Dear Accident Compensation Corporation,

In October 2015, I was advised by a respected orthopaedic shoulder and arm surgeon that the injuries from several falls that have caused multiple areas of injuries extending from my cranial nerves in my head/face down my cervical and thoracic spine, right brachial plexus, right chest muscle, and scapular right shoulder upper arm, elbow, forearm, wrist, hand and fingers, due to the involvement of symptoms to the trigeminal cranial nerves, needs to be first assessed for treatment and rehabilitation purposes by a neurosurgeon, since neither an orthopaedic surgoen, nor a neurologist are appropriate specialists to assess and treat my accident related conditions.

They indicated that any unassessed and untreated comorbid causes of injuries that could elicit similar symptoms to those with which he was considering offering surgery for at the elbow and or shoulder level, that stem from injuries to either the cranial nerves and or exiting nerve roots of the cervical and thoracic spine would first require assessment and treatment if required, prior to further consideration being given to treating by surgery the peripheral shoulder and elbow symptoms. In that way the neurosurgeons diagnosis will aid in their differential diagnosis in treating the elbow and shoulder.

In trying to discern between the roles distinction and demarcation between the fields of neurosurgery, orthopaedic surgery and neurology I came across the following website statements on Auckland Medical Specialists Neurology Servicesweb page that can be found athttps://www.healthpoint.co.nz/private/ne...

"Auckland Medical Specialists Neurology Services
Referral Expectations
Your GP will refer you to see a neurologist if they think you have a problem that involves the nervous system and that needs specialist help in diagnosing or treating that condition.

A history of your symptoms will be taken as well as a review of any medications you are on (so please bring these with you). The doctor may also review any old notes and previous problems you have had.
You will then be examined which may include a general examination as well as an examination of the nervous system. An examination of the brain and nerves may include testing your memory and concentration as well as other aspects of thinking processes. It also involves examining how well the nerves to your head and body are working. You may have further testing to establish the diagnosis.

The specialist will discuss with you the possible diagnosis and what further tests or treatments are recommended. They will correspond with your GP about your diagnosis, results of tests and a treatment plan.

You may also be referred to a physiotherapist or occupational therapist. A physiotherapist provides physical therapy to assist with any disability you have. An occupational therapist reviews what equipment/advice will assist in activities of daily living if you have a disability.

ACC Patients
A patient's referring doctor must first send a letter to ACC requesting coverage for a neurological consultation. A Claims Manager will then be assigned to the patient and will provide the patient with a purchase order number to cover the consultation. We can not see any ACC patients without their purchase order number from ACC.

The exception here is with ACC Nerve Conduction Studies - no purchase order number is required for these specific tests."

My OIA request partially relates to this paragraph on the Auckland Medical Specialists Neurology Services website, as it relates to ACC's provision of services to neurology specialists, and by way of extension, neurosurgeons, and ACC's previous current policies and processes associated with ACC's and public District Health Boards service delivery to ACC claimants whom have issues that require neurosurgical assessment and treatment;-

"ACC Patients

A patient's referring doctor must first send a letter to ACC requesting coverage for a neurological consultation. A Claims Manager will then be assigned to the patient and will provide the patient with a purchase order number to cover the consultation. We can not see any ACC patients without their purchase order number from ACC."

Please provide me with a copies of:-

1. All policy documents, inclusive of all Executive Leadership Team Issues Papers, and equivalent Papers thereof, that relate to;

(i) when, and why ACC first implemented the requirement for an ACC claimant's GP or alternate medical advocate/specialist to obtain a purchase order number from ACC for a consultation with a neurosurgeon,outside of the exception of nerve conduction studies.

(ii) all other matters pertaining to ACC having to supply a purchase order number to an ACC client and or their GP to facilitate the provision of services for neurological consultations for injuries covered under the ACC Act.

2. Please confirm whether the following criteria stipulated in the Auckland Medical Specialists Neurology Services website of;

"ACC Patients

A patient's referring doctor must first send a letter to ACC requesting coverage for a neurological consultation. A Claims Manager will then be assigned to the patient and will provide the patient with a purchase order number to cover the consultation. We can not see any ACC patients without their purchase order number from ACC."

applies equally to ACC claimants whom present to;

(i) neurosurgeons for assessment and treatment of ACC related injuries to the central nervous system inclusive of cranial nerves. i.e. does the ACC claimants GP have to have first obtained a purchase order number from ACC for their patient to be able to be consulted by a neurosurgeon in respect of injury symptoms to the facial nerves.

