In the media

Tend has revealed  "Tend Scribe," their innovative, AI-driven tool has now helped draft over 20,000 clinical notes and easy to understand patient instructions. Tend Scribe listens to clinician-patient consultations and produces detailed draft clinical notes for review and finalisation by clinicians, delivering these to patients within minutes of their consultation.

Tend Scribe is built entirely in-house by Tend’s product team and clinicians to seamlessly integrate with their patient management system, Indici, and internal platform Tender. Underpinning the AI tool is the large language model Claude Sonnet from Anthropic and Amazon Web Services. 

According to Tend's Chief Operating Officer, Josh Robb, this in-house approach ensures the highest quality of data while maintaining total control over the results, ensuring compliance with the NZ Privacy Act and Medical Council guidelines.

“There are off-the-shelf tools for this, but we designed and built Tend Scribe ourselves to enable strong clinical governance, control the quality of the data and ensure it fits seamlessly into our tech platform. It was a critical design goal that patient data never leaves our systems,” says Robb. 

“By building it in-house, we have more control over the data it generates, ensuring high-quality, comprehensive notes that improve both the clinician and patient experience. Integration into our technology also enables us to collect data to continuously monitor quality, safety and equity of the tool, in a way that would not be possible with a third-party product,” adds Robb. 

For clinicians: Saving time, enhancing patient connection

For clinicians, Tend Scribe allows them to fully focus on their patients without the distraction of typing during consultations. Doctors no longer need to spend time during or after appointments writing clinical notes about what was discussed, as the AI generates a comprehensive and structured summary. 

The tool was initially launched for Tend’s telehealth service, Online Now,  and now has expanded to the in-clinic setting with it being used in 65 percent of primary care consults. Around 72 percent of Tend’s GP’s have opted to use it with an estimated 30 percent increase in productivity for online consultations.

Tend GP Dr. Sally McLaren, who has been using Tend Scribe for several months in both her clinic and online consultations, was initially sceptical but is now a strong advocate of the tool. “At first, I was a bit dubious, but now I absolutely love it. I can really sit and listen to my patients, and it saves me so much time and stress. I’m completely sold on it and would recommend it to all my colleagues.”

Dr. Mary Hung echoes this sentiment. “Tend Scribe has made a positive difference in the time saved from not having to type up notes. It also allows me to focus more on my patients during the consultation. Every time I review the notes afterward, I’m amazed at how well the AI captures the relevant details and organises them. It’s especially helpful for managing complex cases. It gets a big tick from me.”

Outside the productivity gains, the comprehensive nature of the notes ensures continuity of care, particularly in Tend’s team-based care model, where accurate and thorough records support ongoing patient care. 

Tend’s Chief Medical Officer Graham Denyer emphasises the importance of this advancement.  “The long-term data quality implications are immense. In general practice time constraints often impact note quality. Tend Scribe ensures consistent, detailed, and well-structured clinical notes, enabling improved multidisciplinary care and patient safety.”

For patients: Clear, comprehensive summaries

Patients benefit from receiving a clear, detailed summary of their consultation, including any action plans and safety netting, shortly after their appointment.  

A recent patient, Sarah, was impressed by the level of detail and care reflected in her notes. "Right after my appointment, simple and clear notes popped up in my app—no confusing shorthand or acronyms, just easy-to-read details of our discussion and a reassuring action plan that made me feel truly heard. I love having access to such detailed notes - it gives me a sense of control over my care, and is super convenient if the condition crops up again."

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Proven and trusted

One of the key benefits of developing our own tool is the ability to maintain close oversight of clinical quality and safety," says Denyer. "For instance, across the 20,000 consultations completed using Tend Scribe, we can confidently report that over 99 percent achieve high scores on a validated quality assessment tool even before any edits are made by our clinicians.”

Tend Scribe has been in action since April 2024 in Tend’s Online Now service and is now available in all Tend clinics for patients who use the Tend app. Patient consent is always obtained before using the technology and uptake has been overwhelmingly positive with 99.6 percent of patients agreeing to use Scribe.

Importantly, Tend Scribe is not used for diagnostics, but simply to enhance the efficiency and quality of clinical documentation. 

With Tend Scribe, Tend patients can expect an elevated level of care, and Tend’s clinicians can work more efficiently, all while maintaining the personal connection that is essential in healthcare.

