To read the article in full text, go to: http://www.bpac.org.nz/BPJ/2015/June/tips.aspx

Health Minister Jonathan Coleman says since the pneumococcal vaccine was introduced in 2008 there have been approximately 600 fewer cases of invasive pneumococcal disease in children under five.

“Pneumococcal bacteria can cause severe ear infections, meningitis, pneumonia, and blood infection. Invasive pneumococcal disease can be fatal in around four per cent of cases,” says Dr Coleman.

“Pneumococcal vaccines have proven to be very effective. Most of the strains covered by the 2008 vaccine have now been almost completely eliminated in young children.

“In 2007 prior to the introduction of the vaccine, there were 156 cases of invasive pneumococcal disease among children under five. In the last five years, this has dropped to 40 to 65 cases a year thanks to the protection offered by the vaccine.”

Based on data from the Institute of Environmental Science and Research (ESR), the rate of pneumococcal disease in children under five decreased by 62 per cent between 2007 and 2014. The rate decreased by 66 per cent for children under two.

Young children and the elderly are most affected by pneumococcal disease.

The pneumococcal vaccine is free to babies and children at age six weeks, three months and five months, with a booster at 15 months of age. It is also funded for adults with certain high risk health conditions.

The Government has made immunisation a top priority, lifting the national target from 90 to 95 per cent of eight month olds immunised. More babies than ever before are being protected against whooping cough and other serious preventable diseases.

To read the paper, Vaccines on the frontline, go to:  http://www.chiefscientist.gov.au/2015/06/paper-vaccines-on-the-frontline/

They hypothesised that prior exposure to opinions rejecting the safety or value of HPV vaccines would be associated with an increased risk of posting similar opinions and tested this hypothesis by analysing temporal sequences of messages posted on Twitter (tweets).

The study design was a retrospective analysis of tweets related to HPV vaccines and the social connections between users. Between October 2013 and April 2014, they collected 83,551 English-language tweets that included terms related to HPV vaccines and the 957,865 social connections among 30,621 users posting or reposting the tweets. Tweets were classified as expressing negative or neutral/positive opinions using a machine learning classifier previously trained on a manually labeled sample.

The authors conclude from their analysis that the heterogeneous community structure on Twitter appears to skew the information to which users are exposed in relation to HPV vaccines. They found that among users that tweeted about HPV vaccines, those who were more often exposed to negative opinions were more likely to subsequently post negative opinions. They go on to say that, although this research may be useful for identifying individuals and groups currently at risk of disproportionate exposure to misinformation about HPV vaccines, there is a clear need for studies capable of determining the factors that affect the formation and adoption of beliefs about public health interventions.

This is an open access article and can be read in free full text at:  http://doi.org/10.2196/jmir.4343

Dunn AG, Leask J, Zhou X, Mandl KD, Coiera E (2015). Associations between exposure to and expression of negative opinions about human papillomavirus vaccines on social media: An observational study. Journal of Medical Internet Research, 17(6), e144.

Two trials were included this review. One (involving 213 women and 213 neonates) evaluated the impact of Hib vaccination during pregnancy and was assessed as having a 'high risk of bias'. The other study (involving 2116 women and 2049 neonates) evaluated the impact of viral influenza vaccination during pregnancy, and was assessed as being at 'low risk of bias'.

The authors describe the findings from these studies and conclude that "further trials for both Hib and viral influenza vaccines with appropriate study designs and suitable comparison groups are required".

This article is available to read in free full text at:  http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009982.pub2/full

Salam R.A., Das J.K., Dojo Soeandy C., Lassi Z.S., Bhutta Z.A. (2015). Impact of Haemophilus influenzae type B (Hib) and viral influenza vaccinations in pregnancy for improving maternal, neonatal and infant health outcomes. Cochrane Database of Systematic Reviews, 6, CD009982. 

Primary health workers throughout the Whanganui District Health Board (WDHB) area have reason to celebrate as the Minister of Health’s national health targets results show primary care achieving the Better help for smokers to quit target for the first time with a 91 percent result. 
 
The results released today report the performance of DHBs against the six national health targets over the 2014/15 Quarter Three period of January to March 2015. Whanganui GP and national primary care tobacco target champion John McMenamin says he’s delighted to see the primary care Better help for smokers to quittarget reached in Whanganui.
 
“Whanganui health workers have every reason to celebrate. This result reflects the determination of primary health workers to encourage people to quit smoking,” Dr McMenamin says. “It’s a result that is very deserving as well as timely, with World Smokefree Day coming up on 31 May.”
 
While the WDHB narrowly missed out by one percent on achieving the 95 percent smoking target set for hospitals, the consistent results achieved for this target each quarter are a credit to the hospital staff offering advice and support for patients to quit smoking, says WDHB chief executive Julie Patterson.

Emergency Department clinical director Athol Steward is delighted that the WDHB’s hospital-wide efforts to admit, discharge or transfer 95 percent of patients from ED within the six-hour target, have been sustained. Dr Steward says it’s interesting to see the WDHB once again achieving 96 percent. “It shows consistency by the Whanganui Hospital’s entire clinical team and management.”
 
The 2014/15 Quarter Three national health target results show Whanganui district residents continue to enjoy a high access rate to elective surgical procedures with the DHB achieving 103 percent for the 100 percentImproved access to elective surgery.
 
But disappointingly, Whanganui’s result for the 95 percent Increased immunisation target has dropped to 86 percent. Whanganui Regional Health Network chief executive Judith McDonald says in addition to the 181 children who were immunised in this quarter, there were a further 19 children who did not receive their immunisation on time. “And given that the target performance includes families who have made an informed decision to decline immunisations, and, families who despite being offered support have not met the target timeline, the result is not surprising,” Mrs McDonald says.

Meanwhile, Mrs McDonald is delighted that for a third quarter in a row, Whanganui exceeded the 90 percent national target for More heart and diabetes checks by one percent. She says this is down to the dedicated efforts of general practice teams and the Whanganui Regional Health Network’s success in targeting patients who have not had a completed cardiovascular disease risk assessment.
 
Mrs Patterson is pleased with the steady progress being made on the new 85 percent Faster cancer treatmenttarget. This quarter’s 67 percent result is a five percent improvement on the 62 percent result achieved in the October to December quarter. The target asks that 85 percent of patients will receive their first cancer treatment (or other management) within 62 days of being referred as having a high suspicion of cancer. The target will increase to 90 percent by June 2017.

Click here for the full National Health Targets results table for 2014/15 Quarter 3.

Integration efforts across the Canterbury Health System remain pivotal to Canterbury District Health Board's performance in meeting health targets.

The National Health Targets performance summary quarter three results for 2014/2015 show Canterbury has exceeded the Shorter Stays in ED target achieving 96 percent despite increasing demand and capacity restraints within the hospital.

David Meates, Canterbury DHB chief executive, says the "remarkable" result represents the ongoing integration of services across the health system, particularly for older people to help them stay well in their own homes for longer.

"Although attendance has grown continuously since the February 2011 earthquakes, we are seeing little growth among the older population, which is a reflection of the strategies to care for older people in their own homes and communities being well embedded," Mr Meates says.

He says the biggest growth in attendances remain the younger adult population where there's been a 46 percent increase in non-enrolled patients aged 25-29 presenting to ED.

"We have increased focus on capturing home addresses appropriately and ensuring this group are provided with the right information on where to access primary care rather than defaulting to ED."

Primary care efforts particularly from the 24 Hour Surgery on Bealey Ave, Moorhouse Medical and Riccarton Clinic play a key role in the Canterbury Health System successfully managing acute demand. 

Other impressive results this quarter have been in our Improved Access to Elective Surgery delivering 100 percent of our target delivery (12,851 elective surgeries out of our 17,484 annual target).

"This is really outstanding given the theatre capacity constraints. It is a sign our priorities to improve patient flow, as well as ensuring we are tracking, monitoring and responding to any changes quickly, are working.

Performance exceeded the 'Better Help for Hospitalised Smokers to Quit' target where the Canterbury DHB achieved 97 percent of the 95 percent target.

"There's been a big emphasis on staff education, documentation and referrals. Hospital staff are also being supported to take on roles to support smoking cessation previously held by the Smokefree control team."

Quarter three has been a first for Canterbury in achieving the Increased Immunisation target of immunising 95 percent of eligible children.

"Low opt-off decline rates have contributed to this quarter's performance as well as targeted efforts by primary care."

Canterbury DHB continues efforts towards the meeting the Primary Care Health Targets of Better Help for Smokers (83 percent) and More Heart and Diabetes Checks (78 percent).

"We are committed to working closely with our Primary Health Organisations to actively support the delivery of primary care Health Targets. Initiatives include ongoing education, enhanced clinical engagement, and supporting high risk populations."

*Canterbury received an achieved based on improvement against the quarter two results.  

More information about how Canterbury performed in the health targets can be found on our website.

The West Coast health system has improved its performance in most of the Government’s health target categories thanks to efforts of teams across the Coast health system.

West Coast District Health Board Chief Executive David Meates says the performance improvements across the various targets have resulted from the health system working together on the areas that needed more focus.  A greater awareness of programmes designed to help people take responsibility for their own health has also played a part.

In the emergency department target which requires 95% of patients to be admitted, discharged or transferred from an emergency department within six hours, the West Coast DHB has scored an impressive 99.4%.

The West Coast’s elective surgery target is to deliver 1592 surgeries during the year ending June 30.  The DHB is tracking at 111.3% with 1288 elective surgeries delivered to date.

“With our smoking cessation advice and services, we have met both hospital and primary care targets this quarter.  West Coast DHB staff provided 97.8% of hospitalised smokers with smoking cessation advice and support – exceeding the 95% target with our best result yet,” Mr Meates says.

West Coast Primary Health Organisation Executive Officer Helen Reriti says general practices have reported giving 4,575 smokers advice about stopping, in the 12 months ending March 2015, representing 94% of smokers expected to attend general practice during the period.

“It’s particularly pleasing to have exceeded the 90% target for the first time.  Our clinicians have made huge efforts to tackle this issue, alongside the introduction of new technology to support their initiatives,” Ms Reriti says.

“Likewise, with 90.3% we have met for the first time the 90% target of ensuring the eligible enrolled West Coast population have had a cardiovascular risk assessment in the last five years.  That represents a 7.6% increase on our figures for the last quarter,” she says.

The range of approaches used to increase performance included identifying cardiovascular risk assessment champions within general practices; nurse-led clinics in practices; evening clinics and protected appointment time allocations for checks; Poutini Waiora nurses collaborating with general practices; conducting checks at local events; and using technology to remind patients.

High opt-off and declines continue to be challenging in meeting the immunisation target (95% nationally).  On the West Coast 89% are being immunised, however, we are reaching 100% of “high deprivation children” and 93% of all Maori children. 

This is the second time DHBs have been assessed against the new cancer treatment target and 62.5% of West Coast DHB patients received their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer.

