COVID-19 (Coronavirus)

See www.cdhb.health.nz/covid19 for information about COVID-19 testing and service changes at hospitals.

CEO Update – Monday 18 January 2021

In this edition of the CEO Update

Acting Chief Executive Andrew Brant welcomes in the new year and asks us all to continue to maintain our good habits to keep ourselves and our community healthy. He notes that the WHO has designated 2021 as the Year of Health and Care Workers, in recognition of the enormous contribution health and care workers have made around the world throughout the COVID-19 pandemic. As many of us adjust to returning to work, Andrew also offers some tips from the AllRight? team as a reminder that it's often the simple things that get us through.

This issue also promotes key people in the Canterbury Health System who were recognised in the 2020 New Year's Honours, shares the good work of the team of orderlies at Burwood Hospital, pays tribute to a well-respected colleague, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for Te Roto o Wairewa/Lake Forsyth

Canterbury DHB’s Community and Public Health unit has issued a health warning after potentially toxic blue-green algae (planktonic cyanobacteria) was found in Te Roto o Wairewa – Lake Forsyth.

People should avoid the Lake and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

Dr Cheryl Brunton, Canterbury Medical Officer of Health, says the algal bloom can produce toxins harmful to humans and animals.

“People should avoid contact with the water until further notice.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips. If you experience any of these symptoms visit your doctor immediately and please let your doctor know if you have had contact with the lake water,” Dr Brunton says.

No one should drink the water from the lake at any time. Boiling the water does not remove the toxin.

Animals that show signs of illness after coming into contact with algal mats or scums should be taken to a vet immediately.

Fish and shellfish can concentrate toxins and their consumption should be avoided. If fish are eaten, remove the gut and liver and wash in clean water. Further information on gathering Mahinga Kai can be obtained below.

Facts about cyanobacteria:

  • Cyanobacteria occur naturally but can increase rapidly during warmer months.
  • Algal blooms are caused by a combination of nutrients in the water (such as nitrogen and phosphorus), and favourable weather conditions (e.g. increased temperature, calm days).
  • If the water is cloudy, discoloured, or has small globules suspended in it, avoid all contact.
  • Not all cyanobacterial blooms are visible to the naked eye and toxins can persist after the blooms disappear.
  • Cyanobacterial concentrations can change quickly with changing environmental conditions (e.g. wind). If a health warning is in place avoid contact with the water.

For further details visit: https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

New charges for short-stay parking at Waipapa will come into effect on 18 January 2020

Canterbury DHB’s move into the new Waipapa building has provided additional short-stay public car parks for use when dropping people off or picking them up at the Emergency Department or hospital.

With our Emergency Department relocating to Waipapa, the short-stay parking was initially opened to the public on a no charge basis with a 30-minute restriction. However, now the relocation has been successfully completed we need to ensure these parks are available for pick-up and drop-off purposes.

The first 30 minutes of parking will remain free. After 30 minutes the following charges will apply from 18 January 2020:

While access to the car park will remain unchanged, from 18 January people will need to ‘pay by plate’ once they have parked regardless of the time period they intend to park for, just as they do for street parking throughout the CBD.

There will be three pay-stations located within the car park and people will need to enter their number plate information to confirm their parking and pay for the time period they have selected. There will be no charge if 30 minutes is selected.

Alternatively, people are able to download and use the ParkMate app on their mobile phones to confirm their parking.

The mobility parks outside Waipapa will continue to be available free of charge, with no time limit.

Correct usage of the car park will be monitored from 18 January onwards.

Canterbury DHB’s Commercial Portfolio Manager Rachel Cadle says the new short-stay parks provide a much improved pick-up and drop-off option than what is currently available outside Christchurch Hospital.

“However, we want to ensure these parks have a fast turnover to provide this improved option for our patients and their whānau accessing Waipapa. They are short-stay parks and we expect the pricing after the first 30 minutes will encourage them to be used in that way.

“These parks complement the DHB’s existing park and ride shuttle service operating from the Deans Ave site, which now also provides a pick-up and drop-off service to Waipapa,” Rachel says.

A full list of parking options in close proximity to the Christchurch Hospital campus can be found on the DHB’s website here: https://www.cdhb.health.nz/patients-visitors/transport-parking/

ENDS

Supervisor Chef Oliver Fernee and Chef Dharam Devkota busy preparing the delicious Christmas meals for our patients.

R:L Supervisor Chef Oliver Fernee and Chef Dharam Devkota

The highlights of a kiwi Christmas can range from backyard cricket to a trip to the beach. But one thing that connects most kiwis is sharing delicious Christmas kai with friends and whānau.

Canterbury DHB’s WellFood team are well aware of the tradition of enjoying a great Christmas meal and that’s why they go the extra mile to serve up a mouth-watering Christmas feast to patients each year.

The team are busy preparing the almost 1100 Christmas meals they’ll be plating up for patients who find themselves in one of Canterbury’s hospitals on Christmas Day.

Some of the delicious options across our five hospitals will include roast turkey, chicken, lamb and baked ham with all of the traditional condiments – cranberry, pineapple, gravy and mint sauce.

The Christmas treats don’t end there with a range of tempting desserts to round off the merry menu including trifle, pavlova, fruit salad, mousses and Christmas pudding.

WellFood Service Manager Neville Patrick says this year has been hard for many and being in hospital over the festive season is never easy.

“If we can give our patients an extra dose of Christmas cheer, it makes all the extra work worth it,” says Neville.

Around 130 staff working in the kitchens will also prepare over 50 “meals on wheels” to spread the Christmas spirit through the local community as well.

“It’s a real highlight each year for our teams across Canterbury, knowing that we’re able to brighten up Christmas Day for our patients.

“We’re also pleased we can give our hard-working staff a Christmas meal while they are working and missing out time with family”, Neville says.

ENDS

For further information, contact:

communications@cdhb.health.nz

 

Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for Waikirikiri/Selwyn River at Chamberlains Ford

Canterbury DHB’s Community and Public Health unit has issued a health warning for Waikirikiri/Selwyn River at Chamberlains Ford.

The warning follows finding moderate to high cover of potentially toxic algae (benthic cyanobacteria) in the Waikirikiri/Selwyn River at Chamberlains Ford.

People should avoid the area and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

There are also other access points along the Waikirikiri/Selwyn River at Chamberlains Ford that may have benthic cyanobacteria present.  People are advised to treat every low-flowing river cautiously, check for the presence of benthic cyanobacteria and avoid contact.

Dr Cheryl Brunton Canterbury Medical Officer of Health, says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area,” Dr Brunton says.

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately.

People and animals should remain out of the waterways until the warnings have been lifted.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months. Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people/ dog-walkers to treat every low-flowing river cautiously.

For further information visit

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

For further information, contact:
communications@cdhb.health.nz

 

A message from Board Chair, Sir John Hansen

Appointment of Chief Executive, Canterbury and West Coast DHBs

I am very pleased to announce that following a global recruitment search, Dr Peter Bramley has been appointed to the position of Chief Executive of Canterbury and West Coast DHBs.

Peter is currently Chief Executive of Nelson Marlborough Health. He started at Nelson Marlborough in 2010 as Service Director Medical and Surgical Services. In 2013, he became General Manager Clinical Services and in August 2016 became Acting Chief Executive and was appointed permanent Chief Executive in 2017. He’s very familiar with Canterbury and West Coast DHBs as he was appointed Acting Chief Executive earlier this year and was in the role during August, September and early October.

Board chair, Sir John Hansen said through his various roles in health and management Peter has managed a wide range of challenging scenarios and has a proven track record in bringing about large-scale transformation.

“His reputation is as a people person, who can support and enable others to achieve great things,” Sir John said. “During his time with us as Acting Chief Executive he proved his relationship management skills and worked positively with all stakeholders from throughout the heath system. He has strong networks and familiarity with the sector. There will be opportunity for Peter to meet with current Acting CEO, Andrew Brant as required during January to ensure a smooth transition.  

“The added bonus for us, is that Peter has already had a wonderful opportunity to learn about the Canterbury and West Coast health systems and meet many of our people. When he arrives in February he will be able to hit the deck running, as we have a big work programme. 

