Te Whatu Ora numbers show Tairāwhiti doing well in ED, cancer treatment

Hospital Main Entrance

There’s a better prognosis for Tairāwhiti cancer patients in the latest Health NZ/Te Whatu Ora report.

Every eligible cancer patient received their first treatment within 31 days of a decision to treat by a health professional during the first quarter of the 2023-2024 year.

The cancer treatment measurement tool is one of the most scrutinised categories within clinical performance metrics data, with the most recent quarterly report just being released by Te Whatu Ora.

The 100 percent rate compares with an average national rate of 84.8 percent, and a Tairāwhiti percentage of 91.1 percent for the same (first) quarter of the 2022-2023 year.

The nationwide target is 85 percent.

During discussions held by the board of the former Hauora Tairāwhiti, it was often stated that successful coordination with Waikato Hospital — where many Tairāwhiti patients receive treatment — was an important factor.

The quarterly report said the public health system was close to achieving the target but improvement in cancer treatment was still being prioritised.

This included the establishment of a National Clinical Cancer Network.

Nine districts out of 20 improved this quarter compared with quarter one of 2022/23 but Tairāwhiti was the only region to achieve a 100 percent rate.

Shorter stays in Emergency Departments (EDS) was another successful category for Tairāwhiti.

EDs are busy throughout the country and Te Whatu Ora-Tairā whiti recently asked the public not to present to ED with non-urgent issues which made for longer waiting times.

The quarterly report said 94.5 percent of Tairawhiti ED patients were admitted, discharged, or transferred within six hours compared to a national rate of just 67.6 percent.

West Coast and Dunedin-Southland were the only regions to improve from the corresponding quarter of last year. Tairāwhiti  fell from 96 percent to this year’s 94.5 percent.

The quarterly report said long stays and overcrowding in EDs were linked to negative clinical outcomes and distress for people.

There had never been sustained achievement of shorter stays in ED in the public health system since its introduction in 2009/2010.

Any achievement in this area was significantly affected by the availability of hospital beds.

“Currently hospital inpatient occupancy in our inpatient beds regularly exceeds 90 percent to 95 percent, which is too high for improved patient flow.”

On the other side of the ledger, immunisation rates for children aged up to two years have fallen away significantly.

The percentage of children who turned two during the quarter and are recorded as fully immunised for their age on the National Immunisation register has plummeted from 82.1 percent to just 68.4 percent.

The national average is 83.0 percent while last year’s national figure was 82.2 percent.

Six other regions recorded small declines in immunisation rates while Hawke’s Bay fell from 82.8 percent to 73 percent.

The quarterly report said improving immunisation rates required a fundamental shift in placing Māori, Pacific and disabled people at the centre of any redesign of the immunisation system to “create more flexible and culturally focused models of care that address current equity gaps”.

The number of Tairāwhiti patients not receiving planned care within four months of being given a commitment to treatment increased to 771 from 228.

The number of patients nationwide waiting longer than four months for treatment has increased from 26,610 in September 2022 to 29,266 in September 2023.

Performance improved in eight of the 20 districts from the first quarter of last year to the first quarter of this year.

The number of Tairāwhiti residents waiting more than four months from referral for a First Specialist Assessment (FSA) increased from 355 to 1001.

Nationally there has been an increase in the number of patients waiting more than four months for a FSA from 35,863 in September 2022 to 59,817 in September 2023.

The total number of Tairāwhiti people who have been waiting on a planned care waiting list for a procedure for more than 365 days from the time they were ready for treatment increased significantly from 5 to 279.

Seven other districts recorded increases.

The quarterly report said there was a focus to deliver more planned care through public hospital, private hospital and primary settings with collaboration across regions and other initiatives to increase capacity such as theatre optimisation, clinical pathways, and clinical prioritisation.

ED presentations in Tairawhiti increased from 6052 to 6508.

In all, 17 districts showed an increase in ED presentations with a national increase of 6.3 percent between the two periods.

The quarterly report concluded hospital specialist and primary care services were under pressure with increasing demand for services as the population continued to grow, including net migration increase.

As it grew it also aged and the number of people with chronic and complex conditions also increased.

People over 80 years of age use up to 10 times more hospital bed days than other adults, and this is the fastest growing proportion of the population.

The report says that increasing capacity in the health workforce, primary care services and hospitals and specialist capacity to meet the needs of communities is the focus of Te Whatu Ora.

“Building this capacity to provide timely primary care and address long wait times and waitlists for specialist care will take time as new staff are trained or recruited from overseas and additional capacity is created.”