POAC Services
Suspected AAA (Abdominal Aortic Aneurysm)
POAC does not fund investigation of suspected AAA
Abscess and Soft Tissue USS
POAC will fund:
Incision and drainage (I&D) of a significant abscess and management post I&D for up to 7 days
Soft Tissue Ultrasound of the breast may be requested under POAC for bacterial mastitis to rule out collection when there is no presumptive diagnosis of breast abscess, but the breast remains enlarged, reddened, and painful following 48 hours of oral antibiotic therapy.
Soft Tissue Ultrasound (non-breast) to confirm a drainable abscess (no trial antibiotics necessary)
Acute Appendicitis
POAC does NOT fund ultrasound investigation for the purpose of excluding appendicitis.
Referral to hospital is recommended
POAC may be used for same-day CT scan if endorsed by surgical specialist.
POAC Ultrasound for Counties Manukau only if AUB and any ONE of the following:
BMI ≥ 30
> 3 months of intermenstrual bleeding
> 3 months of failed medical treatment
Suspected pelvic mass on clinical examination
Haemoglobin ≤ 90 g/dL
Scan approximately 2 weeks, non-urgent booking
Anaphylaxis
POAC will fund four hours of observation time under strict criteria.
Asthma (Acute)
Red flags or Severe - Admit to hospital
Moderately severe asthma may be managed under POAC with extended observation and management, where the initial trial has failed.
POAC funding starts only AFTER the initial trial of therapy
Refer HealthPathway Acute Asthma in Adults and Young People
Update to HealthPathway recommends high-dose orals.
POAC will fund (as at April 2025) up to 3 doses IV cephazolin (adult cellulitis, red flags excluded) following trial of oral antibiotics.
For clinical advice, phone the on-call Infectious Disease Consultant:
Auckland: (09) 307‑2800
Counties Manukau: 021 837‑253 or (09) 276‑0000 (via switchboard)
Waitemata: (09) 486‑8908
Chest Pain / ECG Funding
POAC funds acute ECG under scenarios outlined below:
Strictly non-injury
Acute and safe to scan within 24-48 hours to avoid ED referral
Endorsed by Neurology, Stroke or Med Reg WDHB (POAC can accept if discussed ED SMO, although this is not promoted)
Suspected Stroke excluded
Deep Vein Thrombosis (DVT)
Exclude Red Flags (chest pain, shortness of breath), consider Pulmonary Embolism (PE), discuss with on-call haematology
Proceed to USS if any of the following:
Repeat scan within 7-10 days where recommended by haematology/thrombosis (use same POAC number)
Superficial Thrombophlebitis
Upper Limb (arm)
Pregnant
OR
Wells Score of 2 or more
OR
Elevated D-dimer (age adjusted unless is Point of Care Test)
Note:
Bilateral DVT USS requires haematology endorsement (or Thrombosis CNS/Clinical Nurse Specialist)
If a same-day scan is not available, ensure the clinician is advised to refer to the HealthPathway and consider anticoagulation (oral rivaroxaban, unless contraindicated)
Dehydration
POAC-Funded Management of Dehydration, Including Hyperemesis in Pregnancy
POAC will fund the management of moderate dehydration, including cases of hyperemesis in pregnancy. This support includes:
Intravenous (IV) fluid therapy for adults (2L max/day)
Oral rehydration and observation for children when initial treatment has not been successful
Emergency Departments may refer patients requiring further IV fluids to an Urgent Care Clinic (UCC) or the patient’s usual General Practice. These referrals should be clearly documented in the discharge summary.
A POAC case number is not required at the time of referral—this will be generated by the clinic providing treatment.
See Healthpathway Adult Dehydration
Diverticulitis
Red flags - refer acute general surgery
POAC CT Abdomen may be requested (with contrast) with surgical endorsement
Recurrent or chronic diverticulitis - Refer Diverticular Disease HealthPathway - not POAC
Emergency Department Voucher
Emergency Q App can be used at Middlemore, North Shore and Waitakere Emergency Departments to redirect patients to a select list of contracted Urgent Care Clinics.
Auckland City Hospital ED commenced a voucher system May 2025. This is a manual, paper based referral system.
Patient must attend in the required timeframe
The full consultation cost is covered by Health NZ under this voucher system
Urgent radiology can be funded under POAC
See process and further information on POAC website
Ferinject Iron Infusion
Funded across all three Auckland Districts
Strict clinical criteria for funding of infusion (Hb/Ferritin levels must be current and within funded range)
Patient must be eligible for public health funding (this does not include patients ONLY eligible for maternity care)
POAC facilitates online referral to a 'POAC Infusion Centre', or a clinic can administer infusion in their clinic
Claim via POAC claiming system using Ferinject Coding.
