Akaroa Health Centre Capital Funding Summary

May 28, 2020

If you scroll through the updates section of this website you'll find history of the incredible engagement and participation of the Akaroa and Bays Community to support the building of our new facility which opened in August 2019 and accommodates the GP Practice, 4 Flexi-beds and 8 Aged Care Beds.


Canterbury District Health Board (CDHB) agreed to fund the whole development on community agreement that $2.5M would be repaid to them, being the estimated cost of the aged care bed facility. Aged Care is seen as a private business and is not funded by CDHB. Without these beds , our community would not have had provision for ongoing aged care. Pompallier was not financially viable and we could not seek to borrow from anywhere else as the revenue from 8 aged care beds would not support such a mortgage. However, the community consultation deemed aged care to be an essential component of the integrated health service.

 

A Community Fundraising Target of $3M was set being $2.5M repayment the above debt to CDHB plus $0.5M** for purchase of the GP Practice, professional fees, governance set up, kitting out the new facility etc.


Local fundraising to end of March 2020 (including interest) amounted to an amazing $1.811M plus the Rate Levy underwriting* of up to $1.3 Million (to be paid to ACHT in June 2023). Subject to audit, this results in excess fundraising to date of $122K which we will report back to CCC officers. CCC will advise ratepayers of the impact on the rates figures once known.

 

Fundraising will continue but in a more focussed way given the need to ensure other community activities and charities can also be prioritised.

 

Thank you, Akaroa and Bays Community, for ensuring the financial security of establishing the Health Centre. Challenging as it is, it is clear how much more difficult it would have been to face the current Covid-19 crisis without having such modern, integrated facilities.


ACHT Trustees May 2020

* At ACHT’s request CCC consulted with relevant ratepayers which resulted in a clear majority of respondents supporting a Targeted Rate Levy that would underwrite any fundraising shortfall. The Rate Levy was calculated by CCC at circa $130 (including GST) a year for 4 years from 1 st July 2019 to the end of June 2023 in order to raise the maximum required of $1.3M. The intention being that any excess fundraising would reduce the rate levy dollar for dollar. Given this certainty CDHB deferred the date for the total debt to be
repaid (without incurring interest charges) to June 2023.


** ACHT Trustees will continue to review the appropriateness of the $0.5M requirement in consultation with Directors of Akaroa Health Limited (its wholly owned subsidiary) which is the operating company for all services Akaroa Health Centre delivers.

Akaroa Health - Autumn 2020

March 31, 2020

The next edition of the seasonal Akaroa Health Centre newsletter is available to read now.

COVID-19 - what you need to know

March 30, 2020

COVID-19.govt.nz is a website that provides everything you need to know about COVID-19 in one place. Learn the simple steps you can take to unite against the virus and slow its spread. Find out what help is available and get the latest updates.

If you believe you may have COVID-19 like symptoms, please call the COVID-19 healthline or the Akaroa Health Centre on 03 3047004. Please do not visit the Health Centre without calling first.

For day to day updates from the Akaroa Health Centre please follow our facebook page - click here

Akaroa Health - Summer 19/20 News

January 01, 2020

We'll be keeping the Akaroa & Bays community up to date on Akaroa Health Centre and Akaroa Community Health Trust activity through the seasons. The Summer edition, printed in the Akaroa Mail in December, is available here.

ACHT Fundraising Snapshot: progress toward $3 million target

March 19, 2019

The chart above illustrates the breakdown of committed funds versus funds to be raised prior to ACHT repaying CDHB for the $2.5 million capital cost of the aged care wing of our new Akaroa Health Centre in June 2022.

You can see that the total committed funds is now $1.73 million - already the rate requirement is reducing (from $1.3 million to $1.27 million). This will be updated regularly.

 

Please remember, fundraising efforts will continue and will reduce the rate requirement.

 

The targeted rate is an important backstop to ensure the community is not penalised with continuing debt and interest when it comes to repaying the commitment made to CDHB.

Please contact Paul de Latour 0272034046 if you have any questions.

ACHT Position Paper: History behind a proposal for a targeted rate

February 28, 2020

The old Akaroa Hospital was rendered unfit after a post quake assessment. Since 2011 our community has sought to find a solution to the health needs of our community. For a trot through the time and activity between then and now please click this link.

Targeted rate for Akaroa Health Centre Q&A

March 12, 2019

Community Meeting: Targeted rate for Akaroa Health Centre

9:30am Saturday 16th, Akaroa School Gymnasium

 

 

The community consultation regarding the proposed fixed term targeted rate to raise funds for the new Akaroa Health Centre is well underway. Akaroa Community Health Trustees are grateful for the level of interest and have welcomed the vast array of questions received.

 

A community meeting will be held Saturday 16th, 9:30am at the Akaroa School Gymnasium. The ‘why’ behind the consultation will be presented along with an update on the build and operation of the business before the floor is opened up to questions and discussion. We hope to see many of the community there.

 

Below is a brief Q&A which addresses many of the queries to date. You can also pick up a document produced by the Akaroa Community Health Trust (ACHT), which outlines what you need to know, from the CCC Akaroa Service Centre.

 

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What’s the added value of an integrated health centre? Maintaining the biggest range of services so people of all ages can be seen and treated locally for as long as possible, keeping families connected through generations, getting the best value by bringing services together and having a Community Health Advisory Group to ensure local needs are attended to.

 

Is this a replacement hospital? No. CDHB have been clear that they would not build a replacement hospital. The facility is an Integrated Family Health Centre with a medical practice owned by the community, 4 flexi (in-patient) beds under contract to CDHB and 8 aged care bedrooms operated by Akaroa Health Limited (AHL). Visiting allied health professionals will also be able to use the facility as required.

 

What is the community fundraising for? Two things; $2.5 million capital repayment to CDHB for the building of an aged residential care wing, and $500k for the purchase the medical practice (completed), FFE fitout of the 8 rest home rooms, replacement FFE for the medical practice, and working capital for the enlarged entity. 