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As featured on NZBusiness

Cecilia Robinson and her husband James founded Tend in 2020, a digital-first healthcare provider offering comprehensive online and in-person GP services. With advanced technology and clinical expertise working together, Tend is making healthcare more accessible. Already one of the country’s largest healthcare providers, it’s been praised for its innovation and ability to meet the pressing need for change. NZBusiness sat down with Cecilia for a discussion on entrepreneurship, the ‘why’ behind Tend, and the challenges New Zealand faces in transforming healthcare.

There is no doubt that New Zealand’s healthcare system is in crisis. Doctors regularly raise the alarm about staff shortages and burnout while patients share stories of long wait times and often slow diagnoses. When Cecilia Robinson co-founded Tend, she was struck by the many obstacles facing the industry, especially primary healthcare.

She describes the system as “quite broken,” saying that it impacts all other facets of healthcare. “Effective primary care should reduce pressure on emergency rooms and improve preventative care outcomes. But currently, it does not. Healthcare is, without a doubt, the most complex issue facing New Zealand.”

Cecilia points to issues such as an ageing GP workforce, inadequate replacements, and a funding model that doesn’t deliver necessary outcomes. The latter she says is the biggest challenge facing the sector – a lack of direction around outcomes-based care. “I don’t necessarily subscribe to the narrative that healthcare is entirely underfunded in New Zealand. We spend more than places like Singapore, but we’re not good at generating productivity and outcomes from how we spend,” she explains.

She also points to the fragmented nature of the system, where healthcare runs on “130 different systems” and doctors often use outdated platforms like Windows 7. “You can see your GP, then go to the emergency room, and the ER doesn’t even know who you are. It’s so fragmented, and it shouldn’t be,” she says.

When Tend launched in 2020, its mission was clear: “We want to help New Zealanders be the healthiest people in the world,” says Cecilia. Tend is not just an online service either, simultaneously opening physical clinics. Today, this dual infrastructure remains central to its approach with 25 clinics across New Zealand, Tend’s change management strategy involves hands-on transformative care, clinic by clinic. This includes integrating new technology and reviewing staff roles to align with an evolving healthcare model.

“Change management is not an app you give someone,” she explains, emphasising that true transformation requires reworking both the digital and physical aspects of healthcare. Tend services include medical examinations, certificates, mental wellness support, skin health services, repeat prescriptions online, and urgent prescriptions. The result? Simple: greater accessibility and control over personal health.

The woman leading the charge

The move into healthcare was deeply personal for Cecilia, an already successful entrepreneur and winner of EY’s Young Entrepreneur of the Year in 2013, Tend was driven by her own experiences with the system. After the devastating loss of two babies – a stillbirth and another baby at 17 weeks – she and James endured poor experiences with the healthcare system. They realised that to make a real difference, they needed to create a business that addressed the system’s challenges.

The now mother of three – Thomas, Leila, and Charlie – and New Zealand Innovator of the Year for 2024, is passionate about empowering women and helping working parents navigate their daily challenges.

Tend was founded with the purpose to help make New Zealanders the healthiest people in the world. Cecilia is confident this goal is achievable, especially given the country’s response to the COVID-19 pandemic. She envisions a future where New Zealanders can enjoy some of the highest life expectancies in the world, with Tend playing a key role in delivering better healthcare.

And she certainly has the proven track record to turn this goal into reality. Originally from Sweden, Robinson moved to New Zealand in 2005 to support her brother. On her first night, she met James Robinson, who would later become her husband and business partner. Together, they launched My Food Bag in 2012, transforming home cooking for Kiwis and growing one of New Zealand’s most successful start-ups, which soon exceeded $100 million in revenue.

Rethinking healthcare roles

A common sentiment in New Zealand is that we need more GPs. However, Cecilia believes that the healthcare industry’s problems cannot and will not be solved simply by increasing the number of doctors.

By 2032, New Zealand will have 1,000 fewer GPs, leaving over a million people without access to primary healthcare unless the model changes.

Tend aims to address this by triaging patients through its online doctor app and distributing care across a broader range of healthcare professionals, including nurses, nurse practitioners, health coaches, and pharmacists. This model allows highly skilled GPs to focus on complex cases while empowering other professionals to manage less critical health concerns. “We need to distribute the level of patient interactions across the broader workforce,” Cecilia stresses.

She also points out inefficiencies in the current system, where patients often use the same service, such as a GP visit, for minor conditions like a rash or UTI, which adds unnecessary strain to the system. “It’s not how you resolve the system pressures,” she emphasises.

