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DHB Consultation Begins On Laboratory Services

Joint Otago And Southland District Health Boards Consultation Begins On Laboratory Services

The Otago and Southland District Health Boards (DHBs) have begun consulting with the Otago and Southland communities as of Friday 2 July, on their proposals for changes to the contracting and delivery of laboratory services in the region.

The DHBs have distributed a discussion document to agencies with an interest in the issue, including GP practices, laboratories, midwives, rural health trusts, specialists and hospital services. Issues identified in the document include the need to ensure sustainability of laboratory services through greater efficiency; improved quality of laboratory services to referrers; managing the growth of laboratory tests to sustainable levels; and ensuring that laboratory services are able to meet the increasingly complex demands for laboratory tests for the future.

One key change the consultation document proposes is a consolidation of privately and publicly owned laboratories.

"We believe a consolidation could offer several benefits to the way laboratory services are provided in the Otago and Southland regions, including an improved capacity for workflow opportunities as well as savings that we can re-invest into other health services," Mr Rousseau said.

"It is important to stress that consolidation is not about restricting services - it is all about enhancing services for patients and referrers, and establishing a sustainable laboratory service for the future," Dr Paul said. The document has been circulated to over 300 agencies with an interest in laboratory services issues in Southland and Otago.

Consultation closes at 5pm on Monday 9 August 2004



1. Why do the DHBs want to change the way in which laboratory services are currently delivered in Southland and Otago?

The Southland and Otago DHBs believe that there is a level of under-utilised laboratory infrastructure and capacity in Southland and Otago. Throughout the two DHBs there are currently eleven (11) laboratories providing services, and because laboratories have high costs, we believe that some consolidation of the laboratories could result in savings that would be reinvested into other health services.

Consolidation will not result in any detriment to issues of service, quality, or access. We will continue to ensure the clinical acuity and timeliness needs of referrers, that accurate results are delivered electronically to referrers, and that patients' have access to collection.

2. How will these proposals improve the delivery of laboratory services in Southland and Otago?

The Southland and Otago DHBs believe that there will be several improvements to the delivery of laboratory services. The consolidation of capacity will improve workflow opportunities (over a 24 hour / 7 day period) allowing tests to be undertaken throughout the day and night. It will also enable the better management of workforce issues, including workforce sustainability, and will allow greater integration between primary and secondary testing and results. Key outcomes of this should include the ability to undertake more tests in Southland and Otago, and better health information on the populations.

3. What would be the main changes to laboratory providers if the proposed changes occur?

A consolidation, possibly through a joint venture model, of the privately owned (Southern Community Laboratories and Medlab South) and publicly owned laboratories (Invercargill Hospital and Dunedin Hospital laboratories) could result in a reduction in the number of providers of laboratory services. However, there would be no diminution of quality, service, or access.

4. What differences would laboratory referrers (Medical Practitioners, Midwives etc) experience if the proposed changes occur?

It is our intention that laboratory referrers will experience a more collaborative, rather than competitive, laboratory service.

5. What differences would patients experience if the proposed changes occur?

Patients should expect no change in their access to quality laboratory services. On the contrary the patients would experience seamless care as the potential to duplicate and repeat test will be greatly diminished - essentially an enhanced outcome to the patient.

6. Why are the Southland and Otago DHBs' proposing this joint approach?

The Southland and Otago DHBs are working collaboratively in several clinical and administrative areas. We believe that the DHB environment is appropriate for collaboration and we wish to extend this to a wider range of clinical services. Further, the consolidation of the infrastructure will ensure long term sustainability from a clinical and work force perspective.

7. What impact might these proposals have on rural health issues?

The Southland and Otago DHBs in collaboration with PHOs and the laboratory provider(s) will work with GPs and other rural health providers to identify their needs for laboratory services, including access to specimen collection. There will be enhancement of the service from both a collection and reporting perspective.

8. Would the proposal change the amount of range of tests undertaken?

There are no plans to reduce the range or availability of tests available to referrers, either in the primary or the secondary environment. We anticipate that more tests, particularly sendaway (non-schedule) tests, will be immediately available in Southland and Otago.

9. How will the proposed changes impact on PHOs?

The DHBs are keen to work with the PHOs in Southland and Otago and the laboratory provider(s) to support best practice initiatives, including Continuing Medical Education, for all referrers.

We believe that the contribution laboratory testing can make to diagnosis is a rapidly evolving science and the DHBs would like to see an improved quality of service to referrers to support them to stay up to date with what is considered to be best practice.

10. Once the consultation is completed on 9 August 2004, what happens next?

The consultation will be collected on behalf of the DHBs by the South Island Shared Service Agency Limited. All feedback received will be acknowledged in writing. Once the date for feedback has passed, analysis of the issues raised in the feedback will be undertaken, and full consideration will be given to its impact on the proposed strategy.

A final strategy paper will then be prepared for the Southland and Otago DHB Boards for their consideration. Each member of the two Boards will also be provided with a full copy of all feedback received.

11. When might it be expected that changes to laboratory service delivery would occur?

Subject to the approval of the Southland and Otago DHB Boards, it is out intention to implement any changes to laboratory services by May 2005.

12. Who has been sent this proposal for feedback?

The consultation paper has received wide distribution, including primary referrers, including GPs, Midwives, Primary Health Organisations, South Link Health, Rural Trusts, other DHBs, Hospital Managers and clinicians.

13. What is the guarantee of continued service if there is downtime/redundancy in a single set-up Through the development of closer working relationships between the Otago and Southland DHBs there will be backup for each DHB 's service from the other DHB. Through IT consolidation and infrastructure integration the potential for effective back up from each side will be greatly enhanced.

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