“Importantly, Peter is aware of our financial situation and knows there are plenty of challenges and opportunities ahead,” Sir John Hansen said. 

Peter Bramley said he’s looking forward to moving to Canterbury and starting the new role. “I enjoyed my time in Canterbury and on the Coast and know I’m going to be responsible for two very different DHBs – both have a wealth of talent, and both have complex, but different challenges. With fantastic teams to work with on both sides of the alps, I know we can achieve great things.”

“After a period of transition, I’m looking forward to being able to provide some stability and leadership to the teams. We have significant work to do, and I am looking forward to working with staff and the Boards to improve the health of the Canterbury and West Coast DHBs’ communities.

Peter’s first day with Canterbury and West Coast DHBs will be on Monday 15 February 2021.

Ngā mihi nui

Sir John Hansen KNZM,
Chairman,
Canterbury District Health Board

Dr Peter BramleyDr Peter Bramley – Brief Bio

Peter has extensive management experience and an interesting career path. His academic career began at the University of Otago where he gained a Bachelor of Science in biochemistry and physiology. He worked for the Wellcome Medical Research Institute in Dunedin and at the same time completed a PhD in Medicine.  Dr Bramley lectured in biochemistry, first in Dunedin and then at the University of Canterbury in Christchurch. 

Between 1999 and 2007 Peter held various senior management roles with the accounting software company, MYOB New Zealand Ltd.  In 2008 he stepped back into health as Service Manager of Surgical Services at Southland Hospital in Invercargill. 

At the end of 2010, Peter moved to Nelson and joined the Nelson Marlborough Health Executive Leadership Team as Service Director Medical and Surgical Services.  In 2013 Peter became General Manager Clinical Services and in August 2016 stepped into the role as Acting CE.  Peter has been the Chief Executive Officer of Nelson Marlborough Health (NMH) since April 2017.

Peter is an energetic and passionate people manager, with a strong focus on the importance of accessing healthcare close to home and growing a compassionate workforce in the health sector. 

 

Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for Lake Clearwater

Canterbury DHB’s Community and Public Health unit has issued a health warning after potentially toxic blue-green algae (planktonic cyanobacteria) was found in Lake Clearwater, situated in the Ashburton Lakes Basin area.

The type of cyanobacteria currently present in high concentrations is Synechocystis.

People should avoid the Lake and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

Dr Ramon Pink Canterbury Medical Officer of Health, says the algal bloom can produce toxins harmful to humans and animals.

“People should avoid contact with the water until further notice.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips. If you experience any of these symptoms visit your doctor immediately and please let your doctor know if you have had contact with the lake water,” Dr Pink says.

No one should drink the water from the lake at any time. Boiling the water does not remove the toxin.

Animals that show signs of illness after coming into contact with the water or algal scums should be taken to a vet immediately.

Fish and shellfish can concentrate toxins and their consumption should be avoided. If fish are eaten, remove the gut and liver and wash in clean water. Further information on gathering Mahinga Kai can be obtained below.

“When a bloom of potentially toxic cyanobacteria is present in a lake, there is a possibility of cyanobacteria and toxins being transported downstream.

People are advised to avoid contact with the downstream water bodies,” says Dr Pink.

Environment Canterbury monitors the lake weekly while the warning is in place and the public will be advised of any changes in water quality that are of public health significance.

Facts about cyanobacteria:

  • Cyanobacteria occur naturally but can increase rapidly during warmer months.
  • Algal blooms are caused by a combination of nutrients in the water (such as nitrogen and phosphorus), and favourable weather conditions (e.g. increased temperature, calm days).
  • If the water is cloudy, discoloured, or has small globules suspended in it, avoid all contact.
  • Not all cyanobacterial blooms are visible to the naked eye and toxins can persist after the blooms disappear.
  • Cyanobacterial concentrations can change quickly with changing environmental conditions (e.g. wind). If a health warning is in place avoid contact with the water.

For further details visit: https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

In this edition of the CEO Update

Acting Chief Executive Andrew Brant and Board Chair Sir John Hansen thank everyone in the Canterbury Health System for your work throughout 2020 and wish you all a safe and happy holiday. For those working through, a very special thanks to you for continuing to care for our community into the new year.

This issue also promotes the festive cheer happening across the health system, shares the support for patients with sleep apnoea, celebrates 10 years of the newborn hearing screening programme, looks at the new equipment helping Radiology patients, thanks long-serving staff members who are retiring, raises awareness of some generous Christmas donations from staff and the public, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for the Waiau River at the Waiau Bridge

Canterbury DHB’s Community and Public Health unit has issued a health warning for the Waiau River at Waiau Bridge.

The warning follows the finding of moderate to high cover of potentially toxic algae (benthic cyanobacteria) in the Waiau River at Waiau Bridge.

People should avoid the area and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

There are also other access points along the Waiau River that may have benthic cyanobacteria present. People are advised to treat every low-flowing river cautiously, check for the presence of benthic cyanobacteria and avoid contact.

Canterbury Medical Officer of Health, Dr Cheryl Brunton says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area,” Dr Brunton says.

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately.

People and animals should remain out of the waterways until the warnings have been lifted.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months. Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people to treat every low-flowing river cautiously.

For further information visit:

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

Care around the clock is available for Cantabrians from their usual GP

Care around the clock is available for Cantabrians from their usual GP 24/7

This summer, wherever your holidays take you around New Zealand, remember that you can still get free health advice whenever you need it.

If too much festive cheer leaves you feeling worse for wear, you can call your own general practice team 24/7 for care around the clock.

Before you head off on holiday be sure to load your general practice’s number into your mobile phone, because when the doors are closed and the lights are out a team staff are ready to take your call – any time of day or night, including public holidays. 

You can meet some of the #carearoundtheclock nursing team and learn more about the service they provide here.

Emergency Departments (ED) at hospitals throughout New Zealand often run at capacity over the festive season. Making your regular general practice team your first port of call wherever you are will help keep EDs free for those who need emergency care.

If you are heading away, make sure you pack enough of your regular medications for the duration of your holiday. If you’re going to need a repeat prescription while away, get it sorted before you leave town.

In a life-threatening emergency call 111. 

If you’re feeling anxious or just need someone to talk to you can call or text 1737 any time and you can speak to (or text) a trained counsellor free of charge.

For everything else, whether you’re holidaying in Wanaka or Whangamata, make your general practice team your first call. They can tell you what to do and where to go if you need to be seen urgently.

If you aren’t already enrolled with a general practice team use our handy general practice finder map.

Information for visitors to Christchurch

Visitors to Christchurch who need to see a doctor can visit one of the urgent care practices:

Learn more about what an Urgent Care clinic can do by checking out this video.

Trusted health advice

You can also visit our HealthInfo website or your community pharmacy for health advice.

HealthInfo is a health information website that has information specific to Canterbury. It is written and approved by local doctors, practice nurses, hospital clinicians, and other healthcare professionals and features a mix of health information, fact sheets on different topics and descriptions of local health services.

ENDS

Smoke from fires in Port Hills Road, Hillsborough, Christchurch

A health warning has been issued for smoke from a fire in Clifton on the Port Hills

Canterbury DHB’s Community and Public Health unit has issued a public health warning for smoke from the fire located in Clifton on the Port Hills.

Air around this location is smoky and there is potential that people who are sensitive to smoke – such as those with heart or lung conditions, pregnant women, young children and the elderly ­– may experience symptoms like coughing, shortness of breath or eye, nose and throat irritation.

Canterbury Medical Officer of Health Dr Cheryl Brunton says exposure to smoke can worsen pre-existing health conditions such as asthma and heart disease.

“People affected by the smoke should close windows and doors, and reduce outdoor exercise.

“Anyone experiencing health issues from the Port Hills fire should phone their usual general practice team in the first instance,” Dr Brunton says.

What to do when it’s smoky outside

If you see or smell smoke outside, you should stay inside if it’s safe to do so.

Remember to:

  • Keep your windows and doors shut
  • Switch your air conditioning to ‘recirculate’
  • Air out your house when the smoke clears
  • Look out for children, older people, and others at risk
  • Keep pets inside with clean water and food. Keep pets’ bedding inside if possible.