 

Is the CCC grant solely for the purpose of meeting CDHB capital repayment obligations? Yes. The CCC grant ($1.3 million maximum funded via a fixed term targeted rate) will go entirely to CDHB towards the community’s contractual obligation/debt of $2.5m. 

 

Why doesn’t the government / CDHB pay for aged care? Aged residential care is privatised in New Zealand. In a community the size of Akaroa and the Bays a dedicated aged residential care facility would be non-viable.

 

What’s wrong with Pompallier House? The present Pompallier rest home (operated by a local Akaroa Charity) is not fit for purpose and will close as soon as the new facility is ready. It has only remained open (and significantly subsidised by the CDHB) to ensure current residents didn’t have to move away.

 

Who agreed to the community contribution? Consultation with the community through 2014 and 2015 determined an integrated facility, including aged residential care, that could be community owned and operated sustainably was required. In September 2015 the CDHB confirmed to the Akaroa community that it would build the facility on the Akaroa Hospital site, provided the community contributed $2.5 million. The community again confirmed at a public meeting on 4 September 2015 its wish for the Model of Care that had been established with 12 beds and confirmed that it would raise the $2.5m as its contribution to the facility.

What is ACHT obtaining for its investment? It acquires a 50 year lease on the premises (i.e. the useful life of the building) and an abatement of rental to the extent of the community’s contribution.

 

Shouldn’t CDHB insurance cover the whole build? There was no insurance pay-out for Akaroa Hospital because the earthquake didn’t damage the building. The post-earthquake inspection process did however, identify a pre-existing risk which made the building unoccupiable. Canterbury’s health infrastructure was extensively damaged and CDHB has had to prioritise the allocation of limited resources according to the benefit they provide. The former Akaroa Hospital could not continue to offer the services provided at the date of the earthquake, as CDHB’s were not funded to provide aged care facilities. Therefore, the community was required to fund that aged care if it wanted to provide it. As we know that has come with other benefits from CDHB, including the 4 medical beds otherwise not provided with a standalone Medical Practice.

 

When is the Akaroa Health Centre due for completion? July 2019. Once the facility is up and running the ACHT believes it will be more difficult to raise further capital for the project. We continue to actively pursue national grants and the idea of a cruise ship levy but have not yet received support from CCC, government or the owners to progress this.

 

Why don’t we just continue to fundraise until 2022? ACHT will continue to fundraise and additional funds raised will reduce the rate amount (assessed yearly).

 

Will fundraising stop if the rate is successful? No. ACHT has a dedicated fundraising sub-committee that continues to search out funding opportunities. The proposed targeted rate is set at a maximum and we would hope to be able to reduce it once we reach our $3m target through wider fundraising.

 

How long will the rate apply? Two options have been put forward for consideration; 4 years (to align with the term in which ACHT needs to pay the contribution to CDHB) and 10 years. The CCC will accrue interest in the years leading up to the payment to the CDHB. Any interest earned will be deducted from the rate to be collected. After paying the CDHB in 2022, interest will be incurred and added to the rate to be collected.

 

Is the rate proportionate to capital value of the property? No. The rate will be fixed per rateable property. If you own multiple rateable properties, you will need to pay the targeted rate levy on each of those (unless they are conjoined in which case please speak to the CCC).

What happens if the debt to CDHB can’t be repaid in the given timeframe? Penalty interest will be charged until the sum is paid, plus the community would be in breach of its agreement with CDHB.  The agreement negotiated provided the community four years to raise the funds from the time the premises commenced construction (until June 2022). 

 

How will the Akaroa Health Centre be run? The Akaroa Structure Group formed two charitable entities – Akaroa Community Health Trust (ACHT) and Akaroa Health Limited (AHL).  ACHT is the Shareholder and representative of the community and the Shareholder of AHL which is the operating entity running the new health facility. Caretaker Trustees and Directors were appointed from 2014 to 2017 until fully ratified trustees and directors were appointed in 2017 after a fully advertised and independent appointment process was put in place. All these roles are subject to the usual rotational appointment process.

 

Will the community have on-going involvement in the new Akaroa Health Centre? Yes. A Community Health Advisory Group has been established to ensure we continue to meet the needs of the whole community. 

Will the community have the opportunity to attend AGM’s? It is the intention of the ACHT to hold public community meetings on an annual basis to provide an annual report and financial reports.

Are ACHT and AHL charities? Yes. ACHT and AHL are approved charitable entities. AHL does have to earn more than we spend to sustain the charity – all the more reason to ensure we avoid burdening the charity with a debt from the outset. The facility will be managed to maximise bed utilisation and revenues. We know that funding through contracts will result in tight margins. The integrated services should assist this, along with there being no requirement to pay dividends or make profits.

Thank you for your interest and we hope to see you this Saturday.

 

Gordon Boxall, Chair, Akaroa Community Health Trust

We need your support. Fixed term targeted rate to raise funds for new Akaroa Health Centre

March 12, 2019

Thank you for taking care to understand the fundraising effort for the new integrated Akaroa Health Centre, and in particular, the idea of a targeted rate levy. The new Akaroa Health Centre will keep our people connected and healthy in our community for longer and replace the former Akaroa Hospital which was destroyed after the 2010/11 earthquakes. 

Our community voted for aged care to be a part of the new Akaroa Health Centre and the Akaroa Community Health Trust (ACHT), on behalf of the community, committed to the CDHB to raise the $2.5 million capital requirement. ACHT has requested the Christchurch City Council consult with the community regarding a proposed targeted rate to underwrite $1.3 million of that capital requirement.

Your perspective is essential. Please take a look at this document outlining the rationale behind the rate.

Happy days as the roof goes on

November 03, 2018

With a summery feel in the air, it's exciting to see the roof going on to the new Akaroa Health Centre structure - so long as the sun keeps shining there'll be nothing to slow the builders down as we speed toward a mid-2019 opening. We're so thankful for the progress made to date on the build and in the community fundraising efforts.

Community Health Advisory Group for Akaroa Health Centre

June 21, 2018

A community health advisory group of people that represent the views of the community has been set up by the Akaroa Community Health Trust.

