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The newsletter of Capital & Coast DHB

Capital & Coast

The newsletter of Capital & Coast DHB

Issue #23: 6 September 2004


Solid progress is being made towards the introduction of an immunisation register in this district. This is our part of the National Immunisation Register (NIR), a national database which is being established by the Ministry of Health. The NIR will provide information about the immunisation status of individual children (which will remain confidential to the family’s health care provider), while also allowing data to be extracted on the uptake of immunisation across populations.

C&C DHB’s project manager for NIR, Kaye Hudson, says a key step was the setting up of an implementation planning group, with representatives from a range of health and community organisations with a child health focus. Kaye says health care providers on the implementation group are strongly supporting the NIR, and their commitment and enthusiasm is crucial to its success. The implementation group also has strong representation from Maori and Pacific communities.

An implementation plan for this district is being developed, and other key early tasks include assessing the computer systems of contracted health providers to ensure they are compatible with the NIR systems.

Kaye is supported in this work by NIR administrator Julie Alexandra, who will take over the day-to-day management of the NIR once it is fully operational. They have begun meeting with health care providers to talk about the NIR. These include pregnancy and parenting educators, lead maternity carers, hospital midwives, children’s ward staff, practice nurses, Plunket nurses and other Well Child providers.

The register will “go live” in this district early next year, with March-April pencilled in as the timing for this to occur. The NIR will be implemented nationwide by the Ministry of Health and District Health Boards by the end of 2005. The Ministry of Health is at present testing IT systems in Counties Manukau and Auckland DHBs who are ready to 'go live' on 23rd October.


The NIR is a valuable tool which will record immunisation status, to help ensure children receive the appropriate immunisations at the correct ages.

The Register will help to ensure that children’s immunisations stay on track so that they do not get infectious diseases such as whooping cough and measles.

The Register will be used to record the new Meningococcal B vaccination, which will begin in this district in mid-2005.. This will ensure safety monitoring of the new vaccine.

Overseas experience, including Australia, shows that a register is a vital component in improving childhood immunisation rates.

The NIR will protect the privacy of those listed on it - only authorised providers will be able to update or amend the NIR database. Parents may also request their child’s immunisation information, or request that information be corrected, at any time.

Parents have the choice of opting not to have their child’s immunisation details recorded on the Register. However their child’s unique health number (National Health Index) and date of birth will remain on the Register, so that coverage can be assessed.

The NIR will facilitate opportunistic immunisation to assist in reaching children of highly mobile families, in particular some Maori and Pacific peoples.

The NIR will benefit DHBs by enabling improved monitoring and evaluation of immunisation coverage per district.

The Ministry of Health is working in partnership with DHBs to ensure that the NIR is a functional, accessible and easy-to-use tool.


We want to thank everyone who took the time to consider the proposal for the Integration of Home, Community, Primary and Specialist Services – and especially those who submitted responses or attended public consultation sessions.

A significant number of submissions have been received in response to our public consultation on this proposal, and these have now been collated and analysed.

A report on these submissions has been prepared by an independent party, based on written submissions, attendance at consultation meetings and notes from the forum on 23 June. This report will be available on our website ( later in September.

The overall response to the proposal was very positive, with respondents agreeing the model would improve services, and that the approach it adopts would achieve its objectives. It’s clear that this proposal has generated a lot of debate and enthusiasm from many different groups.

A number of interesting questions were raised during the consultation, many relating to implementation and service development. For example: What are the best ways to implement this model? And how will training, supervision and workforce development occur for those working as Care Managers?

In order to address these and other questions in more detail the recommendations for this proposal will be put to the Board in October. This Board consideration by the Board has been pushed back a month to allow for more thorough preparation of information. We encourage you to look out for the submission report on the intranet or on our external website ( in September, and the Board’s decision in October.


Our staff at Capital and Coast District Health Board do a great job and it is nice when patients recognise this. We would like to share with you a small selection of inpatient and outpatient satisfaction survey comments from recent months.

Child Health

“Your staff we encountered were extremely friendly, patient and genuinely cared and gave me the respect as a concerned mother. I was most surprised at the professionalism of your staff. Made me feel welcome not a hindrance have nothing but good to say about Wellington Hospital.”

Medical Services

“The attention of nurses at all times night and day was excellent. I thought the quality of the services given to the patients in my room was impossible to fault. I was most impressed with the patient and professional assistance given to them and myself. Nurses never seemed too busy to spend time and help them.”


“I was very impressed by the coordination and cohesion of the ward during my stay. I had essentially the same operation in June 2001 and this experience is a huge improvement.”

Kenepuru – Inpatients

“All staff (doctors, nurses, nurse aides) treated me with a lot of care and dignity.

“The caring concern given by nursing staff, doctors and physiotherapists. In fact everyone couldn't have been more gentle and considerate.”

Kenepuru - Outpatients

“Overall a very satisfactory service provided. A smile or friendly manner from staff equals about 50% success of the treatment provided.”

“How informative the doctor was in advising what to do when my child has the same symptoms again.”


“The friendliness of the staff and their wealth of knowledge and helpfulness.”

