministry’s advice and guidelines, including the National Hazmat Response Plan, Major Response to Fires; guidelines for public health units (Revised 2014), Investigation and Surveillance of Agrichemical Spraydrift Incidents: guidelines for public health units.

Narrative reporting: Promotion of the HSDIRT reporting process to GPs, hospitals and others.

6.1.10

Health Protection

Physical environments

Process applications for Vertebrate Toxic Agent (VTA) operations that require public health permissions.

# applications for Vertebrate Toxic Agent (VTA) permission received.

% routine applications for VTA permissions processed within 20 working days.

Ensure that the conditions imposed by the public health HSNO enforcement officer granting permits for the use of controlled vertebrate toxic agents are complied with. Field or desktop audits of all permissions are required to ensure compliance, as appropriate.

# applications for VTA permission issued.

% 1080 operations with permissions audited, either by desktop or field audit, for compliance with permission conditions (expected 100%).

# desk top audits of 1080 operations. # field audits of 1080 operations. # desk top or field audits of non 1080 operations. # VTA complaint investigations received and investigated. # VTA complaints referred to another agency.

6.1.11

Health Protection

Physical environments

Audit compliance with, investigate breaches of, and where appropriate, enforce the relevant Acts and Regulations, including: - attending hazardous substances incidents - monitoring storage and display of hazardous substances and products for retail sale - surveillance of hazardous substances injuries and reporting via the HSDIRT system.

Narrative report: Nature of any significant work not reported elsewhere e.g. beauty industry work such as nail bars. Complimentary narrative reporting.

Regional Public Health 2017-2018 Annual Plan Page 58

#/% audited VTA operations compliant with permit approval conditions (BC,O).

6.1.12

Health Protection

Physical environments

Work with other HSNO enforcement agencies to support their regulatory roles and manage potential public health risk, for example, through assisting with recalls and public warnings as required.

# hazmat incidents or emergencies attended. # hazmat exercises attended. # response plans reviewed and revised, if necessary, following responses and exercises.

Receive annual reports on methyl bromide fumigations.

# area hazmat coordination committee meetings attended.

Maintain effective risk management strategies and Complimentary narrative response plans for hazmat reporting. incidents and emergencies, including deliberate chemical contamination and chemical fires, and including at designated points of entry. Responses are required to be consistent with the Ministry’s advice and guidelines including the National Hazmat Response Plan, Major Response to Fires; guidelines for public health units (Revised 2014), Investigation and Surveillance of Agrichemical Spraydrift Incidents: guidelines for public health units. Represent public health interests at meetings of the Area Hazmat Coordination Committee.

Regional Public Health 2017-2018 Annual Plan Page 59

Narrative reporting: Outcomes of hazmat meetings and exercises.

6.1.13

Health Protection

Physical environments

Advise, encourage and/or assist territorial authorities and regional councils to: - identify potentially contaminated sites in the region and identify contaminants (including clan labs) - implement health impact assessment systems to ensure contaminated land is remedied, where appropriate, and to minimise adverse effects on human health - determine appropriate land use controls for contaminated sites to minimise the risk to the public - ensure appropriate advice is provided to manage any public health risk from sites and during any remediation processes.

Regional Public Health 2017-2018 Annual Plan Page 60

Narrative reporting: Outcomes related to whether territorial authorities have been responding appropriately to public health risks from contaminated land. Complimentary narrative reporting.

6.1.14

Health Protection

Physical environments

Promote public knowledge on the risks of environmental and nonoccupational exposures to hazardous substances and products, including asbestos in the non-occupational environment by: - providing public health advice and information on hazardous substances and products to the public, health professionals and organisations - advising on the safe management of hazardous substances and products, including their removal and disposal from contaminated areas - advising on the safe management of asbestos in the non-occupational environment according to the Ministry of Health’s guidelines and direction - advising on the safe management of products containing lead, including lead-based paint and mercury (including its removal and disposal).

# investigations/activities undertaken, by type (e.g. crayons, face paint, chemical spills). Complimentary narrative reporting.

