Faster Access To Elective Services
Thursday, 31 May 2001
THE format of the Ministry of Health's quarterly report on elective services has been improved to provide more clarity and detail about the status of elective services.
The latest report, covering the period 1 October to 31 December 2000, incorporates league tables to demonstrate the relative performance of the District Health Boards (DHBs).
Ministry spokesperson Brenda Bromell says there has been a considerable improvement on the situation last year, with 81 percent of patients seeing hospital specialists within six months of referral.
"Greater collaboration between general practitioners and hospital specialists is yielding positive results, with 61 percent of patients seen by a specialist within two months of referral by their general practitioners.
Fewer patients either on residual waiting lists or given certainty of treatment are experiencing long waits for treatment. The report shows a 24 percent drop in patients waiting more than two years, and a 14 percent drop in patients waiting more than six months for treatment in the second quarter.
The number of patients waiting on residual waiting lists without certainty of treatment or a plan of care also dropped to 13,225 in December 2000, compared to over 40,000 in June 2000. This figure will fall to zero as these patients are assessed and informed whether or not they will receive treatment.
"Because most patients on residual waiting lists have waited for substantial periods of time, hospitals may not have an up-to-date assessment of their condition. Therefore, many patients have been referred to their general practitioners for an updated assessment, while others have been placed in active review to ensure they receive regular clinical review.
Ms Bromell says active review represents good clinical practice and better continuity of care with all patients scheduled for review within six months.
"This review is carried out with the oversight of a hospital specialist and is free to the patient. Currently, there are 24,430 patients in active review, although this figure is expected to drop and stabilise around 15,000 at any one time."
The report notes that hospitals have been funded for approximately 7,000 more operations than have been reported as completed in the first half of the 2000/01 financial year.
"Hospitals have had to build capability to undertake the extra procedures funded by the Government's additional $96 million for elective services. This 'gearing up' process has taken time, and the Ministry expects that hospitals are better prepared to deliver contracted services in the second half of the financial year.
A Government strategy is in place is reduce waiting times for public hospital elective services. The four key objectives of this are: · a maximum waiting time of six months for first specialist assessment; · all patients with a level of need which can be met within the available funding are provided surgery within six months of assessment; · delivery of a level of publicly funded service sufficient to ensure access to elective surgery before patients reach a state of unreasonable distress, ill-health and or incapacity; and · similar access to elective services, regardless of where a patient lives.
In order to achieve these objectives, seven strategies are in place. These include nationally consistent clinical assessment, an increase in supply of elective services, increase in capacity at public hospitals, better liaison between primary and secondary sectors and active management of the sectors' performance.
Active review is a care pathway for patients for whom elective surgery is considered to be the best option for their care; where · this service is not available within the current public funding or provider capacity; and/or · there is a realistic probability that the patient's condition may meet the threshold for treatment in the foreseeable future, ie the next year or two.
Patients in active review are provided with a plan of care that includes: · the probable diagnosis; · an agreed care plan; · the next action planned; and · who to contact if there is a problem.