Published by Auckland, Counties Manukau and Waitematā DHBs on 8/02/2022 3:08:00 PM.

From this week, we are transitioning to wider primary care involvement in COVID-19 Case Management as Omicron case numbers build in the Northern Region. This is a pivotal moment in the pandemic healthcare response since beginning two years ago.  

From Thursday 10 February, a soft launch will see primary care expected to provide clinical care for their enrolled patients and within this provide a limited assessment of their household bubble. Most of this care can be managed by virtual consult. Patients with low risk and only more mild symptoms will be encouraged after their initial assessment by their GP/nurse to self-care at home and call for help if their symptoms get worse. People at higher risk and or with more moderate symptoms will require more frequent monitoring. A new Case Management Pathway will be live by Thursday to assist with COVID Case Care. 

The Māori and Pacific Co-ordination Hubs will also be working with Māori and Pacific people with COVID-19 and their families addressing welfare needs and, in some cases providing clinical care.
Please contact Māori and Pacific people enrolled with your practice who are COVID-19 positive as a priority group and tell your patients that the co-ordination hubs may also be calling to support with any needs they have. The Hubs will also be recording care in the CCCM record. 

The COVID-19 Clinical Care Module (CCCM) (previously known as BCMS) record is used across the system and will enable a view of who is leading care. Please refer to Health Pathways: COVID-19 Resources regularly to stay up to date including CCCM training information.  

Please remember that up to 90 per cent of fully vaccinated patients who test positive to Omicron will experience either no symptoms, or a relatively mild illness manageable though self-care at home. 
We are working urgently on standard processes which will clarify referral and escalation processes, including with the Whanau HQ Hub and secondary care. It will also clarify roles and responsibilities after hours.   

While it is understood that some practices may not be ready to move to the new framework on Thursday, this date has been chosen because starting at lower case numbers will enable practices to be better supported to more easily take the first steps through the transition. 

After-hours and weekend care 
When patients need help outside normal business hours they should be directed to call Whakaraongorau (Healthline). Using CCCM will enable a shared care record across the system visible to Whakarongorau Healthline to support your patients. 

Consider whether your practice can provide weekend calls which are clinically required because the person is moderately unwell or at higher risk of becoming acutely unwell or whether this needs to be supported by the Whanau HQ Hub. Please let your PHO know your plans. 

New Funding Model 
From 10 February, Metro Auckland will move to a new, regionalised funding framework, aligned with the national model, to pay for COVID-19 case management. We are working to ensure this is usable by practices with a local algorithm. Please await further information which will be published on Medinz. 
Practice changes 

Practices will be asked to:  
·         Assess patients and do a brief assessment of members of household bubbles after notification of patient’s positive test. There will be processes in place at the NRHCC Hub to ensure cases do get picked up as the new systems are adopted. 
·         Provide clinical management of cases as per the Auckland Regional Health Pathways: COVID-19 Case Management in Adults (to be updated on Thursday) and COVID-19 Case Management in Children.
·         CCCM (previously BCMS) should be used to record the care provided to enable shared care and after-hours support for patients. 
·         Proactively let patients know what to expect if they get COVID-19, how to prepare, and when to call for help. 

Webinar on Thursday, February 10 – Auckland Specific Primary Care COVID-19 Care 
The first of a series of primary care webinars will take place at 7.30pm on Thursday evening to support the transition. Speakers will step attendees through the patient journey, how to use the CCCM and funding from a primary care perspective. Please register here. https://smex12-5-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=https%3a%2f%2fwww.goodfellowunit.org%2fnode%2f1017899&umid=1ccdd453-ecd8-48f5-906c-e2151ed6a4e8&auth=77d08566e2aca54990ea4fad5bb6ae193ce6dd74-21342baac5331e5bb2ee15f7df3209316c839d0e
There will be further webinars with Auckland based clinicians who have been looking after COVID-19 cases talking though common queries about patients with COVID-19. 

Support available to practices 
1.       Regular updates to Health Pathways. See the recently published pathway: COVID-19 Answering Patients’ questions
2.       Regular updates via Medinz 
3.       Training for CCCM use via Health Pathways Upcoming Education Events and scheduled webinar times  
4.       Regular webinars to support case management with clinicians and offer Q and A opportunities.  
Patient resources: 
Patients should be directed to Whanau HQ for self-care information  https://immunisation.northernregion.health.nz/whanauhq/

Pivot to Omicron: Goodfellow Unit webinar 
About 2,500 primary care practitioners registered for the Goodfellow Institute webinar on the pivot to Omicron, held on Thursday, February 3. The recording can be found here: https://www.goodfellowunit.org/events/omicron-pivot