Nicky McCarthy talks about being a Rural Dietitian

Thursday, April 13th, 2023 | claly44p | No Comments

Hauora Taiwhenua’s rural health careers video series showcases the inspirational work of rural dietitian Nicky McCarthy. Living in the beautiful Wanaka Lakes area of Aotearoa, Nicky works at Dunstan hospital in Clyde, supporting her rural community through the science of nutrition and translating it for each individual patient.

Want to know more about being a Dietitian? Check out Hauora Taiwhenua’s website here.

Defining catchment boundaries and their populations for Aotearoa New Zealand’s rural hospitals

Saturday, April 1st, 2023 | claly44p | No Comments

Whitehead Jesse, Blattner Katharina, Miller Rory, Crengle Sue, Ram Stephen, Walker Xaviour, Nixon Garry (2023) Defining catchment boundaries and their populations for Aotearoa New Zealand’s rural hospitals. Journal of Primary Health Care , -.

This study provides for the first time in NZ, a standardised description of each rural hospital’s catchment boundary and the socio-demographic characteristics of the population living within it. Confirms that NZ’s rural hospitals serve very different communities.

Included on page 1 is a very helpful box explaining in fairly simple terms, geographic units so that those of us who aren’t familiar them can at least start to understand! (K. Blattner)


Introduction: There is considerable variation in the structure and resources of New Zealand (NZ) rural hospitals; however, these have not been recently quantified and their effects on healthcare outcomes are poorly understood. Importantly, there is no standardised description of each rural hospital’s catchment boundary and the characteristics of the population living within this area.

Aim: To define and describe a catchment population for each of New Zealand’s rural hospitals.

Methods: An exploratory approach to developing catchments was employed. Geographic Information Systems were used to develop drive-time-based geographic catchments, and administrative health data (National Minimum Data Set and Primary Health Organisation Data Set) informed service utilisation-based catchments. Catchments were defined at both the Statistical Area 2 (SA2) and domicile levels, and linked to census-based population data, the Geographic Classification for Health, and the area-level New Zealand Index of Socioeconomic Deprivation (NZDep2018).

Results: Our results highlight considerable heterogeneity in the size (max: 57 564, min: 5226) and characteristics of populations served by rural hospitals. Substantial differences in the age structure, ethnic composition, socio-economic profile, ‘remoteness’ and projected future populations, are noted.

Discussion: In providing a standardised description of each rural hospital’s catchment boundary and its population characteristics, the considerable heterogeneity of the communities served by rural hospitals, both in size, rurality and socio-demographic characteristics, is highlighted. The findings provide a platform on which to build further research regarding NZ’s rural hospitals and inform the delivery of high-quality, cost-effective and equitable health care for people living in rural NZ.

Keywords: catchment populations, Geographic classification for health, geography, health services, rural communities, rural health, rural health inequities, rural hospitals.

Webinar 4th April 12:30pm “How many rural nurses are there?”

Thursday, March 30th, 2023 | claly44p | No Comments

Southern CNMO Office

2023 Education Webinar Series

“How many rural nurses are there”

“Rural nursing workforce review using the Geographic Classification for Heath”

Presenter: Michelle Smith, Registered Nurse, Dunstan Hospital and Research Nurse, University of Otago

Tuesday 4 April 2023, 12.30 – 1.30 pm

Please click the link below to join the Webinar:  Passcode: 512476

This session will be recorded for later viewing

Seeking Consultant Mentors for NZ Students’ Association Mentoring Programme

Wednesday, March 29th, 2023 | claly44p | No Comments

The NZSMA is reaching out to you for support with their Mentoring Program.

4th-year medical student interest in mentoring has increased by 15% across Otago and Auckland this year. The NZ Medical Students’ Association is now looking for 24 more hospital, rural medicine, and GP consultants to sign up to their Mentoring Program.

An Expression of Interest Form for the 2023 Mentoring Program can be found here:

The NZSMA know consultants are living increasingly busy lives in the current health climate, and so the expectations of mentoring in 2023 have been clarified (see expression of interest link above), and NZMSA will provide reminders and resources across the year to nurture a positive mentoring experience.