Mr Meates says the Coast’s small population poses a challenge in this area. 

“We are missing this target by just one patient. But work is ongoing to improve the capture and quality of the Faster Cancer Treatment data which will improve our performance over the next few quarters.” 

Full information on the West Coast DHB’s Health Target performance can be found here, and information on the Ministry of Health’s Health Targets site here.

The results for Quarter Three of 2014/15 have been released by the Ministry of Health.

Results indicate that in this quarter, the Taranaki DHB has performed well in improving access to elective surgeries. With results ahead of the national average, the DHB is also paving the way towards the new faster cancer treatment goal, currently ranking fourth in the country for this target. Taranaki DHB has also achieved its target of 95 percent for shorter stays in Emergency Departments.

Taranaki DHB Planning, Funding, and Population Health General Manager, Becky Jenkins said, “A focus on the six key areas is important to continue to improve health, reduce inequalities and improve the quality of health services for local people. This quarter’s results have seen Taranaki DHBs maintain performance in a number of areas.”

Taranaki DHB Chief Operating Officer Gillian Campbell said, “In terms of our hospital services, the results show people in Taranaki have improved access to elective surgery and that we are working hard to ensure patients referred with a high suspicion of cancer are treated in a timely manner.”

The health target results for Taranaki DHB are:

Shorter stays in Emergency Departments: Target 95%, Achieved 95%
95 percent of patients seen in Taranaki Emergency Departments were admitted, discharged, or transferred from the department within six hours.

This result can be attributed to Taranaki DHB and Midland Health Network, the network of 99 percent of General Practitioners (GPs) in Taranaki, working closely together to ensure patients receive the right care, at the right place. That is, the Emergency Department for all emergencies, and their GP for other non-urgent medical needs.

The target was achieved nationally for the first time against a continuing increase in the number of emergency department presentations with 4,481 more people attending this quarter when compared to quarter two.

Improved Access to Elective Surgery: Target 100%, Achieved 120%
Taranaki DHB has again achieved over the target of 100% (for the population) for the improved access to elective surgery target, with a 4 percent increase from quarter two 2014/2015 results. Taranaki DHB has delivered this across a wide range of surgical specialities and is ranked second for its performance.

Assisting in this result has been an ongoing focus on ensuring patients are well prepared for surgery, and a continued reduction in day-of surgery-cancellations. Taranaki DHB is also undertaking a project to increase the surgical day procedure rate. This project is supported by the Ministry of Health.

Significant benefits also continue to be realised from the implementation of the Enhanced Recovery After Surgery (ERAS) programmes.

The national elective surgery health target has been achieved with 123,585 elective surgical discharges provided, against a year-to-date target of 115,588. This is 7997 (6.9 percent) more than planned.

Faster Cancer Treatment: Target 85%, Achieved 72%
This is the second quarter of public reporting of the new faster cancer treatment health target results. Nationally, results increased by 1.6 percent compared with the previous quarter to 67.4 percent overall. Data includes patients who received their first cancer treatment between October 2014 and March 2015. No DHBs have met the 85 percent target.

Taranaki DHB plans to continue this strong performance, and its collaborative relationship with the MidCentral DHB, to continue to work towards the target.

The target is 85 percent of patients receive their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks by July 2016, increasing to 90 percent by June 2017. Results cover those patients who received their first cancer treatment between July and December 2014.

Increased Immunisation: Target 95%, Achieved 91%
This quarter, 91 percent of Taranaki eight-month-olds were fully immunised. This is a decrease of 2% from the last quarter. These results are in line with historical expectations for quarter three because of the difficulty in vaccinating children during the summer holidays.

Nationally, the increased immunisation health target, national coverage at eight months was 92.9 percent, an overall decrease of 0.6 percent compared with the previous quarter but 1.5 percent higher than the same quarter in 2013/14.

Taranaki DHB has worked closely with primary care organisations, hospital services, outreach immunisation services, the National Immunisation Register and Well Child Providers on strategies to help improve our immunisation uptake, including early enrolment of new-borns with a GP.

A high level of immunisation coverage (around 95%) is required to prevent community spread of two common infectious diseases - measles and whooping cough. Taranaki DHB and the wider sector are working together to increase activity through to June 2015, with the aim of reaching the 95% target.

Better Help for Smokers to Quit (Hospital Target): Target 95%, Achieved 94%
Taranaki DHB continues to work hard to ensure patients and visitors to its hospitals are given advice about quitting smoking. By supporting smokers to quit, the aim is to improve the health of those around them by reducing exposure to second hand smoke.

A national total of 31,522 hospitalised smokers were offered brief advice and/or cessation support during quarter three, out of a possible 32,980.

Better Help for Smokers to Quit (Primary Care Target): Target 90%, Achieved 86%
Taranaki DHB is committed to working collaboratively with our Primary Care Organisation to continue to strengthen and implement a range of good practices to ensure all patients who smoke are offered or given effective stop smoking support.

More Heart and Diabetes Checks: Target 90%, Achieved 91%
This quarter, 91 percent of the eligible population had heart and diabetes checks. This is a one percent increase on Taranaki’s quarter one results.

Diabetes and cardiovascular disease remains one of the main causes of ill health in Taranaki and Taranaki DHB continues to work hard to provide the best outcomes for these people.

The implementation of a multidisciplinary team to support the care provided by GP practices, and the ongoing education of GP’s and practice nurses in the care and management of diabetic patients in the community, are just two examples.

Results show there were approximately 150,600 more checks provided in the five years to the end of March 2015 compared with the five years to the end of March 2014.

Nearly 500 more people were admitted, discharged or transferred within six hours of presenting to Wellington Hospital’s emergency department between January and March this year, an increase of three percent from the previous three months.

Latest health target results released today show that despite another record increase in the number of presentations to the emergency department in the first quarter of 2015, Capital & Coast District Health Board (CCDHB) has improved its performance against the shorter stays in emergency departments target, and three of the five other targets.

“These results reflect the improvements we’ve made to change how we care for people in hospital and the community, and the tremendous efforts made by our staff to provide high-quality healthcare for our patients,” says chief operating officer Chris Lowry.

“Elective surgery performance has improved and we are on track to meet the target this year as we have done in previous years,” she says.

The DHB is also providing more people with help to quit smoking, rising from 80% in the last quarter to 92% of patients provided with brief advice and support to quit this quarter.

“Quitting smoking is the single best thing a person can do for their health. While we have some more work to do in this area to achieve the target, it is promising to see we are supporting more of our patients to do this, especially at the primary care level,” she says.

CCDHB continues to lead the country in the new Faster Cancer Treatment target, and achieved the national immunisation target as second-highest performer.

“Our goal is to achieve all six targets. These latest results are very promising and reflect the amount of time and effort put in by our staff put in to date,” Ms Lowry says.

The recent drop in temperature has many making preparations for winter but at Waikato District Health Board (DHB) the planning has been going on for weeks.

Waikato Hospital’s assistant group manager: hospital operations, Kevin Harris leads a team of people ensuring that all Waikato DHB hospitals are ready for winter and able to cope with the seasonal influx of patients.

“We did this last year and one of the first things we did was to adjust Waikato Hospital’s bed plan for expected increases in patient numbers and then flowing on from that we started planning our staffing needs.”

The final touches are going on at level 7 in the Elizabeth Rothwell Building for the opening of the Waikids winter ward next week.

Despite the late arrival of the flu vaccination, nearly 60 per cent of our staff have already been vaccinated against the flu.

“Having well staff is pivotal to that and that’s why I am very pleased to see the high level of vaccination. A lot of the thanks for that should go to Karren Moss in Health and Safety and the large numbers of volunteer vaccinators in the wards. They’ve given us a head start for winter,” said Mr Harris.

Over the next couple of months, Kevin will be highlighting exactly what goes into winter planning at Waikato Hospital every year.

Planning also involves seeing what happened last winter.

“The demand for beds is monitored daily against our plans, and adjustments to those plans are made when required.

“Nurse managers and duty nurse managers work hard to ensure that Waikato Hospital has the right number of beds open in the right places, at the right times to treat our patients.”

The results of the six national health targets across all 20 District Health Boards (DHBs) have been released today for the January to March 2015 quarter.  We sustained our improvements to achieve the goals again this quarter for Shorter Stays in the Emergency Department, and Better Help for Smokers to Quit for patients admitted to hospital.  A summary of our results for all the national health targets this quarter is provided below.

Just under 96% (9520) of 9961 people were admitted, discharged or transferred from the Emergency Department (ED) within six hours of presenting – A small improvement on last quarter and again achieving the national target.  Compared to the same quarter last year when we had a similar number of people presenting to the Emergency Department, 559 more people had shorter stays in ED this quarter – a sizeable improvement that reflects the concerted effort of a large number of staff to ensure better patient flow processes, and, together with our general practice teams, better manage the demand for acute health care services.

We continue to be ahead of target for the number of people discharged following their elective surgery.  Over this quarter, another 1701 patients were discharged following their elective surgery bringing the total number to 5377 patients who have had their elective surgical procedure over the last nine months – delivering 110% of our planned target year to date.  About 11% of our patients have their planned surgery at other hospitals that provide specialist surgery to residents of the wider region, like Wellington for heart surgery, and Hutt Valley for plastic and burns surgery.

The new national target for faster cancer treatment was published for the first time last quarter.  The target is that by July 2016, 85 percent of patients receive their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks.  Our result this quarter, at 67%, is consistent with last quarter and the same as the national average for this period (results cover those patients who received their first treatment between October 2014 and March 2015).  This target focuses on a sub-set of patients who are referred through a managed, outpatient pathway.  Our aim is to make steady improvements toward this target by examining referral guidelines and pathways to earlier diagnosis and treatment that will ultimately benefit all cancer patients.

The hospital component of the national health target for offering advice and support to quit smoking was achieved for the second consecutive quarter, with a result of 97.0%.  This was a small improvement on the result last quarter and just above the national average (96%).  Of the adult patients admitted to hospital who smoke (about 15% of all admissions), 1111 patients have been offered brief advice and support to quit smoking over the last nine months.

The result for providing better help for smokers to quit in the primary healthcare setting could not be reported in time for publishing this quarter.  This was disappointing, especially as the targeted ‘quit smoking’ campaign that was undertaken over the last few months by our primary health organisation (CentralPHO) and general practice teams is likely to have contributed to a big improvement on our previous results.  We are currently verifying the data and expect that updated data will be published on the health targets website within the next week or so.

Our result for eight-month-old infants being fully immunised on time fell slightly this quarter to 94.4% - just short of the 95% target, which we attained last quarter.  A drop in the rate this quarter is similar to the pattern last year, with the summer holiday period making it a bit more difficult to reach families with infants due for their immunisation.  Our immunisation team, including general practices and outreach services, continue to work together with families to ensure the vast majority of our children are immunised against vaccine preventable diseases.

