Inaugural GP breakfast – great success

​As a prelude to this year’s Metro North Health Forum, more than 80 GPs and practice managers were treated to presentations on New Zealand’s medical home model and joint initiatives that support local GPs and their patients. 

The GP Breakfast Briefing was also an opportunity to network with hospital clinicians and General Practitioner Liaison Officers who are working across the sector to improve integration of care.

Speakers at the breakfast included Dr Anita Green, Professor Les Toop, Dr John Bennett and Associate Professor Jeff Rowland.

Keynote speaker, Professor Les Toop, spoke on the Health Care Home model and how it is being implemented in New Zealand and internationally.

Professor Toop, Head of the Department of General Practice at the University of Otago, in Christchurch, New Zealand, said virtually everyone was enrolled with their general practice in New Zealand because it is less expensive to visit a doctor for enrolled patients.

“But the mutual responsibility that goes with enrolment, I can’t underestimate. That was the biggest single change in New Zealand in the early 2000s, was enrolment. It made a massive difference to what we could do, and the intelligence that we had,” Professor Toop said.

He discussed the key elements of a Health Care Home model that had been implemented in New Zealand by Pinnacle (the Midlands Health Network) and an Ernst and Young report that had evaluated the model.

The report found the Health Care Home model had been evolving since its initial conception in 2010 and by 2016 there were ‘clear and enduring changes to the way participating practices did business’.

According to Professor Toop, the report was “quite a good summary…but they haven’t done it at scale yet. They’ve only done it for three or four practices, so when you get to the number crunching about the effectiveness of it, it is hard to say because it’s just not powered up to do that”.

“So our next step really is to try and do something at scale,” he said.

Professor Toop then spoke about the Canterbury Integrated Family Health Service program, which he described as a “ground-up program” that had been co-funded by the District Health Board and Pegasus.

The program aims to integrate care around individual patients while building sustainable capacity, capability, and the efficiency of primary care teams.

It supports proactive and coordinated care for those patients who need it and links primary care teams with other health and social service providers to start the process of relationship building.

Professor Toop said there was interest in the program from practices covering 76 per cent of Canterbury enrolment, while practices covering 56 per cent of enrolment are at various stages of implementation.

“So the idea that people don’t want to change is not true. People are up for the change and they just want to understand what it is,” he said.

For more information about the Canterbury Integrated Family Health Service program, go to

Other speakers at the GP Breakfast Briefing included Brisbane North PHN Board Chair Dr Anita Green who warmly welcomed the breakfast attendees and invited Dr John Bennett to give an update on the transition of the Pathways Program to the HealthPathways platform.

Dr Bennett and his colleague Dr Fabian Jaramillo are HealthPathways clinical editors and, along with a small support team, have been working to develop a suite of localised pathways since November 2016.

A short video about this activity was screened at the breakfast briefing and is available online at

Dr Bennett said HealthPathways was a tool that helps to improve continuity of patient care.

“That’s very important. We all struggle to try and provide that for our patients and I really believe genuinely [that] this product can help us do that,” Dr Bennett said.

“Our aim is to give you as much information as possible in one spot. Trying to find things is always difficult. If you search, you’re really not sure about the provenance, the quality, the influences that may’ve caused this information to be where it is.

So we’re hopeful of being able to overcome some of those shortcomings with this product,” he said.

Associate Professor Jeff Rowland then took the floor to speak about the GP Rapid Access to Consultative Expertise (GRACE) project operating from The Prince Charles Hospital (TPCH).

A quick electronic poll taken during his presentation showed two thirds of GPs had heard of the GRACE project, but most had not used it.

“We can organise, through GRACE, for [patients] to go to the right place, instead of everybody coming in through the emergency department. It also means that you have an opportunity to get expert advice,” Associate Professor Rowland said.

“Rather than just referring a patient to outpatients and keeping your fingers crossed that you’ve done the right thing, you can actually ring and find out whether that would be the right way to go,” he said.

To contact the GRACE project, GPs can call the TPCH Internal Medicine Team on 07 3139 6896 between 7.00 am and 7.00 pm seven days a week.

Image one caption: Professor Les Toop, Ms Abbe Anderson, Dr John Bennett, Dr Anita Green and Professor Don Matheson

​Image two caption: Dr John Bennett presenting on HealthPathways