 

The new group is “an ear to the current and future health needs of the community so that we can give quality feedback to Akaroa Community Health Trust and think about broader unmet health needs” says Pam Richardson, group Chair and Trustee.

 

Community owned Akaroa Health Limited now owns and operates the Akaroa Health Centre, in April welcoming Jenni Masters as General Manager. 

 

“With Jenni’s feet firmly on the ground it’s important that we bring perspectives from across the the Akaroa and Bays community to help inform our health services” says Pam.  

 

“We were thrilled that we had so many willing volunteers for the group. We feel that there are a lot of approachable people in the group that really want to see that we have good health outcomes for our community.”

 

“Many have backgrounds in healthcare; mid-wifery, dentistry, nursing, elder care, allied health, while others have personal, social, cultural and professional perspectives on health that make them excellent spokespeople.” 

 

The purpose of the group is to represent the attitudes, concerns and suggestions in relation to the delivery of sustainable health services and Pam encourages you to share your thoughts with a member of the group. Their next meeting is later this month.

 

The group members are; Karen Bennet, Kate Clare, Sue Grimwood, Jane Lucas, Janis Haley, Elizabeth Haylock, Teena Irwin, Kevin Scally, Chris Sharp, Jessica Skinner, Mary Smillie, Linda Sunderland, Melanie Tainui, and Gail Woods. 

Model of Care Released

January 17, 2018

We are pleased to now have a final Model of Care, released by Canterbury DHB in January 2018. The model of care outlines those services that could be of value to the Akaroa & Bays community now and / or in the future. It serves as a reference document for the Community Health Advisory Group who will constantly evaluate whether the services provided match the community need.

Click here to download

Akaroa Community Trust - Community Update

June 12, 2017

The recently appointed Trustees of the Akaroa Community Trust would like to take the opportunity to update you regarding progress made towards the establishment of the Akaroa Health Hub. 

Click here to download

Seeking Directors - Akaroa Health Hub Limited

May 04, 2017

Following the appointment of the Establishment Trustees in March 2017 we are now seeking to appoint the governance Board who will oversee the establishment and ongoing operation of Akaroa Health Hub Limited.

Click here to read more

Announcement: Akaroa Health Hub appointment of Trustees

April 12, 2017

The independently chaired Appointments Panel for the Akaroa Health Hub is delighted to announce the appointment of the Establishment Trustees to the Akaroa Health Hub. The Trustees will take over responsibility for the Trust in several weeks. These appointments will be for an initial 2-year period.

The trustees are:

 

Gordon Boxall.

Gretchen Foster

Mike Norris

Pam Richardson

Stewart Sinclair

Rik Tainui

Peter Young

Trustees: Key Community Facility - Akaroa Needs You

December 08, 2016

Following the September 2010 earthquake, which rendered the existing Akaroa Hospital unstable, the community and the Canterbury District Health Board (CDHB) have been working together to create an integrated family health centre for the wider Akaroa region to meet the current and future needs of the community. This new facility will be based on a model of care which includes the provision of medical, primary and residential care services within a 12 bed facility, the funding of which is to come from both the CDHB and the community.

 

The appointment panel is seeking to appoint 4 Establishment Trustees to lead the establishment of this exciting new organisation and ensure its success, with a mix of skills in one or more of the following areas:

- Finance

- Fundraising

- Health Sector

- Communications and Marketing

 

This should be supported by a strong understanding of, and connections within the Banks Peninsula community, proven governance skills and the passion and enthusiasm to deliver this project. It is anticipated that the appointments will be for an initial 2 year term.

To apply in strict confidence, email your cover letter and CV to cvchc@sheffield.co.nz

quoting 355841AH. Applications close on 22 January 2017. Emails will be electronically acknowledged and further correspondence may be by email.

 

To view the Briefing Information please visit the Job Search page at www.sheffield.co.nz

For more information please phone Mike Stenhouse on 0274 428 348.

Progress Report

November 17, 2016

In September 2015, CDHB announced that it would build an Integrated Family Health Centre at Akaroa (the Health Hub) on terms to be agreed with the community. After a meeting chaired by the Hon Amy Adams in April 2016, agreement was reached in October 2016. The terms are:

 

1) CDHB will build the Health Hub.

2) It will be based on a model of care which includes medical services and primary care together with 12 flexi-beds, including 8 for aged care.

3) CDHB will fund the construction project.

4) The community has four years to raise $2.5m as its contribution.

5) A Contract of Service will govern the relationship between CDHB and the operating company of The Health Hub. 

 

Entities in Place

The Akaroa Structure Group has established the Akaroa Community Trust (the Trust) which will hold the shares in the operating company Akaroa Health Ltd. The company will operate and manage the Health Hub in Akaroa, and will negotiate a Service Provision Contract with the CDHB for the medical services to be provided. The Trust and the operating company are registered charities.

 

The Building

The CDHB has produced a concept plan and drawings which were published in the Akaroa Mail on Friday 4 November.

 

Fundraising Drive 

A fundraising committee chaired by Paul de Latour has been formed. The funding drive has begun.

 

The Way Forward

The ASG has approved an Organisation and Governance Plan and has appointed an Independently Chaired Appointments Panel (ICAP) to call for expressions of interest from the community for appointment as Establishment (transitional) Trustees for the Trust for the two years to 31 March 2019.

That appointment process will begin shortly so that the transitional trustees are in place by 31 March 2017.

 

There will be a public meeting in Akaroa on Saturday, December 3rd at 11.00 a.m. at the Gaiety Hall to discuss progress and the crucial process of appointing the transitional trustees.

The trustees have a vitally important role in agreeing further terms with the CDHB, appointing transitional directors for the operating company, fundraising, and in due course appointing the trustees beyond the transitional period.

We cannot emphasise enough the importance of the transitional trustees.

We hope you will attend the public meeting to learn more about the road ahead and to participate in determining the shape of future healthcare in Akaroa.