The proportion of our eligible enrolled population that have had their risk for cardiovascular disease assessed in the last five years was much the same as last quarter.  Although there were another 367 heart and diabetes checks undertaken between January and March, the proportion of the total expected number to have had a risk assessment over the last 12 months fell short of the 90% target, at 85% of the 47,260 eligible enrolled adults.  CentralPHO is continuing to support general practice teams and our Maori and Pacific health providers to enable more people to have a heart and diabetes check to minimise the risk of them having a heart attack or stroke in the next five years.

Chief executive officer Kathryn Cook has thanked staff for their continued efforts to improve on our performance against these targets.

For more details and FAQs about the Health Targets go to: www.health.govt.nz/healthtargets and the 'MyDHB' website.

Health Minister Jonathan Coleman says the latest quarterly health target results show the shorter stays in emergency departments target has been met for the first time.

“DHBs are continuing to improve their performance on the Government’s health targets,” says Dr Coleman.

“Across the country over 250,000 New Zealanders were admitted, discharged or transferred from an emergency department within six hours. Achieving the 95 per cent target for the first time is a significant achievement.

“The number of patients presenting to emergency departments continues to increase. In quarter three, 4,481 more people attended an emergency department compared to the last quarter.

“Reaching the target is a tribute to all the staff working within emergency departments and DHBs. We know that emergency departments only work well when the rest of the hospital is working well too.”

The improved access to elective surgery and the hospital component of the better help for smokers to quit targets were also met:

• 96 per cent of smokers in hospitals were offered advice on how to quit.
• DHBs delivered 7,997 more elective surgical discharges than planned.

“DHBs remain focused on reducing waiting times for elective first specialist assessments and treatment,” says Dr Coleman.

“The extra $98 million for elective surgery in Budget 2015 will provide more New Zealanders with timely surgery. The Government is committed to continuing to deliver increases in elective surgery.”

The results also show good progress on other targets, including:

• The more heart and diabetes checks target increased to 88 per cent.
• The primary care component of the better help for smokers to quit target increased to 89 per cent.
• The new faster cancer treatment health target increased to 67 per cent – this is the second time this target has been reported.

The quarter three (January-March 2015) results can be found at www.health.govt.nz.

The results of district health board performance against six health targets for the third quarter 2014/15 has been released.

The results are available at:  http://www.health.govt.nz/new-zealand-health-system/health-targets/how-my-dhb-performing/how-my-dhb-performing-2014-15

The module will support knowledge of the human papilloma virus (HPV) and the HPV vaccine. It will assist you with knowing when to order an HPV test as part of regular cervical screening, and discussing the results of those tests with women.

To find out more on the LearnOnline website, go to:  http://learnonline.health.nz/course/category.php?id=83

This Account focuses on the quality of services Hutt Valley DHB provided during 2013/2014.

Contents include: Health targets; Quality & safety markers; Serious adverse events; Patient experience Receiving care closer to home; Getting in shape before joint surgery; Getting better at home; Helping cancer patients find their way; Encouraging attendance; Community Safety Initiatives HealthPathways; More heart and diabetes checks; Help quit smoking; Disability services; Empowering staff; Giving babies the best possible start; Patient safety initiatives; Open campaign; Care capacity demand management; Electronic whiteboard; Newborn hearing screening; Malnutrition screening & training; Supervisor training; Looking forward; Future Focus.

This Quality Accounts is available to read in full text at:  http://www.huttvalleydhb.org.nz/content/10ff5f6d-fe7e-4a44-8667-5b72672d3214.html

The authors used data from the Netherlands to evaluate the impact of vaccination against HPV types 16 and 18 on the burden of anal, penile, and oropharyngeal carcinomas among heterosexual men and men who have sex with men. The reduced transmission of vaccine-type HPV from vaccination of girls was assumed to lower the risk of HPV associated cancer in all men but not to affect the excess risk of HPV associated cancers among men who have sex with men.

Before HPV vaccination, 14.9 (95% credible interval 12.2 to 18.1) quality adjusted life years (QALYs)  per thousand men were lost to vaccine preventable cancers associated with HPV in the Netherlands. This burden would be reduced by 37% (28% to 48%) if the vaccine uptake among girls remains at the current level of 60%. To prevent one additional case of cancer among men, 795 boys (660 to 987) would need to be vaccinated; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2162, 3486, and 1975, respectively. The burden of HPV related cancer in men would be reduced by 66% (53% to 805) if vaccine uptake among girls increases to 90%. In that case, 1735 boys (1240 to 2900) would need to be vaccinated to prevent an additional case; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2593, 29107, and 6484, respectively.

The authors conclude that men will benefit indirectly from vaccination of girls but remain at risk of cancers associated with HPV. The incremental benefit of vaccinating boys when vaccine uptake among girls is high is driven by the prevention of anal carcinomas, which underscores the relevance of HPV prevention efforts for men who have sex with men.

This is an open access article and can be read in free full text at:   http://dx.doi.org/10.1136/bmj.h2016

Bogaards, J.A., et al. (2015). Direct benefit of vaccinating boys along with girls against oncogenic human papillomavirus: Bayesian evidence synthesis. BMJ, 350:h2016.

WHO presents World Health Statistics 2015 as an integral part of its ongoing efforts to provide enhanced access to comparable high-quality statistics on core measures of population health and national health systems.

To download the report, go to:  http://www.who.int/gho/publications/world_health_statistics/2015/en/

The objectives of this study were to explore barriers to immunisation in a Pacific island community from the perspectives of community members and health professionals and to conduct a pilot programme whereby immunisation catch-up clinics were held in a Samoan church in western Sydney. 

Interviews were conducted with 12 Pacific island community members and 7 health professionals connected with the Pacific island community in 2013. A partnership with a local Samoan church was established to provide an accessible venue for immunisation catch-up clinics. 

Among the community members there were high levels of belief in the importance of immunisation and a positive view regarding the protection offered by immunisation. A key barrier reported by community members was being busy and therefore having limited time to get children immunised. The important role of the church within the community was emphasised in the interviews, and as a result, two immunisation catch-up clinics were held in a Samoan church in western Sydney. The age range of attendees was 7–33 years. A total of 31 measles, mumps and rubella doses and 19 meningococcal C doses were given during the two clinics. 

The authors conclude that the outcomes of the interviews and the subsequent clinics highlighted the potential of churches as a venue for providing public health interventions such as catch-up immunisation.

This article can be read in free full text at: http://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/277/461  

Scott N et al. Responding to a measles outbreak in a Pacific Island community in Western Sydney: community interviews led to church-based immunization clinics.Western Pacific Surveillance and Response Journal, 2015, 6(2). 

Health Minister Jonathan Coleman says more than one million doses of seasonal influenza vaccine have now been distributed.

“This is the fourth year in a row where more than a million doses have been distributed,” says Dr Coleman. “New Zealanders are protecting themselves, their families and their communities from influenza.”

“This year, the influenza immunisation was delayed globally a few weeks so that two new vaccine strains could be incorporated.

“This will ensure New Zealanders are better protected this winter from the strains of influenza circulating around the world.

“The health sector has met that challenge admirably, with distribution fast catching up to last year’s total.

“DHBs, PHOs, doctors, nurses and pharmacists have worked tirelessly this year, to protect so many New Zealanders against seasonal flu in a tight timeframe.”

Influenza immunisation is free for New Zealanders at high risk of complications and is accessible through their local general practice and some pharmacies. Many employers also provide free vaccination.

High risk groups include those with long-term health conditions such as heart disease, stroke, diabetes, respiratory disease, kidney disease, cancer, as well as pregnant women and people aged 65 and over.

This year there is a particular focus on ensuring younger people with long term health conditions such as severe asthma or diabetes are protected.

Notes:

The influenza vaccine for the 2015 season includes two new strains based on recommendations from the World Health Organization. The composition is:

• A/California/7/2009 (H1N1)-like virus
• A/Switzerland/9715293/2013 (H3N2)-like virus (New)
• B/Phuket/3073/2013-like virus (New)

The publicly funded vaccine is available until the end of July 2015. For further information go to www.fightflu.co.nz or www.health.govt.nz/influenza or call 0800 IMMUNE (0800 466 863).

Medical Officer of Health, Dr Rob Weir says “MidCentral DHB had its first case of laboratory confirmed measles since 2011 earlier this week.  

“The MidCentral Public Health Service has acted to minimise the risk of further spread.  These actions have included advising those close contacts that are not vaccinated or immune from previous measles infection to stay at home for 2 weeks after last exposure to the case.”

Dr Weir said: “Measles is a very infectious disease so anyone who is not immune to measles is at risk if they come in to contact with the disease. It spreads from person to person through the air from breathing, coughing and sneezing, and contact with those secretions.  The disease is contagious from just before symptoms begin until about five days after onset of the rash.  The illness usually starts between 10 and 14 days after contact with the measles virus.”

Measles symptoms include: fever, runny nose, cough, and sore red eyes. After 3-5 days a rash appears on the head and spreads down the body.

Dr Weir said: “For every 1000 cases of measles, approximately 100 will need hospital treatment, 100 will develop an ear infection and 50 will progress to pneumonia.

“This case is a reminder that measles can occur at any time. Vaccination is the best way for people to protect themselves against measles and is free to those who need it.  You can protect both yourself and the community by getting vaccinated.”

Dr Weir said: “Anyone who thinks they may have measles should stay away from work, school or public places. If you think you might have measles I recommend you contact your GP (by phone first) or Healthline on 0800 611116 for more advice. It is very important you tell your GP that you think you might have measles before going in to the surgery.

Eight randomised controlled trials were included. The authors conclude from the results of their analysis that "in patients with cardiovascular disease, influenza vaccination may reduce cardiovascular mortality and combined cardiovascular events. However, studies had some risk of bias, and results were not always consistent, so additional higher-quality evidence is necessary to confirm these findings. Not enough evidence was available to establish whether influenza vaccination has a role to play in the primary prevention of cardiovascular disease".

This review is available to read in free full text at:  http://dx.doi.org/10.1002/14651858.CD005050.pub3 

Clar C, Oseni Z, Flowers N, Keshtkar-Jahromi M, Rees K. (2015). Influen.za vaccines for preventing cardiovascular disease. Cochrane Database of Systematic Reviews,  5, CD005050.

Studies in this issue (attached below):

Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio.

Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions.

Overall, the authors report that their results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.

This is an open access article and can be read in free full text at: http://dx.doi.org/10.1016/j.vaccine.2015.04.040

Jarrett, C., et al. (2015). Strategies for addressing vaccine hesitancy – A systematic review. Vaccine, 18 April [Epub before print]

Eighteen articles were included. Most studies were conducted in the United States. The authors conclude from the results that "there is good evidence that reminder letters will improve influenza vaccination uptake in children with HRCs, but the evidence that telephone recall or a combination of letter reminder and telephone recall will improve uptake is weak. It is not known if multiple reminder letters are more effective than single letters or if multi-component strategies are more effective than single or dual component strategies".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1016/j.vaccine.2014.12.013 or contact your DHB library, or organisational or local library for assistance.

