Immunisation outreach bus

Mahitahi Hauora, Te Whatu Ora and participating general practices worked together to provide a mobile bus focusing on childhood immunisation. The bus visited sites in the Mid and Far North between 15 and 26 May 2023.

Staffed by two vaccinators and a kaiawhina, the bus offered all scheduled immunisations, including flu. It was free for the whole whānau, with no appointment needed.

The Mahitahi Hauora Clinical Hub team contacted whānau with tamariki up to the age of 6 who had any immunisations due who lived in the area via phone calls and text messaging to invite them to attend the van as a drop-in immunisation clinic. Te Whatu Ora contacted Outreach immunisation clients with overdue immunisations and invited them to attend.

The work was ably supported by the Mahitahi Hauora Digital & Data team, which brought data together from the National Immunisation Register and the PMS of participating practices to compile lists of unvaccinated tamariki, which informed where the bus should go and the whānau who should be contacted.

Whānau who have not been specifically contacted were also welcome to attend, and the mobile bus schedule was promoted on radio and social media.

The bus also offered flu immunisations to eligible whānau/tamariki and Covid boosters, however the focus was on childhood immunisations.

Pre-calling whānau to immunise on time

Immunisation is one of the best ways to protect our pēpi, and Mahitahi Hauora has launched new initiatives to encourage whānau to immunise.

One of these initiatives is proactively making direct contact with whānau to encourage them to immunise tamariki on time.

Mahitahi Hauora Clinical Hub Lead Nurse Gaelyn Sinclair pre-calls Māori whānau whose infants are due for scheduled immunisations. The Hub team have used Te Whatu Ora’s Childhood Immunisation Prioritisation Matrix to plan the work, starting with pepi coming up to 6 weeks old, followed by those due the 12-month MMR immunisation. As the initiative rolls out, the Hub team will add other immunisation milestones to the workflow.

The Hub team worked closely with the Outreach Immunisation Service in designing this initiative, aiming to understand what is already provided and endeavouring to fill gaps rather than duplicate existing activity.

The calls started on 27 March. By mid-May, 51 Māori children had been successfully immunised – a number that is increasing by the day!

Whānau whose tamariki are immunised on time receive a $50 Prezzy card as a ‘thank you’ for protecting the next generation of children growing up in Tai Tokerau.

Equitable uptake of immunisation

Mahitahi Hauora is leading a raft of initiatives to improve equitable uptake of immunisation as Northland heads into winter.

Northland is facing a ‘perfect storm’ of infectious illness this winter, with COVID, flu, measles and pertussis, combined with worryingly low immunisation rates across the region, particularly in certain groups such as tamariki Māori.

Alongside that are the challenges faced by general practice to provide immunisation against a backdrop of workforce shortages and heavy primary care workloads.

With funding from Te Aka Whai Ora to address the inequitable immunisation rates for Māori, the Mahitahi Hauora Clinical Hub team is offering several initiatives to support practices to boost immunisation rates. These include:

• Free influenza immunisations available at general practices and pharmacies in Northland for all Māori and Pasifika patients who are not currently eligible for funded immunisation.
• Free GP consultations for Māori and Pasifika whānau to discuss questions or concerns about immunisation.
• Nursing support from the Clinical Hub team with immunisation recalls for practices.
• Support for practices with planning complex catch-up schedules for tamariki who have missed multiple immunisations.

Discharge follow-up for unenrolled patients

Unenrolled patients who are discharged from hospital are at higher risk of missing follow-up care because they lack a GP.

Working with Te Whatu Ora, the Clinical Hub team has arranged for unenrolled patients discharged from Northland’s three hospitals to be referred to the Hub daily, seven days a week. The team triage the referrals to identify patients who may need further support, contact them to introduce the Clinical Hub service and discuss their circumstances to find out if they need help.

The intervention grew out of the Hub’s experience caring for unenrolled patients with COVID-19.

The Hub team try to contact patients within 24 hours of discharge to do a general check on how their recovery is going, whether their medications and pain relief are working, how any wounds are, and to answer any questions or concerns they have. If the patient’s needs are complex, the Hub team do everything they can to find them a GP. The team also assist patients to get enrolled with a GP if they are new to the area, do not understand the healthcare system, or have just not registered with a GP for other reasons.

Since the intervention began in November last year, 48 unenrolled patients discharged from hospital have been referred to the Clinical Hub. Of these, 26 patients (54%) were supported to enrol with a general practice.

The team also step in to coordinate care by other agencies to ensure patients’ needs are met.

For more information, contact Cristina Ross, Network Support Manager.

Free COVID-19 vaccine consults

From November 2021 to the end of February 2022, Mahitahi Hauora funded general practices across Northland to provide 1,041 vaccine hesitancy consults free to patients.

These funded consults enabled people to have an in-depth discussion about the COVID-19 vaccine with a trusted healthcare professional. They gave people a chance to get expert advice from someone who could answer their questions and give them the story straight to help them navigate the conflicting claims, rumours, and information circulating.

As eligibility for the vaccine was expanded to include children, the free consults were expanded to include consults for children as well as adults, and a whānau consult for a family.

The free consults were available to everyone, including those not enrolled with a general practice.

Self-screening test to prevent cervical cancer

Mahitahi Hauora worked with seven Northland general practices to study the implementation of an innovative new self-test that enables women to screen themselves for Human Papillomavirus (HPV), which causes cervical cancer, at home or privately at their GP clinic. Screening for HPV can detect pre-cancerous changes before cervical cancer develops.

The self-test was offered as part of a two-year research study led by Te Herenga Waka—Victoria University of Wellington to explore the challenges associated with implementing this test, as well as its ability to increase uptake of cervical screening in Northland and improve screening services, particularly for Māori, Pacific, and rural populations, who have lower screening rates.

Mahitahi Hauora and the Health Research Council are co-funded this study.

For more information, read the stories on our News page or contact Mary-Ann Clueard, General Practice Services Leader, at mary-ann.clueard@mahitahihauora.co.nz

Building a food secure and resilient Whangaroa

When the 2020 COVID-19 lockdown hit, food supply and transportation in Whangaroa appeared suddenly vulnerable. Local food supply services were sent into overdrive trying to provide for many in the community who were struggling to get food. Over seven weeks, 1,621 kai and 300 hygiene packs were delivered to 1,413 households.

Questions were raised about the resilience of the food supply system in this small rural community. Did food systems need to improve to increase food security and resilience? Could improved food resilience help the Whangaroa community to thrive?

Through Tupu Tahi – Whangaroa Growing Together, a local initiative led by Healthy Families Far North and supported by Mahitahi Hauora and other partners, the community started engaging with these questions and exploring solutions together. Using co-design, the project team explored people’s experiences of the food system and the idea of establishing a food hub to distribute surplus produce, teach, and support the building of small farms and businesses.

The project report provided an insight into the challenges and strengths of those living in Whangaroa and provides a starting point to explore the role of the food hub and how it might operate. It also helped us to think differently about the ways we can support the food system in Whangaroa and how we might draw on the strengths and wisdom of the community.

Download the report: Building a Food Secure and Resilient Whangaroa