Regional Public Health 2017-2018 Annual Plan Page 61

6.1.15

Health Protection

Physical environments

For the following public health issues: - air quality - the disposal of the dead - environmental noise - ionising radiation - non-ionising fields - recreational waters - gaseous, liquid and solid waste - other environmental health issues Undertake the following: - provide information and advice to other agencies, organisations and the public on their adverse effects - take appropriate action to minimise risks and to protect the public health from environmental exposures to these issues - monitor territorial authorities’ actions on these issues to ensure health impacts are minimized - respond to public enquiries and investigate and/or redirect public complaints and queries on these issues - support local government implementation of national policy statements and national environmental standards.

# ionising radiation source transports overseen. # requests for advice or information responded to. # complaints referred to the appropriate agency for action (where it is outside PHU’s responsibility). # complaints investigated (where it is within PHU’s responsibility) .

Regional Public Health 2017-2018 Annual Plan Page 62

% activities and advice related to ionising radiation undertaken in consultation and with approval of the Ministry’s Office of Radiation Safety (expected 100%).

6.1.16

Health Protection

Physical environments

Ensure applications for approvals are complete, and include the health protection officer’s covering report and recommendations before they are forwarded to the Ministry of Health for action, including: - disinterments - burials in special places - medical referee appointments - other burial and cremation approvals. Supervise disinterments as required. Advise and assist applicants to export cadavers, as required, to ensure public health concerns are addressed. (Note that costs may be recovered for this activity.)

Regional Public Health 2017-2018 Annual Plan Page 63

6.1.17

Health Protection

Physical environments

Conduct six-monthly visits to commercial solaria to encourage compliance with best practice guidelines. Conduct and report on prelicensing inspections of early childhood centres, including compliance by the licensee of the premises with the Education (Early Childhood Centres) Regulations 2008.

# commercial solaria visited sixmonthly.

% visits to commercial solaria operators six monthly.

# pre-licensing inspections of early childhood centres.

Complimentary narrative reporting.

# of early childhood centre inspections undertaken as a result of complaints.

Investigate/inspect and report on early childhood centres in response to complaints. Provide advice to schools and early childhood centres during an outbreak investigation and response. 6.1.18

Health Protection

Physical environments

Survey the availability of highpower laser pointers at retail outlets, provide advice on compliance and take compliance action as required by the Ministry of Health.

Regional Public Health 2017-2018 Annual Plan Page 64

#/% known commercial solaria operators who report they are aware of the under-18 age ban (SK,S). Complimentary narrative reporting.

6.1.19

Health Protection

Physical environments

Encourage local authorities to # sanitary surveys conducted by clearly identify, and publically PHU (if it is within the PHU’s notify, existing or potential responsibility). recreational waters, which do not meet minimum microbiological water quality guidelines in the Ministry of Health/Ministry for the Environment Microbiological Water Quality Guidelines for Marine and Freshwater Recreational Areas. Encourage the grading of bathing beaches, as outlined in the Microbiological Water Quality Guidelines for Marine and Fresh Water Recreational Areas. Respond to recreational water incidents and inquiries as required. Investigate cases of suspected or confirmed toxic shellfish poisoning. Provide input into regional and local activities associated with recreational water quality. Provide public and stakeholders with appropriate advice relating to recreational waters (eg, public health fact sheets, media releases, updated website information). Encourage territorial authorities and pool managers (including school pools) to implement the requirements of NZS5826: 2010 Pool Water Quality to avoid or reduce public health risks.

Regional Public Health 2017-2018 Annual Plan Page 65

6.1.20

Health Protection

Physical environments

Conduct routine evaluation of the # sanitary surveys conducted by performance of controlling PHU (if it is within the PHU’s authority management of public responsibility). health aspects of sewage collection and disposal with reference to statute, guidelines, standards, resource consent conditions and accepted public health practice. Investigate and assess the public health need for sewerage systems in areas not adequately serviced. Undertake sanitary and waste surveys as required. Provide a system for monitoring of significant public health risks in waste management. Undertake surveys of representative waste management facilities in the region as resources allow. Liaise with councils to verify that sewage overflows that pose a significant public health risk are adequately responded to, engage with sewage collection and disposal providers to ensure overflows are appropriately managed and reduce overflows to high risk areas. Promote improvements in public sewage collection and disposal systems where this is considered necessary. Investigate clusters and cases of Regional Public Health 2017-2018 Annual Plan Page 66

illnesses associated with nonoccupational exposure to sewage or other waste. 6.1.21

Health Protection

Physical environments

Maintain a 24/7 on-call response.