Aigbogun, N.W., et al. (2015). Interventions to increase influenza vaccination rates in children with high-risk conditions - A systematic review. Vaccine, 33(6), 759-770.

Southern DHB this week launched its staff flu campaign with the aim of increasing the uptake of its flu vaccination to staff to over 65%.

Last year, 54% of Southern DHB staff had the flu vaccination, which was offered free to all staff.

“Health care workers are at a higher risk of exposure to the influenza virus and the message we want to get across to our staff is that they should have the vaccination not only to protect themselves but to protect their colleagues, their families, and above all their vulnerable patients,” commented Southern DHB Executive Director of Nursing and Midwifery, Leanne Samuel.

More information is being provided to staff this year including posters featuring staff stories of how the flu has affected them and the reasons why they should have the flu vaccination; a video featuring a staff member who had the flu; flu facts on the staff intranet and all staff have been sent a letter asking them to have the vaccine to protect themselves, their family and their patients by getting the flu vaccine.

“We’re also using promotional material from the National Influenza Specialist Group who manage the national annual influenza awareness campaign to help raise staff awareness about the benefits of the vaccine,” said Ms Samuel.

The DHB is providing clinics at various locations and times for staff to have their vaccination carried out by authorised vaccinators especially trained to prescribe and administer vaccinations. There will also be roving clinics for staff who can’t make the fixed clinics for reasons such as being on permanent night shifts.

“Our vaccination team will do their very best in making the flu vaccine accessible to all staff,” said Ms Samuel.

The influenza vaccine is free for New Zealanders at high risk of complications - pregnant women, people aged 65 and over, and people of any age with long-term health conditions such as heart disease, stroke, diabetes, respiratory disease (including serious asthma), kidney disease and most cancers.

Flu is a highly contagious infection that anyone can catch and for some, especially the elderly, vulnerable patients in hospital and for those in ‘at risk’ groups it can be very serious.

Although symptoms are similar to the common cold, they tend to be more severe and last for longer.  Flu symptoms include a sudden high temperature, headache, general aches and pains, tiredness and a sore throat.  They can make you feel so exhausted and unwell that you have to stay in bed and rest until you feel better.

For advice about influenza immunisation visit www.fightflu.co.nz  or text FLU to 515

For free health advice, call Healthline on 0800 611 116.

These can be viewed online and printed copies ordered at: Child health/Well Child programme. Their HealthEd codes range from HE2433 to HE2458.

The committee concludes that this streamlined set of measures could provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas.

The report can be read for free online at:  http://www.iom.edu/Reports/2015/Vital-Signs-Core-Metrics.aspx

Read about her experience on Waikato DHB Newsroom:  http://www.waikatodhbnewsroom.co.nz/2015/04/28/a-new-mums-nightmare/

Between October and December 1918 an influenza pandemic travelled across the globe and hit New Zealand. By December the death toll had topped 8600. Records are a bit sketchy but Māori suffered heavily, with at least 2160 deaths.

Te Puna Oranga, general manager, Ditre Tamatea, recalls his kuia’s memories of the pandemic.

“My grandmother witnessed the nightmare as a child and can recall carts of dead bodies rolling through the streets. There is talk in our oral traditions that our people living in Māori communities were denied access to hospitals, the roads were blocked by armed police; was that just management of the influenza outbreak, or something else? It is a chapter in our history which is quickly being forgotten by many,” he said.

“For Māori our marae became our hospitals, we tended to the sick and the dying, and there were plenty of our people in both categories. Whatever the response was in those days, influenza like death, did not discriminate.”

New Zealand lost about half as many people to influenza as it did the First World War. The impact was nothing short of catastrophic. Globally it infected 500 million people, including remote Pacific islands and the Arctic; of those 50 to 100 million of died. It was one of the deadliest natural disasters in human history.

Seasonal influenza visits us every year, this winter’s strain from the northern hemisphere is particularly deadly. What we saw in the United States and United Kingdom indicates it is likely to see many hospitalized and some of our whānau are likely to die from influenza, said Ditre

“Immunisation against influenza is perhaps your best defence.”

But how do we reach our whānau? How do we encourage our kaumātua to get their immunisation against influenza? Certainly if you are over the age of 65 you can go to your GP and get immunised for free.

But what else can we do? Why don’t we go to where our kaumātua are, like the Kaumātua Idol day, now there is a thought?

It was the 2015 Kaumātua Idol. More than 200 of Hamilton’s kaumātua filled the Te Wānanga o Aotearoa auditorium for a day of song, food and flu jabs.

Yes, flu jabs.

Rauawaawa Kaumātua Charitable Trust and Waikato District Health Board Māori Health unit – Te Puna Oranga joined forces to promote healthy lifestyles for older people in their communities.

Rauawaawa Kaumātua Charitable Trust chief executive Rangimahora Reddy said events like this brought kaumātua together in an environment that could improve their hauora (health).

“Kaumātua are lot more open to initiatives like flu vaccinations if they have their peers going with them – it acts as a support group for them,” she said.

“We work with the DHB and Midlands Health Network to access as many opportunities to improve our kaumātua wellbeing.”

Tamatea said this was a new way to bring health messages to Maori communities.

“It is about thinking outside the square and finding people where they normally are,” he said.

Within the Waikato DHB there are only about 2000 kaumātua aged 65 plus, which Tamatea said makes them a rare and much valued resource.

In total 105 kaumātua were vaccinated but Tamatea said the wider reach is the real success.

Natania Katene project manager from Te Puna Oranga worked with vaccinators and Rauawaawa staff to help co-ordinate the day’s events “attending today’s Kaumātua Idol is about bringing a service to the people.

“Our kaumātua are very precious to us, and unfortunately they are at risk of serious complications should they catch influenza,” she said.

Roy Manukau kaumātua took the opportunity to get immunised on the advice of his niece Natania.

“My family are always looking out for me and I trust them,” was the sentiments Roy shared.

This winter Te Puna Oranga wants to work alongside several Māori organisations to not only vaccinate kaumātua, one of the most at risk populations of serious health complications from influenza, but to also promote why vaccination is important, particularly to Māori.

“This is about DHB services, other services, coming together to fight the impacts and incidence of influenza on our people because it does not just make people really sick it actually can kill them,” said Tamatea.

“A lot of people don’t realise the flu hospitalises and kills people – so it is about promoting that message among our kaumātua and that in vaccinating themselves they not only better protect themselves but also protect other members of the whānau like their mokopuna,” he said.

FREE immunisation against influenza is available at your local doctors if you are in any of the following groups:

• are aged 65 years or over (if you are in this group you can also get a FREE immunisation from your pharmacist)
• are pregnant
• regularly use an asthma inhaler
• have diabetes
• have heart disease
• have kidney problems
• have cancer
• have a serious medical condition
• a child aged 4 years and under who has been hospitalised for a respiratory illness, or has a history of significant respiratory illness
• If you have another ongoing serious medical condition you may also be eligible for a FREE influenza immunisation

If you do not have one of these eligible conditions, you still will benefit from an influenza vaccination which you can get from your local doctor at a small cost.

Plunket says World Immunisation Week, which kicks off today (24 April), is a wonderful opportunity to promote the importance of immunisation to communities throughout New Zealand.

World Immunisation Week (24-30 April) is a World Health Organization initiative to promote the use of vaccines to protect people of all ages against disease.

PlunketLine National Advisor Elaine Gordon says immunisation is a vitally important a tool to protect New Zealand families and communities.

“Childhood immunisation is one of the most effective ways to protect the health of your children, family, and community. The World Health Organization ranks immunisation among the most cost-effective public health measures ever developed,” she says.

“Immunisation is a free, proven way that parents can protect their children against 11 serious diseases, including measles and whooping cough.

“It is never too late to catch up on immunisations, even if a child has fallen behind on the immunisation schedule,” she says. “The free whooping cough immunisation is also available for any woman who is between 28 and 38 weeks pregnant. This helps protect the baby as some of the mother’s immunity is passed to the baby.”

The rate of New Zealand children who are fully immunised is increasing steadily. New Zealand’s immunisation rates for babies aged 8 months are higher than they have ever been, with an immunisation rate of 93.5% reached in December 2014. Plunket says it is encouraged by this, and would like to see the rate continue to rise. “Families tell us that getting the right information at the right time helps them make an informed decision about immunisation.”

At every Well Child health check, Plunket Nurses share information about immunisation with families and caregivers. If parents are not sure when their child is due for immunisation they can check the immunisation schedule at www.plunket.org.nz or call their doctor or practise nurse.

Plunket is inviting families to join its Facebook live chat when PlunketLine nurses will be on hand to answer questions from parents and caregivers on supporting your child through their immunisation journey. The chat will take place at 8-9pm on 27th May at facebook.com/PlunketNZ.

Plunket is one of many community groups that give immunisation information to parents and caregivers. For more information about immunisation you can talk to a Plunket nurse or call PlunketLine on 0800 933 922 (24 hours 7 days).

The Immunisation Advisory Centre also offers information and advice about immunisation and preventing the spread of infection through its toll-free line 0800 IMMUNE (0800 466 863) and www.immune.org.nz.

Link to news item in Waikato Times: Story about Waikato Woman who became seriously ill from complications of flu while pregnant.

http://www.stuff.co.nz/life-style/parenting/pregnancy/67736792/call-for-pregnant-women-to-get-flu-jabs.html

Health Minister Jonathan Coleman today launched the annual influenza immunisation campaign at Victoria University of Wellington’s Student Hub.

“The Government is committed to increasing influenza protection in New Zealand, especially among high risk groups,” says Dr Coleman.

“This year there is a particular focus on ensuring younger people with long term health conditions such as severe asthma or diabetes are protected.”

High risk groups include those with long-term health conditions such as heart disease, stroke, diabetes, respiratory disease, kidney disease, cancer, as well as pregnant women and people aged 65 and over. 

Influenza immunisation is free for New Zealanders at high risk of complications and is accessible through their local general practice and some pharmacies. Many employers also provide free vaccination.

“This year, the influenza immunisation was delayed globally a few weeks so that two new vaccine strains could be incorporated,” says Dr Coleman.

“This will ensure New Zealanders are better protected this winter from the strains of influenza circulating around the world. The vaccines are expected to be administered well before peak influenza season in winter, and similar to last year, a total of 1.2 million doses are expected to be distributed.”

This week is also Immunisation Week which is an opportunity to talk about immunisation for babies and young children, as well as protecting Kiwis throughout their life.

“Adults can protect themselves, their families and their communities by immunising against serious diseases, including influenza, whooping cough and measles. People should talk to their GP to find out if they need to catch up,” says Dr Coleman.

Notes:

The influenza vaccine for the 2015 season includes two new strains based on recommendations from the World Health Organization. The composition is:

• A/California/7/2009 (H1N1)-like virus
• A/Switzerland/9715293/2013 (H3N2)-like virus (New)
• B/Phuket/3073/2013-like virus (New)

The publicly funded vaccine is available until the end of July 2015. For further information go to www.fightflu.co.nz or www.health.govt.nz/influenza or call 0800 IMMUNE (0800 466 863).

