Health minister HIP with the programme as Porirua practice opens up to guests

Health and wellbeing staff em­ployed through Te Tumu Waiora are proving invaluable for high-needs general practice Porirua Union & Community Health Service, says GP Bryan Betty.

The service enjoys the contributions of health improvement practitioner (HIP) William Teleaga and health coach Willie Te’o, Dr Betty says. The pair have been at the clinic for over 18 months.

On 12 April, health minister Andrew Little made a low-key visit to the clinic, in Cannons Creek, to check on progress with Te Tumu Waiora. Other guests were present for the occasion.

The programme is being rolled out to the regions after being developed and piloted in Auckland in 2017.

It was funded in Budget 2019, when $455 million was set aside over four years, and tagged for expanding access to and choice of primary mental health and addiction support.

In the greater Wellington region, the Access and Choice programme, is run by PHOs Cosine, Ora Toa, Te Awakairangi Health Net­work and Tū Ora Compass Health.

Tū Ora acting chief executive Justine Thorpe says the Wellington area has more than 40 HIPs and health coaches and staff supporting them.

Porirua Union & Community Health Service caters to more than 7000 most­ly Māori and Pacific patients. Dr Betty says it is a high-pressure clinic, and many patients have complex problems.

He says clinicians can hand over pa­tients to Mr Teleaga and Mr Te’o to do lifestyle and basic mental health inter­ventions. “They have had a very tangi­ble effect on patients.”

Dr Betty says it was useful to have Mr Little at the clinic: “[He saw] our HIPs work with patients with very complex backgrounds. We were able to talk about the benefits of doing so.”

Staff also outlined to the health minister the wider issues for general practice, of care becoming increasingly complex. “He was very receptive to that and also engaged with the patients,” Dr Betty says.

For many patients, having on-site HIP workers available “extends their 15-minute GP consult”, he says.

For example, a doctor may diagnose a patient with type 2 diabetes, prescribe them medication and diary their recall consultations. Then the doctor walks the patient over to Mr Teleaga, who spends 15 to 30 minutes going through basic lifestyle, exercise and diet advice.

Another scenario is where a patient may present to a doctor with moderate­ly severe depression or anxiety. Mr Teleaga then does basic cognitive work on the patient’s anxiety and mood management, and basic lifestyle changes to aid that work.

In both scenarios, as with most cases, HIP workers conduct regular phone or in-person follow-ups, Dr Betty says.

“Another big, big thing about William and Willie is they live in the communi­ty, and they’re from the community, so they have gained a lot of trust.”

It was really important that in help­ing to improve access to health coaches, they could relate to the community.

The number of health improvement practitioners (HIPs) by full-time equivalent hours remains small, but is growing. As at the end of February 2021, the Integrated Primary Mental Health and Addiction services workforce, of which HIPs are part, had provided 93,205 sessions to people experiencing mild-to-moderate distress. In the month of February, 10,700 sessions were provided. HIP numbers (full-time equivalents) are:

• Auckland – 114.9
• Canterbury – 41.6
• Hawke’s Bay – 17
• Lakes – 12.6
• MidCentral – 17.8
• Northern – 20.4
• Southern – 25.3
• Taranaki – 10.5
• Waikato – 42.5
• Wellington – 40.4
• Whanganui – 7.2

Source: Ministry of Health