# health protection officers (HPOs) and medical officers of health (MOoHs) that carry out on-call duties.

Regional Public Health 2017-2018 Annual Plan Page 67

% HPOs and MOoHs that have maintained the required competency.

6.2 Promote safe and healthy urban environments RPH will influence key decisions made in health, housing and urban planning processes that have the greatest potential to improve Māori, Pacific, and child health. RPH will do this by continuing the delivery of Heathy Homes Systems (inlcuding Well Homes) which is focused on improving the living environments of those at risk of housing related illnesses (respiratory, rheumatic fever), vulnerable infants/children/new mothers, and priority populations affected by housing, and social disparities. Also, by working with communities, local and central government to influence good urban design and planning. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Reducing Rhuematic Fever, Child Health and Living Well with Diabetes. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

# evidence based public health advice to urban design or transport planning processes and/or policy making processes (minimum 3).

% identified urban design or transport planning processes and/or policy making processes responded to.

6.2.1

Health Promotion

Physical environments

Assess relevant planning or community initiatives for likely public health impact and influence planners and developers to improve health outcomes through sustainable and community centered design.

6.2.2

Health Promotion

Physical environments

From a Health in all Policies # public health intelligence approach, develop and promote initiatives completed. public health intelligence that supports healthy urban environments in areas of high socioeconomic deprivation through information papers, research and workshops.

6.2.3

Health Promotion

Not MoH core contract

Deliver a sustainable healthy # Māori, Pacific and low income housing programme to improve the families who receive a healthy health outcomes of Māori, Pacific housing assessment. and children in areas of high socioeconomic deprivation (HVDHB and CCDHB).

Regional Public Health 2017-2018 Annual Plan Page 68

Is anyone better off = #/%

#/% territorial authorities that report that they have utilised public health advice (BC,S).

#/% territorial authorities, private planners and/or community groups that RPH has engaged with, that have obviously used public health input (BC,S).

% families who receive a healthy housing assessment receive a standardised follow-up within 12 weeks of the referral being received.

#/% families provided with healthy housing interventions (BC,O).

6.2.4

Public Health Capacity Development

Not MoH core contract

Deliver proactive healthy housing training to primary and secondary health care staff working with clients and whānau in high deprivation areas, with a focus on Māori, Pacific and child health providers.

6.2.5

Health Promotion

Not MoH core contract

To build and facilitate the supply of # Māori, Pacific and low income housing interventions (HVDHB and families who receive housing CCDHB). interventions.

# primary and secondary care staff who received healthy housing training.

% training participants who are from a Māori, Pacific or child health provider.

#/% health providers who received healthy housing training reported an improved knowledge around addressing common housing issues with clients and whānau (SK,S).

#/% whānau supplied with housing interventions will use them in the manner the assessor intended.

Working in conjunction with He Kaianga Oranga a % of whanau who have received a housing visit will be evaluated, and their understanding around why they were given the intervention assessed.

6.4 Health Promoting Schools This action plan is designed to work within school based settings to improve child health outcomes in communities of high need - Māori, Pacific and low income. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Childhood Obesity Plan, Child Health (HVDHB and CCDHB). Performance measures #

6.4.1

Core function

Health Promotion

Issue

Not MoH core contract

Activity

Engage schools with high Māori and Pacific enrolments and their communities for the purpose of community-led development.

How many = #

# schools RPH engages with, for the purpose of community-led development.

Regional Public Health 2017-2018 Annual Plan Page 69

How well = %

Is anyone better off = #/%

#/% school communities report developing ways in which to effectively engage with their wider community through the involvement of RPH (BC,S).

6.6 Border health and response to emergency events This action plan aims to improve the health outcomes for the population of the sub-region including vulnerable communities through reducing risks associated with the introduction to New Zealand of vectors and diseases of public health significance. Through collaborative emergency planning and response, the impact of emergency events on vulnerable communities (particularly Māori) will be minimised. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil. Performance measures #

6.6.1

Core function

Health Protection

Issue

Physical environments

Activity

Undertake surveillance of mosquitoes at appropriate frequency (weekly over summer and fortnightly over winter) at international sea and airports or monthly audits of surveillance undertaken by the air or sea port.