“Friendly midwives and nurses and very quiet and room very nice and comfortable.”


In late August we had the pleasure of attending a workshop on community participation and PHO responsiveness. The Wellington workshop, which C&C DHB co-hosted, was one in a series of regional workshops organised by the Ministry of Health as part of its ongoing commitment to the future development of PHOs.

The Primary Health Care Strategy has a strong emphasis on PHOs involving their communities in their governing processes and it was encouraging to see the good turnout from the five PHOs in our district, and also from the groups in Karori who are currently proposing the formation of a sixth PHO.

The workshop was also well attended by PHO staff, PHO community board members, other community representatives and DHB staff.

Dr Pat Nuewelt helped run the workshop, and also gave an excellent presentation on community participation in PHOs – a subject she is currently working on for a PhD in public health. Her presentation included definitions of community, levels of community participation and methods for involving the community.

Ngati Porou Hauora also gave an excellent presentation about how their community-governed organisation is working successfully with communities in Tairawhiti on primary and community-based health services.


Keep an eye on your letterbox next week for our annual publication which provides an update on achievements in the past year and some of the progress planned for the year ahead. “Annual Check-Up” was published for the first time in September last year, and this year it will once again be going to all letterboxes in the district during September. This year’s edition includes a special four page lift-out on our $303m Hospital Redevelopment Project.

If you require multiple additional copies for the organisation or group you work with then please contact our Communications Manager, Michael Tull, at – indicating the number of copies you require and the postal address they should be sent to.


The Ministry of Health is reviewing how it delivers oral health services to children around the country, and is inviting members of the community to have their say. The project objectives are to:

facilitate the completion of a review of School Dental Service facilities within each region/DHB,

describe the future vision and possible service reconfiguration models, and document DHB plans to implement the outcomes of the review.

The Wellington Regional Dental Service will manage the review on behalf of Capital and Coast DHB and Hutt Valley DHB.

Initially, there is a physical stocktake of the existing facilities and equipment, to obtain specific information about the condition of dental clinics and equipment. The review will also involve looking at how to reduce child oral health inequalities and best meet the oral health needs of all New Zealand children in the future. This is where feedback from the community is important.

To aid its review, the School Dental Service Project Team has sent letters to all Principals and Boards of Trustees of primary and intermediate schools in the region seeking their feedback on the School Dental Service and how it delivers its services. They are also inviting wider community to input into the review and would like to know what the community wants from their School Dental Service. Feedback and comments are a vital component in identifying areas in service delivery that can be improved or reconfigured to provide a School Dental Service that is appropriate for the 21st century.

The Project will report back to the Ministry at the end of October. The outcome of the review report will be known late in 2004 or early 2005.

Suggestions and comments can be made to Debbie Jeffery, SDS Review Project Manager, phone 025 2404 533 or


Our congratulations, and our warmest welcome, to Louis Smith - who has recently been appointed to the vacant manager’s position at the Porirua Healthlinks Trust. Louis is Samoan raised in New Zealand and has worked with a number of local communities to help them identify their own concerns and bring those issues to the table. Louis has also been involved with the Porirua Community Health Group, the Porirua Healthy Safer City Trust and the Porirua Health Partnership. He has recently returned from six months as a fellow of the Kettering Foundation in the USA, where he focused on indigenous, minority ethnic groups and youth.

Louis is keen to continue to ensure the voices of young people are heard, and to seek ongoing involvement of people and communities in all parts of Porirua City. The role of Healthlinks as a mechanism for information sharing, communication, advocacy, and facilitation on health and related issues will be strengthened with the appointment of Louis. A formal welcome will be held at the Community Health Forum on Friday, 3rd September 2004 at 12.30pm at Pataka Museum, Porirua.


The focus of Epilepsy Awareness Week this year is on Adolescents.

Officially, epilepsy is a disorder of the central nervous system, where a temporary disorganisation of the electrical and chemical activity in the brain causes a seizure. In layman’s terms, it’s a temporary breakdown of the brain’s communication system caused by abnormal brain cell activity – a burst of electrical activity within the brain.

It can take any form depending on which part of the brain it arises from. It may present as a convulsion, unusual body movement, change in awareness or simply a blank stare. Seizures end naturally as specific chemicals in the brain bring cell activity back to normal.

Most seizures are accompanied by an altered state of consciousness and sometimes by involuntary movements. They also vary from person to person, ranging from one or two seizures during a lifetime to several seizures a day, usually lasting a short time, ranging from a matter of seconds to four or five minutes.

People with epilepsy usually learn to know what might trigger a seizure. Factors such as lack of sleep, too much alcohol, stress, forgetting to take their medication or flashing lights might be a trigger that people need to learn to avoid. For most people with epilepsy the disruption a seizure causes is brief and infrequent. However, there are some consequences to having the condition that people often feel stigmatise them.

These include not being able to drive unless they have been seizure free for 12 months. That can add to someone’s burden, as the person then becomes dependent on other people to get around; it affects employment appeal and can lead to lower self-esteem and that in turn can be the beginning of a whole new set of problems.

Bob Henare – Chairman, Capital & Coast DHB

Margot Mains – CEO, Capital & Coast DHB

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