ENDS

In this edition of the CEO Update

Acting Chief Executive Andrew Brant thanks all those working in the managed isolation facilities for their ongoing professionalism and care as they continue to work hard to keep our community COVID-free and to ensure whānau can reunite safely when they return to New Zealand. With our Emergency Department experiencing extremely high demand, he asks that people save ED for emergencies and instead seek care from their general practice team or one of our three urgent care practices. He also provides an update on the recruitment of executive roles.

This issue also includes a farewell to outgoing Chief Medical Officer Sue Nightingale, encourages Kiwis to make this summer unstoppable and COVID-free, promotes research funding grants awarded to Canterbury and West Coast DHBs, looks at how the government and unions are working together for the health workforce, pays tribute to two long-serving staff members who are retiring, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Smoke from fires in Port Hills Road, Hillsborough, Christchurch

Smoke from fires in Port Hills Road, Hillsborough, Christchurch

Canterbury DHB’s Community and Public Health unit has issued a public health warning for smoke from the fire located at Port Hills Road, Hillsborough, Christchurch.

Air around this location is smoky and there is potential that sensitive groups – such as those with heart or lung conditions, pregnant women, young children and the elderly ­– may experience symptoms like coughing, shortness of breath or eye, nose and throat irritation.

Medical Officer of Health Dr Cheryl Brunton recommends that people affected by the smoke should close windows and doors, and reduce outdoor exercise.

“The advice to people experiencing any health issues from the Port Hills fires is to phone their own GP team for #carearoundtheclock​ 24/7,” Dr Brunton says.

“After hours, and when they're closed, a team or nurses is ready to take your call.”

ENDS

Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for the Hurunui River at SH1

Canterbury DHB’s Community and Public Health unit has issued a health warning for the Hurunui River at State Highway 1.

The warning follows the finding of moderate to high cover of potentially toxic algae (benthic cyanobacteria).

People should avoid the area and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

There are also other access points along the Hurunui River that may have benthic cyanobacteria present. People are advised to treat every low-flowing river cautiously, check for the presence of benthic cyanobacteria and avoid contact.

Canterbury Medical Officer of Health, Dr Cheryl Brunton says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area,” Dr Brunton says.

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately.

People and animals should remain out of the waterways until the warnings have been lifted.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months. Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people/dog-walkers to treat every low-flowing river cautiously.

For further information visit

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

Inpatient falls and pressure injuries continue to be the two major serious adverse events reported by Canterbury DHB for the 2019/20 financial year.

The release of a Serious Adverse Events Report by each DHB is an initiative led by the Health Quality and Safety Commission. The reports highlight events which have resulted in significant additional treatment, major loss of function, are life threatening or have led to an unexpected death.

Of the 77 adverse events identified as serious by Canterbury DHB, 31 were health care associated pressure injuries.

Canterbury DHB’s Chief Medical Officer Dr Sue Nightingale says the Canterbury Health System is continuously implementing improvements to reduce the harm caused by healthcare associated pressure injuries.

“The DHB continues to focus on identifying risk factors and tailoring pressure injury prevention strategies to ensure the safety of patients within our hospital and in the community.

In the past year, we have established a Transalpine Pressure Injury Prevention Community of Practice to strengthen best practice across the Canterbury and West Coast health systems, upskilled nurses as Pressure Injury Prevention Link Nurses to better equip them to prevent, assess and manage pressure injuries and, in partnership with ACC, produced an education video on preventing pressure injuries in a community and hospital setting.

“We have also upgraded our mattresses to dual purpose ones specifically designed to reduce and relieve pressure, implemented a high protein diet and teaching tools for patients who have pressure injuries to aid their recovery, developed online training for nurses and upgraded our policies,” Dr Nightingale says.

Nationwide, there was a total of 975 reported events, with the highest reported event category related to clinical management.

As noted by Health Quality & Safety Commission clinical lead for adverse events Dr David Hughes, “event numbers are closely linked to reporting rates, and an increase doesn't necessarily mean more adverse events have occurred. What it may in fact demonstrate is organisations continuing to develop an open culture where events are reported and learnt from, rather than an increase in preventable harm.”

Dr Sue Nightingale agrees and says “Canterbury DHB has robust incident reporting systems that encourage staff to report adverse events.”

“By looking into the factors that contributed to these events and reviewing what happened we can learn and improve our systems and processes to make them safer.

“While we aim for zero harm, having a strong incident reporting culture where staff are encouraged and supported to report adverse events is vital to ensure the quality and safety of our treatment and care is constantly improving,” says Dr Nightingale.

ENDS

More information: Canterbury DHB Serious Adverse Events Reports are available in our online Document Library.

Artist’s Impress of New Family Health and Urgent Care Centre coming to North Canterbury

Artist’s impression of new Family Health and Urgent Care Centre coming to North Canterbury

A new health centre for North Canterbury will soon be built as part of the Canterbury DHB’s Rangiora Health Hub. The new 1,250m2 facility will sit alongside the DHB’s Maternity Unit and Community Services Centre.

The Minister of Health has approved the DHB’s proposal to lease land at the Hub to the South Link Health Services Group, for them to build and operate a family health and urgent care centre that will be known as Rangiora Medical Centre.

The new facility will bring together existing general practices Good Street Medical and Rangiora Family Doctors, and will be open for care seven days week for extended hours between 8am and 10pm, 7 days a week.

Ralph La Salle, Acting Executive Director Planning and Funding and Decision Support for Canterbury DHB is delighted to be able to share this great news with the community.

“North Canterbury’s population continues to grow rapidly, and so does its need for primary healthcare.

“Some time ago the DHB saw an opportunity to make space available at the Rangiora Health Hub for a new primary care facility, alongside our own facilities. In 2019 we invited expressions of interest from any party with a successful track record in similar developments.

“South Link Health Services and its local partners put forward a very strong proposal to the DHB, and I’m very pleased that we’ve now got ministerial approval to proceed. This will provide North Canterbury with a new, purpose-designed facility that will deliver additional primary healthcare capacity that will reduce the need for people to travel to Christchurch for urgent care,” says Ralph.

South Link Health Services’ CEO, Professor Murray Tilyard is thrilled to get the go-ahead.

“An integrated family health and urgent care centre had always been the third and final piece needed to complete a health hub puzzle that will meet the needs of the people of the Waimakariri and Hurunui Districts.

“For South Link, this is a great opportunity and aligns with our goal of providing equitable and responsive quality health care to our communities.

“As South Link is a not for profit health provider, this allows us to invest our profits back into the community to continue growing our health resources and services. Based on our experience in developing the Three Rivers Medical Centre in Ashburton, it will be a privilege to again partner with the DHB to serve this community,” Professor Tilyard says.

Local GP Dr Lorna Martin of Rangiora Family Doctors is also very excited about this development.

 “I am delighted to see this dream come to fruition for Rangiora and the wider community. Prior to the earthquakes this small town was well supplied with medical facilities. Since the earthquakes our needs have massively increased.

Having been a General Practitioner in Rangiora for 30 years, living and working in the community. I am committed to improving the options available. I have worked alongside and in partnership with South Link health for some years and see this development as an exciting addition to our community,” said Dr Martin.

Ralph La Salle adds, “As a necessary part of this development, we need to remove the old Rangiora Hospital building. While it has served this community well over the years it has been closed for some time now and is no longer suitable for delivering contemporary models of healthcare – and we now have a better use for the space it occupies.”

“Its removal will make way for the new facility and more parking, making it easier for people to access the care they need in one location, and for clinical staff to provide well-coordinated care.”

Demolition is expected to begin in March 2021 following work to safely remove asbestos from the building.

Site preparations and construction will commence shortly after the demolition, and the facility is scheduled for completion in late 2022.

Professor Tilyard says during this time South Link will work with the DHB on keeping local people informed about plans and progress.

ENDS

 

In this edition of the CEO Update

Acting Chief Executive Andrew Brant outlines plans for a fit-for-purpose outpatient facility for Child, Adolescent and Family Services, which will be jointly funded with Māia Health Foundation. He also reminds staff of the support options available to them and to look out for each other as the Royal Commission of Inquiry into the Christchurch terrorist attacks is due to be released tomorrow .

