ELECTIVE ORTHOPAEDIC LIMITATIONS IN NDHB March 2018 LIMITATIONS

ELECTIVE ORTHOPAEDIC LIMITATIONS IN NDHB March 2018

LIMITATIONS � Increasing Acute Load � Hospital bed capacity � Available theatre sessions � Increasing population, elderly, comorbid, increasing referrals…

Theatre sessions (per week) � Elective: approx 10 -12 half day sessions per week � Aim 10 -12 joints per week � 3 -4 joints per day � Acute : aiming for 8 half day sessions per week � 1 Kensington list per fortnight � 1 KTA list a month

Current Surgical waiting list Ministry agreement only to add <90 patients per month to surgical wait list from March 2018.

Joint replacements 700 600 500 400 MOH target 300 NDHB delivery 200 100 0 2015/16 2016/17 2017/18

Standardised Intervention Rate Surgical Procedures 2016/17 Northland Auckland Waitemata Counties THJR 1. 16 0. 50 0. 99 0. 84 TKJR 1. 23 0. 81 1. 28 1. 04

REFERRALS e-referrals increasing 8% per year e referrals 2250 2200 2150 2100 2050 e referrals 2000 1950 1900 1850 2015 2016 2017

Expectations mismatch � GP anger and frustration Patient anger and frustration Surgeon anger and frustration � UNMET NEED � �

Working Wiser � Accept referrals for those we are in a position to consider being able to offer treatment

2017 e- referrals 80 70 60 50 Ortho % FSA 40 Spine % FSA 30 20 10 0 Jan Feb Mar Apr May Jun July Aug Sept Oct Nov Dec

Nationwide Ministry Scoring Tool

Recent Joints Scoring � 35 most recently scored THJR/ TKJR � Score range: 55 -90 � Surgical Booking List ( > 70) DC to GP ( score < 65) Review 6/12 � � : 13 : 11

MAP PROGRAMME � � Hips Knees Shoulders Spines