More patients miss the cut in lower NI

Patients living in the central and lower North Island are most likely to be rebuffed from the operating table because their district health boards are struggling to cope with surgical demand.

The number of patients denied surgery is creeping up, and new Government figures paint a more detailed picture of the reasons New Zealanders living in pain are missing out.

Patients hailing from the DHB regions of Tairawhiti, Hutt Valley, Taranaki and Bay of Plenty, have the highest probability of being denied surgery. The Ministry of Health’s latest release of its National Patient Flow statistics, show that in December last year, those regions had rejection rates ranging between 10.7 per cent for Hutt Valley, and 11.9 per cent for Tairawhiti.

Those figures had significantly come down from the previous month however, which saw 22.9 per cent of all patients in the Tairawhiti region denied surgery for not meeting the threshold, and 12.8 per cent of both Hutt Valley and Bay of Plenty patients.

National figures, however, had slightly increased since the last release of data.

The Ministry of Health has said this would be likely at the start, as the quality of the data improved across DHBs.

The latest data shows that between October 1 and December 31, 2015, there were 161,881 referrals for a First Specialist Assessment – one of the first gateways to approve a surgery.

Of those referrals, 141,132 (87 per cent) were accepted, and 7762 (5 per cent) were declined as they did not meet the threshold.

Surgery thresholds between regions.

Patients in need of surgery are ranked by their pain and mobility and only make it on to the waiting list if their score is high enough to meet five different criteria thresholds.

It is a deliberate measure to ensure a DHB has the resources to perform a surgery within the vary national target timeframe. However, not all surgeries are declined because of a lack of resources.

The figures show 12,987 – or 8 per cent of patients – had their requests held or declined for other reasons.

Mostly commonly, that was so further investigations could be carried out, or because there was insufficient information from the GP, the service was no longer required or the patient was transferred to another DHB or another specialty.

This is the third release of such information since the Government bowed to public pressure over ‘‘phantom wait lists’’ and began recording those not having their surgery needs met.

Health Minister Jonathan Coleman said the information helped the ministry better understand the reasons people were missing out.

‘‘This is information that has never been available before.

‘‘It’s important for patients that the sector provides transparency, while DHBs and primary care will find this useful data to help them improve services.’’

He said the figures should be placed in the context of increased numbers of specialist assessments.

In 2014-15 there were 542,645 surgical and medical assessments carried out across the country – a 26 per cent increase on the 432,048 carried out in 2008-2009.

Coleman said surgical thresholds were a useful and valuable tool to help DHBs prioritise.

The integrity of the data was expected to improve with each quarterly release. ‘‘The Ministry of Health expects that the number of patients sent back to their GP for care as they did not meet the threshold, may rise to around 10 to 15 per cent.’’

Earlier this week, Labour health spokeswoman Annette King released her own figures of surgical rejection gleaned from Official Information released by the DHBs. She found that across the entire year, 45,000 patients were sent back to GPs, without getting to see a specialist.