This issue also looks at some of the festive celebrations that have started at Specialist Mental Health Services and the Radiology Department, highlights the team behind a study into the effectiveness of a device that can stop PICCs moving out of place, promotes the high level of community midwifery care in Canterbury,  provides a reminder of the importance of keeping patients information safe, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Health News

Canterbury and West Coast DHBs have received research funding to benefit local and New Zealand health care

Canterbury and West Coast DHBs have attracted a broad array of research funding to benefit local and New Zealand health care in new research funding from the Health Research Council.

Five different grants received approval ranging from developing tools for better predicting Emergency Department bed need through to “What growing up well looks like for Coast kids”. Two more grants are under negotiation.

The largest grant for the DHBs went to Canterbury Health Laboratories Anatomical Pathologist Dr Gavin Harris for his work on developing computational pathology capability and expertise for breast cancer.

Gavin explains that his day job in anatomical pathology involves looking at cancerous tissue under microscopes and predicting how someone’s cancer is likely to behave or respond to different therapies. His specialty is breast cancer. Increasingly in pathology, glass slides are now being digitised so they can be viewed on a high definition monitor rather than using a microscope.

Gavin’s research is focused on developing the cutting-edge practice of computational pathology. This involves generating computer algorithms that can be used to analyse digitised glass slides for much quicker, accurate, objective analysis.

“At the moment it takes one to two hours to manually review a single breast tissue sample and produce a report for clinicians to view.

“With computational pathology we would expect that that would reduce the time significantly. This would have big implications for how we meet increasing cancer rates with scarce specialist resources,” says Gavin.

This latest grant is the third Gavin has received for this work since 2019 and will provide the funding to partly step back from his day job and devote more time to his research.

While the field is attracting big interest and funding overseas, it’s in its early stages in New Zealand. Gavin believes our local capability, including the Canterbury Health Laboratories, Te Papa Hauora/Health Precinct partners and Cancer Society Tissue Bank, puts us in a unique position to lead developing computational pathology technology in New Zealand.

“My goal is to attract funding to develop computational pathology expertise locally, which has maximum benefit for New Zealand cancer patients. The aim would be to use New Zealand data and expert analysis, so ultimately New Zealand cancer patients and their clinicians would have more information about their cancers and how they might respond to various treatments. This would support a more personalised approach to cancer management.”

Canterbury DHB Chief Medical Officer Sue Nightingale says, “We’re delighted to have attracted such a broad range of grants from across different specialties and determined to keep growing our research activities here to help improve the health and wellbeing of our communities.”

The full list of Health Research Council Health Sector Research Collaboration Grants for Canterbury and West Coast DHBs are: a Research Activation Grant for Dr Cameron Lacey, Canterbury DHB Clinical Director Research, for a “Review of Māori consultation processes for research” with a second research activation grant in negotiation. There are four Research Career Development Awards granted to: Jane George, West Coast DHB Director of Allied Health, Scientific and Technical, for “Rural early years ‘What growing up well looks like for Coast kids’”; Dr Laura Hamill, Canterbury DHB Emergency Department Fellow, for “Improving Care and Equity in acute medical decision making”; Dr Gavin Harris, Canterbury Health Laboratories Anatomical Pathologist, for “Developing computational pathology capability and expertise for breast cancer”; and Emily Timothy, Canterbury DHB Community Stroke Rehabilitation Service Physiotherapist, for “Conceptualising inpatient rehabilitation early intervention vocational services”. A further research career development award is in negotiation

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Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for the Waimakariri River at Thompsons Road

Canterbury DHB’s Community and Public Health unit have issued a health warning for the Waimakariri River at Thompsons Road (The Willows).

The warning follows finding moderate to high cover of potentially toxic algae (benthic cyanobacteria) in the Waimakariri River.

People should avoid the area and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

There are also other access points along the Waimakariri River that may have benthic cyanobacteria present. People are advised to treat every low-flowing river cautiously, check for the presence of benthic cyanobacteria and avoid contact.

Canterbury DHB Medical Officer of Health, Dr Cheryl Brunton Canterbury Medical Officer of Health, says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area,” Dr Brunton says.

Reticulated town water supplies are currently safe but no one should drink water from the river at any time

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately. People and animals should remain out of the waterways until the warnings have been lifted.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months. Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people/ dog-walkers to treat every low-flowing river cautiously.

For further details visit: https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

An artist's impression of the integrated family services centre

Canterbury DHB is pleased to announce Leigh’s Construction has been appointed as the lead contractor for the $81.8m project constructing two new facilities to house relocated Specialist Mental Health Services on the Hillmorton campus.

Leighs Construction has been part of previous projects for Canterbury DHB including the five-storey Outpatient Building on Oxford Terrace and the Burwood Hospital redevelopments.

This appointment is the first major development in construction on the Hillmorton campus and signals the implementation of the long term Master Plan for mental health facilities. Construction of a High and Complex Needs unit and an Integrated Family Services Centre is expected to begin in early January and both should be ready for patients in late November 2022.

Work has already begun on site, with the North Car Park expected to be completed mid-December. The first stage of water bore drilling on the main green is almost complete. This is essential to provide an efficient and environmentally friendly heating and cooling source for our new buildings through ground source heat pumps. The original project did not have a budget for Green Star certification, however, an application was made to the Energy Efficiency and Conservation Authority (EECA) and funding was secured and the buildings are now designed to meet the four star Green Star criteria making them environmentally friendly.  

Leighs Construction Managing Director Anthony Leighs said the Leighs team were proud to be entrusted with another important Canterbury DHB health project and are very much looking forward delivering these projects which will make such a difference for people seeking treatment, care and support from Specialist Mental Health teams.

Integrated Family Services Centre

The new Integrated Family Services Centre (IFSC) will bring the Mothers & Babies and Eating Disorders services and the Child and Family Inpatient Unit from The Princess Margaret Hospital.

The Centre will house a 16-bed inpatient and day patient child, adolescent and family service, a 13 bed and 5-7 cot mothers and babies unit, along with eating disorders inpatient and outpatient services.

The IFSC unit will support a contemporary model of care in a modern, therapeutic environment. Centralised courtyards, single rooms and flexible spaces will be a massive improvement on current facilities and will bring our services in line with world class facilities for our families.

Patients will be homed in a warm, welcoming and friendly environment with spaces designed to enhance family interaction and healing.

High and Complex Needs Unit

An artist's impression of the new High and Complex Needs facility

The High and Complex Needs unit will bring the existing Seager Clinic, currently at The Princess Margaret Hospital, onto the Hillmorton campus.

This unit will provide 16 adult inpatient beds for a range of treatment options including long term and intensive rehabilitation.

Featuring a welcoming warm and homely feel, the unit is designed to enhance patient’s privacy and dignity with a range of spaces for patient, family whanau and staff use. With lots of natural light and a connection to outdoor spaces with centralised courtyards, the unit Is designed not only for our current patients, but will cater for future patient groups and changing health care needs.

Hillmorton Campus is the home of specialist mental health services for Canterbury.

Care and support is provided for people from throughout our community and our specialist services are more in demand now than ever before.

Canterbury DHB is confident that this partnership with Leighs Construction will ensure a solid future for our mental health services. 

The Hillmorton campus is embarking on a journey that will see many of its buildings and facilities improved, modernised and transformed. The aim is to create an environment that makes it easier to support people’s treatment and recovery.

ENDS

Health warning  – algal bloom in Lake Pegasus

A health warning has been issued for Lake Pegasus

Canterbury DHB’s Community and Public Health unit has issued a health warning after potentially toxic blue-green algae (planktonic cyanobacteria) was found in Pegasus Lake.

People should avoid the lake and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

Canterbury DHB Medical Officer of Health, Dr Cheryl Brunton says the algal bloom can produce toxins harmful to humans and animals so people should avoid contact with the water until further notice.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms visit your doctor immediately and please let your doctor know if you have had contact with the lake water,” Dr Brunton says.

No one should drink the water from the lake at any time. Boiling the water does not remove the toxin.

Animals that show signs of illness after coming into contact with algal mats or scums should be taken to a vet immediately.