People 65 years and over have the choice of getting their free flu vaccination at one of 23 pharmacies in the Waikato District Health Board (DHB) region from today (Tuesday 21 April) or from their general practitioner.

It is a New Zealand first which will reduce the burden on general practice at this busy time of the year, said Dr Damian Tomic, Waikato DHB clinical director for primary care.

“We know from what happened in the northern hemisphere that more elderly people ended up in hospital with pneumonia so here in New Zealand, we wanted to ensure we included protection against the strains that were prevalent there.

“Influenza A H3N2 has been the dominant strain in the northern hemisphere and it’s likely it will come to New Zealand this winter. We know that this strain of influenza hits those aged over 65 the hardest,” said Dr Tomic.

The delay to the start of the 2015 influenza season, it usually starts in March, was because two new strains needed to be added to the vaccine to provide greater protection from flu.

Allowing pharmacists to give the free preventative vaccination came about in Waikato and through national agencies.

Following this an approach from Waikato DHB’s chief executive Dr Nigel Murray, Dr Tomic and medical officer of health Dr Felicity Dumble to the Midland Community Pharmacy Group established a mechanism for this to occur quickly in time for the forthcoming season.

“The effects of influenza are often underestimated.

Each year around 400 New Zealanders die, directly or indirectly from the influenza.

“Vaccination is your best protection from influenza, and by getting immunised you protect not only yourself but your family and friends,” said Dr Tomic.

Waikato has 56,270 people aged 65 years and over – 8 per cent of them are Maori and just over 1 per cent Pacific people.

Last year, about 68 per cent of the 65 years and over population got their vaccination.

Dr Tomic said the goal this year is to get as many as possible of the people 65 yrs and over vaccinated.

“That’s why getting the pharmacies on board is so critical for us.”

Midland Community Pharmacy Group chief executive Cath Knapton said the DHB had helped pharmacists by providing additional resource so that those immunised each day could be added to the National Immunisation Register.

“We’re very pleased to be able to help our valued 65 year olds and over in this way. This initiative is clearly clinically driven and patient focussed to make it as easy as possible for them to get that protection against flu,” she said.

Below is the list of pharmacies where people 65 years and over can obtain their free flu vaccination:

Cathy Houlihan has seen first-hand the worst case scenario when people don’t get vaccinated.

She has been on a journey over the last seven years to keep her daughter Ariana free from bugs even when she had little or no immunity.

Ariana was diagnosed with Acute Lymphoblastic Leukemia soon after her fourth birthday. She was due to have her last childhood vaccinations when she was diagnosed and so was not fully immunised when she got sick. Two and half years of treatment followed including lots of trips back and forth from Starship Hospital in Auckland. 

Then in July 2010 came the heart breaking news that Ariana had had a complete relapse and would need a full bone marrow transplant. Along with the chemotherapy drugs Ariana was taking, this left her with no immunity to any diseases.

Ariana was off school for 18 months says Cathy. “Seven of those months were spent at Starship Hospital. We saw people who were being treated for cancer who didn’t make it because they had picked up a virus. I particularly remember a 15 year old boy who had nearly beaten his cancer but died after catching chicken pox.”

“It really reinforced for me how important immunisation against these potentially fatal diseases is. I just wanted to keep Ariana away from people who could pass anything on to her.”

“We live 15 minutes out of town and that helped avoid a lot of people contact. It was very scary when Ariana did return to Ormond School. However, the school community was great at letting me know if anyone was sick. If someone at school had chickenpox or shingles Ariana would be off school for 14 days.”

Ariana is now a happy 11 year old attending Ilminster Intermediate. She has caught up with her immunisations and enjoys spending time with her dog Lumpy, two cats, two kittens, chickens and riding horses when she gets the opportunity.

Get your children immunized implores Cathy. “It is an easy thing to do to keep them safe. If you don’t, you never know when the virus they are carrying could be passed on to a vulnerable person with disastrous affect.”

Tairawhiti District Health is celebrating Immunisation Week along with the rest of New Zealand and about 180 other countries and territories as part of a World Health Organization initiative.

New Zealand’s focus for the week is on promoting immunisation throughout the lifespan. Parents are encouraged to protect their children from whooping cough and other serious diseases by ensuring they immunise their children on time.

Babies need their free immunisation when they’re 6 weeks, 3 months and 5 months old to be protected. Boosters are given to children when they’re 4 and 11 years old. Parents are encouraged to immunise their children on time to get the best protection.

Free immunisations are also available and recommended for pregnant women. Please note chickenpox vaccine is not on the New Zealand schedule. If a parent would like their children vaccinated against chickenpox it can be purchased. Please talk to your GP or practice nurse

Capital & Coast DHB are doing their bit to protect patients from influenza this winter, with immunisation clinics for staff to receive free vaccinations starting this week.

Director of nursing and midwifery Andrea McCance helped out at one of the clinics on Tuesday.

“As health workers we have a duty of care to protect our patients and one of the best ways we can do this is to get immunised ourselves.

“Influenza A H3N2 has been the dominant strain in the Northern Hemisphere in the last few months, and it’s likely it will come to New Zealand this winter. We know that this strain of influenza hits those aged over 65 the hardest. 

“By being immunised we reduce the risk of spreading infection and make the hospital safer for both patients and staff.”

In addition to the clinics, 52 staff volunteered to become immunisation champions and offer vaccinations to their colleagues on the ward.

“So far the response to the campaign has been great with 342 staff immunised on the first day the clinics were opened, 100 more than last year.

“Our rates of immunisation have been increasing each year, and last year around 60 per cent of our staff had their influenza vaccination.”

The World Health Organisation recommend an influenza uptake of at least 80 per cent by healthcare workers to offer a 'ring fence' around those most vulnerable.

The effects of influenza are often underestimated. Each year around 400 New Zealanders die, directly or indirectly from the influenza.

“Vaccination is your best protection from influenza, and by getting immunised you protect not only yourself but your family and friends,” says Andrea.

Visit influenza.org.nz and see if you fit the criteria for a free vaccination, or talk to your GP to see what options are available to you.

New Zealand parents who turn down vitamin K for their newborns are more than 14 times more likely to not get their children immunised, a new University of Otago study has found.

The Department of Women’s and Children’s Health researchers suggest that this newly revealed link pinpoints a small, but easily identifiable, group of families to whom targeted early education about the benefits of immunisation could be offered.

Their findings are published in the international Journal of Paediatrics and Child Health.

Vitamin K in newborns is given to prevent vitamin K deficiency, which can in rare instances lead to severe bleeding and death. It is usually administered by intramuscular injection, but can also be given orally.

The researchers’ study of the medical records of 3,575 babies born in Dunedin in 2010 and 2011 found that of those 3% of parents who declined vitamin K for their babies, 17% went on to turn down all early childhood immunisations. These immunisations are scheduled for 6 weeks, 3 months, 5 months and 15 months.

In comparison, of those who consented for vitamin K to be given, only 1.2% declined subsequent immunisation.

Five per cent of children whose parents opted for oral vitamin K (4.8% of the study group) did not have any subsequent vaccinations. These parents were also more likely to be late for immunisations at 6 weeks of age, a lack of timeliness that puts infants at greater risk of catching diseases such as whooping cough.

Additionally, children whose parents declined vitamin K were more than five times as likely to have completed only some of their vaccinations.

Study lead author Dr Ben Wheeler says the findings strongly suggest that parental decision-making around vitamin K is a good predictor of wider choices about having a child immunised or not.

“From a public health perspective, this is an important insight. It highlights how pregnancy and the newborn period is a critical time for education and support to promote public health initiatives. Maintaining high immunisation rates in New Zealand is vital to ensure our children do not fall prey to sometimes deadly infectious diseases that we thought we’d left behind,” Dr Wheeler says.

Targeted education and support for parents who decline Vitamin K injections could potentially be offered at an early stage to better inform their choices and hopefully improve immunisation coverage, he says.

Health Minister Jonathan Coleman says new Before School Check resources aim to further increase participation in the free programme.

“The B4 School Checks programme gives children the best start at school by identifying and addressing any potential health or developmental problems at an early stage,” says Dr Coleman.

“We are on track again this year to reach the goal of checking 90 per cent of all four-year-olds.

“The number of Māori children getting a B4 School Check has increased from 68 per cent in 2011/12, to 83 per cent in 2013/14, and from 66 per cent to 80 per cent for Pacific children.

“New videos featuring Māori and Pacific families sharing their experiences of B4 School Checks aim to raise awareness and further boost participation.

“We want to see every family using this programme. B4 School Check providers continue to work closely with other services such as early childhood education to encourage uptake, particularly in harder to reach communities.”

Funded by the Ministry of Health, the new resources include leaflets for parents, caregivers and early childhood educators - some leaflets have been translated into Te Reo, Samoan and Tongan.

The new videos can be found on the Ministry of Health’s website www.health.govt.nz/B4schoolcheck.

The Government invests more than $10 million each year to provide free B4 School Checks for all four-year-olds. More than 280,000 children have been checked since the programme began in 2008.

The first shipment of this year’s funded influenza vaccine has arrived and is being distributed to general practices this week, says Dr Don Mackie, Chief Medical Officer at the Ministry of Health.

“We aim to immunise more than 1.2 million New Zealanders against influenza over the course of the influenza season. More than half a million vaccines are now in the country - with the first batch of 208,000 doses now being distributed to GP practices. A second batch of 340,000 vaccines will begin to be distributed after Easter."

"The first shipment means that vaccination can start but the Ministry of Health has asked practices to first prioritise those with serious health conditions and pregnant women, followed by healthy people aged 65 and over."

There has been a global delay in vaccine production, in order to incorporate two new strains to give better protection against the strains of influenza predicted to be circulating this year. The influenza immunisation programme is beginning a few weeks later than usual as a result. General practices will be busy this year during April and May immunising their patients before the expected seasonal increase in influenza illness in June.

Some private vaccination providers have also been able to source comparable vaccines – these typically are delivered through workplaces where employers choose to provide vaccinations for their staff.

“This is a useful addition and will help handle some of the demand, while of course, every person immunised helps reduce influenza’s strain on our hospitals when the season peaks, ” Dr Mackie said.

Community pharmacist vaccinators will also play an important role again this year in making the vaccine more accessible to more people aged between 18 and 65.

Infectious disease experts are this week calling New Zealand's pneumococcal vaccination schedule an unequivocal success.

New studies show that certain strains of pneumococcal disease have almost been eliminated in children under five and the number of hospitalisations for invasive pneumococcal disease has plummeted as a result.

 Associated studies show the vaccination schedule has also reduced socio economic and ethnic disparities as well as the risk of disease in older, unvaccinated groups through herd immunity.

 The studies were presented at the Annual Scientific Meeting of the Australasian Society for Infectious Diseases in Auckland on Wednesday.

