Managing Acute Demand in New Zealand
Across New Zealand, many District Health Boards run programmes to assist primary care to manage
acutely unwell patients in the community. The term ‘Hospital in the Home’ is less familiar in the NZ
setting with services known under a range of terms including Acute Demand; Primary Options for
Acute Care and Integrated Services.
The NZ Ministry of Health is keen to see Primary health care as the principal provider of both routine
and urgent health care to the New Zealand population, and to see all DHBs developing alternative
pathways through which patients can access acute services.
The New Zealand Ministry of Health is currently running a service improvement programme aimed at supporting organisations to provide managed acute care in the community rather than unplanned care in hospital. As part of this programme, useful documents from across NZ, UK and Australia have been collected and are provided as a resource in this MoH microsite. You will need to create a login, but access is free.
This site contains nearly 150 documents grouped into section such as Heart Failure, Paediatric Pathways and GPs with Special Interests and you are welcome to view, comment and add your own documents to share with the wider community.
HealthPathways & HealthInfo
HealthPathways is an online manual used by clinicians to help make assessment, management, and
specialist request decisions for over 550 conditions.
Rather than being traditional guidelines, each pathway is an agreement between primary and
specialist services on how patients with particular conditions will be managed in the local context.
Each health jurisdiction tailors the content of HealthPathways to reflect local arrangements and
opinion, and deploys their own instance of HealthPathways to their clinical community.
The target audience for HealthPathways is the primary care clinicians responsible for managing
patients in the community, and for initiating requests (including referrals to hospital) for specialist
HealthPathways are now in place across many DHBs in NZ and a range of states in Australia. These
HealthInfo is a health information website, aimed at patients. The information on HealthInfo has
been written and approved by local doctors, practice nurses, hospital clinicians, and other
healthcare professionals, and is specific to Canterbury, New Zealand.
The website has a mix of health information, ranging from factsheets on different topics and
descriptions of local health services and supports, through to links to recommended websites for
further reading and research.
HealthInfo has specific information on Acute Demand and further information can be found here.
Further Articles of Interest
The Acute Demand Programme in Canterbury has been in operation for nearly 15 years and
currently manages around 29,000 acute episodes of care for a population servicing around 510,000.
Primary Options for Acute Care (POAC) is Auckland based and Primary Options in Northland.
See here for further information on Canterbury and Radiology Options in Canterbury.
Measuring unexplained variation in acute hospital use by patients enrolled with northern New
Zealand general practices
Designing and improving patient flow through a busy 24 hour accident & medical/urgent after-hours
Innovative programmes deliver more community-based care in Canterbury
Whangaroa Health Services Review