While many healthcare companies focus on niche offerings, such as reproductive health or mental health apps, Tend takes a comprehensive approach. She explains that focusing on one aspect of health means “you don’t get the full view of the person.”

Innovating for a healthier tomorrow

Cecilia says that her path to entrepreneurship wasn’t defined by a single moment, but by a series of experiences. Describing herself as an “accidental entrepreneur,” she recalls her time as an au pair in America, which inspired her first business, Au Pair Link. This venture quickly grew into one of Australasia’s largest au pair agencies.

Fast forward to being recognised as Innovator of the Year is something Cecilia reflects on humbly, attributing Tend’s success to the collective effort of her team. “It’s definitely not about me; it’s about the team.”

Unlike her previous ventures, where ideas could move quickly from concept to market, healthcare innovation requires a much more cautious approach. “We have to get it right,” she says, acknowledging the high stakes involved in healthcare.

Despite resistance to change within the healthcare system, she remains focused on the long-term goal of making Tend one of New Zealand’s largest healthcare providers in the next decade, improving patient outcomes and delivering better care.

“Large, meaningful change” is what drives Cecilia. The complexities of the healthcare sector may present significant challenges, but for Cecilia, this only strengthens her resolve to transform the industry.

Cecilia is making meaningful change in more ways than one: this year, Tend launched the first Woman’s Health Week in NZ. “I couldn’t believe it. It was offensive to me that there wasn’t one,” The success of Women’s Health Week went beyond raising awareness – many women took actionable steps toward improving their health by scheduling check-ups.

Ultimately, her vision is for a seamless, personalised healthcare experience for all New Zealanders, where proactive care is integrated into everyday life. “It should just be delivered to you,” she says, believing that technology will play a key role in creating a more connected and efficient system.

Despite the challenges faced by healthcare in the country, Cecilia is optimistic: “I think we can become the best country in the world. Every day there’s a negative headline about healthcare in New Zealand, but I think we can turn it around. I want to be able to leave a better legacy for our Tamariki. I want my kids to be able to feel like they can grow up in New Zealand and have the best healthcare system.”

6 September 2024

Tend Health is thrilled to welcome Ngāi Tahu Holdings as a shareholder, marking a significant milestone in its commitment to deliver state-of-the-art healthcare services across Aotearoa.

As New Zealand’s leading digi-physical healthcare provider, Tend is transforming how healthcare is accessed and experienced. Through its app, Tend has already facilitated 2.7 million interactions, serving 100,000 patients. The company supports over 135,000 enrolled patients and operates a network of 25 clinics from Auckland to Invercargill, with 11 of these fully integrated on the Tend platform by the end of September.

Cecilia Robinson, Founder and Co-CEO of Tend Health, is enthusiastic about the new partnership with Ngāi Tahu Holdings. "Welcoming Ngāi Tahu Holdings to Tend's register represents a substantial step forward for us. It underscores our dedication to engaging meaningfully with iwi and ensuring that our services align with the needs and values of the communities we serve."

Ngāi Tahu Holdings is an intergenerational New Zealand-focused investor and has a diverse investment portfolio. It supports iwi-focused outcomes, such as social and cultural programmes, as well as economic empowerment for Ngāi Tahu whānau now and in the future.

Ngāi Tahu Holdings Chief Executive Todd Moyle says Tend Health’s goal of improving healthcare outcomes for all New Zealanders strongly aligns with Ngāi Tahu values.

“We are proud to invest in Tend Health, which is embracing cutting-edge solutions to create a more equitable and accessible health service for whānau.

“This investment is part of our New Economy strategy to support innovative and sustainable businesses throughout the motu,” he says.

Tend’s Co-Founder and Director of Population Health and Equity, Dr Mataroria Lyndon, emphasises the significance of working with Ngāi Tahu Holdings. Tend is deeply committed to advancing health access and equity, as evidenced by one of our recent integrations where we significantly increased Māori enrolments at a medical centre from 8% to 18%, and Pacifica enrolments from 2% to 14%. This demonstrates our ongoing dedication to improving healthcare outcomes for all communities.”

Tend is currently expanding across the South Island, integrating additional clinics into its digi-physical platform as part of its broader growth strategy. Alongside this expansion, Tend is focused on significantly reducing wait times in primary care, developing innovative care delivery models, and streamlining administrative tasks. By implementing its AI-powered tool, Scribe, Tend also aims to boost workforce productivity and reduce administrative burden while
continuing to improve healthcare outcomes.

