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Thursday
Oct042018

WDHB Responds to My OIR Request

These are the questions I submitted to the Chief Executive of the Waikato District Health Board:

  1. What services have ceased to be provided by Thames Hospital over the last five years?
  2. What changes, if any, are planned to the services provided by Thames Hospital?
  3. What operational or managerial role changes, if any, are proposed for Thames Hospital?
  4. If there are any changes proposed under 2 or 3 above, can you please provide detail as to why they are occurring, and whether and when such changes have come before the Board for approval?

This is a request under the provisions of the Official Information Act, but I would appreciate answers as soon as practicable. I intend to reproduce in full whatever answers are provided on my blogsite – [billbarc.squarespace.com].

These are the responses provided today - 19 days after my request was submitted:

Dear Mr Barclay

Official Information Act Request - information about Thames Hospital

Thank you for your enquiry dated 9 September 2018 made under section 12 of the Official Information Act 1982.

You requested the following information noting your intention to reproduce it in full on your blogsite billbarc.squarespace.com

1.    What services have ceased to be provided by Thames Hospital over the last five years?

  •        Urology procedures e.g. cystoscopies no longer performed Outpatient facilities remain in place           Reason: Private provider withdrew the procedural services.
  •     Reduction of 5-day week overnight surgery. We now complete overnight surgery on Mondays and Tuesdays with the remainder of days being day case surgery. Reason to mitigate against high rate of on call for general surgeons to one week in three (or less when surgeons on leave)   

2.    What changes, if any, are planned to the services provided by Thames Hospital?

a)    Working with Women's health service at Waikato hospital to introduce day surgical services

b)    A further increase in chemotherapy services at Thames hospital.

c)    Development of a primary care partnership service delivery model to promote the use of primary care to people in the community with a focus on preventative and anticipatory care to reduce late presentations people for acute care in the Emergency Department. And the DHB also want to work more closely with primary care to improve access/reduce wait times for specialist care and diagnostics through a potential co-location service delivery model.

3.    What operational or managerial role changes, if any, are proposed for Thames Hospital?

a)    With the recent resignation/retirement of our long standing Thames Hospital manager, we are recruiting to this vacancy.

b)    At an executive level Thames Hospital sits in the directorate of 'Community Services and Clinical Support', Waikato DHB. In May 2018, the Executive Director for Community Services and Clinical Support left the DHB to take up a new role in Australia. This exit created a vacancy and the replacement Director has been in post since May 2018.

c)    A clinical nurse director role will be advertised and introduced in the next 2-3 months to increase the support for the nursing workforce plans for the future.

4.    If there are any changes proposed under 2 or 3 above, can you please provide detail as to why they are occurring, and whether and when such changes have come before the Board for approval?

 •       3 a) - the Manager of Thames Hospital and Community Services recruitment.

Reason - an integral role and therefore a 'replacement' that is within the delegation of authority of the Director for Community Services and Clinical Support therefore does not require Board approval.

  •  2 a), 2 b), 3 b), 3 c) - any changes to service delivery models not requiring delegated Board reporting are managed and approved at an executive management level, as per Waikato DHB Delegationof Authority policy.

Reason - to improve access to clinical services that can be safely and effectively provided closer to the Thames/Coromandel and Hauraki community.

 2 c) - development of a potential new service delivery model that is externally focused required approval from the Board to proceed to a RFP (Request for Proposal). This approval was sought and approved in February 2018

Reason - improve access, effective healthcare pathways and specialist support in partnership with our primary care providers.

5.    Other changes worthy of reporting are (list not exclusive):

  • An increase in the delivery of chemotherapy and other infusiontherapy at Thames Hospital for local catchment ie from 3 day per week to 5 day per week.
  • The purchase of a new CT scanner and introduction of CT colonography at Thame.
  • Incrrease the endoscopic procedures at Thames hospital.
  • 80%  - 100% occupancy of the 10 bed rehabilitation unit at Thames for patients receiving post-acute care delivered at Waikato hospital
  • Increased use of tele-health to prevent patient travelling to Waikato.
  • Set up of district nursing clinics on site at Thames hospital which has increased to deliveryt to the community around the Peninsula, by 30%.
  • The introduction of junior medical staff 'in training' of senior house officers, Monday to Friday (0800 - 2200 hours, seven days per week to support the senior medical staff in the inpatient units.
  • The introduction of a Clinical Nurse specialist role in the emergency department, seven days a week has been implemented in the last six months to support the care of lower acute Emergency Departrment presentations and reduce waiting times before being seen.
  • Five days a week on site ultrasound services.
  • Inpatient detox services introduced in May 2018.

I hope that this answers your questions and I would like to add that the DHB is committed to the future of Thames Hospital as a vital role in healthcare delivery for our Waikato DHB population.

Yours sincerely

David Nicholson

Acting Chief Operating Officer

Waikato District Health Board

 

I think you will agree that although Mr Nicholson has kindly provided a great deal of useful information, much of it not actually requested, the essential answer I was seeking is contained, albeit obliquely in the paras I have highlighted above, as follows:

"development of a potential new service delivery model that is externally focused required approval from the Board to proceed to a RFP (Request for Proposal). This approval was sought and approved in February 2018

Reason - improve access, effective healthcare pathways and specialist support in partnership with our primary care providers."

I think that answers my primary question, and that we are capable of putting two and two together to come up with the conclusion that discussions are under way with a view to developing a "service delivery model" based on Te Korowai, and that this proposal was approved by the Board in February. Perhaps Sally Christie should be asked to explain why she saw fit to avoid informing us, or was it possibly decided under 'public excluded?' Regardless, we have been ill-served by our so-called 'representative.'

We still do not know the point that has been reached in these negotiations - I will now attempt ito tease this information out, together with a semblance of the actual model being contemplated, and will keep you informed.

Ka kite ano!

 

 


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