 "This is great news.  These studies emphasise the importance of infant immunisations both for the individual and the community,” says Dr Helen Petousis-Harris, Director of Immunisation Research and Vaccinology at the University of Auckland's Immunisation Advisory Centre.

 Pneumococcal disease in young children causes serious illness - in particular pneumonia, meningitis and blood infections - and even death.

In New Zealand, Pacific peoples and Māori ethnic groups are disproportionately affected, with rates four to three times higher than in the European ethnic group.

In 2008, a vaccine for children shown to be almost 100 per cent effective against a number of severe strains of pneumococcal disease was introduced into New Zealand.

The vaccine does not cover all strains of pneumococcal disease - there are more than 90 - but it does protect against the majority that result in serious illness in young children.

Since its introduction, hospitalisations of children aged under six for invasive pneumococcal disease have halved and the strains of the disease the vaccine targets have been virtually eliminated in children under five.

The vaccine has an excellent safety profile.  

Routine infant immunisations have also indirectly benefitted non-immunised groups through herd immunity. 

In five to 64 year olds the rates of pneumococcal disease targeted by the vaccine has more than halved and in people over 65 this reduction increased to 76 percent.

Although all groups have seen fewer hospitalisations, the greatest reductions were seen in Māori and Pacific children and children from high deprivation areas, where a 70 percent decrease was seen. Such dramatic results were not anticipated.

“We didn’t predict the extent of the impact the vaccination schedule would have on these groups,” says Dr Helen Petousis-Harris.  “The greatest improvements were seen amongst children from groups that carry the greatest burden.  This is a very positive result.”

 The challenge now, say experts, is to continue to develop new vaccines and adapt the ones we have in order to keep pace with rapidly evolving bugs.

To read the full story on the Health Research Council website, go to:  http://www.hrc.govt.nz/news-and-publications/news-media#hopes-raised-for-rheumatic-fever-vaccine

Waikato DHB’s National Immunisation Register team (NIR) recently moved into the Midlands Health Network Hamilton office to sit alongside the mobile immunisation team.

The NIR is an electronic information system holding immunisation details about children from 2005 onwards. The NIR team is notified by practices when children are immunised, which is entered into the register.  A majority of messages come in electronically from practices, which they monitor.

They also send reports to practices highlighting over-due immunisations and forecasting future immunisation coverage, to support practices to improve immunisation rates.

Bronwen Warren, team lead for immunisation and child health champion at Midlands Health Network says there is a lot of scope for practices to use this information.

“While practices and the mobile immunisation team are doing a great job of protecting patients from preventable diseases, the relocation of the NIR team to Midlands Health Network will help us better connect the dots between the services,” says Bronwen.

“The full administrative team of three is here. The team leader and service delivery manager are still based at Waikato DHB, I am the contact person for the team and meet regularly with them.”

The NIR and mobile immunisation teams support all Waikato practices, including non-Pinnacle ones, and the move is a part of a wider initiative to bring services from secondary care into primary.

“Co-locating the NIR team with the mobile immunisation team, which also moved here from Waikato DHB two years ago, will help get things done quicker and more efficiently. What would have been a game of phone tag or faxing between the two teams is now a one-to-one conversation,” says Bronwen.

“The closer relationship will help develop an understanding of how the two teams work and encourage the refining of processes.”

“We are happy for them to be here and excited at the opportunities it opens up.”

The NIR team are still employed by the DHB, and their contact number remains 0800 100 273.

To read the full story, go to the HRC website:  http://www.hrc.govt.nz/news-and-publications/news-media#spotlight-on-whooping-cough-vaccine

The JCVI has today (13 March 2015) advised that immunisation for meningococcal group W (MenW) disease be offered to 14 to 18 year-olds.

This advice follows a report from Public Health England (PHE) that showed a continuing rise in cases of MenW since 2009. Whilst the number of MenW cases and overall risk remains very low, there has been an increase in prevalence with 117 cases last year.

Andrew Pollard, Chair of the The Joint Committee on Vaccination and Immunisation (JCVI), said:

We have seen an increase in MenW cases this winter caused by a highly aggressive strain of the bug. We reviewed the outbreak in detail at JCVI and concluded that this increase was likely to continue in future years unless action is taken. We have therefore advised the Department of Health to implement a vaccination programme for teenagers as soon as possible which we believe will have a substantial impact on the disease and protect the public’s health.

The Department of Health has accepted JCVI’s advice and is now planning the implementation of a combined MenACWY immunisation programme.

John Watson, Deputy Chief Medical Officer for England, said:

We accept JCVI’s advice for an immunisation programme to combat this devastating disease. We are working with NHS England, Public Health England and the vaccine manufacturer to develop a plan to tackle the rising number of MenW cases.

Dr Shamez Ladhani, Paediatric Infectious Disease Consultant at PHE, said:

Meningococcal group W disease is a rare but life-threatening infection in children and adults. We will now work with the Government and NHS England to roll out a vaccination programme.

It’s crucial that we all remain alert to the signs and symptoms of the disease and seek urgent medical attention if there is any concern. The disease develops rapidly and early symptoms can include headache, vomiting, muscle pain and fever with cold hands and feet. Be aware of all signs and symptoms - and don’t wait for a rash to develop before seeking urgent medical attention.

PHE is also urging health professionals to be mindful of the increase in MenW disease and maintain a high index of suspicion across all age groups. Early recognition and effective treatment with antibiotics for patients with invasive MenW disease can be life-saving.

Background

1. MenW was discussed at the Joint Committee on Vaccination and Immunisation (JCVI) meeting on 4 February 2015. Read the minutes from the meeting.

2. MenW cases caused by the emergence of a particularly virulent strain have been increasing year-on-year, from 22 cases confirmed in 2009 to 117 confirmed in 2014. Latest figures for January 2015 show that there were 34 laboratory-confirmed MenW cases in England, compared to 18 in January 2014 and 9 in January 2013. See theMeningococcal group W disease in England: laboratory-confirmed cases to end January 2015 Health Protection Report.

3. The meningococcal bacteria, Neisseria meningitidis, are the leading cause of septicaemia and meningitis in the UK. Six different types of meningococci, known as serogroups A, B, C, W, X, and Y are responsible for most of the disease across the globe. For decades, meningococcal group B has been the main serogroup responsible for over 90% of meningococcal disease, although incidence has been falling since 2000.

4. Meningococcal group C was also common until the MenC vaccine was introduced in 1999, reducing cases to just a handful each year.

5. Currently, vaccination against MenW disease is not included in the UK’s immunisation schedule, but it is recommended for groups at increased risk of infection such as those with splenic dysfunction, and for travel to certain parts of the world - so remaining alert to the signs and symptoms of the disease is crucial. MenW is potentially preventable through vaccination with the quadrivalent MenACWYconjugate vaccine.

6. The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert advisory committee of the Department of Health. The JCVI has a responsibility to provide high quality and considered advice and recommendations to the UK Health Ministers. This includes giving advice on recommendations on matters of both a ‘routine’ nature and also on any specific or special matters that Ministers may request. In formulating any advice and recommendations, the Committee must take into account the need for and impact of vaccines, the quality of vaccines and the strategies to ensure that their greatest benefit to the public health can be obtained from the most appropriate use of vaccines.

7. More detailed information on the symptoms of meningococcal disease is available on NHS Choices.

Postgraduate researcher Karen Page who is studying with Massey’s College of Health wants to find out why New Zealand’s vaccination rate is much lower than other countries like Australia and the UK.

She has discovered that vaccination rates in high decile schools are 20 per cent lower than in low decile schools in the catchment area of the Whanganui District Health Board and would like to extend this research to the rest of the country".

To read the full news story on the Massey University website, go to:  http://www.massey.ac.nz/massey/about-massey/news/article.cfm?mnarticle_uuid=7A6CFC8E-B77E-EE4D-4392-266C02A17699

Topics covered in this publication are:

• Immunisation in 2014
• Rotavirus – the Australian experience
• Hepatitis B in NZ
• Immunisation of special groups
• Vaccination of preterm infants
• Pain management for immunisation
• Meningococcal vaccination
• Varicella vaccination
• Issues with BCG
• Pertussis in Australia
• Pertussis in NZ

To subscribe to the Research Review, go to: http://www.researchreview.co.nz/

For further information about this event, go to:  http://ici2016.org/

The Ministry of Health is working closely with PHARMAC, vaccine suppliers, DHBs and PHOs to make sure this year’s influenza immunisation campaign rolls out smoothly this April following the global delay in the vaccine, says Chief Medical Officer at the Ministry of Health, Dr Don Mackie.

“This year’s Southern Hemisphere vaccines contain two new strains, to give better protection against the influenza strains that have been circulating around the world through the Northern Hemisphere winter. We hope the improved Southern Hemisphere vaccines will avoid the difficulties the US, United Kingdom and Europe have had with a poor match for the H3N2 component of the vaccine. “

“The unavoidable outcome of the addition of the new strains is a delay in the vaccines’ manufacture by a few weeks. The Ministry of Health expects it will be arriving at General Practices in early April."

“This is well in advance of the usual seasonal increase in influenza illness in June, but it means that General Practices will be busier than usual in April and May.”

The Ministry’s target is 1.2 million doses over the course of the influenza season, which generally ends on 31 July.

“Influenza A H3N2 has been the dominant strain in the Northern Hemisphere in the last few months, and it’s likely it will come to New Zealand this winter. We know that this strain of influenza hits those aged over 65 the hardest. The health sector is already preparing to ensure that New Zealanders have the best protection available against influenza.”

Influenza vaccination is about 73 percent effective in preventing infection with influenza A and B viruses in healthy adults under 65 years of age, when there is a good match between vaccine and circulating influenza strains.

Information about this year’s influenza vaccine is available at www.fightflu.co.nz and www.influenza.org.nz

Studies in this issue (attached below):

Based on the results, they conclude that the "... results are promising for the long-term population-level effects of HPV vaccination programmes. However, continued monitoring is essential to identify any signals of potential waning efficacy or type-replacement".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1016/S1473-3099(14)71073-4 or contact your DHB library, or organisational or local library for assistance.

Drolet, M., et al. (2015). Population-level impact and herd effects following human papillomavirus vaccination programmes: A systematic review and meta-analysis. The Lancet Infectious Diseases, 15(5), 565–580

Studies reported in this issue (attached below):

In their latest Best Practice magazine, bpac have detailed the interventions with the greatest potential to prevent further deterioration in patients with chronic obstructive pulmonary disease (COPD), including smoking cessation, daily exercise and annual influenza vaccination.

The Year 7 video includes details about the diphtheria, tetanus and pertussis (whooping cough) vaccination. The Year 8 video provides information about the human papillomavirus vaccination.

