Planned Care Update 27 June 2022

Welcome to the first of what will be regular updates from the Planned Care Taskforce.

Te Whatu Ora - Health New Zealand and Te Aka Whai Ora - Māori Health Authority established the Planned Care Taskforce to address the growing volumes of people waiting for planned care (elective services) through a public hospital.

The group is chaired by Counties Manukau District Chief Medical Officer and colorectal surgeon Dr Andrew Connolly. Membership includes significant leadership from throughout the health system including clinical, funding and commissioners, primary care, hospital and specialist services and Māori health and equity members.

Planned care and timely access to services such as specialist assessments, diagnostic tests and surgery is important to all New Zealanders. Waiting lists were already long before COVID-19 and will increase further as the predicted Winter 2022 impact of COVID-19, flu and other winter illnesses along with staffing challenges affects hospital services.

Despite these challenges the Planned Care Taskforce is working on short- and longer-term strategies and opportunities both regionally and nationally to:

• reset and restore planned care health services in a sustainable way to align with changes happening within the health system as part of the health and disability reforms.
• capitalise on work underway in some regions that could be scaled up to offer rapid benefits to improve waitlist access in other areas.

The Taskforce has a clear focus and a genuine commitment to wanting to see change.

The Taskforce looks forward to updating you on progress that will deliver a clear understanding of who is waiting and why, where there is capacity, how we can make best use of public and private resources and how that can be applied for the best clinical outcomes for New Zealanders.

The Taskforce has written to Te Whatu Ora districts and asked them to:

• Review the clinical information of people waiting the longest– those people who have been waiting longer than 365 days and then those waiting longer than 180 days. Where evidence suggests a deterioration or change in clinical needs, a review of the patient may be necessary; otherwise, treatment must be scheduled as soon as possible.
• Any patient who is a high priority case and has waited longer than 120 days needs to have their clinical
  needs reviewed with urgent action taken to treat those cases who are of a genuine high clinical priority.
• Districts are to work regionally to maximise resources such as theatre capacity and diagnostics and to use
  the private sector for diagnostic tests and procedures as well as extend public sessions wherever possible.
• Gathering up-to-date data is a key piece of this work with the Taskforce supporting districts to analyse wait
  list data, specialty-by-speciality. This will then enable a more targeted approach for those specialities with
  longer waitlists using a regional and national solution to access treatment for patients
• Districts are to put in place regular reporting and monitoring of patients who need follow-up appointments
  to make sure these are clinically required, with an emphasis on what value a patient gains from a followup.
  Reducing unnecessary consultant follow-up appointments will help create more capacity for first
  specialist appointments.

Workforce

The Taskforce is supporting Te Whatu Ora’s Health Workforce Directorate drive to recruit overseas trained staff and attract previously registered New Zealand clinical staff to return to practice. This is an immediate step, and more work is underway nationally that the Taskforce will support in any way it can.

Mapping out capacity with the private sector

The Taskforce is working with private providers to map out private sector capacity and how it can be used to
improve patient access across the country.

Work is underway to put in place a long-term strategic plan to provide effective outsourcing and reduce wait
list backlogs.

This will provide visibility of national capacity and enable a partnership model for both public and private
health providers.

Primary Care

A working group has been set up for primary care, led by Taskforce member and GP Dr Jeff Lowe to support
clinical priority waitlist analysis.

Leading on equity

As an immediate step, districts are to address health inequities amongst long waiting Māori and Pasifika
patients and prioritise those patients. In addition, plans to avoid inequity of access for these patients who
have been waiting longer than 365 days and cannot be referred to a private provider for whatever reason
must be given public access to treatment as a priority. Māori are disproportionately represented in those
patients waiting greater than 365 days compared with other groups.

An expert group working with the Taskforce is being established to advise on ways to aid equity, reduce
barriers and develop strategies to avoid inequity of access for patients.