(ii) triage departments within New Zealand District Health Boards (NZ DHB), by way of GP referal for assessment and treatment of ACC related injuries to the central nervous system inclusive of cranial nerves.

in that an ACC patient would require a purchase order number from ACC to present to the neurosurgeon, and or the triage department at a NZ DHB, prior to either the neurosurgeon, and or triage staff at the relevant DHB being able to offer assessment and treatment to an ACC client with injuries that extend to include those of the cranial nerves of the face. i.e. does the ACC claimants GP have to have first obtained a purchase order number from ACC to be presented with the GP's referral to the triage department at the District Health Board, before their patient is able to be referred for a neurosurgical consult within a New Zealand DHB for the assessment and treatment of injury symptoms to the facial nerves caused by accident.

Under s16(2) of the Official Information Act, my preferred way of receiving a response is by email to the address from which ACC received the original request, not by post.

I respectfully request that this information is provided to me under the provision of urgency in line with the Official Information Act for the purposes of review and appeal purposes by the end of business close on the 26 April 2017.

I thank you for your time and assistance.

Yours faithfully,

David Lawson

Dear Government Services,

I note receipt of your correspondence dated 13 April 2017.

I am writing to tidy up three matters which I identify below;

Matter 1:

I wish to correct a typing error in my OIA request of 12 April 2017. I mistakenly used the medical specialty neurosurgeon as opposed to neurologist within my first OIA request under 1. ((i) which incorrectly reads;

"1. All policy documents, inclusive of all Executive Leadership Team Issues Papers, and equivalent Papers thereof, that relate to;

(i) when, and why ACC first implemented the requirement for an ACC claimant's GP or alternate medical advocate/specialist to obtain a purchase order number from ACC for a consultation with a neurosurgeon,outside of the exception of nerve conduction studies."

It would be welcomed for the purpose of my OIA request dated 12 April 2017, if you would correct and confirm that the above error on my part has been corrected to read going forward as;

1. All policy documents, inclusive of all Executive Leadership Team Issues Papers, and equivalent Papers thereof, that relate to;

(i) when, and why ACC first implemented the requirement for an ACC claimant's GP or alternate medical advocate/specialist to obtain a purchase order number from ACC for a consultation with a neurologist,outside of the exception of nerve conduction studies.

Matter 2

I note that your correspondence dated 13 April 2017, has failed to reconfirm back to me my exact OIA questions, and hence does not provide me with the acknowledgement that ACC Government Services fully understands my complete series of requests for OIA information that I have requested on 12 April 2017.

I therefore respectfully request that ACC Government Services, factoring in my correction today outlined in Matter 1 above, return to me through the FYI website a comprehensive acknowledgement letter that quotes in full all of my OIA requests detailed in my OIA request submitted on 12 April 2017, amended as per matter 1 requested in my correspondence today.

ACC Government Services enactment of my request under Matter 2 will ensure that there are no areas of ambiguity at all associated with my OIA requests about ACC's requirement for the pre approval of service provision, that will cause any unnessary delays in the full OIA information being provided to me in the first instance, since once completed ACC will have proven to me that they fully understand both the scope and the breadth of my complete OIA requests and the specific information that I am seeking.

Matter 3

In my original OIA requests dated 12 April 2017, I respectfully asked urgency to be applied to my OIA requests surrounding ACC's requirement for the pre approval of service provision and I quote from my original request, which also stipulates the reasoning behind my request for urgency to be afforded to my request;

"I respectfully request that this information is provided to me under the provision of urgency in line with the Official Information Act for the purposes of review and appeal purposes by the end of business close on the 26 April 2017."

ACC Government Services response dated 13 April 2017 has failed to provide me with any valid response as to why my request for urgency cannot be achieved, and in fact has completely omitted to address the issue of my respectful request for urgency to be afforded in this instance.

I would therefore like to repeat my request for the full OIA information requested in my letter dated 12 April 2017, (amended in respect of Matter 1 corrected today), to be provided in full under the provisions of urgency in line with the Official Information Act for the purposes of review and appeal purposes by the end of business close on the 26 April 2017.

I welcome ACC Government Services confirmation that the OIA requested information will be supplied to me by the end of business close on the 26 April 2017, when ACC government Services fully enacts my request under Matter 2 above, and provide me with a complete OIA acknowledgement letter that quotes in full all of my OIA requests detailed in my OIA request submitted on 12 April 2017, amended as per matter 1 requested in my correspondence today.

I thank you for your time and assistance.

Yours sincerely

David Lawson