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Programmes » Rheumatic fever prevention programme - Waikato

Rheumatic fever prevention programme

Waikato | Respiratory | Under 18 | Over 18 | Over 65

Overview

As part of the Rheumatic fever prevention programme, free throat swabs can be offered to eligible populations with suspected Group A streptococcal throat infections. Read more about rheumatic fever on Te Whatu Ora's website.

PHARMAC has increased the amount of certain antibiotics that practitioners can obtain through a Practitioner Supply Order (PSO), as part of the Rheumatic Fever Prevention Programme (RFPP).  

These medications will be dispensed free to the patient in accordance with the clinical protocol via a PSO.  

This service is part of the Advanced Primary Options programme.

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

This is NOT a clinical guideline. 

Details

Which practices can claim for this service?

All Pinnacle practices in Waikato region can claim for this service.

Service components
  • Claims can be initiated by a registered nurse/GP.
  • Only 1 claim per throat swab can be submitted.
  • A patient that has returned to the practice with another episode of a sore throat, following a previous negative throat swab, can have another funded swab under a new referral where clinically indicated. 
Who is eligible for the service?

General practitioners and nurses are able to provide patients domiciled in Te Whatu Ora Waikato area, with a free throat swab service if the patient meets the following criteria: 

  • patients aged between 4-19 years and of Māori/Pacific ethnicity; or
  • patients aged 4-19 years and living in deprived areas (Quintile 5) \
  • household contacts (aged between 3-35 years) of eligible patients (above criteria) who have had a positive swab result.  
Who is excluded under this service?
  • Patients who are not eligible for New Zealand funded health care.
  • Patients who do not meet the eligibility criteria.
  • Patients not domiciled in Te Whatu Ora Waikato area.   
When is the service complete?

The episode of care ends when the outcome and claim are submitted.

Payment will be made once an outcome has been lodged for the case.

Each sore throat swab will require a new claim. 

Claiming guidelines

Please make your claim by selecting the service from the list of eligible services for indici practices or via advanced form for Medtech practices

Prices are GST inclusive. 

RF throat swab:  $22.42
The claim for a throat swab for a patient who meets criteria for eligible population or who meets the criteria for household contact.

Submit your claim by selecting the appropriate service from the following:  

  • RF throat swab – eligible population
  • RF throat swab – household contact. 

Due to reporting requirements, the result of the swab needs to be included as well as the name of the antibiotic prescribed if the result of the swab is positive.  

Payment for the swab cannot be made until the outcome has been lodged with the required information.  

What level of clinical notes do I need to submit?

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding.  

Due to reporting requirements, the result of the swab needs to be included as well as the name of the antibiotic prescribed if the result of the swab is positive.

If there are any RF sore throat swab referrals with missing outcomes or the notes submitted do not contain the swab result and/or antibiotics prescribed, the team will call the practice in order to complete the report.   

Does the patient have to pay?

No. No co-payment can be charged to the patient. 

How the service is funded?

The service is funded by Te Whatu Ora

Contact

Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312

RELATED RESOURCES
Primary Options resources
Published: 18/02/2025 | 22 files | Document

Quick guides to assist practices with identifying eligibility criteria;invoices that can be claimed; managing claims and providing assistance with understanding remittance reports

View resource | Download files
One point lessons: Advanced forms
Published: 30/09/2024 | 2 files | Document

One point lessons: Advanced forms.

View resource | Download files
Rheumatic fever resources
Published: 19/05/2025 | 4 links | Document | Website

Te Whatu Ora Health NZ, in collaboration with relevant partners, has undertaken a full review of rheumatic fever (ARF) and rheumatic heart disease (RHD) guidelines and the Acute Rheumatic Fever Chapter of the Communicable Disease Control Manual.

View resource
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