How many = #

How well = %

# interceptions.

% responses initiated within 30 minutes of notification.

# incursions. # responses to other organisms.

Provide mosquito interception response situation reports to the Environmental and Border Health team using the template in the biosecurity section of the Environmental Health Protection Manual. Respond promptly to interceptions of pests with a human health significance e.g. rats, ticks, poisonous spiders and cases of imported disease.

Regional Public Health 2017-2018 Annual Plan Page 70

Narrative report on mosquito surveillance and whether it is occurring at appropriate frequency.

Is anyone better off = #/%

#/% exotic mosquitoes that have crossed the border and established in the Wellington sub-region (CC,O).

6.6.2

Health Protection

Physical environments

Ensure designated points of entry achieve and maintain core capacities as required by the International Health Regulations 2005; audit core capacities annually as required by the Ministry of Health. Identify and monitor border health protection risks from biological (including pests and diseases), chemical and physical (including ionising radiation) hazards.

# authorised or accredited persons under the Biosecurity Act 1993.

Narrative report on requirements of a competent authority met by PHU.

# intersectorial meetings at WIAL.

% current staff members involved in ship sanitation inspections who have completed the WHO on-line ship sanitation course.

# intersectorial meetings at CentrePort. # responses to border public health incidents. # maritime pratiques issues.

Develop/maintain contingency plans to deal with border health risks including surveillance, ill traveller protocols, and border emergency response plans; work with border stakeholders to support the inclusion of public health response plans within sea and airport emergency response plans.

# maritime pratiques issued on arrival. # aircraft met on arrival. # ships sanitation exemption extension or control certificates issued. # public health training (advice, update, training) to air and sea port staff.

Respond promptly to requests for pratique, inspections and certification (e.g. ship sanitation). Attend border and other intersectorial meetings with relevant agencies and organisations on matters relating to border health protection. Provide sound technical and professional advice on public health issues that are related to border health protection objectives in relation to imported risk goods,

Regional Public Health 2017-2018 Annual Plan Page 71

#/% international points of entry that meet requirements of annual verification assessment under International Health Regulations 2005 (BC,O). #/% international points of entry that have contingency plans to deal with ill travellers and other border health responses that are interoperable with public health response plans (CC,O).

disease vector surveillance and control, preparation of contingency plans for emergency response, preparation of submissions as appropriate on proposed pest management strategies. Provide public health training to air and sea port staff, as required, on border health protection risks and their management. Contribute to or lead (when required) the preparation of health impact assessments in relation to border health protection threats and eradication and control activities. Maintain on-call roster to ensure appropriately trained staff are available at all times for any border responses.

6.6.3

Health Protection

Physical environments

Maintain, exercise and regularly review plans for responding effectively to a range of public health emergencies, including national, regional and local meetings, exercise and training opportunities.

# exercises.

6.6.4

Health Protection

Physical environments

Maintain civil defence and public health emergency planning and response capacity, and ensure there are appropriate numbers of staff trained in emergency management/CIMS.

# RPH staff.

Regional Public Health 2017-2018 Annual Plan Page 72

Narrative reporting: Outcomes of exercises.

#/% RPH staff trained in CIMS 2 and 4.

#/% health protection officers and medical officers of health graduated from CIMS 4 or CIMS (Health) training (SK,O).

6.6.5

Health Protection

Physical environments

Carry out all emergency management planning, preparedness and responses in collaboration with other relevant agencies and according to Ministry of Health guidelines, plans and advice.

# responses.

% PHU plans include Reduction, Readiness, Response, Recovery and Resilience, and identify resources needed to support and carry out public health action (expected 100%). % plans and standard operating procedures (SOPs) updated each year (required 100%).

Maintain and review the RPH Major Emergency Response Plan. There must be volumes covering the following minimum areas * Border Health Response * Communicable Disease – Outbreak/Pandemic * Hazardous Substances (including radiation, and Chemical and Biological Counter Terrorism Response) * Civil Defence/National Disaster.

% plans tested, including emergency communications (required 100%). % exercises and responses that are followed by a debrief (required 100%).