Finally, any hours you spend mentoring can also go towards your CPD requirements and can be claimed through your College’s CPD programme.

For further details contact

Patrick Macaskill-Webb (he/him) 

2023 Vice President Engagement

New Zealand Medical Students’ Association

M | +64 21 024 32886      E |

What is important for high quality rural health care?

Tuesday, March 28th, 2023 | claly44p | No Comments

Atmore C, Dovey S, Gauld R, Stokes T. What is important for high quality rural health care? A qualitative study of rural community and provider views in Aotearoa New Zealand. Rural and Remote Health. 2023 Mar 2;23(1):7635-.

Open Access

This qualitative study, recently published in Rural Remote Health journal, was conducted across four NZ rural communities (each with access to a rural hospital) and adds to the growing literature supporting the rural-proofing of health policy



While the general principles of healthcare quality are well articulated internationally, less has been written about applying these principles to rural contexts. Research exploring patient and provider views of healthcare quality in rural communities is limited. This study investigated what was important in healthcare quality particularly for hospital-level care for rural communities in Aotearoa New Zealand.


A pragmatic qualitative study was undertaken in four diverse rural communities with access to rural hospitals. Data were gathered through eight community and indigenous (Māori) focus groups (75 participants) and 34 health provider interviews, and analysed thematically.


Two study sites had large Māori populations and high levels of socioeconomic deprivation, whereas the other two sites had much lower Māori populations and lower levels of socioeconomic deprivation, but further travel distances to urban facilities. Rural hospitals in the communities ranged from 12 to 80 beds and were both government and community trust owned. A theme of the principles of high quality rurally focused health services was developed. Nine principles were identified: (1) providing patient- and family-centred care that respected people’s preferences for where treatment was provided; (2) providing services as close to home as could be done well; (3) quality was everybody’s job; (4) consistent care across settings, with reduction on unwarranted variation; (5) team-based care across distance, with clear communication and processes between different facilities working together; (6) equitable health care particularly for Māori, and then for the whole rural community; (7) sustainable service models, particularly for workforce, as a counterbalance to ‘closer to home’; (8) health networks to improve patient flow, and reduce waste; and (9) value was more than value for money, and including valuing respectful, timely care. Another theme around rural and urban healthcare quality was developed. While the nature of care was different in different settings, patient experience should be the underlying measure of quality, and quality measures needed to be interpreted in the context of local circumstances, with rural-specific quality measures where appropriate.


The researchers developed principles of healthcare quality specific to rural communities regarding patient and family preferences for where care was received, a broader focus on value beyond value for money and a strong focus on equity for indigenous people. These principles add to the rural principles previously described. Patient experience should be the underlying focus of quality, while noting that the nature of health care provided in rural and urban settings is different. The present study’s findings support the concept that quality measures should be interpreted in the context of local circumstances, with the development of rural-specific measures. The authors hope the findings, when locally contextualised, will assist health policy makers, planners, providers and community leaders as they strive to improve the quality of health services for their rural communities.

National Travel Assistance Scheme

Friday, February 24th, 2023 | claly44p | No Comments

We are all aware that access to health services in Aotearoa is inequitable especially regarding ethnicity and rurality. The National Travel Assistance Scheme started in 2005 to provide financial help for those having to travel far to receive specialist care. In this literature review, undertaken through an Otago Medical School Deans Research Scholarship, third-year medical student, Lucy Maher, describes what is known about the NTA scheme and identified significant knowledge gaps that pose numerous questions for future research.

Thanks Lucy – great work, enjoy your gap year!

NTA Project Report 2023[81]


Postgraduate congratulations to Cook Island’s doctors

Monday, February 20th, 2023 | claly44p | No Comments

Celebrations to Dr Koko Lwin and Dr Te Ariki Faireka on their University of Otago postgraduate success.  At a recent ceremony in Rarotonga Dr Koko Lwin graduated with a Postgraduate Diploma in Rural & Provincial Hospital Practice which he completed in 2021, as well as a Postgraduate Certificate of Clinician Performed Ultrasonography completed in 2022.  Dr Te Ariki Faireka graduated with a Cook Islands Fellowship in General Practice. Present for the ceremony was Otago’s Pacific Island Nation Liaison (Va’a o Tautai) Dr Kati Blattner.

