Southern DHB provides around $1 billion worth of health services annually that encompasses the public and private health services, primary healthcare, acute, chronic and aged care, community based services, population health services - in a variety of settings. Keeping an eye on what’s ahead will be a key task for the new Board.

Health is about what happens at home, at school, our workplaces and in our communities and for most people, primary health care can address the vast majority of health care needs throughout our lives.

Fortunately most of us are infrequent users of hospitals which are the provider of first choice for acute illness and complex care.

Health governance and leadership is centred on the ability to identify priorities, provide strategic direction to multiple actors within the health system, and create commitment across the health sector to address those priorities for improved health services.

Here are some emerging challenges and opportunities that I think will be important.

1) Workforce shortages

There is a global shortage of healthcare workers of all kinds to address current and emerging population health needs. These include not only numerical workforce shortages but imbalances in skill mix, geographic maldistribution, difficulty in inter-professional collaboration, inefficient use of resources, and burnout. Effective health leadership and workforce management is therefore critical to addressing the human resources needs within health systems and strengthening local capacity and capability.

Work-related injuries, violence in the workplace and stress on the job are interrelated aspects of work conditions that are sensitive to both internal changes (such as staff cutbacks) and external changes.

Healthcare workers’ safety and health have implications for patient care and costs because staff turnover and lost work days affect continuity of care and availability of trained staff.

Healthcare professionals will want to help people in need, but the sheer logistics of expanded care delivery, the current and growing shortage of personnel, and the limited resources available will be a significant challenge.

2) Aging populations and increasing burden of chronic disease and cancer

We will need better integration of models of care - from community services to primary care to hospital based services - to help prevent illness and keep people well. Efforts to help people stay at home or in their community should be strengthened to reduce the need for hospital care. Sufficient funding to support an ageing of the population, the parallel rise in chronic disease and the rising cost of medical technologies will always be a challenge.

The World Health Organisation has done some excellent work on “best buys” to address these challenges and we should be looking to incorporate the evidence based approaches that have been identified.

3) New technologies

Telehealth and telemedicin e is already being used for midwifery - obstetric consultations in Southern DHB so we should explore how this could be expanded to support health providers in small towns. This approach reduces travel for all and helps build primary care capability.

Artificial intelligence applications can take on some of the more routine and repetitive tasks in health care, freeing up valuable time of trained health care providers to continue with what they do best - working with patients.

Technological advances - equipment, new devices and pharmaceuticals will continue to have a large impact on the delivery of healthcare and will affect all stakeholders in some way.

While uptake of many new technologies will (rightly) be decided at a national level there will need to be processes in place to assess these in a systematic way. We need to be smart about “new is better” because that is not always the case.

The new Board will need to make strategic decisions in the best interests of the communities in Southland and Otago.

VOTE # 1 Marion POORE for Southern DHB

• Authorised by Marion Rosalind Poore, 307 Morven Ferry Rd, Arrow Junction Queenstown 9371