Bay Of Plenty DHB is using a new GP shared care (GPSC) flexible funding model to change the way opioid substitution treatment (OST) is delivered in the Bay. This new Equally Well approach to OST care will improve physical health outcomes for people using OST, who often suffer the consequences of long-term substance use. 
 
The key objectives of OST in New Zealand are to improve the physical and psychological health and wellbeing of people who use opioids through reducing or stopping illicit opioid use and its associated risks, while promoting recovery journeys and access to support systems and networks. 
 
For each person receiving OST care, two GPSC funding streams are now available. One stream pays for GP appointments, while the other can be used flexibly to pay for:
  • regular physical health checks and screening
  • preventative measures such as flu injections
  • access to ongoing support through any funded chronic conditions service
  • dental treatment.
The new process was developed and refined by secondary OST services, interested GPs, Western Bay of Plenty PHO and Bay Of Plenty DHB Planning & Funding.  The GPs will provide quarterly reporting to the PHO on the use of the flexible funding, and feedback on the value of this approach will be sought from people receiving OST care in two years.
 
Norman McFadyen, GP liaison clinician for the shared care arrangement, says the primary focus is to ensure that people living in the Bay are treated with dignity and respect, and have good treatment outcomes. 

In the Bay of Plenty, 204 people are currently receiving OST care for their addictions, with 158 people under the care of the specialist team and 46 people in a shared care arrangement. The target is to move a further 24 people into the shared care arrangement by the end of 2017, and another 30 by the end of 2018, to reach the Ministry of Health target of 50 per cent. These people will still have one secondary service review annually but receive all other care from their GP and the Addiction Liaison clinician.