KEY POINTS:
South Auckland's health board has achieved a thumping increase in surgery numbers, without adding to staffing numbers or facilities.
The elective surgery rates at Counties Manukau District Health Board have risen 37 per cent from 2004 to 2007, with marked increases in cataract, hernia and tonsil surgery.
The board also reported yesterday an 18 per cent increase in annual patient numbers since 2001 - without increasing facilities.
The news brought glowing praise from Health Minister David Cunliffe yesterday. He told the Herald the result was "an outstanding achievement" for the health board, noting the hard work of its staff.
Between 2004 and 2007, elective surgery for Maori increased 21 per cent, nearly double the region's Maori population growth of 12 per cent.
Elective surgery for Pacific people increased 42 per cent despite the region's Pacific population growing by just 25 per cent.
The results mean people in Counties Manukau are getting equal access to elective surgery, compared to the rest of New Zealand, for the first time in the health board's history.
Some surgery outputs, including hip surgery, have declined in the three-year period, and hip replacements were also being performed at a lower rate than the national average, stemming from a lack of demand for that operation in Counties Manukau, rather than a barrier to access.
Mr Cunliffe said the example set by Counties Manukau was one he hoped other health boards would learn from.
Board chief operating officer Ron Dunham told the Herald yesterday the improvements were a reflection of the "very focused" push towards teamwork among staff at Middlemore and the Manukau Superclinic.
"Doctors, nurses, clerical staff, orderlies, cleaning staff and many others, they're all part of the team. And they've worked together to improve our performance."
Making those improvements had proved a challenge at times, he said, as limited operating theatre space, full wards and very busy outpatient clinics had added pressure to hospital staff.
"But our other team of community-based providers have also risen to the challenge, to make sure we support patients on discharge from hospital."
The health board was entering a period of facility expansion, he said, with additional beds and operating theatres planned for Middlemore over the next five years.
Today, Mr Cunliffe will open its new adult medical centre lobby and courtyard, and a new intensive care unit will get its first patients on June 29.
Construction is due to start at the board's other major facility, the Superclinic, on Monday.
It serves outpatients and is the base for much of the board's elective surgery.
Mr Dunham said the Superclinic's $10 million upgrade was designed to set Counties Manukau up to meet future demands "so that we are better placed to meet the expectations of our community".
Making better use of staff and operating on weekends are two of the key ways Counties Manukau has been able to increase surgery numbers in the past three years.
Chief operating officer Ron Dunham said the "outstanding achievement" was also due to a more focused effort by staff and streamlined processes that meant more operations could be done each week.
"We are better utilising the full capacity of the system," he said. "Basically we are doing more in the same seven-day week and that is just a team effort to do that really.
"We have always been one of the best performing health boards so it wasn't like we were at the bottom of the heap. We have always had a good elective output, it's just even better now."
While staff numbers had not increased, employee time was being used more efficiently, and in some cases that meant the weekends.
Some surgeries are now performed on Saturdays and Mr Dunham said the board was reviewing theatre time.
"We can't work people for seven days a week but if we get enough staff we can rotate them through and operating theatres can get used 24/7."
Mr Dunham said there had been a focused effort on building up staff levels - not through extra staff but filling gaps - and keeping them happy in the job.
"We did some patchwork around some of the occupational groups but the majority of the extra work has been done with existing staff. They are getting more operations done in the same time."
Some services were also being contracted out, although it was hoped everything would be done at Middlemore and Manukau hospitals in the near future.
