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What is a Health Improvement Practitioner?
A Health Improvement Practitioner, otherwise known as a HIP, is part of a general practice team. They work with patients and enable them to achieve goals by providing support and follow-up for issues related to mental health.
What can a health improvement practitioner help with?
A HIP can see people of all ages and at all stages of their lives and help with any type of issue related to behavioural change or mental wellbeing. Your GP or doctor may refer you to a health improvement practitioner and you can usually see them immediately to provide clinical support. A typical consultation with a HIP will take about 30 minutes and is usually focused on evidence-based brief interventions, they can also educate other team members and help to develop pathways and protocols around mental wellbeing and addiction support. Being based in a general practice, there are no barriers as to who can see them, as long as you are enrolled in the practice. Appointments/consultations are funded.
What training does a health improvement practitioner have?
A HIP will need to complete specialist training in the Te Tumu Waiora primary mental health model – a new model of mental health and addictions care and support in general practice. This new mental health model aims to provide all New Zealanders experiencing mental distress or addictions challenges with access to convenient, high quality, integrated and person-centered care and support.
The Doctors Silverstream has a part-time Community Support Worker.
What does a Community Support worker do?
Community Support Workers are able to help patients that are over 18, who are not already receiving any support from a Non-Governmental Organisation or District Health Board, and are experiencing difficulties that are affecting mental wellbeing. Some examples of what the Support Worker can help support with:
- MSD entitlement issues
- Housing
- Mild to moderate mental health and addiction issues
- Counselling referrals
- Food bank referrals
- Family relationship issues
- Employment support to find and maintain work
- Stress Anxiety Depression symptoms
- Budgeting struggles
- Isolation
- Goal planning support
- Total mobility cards for discount transport
- Funding for physical activity classes
- Funding for items that remove barriers to goal attainment (under $300)
If a need is beyond the Support Workers scope of practice they will support patients to link into a pre-established service that will meet the requirements. Patients do need to be referred from a The Doctors Silverstream Staff member. Once referred the Support Worker will then make contact to discuss possible supports.
The Doctors Silverstream has a part time Health Coach who works in the practice on a Thursday and every second Monday.
What does a Health Coach do?
A Health Coach meets with patients regarding their health and wellbeing journey. They provide walk-alongside support to help individuals gain the skills, knowledge and confidence to reach the direction they want to go! They can help to set goals and action healthy lifestyle choices to improve all aspects of their wellbeing.
Examples of what a Health Coach can help patients with:
- Learning about good nutrition, healthier meal alternatives and helping those on a weight-loss journey
- Getting into more exercise and general activity
- Living well with long-term health conditions
- Improving sleep quality and learning stress-management strategies
- Smoking cessation
- Long term goal setting!
The Doctors Silverstream offer a limited number of same-day appointments for patients who have urgent or acute issues that need to be dealt with immediately. This service is intended for enrolled patients who have an urgent condition that cannot wait for a routine appointment. Once at maximum capacity you will be directed to alternative providers.
For patients seeking urgent care you will be contacted by a clinician for triage, then either booked in, resolved over the phone, or alternative arrangements made. Please note, routine issues such as WINZ forms and insurance medicals do not qualify as urgent and will not be given a same day appointment, as these appointments are reserved for those who have serious clinical issues.
To request an urgent appointment, please phone reception. Please see fees here.
If you have a medical emergency, please call 111
The Doctors App
The Doctors App is an online portal for patients 16 years and over that allows you to access your medical records, view medical conditions, lab results, immunisation records, allergies, prescriptions, and share health information as required with other healthcare providers. It also offers services such as booking online appointments and ordering repeat prescriptions. Parents/Guardians are able to book appointments via the App for registered dependants.
The Doctors App will help you to take charge to stay on top of your health and wellbeing, and is accessible online, anytime.
To sign up for The Doctors App and more information head to https://thedoctors.co.nz/app
Immunisation is the most effective way to actively protect you and your child from preventable diseases, such as whooping cough, tetanus, hepatitis B and measles.
The first time we are exposed to a germ, for example a bacterium or virus, it takes time for the immune system to respond and we become unwell. However, once the immune system has memory of the infection, it is able to respond rapidly to destroy the germ the next time we are exposed. Vaccines contain parts of, or weakened versions, of a particular germ. Vaccination exposes the body to parts of the germ for the first time without causing disease, and subsequently, the real germ can be rapidly destroyed if it enters the body to prevent illness.
The national immunisation schedule
The national immunisation schedule provides the best protection for our children when they are most at risk. From six weeks of age, children can be protected from several potentially dangerous diseases. It is very important to stick to the schedule – as not immunising your child increases the risk of them getting the infection, and not keeping up to date reduces the protection that the immunisation can provide. It takes a few months and repeated doses of a vaccine for an infant to be fully protected.
Scheduled childhood vaccinations are funded so there is no cost to you.
Funded vaccines against the following diseases are available for children in New Zealand:
- Chickenpox (varicella)
- Diphtheria
- Hepatitis B
- Haemophilus influenza type b (Hib)
- Measles
- Mumps
- Pneumococcal disease
- Polio
- Rotavirus
- Rubella
- Tetanus
- Whooping cough (pertussis)
- Human papillomavirus (HPV)
- Bexsero (meningococcal B strain)
Meningococcal disease vaccinations
For best protection against all meningococcal disease in New Zealand, there are 2 separate vaccinations. Bexsero protects against group B strain and Menactra or Niminrix protects against groups A, C, Y & W strains.