Foreign Body (FB) Radiology
POAC may fund:
CXR for ingested FB in child (note: POAC DOES NOT fund inhaled FB)
Soft tissue investigation of FB (XR/USS, depending on the material of object (e.g. wood/glass/plant)
Hepatitis C Testing and Treatment
POAC provides funding for testing and treatment of Hepatitis C in GP/UCC and pharmacy for the Auckland Region.
General Practice & Urgent Care Clinics
Patients with confirmed active Hepatitis C infection (HCV RNA positive) suitable for an 8-week course of Maviret. Submit referral using code 'Hepatitis C Testing and Treatment', claim Hep C extended GP Consultation only.
Pharmacy
Submit claim via POAC website
Maternity
POAC Inclusions:
Ectopic Pregnancy - where endorsed by gynaecology/obstetric team
Urgent obstetric scan for Counties Manukau Health (see further details here) - See CMH Urgent Scan Request POAC SOP Process here
Counties Manukau Co-Payment Voucher:
Under POAC, funding is available for specific maternity ultrasound scans for women delivering at a Counties Manukau Health facility. POAC will fund co-payments for:
Growth scans for all women who are unable to self-fund.
Anatomy and nuchal scans are funded for women who hold a Community Services Card (CSC), have multiples pregnancy or teen pregnancy.
Dating scans are not covered under this funding arrangement.
POAC supports a patient shared care arrangement with GP and CADs (across all three Auckland districts)
POAC automatically process quarterly claims
Contact Aimee Williams with any queries
Pelvic Ultrasound Policy
POAC funding of pelvic ultrasound inclusions:
Retained products of conception (RPOC) - persistent pain >12 hours, heavy bleeding 1-2 pads/hour)
Suspected ectopic pregnancy - endorsed by gynae
Suspected pelvic collection - with signs of infection, including PID (non response to treatment), post op, adnexal mass
Lost IUCD strings - where significant pain and not located with physical examination
Acute pelvic pain attending Emergency Dept - referral by ED only
POAC exclusions:
General pregnancy-related pain (routine maternity referral)
Ovarian cyst
Pelvic pain of unknown cause
For Abnormal Uterine Bleeding (AUB) - non acute ultrasound, refer www.poac.co.nz/aub. (POAC only coordinates and funds the ultrasound for Counties Manukau)
Pyelonephritis
POAC may provide funding for the following for Pyelonephritis:
IV antibiotics
IV fluids
Ultrasound is not indicated and not funded under POAC.
St John may refer patients to their General Practitioner (GP) or an Urgent Care Clinic (UCC) as an alternative to transporting them to a hospital Emergency Department.
The St John Clinical Hub can make direct referrals to UCCs using the Emergency Q (EQ) app, which will generate a St John EQ voucher number.
All initial consultation costs, which would normally be charged to the patient, will be funded by POAC under this scheme.
If the patient requires hospital transport following their initial assessment, this will also be funded by POAC.
Testicular Ultrasound
Testicular Torsion - must discuss with on-call urology for same day USS (red flags excluded)
Epididymitis - POAC will fund USS if 48 hours antibiotics and negative STI screen
TIA/Stroke
POAC may fund the following for TIA where discussed and endorsed by named TIA/Stroke specialist.
CT Head (non contrast)
Carotid USS
Suspected Stroke Excluded: Investigation of a suspected stroke is not funded by POAC. If within 7 days, discuss with the Stroke service and arrange acute assessment or admission. See HealthPathway for further information.
Radiology (non-POAC options)
Access to Diagnostics (ATD):
Available for Auckland and Counties Manukau
Adults only (15 years and over) - some less acute ultrasounds may be required under POAC for Counties Manukau as they do not have access to urgent USS in hospital radiology. Discuss with POAC Service Manager or Clinical Director for approval
Practices hold an allocated budget for all investigations (based on enrolled population)
If practice is 'over budget', they can still request appropriate investigations over and above this limit
If practice is 'hard floored', they should contact ATD manager (09 377 7827) to discuss
ATD is accessed via the Practice Management System (PMS), selecting ProXtra form
E-referral:
Additional Imaging Requested (when under POAC):
Mammogram - not funded by POAC
If contrast is requested, POAC may approve based on radiologist's recommendation
Further imaging for incidental findings should be reported to the referring clinician, and appropriate referrals made for further imaging
If uncertain, ensure to escalate to POAC Team Leader or Service Manager as this may require urgent Clinical Director review to approve in time sensitive manner
Urinary Catheterisation
POAC funds urinary catheterisation. Submit referral via PMS using code 'Urological'
No coordination required unless this is a home nursing request which can be completed using the online form and provided by Total Care Health nursing service
UTI (Multi-Resistant) - Fosfomycin Treatment
This service is no longer provided by POAC as the recommended drug fosfomycin (previously only available in hospital pharmacy) is now available in the community
Counties Manukau Residents Only
Infusion subsidy for Osteoporosis
$80 subsidy for eligible patients (patient pays co-payment)