The videos can be viewed online at: https://www.healthed.govt.nz/resource/year-7-and-year-8-immunisation-dvd

The article is available to read in free full text at:  http://dx.doi.org/10.1111/1753-6405.12328

Dawson, B. and Apte, S. H. (2015). Measles outbreaks in Australia: Obstacles to vaccination. Australian and New Zealand Journal of Public Health, 39(2), 104–106

More people are getting access to elective surgery and more people are getting faster treatment for cancer as Tairāwhiti District Health (TDH) comes close to achieving national Health Targets.

The latest quarterly results show TDH is well on the way to meeting all Health Targets set by the Ministry of Health.

It is very pleasing to see an improvement in the number of eight month olds who have had their immunisation at six weeks, nine months, five months and are now fully immunised, says Chief Executive Jim Green. “Reaching this target is a partnership between TDH staff and those working in primary care including GP practices.”

“We have also made a great start to achieving the new cancer target. Already 74% of people in Tairāwhiti who are referred with a high suspicion of cancer are getting treatment within 62 days from the time they are first referred. Our team is refining their processes to make sure our patients get the treatment that they require in what is often stressful circumstances for them. The team is committed to working together to ensure we meet the target of 85 percent of our people getting that fast treatment by July 2016”

This is the first time of reporting the faster cancer treatment target results. The new target is broader than the previous shorter waits for cancer treatment target. It measures how long patients wait from the time their GP’s referral is accepted by the hospital and clinicians strongly suspect they have cancer, to the start of treatment – which could be surgery, chemotherapy, radiation therapy or even palliative care.

The percentage refers to the number of patients who receive their first cancer treatment (other than management) within 62 days of being referred with a high suspicion of cancer.

The intent is to measure right across the cancer diagnosis and treatment pathway.

TDH’s results (compared to the national target) for the quarter are:

• Shorter stays in emergency departments 96% (95%)

• Improved access to elective surgery 99% (100%)

• Faster cancer treatment 74% (85% by June 2016)

• Increased immunisation 93% (95%)

• Better help for smokers to quit – hospitals 94% (95%); primary care 87% (90%)

• More heart and diabetes checks 88% (90%)

The Canterbury District Health Board continues improving on the National Health Targets particularly in prevention and early detection of disease despite ongoing post-quake challenges.

The National Health Targets report for quarter 2 was released today and results show more Cantabrians are receiving advice and support for smoking cessation and heart and diabetes checks.

In this quarter, 86.7 percent of smokers attending primary care received advice to quit – which is a 6 percent increase on the previous quarter and is almost double the previous year's quarter 2 result of 49 percent.

Canterbury also has had the largest increase of all health boards in the More Heart and Diabetes Checks target – with 76.7 percent of eligible patients receiving a check – a 5.6 percent increase on quarter 1 and up more than 30 percent on the year before.

David Meates, Canterbury DHB Chief Executive, says efforts to ensure our community is kept well and in their own homes through prevention and early detection of disease are nothing short of dedicated.

"It's remarkable how our results have gone from strength to strength in the past year and this reflects the commitment, collaboration and integration across the Canterbury Health System.

"I continue to be impressed by, and thankful for, the efforts and achievements of staff in the context of a still challenging environment of hospital redevelopment and post-quake recovery."

Mr Meates says the Canterbury is faced with significant challenges four years on from the earthquakes.

"Many of the associated health impacts post a major disaster are panning out in the community – particularly in mental health. While it's amazing to see things coming together with the rebuild – there's also a whole set of new challenges emerging for the Canterbury Health System."

Mr Meates says one major challenge is the continued growth in presentations to Christchurch Hospital's Emergency Department.

"Since the quakes and the influx of about 30,000 workers to Christchurch, use of our Emergency Department has spiked 50 percent for the 25-29 age group and almost 30 percent for the 20-24 year old age group."

"Remarkably staff met the target in quarter 2 for Shorter Stays in ED with 95 percent of patients admitted, discharged or transferred from ED within six hours – but if numbers continue to climb it only increases waiting times, contributing to crowding and placing ED staff under greater pressure."

Meanwhile Mr Meates says overall the DHB's performance in all targets was strong.

"It's about having the initiatives and integration in place to enable us to do that.

"For example, in the last year Canterbury provided care to 30,000 people in the community who in any other parts of the country would otherwise have been admitted to hospital."

"Keeping everything we do patient centric keeps us focused on our six key priorities to ensure our system is running as efficiently as it can be."

The five priorities and key spotlight area :

• Frail Older Person's Pathway – better support for frail older people both in an out of hospital
• Theatre Utilisation – capacity remains a major constraint until the new hospital is built.  Clinicians are focused on improving the performance and productivity of operating theatres, reducing cancellations, improving patient flow and achieving shorter waiting times for patients before their treatment and ensure no time is wasted in the system
• Enhanced Recovery after Surgery (ERAS) – supports early recovery and discharge from hospital and reduced waiting times
• Faster Cancer Treatment – timely access and better links across the health system to improve care;
• Outpatient and Surgical Flow (100 days) – aiming to provide a patient's first appointment with a specialist or surgical treatment within 100 days (to a maximum of four months)
• Mental Health – services are coming under increased pressure and the DHB has prioritised ensuring we can meet the needs of the community.

Targets at a glance:

• Increased immunisation – this target rose from 90 percent at June 30 2014, to 95 percent by December 31. Canterbury achieved immunisation rates of 93.49 percent of eligible children, while five percent of parents or caregivers of the eligible population declined or opted out of the free immunisation programme
• Faster cancer treatment - a new target was introduced this quarter. The target is 85 percent of patients receiving their first cancer treatment within 62 days of being referred with a high suspicion of cancer. Canterbury achieved 68 percent against a national average of 65.8 percent. Canterbury continues to meet the previous target of 100 percent of cancer patients who are ready for treatment, getting it within a month
• Improved access to Elective Surgery -  Canterbury delivered 97.4 percent of its elective surgery target this quarter, and expected to increase numbers over the next few quarters
• Better help for smokers to quit – hospitalised - Canterbury met the target of 95 per cent of eligible hospitalised smokers getting cessation advice and support.

Chief executive Kevin Snee said two priority projects within Hawke’s Bay Hospital, which had been running for some months, were now making an impact. The Acute Inpatient Management (AIM24/7) project was improving the quality and timeliness of care for patients seen in or admitted through the Emergency Department (ED), and the Theatre Productivity project was working to improve the ability to provide more elective surgery for the people of Hawke’s Bay.

To read the full story, go to:  http://www.voxy.co.nz/health/improvements-four-health-targets-hb-dhb/5/214657

The latest quarterly results show Waikato DHB tracking well on all national health targets.

“It is very pleasing to see an improvement in the 6 hour acute goal and to make a start toward achieving the new cancer target,” said interim chief operating officer Brett Paradine.

“Improvement in both of these areas will be a priority for the coming year,” he said.

Waikato DHB’s results (compared to the national averages for all district health boards) for the quarter are:

• Shorter stays in emergency departments 94% (94%)
• Improved access to elective surgery 115% (107%)
• Faster cancer treatment 68% (66%) – this is a new target, see below.
• Increased immunisation 91% (94%)
• Better help for smokers to quit – hospitals 96% (95%); primary care 87% (89%)
• More heart and diabetes checks 88% (87%)

Four out of the six target rates show improvement by Waikato DHB compared to the previous quarter, and the other two have held steady.

This is the first time of reporting the Faster cancer treatment target results. The new target is broader than the previous Shorter waits for cancer treatment target. It measures how long patients wait from the time of their GP’s referral is accepted by the hospital and clinicians strongly suspect they have cancer, to the start of treatment – which could be surgery, chemotherapy, radiation therapy or even palliative care. The percentage refers to the number of patients who receive their first cancer treatment (other than management) within 62 days of being referred with a high suspicion of cancer.

The intent is to measure right across the cancer diagnosis and treatment pathway. The target is to reach 85 percent by July 2016, but the current result of 66 percent averaged across all DHBs was expected – this is very similar to the UK results when a similar target was introduced. The target will be reported on a rolling 6-month basis rather than quarterly.

“At Waikato DHB we are now adopting a whole team approach to make sure our patients get the treatment that they require in what is often stressful circumstances for them,” said Amanda Wright, assistant group manager Internal Medicine and Oncology at Waikato Hospital.

“A lot of effort has gone into ensuring we have a robust process for tracking these patients. Our cancer care coordinators and clinical nurse specialists have done a wonderful job. We are pleased with the result and are working on a plan that will focus on improving our percentage to the expected 85 percent by June 2016,” she said.

Read the Waikato DHB results here

Read all national results here

Health Minister Jonathan Coleman says the latest quarterly health target results show DHBs are making good overall progress.

“DHBs are continuing to improve their performance on the Government’s health targets,” says Dr Coleman.

“The latest results for quarter two show that almost all DHBs are now exceeding the number of elective surgeries they had planned.

“DHBs carried out 5,441 more elective surgeries than planned in the last three months of 2014. DHBs have also been focused on reducing waiting times for elective first specialist assessments and treatment, such as hip replacements.

“Despite more people presenting to emergency departments, DHBs have continued to perform well on the target with a national result of 94 per cent.”

Results have been reported for the first time on the new faster cancer treatment health target. DHBs consistently achieved the previous target and the new broader target covers time from referral to treatment.

“Two thirds of patients with a high suspicion of cancer received their first treatment within 62 days of referral,” says Dr Coleman.

“This is comparable with other countries when they have first introduced a similar new target. I know we will continue to see steady improvement towards the target of 90 per cent by June 2017.”

Results for quarter two 2014/15 show improvements in all the targets:

• 94 per cent immunisation coverage for eight-month-olds is the highest ever level of coverage for any immunisation health target.
• 87 per cent of eligible people had their heart and diabetes check.
• The number of smokers in primary care offered advice or support on quitting slightly increased to 89 per cent.
• The hospital component of the target has been consistently achieved in the last two years, with a national result of 95 per cent.

The latest health target results can be found at www.health.govt.nz.

MidCentral District Health Board has improved sufficiently to attain two of the six national health targets –results of which were announced today.

MidCentral’s has  previously struggled to achieve the Shorter Stays in the Emergency Department and Better Help for Smokers to Quit –both of which it attained for the first time since targets were introduced.

Our results across all the national health targets for this quarter are outlined below.

Just over 95% of 9,812 people who attended the Emergency Department were discharged, transferred or admitted within six hours presenting – achieving this target for the first time.

While we have been steadily improving our performance toward achieving this target, it has been the concerted effort of many staff and departments that have been making changes to improve the flow of patients throughout the hospital that has made the big difference in recent months.  Operations Director, Hospital Services Lyn Horgan has praised staff throughout the organisation on reaching this goal.  “While this result is to be commended and celebrated by all staff involved we need to continue the momentum to ensure we sustain these results in the future to benefit our patients.  We know that the last quarter of the year is generally a quieter period in all hospital work, so with the coming build-up toward the higher demand for beds over autumn and winter it will be a challenge to maintain these improvements.  We are mindful that maintaining the drive and applying what we learned through the second half of last year will be required if we are to continue to achieve the high rate for shorter stays in the Emergency department in future quarters,” she said.

