The Primary Options Acute Demand Management Service (POADMS) supports Te Tai Tokerau primary care to provide safe, appropriate acute care in the community. By providing funding and resourcing for people to receive care in a community setting, rather than in hospital, it aims to reduce hospital presentations, shortens the length of stay, and prevents readmission to secondary care services.

To ensure equitable access, POADMS maintains a strong focus on serving high deprivation populations, those living in quintile 4 & 5, Māori, Pacific peoples, older people and children, or those experiencing financial hardship.

From 1 July 2025, the POAC (Primary Options for Acute Care) and POADMS (Primary Options for Acute Demand Management Services) programmes will implement uplifted fee schedules across applicable services, as per the table below.

1. Eligibility for Uplifted Rates
   • Uplifted rates will apply only to services commenced on or after 1 July 2025.
   • Services that commenced prior to 1 July, but are claimed after 1 July, will be reimbursed at pre-1 July rates.
2. Changes to Administration Fees
   • Administration fees will no longer be claimable.
   • This change reflects ongoing improvements to POAC/POADMS IT infrastructure aimed at reducing administrative burden.
   • Administrative time has been incorporated into the new ‘all-inclusive’ fee structure.
   • Providers are encouraged to share feedback or reach out for support during this transition.
3. Patient Copayments
   • A reminder that no copayments may be charged to patients for services claimed under the POAC/POADMS programmes.

 * Indicates ‘all-inclusive’ fee. No additional consult, observation or consumable fees claimable unless explicitly specified under business rules.

Referral

Patients must have a full clinical assessment to be referred to POADMS. There are a number of entry points, including general practice, urgent care clinics, and ambulance services. Once a patient is referred, all services in the package of care are free to the patient while they are acutely unwell (usually up to three days), except for the initial 15-minute consultation. The anticipated total cost of the package of care will be under $400 or requires acceptance from POADMS Nurse Coordinator.

Patient eligibility

To receive a funded service the patient must meet the following criteria:

• Be eligible to receive publicly funded healthcare in New Zealand; and
• The patient consents to being managed through POADMS; and
• The patient can be safely managed in the community; and
• Is not covered under another funding stream – e.g. ACC, maternity, private health insurance, primary response in medical emergencies (PRIME), palliative care; and
• Is not able to self-fund the care provided.

Please refer to individual service information on the POADMS page in Northland HealthPathways for further information.

Clinical responsibility

Primary care provider

The initiating doctor/NP carries clinical responsibility for managing the patient’s care unless the clinical responsibility can be handed over to a colleague within the practice, to a clinician in an urgent care clinic, or to the patient’s registered GP.

It is the responsibility of the clinicians using POADMS funding to ensure that they and their staff:

• have the necessary skills and competence for the clinical or diagnostic procedure they are performing.
• have any requisite or relevant formal or experiential training and periodic reaccreditation (if appropriate).
• are frequently performing procedures to maintain adequate competence.
• are following the relevant evidence-based pathway for the procedure performed or care provided.

POADMS operates on a high-trust model, supporting frontline clinicians to deliver care that reduces secondary service utilisation. Funding is provided on the understanding that clinicians are adequately skilled to provide the interventions claimed for. Claims are regularly reviewed and any concerns about the quality of funded care provided will be subject to the program’s clinical governance procedures.

Contacts

POADMS Clinical Services Team
0800 PRIMARYOPS – Option 1
primaryops@mahitahihauora.co.nz

Kathrynn Wrightson
POADMS Clinical Nurse Coordinator
0800 PRIMARYOPS – Option 2
Kathrynn.wrightson@mahitahihauora.co.nz