Take appropriate emergency actions as the need arises. This includes: * Liaison with and taking directions from other agencies involved in the emergency * Providing services for and/or be directed by * Report to Civil Defence authorities. Ensure key health messages are available in educational and promotional materials through collaboration with other agencies/organisations involved in emergency planning and response. (Also links to activity 5.1.5) Regional Public Health 2017-2018 Annual Plan Page 73

% debrief recommendations that are incorporated into plans and SOPs.

#/% PHU Emergency Planning and Response Plan interoperable with stakeholder plans (i.e. TAs, DHBs, airport, seaport (CC,O).

7.1 Business support This action plan outlines the business support services that will be provided by the Business and Analytical Support Unit. It includes four clusters of work: administration support; information support; working with primary healthcare; and business support. The administration support cluster provides administrative and desktop publishing service to the organisation. The information support cluster develops and maintains information systems, provides specialist informatics, data management and manipulation services for RPH. The primary care work involves a public health physician who works with primary health care to identify and build links and synergies to contribute towards improving population health through preventing disease and promoting healthy behaviours. The business support cluster leads the business (including financial) planning and reporting, as well as providing project management support. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Primary Care Integration, Living Within our Means. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

7.1.1

Public Health Capacity Development

Internal allocation for all contracts

Maintain and develop the # entries into HealthScape for information systems that underpin this period. good public health service delivery.

7.1.2

Public Health Capacity Development

Internal allocation for all contracts

Coordinate and facilitate the RPH annual planning and reporting processes (links to 7.4.1).

# reports submitted to funders.

7.1.3

Public Health Capacity Development

Internal allocation for all contracts

Provide administrative support, desktop publishing and maintenance of the office work environments for the four bases.

# significant design projects carried out.

% client satisfaction with work done.

7.1.4

Public Health Capacity Development

Internal allocation for all contracts

Influence and support DHB and primary care to take public health approaches.

# DHB/PHO/Service Level Alliances meetings attended.

% DHB/PHO/Service Level Alliances meetings attended.

Regional Public Health 2017-2018 Annual Plan Page 74

% locations geo-coded in Healthscape.

Is anyone better off = #/%

7.2 Māori action plan The intent of this action plan is to implement and embed service wide components of our Māori Strategic Plan. The action plan will largely focus on establishing an internal organisational culture change that supports future action planning. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil. Performance measures #

Core function

Issue

Activity

7.2.1

Public Health Capacity Development

Internal allocation for all contracts

Te Ara Tuatahi: Relationships Maintaining and developing our operational relationships with Māori stakeholders is critical to improving Māori health outcomes as is the sharing of those experience with RPH colleagues.

7.2.2

Public Health Capacity Development

Internal allocation for all contracts

Te Ara Tuarua: Workforce development - In selecting new staff, we will place a high value on their ‘fit’ with our organisational aspirations. Our workforce reflects the sub-regional demographic for Māori.

How many = #

# employment opportunities promoted directly to iwi and Māori health service provider networks and partnerships.

How well = %

Is anyone better off = #/%

% staff satisfied with work being undertaken with Māori workplaces, communities, whānau and individuals (Likert Scale 1-5).

# engagements are available through HealthScape reporting (BC,O).

% recruitment advertisements actively used to recruit Māori.

#/% increase in the number of Māori staff recruited to RPH (BC,O). #/% RPH staff enroll in training opportunities (SK,S).

# internal training opportunities offered to RPH staff.

Equipping staff with the information, guidance and training they need to improve their work with Māori. 7.2.3

Public Health Capacity Development

Internal allocation for all contracts

Te Ara Tuatoru: Accountability # RPH consultation hui held. RPH is accountable for improving Māori health. The opportunity to critically reflect on and improve our performance regarding Māori health is required.

Regional Public Health 2017-2018 Annual Plan Page 75

% feedback from RPH management and staff demonstrates engagement with the Māori community (Likert Scale 1-5).

#/% RPH workforce recognise their contribution to improving Māori health outcomes (BC,S).

7.2.4

Public Health Capacity Development

Internal allocation for all contracts

Te Ara Tuawha: Communication # dedicated communications RPH wants a well informed staff sent to RPH staff that has access to Māori-related (weekly/quarterly). stories, research and information (national, regional, local). To support this, strong and pro-active internal communication and feedback mechanisms are essential.