Read the full story here


Cost savings of the rural accelerated chest pain pathway

Thursday, December 22nd, 2022 | claly44p | No Comments

The cost savings of the rural accelerated chest pain pathway for low-risk chest pain in rural general practice: a cost minimisation analysis.

Rory Miller, Garry Nixon, Tim Stokes, Michelle Smith, John W. Pickering, Talis Liepins and Martin Than. Journal of Primary Health Care 2022 doi:10.1071/HC22117

Hot off the Press & available to all at

With a rural accelerated chest pain pathway developed and shown to be equivalent to accelerated diagnostic chest pain pathways in urban EDs for patients with low-risk cardiac events, the team has now surveyed patients to evaluate the potential cost savings to both individuals and the health system.  Despite the low response rate, it is evident that savings can be made at many levels.  This pathway will  now be evaluated across Aotearoa NZ



Introduction. The rural accelerated chest pain pathway (RACPP) has been shown to safely reduce the number of transfers to hospital for patients who present with chest pain to rural general practice. Aim. This study aimed to estimate the costs associated with assessing patients with low-risk chest pain using the RACPP in rural general practice compared with transporting such patients to a distant emergency department (ED). Methods. This was a retrospective cost minimisation analysis. All patients with low-risk chest pain that were assessed in New Zealand (NZ) rural general practice using the RACPP between 1 June 2018 and 31 December 2019 were asked to participate. The costs incurred by patients were determined by an online survey. Patients were also asked to estimate the costs if they would have been transferred to ED. System costs were obtained from the relevant healthcare organisations. The main outcome measure was the total cost for patients who present with low-risk chest pain. Results. In total, 15 patients (22.7% response rate) responded to the survey. Using the RACPP in general practice resulted in a median cost saving of NZ$1184 (95% CI: $1111 to $1468) compared with transferring the same patient to ED. Discussion. Although limited by low enrolment, this study suggests that there are significant savings if the RACPP is used to assess patients with low-risk chest pain in rural NZ general practice.

Time to take a bow, Professor!

Friday, December 16th, 2022 | claly44p | No Comments

Congratulations to Professor Garry Nixon on his well-deserved promotion! We are proud of the Prof’s achievements! An awesome clinician, researcher and leader as well as an all round good bloke!

Garry continues to live and practice as a rural doctor in the same Central Otago community he has always worked in.

His research focuses on health outcomes and improving health services for rural communities like his own. His earlier research centred on point-of-care diagnostic technologies, including ultrasound and laboratory testing, examining their safety and impact on patient care.

In more recent times he has led a team of researchers who have developed and validated a new urban rural classification for health and are using it to compare urban and rural health outcomes and access to services.

He has collaborated closely with rural researchers in other parts of the country including the Far North and Waikato.

He has PhD students researching rural chest pain assessment pathways, the scopes of practice of rural allied health professionals, healthcare consumption across the urban rural spectrum and the workforce outcomes of rural interventions in the undergraduate medical programme.


New chest pain test for rural hospitals and general practices

Tuesday, December 13th, 2022 | claly44p | No Comments

Congratulations to Rory and the team with their successful pilot study, supported by the Heart Foundation, evaluating the safety and effectiveness of an accelerated chest pain pathway, including a troponin test performed in rural settings.  Read more:

A message from Rory:

A sincere and huge thank you to all sites that contributed to this project and made it a success. The primary findings have been published here as an open access article: and covered here in LOFP:

The project is discussed here on the podcast:

We have subsequently been awarded a research grant to implement a high sensitivity point-of-care troponin in 30 rural health facilities across Aotearoa. If you are currently using a point-of-care troponin and are interested in being part of this project then please reach out to: