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Major Changes For Orthopaedic Services

10 June 2004

Major Changes For Orthopaedic Services Across Greater Auckland

Months of planning have gone into ensuring that major changes to the delivery of adult orthopaedic services in the Auckland region go smoothly and safely in June.

The changes mean bone and joint surgery will be brought into line with other specialties, allowing most Aucklanders with straightforward requirements to get treatment closer to their homes.

The decisions about the future of orthopaedics in Auckland have been led by a multidisciplinary steering group and project team drawn from all three DHBs. They have considered in great detail the clinical criteria relating to the transfers and the flow-on effects for patients and all the other hospital services that are impacted by the changes.

By the end of 2004 most adult orthopaedic patients will receive both their acute and their elective orthopaedic care at their own DHB’s orthopaedic unit. Currently district orthopaedics catchments match neither DHB boundaries nor other medical and surgical service boundaries.

From June 14 patients needing either acute or elective orthopaedic operations may receive their care in a different hospital than in the past. The principle changes on this date are:

North Shore Hospital starts an acute trauma service for people living on the North Shore and in the eastern half of Rodney (currently undertaken on their behalf by Auckland City Hospital). At present North Shore only undertakes elective orthopaedic surgery.

Auckland City Hospital takes back those patients requiring elective surgery who live in the northern part of central Auckland whom it currently sends to North Shore.

Auckland City Hospital takes over the provision of both acute and elective orthopaedic services from Middlemore Hospital for the southern half of central Auckland, with the exception of people living in Otahuhu who will continue to go to Middlemore. This aligns orthopaedic boundaries with other medical and surgical boundaries between the two hospitals.

On December 13 people living in West Auckland (Waitakere City and the western half of Rodney) will be treated at North Shore Hospital, rather than at Middlemore as occurs at present. The transfer includes both acute and elective procedures.

All GPs in the Auckland region have been advised of the changes and all patients currently on waiting lists will be kept informed. The transition is designed to have minimal impact on patient waiting times. Patients who are transferred to a different DHB will not go to the bottom of the list.

Specialists from all three DHBs are working together to ensure that transfers of patients with existing relationships with one specialist to another are clinically safe and that all relevant material is also transferred. There will be continuing close contact between specialists in each patient’s case.

North Shore Hospital will not be treating a small number of patients with very complex (tertiary) acute trauma who will continue to go either to Auckland City or Middlemore Hospitals. St John Ambulance staff will make the initial assessments and take patients to the appropriate hospital.

Orthopaedic services for children remain unchanged.


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