Environment Canterbury monitors the lake weekly during summer and the public will be advised of any changes in water quality that are of public health significance.

Facts about cyanobacteria:

  • Cyanobacteria occur naturally but can increase rapidly during warmer months.
  • Algal blooms are caused by a combination of nutrients in the water (such as nitrogen and phosphorus), and favourable weather conditions (e.g. increased temperature, calm days).
  • If the water is cloudy, discoloured, or has small globules suspended in it, avoid all contact.
  • Not all cyanobacterial blooms are visible to the naked eye and toxins can persist after the blooms disappear.
  • Cyanobacterial concentrations can change quickly with changing environmental conditions (e.g. wind).
  • If a health warning is in place avoid contact with the water.

For further details visit: https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

In this edition of the CEO Update

Acting Chief Executive Andrew Brant welcomes the Minister of Health’s announcement on Friday of funding for the construction of an additional tower for the new Waipapa building. He also shares the findings from a recent report into how early intervention and collaborative approaches, such as those being put in place by Mana Ake – Stronger for Tomorrow, result in a range of wellbeing benefits for children and their whānau.

This issue also looks at tips on how to survive the silly season, shares another Canterbury DHB first with new Cath Lab technology, promotes a recent award for the Burwood Spinal Unit, celebrates a milestone for Hospital HealthPathways, urges staff to go for their catch-up measles immunisation, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Health warning  – algal bloom in Lake Pegasus

A health warning remains in place for Selwyn/Waikirikiri River at Whitecliffs Domain and Road

Canterbury DHB’s Community and Public Health unit has issued a health warning for Selwyn/Waikirikiri River at Whitecliffs Domain (camping area) and upstream of Whitecliffs Road (picnic area).

The warning follows the finding of moderate to high cover of potentially toxic algae (benthic cyanobacteria) in the Selwyn/Waikirikiri River.

People should avoid the lake and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted. 

There are also other access points along the Selwyn/Waikirikiri River that may have benthic cyanobacteria present. People are advised to treat every low-flowing river cautiously, check for the presence of toxic algae and avoid contact.

Canterbury Medical Officer of Health Dr Cheryl Brunton says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area,” Dr Brunton says.

The Selwyn District Council, as the drinking water supplier, is following agreed procedures and monitoring their nearby drinking water intakes.

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately.

“People and animals should remain out of the waterways until the warnings have been lifted,” says Dr Brunton.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months.
  • Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people/ dog-walkers to treat every low-flowing river cautiously.

For further information visit

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

Top row, from left: Emergency/Cardiology Research Scientist Joanna Young, Cardiologist Alison Nankivel, Ward 12 Charge Nurse Manager Margaret Cumming, Cardiologist Sally Aldous, Cardiologist John Lainchbury, Data Scientist John Pickering, Project Manager Alieke Dierckx. Front row, from left: Information Analyst Melanie Browne, Management Accountant Harue Akimoto, Consultant Physician Martin Than, Senior Research Nurse Felicity Turner, Consultant Physician Jacques Loubser, Canterbury Health Laboratories Patient and Client Service Manager Vanessa Buchan, Canterbury Health Laboratories Clinical Biochemist Professor Chris Florkowski

Canterbury health teams have been recognised in the prestigious international UNIVANTS of Healthcare Excellence Awards that recognise teams “who have achieved measurably better healthcare performance through unity and avant-garde thinking”.

UNIVANTS, which stands for ‘unity’ and ‘avant-garde’ is a healthcare industry award that annually recognises teams who collaborate across disciplines and transform healthcare delivery, and ultimately patient lives.

Canterbury DHB won the UNIVANTS of Healthcare Excellence 2020 Asia Pacific area award for a project called ‘Reducing Patient Risk and Enhancing Care through the Development and Implementation of a new chest pain pathway expedited by and for the COVID-19 era’.

There were 180 applications from 141 countries and the Canterbury project was unique in being the only application to receive seven stars of distinction from all judges.

The project included contributions from right across the Canterbury Health System including primary care and the Acute Demand Nursing Service; hospital and community laboratories; corporate services; researchers; and administration and clinical staff from the Cardiology and Emergency departments at Christchurch Hospital.

The project leaders were: Canterbury DHB Emergency Medicine Specialist Dr Martin Than, Emergency Department (ED) Specialist Dr Jacques Loubser, Associate Professor of the University of Otago John Pickering, Clinical Biochemist Chris Florkowski, and Cardiologist Dr Sally Aldous.

Dr Martin Than says the initiative was a rapid response to redesign Canterbury DHB’s processes for people who have suffered possible heart attacks being investigated at Christchurch Hospital.

“It was in response to the COVID-19 pandemic where we were trying to reduce admissions to hospital and reduce the amount of time people spend in ED, where they had the potential to pass on any infection.

“I’m very proud of the team for what they have done. But I am most proud of the collaborative history that sits behind the team that allowed us to make an effective, necessary and agile change,” says Dr Than.

Dr Jacques Loubser says for clinicians it is nice to be able to offer this service and do it confidently.

“It’s good for the hospital system too, the capacity that it opens up is massive, especially if we are expecting an influx of patients,” Dr Loubser says.

The judging organisations were: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), American Association for Clinical Chemistry (AACC), European Health Management Association (EHMA), Modern Healthcare, Healthcare Information and Management Systems Society (HIMSS), National Association for Healthcare Quality (NAHQ), Institute of Health Economics (IHE).

A statement from UNIVANTS says: “It is with great honour that we congratulate all participating teams while celebrating strategic activation and insights from clinical and laboratory medicine to achieve measurably better outcomes for patients, payors, clinicians and health systems.”

You can view a video of the team speaking about their work here.

The full list of winners and projects is available here.

ENDS

The new hybrid operating theatre

Canterbury DHB’s new operating theatres in Waipapa, Christchurch Hospital have begun to be used as patients start to receive their surgery in the brand-new state of the art theatres, following a meticulous testing and audit process.

Perioperative Nurse Manager Marie Lory says the DHB’s perioperative teams are really excited to be making use of the new building with all of the new equipment.

“One of the new theatres is a hybrid operating theatre which combines state of the art imaging with operating capability. This means that surgeons can receive real time imaging to allow critical procedures like arterial stents to be inserted with very small incisions dramatically improving recovery times,” Marie says.

Perioperative is the term used to describe all services associated with a person having a surgical procedure, from booking through to pre-operative care, anaesthesia, surgery and recovery.

“While we will continue to use our existing theatre space in Christchurch Hospital, the new theatres in Waipapa will expand our capacity.

“With an ageing population and more operations performed each day, operating theatres are in high demand. The additional theatre capacity means that over time we will be able to bring more of our surgery back in house,” says Marie.

Surgical teams have been carrying out training in new theatres, in preparation for their use this month

The Orthopaedic and Anaesthesia teams were first to use the new theatres last week, with orthopaedic surgeon Gordon Beadel carrying out the first surgery on a wrist fracture.

Mr Beadel says the first surgery performed in Waipapa is monumental for the Canterbury Health System and the use of the new theatres signals an increase in the DHB’s ability to manage its acute trauma and injury load and perform more surgeries in its own facilities.

“Operating in the Waipapa theatre suite was a very pleasant experience and went very well thanks to a huge amount of work from a number of talented staff. This facility and its brand new theatres are a fantastic resource for our community and those who travel to Canterbury for surgery,” says Mr Beadel.

Tomorrow’s final patient moves will signal the completion of the DHB’s relocation to the new Waipapa facility.

ENDS

In this edition of the CEO Update

Acting Chief Executive Andrew Brant congratulates all those involved in the smooth and safe relocation of patients and services to Waipapa, with the final moves to be completed tomorrow. With the Emergency Department experiencing high demand, he makes a plea for people in the community to save the Emergency Department for emergencies. He also provides an update on the Accelerating our Future programme, encourages those who can to book in some annual leave, and reminds us of the simple things we can all do to enjoy an Alert Level 1 Christmas.

