Positive solutions are needed to address growing elective healthcare needs across Aotearoa

With many health targets to meet and a stretched healthcare workforce across hospitals and primary care, it’s time to start thinking collectively on how all facets of our health system can work together to address the backlog of surgical waitlists.

Te Whatu Ora has issued a directive that by the end of 2023, no patients will wait longer than 12 months for treatment, from the date the decision to treat is made. To reduce the backlog, hospitals are scheduling surgical procedures on the weekends.

According to Te Whatu Ora’s Elective Services Patient Flow Indicators Web Tool*, May 2023 was the first time since December 2022 where the number of patients who were given a commitment to treatment but not seen within the four-month timeframe fell below 40%.

Bindi Norwell, ProCare Group CEO says: “We need to take a solutions-focused approach to planned care in order to take the pressure off hospitals and get the community the care they need.”

“For our health system to thrive we can’t work in silos. It requires all of us to work together and take a proactive approach to keeping our community as fit and healthy as we can, to avoid the need for invasive measures such as surgery. Of course, there will be times when this is needed, and in these cases, we need to support patients to navigate the various services as and when they need them seamlessly,” concludes Norwell.

Dr Craig King, Chair of ProCare Network Board says: “While we acknowledge the waitlist targets is a step in the right direction, 12-month wait times are still unacceptable. It is our belief that primary care could be better funded and equipped to help get a better result.

“Empowering general practice teams to access investigations and treatments that already exist in the community would allow them to assess their patients against the agreed and evidence based clinical pathways – something we have already proposed as part of our primary care feedback to the previous Minister’s Planned Care Taskforce,” continues Dr King.

Undertaking such an assessment would mean general practitioners can provide the analysis of unmet needs, as well as intervening early to give certainty and in some cases alleviate the suffering and stress associated with waiting for planned care services. This could help prevent the need for referral to hospitals, and in some cases, the need for elective surgeries.

Utilising primary care to ease the workload of other healthcare providers is not new. Recently ProCare piloted a GP MRI programme, training and enabling GPs to successfully and safely order MRIs for their patients. Through this pilot, there has been a reduction by more than 50% in wait times.

ProCare is also acutely aware that the current backlog of people waiting for hospital-based planned care services are creating flow on impacts for all patients wanting to access primary care, as general practices are having to work harder to support patients in pain.

A key determinant of the success in enabling primary care to address the backlog of surgical waitlists, is having the funding required to train, hire and support the workforce required to deliver these extra services.

Enabling this would be a win for patients, a relief for general practices and hospitals, and it would be a positive, solutions-based move to improve the performance and sustainability of hospital services.

*You can find the webtool here https://tewhatuora.shinyapps.io/ESPI_app/. The latest data that is publicly available is May 2023.

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