10th February 2022
Andrew McGregor
Private/Individual
Email:
[email address]; fyi-request-17691-
[email address]; [email address]
Dear Andrew
Official Information Act Request for – Guidelines/Protocols
I write in response to your Official Information Act request received by us 22nd December 2021 by way
of transfer from the Ministry of Health, you requested the following information:
1. What are the official Guidelines/procedures for urgent X-rays (24 hour)
2. What are the Guidelines/procedures for patients repeatedly admitted to Emergency
Department with severe epigastric pain/ and upper right and left quadrant pain
3. Guidelines/procedure for investigating possible Colonic Motility Dysfunction/Defecatory
Disorders/Anorectal Dysfunction
Counties Manukau Health Response:
For context Counties Manukau Health (CM Health) employs over 8,500 staff and provides health and
support services to people living in the Counties Manukau region (approx. 601,490 people). We see over
118,000 people in our Emergency Department each year, and over 2,000 visitors come through
Middlemore Hospital daily.
Our services are delivered via hospital, outpatient, ambulatory and community-based models of care.
We provide regional and supra-regional specialist services i.e. for orthopaedics, plastics, burns and spinal
services. There are also several specialist services provided including tertiary surgical services, medical
services, mental health and addiction services.
1. What are the official Guidelines/procedures for urgent X-rays (24 hour)
Please see information below.
•
Inpatients
1. An e-order is generated by the referring team into the electronic system. The referring
clinician needs to indicate in the form that they wish the x-ray to be done within 24
hours.
2. The MRT’s receive the referral and arrange for the patient to be imaged. This can be
by bringing the patient down to Radiology or if required using a mobile machine to x-
ray them in the ward.
Please note that this is for referrals where it is stated the requirement is urgent and to
be done within 24-hours.
•
Outpatients
1. The GP/referrer sends in an e-order (electronic) including the details of the 24-hour
requirement. Normal y the GP wil then give the outpatient a copy of the referral and
advise them to come to MMH as a ‘walk in’.
Counties Manukau Health
Private Bag 93311, Otahuhu, Auckland
T: 09 276 0000 | cmdhb.org.nz
2. When the patient arrives at Middlemore Hospital the Medical Radiation Technologist
(MRT) wil pick the referral up out of the system and scan the patient.
Please note that this is for referrals where it is stated the requirement is urgent and to
be done within 24-hours.
•
Walk in Service:
A walk-in service is available for Chest X-rays at Middlemore Hospital only.
• Monday to Friday 8.30 am to 4.00 pm. No phone cal required.
• Requests are to be sent by referrer via e-Referral – Radiology with the words
"WALK-IN" at the beginning of the text field under "clinical information".
• A copy of the e-Referral is to be given to the patient, and the patient sent to
Middlemore Hospital Radiology reception.
• For urgent chest X-rays, the request is to be clearly marked as urgent and a
telephone and email contact details to ensure priority reporting and rapid
turnaround of urgent reports.
•
All other X-rays
• All other X-ray requests must be discussed if required urgently.
• To request al other urgent (same day) X-rays, the liaison radiologist/registrar is to
be contacted by referrer
• If accepted a request is to be sent via e-Referral – Radiology.
• A copy of the e-Referral is to be given to the patient and they are asked to present
to Middlemore Hospital Radiology reception at their allocated time.
• All non-urgent X-rays, requests are to be sent via e-Referral – Radiology.
• For clinical queries, the liaison radiologist/registrar is to be contacted
2. What are the Guidelines/procedures for patients repeatedly admitted to Emergency
Department with severe epigastric pain/ and upper right and left quadrant pain?
We do not have a written guideline or procedure specifically for patients with upper abdominal
pain. Custom practice is to get a Senior Medical Officer review for patients who represent to
the Emergency Department with the same problem.
3. Guidelines/procedure for investigating possible Colonic Motility Dysfunction/Defecatory
Disorders/Anorectal Dysfunction
We do not have a written guideline or procedure for investigating possible Colonic Motility
Dysfuncion/Defactory Disorders/Anorectal Dysfunction. Treatment decisions for these issues
are based on clinical assessment and individual patient needs.
I trust this information answers your request. You are entitled to seek a review of the 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 may be published on the Counties Manukau
Health website. If you consider there are good reasons why this response should not be made publicly
available, we will be happy to consider this.
Yours sincerely
Dr Peter Watson
Acting Chief Executive Officer
Counties Manukau Health