% increase of sharing and showcasing Māori specific stories, research and information from Māori stakeholders and nation-wide sources.

#/% increase in the number of RPH staff exposed to Māori specific stories, research and information on a weekly or quarterly basis (SK,S).

7.2.5

Public Health Capacity Development

Internal allocation for all contracts

Māori Strategic Plan 2017-20 - The intention of this activity is to revise the current Māori Strategic Plan (2014-2017).

% feedback from RPH management and staff demonstrates consultation engagement on the Māori Strategic Plan (Likert Scale 1-5).

#/% RPH Māori Strategic Plan tasks operationalised in practice.

# RPH consultation hui are held.

Regional Public Health 2017-2018 Annual Plan Page 76

7.4 Public health infrastructure Public Health infrastructure includes public health governance (quality);workforce development; planning and reporting. These enable RPH to deliver all of the five core public health functions (public health capacity development, health assessment and surveillance, health promotion, health protection and preventive interventions). Activities contribute to the following planning priorities for DHB 2017-18 annual plans: Improving Quality, Living Within our Means. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

# staff initiating study in public health during the period. # Māori and Pacific scholarships awarded to RPH staff to undertake tertiary training.

% staff working towards a recognised public health qualification.

#/% staff with a recognised public health qualification, including breakdown of ethnicities (CC,O).

#/% RPH staff who report increased awareness of Pacific cultural values as a result of the workshops (SK,S).

7.4.1

Public Health Capacity Development

MoH core contract generic

Coordinate and facilitate the RPH annual planning and reporting systems and processes (links with 7.1.2).

7.4.2

Public Health Capacity Development

MoH core contract generic

RPH supports workforce development, including working towards 75% of RPH staff holding a public health qualification; and offering scholarships to Māori and Pacific staff.

7.4.3

Public Health Capacity Development

MoH core contract generic

Deliver Pacific cultural # Pacific cultural competencies competencies training for RPH staff. workshops held by April 2018.

% RPH staff who report positive feedback about delivery and content of workshops.

7.4.4

Public Health Capacity Development

MoH core contract generic

Implement a public health # new quality improvement governance/quality improvement projects identified. programme including a three year cycle of quality assurance using public health standards adapted from the National Public Health Performance Standards of America; implementing quality improvement initiatives and projects; and aligning to DHB quality and risk systems.

% of reports completed for HVDHB Clinical Governance Board quarterly meetings.

Regional Public Health 2017-2018 Annual Plan Page 77

Is anyone better off = #/%

7.6 Public health analytical services This action plan outlines the range of analytical services that will be provided by the Business and Analytical Support Unit (BASU) and the Medical team to support RPH and the wider public health sector. The focus of the plan is evaluating and strengthening RPH programmes and interventions. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil. Performance measures #

Core function

Issue

Activity

How many = #

7.6.1

Public Health Capacity Development

MoH core contract generic

Research and evaluate public # projects that analytical health programmes and support was provided for. interventions with a focus on improving Māori health and achieving health equity. Support service delivery through data extraction, integration and analytics, logic modelling, GIS services and public health medicine specialist expertise.

7.6.2

Public Health Capacity Development

MoH core contract generic

Provide training to RPH staff, peer review analytical work and mentor staff that are applying analytical techniques to their work. Strengthen capacity in using interactive analytic tools including R and R Shiny.

# skills development activities provided.

Regional Public Health 2017-2018 Annual Plan Page 78

How well = %

#/% projects where analytical support was provided that focus on Māori and other vulnerable populations.

Is anyone better off = #/%

#/% projects where results have been useful for future planning or delivery (AO,S).

#/% attending training who report they have increased confidence/skills (SK,S).

7.8 Communications support and health information dissemination This action plan outlines the RPH communications support and health information dissemination services. This work includes two areas of work: communications support and health information. The communications support work area is responsible for developing and implementing a consistent, high quality approach to communications across RPH. The work supports RPH staff by overseeing the development of resource material, providing media advice and management of online content, including web and social media. The health information work area is responsible for improving health literacy by maintaining an efficient health education resource distribution service to support health professionals and the delivery of public health services. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

7.8.1

Public Health Capacity Development

MoH core contract generic

Provide media management for RPH staff and medical officers of health.

