Outsourcing more surgery ‘inevitable’ | Otago Daily Times Online News


The combination of a second Covid-19 Level 4 lockdown and planned strike action by nurses make it inevitable the Southern District Health Board will have to outsource more operations, a report to the board says.

The SDHB has struggled ever since the first Covid-19 lockdown to catch up with elective surgeries postponed at that time, and it still has substantial waiting lists for several surgeries, most notably orthopaedic, ear nose and throat and general surgery patients.

Specialist services executive director Patrick Ng said to both maximise revenue and to meet Ministry of Health surgery targets, the SDHB would need to step up how many operations it did in this financial year.

“It is inevitable that more outsourcing will be required … once we come out of lockdown, we will therefore gear up to complete higher levels of outsourcing than previously planned for.”

The SDHB’s demand for outsourced operations would probably be higher than the capacity in the South, Mr Ng warned in his report.

“We will review options for outsourcing out of the district, noting that other DHBs are likely to be in a similar situation and placing higher than usual demands on the outsource providers across the country.”

The SDHB already sends three orthopaedic patients a week to Timaru for treatment.

As well as looking further afield, greater efficiency in how the SDHB utilised its operating theatres could also make a difference to electives waiting lists, Mr Ng said.

A recent survey of how the board managed acute surgery capacity suggested it scheduled between 25 and 28 hours less acute surgery than it should each week.

“This in turn translates into elective cases being cancelled for priority acute cases,” Mr Ng said.

“An additional eight hours of acute list time is being planned for Saturdays initially, and we will progressively recruit to cover this, plus add four hours to the end of a regular acute list each working day.”

While running operating theatres for longer was expensive, outsourced surgery was three times more expensive than doing the same operation in-house, so the increased workload should pay for itself in other benefits, Mr Ng said.

“We are aiming to have sufficient resources recruited (or alternative arrangements made) to be able to run the Saturday lists permanently by the end of the calendar year and sufficient perioperative staff employed to be able to supply the Monday to Friday additional acute hours by early in the next calendar year.”

Last month, orthopaedic staff held a workshop to debate ways to reduce the service’s wait list, but Mr Ng warned there were few “quick wins” to be found within the SDHB itself.

“We do need to get more of the complex surgery done in order to reduce the long waits on our wait list.

“We will re-engage with Southern Cross on the possibility of completing more of this complex surgery both in Christchurch and at Queenstown, when they open their new private hospital there later this year or early next year.”


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