Planned Care: delivering on the backlog

With the Ministerial Planned Care Taskforce within Te Whatu Ora working on a full review of Aotearoa’s current waiting list backlog, we’re sharing insights from a global health operations perspective on what the taskforce could recommend and what each system will need to focus on to improve waiting time standards in New Zealand.

Ensuring access to high quality care for patients at the right place and right time is the responsibility of the whole healthcare community. While the health workforce has faced significant pressure over the last few years, the efficient management of our waiting lists unlocks benefits across all parts of the health system. The scale of the problem is vast and requires immediate action, but there are solutions available. As we await the report from government, we aim to provide realistic context, drawing on international experience, for examples of ?how to tackle the backlog and ensure that the patient is always kept at the centre of the decision-making process.

A System Issue

The whole system working in unison and, more importantly, aware of its accountabilities is a critical component of understanding the dynamics at work that drive forward sustainable performance and accountability in planned care. Whole system working is essential for Regional healthcare teams over the next 12-24 months.

Key Functions:

Providers

Operational implementation is the most critical skillset in healthcare management in the pursuit of planned care recovery. There are 8 domain areas for providers that we believe the plan for elective care must address:

1. Data Quality - up-to-date waiting lists that are accurate and clean;
2. Leadership - accountability and business rhythm;
3. Governance - policy and treatment management compliance;
4. Training - up-to-date modular and clinical training refresh courses;
5. Clinical governance - clinical prioritisation guidelines and safety measures;
6. Booking & Scheduling - consistent use of chronological booking and advice & guidance to patients;
7. Capacity & Demand - balance in specialty profiling & updated clinical templates;
8. Workforce - clinical alignment, engagement and regional workforce strategies.

?Commissioners

Commissioners have significant strategic, planning and contractual responsibilities in planned care programs of work. A consistent approach to equity, pathway reform and contractual specification allows Commissioning teams to enable Provider organisations to focus on areas of highest value and opportunity.

Health regulation and system management

Enabling the system through proactive regulation and oversight across Aotearoa can bring clarity of purpose to health and care systems. We recommend an oversight system that targets these system-wide enablers:

Sequencing is the Key

Sequencing interventions over the next twelve months will be the most crucial factor in succeeding to reduce the backlog & gain control over waiting times. It may sound simple that the best approach for planned care is, in fact, planning, but it requires the right skills, approach and sequential prioritisation. Healthcare leaders can describe the issues they face, but the most successful planned care recovery programmes are able to sequence those activities and connect measures and interventions.

All parts of the health and care eco-system are vital in achieving success. From administrative validators through to tertiary surgical teams. Team effort, openness and collaboration will provide the foundations for success.

If you’d like to discuss further, get in touch with our KPMG Hauora team:

John Bennett : Principal, Health Industries SME, KPMG New Zealand [email protected]

Ben Longhurst , Manager, KPMG New Zealand [email protected]

Rachel Scott , Partner, KPMG Hauora Lead, New Zealand [email protected]

The information contained herein is of a general nature and is not intended to address the circumstances of any particular individual or entity. Although we endeavour to provide accurate and timely information, there can be no guarantee that such information is accurate as of the date it is received or that it will continue to be accurate in the future. No one should act on such information without appropriate professional advice after a thorough examination of the particular situation.