 

Regards

Alan Bradford

Chair

Akaroa Structure Group

Update from the Chair of the Structure Group

July 25, 2016

In April we announced that an agreement had been reached with the Canterbury DHB that it would construct a new Akaroa health facility (‘Akaroa Health Hub’) on terms which required substantial community funding over time. While the CDHB has been progressing the design process, members of the Structure Group have been working on the transition process into the new facility.

We have three subgroups working with the CDHB in different ways:

 

1)    a User Group, representing the expertise of healthcare providers, who are working to ensure that the design is fit for purpose and that there is an appropriate transition process for staff;

2)    a Building Group, representing expertise in construction and project management, liaising with the CDHB on all building-related issues; and

3)    a Business, Finance, and Legal Group, focused on developing a workable business model for the new community-owned company (Akaroa Health Ltd) which will be responsible for the overall operation of the Health Hub. There are complex financial and legal issues involved in creating and transitioning to the new company.

We also have a Fundraising Committee, which is working together with a fundraising consultant (Carol Harris) and an independent community fundraising group, chaired by Paul de Latour. In April, Nick Walls, a ‘local’ man and qualified chartered account whose expertise is essential to this process, joined the Structure Group. In June, the group was joined by Steve Shamy, General Manager of Rannerdale Veterans’ Care, who is providing us with valuable insight and advice required for our negotiation of the Service Contract with the CDHB.

User Group

The User Group has been meeting with staff employed by the three existing health entities operating in Akaroa (CDHB, Pompallier House, and Akaroa Medical Centre) and with representatives of the CDHB. It will be involved with the Design Lab to refine the way the building will work. It is working closely with Win McDonald, the CDHB’s Transitional Change Manager, who will be assisting the transition to the new company. The User Group will look to include representatives of patients and the wider community.

 

Building Group

The Building Group has been meeting with the CDHB to keep up with the progress in designing and constructing the new facility. While design and construction are the responsibility of the CDHB, it is important that, as major contributors and future users, we are all informed of progress and issues arising.

Announcements regarding design and construction will come from the CDHB, which is proceeding with the contracting process for the various parts of the construction project. Contrary to some earlier reports, the project is not being contracted in two phases (medical centre + rest home) but in a single phase, as one building.

 

Business, Finance, Legal

The Business, Finance and Legal Group is working with the User Group to develop a sustainable model of care and service for the centre as part of the Service Provision Contract negotiations, as well as investigating all other relevant healthcare funding options available to us within the region.

The Business, Finance, and Legal Group is currently negotiating two Agreements:

a. The Heads of Agreement: This is the binding form of the agreement reached with Amy Adams and the CDHB in April. It formalises that agreement and sets out the terms of the build by the CDHB and the community’s contribution to it.

b. The Service Provision Contract between the CDHB and the Akaroa Health Hub as operator: This is a complex agreement, and we are working through the financial arrangements and implications. It is likely to take until early next year to finalise, but this will not hold up the build, as we understand it.

We are talking with other community-based integrated health facilities (including Golden Bay, Kaikoura, Tapanui, Methven, Clutha, and Wanaka) to learn from their experience. There is much to learn, and we are grateful they are willing to share their experience.

 

The Operating Company

The Akaroa community, through the Akaroa Community Trust, will own Akaroa Health Ltd, which in turn will run the new Health Hub. Akaroa Health Ltd will need Directors with a high level of expertise—in management, governance, finance, and accounting to the community and the funders—to navigate this new venture. These will be positions of very considerable responsibility. We are beginning the process of asking who might commit their time and skills to this. We have learned a lot in three years of our ‘life’ as a Group but have a long way to go. We have some members who may offer themselves for appointment, but until we can tell you exactly what has been agreed with the CDHB, we can only chart the course that we are taking and advise more as the detail of the project firms up.

 

Thank you for your continued patience and support.

 

Alan Bradford
Chairman
Akaroa Health Hub Structure Group

Joint communication from Canterbury DHB and The Akaroa Health Hub Structure Group: New Akaroa Integrated Health Facility one step closer

April 25, 2017

Canterbury DHB confirmed on 15 April 2016 that they are tendering for the construction of the new Integrated Health Facility in Akaroa, on the site of the former Akaroa Hospital. The DHB has committed to commence construction on the facility, which is anticipated to be underway by November 2016, with a projected completion date of October 2017.

To enable the facility to include beds for aged residential care, a substantial one-off contribution from the community will be needed, to be capped at $2.5M. With this contribution, the facility will have 8 residential beds and 4 “GP” beds for inpatients and will house the general practice and other community services.

It has been agreed that sufficient time will be provided for the community fundraising targets to be reached, with the DHB funding cash-flow in the interim. While further details of financing and ownership are still being worked through, Canterbury DHB is committed to proceed without further delay on the new facility.

The intended facility more than meets the DHB’s specific obligation to replace the damaged and outdated Akaroa Hospital. The Akaroa community has previously agreed with the proposal that a community-owned company, Akaroa Health Hub Ltd, will be the provider of the services in the new facility. Work is being undertaken with the existing Akaroa health service providers (rest home, hospital nurses and health centre), as well as other services such as physiotherapy and pharmacy, to integrate the services and design the model of service delivery for the future. This work will be completed before the facility design is finalised to ensure it will be fit for its purpose of delivering services in an integrated and sustainable way.

Canterbury DHB Chief Executive David Meates says that reaching this milestone of inviting tenders for construction is a huge achievement.

 

“Especially in light of the unique complexities of this process and the other priorities competing for health resources in our post-quake Canterbury environment. Our positive engagement with the community to date gives me great confidence that this partnership approach is the best way forward.”

Alan Bradford, chair of the Akaroa Structure Group, welcomes the development.

“We are very pleased that the Akaroa community can now count on the continued local provision of health services. We recognise that the lack of apparent progress has been frustrating for many, and we are pleased to have reached this important milestone.”

 

The DHB and the Akaroa Structure Group would like to acknowledge the support of Amy Adams, Member of Parliament for Selwyn, for her assistance in facilitating an agreed way forward.