As the network grows, Tend remains committed to leveraging technology and innovation to create a more sustainable and customer centric healthcare system across Aotearoa.

8 August 2024

Encouraging Kiwi women to embrace the importance of their own wellbeing 

Tend Health launches Te Wiki Hauora Wāhine/Women’s Health Week to raise awareness, educate, encourage and empower Kiwi women to prioritise their health and wellbeing. 

Tend Health Founder and Co-CEO Cecilia Robinson says all too often Kiwi women put other’s wellbeing ahead of their own, suffering in silence while supporting their loved ones. 

According to a new survey of female-identifying patients to understand their relationship with their own health and wellbeing, more than half (57%) of women don’t get regular annual health checks.

“When we asked everyday Kiwi women about their health, it became evident women can feel the need to shy away from discussing their health – both with medical professionals and each other,” says Robinson. 

In fact, 40% of survey respondents didn’t feel comfortable talking about their health with their friends.

Furthermore, more than one-third (38%) have never talked with their mother or female caregiver about their periods, and more than half (58%) have never talked about menopause. 

“This week, we’re encouraging all of Aotearoa New Zealand’s wāhine to take the reins of their health, to check up on each other, and to have those brave conversations with one another and medical professionals,” says Robinson. 

“We have days, weeks and months dedicated to raising awareness for men’s health and wellbeing which is an important step. But our wāhine are precious too. They deserve a week in the health spotlight and a reminder that their health matters too. 

“Better health for our wāhine benefits everyone. When women have access to quality healthcare, they’re better able to achieve their goals, participate in the workforce, contribute to economic growth, and support their families' health and wellbeing. Women's health is whanau health.”

As part of the inaugural Te Wiki Hauora Wāhine, the Women’s Health Week website hosts stories, blogs, videos and podcasts covering a wide range of topics to act as an educational resource. 

Kiwibank is proud to support Tend’s Women’s Health Week to encourage more women to be aware of the options for them to take an active role in their health journey.

Kiwibank Chief Executive Steve Jurkovich said, “Raising awareness and supporting women to engage in important conversations about their health and prioritise their wellbeing is essential. 

“Not only does this lead to better health outcomes, but it also provides an opportunity to strengthen family and community dynamics. Fostering a supportive environment is better for everyone. We know that good health is a key factor in achieving other life goals, including financial stability and success.”

Go online here to complete the Kiwibank Health Personality quiz, a fun and easy way for women to start thinking about how they approach their health. It includes tips and the chance to win 1 of 10 $1,000 Prezzy cards thanks to Kiwibank.

Key sponsor Denise Cosgrove, The Selwyn Foundation Chief Executive, says it’s important for Aotearoa New Zealand to have open, frank discussions about women’s health - especially when it comes to vulnerable older women and their needs. 

“As a society, we can sometimes lose sight of the most vulnerable in our communities. As our population ages, it’s paramount we continue to support the wellbeing of our older wāhine and enable them in getting preventative screening and other health checks wherever possible,” says Cosgrove. 

Throughout Te Wiki Hauora Wāhine, there will be a range of activities and topics covered with support from many famous Kiwi women sharing their stories including Dame Valerie Adams, Stacey Morrison, Matilda Green, Suzanne Paul and Megan Alatini – to name just a few.

There will also be insights from prominent female clinicians and healthcare experts including Dr Eileen Sables, Dr Alex Lafaele, Dr Lee Mathias, Dr Olivia Smart, Dr Amelia Ryan, Dr Bev Lawton, Dr Jenny Kruger, Lily Henderson and Michelle Kasey. 

Additional partners include My Food Bag Fresh Start, The Period Place, Breast Cancer Foundation NZ, Talk Peach Gynaecological Awareness, EttieKits, femfit® by JUNOFEM, MenoMe and Embodyme.

Tend Women's Health Survey: Read the research highlights

Get involved: Download a zip file containing the Media Corporate Pack

10 June 2024

The much-anticipated opening of Tend Pāpāmoa Medical Centre was marked by a special ceremony on Friday led by respected kaumātua and leadership from Ngāi Te Rangi, who blessed the site with a karakia. The new clinic, which will officially open its doors on June 10, 2024, represents a fresh chapter in the provision of healthcare services to the Pāpāmoa community.

"As one journey ends, another one begins to provide more accessible and equitable healthcare," said Dr Mataroria Lyndon, co-founder of Tend acknowledging the closure of the previous Pāpāmoa Pines Medical Centre and the beginning of Tend Pāpāmoa. 

