Appendix One “1. Cardiology workforce capacity (2018–2025) For each calendar year 2018–2025, please provide: 1.1 Workforce numbers For: • Cardiologists • Cardiac physiologists • Cardiac sonographers / echocardiographers • Al ied cardiac technicians • Cardiac catheter laboratory staff (nurses + technicians) Please provide: • Headcount • Employed FTE • Funded FTE • Vacant FTE • Vacancy rate (%) 1.2 Workforce shortages Any national-level estimates or modelling of numerical FTE shortfall for each profession, including forecasts to 2030 if available. 2. Cardiology wait times & service delays For each year 2018–2025: 2.1 Diagnostics • Median and 90th percentile wait times for: • Echocardiography • Exercise tolerance testing • Holter monitoring • CT coronary angiography • Cardiac MRI 2.2 Treatment and intervention • Average and median time from referral to: • First specialist appointment (FSA) • Angiography • Percutaneous coronary intervention (PCI) • Electrophysiology procedures • Number and % of patients breaching recommended timeframes for chest pain or suspected cardiac disease. 2.3 Acute presentations • Number of STEMI and NSTEMI cases per year • Median time-to-balloon (door-to-balloon) • Median time-to-lysis (if applicable) • Number of hospitals meeting/not meeting national performance indicators If routinely held dashboards are used, please provide them.
3. Stroke workforce & capacity data (2018–2025) 3.1 Workforce For: • Stroke physicians • Neurologists • Stroke nurse specialists • Thrombectomy-capable radiologists • Rehabilitation physicians Provide: • Headcount, FTE, funded FTE, vacant FTE, vacancy rate. 3.2 Stroke pathway performance For each year 2018–2025: • Median time from ED arrival to CT/CTA • Door-to-needle time for thrombolysis • Door-to-groin time for thrombectomy • % of stroke patients receiving thrombolysis • % eligible patients receiving thrombectomy • Availability of 24/7 thrombectomy across NZ (list hospitals) 3.3 Delayed presentations Any reports or dashboards showing: • Increased late presentation (outside thrombolysis window) • Causes identified such as ED delays, GP shortages, or reduced acute capacity
4. Acute medical services (2018–2025) Please provide: 4.1 Workforce For acute medicine specialists and acute assessment units (AAUs): • Headcount • FTE • Funded vs vacant FTE • Sickness/absence FTE lost 4.2 ED & AAU performance indicators • Median wait times for triage categories 1–5 • Number and % of patients leaving before being seen • Breaches of 6-hour ED target (if still monitored internal y) • Annual number of “unsafe staffing” or “red status” shifts • Internal capacity/demand dashboards (with redactions if required) 4.3 Bed capacity constraints For each year: • Number of medical beds • Average occupancy rate • Number of days >95% occupancy • Instances of bed block or “access block” • Transfers or diversions due to lack of acute capacity
5. Mortality risk indicators & adverse events (2018–2025) These questions seek aggregated, non-identifiable data. 5.1 Adverse events linked to delays Any aggregated national reporting on: • Mortality associated with delayed cardiology or stroke care • Adverse events linked to delayed imaging, diagnostics, or treatment • Critical or severe harm events recorded in the national incident management system relating to: • ED overcrowding • Acute bed shortages • Delay in FSA • Delay in radiology If no analysis exists, please confirm. 5.2 “Deaths within 30 days of acute presentation” If held, please provide annual aggregated totals for: • Acute cardiac deaths within 30 days of presentation • Acute stroke deaths within 30 days • Deaths linked to delayed transfer or ED wait longer than 6 hours (If not held, please confirm.)
6. Impacts of workforce shortages on acute outcomes For 2018–2025, provide any internal risk assessments or reports describing: • Links between cardiology, stroke, or acute medicine shortages and increased morbidity/mortality • Clinical safety concerns raised by district clinical directors • Any warnings escalated to national leadership or Ministers • Any reviews of “near-miss” or sentinel events relating to acute care delays If none exist, please confirm.
7. Ministerial briefings (2020–2025) Please provide: • A list of al briefings, memos, or reports to the Minister of Health relating to: • cardiology capacity • stroke pathway performance • ED overcrowding • acute medical shortages • any acute care risk or service degradation • And provide the first five documents in each category.
8. Format • Please provide numerical data in CSV or Excel where possible. • Provide documents as PDF. • If another agency holds specific information (e.g., National Stroke Network), please transfer under s14.”
