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.

No co-payment may be charged to the patient if claiming for the above services via POAC/POADMS.

Patient eligibility

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

• The period of care is anticipated to completely resolve within 3 days or less.
• The anticipated total cost of the package of care will be under $300 or requires acceptance from POADMS Nurse Coordinator.
• 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 with evidence based, best practice interventions; and
• The patient is experiencing an acute episode that, without intervention, would result in the patient being referred to hospital; or
• The patient’s treatment needs align with a service pathway for preventative intervention therapy through this programme.
• Is not covered under another funding stream – e.g. ACC, maternity.

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

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.

Clinical responsibility

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.

The patient must be informed and agree that the information on the claim form and other information relating to the illness will be made available to the clinical co-ordination centre team and sub-contracted health care providers.

The patient must also be informed and agree that they may be liable for costs if the claim is declined.

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