Waikato District Health Board breaches Govt's targets on waiting times to see a specialist

Waikato Hospital says it has a plan to fix its problems in orthopaedic surgery. Photo / Christine Cornege.

Waikato District Health Board, whose major problems with orthopaedic surgery have been exposed, breached national targets in October and November for the number of patients waiting too long to see a specialist.

It was also the worst-equal performer of DHBs nationally in the 12 months to September, according to the latest data published by Ministry of Health.

Waikato breached the Government targets in nine of those months, both on waiting times for first specialist assessment (FSA), and for treatment.

In September, nine of the 20 DHBs were in breach of the treatment target and eight were in breach of the FSA target. Others also had some patients waiting too long, but not enough to trigger what the ministry formally names a breach.

Lakes DHB was worst-equal with Waikato, at nine months in breach for first specialist assessments.

And Hawke's Bay was worst-equal with Waikato for treatment delays, with nine months in breach.

The targets are that patients have an FSA within four months of the hospital receiving the referral, if the referral is accepted; and performing elective surgery or other treatment within four months of the DHB confirming it can be provided.

DHBs decide how sick or disabled a person must be to receive taxpayer-funded elective treatment, by setting - and adjusting - their "financially sustainable thresholds".

Waikato Hospital data supplied under the Official Information Act indicates that in July, lower-priority patients in plastic surgery, gynaecology and respiratory medicine faced some of the longest waits for an FSA.

While priority one patients in gynaecology waited on average just nine days, those at priority three waited an average of 137 days - more that four months.

For priority three respiratory and plastics patients the average waits were 130 and 132 days respectively.

In orthopaedics, the most disabled patients waited on average 134 days for treatment. Some who were less disabled waited on average 165 days - more than five months. Some below the usual treatment threshold were treated, and their waits were shorter: 125 days on average.

The Herald revealed last month that 13 Waikato DHB orthopaedic surgeons criticised management in a September letter for blocking them from patients needing post-operative follow-ups and repeatedly postponing some elective surgeries so the FSA target could be met.

The management acknowledges problems in orthopaedics, but says the order to stop follow-ups was a miscommunication.

"We recognise we have a problem in orthopaedics, we are short-staffed and some of our equipment needed replacing," said the DHB's director of surgical and critical care, Kevin Harris.

He reiterated the improvement plans, which include the appointment of an elective services commissioner, the hiring of 12 more orthopaedic nurses, two surgeons starting in February and April and the hunt for a locum.

"Other DHBs and private providers have been helping us with both surgery and FSAs. We are expecting that these measures will help us continue to meet our elective surgery target.

"In fact the compliance in October and November [with the treatment target] and the support of neighbouring DHBs has enabled us to put more patients on the wait list, so ensuring that more patients get treated.

"Meeting FSA targets is a challenge but we are doing all we can to ensure we see the people most in need in the most timely way possible."

Health Minister Jonathan Coleman was not immediately available to comment today.

His spokeswoman said 50,276 Waikato DHB patients had received an FSA in 2015/16 compared with 37,462 in 2008/09 - a 34 per cent increase.

She said the ministry was working closely with the DHB "to help improve their processes and timeframes".

Last month, the minister highlighted the compliance of DHBs - when all counted together - with another of his electives targets, the one requiring an increase of on average 4000 elective surgeries a year.

"The improved access to elective surgery target has again been achieved, surpassed by 5 per cent. Delivering more elective surgery remains a key Government priority - the answer to increased demand is to do more," Coleman said.

This year's Budget provided an extra $96 million over four years to help DHBs meet the elective surgery volume target.

Elective services waiting-time breaches
District health boards' number of months in breach of the four-month target for a First Specialist Assessment in the year to September:
0 - Auckland
0 - Bay of Plenty
5 - Canterbury
0 - Capital and Coast
4 - Counties Manukau
6 - Hawkes Bay
5 - Hutt Valley
9 - Lakes
5 - MidCentral
2 - Nelson Marlborough
6 - Northland
2 - South Canterbury
7 - Southern
6 - Tairawhiti
2 - Taranaki
9 - Waikato
4 - Wairarapa
1 - Waitemata
5 - West Coast
0 - Whanganui
Note - A breach is 0.4 per cent of patients or more.

Number of months in breach of the four-month target for elective treatment:
5 - Auckland
3 - Bay of Plenty
6 - Canterbury
0 - Capital and Coast
0 - Counties Manukau
9 - Hawkes Bay
4 - Hutt Valley
9 - Lakes
7 - MidCentral
0 - Nelson Marlborough
8 - Northland
3 - South Canterbury
7 - Southern
0 - Tairawhiti
1 - Taranaki
9 - Waikato
3 - Wairarapa
0 - Waitemata
2 - West Coast
2 - Whanganui
Note: A breach is 1 per cent of patients or more.

- Additional reporting, Nikki Preston