This issue also looks at the international healthcare award for Canterbury health teams, announces the establishment of a Clinical Ethics Advisory Group, shares a tribute to a well-respected member of the Bioengineering team, provides a sneak preview of the new patient information boards, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)

Anna and Cole check out the Matatiki hub

It was children's day out today as our Child Health wards and services, now known collectively as ‘Matatiki’, moved into their new spaces in Waipapa. 

The new Child Health spaces have been fully kitted out for their new arrivals, with a beautiful new patient playground, the Matatiki Hub, and new Activity Room. Parents will also be looking forward to the move with parent beds in each room.

Canterbury DHB’s Chief of Child Health Dr Clare Doocey says the new spaces in Waipapa are amazing and the move to the new facility is really going to benefit our young patients.

“The new spaces are light, bright and colourful. The atmosphere is completely different to our previous wards in Christchurch Hospital and will be very pleasant and calming for families staying with us.

“There has been an incredible amount of planning that has gone into the relocation of our wards. What makes it all worth it is the smiles on patients’ faces today as they were whisked away from the existing Christchurch Hospital to the brand new sparkling wards of Waipapa,” says Dr Doocey.

The move from the existing wards in Christchurch Hospital takes patients on a 8-10 minute journey, through the new ‘linkway’ and on to Waipapa.Children's Acute Assessment was part of the Emergency Department move yesterday and patients and whānau are loving the new spaces. 

Saying farewell to their old room in Ward 22, Riverside, was not a hard ask for Anna and her son, Cole, this morning.

Cole has spent nearly three of his eight months of life in the Children’s Wards of Christchurch Hospital, and while the staff have been unfailingly fantastic, the facilities haven’t.

“We’ve just come back from a couple of days at home, but before that we were here for ten days,” Anna said as she packed up her and Cole’s bits and pieces for the journey to Waipapa.

“It will be nice to move. It’s quite drafty and a bit rundown and dismal looking. So it will be really nice to get into the new one and have your own bathroom, things like that.”

Cole was one of seven patients to be moved from Ward 22 to Chidlren’s A7 in Waipapa this morning, either in beds, cots or pushchairs.

Upon arrival to her room in Children’s A7, the first thing Anna noticed was the view, closely followed by the room’s ensuite. A wander through the Ward and facilities had both Anna and Cole very impressed.

“This is just fantastic, so many amazing facilities. I’ve said ‘amazing’ so many times today.

“There are just so many thoughtful things that have been added in to make life a lot easier for some of us frequent fliers. It’s hard work sometimes when you have to balance everything. It’s going to make spending time here a lot more pleasant,” Anna said.

ENDS

Health warning  – algal bloom in Lake Pegasus

A health warning remains in place for Lake Ellesmere

Canterbury District Health Board’s Community and Public Health unit have issued a health warning for Selwyn/Waikirikiri River at Glentunnel.

The warning follows finding moderate to high cover of potentially toxic algae (benthic cyanobacteria) in the Selwyn/Waikirikiri River at Glentunnel.

People and animals, particularly dogs, should avoid the area of the Selwyn/Waikirikiri River until the health warning has been lifted. 

There are also other access points along the Selwyn/Waikirikiri River that may have benthic cyanobacteria present.  People are advised to treat every low-flowing river cautiously, check for the presence of benthic cyanobacteria and avoid contact.

Dr Cheryl Brunton, Canterbury Medical Officer of Health, says the algae look like dark brown to black mats and can produce toxins harmful to people and animals.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips,” Dr Brunton  says.

“If you experience any of these symptoms, visit your doctor immediately, also let your doctor know if you’ve had contact with dark brown/black algal mats or water in this area.”

The Selwyn District Council, as the drinking water supplier, is following agreed procedures and monitoring their nearby drinking water intakes.

Pets that show signs of illness after coming into contact with algal mats should be taken to a vet immediately.

Dr Brunton says people and animals should remain out of the waterways until the warnings have been lifted.

Environment Canterbury is monitoring the sites and the public will be advised of any changes in water quality.

Facts about cyanobacteria:

  • Appears as dark brown/black mats attached to rocks along the riverbed.
  • A low cover of the algae can occur naturally but can increase rapidly during warmer months. Algal blooms are influenced by a combination of available nutrients in the water and sediments (such as nitrogen and phosphorus), a sustained period of low and stable flows, and favourable weather conditions (e.g. increased temperature, calm days).
  • It often has a strong musty smell and algal toxin concentrations can vary over short periods.
  • Although high river levels will remove the algal bloom, detached mats can accumulate along the shore and increase the risk of exposure to toxins.
  • If a health warning is in place avoid contact with the water.
  • Although district or city councils may place warning signs, these may not be seen at the numerous river access points, hence the need for people/ dog-walkers to treat every low-flowing river cautiously.

For further information visit

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

Matthew being treated by acute care nurse Henry Richardson

Christchurch Hospital’s Emergency Department relocated to its new location in the Waipapa building today and started receiving patients from 7:30am.

One of first patients to be seen in the new Emergency Department was Matthew who was doing a good deed for a friend this morning, cutting up some old tree branches for kindling, when the chainsaw slipped.

A trip to the GP had him referred to the Emergency Department.

“It was quicker than it normally is but that may be because it’s the first day,” said Matthew, who has had his share of visits to the ED as a keen sportsman and mechanic.

“It’s very good and all the staff have been very helpful and kind. It’s clean, bright, and efficient. It’s exactly what you’d expect from a modern hospital.”

After being assessed in ED, Matthew was sent to Acute Observation before nipping around the corner for an X-Ray in the new Emergency Radiology area.

A temporary cast was being applied when we spoke to him, and he was getting ready to head off to a ward awaiting surgery under local anaesthetic to repair a tendon in his finger.

“They can do what they need to do, as long as I can’t feel it and I can’t see it!” Matthew said.

ENDS

The latest edition of our WellNow magazine is out now

Look out for the latest edition of Canterbury DHB’s WellNow magazine that is being delivered to mailboxes across the region this week.

Canterbury DHB Acting Chief Executive, Andrew Brant, says the magazine informs those who want to keep up with our fast-moving health system and is well worth a read.

“It is still one of our most effective and direct channels for letting Canterbury people know what’s going on in their health system.

“As well as stories about the health journeys of Canterbury people, it holds valuable information on the services that are available and how to access them. Most importantly for this edition though, it includes an introduction, mostly in pictures, to Waipapa – our newest, state-of-the art health facility which is opening to the public this month,” says Dr Brant.

The name “Waipapa” was gifted to the people of Canterbury by Te Maire Tau, Ūpoko (head) of the Ngāi Tuahuriri hapu, a gift strongly endorsed by Manawhenua Ki Waitaha, Canterbury DHB’s health partners. It builds on the DHB’s partnership with Manawhenua Ki Waitaha and acknowledges the mana of Te Ngāi Tūāhuriri Rūnanga who are papatipu rūnanga for the land on which the new building sits.

“The new Emergency Department (ED) opens to the public today, 18 November – but to help our teams move and acclimatise, we ask that people save ED for emergencies and if they don’t need emergency care, they instead take advantage of their own GP team or one of our three Urgent Care facilities – 24hrs Surgery in Bealey Ave, Moorhouse Medical or Riccarton Clinic.”

From today the new ED can be accessed off Riccarton Avenue, with the entrance to the left as you face Christchurch Women’s Hospital.

Other highlights include stories that go behind the scenes of our COVID-19 response – celebrating just some of those teams that worked away unseen in health’s engine room. Read about the wellbeing and mental health benefits for Māori who connect regularly with whānau and learn about their whakapapa, and hear 86-year-old Shirley’s story that shows just how important it is to get up and moving as soon as possible after surgery.

There’s also information on the National Bowel Screening Programme. It advises people aged 60-74 years to look out for their free bowel screening test kit in the mail near one of their next two birthdays, and use and return it. The test detects signs of cancer early, when it’s easier to treat, and during the first year alone could help find around 100 cancers and save as many lives.

In addition to the print edition, there is an online version of WellNow on the Canterbury DHB website. An important additional section called “How we measure up” will be added later this month. This extra section looks at our performance and is more focused on data that highlights areas where we need to improve and charts our progress.