Update from the Chair of the Structure Group

December 03, 2015

To Akaroa and Wider Community,

 

The Structure Group has reported on recent developments and now updates that.. CDHB has expressed commitment to the Akaroa Health Hub under a model of care which includes rest home beds. David Meates spoke to the community to that effect, and since then CDHB has been working with what we call the User Group on designs which will have cost savings and be within the capital cost which CDHB thinks manageable. Simon Hemmings, CDHB Architectural Technician has met with the User Group reps and there is consensus from our key health providers that the planning is on the right lines.

 

CDHB expects to submit the current plan to its board in February 2016. We have therefore set up two work streams within our Group. The first is Land and Buildings which will settle the physical structure and layout of the Medical and Care facilities. That is already under way. The second is what we call Operations. This anticipates that if we are to run the Hub as a community, we need to have the skill sets and commitment from our well- resourced catchment in place and ready to go. So we are meeting as a sub group and adding to it people who can help get ready for this big transition if that is how it works out. 

 

Make no mistake that we appreciate just what this involves. For example, we may take a lease from CDHB and enter a contract of service with CDHB to cover the cost of the operations. There are issues of finance, compliance, employment, health and safety and so on. But we are now working on these in parallel with the Land and Buildings work. In effect we are having a dry run at a Transitional Board, as if that Board will soon be running the Hub. All this is taking time but I want to assure you that the change of plan which we were working to leaves us undaunted and we are pressing on.

The trustees have reported to you separately as they must and we hope the goodwill to donate is expressed with donations and commitments so we can see how the community’s input will work. We see the add-ons to the basic services as something that the community can get behind from inception, and an example is the landscaping and then the gardens which we think should be a feature of this site. If people have particular skill sets and the time to help with our work please let one of the Structure Group know.

I would also like to again acknowledge the support that our Community has received from CDHB since the closure of our Hospital. We look forward to working with them in re-establishing our new Akaroa Health Hub and operating this facility into the future.

Alan Bradford,
Chairman,
Akaroa Health Hub Structure Group

Open Letter from Trustees

November 19, 2015

The Trustees of the Akaroa Community Trust have released the following open letter regarding the Health Hub:

 

Open Letter From Nicholas Davidson, Pam Richardson and Lee Robinson as Trustees of the Akaroa Community Trust and Directors of Akaroa Health Hub Limited

 

We are the Trustees of monies donated by the community for the Akaroa Health Hub. As such we are obliged to account to the community for all donations received and how the funds are spent. A short form statement of donations and accounts paid is attached. 

 

Donations were received before and after the public meeting held in the School Hall on 25 October 2014 which announced the Project. At that meeting the basis for fundraising was clearly set out. The project capital costs would be financed by Ngai Tahu to a set limit, together with any other investor in the land and buildings. The community and CDHB would hold an interest in the land and buildings according to our community means. The CDHB would lease the premises for a rent which allowed a return on capital for the investors.

The Structure Group, for the community, then went ahead with detailed work to plan a purpose built facility including rest home beds, under a model of care which was agreed with CDHB. Although not laid down in concrete, as there was still much to be done, this was the basis for fundraising. This process was well advanced by mid 2015 including design and detail for works and traffic on the site, but came to a halt when the project was revisited by CDHB for several reasons. Ngai Tahu withdrew its support for its own reasons. 

At the public meeting called on 5 September 2015 at our instigation, the Structure Group and CDHB addressed this rethink. While disappointed that the project was changing shape, the Structure Group committed to work to what it and the meeting agreed is an essential outcome for the Peninsula. 

David Meates of CDHB indicated the way forward at that meeting, and since then there have been further discussions, and some progress, but nothing is yet finalised. The Structure Group will report to you on progress. At the meeting on 5 September 2015 the Structure Group was heartened to be told from the floor that it should proceed in the new direction and work with CDHB.

As Trustees we have a different and higher obligation than the Structure Group as we are accounting for donated funds. As Trustees we are not prepared to spend any money without all donors, past and future, knowing that the project has changed in significant ways and is still not settled. We must also report to the Charities Commissioner. In essence, we must be transparent and be certain that any money donated is used wisely and with full public knowledge of what is still an undetermined structure. So far we have authorised expenditure as you can see from the attached. CDHB has met the rest.

We do not know if the community will own a share of the land and buildings. That has still to be worked out. We expect a community based company will operate the Health Hub, but that too is under discussion. The outcome in terms of ownership will be different from what we and the community thought would result and that is why we must write to the whole community. We do not expect the model of care to change given CDHB’s advice. We will not authorise expenditure of any donated money unless it is essential to keep the project going and that we believe it is heading to a successful conclusion. It is equally essential that those who so willingly and generously have donated time, effort and money, and want to do so, should understand the position of the Trustees and all those who want to donate (and there are many of you), understand the position. We would like your support, expressed in any way you choose.

 

Whatever the final form of the Health Hub any funds donated will go towards making it the best we can for Akaroa and the Peninsula. That is what you all deserve.

Signed: N R W Davidson, P Richardson, L M C Robinson

Dated: 12 November 2015

Withdrawal of Ngâi Tahu Property Ltd

October 08, 2015

The Canterbury District Health Board (CDHB) and Ngai Tahu Property Ltd (NTP) have been unable to reach agreement on terms for NTP’s involvement in the Akaroa Health Hub. As a result, NTP has withdrawn from the project. The Structure Group has received the following statement from David Meates, Chief Executive of the CDHB:

 

Canterbury DHB is committed to work with the community on delivery of health services in Akaroa and ensure there are appropriate facilities in Akaroa to support service delivery. At the public meeting on 6 September we advised we will work with you to make this happen. At that meeting we said, “If the proposal in front of us changes for any reason, Canterbury DHB remains committed to working with the health providers to integrate the services and support long term solutions in Akaroa”. 

 

Recent discussions with Ngai Tahu Property have determined that NTP no longer wish to invest in a new building in Akaroa. This in no way diminishes the commitment by the DHB. We accept that the existing infrastructure in Akaroa is insufficient to support the vision of integrated services. We will work with your community group to determine the next steps for a new IFHC in Akaroa. 

