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Programmes » National bowel screening programme – Primary Care Services - Tairāwhiti

National bowel screening programme – Primary Care Services

Tairāwhiti | Gastroenterology | Preventative | Over 18 | Over 65

The National Bowel Screening Programme has two objectives; reduce mortality rates from bowel cancer and to identify and remove pre-cancerous advanced adenoma from the bowel before they become cancerous.  

This service provides funding for the primary care management of positive FIT (faecal immunochemical test) results including consulting with the patient and facilitating the referral of these individuals through to Te Whatu Ora Tairāwhiti for colonoscopy.  

It is also expected that primary care providers will further support the programme by raising bowel screening awareness with eligible people, encouraging participation particularly for Maori and Pacific Island people, and continue to work to identify and manage bowel cancer risk in the non-screening age population in line with clinical guidelines. 

Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agree to the business rules set out in this service sheet. 

This is not a clinical guideline. 

Details

Which practices can claim for this service?

Any Pinnacle practice in Tairāwhiti locality can offer and claim for this service. 

Service components

The service offers funding for the management of positive FIT results. For the purpose of this service, 'management' must include: 

  • a free consultation (virtual or face to face) with eligible patients to inform them of their result and advise of the next steps in the pathway 
  • a completed BPAC bowel screening referral to Te Whatu Ora Tairāwhiti (either a referral for colonoscopy or information referral if participant has chosen to be treated privately, declined colonoscopy or providing information that the colonoscopy is not an appropriate investigation based on the clinical status of the person). 
Who is eligible for the service?

Any participant in the National Bowel Screening Programme, resident in the Te Whatu Ora Tairāwhiti area and enrolled with a Pinnacle practice who has had a positive FIT test result. 

Who is excluded from the service?

Any participants in the National Bowel Screening Programme who have had a negative FIT test result 

Patients outside the National Bowel Screening Programme (not aged between 60-74, inclusive), these patients should be managed in line with clinical guidelines and are not included in this service. 

When is the service complete?

The episode of care is complete when the GP submits the BPAC eReferral to Te Whatu Ora Tairāwhiti. This act also triggers the claiming mechanism.  

Claiming guidelines

Funding is for $72.45 (GST inclusive) per episode of care which includes: 

  • GP or practice nurse consult (virtual or face to face) informing the patient of the positive result and next steps 
  • completion of bowel screening eReferral through to Te Whatu Ora Tairāwhiti 
  • completion of referral to support services (Turanga Health, Ngati Porou Hauora or Pacific Island Community Trust) if the patient requires support to access the colonoscopy service. 

Claiming process

Payments will be made monthly based on the number of eReferrals submitted by a practice and will be processed on your practice’s behalf by Pinnacle, based on a monthly eReferrals report from Te Whatu Ora.  

The payment from Pinnacle to your practice will be accompanied by a report containing the NHI details of the individuals referred in that month, for which the payment is for. 

You may choose to create a screening tool or similar within your PMS to keep track of the outstanding claims and reconcile against.  

Does the patient have to pay?

No.

How is the service funded?

This service is funded by Te Whatu Ora.

Contact

Tracy Fergus, District Manager - Tairāwhiti
tracy.fergus@pinnacle.health.nz
027 246 1698

RELATED RESOURCES
National Bowel Screening Programme
Published: 13/12/2022 | 4 files | 1 link | Presentation | Video | Website

National Bowel Screening Programme resources including the clinical Zoom recording and quick reference guide for primary healthcare teams.

View resource | Download files
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