ENDS

Health warning  – algal bloom in Lake Pegasus

A health warning remains in place for Lake Ellesmere

Canterbury District Health Board’s Community and Public Health unit has been advised by Environment Canterbury that the dominant species of potentially toxic blue-green algae (planktonic cyanobacteria) found in Lake Ellesmere (Te Waihora) has changed from the initial health warning that has remained in place since 24 December 2017.

The type of cyanobacteria that are currently present in high concentrations are:

  1. a) Nodularia which can appear as a thick surface scum or be suspended throughout the water.
  2. b) Dolichospermum (formerly called Anabaena) which can be present as green globules floating in the water column or form surface scums or sheens.

People should avoid the lake and animals, particularly dogs, should not be allowed near the water until the health warning has been lifted.

Dr Cheryl Brunton, Canterbury Medical Officer of Health, says the algal bloom can produce toxins harmful to humans and animals; people should avoid contact with the water until further notice.

“Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips. If you experience any of these symptoms visit your doctor immediately and please let your doctor know if you have had contact with the lake water.

“No one should drink the water from the lake at any time. Boiling the water does not remove the toxin,” Dr Brunton says.

Animals that show signs of illness after coming into contact with algal mats or scums should be taken to a vet immediately.

Fish and shellfish can concentrate toxins and their consumption should be avoided. If fish are eaten, remove the gut and liver and wash in clean water.

Further information on gathering Mahinga Kai can be obtained below.

Environment Canterbury monitors the lake weekly at Lakeside Domain during summer and the public will be advised of any changes in water quality that are of public health significance.

Facts about cyanobacteria:

  • Cyanobacteria occur naturally but can increase rapidly during warmer months.
  • Algal blooms are caused by a combination of nutrients in the water (such as nitrogen and phosphorus), and favourable weather conditions (e.g. increased temperature, calm days).
  • If the water is cloudy, discoloured, or has small globules suspended in it, avoid all contact.
  • Not all cyanobacterial blooms are visible to the naked eye and toxins can persist after the blooms disappear.
  • Cyanobacterial concentrations can change quickly with changing environmental conditions (e.g. wind). If a health warning is in place avoid contact with the water.

For further details visit: https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

Peaberry café in Waipapa will open to the public tomorrow

Fresh, locally sourced food, premium coffee and tea, thoughtful gifts and more. That’s a selection of what people can expect when Waipapa’s café and retail store open their doors to the public tomorrow, Wednesday 18 November.

With two brand new stores, Peaberry and Willow Lane, patients and visitors will have a wide of variety of options to choose from.

Located on the ground floor in the main foyer, Peaberry provides a modern, comfortable space to sit down and relax while in Christchurch’s newest hospital building – Waipapa.

Willow Lane is located next to Peaberry and will offer premium coffee, grab’n’go food options and a range of giftware and other necessities for a stay in hospital.

Retail Manager Nick Abernethy says he’s looking forward to providing patients, visitors and staff with great choices.

“Just because people are in a hospital shouldn’t mean they miss out on quality retail and hospitality options. We’ll be preparing our selection of fresh food on site daily, with the variety on offer is sure to have wide appeal.

“Both sites will cater to a range of dietary requirements, with gluten free, dairy free and vegan options available. There’s something for everyone at Peaberry and Willow Lane,” says Nick.

For those in a hurry, Willow Lane will also offer an easy-to-use ordering app to ensure people can get their fix without the wait.

Customers can look forward to top quality espresso coffee, with Canterbury DHB partnering with two of New Zealand’s top coffee roasters, Allpress and Atomic. All of the passionate baristas have undergone intensive training to ensure the coffee appeals to even the harshest critic.

Complementing the coffee at Peaberry is T2 tea, and if you know T2 then you know that it’s not your average tea experience.

Both options will be open 7 days a week. Peaberry will be open 7am–4pm Monday–Friday and 9am–3pm Saturday– Sunday. Willow Lane will be open every day 8am–8pm.

See you there!

ENDS

The new ED at Waipapa will open tomorrow (entrance highlighted)

“Keep the Emergency Department for emergencies only” is the message from clinicians as the Canterbury DHB prepares to relocate the busy department.

From 7.30am tomorrow, Wednesday November 18, Christchurch Hospital’s Emergency Department (ED) will be located on the ground floor of Waipapa – Christchurch Hospital, Hagley next to Christchurch Women’s Hospital.

The time-restricted (30 minutes max) emergency drop-off­ and pick-up parking in front of the new ED will also open at 7:30am tomorrow. To access the new drop-off parking, turn left in front of Christchurch Women’s Hospital when driving in off­ Riccarton Ave. New mobility parking is also available.

Moving equipment and some office staff has already occurred in the lead-up to the move.

ED Clinical Director, Dr David Richards, is asking that only patients with urgent and serious medical issues come to ED.

“It would be incredibly helpful if people make use of their own GP team or go to one of Christchurch’s three urgent care centres. This will enable staff to focus on only those who really need emergency care and carry out a safe and successful move.

“On Sunday 15 November, hospital emergency staff treated 359 people, a record number for a single day (where a large-scale emergency event didn’t take place). The week prior was also a record week for presentations to ED,” says Dr Richards.

Patients who don’t have serious emergency needs are being urged to make their GP the first port of call. A reminder that for care around the clock, people in Canterbury can call their own General Practice team for free heath advice from a nurse after hours.

Christchurch Hospital’s ED is the sole emergency medical facility in the city and one of the busiest in Australasia.

People are encouraged to visit www.cdhb.health.nz to familiarise themselves with the location of the new Emergency Department and other acute services which are also relocating.

The three extended-hours Urgent Care practices in Canterbury are:

ENDS

In this edition of the CEO Update

Acting Chief Executive Andrew Brant confirms the first patients from existing wards at Christchurch Hospital were successfully relocated to the brand new Waipapa building today. It was a huge undertaking and everyone involved is to be congratulated for their incredible efforts. The latest edition of WellNow magazine is due to hit mailboxes in the coming weeks, so keep an eye out for it or check it out online. Lastly, it's Aotearoa Patient Safety Day tomorrow, with this year’s focus on mental health and wellbeing.

This issue also looks at World Antimicrobial Awareness Week, promotes the giant bowel on tour for the National Bowel Screening Programme, raises awareness of STOP Pressure Injury Day, showcases the maternity quality and safety programme, shares the special gift to the Labs team from school students, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)

A Haematology patient is moved from the existing Christchurch Hospital over to the new Waipapa facility

The first relocation of patients from existing wards at Christchurch Hospital over to the brand new Waipapa building have taken place today.

Our Haematology and Oncology wards have now finished the huge undertaking of moving their patients, with approximately 24 patients making the journey over to Waipapa.

Our Radiology services are now fully operational in Waipapa and ready to image patients as the various wards relocate to Waipapa over the next two weeks.

Canterbury DHB Director of Nursing Lynne Johnson says it was an exciting day for both patients and staff making the move to brand new facilities.

“The relocation of wards to a new facility is a huge undertaking and our teams have been so impressed by the commitment of our staff, the effort that has gone in to planning these moves and the support from all over the health system to enable a smooth transition.

“With further moves ahead of us over the next couple of weeks, we will be able to apply our learnings from this move,” says Lynne.

The move from the existing wards takes patients on a 8-10 minute journey from the existing wards of Christchurch Hospital, through the new ‘linkway’ and on to Waipapa.

Haematology Charge Nurse Manager Sally Braycotton who was a key part of the ward’s relocation to Waipapa today says it was quite a task to move sometimes quite unwell patients from one hospital building to the other.

“We have a complex mix of patients in Haematology and there has been a substantial amount of planning to execute the moves and safely transport our patients to Waipapa.

“What makes it all worth it is the smiles we saw on the patients’ faces today as they are whisked away from the existing Christchurch Hospital to the brand new sparkling wards of Waipapa!” Sally says.

Haematology patient Tane Loper was one of the first patients to make the move to Waipapa, and once he was settled in to his new room he told us how impressed he was with the new space.

“It’s got all the mod-cons and is very tidy, it’s awesome. The best thing about it is the view from the rooms, they’ve done well designing it.

“There’s heaps of room. I’m blown away. It’s actually a whole heap better than I thought it would be!” Tane said.