The national health target for offering advice and support to adult inpatients who are smokers to quit smoking was achieved for the first time this quarter, with a result of 96.3%.  While we have been making steady improvements across the hospital, we have never managed to reach the 95% target for any previous three-month period until now.  Director Patient Safety and Clinical Effectiveness Muriel Hancock said this is a great result and was largely the effect of better electronic data capture and increased staff knowledge.  “It is a fantastic result for everyone involved and a great effort by all of our staff. The longer term objective is to reduce smoking-related health issues in our community, so it is important that we keep this high rate going in the hospital setting as well as support our healthcare partners to improve performance in the primary care setting”.  The result for providing brief advice and help to quit smoking in primary health care settings was disappointing – reducing to the lowest result for quite some time at only 73% of the estimated 17,237 adults seen in general practice over the year to December.  The DHB and Central PHO are committed to working with general practice teams and others to improve this result over the coming months.

We continued to achieve the target rate (95%) of eight month old infants being fully immunised on time.

The national target increased from 90% to 95% by the end of December 2014. We have been consistentlymeeting the higher target rate this year through the efforts of a strong team approach across the district to ensure we improve and sustain excellent immunisation coverage rates.  

We were well ahead of target again for the number of people discharged following their elective surgery.

Over this quarter, 203 more patients than originally planned had had their elective surgical procedure bringing the total to 3676 discharges by the end of December – 108% of target.

The proportion of eligible people who have had their cardiovascular disease risk assessed in the last five years reduced slightly to 85% of 46,959 eligible enrolled adults this quarter   – below the 90% target and lower than the national average for all DHBs (87%).

While there are some general practice teams throughout the district that are achieving, or close to achieving, this target, there are others that need to lift their performance levels to ensure more eligible patients receive their assessment for risk of heart disease.  Central PHO is helping these practices with a number of strategies, including “text to remind”, better information management, health promotion material and having health checks at health expos like the Whanau Ora days.

The new national target for faster cancer treatment was introduced in July and is reported for the first time this quarter.

This health target replaces the previous one for shorter waits for chemotherapy and radiotherapy which has been consistently achieved over the last couple of years.  The new target is that by July 2016, 85 percent of patients referred with a high suspicion of cancer and a need to be seen within two weeks receive their first cancer treatment (or other management) within 62 days. It covers the time patients wait for all tests and investigations needed to confirm a cancer diagnosis and subsequent treatment, such as radiotherapy, chemotherapy, surgery, non-intervention management such as active surveillance, and palliative care.  The new cancer target applies to a specific group of patients who are referred through a managed, outpatient pathway with a high suspicion of cancer and a need to be seen within two weeks. Focusing on this group presents the greatest opportunity to improve the cancer pathway, from referral to first treatment, and make improvements that benefit all cancer patients.

Our result, at 66%, is the same as the national average.  At this stage, the volume of eligible patients referred through the outpatient pathway is quite small and so a rolling six-month period is reported.

For more details and FAQs about the Health Targets go to: www.health.govt.nz/new-zealand-health-system/health-targets.  

The results of district health board performance against six health targets for the second quarter 2014/15 has been released.

This website is produced by Conectus, an alliance of maternal and child health services based at the School of Population Health, The University of Auckland. Conectus promotes the Well Child/Tamariki Ora programme and supports the annual Well Child Week.

The Well Child Tamariki Ora (WCTO) programme is free for all children up to five years of age, and is designed to identify any health and development issues as early as possible.

To read the full media release from Well Child, go to:  http://www.scoop.co.nz/stories/GE1502/S00068/well-child-week-starts-today.htm

http://www.ssc.govt.nz/bps-supporting-vulnerable-children

Health Minister Jonathan Coleman says the Better Public Services results released today show immunisation rates have reached an all-time high and rheumatic fever rates have dropped considerably.

“It is important that children get the best possible start in life. The Government is focused on making progress on issues that affect vulnerable children,” says Dr Coleman.

The latest Better Public Services update shows immunisation rates for eight-month-old babies have reached 93.5 per cent.

“More babies than ever before are being protected against whooping cough and other serious preventable diseases,” says Dr Coleman.

“We raised the bar on immunisation, lifting the target from 90 to 95 per cent, and it is encouraging to see immunisation rates reach an all-time high. This is a tribute to the hard work of GP teams, Well Child providers, community outreach teams, midwives, DHB staff and the immunisation programme team. 

“While the result fell just short of the target, the new target is by its very nature extremely challenging. We will continue to strive to hit this ambitious goal. With around 15,000 babies immunised each quarter, we were about 200 immunisations short, and some of those babies have now been immunised.”

The latest figures on rheumatic fever show a 14 per cent decrease in first episode rheumatic fever hospitalisations since the target was introduced in 2012.

“While the latest provisional figures show the range of initiatives to tackle rheumatic fever are making a considerable difference, there is more work to be done,” says Dr Coleman.

“The Government has invested more than $65 million to prevent and treat rheumatic fever. 13,000 young people have accessed the free rapid response sore throat clinics in Auckland and Wellington.

“This initiative is being expanded to another seven DHBs, and when new services are open, more than 200,000 young people in high-risk areas will have access to prompt assessment and treatment for sore throats.

“As a result of the Auckland Healthy Homes Initiative, over 1,100 families have been offered a package of housing-related interventions. The Ministry of Health is setting up similar initiatives in seven other DHBs.

“Over 20,000 Auckland and Wellington Pacific families have been engaged through home visits and community events to raise awareness of rheumatic fever.”

The site provides access to Alcohol ABC and ABC Smoking Cessation modules, together with a range of other health modules eg immunisation, lean thinking, risk management.

The authors identified 27 studies, the designs including observational studies, economic analyses, systematic reviews, and commentaries. The NNV has been used in the literature to describe three main themes: potential benefits of vaccination programmes, cost-effectiveness, and economic analyses, and modelling studies to compare different vaccination strategies.

Conclusions: NNV has been used in a wide variety of ways in the literature, yet there are no defined thresholds for what is a favourable NNV. Furthermore, the generalizability of the NNV is usually limited. Further work is required to determine the most appropriate use of this measure.

This is an open access article and can be read in free full text at:  http://dx.doi.org/10.1016/j.vaccine.2014.12.033

Hashim, A., et al. (2015). How and why researchers use the number needed to vaccinate to inform decision making—A systematic review. Vaccine, 33(6), 753–758.

Includes information on health targets; quality and safety markers; patient experience; nursing practice partnership; consumer experience; communication skills development; community safety initiatives; community based care without the wait; pathways to good health; the shared care record; disability services; advance care planning; immunisation; patient safety initiatives. 

To read the quality accounts, go to:  http://www.ccdhb.org.nz/aboutus/statutory-publications.htm

Dr Noni MacDonald is the key note international speaker - she will explore aspects of vaccine hesitancy, and how better to engage with this group.

For further information about the workshop and onference, go to: http://nzimmsconference.co.nz/

Auckland Regional Public Health Service (ARPHS) was notified of a case of diphtheria on 2 February.

The person with the disease has been isolated, and is being treated with antibiotics and immunisation boosters. They are in good health and do not need hospital treatment.

It is very likely the person caught the disease overseas.

Everyone who has been in close contact with that person has been identified. They have all been given antibiotics and immunisation boosters as a precaution, because these work really well against diphtheria.

ARPHS Medical Officer of Health Dr Brad Novak says no one else has tested positive for the disease, which is very reassuring.

“There is little or no risk to the public. Diphtheria is a serious disease, but in this case we have contained it early.”

Cases of diphtheria are very uncommon in New Zealand, where our immunisation programme helps protect us, Dr Novak says. 

“This is an important reminder to ensure all of our children are immunised, and that adults have immunisation boosters too.”

The event gathers researchers, clinicians and other health professionals to share and exchange research regarding the epidemiology of HPV, virus vaccines, cervical cancer prevention and other papillomavirus associated diseases. 

For further information about this event, go to:  http://www.hpv2015.org/

Health Minister Jonathan Coleman says more children than ever are benefiting from the free before school health checks.

“The B4 School Checks help to give children the best start at school by identifying and addressing any potential health or developmental problems at an early stage,” says Dr Coleman.

“In 2013/14 the programme reached 91 per cent of all four-year-olds, an increase of 11 per cent on the previous 12 months. Uptake of B4 School Checks was also 90 per cent among those living in high deprivation areas.  

“We want to see every family participate in the free before school health check. B4 School Check providers are working closely with other services such as early childhood education, and focusing on harder to reach communities, to encourage uptake.”

Introduced in 2008, the B4 School Check is the final core Well Child/Tamariki Ora check. Checks are provided free through a range of community health services and include hearing, eyesight, height, weight, and oral health assessments, as well as comprehensive health and development questionnaires.

Getting the check as close to four years as possible ensures families are able to connect with any additional support services they might need before their child starts school.

In the six months to the end of December 2014, 29,558 four-year-olds were screened nationwide, an increase on the 29,196 screened in the same period in 2013.

Midlands Health Network's ground-breaking National Child Health Information Platform has reached a major milestone with its 1,000th enrolment.

More than 1,000 Waikato new-borns have now been enrolled on the service in less than a year, ensuring every one of them has the opportunity to receive the checks and health services they are entitled to. 

Midlands Health Network Chief Executive, John Macaskill-Smith says the service has been steadily rolled out across the region since it first launched in Thames in August 2014.

"This is a major milestone and an acknowledgement of the hard work that has gone into creating this ground-breaking service," he says.

"All Waikato midwives and birth unit administrators can now electronically enrol a new-born at the time of birth, removing unnecessary paperwork and processes. 

"It is a simple, one-step process to notify the National Immunisation Register, newborn hearing, oral health, general practice, and Well Child provider / Tamariki Ora.

"These providers can then see a shared online view of a child's progress towards their 29 health milestones, which include immunisations, oral health, hearing and vision checks, and before school checks."

Should a child miss one of their checks, the health providers can access the telephone-based Child Health Coordination Service to help locate the child.

NCHIP will continue to grow as more providers are trained and given access.

"The Waikato roll-out will be completed by March 2015 at which point it will be evaluated and expanded to Gisborne, Taranaki and Taupo, before a nation-wide rollout," says John. 

"The service currently includes children from birth to six years of age, but this will also increase at a later date to include those under 18.

"This is a first for New Zealand, it means early childhood health services are delivered in a more coordinated way, creating better efficiencies across the entire health system and ensuring that no child falls between the cracks.

"NCHIP is another important component to supporting the development of a primary health care home. People live in the community and access the majority of their health care outside of hospitals and other large health institutions, so it's important to see investment and broader development of services closer to home."

NCHIP is funded by The Ministry of Health, Waikato DHB, Lakes DHB, Tairawhiti DHB, Taranaki DHB, National Health IT Board and Midlands Health Network.

For more information about NCHIP, visit www.midlandshn.health.nz/programmes/child-health-service.