PSAAP communique 30 April 2024

A meeting of PHO Services Agreement Amendment Protocol (PSAAP) took place on Tuesday 30 April 2024. It was an additional meeting of PSAAP aiming to ensure all procedural aspects of the updated Protocol were in place and to begin to debate potential variations to the PHO Services Agreement (PHOSA).

A quorum was achieved, amendments to the Protocol from the last PSAAP meeting noted as correct, and the process for appointment of Contracted Providers accepted. There are some details yet to be finalised over time.

Instead of appointing a negotiation team it was agreed that a small working group be established as soon as possible related to the annual uplift. Working group names from PSAAP partners have been requested to be with Health New Zealand | Te Whatu Ora by Friday this week. The group will develop options related to the uplift and the potential incorporation of the nursing pay parity funding and the equity adjustor, the revision of weightings and associated fees arrangements.

Another working group requested for urgent establishment, is for finalising the immunisation pre-call/recall and immunisation coordination support, to ensure timely payment. Two other working groups will be established to discuss data and digital security amendments and changes to the system level measures (SLM).

With changes to the Commerce Act over the past few years, and examples of where the Commission has taken action against the health sector participants, it is also timely to review the PSAAP arrangements. HNZ is going to take this forward.

There were a range of matters raised by PSAAP members, most of which will be discussed in more depth in the working groups. This included (but was not confined to) the pressures on the VLCA practices, issues with the disbursement model applied to the Equity Adjustment Funding, the definition of rural classification, the balance of resource being directed to the front line or PHOs, the potential for incremental changes to the capitation formula, and the importance of a collaborative approach for the SLM development.

Considerable pessimism was expressed about the likelihood of the uplift being adequate to address the significant issues in the sector. It was also noted the pressure created by work that used to happen in hospital being referred to primary care, for example the expectation that patients who have been waiting more than four months for a hospital appointment should go to their G.P.

The budget announcements about the uplift will not occur until late May. The timeframe to achieve a contract by July is extremely tight, but Health New Zealand is committed to do their utmost to manage it in time to ensure timely payment for practices. A timetable will be set down for the work to be done in the forthcoming weeks. The next meeting of PSAAP will be in early June.