A number of other wards and departments will also be making the move to Waipapa over the next two weeks including ICU and our children’s wards.

The new Emergency Department will be open on the ground floor of Waipapa at 7.30am on Wednesday 18 November.

ENDS

WellNow Magazine - November 2020WellNow Canterbury is our community health magazine that goes to every mailbox in Canterbury and the Chatham Islands twice a year. This ‘A Snapshot of How We Are Doing' doing edition demonstrates how we are meeting the Health Quality & Safety Commission’s requirements that DHBs give an account for the quality of their services, providing a snapshot of how our health system is meeting Canterbury’s health needs, and showcases our
work to improve services and standards of care.

How we measure up

This online-only version of WellNow also features a How we measure up section, charting our performance against the national health targets, the quality and safety markers as set by the Health Quality & Safety Commission, and other key measures.

Highlighted stories

Waipapa (Christchurch Hospital Hagley) opens in November 2020: Take a ‘walk’ through some of the highlights, in pictures.

Te Whare Whetū (House of Stars): The health benefits of reconnecting Māori health consumers with their whakapapa
A programme run by and predominantly for Māori, Te Whare Whetū helps people explore their whakapapa (cultural identity), build important links with their whānau and community, and improve their mental health.

Canterbury joins the National Bowel Screening Programme: Over the next two years 90,000 people aged from 60-74 years will receive a free bowel screening test kit in the mail. All they need to do is complete the test and return it in the packaging provided. During its first year alone, the programme will detect bowel cancer in 100 people who didn’t know they had it, enabling it to be treated earlier and with a much better chance of a good health outcome.

You can read the full online magazine in two different formats:

View on issuu.com Download PDF (5MB)
Health warning  – algal bloom in Lake Pegasus

The health warning in place for Lake Forsyth has now been removed

Canterbury District Health Board’s Community and Public Health unit has lifted its algal bloom health warning for Lake Forsyth/Te Roto o Wairewa.

Recent water testing at Lake Forsyth/Te Roto o Wairewa has shown the quantity of potentially toxic blue-green algae (planktonic cyanobacteria) in the lake has decreased and concentrations are now below levels that are of concern to public health.

Canterbury Medical Officer of Health Dr Ramon Pink says Environment Canterbury’s sampling of Te Roto o Wairewa will continue on a fortnightly basis during the summer months. 

“The public will be informed if testing shows that concentrations have increased and there is a risk to public health again,” Dr Pink says.

Facts about cyanobacteria:

  • The algae occur naturally but can increase rapidly during warmer months.
  • Algal blooms are caused by a combination of nutrients in the water (such as nitrogen and phosphorus), and favourable weather conditions (e.g. increased temperature, calm days).
  • If the water is cloudy, discoloured, or has small globules suspended in it, avoid all contact.
  • Not all cyanobacterial blooms are visible to the naked eye and toxins can persist after the blooms disappear.
  • Cyanobacterial concentrations can change quickly with changing environmental conditions (e.g. wind). If a health warning is in place avoid contact with the water.
  • If a warning is in place, people and animals should not drink the water from the lake at any time, even boiled water.
  • Exposure to an algal bloom can cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips. If you experience any of these symptoms visit your doctor immediately and please let your doctor know if you have had contact with lake water when there is a health warning in place.

For further information visit:

https://www.lawa.org.nz/explore-data/canterbury-region/

Or contact Community and Public Health on (03) 364 1777:

https://www.cph.co.nz/your-health/recreational-water/

For more information about Mahinga Kai:

https://www.cph.co.nz/wp-content/uploads/saf0112.pdf

ENDS

In this edition of the CEO Update

Last week Acting Chief Executive Andrew Brant welcomed Director General of Health Ashley Bloomfield to Christchurch, where he met with teams across the Canterbury Health System and was taken on a special tour of Waipapa. With only a week to go until the first inpatients are welcomed into Waipapa, Andrew encourages readers to sign up to the Waipapa newsletter for the latest updates. He also shares the resources available to order or print to help promote the soon-to-be new location of our Emergency Department and acute services and wards.

This issue also looks at how the Canterbury Health Laboratories' scientific officers are at the forefront of NZ's COVID test service, welcomes the latest group of graduates from the Gerontology Acceleration Programme, pays tribute to the Neonatal Nurse of the Year, promotes the importance of reporting medicine side effects this MedSafetyWeek, and much more.

You can read the Canterbury DHB CEO Update in two different formats:

View on issuu.com Download PDF (5MB)
Covid-19

COVID-19 testing will continue to be available over the weekend

Cantabrians are being reminded of the COVID-19 testing options available to them if they want to be tested this weekend.

Free COVID-19 testing continues to be available at general practices and urgent care facilities in Canterbury and at three Community-Based Assessment Centres (CBACs):

Community based testing clinical leader Dr Hannah Gordon says anyone who is concerned about the recently reported positive cases in Christchurch or thinks they may have been a contact of a case is welcome to attend.

“No appointment is necessary and testing is free for everyone. You do not need a referral to attend a testing centre and you can drive-up or walk-in,” says Dr Gordon.

Please be aware though that if it’s busy you may have to wait for your test. Please arrive at least half an hour before the facility closes.

Check with your general practice if testing is available outside of Monday to Friday.

It’s important to note that Canterbury remains at Alert Level 1 and both of the cases announced this week work in a Managed Isolation Facility.

Symptoms of COVID-19 include:

  • A new or worsening cough
  • Sore throat
  • Runny nose
  • Fever
  • Temporary loss of smell
  • Difficulty breathing

If you or someone in your whānau have any of these symptoms, please call your own general practice team or Healthline on 0800 358 5453 for advice – they will explain what to do.

It’s important to continue following the Ministry of Health’s advice:

  • Stay home if you’re sick
  • Practice good cough, sneeze and hand hygiene
  • Download and use the COVID-19 Tracer app

For more information: call Healthline: 0800 358 5453 (a free, 24/7 service with interpreters available). You can also visit www.covid19.govt.nz.

ENDS

Covid-19

The second COVID-19 case in the community visited the Chemist Warehouse

The second staff member from the Christchurch Managed Isolation Facility who tested positive for Covid-19 yesterday visited the Chemist Warehouse at the South City mall between 3.52pm and 4:03pm on Friday 30 October.

Medical officer of Health, Dr Ramon Pink, says the person was in the store for a short period of time and didn’t have any close contact with other people during their time in to the store. The person checked into the store using the tracer app which is most useful as we know the exact time the person was in store. This morning the Ministry of Health has sent an alert to everyone else who checked into the store around that time.

“We are aware that people may be concerned if they were in the store at the same time as this person, even though the risk to other shoppers and staff is considered extremely low.

“It’s important to stress that this person didn’t have any symptoms when they were in the store, and at that stage didn’t know that they would later test positive for Covid-19.

“Anyone who is concerned and would like to be tested for Covid-19 is welcome to attend any of our community based Covid-19 testing centres – testing is free and no appointment is necessary.  You don’t need to have symptoms to qualify for free testing.

In addition to our usual centres, we have a pop up Covid-19 testing centre in the carpark outside The Princess Margaret Hospital, operating from 11.30am – 4.30pm today and people who shopped at The Chemist Warehouse are welcome to come along.

Entry to the pop-up facility is signposted at The Princess Margaret Hospital,  95 Cashmere Road.  Follow the instructions at the site.

Free Covid testing continues to be available at most general practices in Canterbury and at two Community Based Assessment Centres (CBACs):

Symptoms of Covid-19 include:

  • A new or worsening cough
  • Sore throat
  • Runny nose
  • Fever
  • Temporary loss of smell
  • Difficulty breathing

If you or someone in your whanau have any of these symptoms, please call your own general practice team or Healthline on 0800 358 5453 for advice – they will explain what to do. 

It’s important to continue following the Ministry of Health’s advice:

  • Stay home if you’re sick
  • Practice good cough, sneeze and hand hygiene.
  • Download and use the COVID-19 Tracer app

For more information: call Healthline: 0800 358 5453 (a free, 24/7 service with interpreters available). You can also visit www.covid19.govt.nz.

Page last updated: 4 November 2020

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