Hospital Services
North Shore Hospital Campus
Shakespeare Road, Takapuna
Private Bag 93-503, Takapuna
Auckland 0740
Telephone: 09 489 0527
28 March 2022
J. Mitchell
Via email: [FYI request #18715 email]
Dear Jared
Re: OIA request – Cover for senior doctor and junior doctor vacant shifts
Thank you for your Official Information Act request received 28 February seeking information from
Waitematā District Health Board (DHB) about vacant doctor shifts.
Before responding to your specific questions, it may be useful to provide some context about our
services.
Waitematā is the largest and one of the most rapidly growing DHBs in the country, serving a
population of around 650,000 across the North Shore, Waitakere and Rodney areas. We are the
largest employer in the district, employing more than 8,900 people across more than 80 locations.
In addition to providing care to our own resident population, we are the Northern Region provider of
forensic mental health services and child rehabilitation services, plus the metro Auckland provider of
child community dental services and community alcohol and drug services.
In response to your request, we are able to provide the following information:
1. How many RMO (junior doctor) shifts were left uncovered/vacant for each month of last
year?
2. How many SMO (senior doctor) shifts were left uncovered/vacant for each month of last
year?
We are providing a combined response to questions 1 and 2.
There is no electronic rostering system for RMOs or SMOs that holds the information requested.
Providing information on shifts left uncovered/vacant over the last year would require the manual
collation of information by Waitematā DHB and shared service agency staff across a number of
services.
This is not information that is centrally collected or coordinated as each service would manage these
instances differently in relation to the type of shift the RMO or SMO was scheduled to be working.
Manually collating the information requested would take staff away from their core duties and
prejudice our ability to provide essential services at a time when our clinicians, managers and staff
are concentrating on efforts to manage the current COVID-19 outbreak.
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The information you are seeking would be difficult to collect in a business-as-usual environment and,
in some instances, may not be available with any data provided likely to be incomplete and / or not
accurate.
We have considered whether charging or extending the timeframe for responding to these aspects
of your request would assist us in managing this work and have concluded it would not. We have,
therefore, determined to refuse these aspects of your request under Section 18(f) of the Official
Information Act due to substantial collation and research.
You have the right to seek an investigation and review by the Ombudsman of this decision.
Information about how to seek a review is available at
www.ombudsman.parliament.nz or
freephone 0800 802 602.
3. What steps/processes are taken to fill these vacancies?
The steps to fill RMO vacant duties are usually as follows:
where cover is not available for vacant duties in ordinary hours Monday to Friday 0800-1600
(8am-4pm) and we cannot get an additional RMO or SMO to provide cover, a vacant duty
may be cross-covered by other RMOs working the day shift. Cross-cover is where a doctor
provides care or oversight to additional patients alongside those allocated that day.
where the vacant shift involves after-hours which can be the long-day portion between
16:00 – 22:00 (4pm-11pm), nights and weekends then additional duties (equivalent of
overtime) are offered to RMOs employed within the DHB who have worked in the service
previously, noting that additional duties are voluntary
where the DHB is unable to source cover via additional duties from staff already employed
at the DHB then locum cover is sourced. For RMOs the majority of locums (employed on a
casual basis) are permanent employees working at one of the other two DHBs in the
Auckland metro region. Given this, their availability is limited to after-hours and weekends in
most instances
in certain circumstances escalated additional duty rates may be offered to assist with filling
vacant shifts where this has been approved by the DHB. However, this is generally limited to
peak periods such as winter or where there are permanent staff shortages in particular
services during peak demand.
For SMOs:
SMO shift vacancies do not always require cover as it depends on work that is
scheduled. SMOs may be scheduled to work a non-clinical day, run a clinic, complete
ward round, a theatre list or complete training. Each of these vacancies would be
managed differently and may or may not require cover.
4. What procedures are in place during these uncovered/vacant shifts to ensure the safety of
both patients and staff?
Where RMO cover is unable to be sourced for vacant shift and where the vacant shift is known prior
to the shift start, i.e. the service has had time to plan and prepare, the service contingency plan will
be implemented. There is no generic contingency plan, this will be different for services dependent
on patient numbers and the acuity of patients on the particular day but it may include (but is not
limited to);
redeployment of staff or services
a step down process for cover such as an SMO covering the Registrar and/or a Registrar
covering a House Officer vacancy
a reduction in planned care such as deferring clinics or elective surgeries.
I trust that the information we have been able to provide is helpful.
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Waitematā DHB supports the open disclosure of information to assist community understanding of
how we are delivering publicly funded healthcare. This includes the proactive publication of
anonymised Official Information Act responses on our website from 10 working days after they have
been released.
If you consider there are good reasons why this response should not be made publicly available, we
will be happy to consider your views.
Yours sincerely
Fiona McCarthy
Director People and Culture
Waitematā District Health Board
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