 

Our immediate concern will be to review the concept design of the proposed facility to ensure it will be fit for purpose and is an affordable long term proposition for both the DHB and the community providers of health services. Canterbury DHB and the Akaroa Structure Group are independently investigating the minimal cost of a facility that will meet the requirements for the health service. This will allow us to collectively agree on the requirements.

 

Once we know what capital outlay is required, we will, together with the Akaroa community group, agree the funding and ownership structure for the new facility. If it transpires the land cannot be transferred because of legal impediments, alternative options will be explored where the DHB retains ownership of the land. We will meet with the Akaroa community representatives during October to work this through a plan for this.

Public Meeting

August 13, 2015

As some of you will have noticed, our original targets of demolition of the old hospital by February 2015 and commencement of construction of the new facility by July 2015 have not been met. The Structure Group has worked very hard to keep the project on schedule, but there are legal and governmental restraints which are taking longer than expected, and much is outside our control. A public meeting will be held on Sunday 6th September at 10.30 a.m. at the Akaroa Area School Gym to discuss the current situation and enable to you to ask questions and register your views. Representatives of the CDHB and Ngâi Tahu Property Ltd, as well as the AHH Structure Group, will be present. This meeting will also encompass—but is not limited to—a consultation process on land-ownership transfer that is required by the Ministry of Health. We hope you will attend the meeting and make your views known.

Akaroa Health Services Update

October 23, 2014

The Structure Group invite the Akaroa area community to a public meeting on Saturday, 25 October 2014 at 10.30 a.m. at the Akaroa Area School gymnasium.

 

Members of the Structure Group, the Canterbury District Health Board and Ngāi Tahu Property Ltd will explain the current stage of progress toward creating the Akaroa Health Hub and the next steps in the process. We urge the Akaroa area community to attend this meeting to hear about progress to date and to raise any questions or concerns you may have. For those who cannot attend, information from the meeting will be placed on the website next week.

Akaroa Health Hub Public Meeting
10.30 a.m.
Saturday 25 October Akaroa Area School Gymnasium

If you have any questions or comments, please email us at information@akaroahealthhub.org.nz

Or write to us at Post Box 161, Akaroa 7542 Or visit www.akaroahealthhub.org.nz 

Akaroa Health Services Update

October 09, 2014

Significant progress has been made toward an Akaroa Health Hub. The project poses many challenges. We have worked through some, and others remain.

 

We would like to present the progress made and the next steps to the Akaroa area community. There will be a public meeting on 25 October 2014 at 10.30 a.m. for this purpose. The meeting will be held at the Akaroa Area School gymnasium.

 

In addition to the Structure Group, the Canterbury District Health Board and Ngāi Tahu Property Ltd will be represented at the meeting. Without the contributions of both of these organisations, we could not have progressed the Health Hub project as far as we have. The planned model of care and building site remain as described in previous updates. We are aiming for an Integrated Family Health Centre that combines GP, accident and emergency, and physiotherapy services with 12 flexi-beds that can be used for primary care (e.g., observation beds), aged (rest-home) care, post-operative care, palliative care, acute nursing, and post-natal care. Services such as visiting specialist, community nursing, and Well Child will also operate from the Health Hub. The preferred site remains the old hospital site.

 

New information will be presented on funding, governance, management, and ownership arrangements. We will also discuss plans for fundraising and for the transition from existing services to the new Integrated Family Health Centre.  We urge the Akaroa area community to attend this meeting, not only to learn about the progress made but also to raise any questions or concerns you may have.

 

Akaroa Health Hub Public Meeting
25 October at 10.30 a.m. Akaroa Area School Gymnasium

If you have any questions or comments, please email us at information@akaroahealthhub.org.nz or write to us at Post Box 161, Akaroa 7542, or visit www.akaroahealthhub.org.nz 

Update

July 17, 2014

Good progress has been made toward an Akaroa Health Hub, but it is not yet a sure thing. There are several challenges that must be met before we can be confident that the Akaroa Health Hub initiative will succeed.  

  • Support from the Canterbury District Health Board (CDHB):  The Akaroa Health Hub is a community-driven initiative, and the expectation is that the resulting facility would be community-owned. We will not succeed, however, without the support of others. In particular, we will need a contribution from the CDHB towards the cost of building a new facility. We will also need support from the CDHB to operate the Akaroa Health Hub, through contracts for many of the services it would provide. Without this support, we are likely to have only a GP-led health clinic rather than a facility with 12 “flexi-beds” available for a variety of healthcare and aged-care functions.  The CDHB will not support a new “hospital”. They will support an Integrated Family Health Centre (IFHC), but only if they are presented with a business case that they regard as robust and viable. An IFHC would be able to provide most of the services formerly provided by the hospital, including acute nursing, post-operative care, and palliative care. The IFHC would not include a birthing unit, as this would not get sufficient use to be economically viable, but it would provide post-natal care. 

Because “Akaroa Integrated Family Health Centre” is a bit of a mouthful, we call it the Akaroa Health Hub. We would like to emphasise that it refers to an IFHC, not a hospital.  There would be no separate “hospital unit” in the Health Hub. The IFHC would be a single, integrated operation: the beds are called “flexi-beds” to signal that they can be used for a variety of functions, including primary care (e.g., observation beds) as well as aged (rest-home) care and the formerly hospital-provided services mentioned above (post-operative care, etc.).

 

  • Completing the business case:  The model of care and the potential building sites have been investigated, but a business case requires much more than that.  It will require a detailed evaluation of projected capital and operational costs to demonstrate financial viability. It is also necessary to devise a satisfactory governance and management structure that enables accountability to the community and to investors, effective management of the Integrated Family Health Centre, and responsible management of capital assets. It will also need to devise satisfactory plans for fundraising and for the transition from existing services to the IFHC.  It is expected that the business case will be completed in September.

 

  • Public support: Once the business case has been completed, the Structure Group will explain the case to the wider Akaroa area community and provide ways for the community to express its views.  Without strong community support, it is unlikely that the IFHC can succeed.  For that reason, a lack of community support would also discourage CDHB support.

