Auckland DHB
Chief Executive’s Office
Level 1
Building 37
Auckland City Hospital
PO Box 92189
Victoria Street West
Auckland 1142
Ph: (09) 630-9943 ext: 22342
Em
ail: [email address]
4 June 2020
Amy Van Wey Lovatt
Email: [FYI request #12108 email]
Dear Ms Van Wey Lovatt
Re:
Official Information request – endocrinology services
Thank you for your Official Information Act request received Friday 1 May 2020 seeking information
about referral pathways policy/guidelines for Endocrinology services from Auckland District Health
Board. Auckland DHB serves a population of more than 500,000 within the Auckland Isthmus.
In addition to providing Endocrine services to our own population, we provide Endocrine Testing for
the greater Auckland Area and a tertiary Endocrine Service often associated with Neurosurgical
services.
You requested the following information:
A copy of referral pathways policy/guidelines for Endocrinology services.
The Auckland District Health Board endocrine service utilises an e-referral system with primary care
and other specialists for all endocrine diseases in adults who are domiciled within our area and for
those requiring tertiary level opinions. Endocrine referral guidelines are available on the Auckland
Regional Health Pathway should GP’s require assistance with decision making regarding referrals.
These pathways are designed for website use with multiple pull down boxes that leads the GP
through their assessment and the referral process. The website does not translate to a hard copy,
and as there is thus not a document s18(e) OIA applies – the document requested does not exist.
For example, the Endocrinology Health Pathways include all the specific links listed below, while
other service pathways, e.g. resistant hypertension under General Medicine, refer GP back to
Endocrinology if secondary causes of hypertension are suspected.
Acute Endocrinology Assessment
Amenorrhoea
Calcium Supplementation
Endocrinology Advice
Fatty Liver
Gender Diversity and Transgender Health
Goitre in Adults
Hypercalcaemia
Hyperthyroidism
Hypothyroidism
Impalpable Thyroid Nodule
Long Term Glucocorticoids (Steroids)
Medications for Osteoporosis
Non-acute Endocrinology Assessment
Osteoporosis
Palpable Thyroid Nodule
Subclinical Hyperthyroidism
Testosterone Deficiency in Men
Testosterone Undecanoate (Reandron) Injections
Thyroid Function Tests
Thyroid Specialist Assessment
Vitamin D Supplementation
Zoledronic Acid Infusion
We also provide advice from an on call Endocrinology Registrar & Consultant Monday to Friday 8am
to 5.30pm.
Endocrinologists triage the referrals into five priority categories spread across General Endocrine
Clinics, Bone Clinics, Thyroid Clinics or Nurse Led Outpatient Procedures.
•
P1 – urgent cases that are potentially life threatening to be seen within 14 days.
•
P2 – semi-urgent cases that require a prompt diagnosis and management plan to be seen
within 2-4 weeks
•
P3 –to be seen within 8 weeks.
•
P4 – within 16 weeks
•
virtual advice with management care plan returned to GP within 48 hours
We see referrals within these timeframes.
The Endocrinology Department has protocols for the investigation and diagnosis of a wide range of
endocrine conditions. These protocols are evidenced based. This includes a full range of imaging
modalities available either locally or regionally.
A comprehensive range of laboratory tests are available. We also provide a range of test protocols
for specific conditions. Testing is carried out by an experienced team of Endocrine nurses at the
direction of the Endocrinologists within our department or in conjunction with the radiology
department (for example adrenal vein sampling). We have an experienced team of endocrinologists
who work together as a multi-disciplinary team to discuss difficult cases at regular departmental and
combined department meetings across the week.
I trust that this information is helpful.
You are entitled to seek a review of this response by the Ombudsman under section 28(3) of the
Official Information Act. Information about how to make a complaint is available at
www.ombudsman.parliament.nz or freephone 0800 802 602.
Please note that this response, or an edited version of this response, may be published on the
Auckland DHB website.
Yours faithfully
Ailsa Claire, OBE
Chief Executive