More Certainty For Patients Seeking Elective Services
Steady progress continues to improve waiting times for electives services, according to the Elective Services Third
Quarterly Report released by the Ministry of Health today. The report covers progress in the third quarter between 1
January and 31 March 2001.
The report shows that over 340,000 people received outpatient services (no overnight stay required) in this period. More
than 83 percent of those referred to a specialist were seen within the Government's six month minimum standard.
In the year to 31 March 2000, over 124,000 patients received publicly funded emergency or elective treatment services
compared with 118,000 this time last year. An increased number of patients were booked or given certainty of treatment
in quarter three, in line with the Government's objectives for elective services.
Ministry of Health spokesperson Brenda Bromell said progress this quarter has been pleasing, with the number of patients
waiting longer than six months for treatment down 56 percent (to 16,378 patients) from quarter three in 1999/00. The
number of patients waiting greater than two years for treatment dropped by 69 percent in this same period.
Ms Bromell said the sector had worked hard to ensure all patients have a plan of care and certainty of treatment status.
By 31 March 2001, only 10,709 patients remained on residual waiting lists (down from 49,734 in March 2000) without
certainty or a plan of care. A number of DHBs including Auckland, MidCentral, Otago, and South Canterbury have
completely retired their residual waiting lists.
"Hospitals need up-to-date information about these long wait patients to ensure they receive appropriate care.
Therefore, many have been referred to their general practitioners (GPs) for an updated assessment, while others have
been placed in active review to ensure they receive regular clinical review.
"Active review represents good clinical practice and enhanced 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 25,562 patients in active review, although this figure is expected to drop as former residual
waiting list patients are reassessed and placed in more appropriate care categories.
Momentum within the sector continues to drive towards achieving the Government's policy objectives for electives
services. Increasingly, gains from work with primary care will flow through to improved timeliness for specialist
assessments and the secondary sector will continue to work to ensure patients receive assessment and treatment in a
For more information contact: Hayley Brock, Media Advisor, ph: 04-496-2115 or 025-495 989
Background Information 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 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.
Patients in active review are to receive a six monthly review of their condition. This review is free to the patient.
Work with primary care As well as consolidating gains within the hospital sector, work has commenced with primary care
providers such as GPs and iwi providers to reduce the number of patients requiring hospital based assessment and
treatment services. The bulk of the national referral and assessment guidelines have been released to assist in
determining relative priority of patients seeking assessment and treatment. In addition, local guidelines for the
effective management of low priority, common conditions by primary care are being developed for each DHB region.
Other work is being done by more than 80 primary-secondary working groups around New Zealand to enhance primary care
access to diagnostic tests and specialist advice. A number of national specialty forums have been held to share
innovations developed by these groups.