The recent closure of Pāpāmoa Pines Medical Centre in early March 2024 highlighted the urgent need for additional healthcare services in the area, a need that the new Tend Pāpāmoa clinic aims to address. 

As winter approaches, the strain on New Zealand's healthcare system becomes increasingly evident. With GP resources stretched to their limits, the opening of a new medical clinic in Pāpāmoa is a welcome relief for patients, manawhenua, and the wider community.

New Zealand has been grappling with a critical shortage of General Practitioners (GPs) for several years. The pressures on the healthcare system are particularly pronounced in rapidly growing areas like Pāpāmoa, where the demand for medical services often outstrips supply. This imbalance has led to longer wait times, reduced access to care, and increased stress on existing medical facilities and staff.

The opening of Tend Pāpāmoa comes at a critical juncture, says Cecilia Robinson, Founder and Co-CEO of Tend Health. “As winter illnesses begin to surge, the availability of a new medical facility is incredibly exciting and provides a beacon of hope for residents. Our goal is to ensure that the Pāpāmoa community have access to timely and high-quality medical care, especially as we head into winter when demand for healthcare services typically increases."

Tend Health is known for its innovative approach to healthcare delivery, leveraging technology to improve patient access and reduce administrative burdens on clinicians. The new clinic will incorporate these innovations, making healthcare more convenient and accessible.

The Tend Pāpāmoa Medical Centre will also offer digital healthcare services, which have proven to be highly effective in reducing wait times. The "Online Now" urgent care service, for example, offers virtual appointments, this service will be crucial during the winter months, allowing patients to timely access 7am to 9pm seven days a week.

"Our commitment to delivering the best healthcare experiences is at the very heart of what we do. We believe healthcare should be equitable, accessible, and designed for you and your whānau," Robinson concluded. "We hope that the opening of Tend Pāpāmoa, coupled with the recent integration of Tend Bethlehem, Tend Greerton and Tend South City in the Bay of Plenty, offers hope to the local community."

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6 June 2024‍

Opinion as featured in the New Zealand Herald.

Last weekend the Australian Sun reported that Australian teenagers are facing a major health crisis due to toxic social media. Rates of suicide, self-harm, and eating disorders among children under 19 have surged dramatically, with eating disorders up 200 per cent over the past 12 years.

Experts link this to the explosive rise of social media. A strong movement is now pushing the federal government to raise the social media access age limit to 16. This alarming situation in Australia should serve as a wake-up call for New Zealand, as we are witnessing the same troubling trends here. In New Zealand, anxiety diagnoses among young men increased by 131 per cent from 2011 to 2020, while among young women, they surged by 259 per cent over the same period.

Additionally, hospitalisations for intentional self-harm among males aged 15-19 rose by 115 per cent from 2010 to 2019, and among young women the increase was 138 per cent, according to American sociologist Dr Jonathan Haidt. So what happened? Haidt has researched this phenomenon and found rates of depression, anxiety, and self-harm among teenagers began skyrocketing around 2012-2013, after being stable for more than a decade before this period.

He states the “great rewiring of childhood” occurred between 2010 and 2015. This shift led away from a “play-based childhood” to a “phone-based childhood”, where teens spend most of their waking hours on their phones. By 2015, most teens had smartphones and were heavily using social media platforms such as Instagram and Snapchat.

As an employer, I’ve noticed a significant shift in Gen Z compared to millennials from just a decade ago. Many young people today are less accustomed to face-to-face interactions, preferring to message or text rather than converse or call. Additionally, anxiety is prevalent in this generation, impacting their communication preferences and interpersonal skills.

Many of the teenagers I encounter are glued to their phones, which Haidt discusses in his research. For girls, the main issue is social media, while for boys, it’s gaming, although the latter is generally less problematic. Opponents of Haidt’s theory argue the rise in teen mental health issues could be due to other factors, such as increased diagnosis rates, racism, poverty, or that the trends observed in the US do not apply globally.

However, Haidt’s extensive research counters these points with compelling evidence. He demonstrates the surge in rates of depression, anxiety, and self-harm around 2012-2013 coincided with the widespread adoption of smartphones and social media. These trends are consistent across multiple countries, indicating an international issue linked to the “great rewiring of childhood” between 2010 and 2015, when smartphones became prevalent.