 

  • Fundraising:  Currently the Structure Group is focused on completing the business case, because without a robust business case, there will be no Akaroa Health Hub. Once the business case is completed, and assuming it is accepted, the Structure Group will embark on a fundraising campaign.  The cost of building the facility is likely to be around $7 million. Different options for meeting this cost are being explored, but community fundraising is certain to be an important part of the strategy.

 

It is already possible to donate to the Akaroa Health Hub, should one wish, at the Bank of New Zealand in Akaroa or through electronic banking using the following account details:

Account Name: Akaroa Health Hub Ltd
Account Number (BNZ): 02-0832-0063776-00 

Donors to this account can obtain tax receipts, and they can choose to be anonymous or to be acknowledged by name.

Update

July 03, 2014

In April 2014, the Structure Group appointed The Project Company Ltd to produce the business case for an Akaroa Health Hub. The Project Company Ltd has carried out a preliminary analysis of the three potential sites for the facility: the “Pompallier” site in Rue Viard, the “BP Meats” site behind the butcher shop, and the “Old Hospital” site on the corner of Aylmer Valley Road and Onuku Road. The objective was to identify a preferred site, which will be subject to a more detailed and costly analysis as part of a sound business case. This will enable us to avoid wasting scarce resources on a full analysis of all three sites. 

A concept design, based on the preferred Model of Care that calls for a facility combining a health clinic with 12 inpatient ‘flexi beds’, was completed for a facility on each of the three sites. The concept design indicated how the functional requirements of the facility might be met on each site. The cost to build the facility in each case was estimated by a quantity surveyor. Twenty-four critical aspects of the sites were then evaluated to identify any constraints that might cause difficulties for the Health Hub project. These included zoning, resource consents, heritage and historic precinct requirements, geotechnical, tsunami and flooding risks, parking, limitations of existing buildings, future expansion potential, design layout constraints, difficulty of development, transition risk and time to complete. The analysis drew on architectural, engineering (geotechnical, flooding and structural), town-planning, traffic and parking, building and construction, legal, health and medical, and project-management expertise. 

The estimated building costs are similar across the three sites. The analysis of constraints, however, highlighted differences among the sites and showed the Old Hospital site to be most suitable. Major constraints of the Pompallier site include: potential long delays and costs associated with resource-consent and heritage-building issues, geotechnical issues, inadequate parking space, lack of room for expansion, and a disruptive transition. Major constraints of the BP Meats site include flood risk as well as potential delays and costs associated with resource-consent and historic-precinct issues; in addition, constraints on building layout may raise operational costs, and there are difficulties at that site with traffic, parking, and noise. There were no major constraints identified for the Old Hospital site. 

A recommendation to select the Old Hospital site as the preferred site has been accepted by the Structure Group. Preparation of the business case will proceed on this basis. It is possible that a more detailed technical analysis will reveal unexpected problems with the Old Hospital site, in which case it may be necessary to revise this decision. 

Model of Care Update

May 08, 2014

On 17 April, the Structure Group received Jane Cartwright’s report on potential models of care for an Akaroa Health Hub. Jane considered three options:

  • Health clinic and 12 inpatient ’flexi beds’

  • Health clinic and 10 inpatient ’flexi beds’

  • Health clinic only 

 

In addition to a financial analysis of projected income and expenses, Jane also took into account: 

  • The demographic trends of the Akaroa area and the expected health-service needs of this population. 

  • Feedback from the community, which indicated clearly that residents place high importance on being able to receive palliative care, post-natal and post-operative care in Akaroa. Residents also wish to be able to retire in Akaroa with a good level of support for themselves and their families.

  • The impact of the range of services on the ability to attract and retain health professionals. The inclusion of in-patient beds makes working in the community a far more attractive option for health professionals, because it is a safer place to practice. This is because there is a greater ability to respond adequately to emergencies due to the support of a team of health professionals (especially nurses) available 24 hours a day, in addition to the St John team. In addition, access to quality rest-home and in-patient beds keeps more people living locally and enrolled with the health clinic, which translates into more funding for local health services. There is a concern that without such beds, the ability to retain the services of GPs would be compromised. 

  • The fact that Akaroa and its surrounding area are typically cut off from outside services for at least 36 hours each year as a result of floods, snow and earthquakes. Access to a comprehensive range of services locally is invaluable at those times.

 

Jane’s report recommends against the clinic-only option and for an Akaroa Health Hub that would encompass the following services:

  • Medical centre services, including:

    • GP consultations

    • Nurse clinics

    • Accident and medical emergencies

    • Community nursing services

      • District nursing

      • Acute nursing

  • Physiotherapy 

  • Rehabilitation

  • Visiting services

  • Mental health services (such as Brief Intervention Counseling)

  • Māori Health services

  • Others such as

    • Audiology

    • Podiatry

    • Optometry 

    • Respiratory health

    • Diabetes care

    • Child Health, including Well Child and specialist services

  • Rest home residential services, including respite care 

  • In-patient beds to be used flexibly for:

    • Acute observation

    • Post-natal care

    • Palliative care

    • Post-operative care

 

Jane looked at two options for a combined-services hub, one with 10 beds and one with 12 beds. She has concluded: “It is operationally feasible to establish the Akaroa Health Hub with beds to be used by the local population. The selection of the site and final building costs will determine whether a 10- or 12-bed facility should be built.” Jane also recommends the appointment of a project manager to oversee the completion of the business case.

 

Jane’s report will inform the business case and will be considered in relation to other key elements, such as building site and financial plan. A public version of Jane’s report is available here.

Jane and the Structure Group would like to thank all those who spoke with Jane during the preparation of this report for their generosity in giving up their time and for their willingness to share their experience. 

In response to the recommendations in Jane Cartwright’s report, the Structure Group has appointed The Project Company Ltd to produce the business case for an Akaroa Health Hub, building on the preliminary and ongoing work of the Structure Group. The business case will bring together a property plan (including detailed analysis of potential sites), model of care, transition plan, financial plan, and an organisational and governance plan. A diagram of this process can be found on the website here.