# times RPH features in print media proactively and reactively each month.

% proactive media pitches captured in printed media.

7.8.2

Public Health Capacity Development

MoH core contract generic

Continue to provide support to maintain and update the RPH website and RPH's social media platforms.

# new visitors to the RPH website per month.

% RPH web content (parent pages) up-to-date at 30 June 2018.

7.8.3

Public Health Capacity Development

MoH core contract generic

Distribute health information resources and update stakeholders on revised, deleted and new resources.

# requests received for health information resources.

% requests for health information resources are responded to within five working days.

Regional Public Health 2017-2018 Annual Plan Page 79

Is anyone better off = #/%

Narrative report on the top five pages visited per month, compared with new/emergent issue (i.e. during a measles outbreak, the 'measles' page of the RPH website ranks at the top of the five most visited pages for the month).

7.9 Central region public health advice (Schedule D) The goal of this action plan is to improve public health through supporting central region public health services and providing regional leadership. This will be achieved through: providing specialist and technical public health advice for central region public health units, facilitating training relevant to the needs of the public health units, facilitating and leading collaboration with the central region public health units through the Central Region Public Health Clinical Network (CRPHCN), and providing specialist public health advice and/or representation to the Ministry of Health or other relevant central government agencies. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil. Performance measures #

Core function

Issue

Activity

How many = #

How well = %

Is anyone better off = #/%

7.9.1

Public Health MoH core Capacity contract schedule Development D

Provide specialist, technical and analytical public health advice for regional public health units and central government agencies.

# instances where specialist, technical and analytical public health advice provided to other public health units and Government agencies.

% public health units that receive specialist, technical and analytical public health advice within agreed timeframes.

#/% public health units who received specialist and technical analytical advice who report that their public health practice was strengthened through the advice (SK,S).

7.9.2

Public Health MoH core Capacity contract schedule Development D

Lead and participate in the Central Region and National Public Health Clinical Networks including active participation in the health protection, health promotion and public health nurses managers networks.

# central region public health clinical networks actively contributing to.

% central region public health clinical network attended.

Brief narrative report on outcomes of projects (BC).

7.9.3

Public Health MoH core Capacity contract schedule Development D

Participate in central region panel on health protection officer competency assessments.

# primary assessments conducted by RPH staff.

% primary assessments conducted by RPH staff.

#/% health protection officers who submitted work for assessment and were deemed to have maintained competency (SK,O).

Regional Public Health 2017-2018 Annual Plan Page 80

7.9.4

7.9.5

Public Health MoH core Capacity contract schedule Development D

Health Protection

MoH core contract schedule D

Support Central North Island Drinking Water Assessment Unit administration centre.

# hours of staff time provided to support administrative functions of the Central North Island Drinking Water Assessment Unit.

Development and implement a surge capacity agreement across central region public health units.

# PHUs who have signed the agreement.

% Central North Island Drinking Water Assessment Unit offices that have positive working relationship with administration centre, as shown in correspondence.

#/% offices that hold IANZ accreditation for drinking water work (CC,O).

Brief narrative report on outcome of the project.

8.1 Standalone contracts This action plan brings together a collection of contracts that have their own specific funding lines and are not well aligned to other action plans. It includes contracts that focus on the following areas: support to the national Public Health Clinical Network and supervision for registrars on the New Zealand College of Public Health Medicine vocational training programme in the central region. Activities contribute to the following planning priorities for DHB 2017-18 annual plans: nil Performance measures #

Core function

Issue

Activity

How many = #

8.1.1

Public Health Capacity Development

Not MoH core contract

Deliver on the Public Health Clinical Subject to separate contractual Network (PHCN) contract. reporting requirements.

8.1.2

Public Health Capacity Development

Not MoH core contract

Provide public health medicine Subject to separate contractual training programme supervision for reporting requirements. central region.

8.1.3

Health Protection

Not MoH core contract

Deliver on the MidCentral Medical Officer of Health contract.

Subject to separate contractual reporting requirements.

Regional Public Health 2017-2018 Annual Plan Page 81

How well = %

Is anyone better off = #/%

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