The evidence, encompassing correlational, longitudinal, and experimental studies, along with eyewitness testimony, overwhelmingly supports the conclusion that the increase in mental health problems among teens is tied to the rise of social media and smartphone use, not other socio-economic factors. While research in New Zealand is limited, Dr Samantha Marsh recently published a study on children’s screen use in Aotearoa. Parents report extensive screen use by their adolescents, which often occurs through the night, impacting their sleep.

Parents reported witnessing addict-like behaviour in their kids, and worried about exposure to harmful and trivial content. Other concerns included their children increasingly living in a virtual world, and the negative impacts of screens on their teen’s physical, mental, and cognitive wellbeing. Parents in the study also reported barriers to managing screens. These included wanting to avoid conflict with their children, difficulties with consistency or follow-through on rules, and a lack of parental technical knowledge.

So what is the solution? While some argue further education for parents is needed to reduce or prevent smartphone usage among children, the potential for harm makes this situation similar to the regulation of alcohol, tobacco, and driving. Therefore, I believe smartphones should be banned for individuals under 16 years old. By implementing such a ban, we can protect the mental health and cognitive development of adolescents during these crucial years. Sixteen may sound arbitrary but between the ages of 10 and 16, children experience significant brain development.

This measure would help mitigate the negative effects of excessive screen time and social media use, ensuring young people have the opportunity to develop essential life skills without the constant distractions and pressures of the digital world. With mounting evidence, governments worldwide will likely begin enforcing bans on smartphones and social media for adolescents within the next decade. The spiralling societal costs will necessitate action.

Marsh supports a ban, stating: “Barriers to getting kids off screens were also included, and I think these are important because if we banned these devices, it would remove a lot of conflict in the home.” With the strong movement to push the federal government in Australia for legislative change, it seems as if Australia may get ahead of us again. So the question is, will New Zealand be a follower or a leader? I hope for the latter.

14 May 2024‍

Opinion as featured in the New Zealand Herald.

We need to stop asking the question, “How long is the wait time to see your GP?” Instead, we need to ask the question, “How long is the wait time to access your primary care team?”

While many perceive primary healthcare as the backbone of our community, readily available at all times, the stark reality reveals otherwise. Healthcare resources are finite, leading to significant shortcomings in serving our population adequately, and the reality is this is only set to get worse.

Martin Hefford, director of the national agency’s living well division, stated in a webinar last week that the system currently lacks about 200 GPs. He projected this shortage could increase up to 1000 by 2033 due to factors such as an ageing population and rising healthcare demands, despite a record intake of 234 GP trainees this year. Compounding these challenges is an ageing workforce, with 37 per cent of GPs planning to retire within the next five years.

In addition, healthcare needs are becoming more complex. GP visits have surged by 2.2 million since 2008, and the strain on the system is evident as one in three practices (34 per cent) are no longer accepting new patients, marking a fourfold increase since 2019.

By 2028, projections indicate one in every five individuals will be 65 or older, signalling a significant demographic shift. Additionally, by 2042, one in three children is expected to identify as Māori, who experience higher health inequities. These changing demographics also coincide with a rise in complex health issues, especially among the elderly, who often need multiple medications.

Lifestyle factors are also impacting health, with three in 10 New Zealanders having a BMI over 30, contributing to increased rates of diabetes, cardiovascular diseases and certain cancers. Moreover, mental health is a critical issue, with one in four young adults experiencing significant psychological distress.

As each GP typically manages around 1500 patients, with up to 1000 less GPs, this could leave approximately 1.5 million New Zealanders without a primary care provider. Therefore, the GP workforce crisis represents a critical issue that demands a significant rethinking of our approach to delivering primary care.

So, what should we do? Well, we need to make the GP role more appealing to new doctors and improve their working conditions. Because who wants to be a GP in a sector that’s in crisis?

Therefore, the first step must be to appropriately value our current workforce. We need to improve working conditions and raise funding for our current GPs to prevent burnout as resources dwindle. Additionally, we need to encourage those nearing retirement to stay in the workforce. We should consider implementing a retention strategy that makes continuing to work a viable option for GPs.

GPs also need to be empowered to delegate less complex health issues to other qualified providers, without being penalised at a funding level. The primary care model will have to evolve towards a hospital-like structure, where GPs supervise a team of clinicians, providing guidance and oversight instead of being on the front line at all times.

Of course, many GPs already operate in this way, even when the financial incentives do not align with this form of care delivery. Despite these efforts by individual practitioners, the significant disparities in healthcare funding across fragmented primary health organisations (PHOs) remain a pressing concern, with some PHOs creating barriers that lead to unequal access to healthcare services, underscoring the need for systemic change.