Only Bexsero is on the NZ schedule for all infants, given at age 3 months, 5 months, and a booster at 12 months.
Menactra is only on schedule for eligible groups – those living in close quarters like Uni halls, boarding school, or prison.
Immunisation reminders
If you are enrolled at The Doctors Silverstream you will receive a recall 7-10 days prior to the immunisation due date for your child. You will then need to contact us to make an appointment. It’s important not to come earlier than the scheduled dates, especially for Bexsero.
Immunisation appointments
We run designated immunisation clinics to ensure we are running as close to time as possible, as you may be required to stay for 20 minutes after your appointment. Please bring your child’s WellChild book to your appointment.
Flu Vaccination
Flu can be anywhere and your best form of protection is to get a flu vaccine. Influenza(commonly called the flu), can be a serious illness that is sometimes fatal. Infection with the flu virus may lead to a stay in hospital for any age group, but particularly if you are elderly, or have an ongoing medical condition. Flu can make an existing medical condition, such as asthma or diabetes, a lot worse.
Every year the practice runs a series of Flu clinics providing flu vaccinations for patients to try and immunise as many people prior to the winter flu season.
Shingles vaccination
The shingles vaccine protects against the herpes zoster infection, shingles. Vaccination with the shingles vaccine can reduce your risk of shingles and the long-term pain it can cause. It is only on the schedule and funded for adults aged 65 years.
We offer offer INR point of contact testing. Point of contact INR is a easy and fast procedure to test your INR, in which we only need a small amount of blood (ladybird size) from a finger prick. This procedure takes 3 to 5 minutes, after which you will get your test results and warfarin dosing.
To book, please call us on 04 527 7376.
This service is free of charge for The Doctors Silverstream registered patients on warfarin.
Rather than having to go to a hospital, there are some minor surgical procedures which can be performed by your GP in our specialised treatment rooms. These appointments may require extra time, so please discuss any of these with your doctor so appointments can be booked appropriately.
Minor surgical procedures performed at The Doctors Silverstream:
- Removal of skin lesions
- In-grown toenails
- Removal of contraceptive devices
- Steroid joint injections
- Cryotherapy with liquid nitrogen for treating lesions, such as skin tags and verrucae.
More Information
A minor surgical procedure is an operation carried out in our treatment room, often using local anaesthetic. The anaesthetic is administered using a very fine needle, but the solution can cause some initial stinging in the skin, but which settles quite quickly. You should not feel any sharp pain after the area has been anaesthetised. When the anaesthetic has worn off (in a few hours) you may require paracetamol, but stronger pain relief is not usually required.
Sometimes there will be complications to minor surgical procedures, including wound infection, breakdown of the wound (particularly on the lower limbs and back), and sometimes numbness in the vicinity of the wound. Excessive bleeding can be a problem, in particular if you are taking warfarin, but Aspirin is not a problem. Other complications are very rare.
Costs
We have tried to keep the cost of minor surgery as low as possible as we do not want this to be barrier, but the extra time involved for the doctor and the nurses and the materials used all add to the cost. If cost is a problem please discuss this with your doctor. For those with health insurance, check and see if your insurance company is funding minor surgery in primary care now, as many have elected to. Alternative arrangements for minor surgery such as private specialist or public hospital specialist services are available and you might like to discuss these with your doctor.
Aclasta infusions are used in New Zealand for the treatment of osteoporosis and Paget's disease. These infusions are available at Silverstream Health Centre for enrolled patients, and also to patients who may be referred from another medical centre.
During the infusion you will be administered with Zoledronate (also known as zoledronic acid or Aclasta). Zoledronate is given by an intravenous infusion (into a vein in the arm via a “drip”) over about 15-30 minutes and can be given each 12-24 months as needed for treatment of osteoporosis.
Other than flu-like symptoms after the first infusion, side effects from Zoledronate treatment are uncommon, and are in general no different from placebo-treated patients in randomised trials. It should be remembered that major fractures can be very dangerous, so this should be balanced against the small risk of ill effects from treatments. Treatment is usually accompanied by some calcium tablets and /or vitamin D tablets before the infusion, to keep blood calcium levels normal.
Please discuss your suitability for this treatment with your own clinician. If you are not a registered The Doctors Silverstream patient, your registered clinician must refer to us for the procedure.
Cost
| Initial consult — |
Standard consultation fee (see our fees page) |
| Aclasta script — |
$5 per item at the pharmacy (for patients who meet the funding criteria above) |
| Infusion service — |
$150.00 |
Process
- Clinician appointment: Book an appointment to see your clinician for an osteoporosis consultation. Please do not try to squeeze this into another consultation, as there is a lot to cover. This consult is to:
- Assess whether you are a suitable candidate for Aclasta
- Arrange appropriate blood tests to ensure you are fit to have Aclasta
- Provide you with information about the procedure and check your medications
- Apply for special authority funding to meet the $600 cost of the Aclasta infusion
- Supply you with prescriptions for Aclasta, paracetamol, calcium and vitamin D supplements
- Arrange a time for you to return for the Aclasta infusion
- Nurse appointment: Return to have your Aclasta infusion at the scheduled time. Please remember to bring your Aclasta with you when you come. Allow at least 60 minutes for this appointment.
- Book follow/up infusions: You will be put on our recall system to organise any subsequent infusions that are required, and our nurse will contact you when these become due
Referring clinician only