Giving More Voice To Future Health Care Planning

Many more people in Otago and Southland can now rest assured health providers will know what their health care wishes are at times where they are unable to speak for themselves, often at the end of their lives.

In February 2024, WellSouth, the primary health organisation (PHO) for Otago and Southland, changed the way they fund general practices to support patients writing and recording Advance Care Plans (ACP).

WellSouth has created a funding stream for practices to claim for processing ACPs, alongside offering training and support via two dedicated WellSouth Shared Care Plan Coordinators.

The funding from WellSouth for general practices means that anyone 60 years and over, or people of any age who are Māori, Pasifika or who are former refugees are eligible for a free ACP consultation. General practices can identify these people and contact them to start talking about advance care planning.

Since ACP consultations became funded by WellSouth in February 2024, 36 general practices have created 154 ACPs, well above previous years.

WellSouth Shared Care Plan Coordinator, Helen Sawyer, says, “Creating an ACP involves thinking and talking about your values and goals and what your preferences are for your current and future health care.”

People can write what is important to them in a book available from their general practice. Alternatively, there is an ACP template on the national advance care planning website which can be downloaded at www.myacp.org.nz. People can start their ACP with or without help from a health professional. Most people work with the team at their general practice, however health professionals in hospitals and aged care facilities and other health providers can also help.

Mrs Sawyer says these conversations are critical to people and their families.

“An advance care plan speaks for you often because you can no longer speak for yourself,” she explains.

“However, while these plans are important, clinicians often have limited time, and feedback to WellSouth from practices was that ACPs, done well, take time to complete and upload. The funding for ACPs is in recognition of this feedback, acknowledging the time and effort to complete these plans with patients,” says Mrs Sawyer.

People can discuss their wishes with a GP, practice nurse, Health Improvement Practitioner or Health Coach at their general practice. To ensure plans reflect the person’s wishes needs and are clinically safe, all plans are signed off by a GP or nurse at the practice the patient is enrolled at.

Mrs Sawyer or Michelle Anderson, also a WellSouth Shared Care Plan Coordinator, review the ACPs to ensure they are medically interpretable across the spectrum of healthcare provision. This process also ensures that the person’s voice is heard during critical health events. The Shared Care Plan Coordinators also support practices with advice particularly on complex plans, and in rare instances do home visits, when people are unable to visit their general practice, for example.

“The funding availability is helping people, and their loved ones access the support required to complete an ACP, and feel secure in their wishes being met, easing anxieties and burdens,” says Mrs Sawyer.

“These plans are important to a person and their family. They should be in a person’s life kit with wills and insurance policies, and we encourage anyone to have an ACP conversation with those they love, and to contact your general practice to ask for an appointment.”

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