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PHO Services Agreement Amendment Protocol (PSAAP) Meeting Summary of meeting outcomes
PHO Services Agreement Amendment Protocol (PSAAP) Meeting Summary of meeting outcomes
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· PSAAP held its first in-person meeting since COVID-19, in Wellington on 1 June 2022.
· PSAAP farewelled its longstanding Independent Chair, Neil Stiles, who has chaired PSAAP for 15 years. Neil has held the trust and respect of all parties to PSAAP. He has helped ensure PSAAP has worked in a collegial manner with all parties able to voice their views and come together to largely agree changes with consensus. The process to appoint a new Chair is underway.
· The substantive item for discussion was the annual price uplift, known as the Annual Statement of Reasonable Fee Increase (ASRFI). The ASRFI rate is independently calculated using methodology previously agreed to by PSAAP.
· The ASRFI has enabled funding to increase at a higher rate than StatsNZ’s CPI increases. Since 2017, the CPI has increased by a total of 13.3%, whereas capitation funding has increased by 14.8%.
· The ASRFI rate for 2022/23 is 2.38%. To acknowledge the higher inflation rate in the first part of 2022, interim Health New Zealand offered a 3% increase to frontline general practice services. This is consistent with other health sector price increases for 2022/23. This increase allows for many general practices to also increase revenue from patient co-payments by 2.38%. In dollar terms this could see an average adult co-payment increasing by around $1 per consultation.
· Interim Health New Zealand also offered a 20% price increase to immunisation services and a 30% increase for immunisations delivered to Māori and Pacific populations.
· Interim Health New Zealand has also invested additional funding to maintain the current maximum patient fee amounts for the following schemes:
o Zero Fees for Under 14s
o $13 co-payments for people aged 14-17 years old in Very Low Cost Access practices or if they have a Community Services Card
o $19.50 co-payments for people aged 18 years and older in Very Low Cost Access practices or if they have a Community Services Card.
· Outside the PHO Services Agreement (PHOSA), Interim Health New Zealand will also be providing an additional $4 million in funding to support rural general practice and is committed to additional support for the GP registrar programme to increase the number of GP trainees.
· In addition, Budget 22 provides $86 million over four years to ensure general practices are allocated funding more equitably and on the basis of their enrolled high needs populations.
· Budget 22 also delivered funding for additional primary care team members such as pharmacists, kaiawhina, and clinical care coordinators to reduce the workload on GPs.
· Interim Health New Zealand acknowledges the need to achieve pay parity for primary care nurses with their secondary care employed counterparts. Work is underway by the Ministry of Health (Ministry) to develop a framework and processes for this.
· Interim Health New Zealand also has work underway to review the capitation funding model and support primary care workforce initiatives. This programme includes representation from the primary care sector.
· Interim Health New Zealand has begun the initial work on a new modular contract that will eventually replace the PHOSA. This work will be undertaken with primary care and community sector input. PSAAP were advised that it is likely that Health New Zealand will be replacing the PHOSA within the next two years.
· As the Contracted Provider Caucus left negotiations there was not a quorum to discuss the other items on the PSAAP agenda including:
o implementing the new Health System Indicators from 1 July 2022, and
o changes to the PSAAP Protocol to reflect the health system reforms from 1 July 2022.
· The Ministry and District Health Boards will now implement the annual rate increases through a Compulsory Variation that will come into effect from 1 July 2022.