For instance, one PHO in Auckland might provide patients with free sexual health checks, post-natal check-ups for mothers and mental health support, while another in the same city offers none of these funded services. Given the funding influence of PHOs, such inconsistencies perpetuate a postcode lottery in healthcare access.

Another example is the role of health improvement practitioners (HIPs) and health coaches, with funding provided by Health New Zealand - Te Whatu Ora to PHOs, who hold the purse strings on community allocation. Instead, this funding should be directly accessible to front-line primary healthcare providers, enabling them to allocate resources in the best interests of their communities and patients.

The public also has a role to play in alleviating the strain on GPs. Not every sniffle requires a visit to the doctor. There are also many other skilled health professionals who can provide care, including nurse practitioners, nurses, pharmacists, physiotherapists and mental health coaches, among others.

But the public needs to choose alternative care providers and the Government needs to provide adequate funding to support a clinical teams model without GPs being penalised for diversifying their workforce.

If the Government is genuinely committed to resolving our primary healthcare crisis, it must foster the right operating environment and put the right incentives in place. This involves shifting the focus from the question, “How long is the wait time to see your GP?” to “How long is the wait time to access your primary care team?”

This change underscores a move towards a more collaborative and efficient primary care model which can be sustainable into the future.

5 May 2024‍

Opinion as featured in the New Zealand Herald.

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Throughout history, pivotal decisions have profoundly shaped societal norms and public welfare. For example, New Zealand’s groundbreaking 1893 decision to grant women the right to vote significantly advanced gender equality. Similarly, measures like raising the age of consent, tightening restrictions on tobacco sales to minors, and mandating seatbelt use have collectively enhanced societal safety and welfare, setting precedents for future generations. Today, we face a similar crossroads with regard to children’s access to smartphones.

The Government’s decision to ban the use of phones in schools is a significant and commendable step. While I deeply appreciate this move, I would urge the Government to go even further by implementing a ban on smartphones for children under 16.

As a parent of three, with an almost-12-year-old, my husband and I have consistently taken a stricter approach to limiting our children’s exposure to digital devices. When our son turned 11, we gave him a basic Nokia brick phone rather than a smartphone. This decision reflects our commitment to delaying his exposure to smartphones while ensuring we can still stay in contact with him during his hour-long daily commute.

However, most of his friends already have smartphones.

Research from the UK states a staggering 97 per cent of 12-year-olds in Britain own a smartphone. This widespread access has not come without consequences. Research reveals the detrimental effects of these devices, such as exposure to inappropriate content, increased risk of addiction, and significant mental health issues. These problems are exacerbated by the omnipresence of social media that can lead to cyberbullying, body image issues, and overall lower self-esteem.

Moreover, the social implications of restricting smartphone use are also significant. For instance, our son, starting at a new school, found himself somewhat isolated because most of his new friends communicated primarily through platforms such as Snapchat. This dichotomy between connectivity and isolation poses a complex challenge for parents navigating the digital landscape with their children.

Most parents want to do the right thing and believe they can effectively regulate the content their children access online, but this often proves to be a misconception. Several of my friends have recounted instances where their children circumvented parental controls, either by altering the settings themselves or by finding loopholes in the safeguards meant to protect them.

This challenge underscores a broader dilemma many parents face: the fear of social isolation if their child does not have a smartphone. Consequently, many parents yield to peer pressure, choosing to provide smartphones to avoid this isolation. In our family, addressing this complex issue has required us to maintain open and honest communication with our son. This approach is vital, particularly in an environment where many parents are battling their own smartphone addictions.

In fact, tech companies invest billions in making apps and devices intentionally addictive, affecting young brains in ways similar to gambling. One disturbing statistic from a study is that one in five teens engages with YouTube “almost constantly”. This level of engagement has tangible effects on mental health, with heavy social media use linked to a 50 per cent increase in depressive symptoms among girls, compared with 35 per cent for boys, highlighting a gender disparity in the impact of these technologies.

In my role, I am confronted daily with the rising tide of mental health issues among youth. This is occurring in an environment where our healthcare resources are already stretched thin. Given this context, it is critical to re-evaluate the role of potentially harmful digital tools in the lives of our children.

Opponents argue phones are essential for classroom research, yet viable non-smartphone alternatives exist. I believe reliance on smartphones is unnecessary before age 16. Furthermore, education on responsible device usage should be introduced after age 16, when the brain is better equipped to handle the digital world.