We would like to thank the Canterbury District Health Board for its continued support.

If you have any questions or comments, please email us at information@akaroahealthhub.org.nz.

The Structure Group

March 13, 2014

The Akaroa Health Hub Structure Group has been charged with developing the business case for future health services in Akaroa, which will be presented to the community and the Canterbury District Health Board (CDHB). The business case will include a proposed model of care (identifying which services will be provided and how); the recommendation of a site for the Health Centre, following investigation of the available sites; evaluation of the financial viability of the recommended model of care, addressing capital and operational costs; and a proposed structure for holding capital assets and for managing operations. 

A charitable company, Akaroa Health Hub Ltd, has been established. Currently the role of the company is to receive funds for costs related to developing the business case and for the new health facility itself. Eventually the role of Akaroa Health Hub Ltd would be to manage the new health facility, providing services under contract from the Canterbury District Health Board and others (such as the Rural Canterbury Primary Health Organisation and ACC).

The Structure Group includes current providers of health services and others with a range of relevant expertise. The members are:

Garry Benson: Garry has lived in Akaroa for three years and is co-owner of the Akaroa Pharmacy with pharmacist wife Jennifer. He has ten years’ experience in the field of hospital- based psychiatric care and 25 years’ experience as a company director. He is a member of the Akaroa-Wairewa Health Steering Group.

Maryjane Berry: Maryjane is a resident of Akaroa and a Registered Nurse with broad experience in healthcare, spanning teaching and acute hospital care. She works for the CDHB in operational management, which includes strategic planning and change management. She is a fundraising liaison contact for the Structure Group.

Alan Bradford: Alan has been living in Akaroa for 13 years and is a self-employed Licenced Building Practitioner. He has been President of The Guardians of the Akaroa Hospital for the last 3 years, is a member of the Akaroa-Wairewa Health Steering Group, and is the Chairman of the Akaroa Health Hub Structure Group.

Nicholas Davidson: Nick lives in Akaroa, and is a Barrister in Canterbury Chambers in Christchurch. Aside from litigation, he has held and holds roles in Tribunals, trusteeships and Boards and has commercial property experience. He contributes this experience and his legal expertise to the Structure Group.

Frances de Latour: Frances has lived in the outer bays of the Peninsula for 38 years and has worked as a nurse in Akaroa since 1991. She has been a member of the Guardians of Akaroa Hospital for 10 years and is current vice president.   She is a member of the Akaroa-Wairewa Health Steering Group.  In the Structure Group, she is responsible for secretarial duties and is a fundraising liaison contact. 

Kevin Dysart: Kevin has been a physiotherapist in Akaroa for the last 16 years and brings his knowledge of the needs of a physiotherapy practice to the Structure Group.   He is a member of the Akaroa-Wairewa Health Steering Group. His many local commitments include The Silver Band and other music groups, the Lighthouse Preservation Society, and the Banks Peninsula Soccer club. 

Dr Joanna Goven: Joanna has lived in Pigeon Bay for 16 years and is a former university academic with experience in facilitating community consultation and participation.  She is a member of the Akaroa-Wairewa Health Steering Group. She is responsible for the communications work of the Structure Group. 

Dr Suzanne Knapp: Suzanne, who is Peninsula born and bred, has been working at the Akaroa Health Centre over the last 20 years as a GP and currently owns the practice. She is a member of the Akaroa-Wairewa Health Steering Group. She brings her central knowledge and experience to the Structure Group.

Bruce McLean: Bruce is a civil engineer and has 40 years’ experience developing, governing and managing diverse building and infrastructure projects in New Zealand and overseas. He contributes his project-management experience and engineering expertise to the Structure Group.

 

Rick Menzies: Rick has lived on the Peninsula for all of his life. He has been a member of the Board of Directors of the Rannerdale War Veterans Home Ltd, which operates the veterans home in Christchurch, and for the last seven years has been the Chairman of the Rannerdale Trust. He is a Community Representative on both the Akaroa-Wairewa Health Steering Group and the Structure Group.

 

Pam Richardson: Pam has lived and farmed in Pigeon Bay for 25 years. She is a board member of the Rural Canterbury Primary Health Organisation and Chair of the Akaroa-Wairewa Community Board and of the Akaroa-Wairewa Health Steering Group. She brings her extensive knowledge of what works well for rural communities to the Structure Group. 

 

Lee Robinson: Lee is a long-term resident of the Peninsula and is a senior partner of law firm Saunders Robinson Brown, with 40 years’ experience in business property and commercial law. He has a long involvement at governance level and as legal advisor to many health and health-related charitable organisations. He contributes this legal expertise and experience to the Structure Group.

 

Please contact us at information@akaroahealthhub.org.nz if you have any questions. Keep an eye on our website (www.akaroahealthhub.org.nz) for further developments and information.

Update

February 13, 2014

The Canterbury District Health Board (CDHB) does not intend to rebuild or replace the Akaroa hospital. The CDHB has instead committed to making a contribution towards a new community-owned health facility in Akaroa on condition that it is presented with an acceptable business case that also has community support.  

In October-November 2013, the Akaroa-Wairewa Health Steering Group distributed a consultation document describing the proposed model for an Integrated Family Health Centre, together with a survey questionnaire.  In the proposed model, a community-owned organisation would be responsible for building the new facility and would contract with the CDHB and other service providers to provide health services.   A very large majority (96%) of respondents to the survey agreed to this proposal.  

The CDHB has provided funds for an independent consultant, Jane Cartwright, to consider how different health services might be grouped together in a new centre.  Jane’s work will be used to assess whether an Integrated Family Health Centre in Akaroa can be both clinically and financially sustainable.  Jane expects to complete her work by April 2014, and the results will be presented to the community.  Detailed work on possible sites for the facility is also underway. This will also be presented to the community when completed. 

Future reports in the Akaroa Mail will discuss potential sites and services in more detail. These reports and further information will be available at www.akaroahealthhub.org.nz.  The Akaroa Health Hub Structure Group can be contacted at information@akaroahealthhub.org.nz

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