The advice was among a tranche of papers and correspondence from Ministry of Health officials and Mrs Grant released by Dr Coleman's office.
It covers the first three months of the commissioner regime at the Southern District Health Board, when the Government was keen to put a lid on southern health after an uproar in the rural community over funding cuts, and the public sacking of an unpopular board.
The papers indicate the under-pressure board, before members were dismissed, had been gearing up to slash $12 million from the looming $42 million deficit.
The commissioner team seems to have adopted a different approach - the most recent estimate is a shortfall of $39.7 million.
Officials and Mrs Grant have been keeping Dr Coleman updated on the board's woes, including the ''fragility'' of its IT system, kitchen staff mediation, executive staff vacancies, rural GP funding upset and the development of a communications plan, the papers show.
Questions over the future of healthcare in Waitaki and Queenstown are among concerns deemed ''potential distractions'' by officials.
''You may wish to note the need for the commissioner and her team to remain focused on achieving the action-plan deliverables to improve the DHB's financial performance in the face of many potential distractions as noted...'' a suggested talking point ahead of a meeting with the commissioner team reads.
Dr Coleman was also advised on progress clearing a highly publicised waiting list of breast reconstruction surgeries, which involved settling a price with a private provider.
The ministry appears to have attached particular importance to the development of a communications plan at the board.
Officials suggested Dr Coleman reinforce the ''no surprises'' rule.
''There have been some issues that have arisen recently - for example, training accreditation for orthopaedics - that the minister's office and the ministry have become aware of via media.''
The Cromwell Medical Centre was unhappy with a shake-up of rural after-hours funding, and voiced opposition in local media, officials told Dr Coleman.
''Detailed advice'' had been provided to Dr Coleman's office for a discussion between Waitaki MP Jacqui Dean and the unhappy practice.
Mrs Grant kept Dr Coleman up to date on the board's search for a new head of finance.
Meetings of the commissioner team and ''key stakeholders'' included ''senior staff at the Otago Daily Times'', Mrs Grant told Dr Coleman.
Parts of the papers - including some of the ''risks'' to the board specified by Mrs Grant - have been withheld under various sections of the Official Information Act.
In respect of the $12 million cuts, officials do not specify who put them forward and when.
They appear in an August briefing. When contacted yesterday, Mrs Grant clarified the suggested cuts were associated with the previous board.
''They certainly predate the commissioner team appointment.''
Asked if Wellington officials were keeping a tight rein on the commissioner team, Mrs Grant said she did not see it that way.
''I wouldn't necessarily choose that wording, but you will appreciate that the minister ... signalled that he had serious concerns in relation to the Southern DHB, and so the appointment of a commissioner team was really one step in the process.
''I think it's fair comment to conclude that the minister continues to keep a close watching brief on what is happening at Southern,'' Mrs Grant said.
Risks to SDHB
• Decision of New Zealand Orthopaedic Association over trainees at Dunedin Hospital [appeal still pending]
• Waitaki health services
• Redacted
• Redacted
• Proposed restructuring of property and maintenance services
• Challenge of funding short-term initiatives for longer-term financial gain
• Redacted
• Rural health funding model: implementation of change
• Stewart Island primary care model
Source: Letter from Kathy Grant to Dr Jonathan Coleman, August 27
