The Purpose of Primary Options Acute Demand Management Service (POADMS) is to:

• provide a service that maintains a strong focus on serving high deprivation populations (those living in quintile 5), Māori, Pasifika, older people and children
• ensure equitable access for all populations
• ensure that interventions are demonstrating clinically suitable treatment plans that meet the eligibility criteria, with a clear line of clinical reasoning towards the referred outcome
• ensure that a high trust approach to clinical leadership is taken, by that the service is accountable to funded packages.

A range of community diagnostic, therapeutic and logistic services are provided at no cost (except the initial GP consultation) to the patient/whānau. These include:

• diagnostic procedures, for example x-ray, ultrasound, IV antibiotics for cellulitis (see guidelines) and laboratory blood tests
• GP and practice nurse home visiting
• follow-up and return visits to general practice locations
• intravenous therapy
• transport to and from primary care locations
• rest home care
• early discharge from hospital

‘Fair Funding’ describes an approach to ensure that providers delivering packages of care are remunerated appropriately for the work undertaken. It will apply to every intervention funded. POADMS will implement a policy of a high trust, low bureaucracy approach to accessing funds from primary and community care through this policy. The package of care must contribute to a reduction in:

• Ambulatory Sensitive Hospitalisations (ASH)
• unplanned ED admissions
• Acute Bed Day (ABD) occupation
• Acute Patient Access measures of ED departments (still to be determined).

Short term interventions to achieve this include:

• IV therapy (either antibiotics or fluid administration)
• GP, nurse practitioner or nurse consultation
• nurse observation
• Private x-ray or ultrasound, fast tracking diagnostic procedures
• Rest home stay
• Home support services
• Equipment hire services
• Transport support.