Meanwhile, the evidence is clear and compelling — as a society that has historically regulated substances such as alcohol and tobacco to protect our young, it is logical and necessary to extend these protections to include the risks associated with digital device use among youth.

Therefore, I urge the Government to take a bold step further by considering a ban on smartphones for those under 16 in New Zealand. This measure would not only safeguard our children’s mental and physical health, but could set a global precedent similar to the way we led the world in granting women the right to vote.

Let’s start a movement to make New Zealand the first country to regulate smartphone use among children. Who’s with me? Together, we can make the decision to help protect our young generation from excessive digital exposure and set a positive example for the world, significantly enhancing the health and wellbeing of our children.

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25 April 2024‍

Opinion as featured in the New Zealand Herald

The recent issues surrounding the new Tōtara Haumaru hospital on the North Shore, which remains unopened due to staffing and budgetary issues, serve as a poignant reminder of the misplaced priorities in our healthcare spending.

While it’s tempting to invest in grand new facilities like Tōtara Haumaru, with its innovative healing garden and state-of-the-art surgical suites, these investments miss the mark if the basic healthcare needs of the community are not met first.

It is well known that primary care is the cornerstone of a functional healthcare system. It is where prevention happens, where chronic diseases are managed, and where minor issues are treated before they escalate into emergencies that require hospital care.

By strengthening primary care, we can reduce the demand for hospitalisations, and emergency department visits, thereby easing the burden on our healthcare infrastructure.

Highlighting the critical role of primary care in preventing escalating healthcare demands, a reduction in GP consultations could potentially double emergency department presentations. Moreover, the financial disparities in delivering primary care versus tertiary care are well documented; for instance, in Australia, the government spends about $595.17 on a non-admitted emergency department visit compared to just $76.95 for a GP consultation.

In Canada, improved access to primary care is linked with up to a 30 per cent reduction in hospitalisations for conditions such as diabetes and hypertension. This dramatic difference highlights the economic benefit of strengthening primary care to address health issues before they escalate into costly hospital care. Investing in primary care yields substantial returns, significantly reducing hospital stays and thereby not only saving costs but also improving health outcomes.

This investment strategy extends beyond mere financial savings, fostering a healthier population and enhancing overall quality of life, making it a pivotal and life-enhancing approach to healthcare management.

The benefits of robust primary care are even more significant for underserved communities, such as Māori, Pasifika, and those living in rural areas. These groups often face the greatest barriers to healthcare access and have higher rates of health inequities.

Strengthening primary care can not only help reduce these inequities but also supports the health system’s sustainability by preventing manageable conditions from becoming acute crises. For a government that is focused on outcome-based initiatives, primary healthcare should be an easy investment thesis. In the upcoming healthcare budget, the Government stands at a pivotal crossroads, with an opportunity to make a transformative investment in our nation’s health.

Should the proposed increase in funding be minimal, it will not adequately address the profound challenges facing our primary care system. An underwhelming allocation of resources risks leaving primary care facilities unable to maintain access or enhance services and risks having long-standing GPs exiting the profession faster than anticipated.

Consequently, this limitation could place undue strain on already overstretched hospitals and aged care services, inhibiting their ability to deliver comprehensive care.

A substantial boost in funding for primary care is not just a matter of budget allocation; it is an investment in the very fabric of our society’s health and wellbeing. Without it, we risk continuing the cycle of reactive healthcare, where more resources are consistently funnelled into emergency and acute care settings — areas that could have been less burdened had there been adequate preventative care measures in place.

In addition, once the funding has been confirmed, it’s crucial to scrutinise the funding distribution process, as too often, the intended funds do not reach primary care providers directly. This issue is especially evident with mental health and health improvement practitioners, including health coaches, who are vital in primary care settings but the primary care provider, not receiving the direct funding instead these are provided by PHO’s, without the funding reaching frontline primary care. This gap underscores the need for a more transparent and effective distribution mechanism to ensure that resources are utilised where they are most needed.

So, while new hospitals like Tōtara Haumaru are impressive, they should not come at the expense of primary care—the real frontline of health prevention.

We need a strategic shift in our health budget to prioritise primary care, ensuring it receives the support necessary to fulfil its critical role. This is how we build a healthcare system that not only saves money but also, more importantly, saves lives.

‍- Cecilia Robinson is a founder and co-CEO of primary care provider Tend Health