Good afternoon Mr Lawson

Thank you for your request below asking for information relating to the requirement of purchase orders for specific consultations.

This email is to inform you that we are currently working on your request and will be in touch with you as soon as possible, and certainly by 15 May 2017.

In the meantime, if you have any questions we can be contacted by email at [email address]

Regards

Government Services

-----Original Message-----
From: David Lawson [mailto:[FOI #5716 email]]
Sent: Wednesday, 12 April 2017 5:59 a.m.
To: Information Website Mail
Subject: Official Information request - ACC's requirement for the pre approval of service provision.

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

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Link: [1]File-List

Dear Mr Lawson,

 

We write in relation to your two emails of 12 April 2016 (one concerning
purchase orders regarding consultations with neurosurgeons and the other
 concerning policy documents about long term claims) and that of 20 April
2017 (concerning agreements for services between ACC and DHBs).

 

1.     Request regarding purchase orders

In relation to your request concerning purchase orders, we note that you
have amended your request so that it relates to neurologists instead of 
neurosurgeons.  As you have asked that ACC deal with this matter with
urgency, and as you regularly request information from ACC and this might
inform future requests, we note that such an amendment has the effect of
allowing us to treat it as a new request under section 15(1AA) of the
Official Information act 1982 (the Act) and the response date would be
reset accordingly.

 

Notwithstanding that, after carefully considering your request, we have
reached the view that it is frivolous and the subject matter trivial. We
have accordingly decided to decline it under section 18(h) of the Act. In
taking that position, we make the observation that raising a purchase
order is a usual part of business and is neither controversial nor
particularly complicated. Any associated information will be at best
administrative in nature. 

 

2.     Request regarding policies and request concerning contracts between
ACC and DHBs

We wish to assure you that your requests are being progressed and our
response will be provided to you as soon as reasonably practicable and in
accordance with the Act, the present due dates being no later than 15 and
19 May 2017 respectively.

 

3.     Other matters

In addition to requesting the information discussed above, you have  also
raised concerns about how and when ACC should provide the information to
you, we deal with each of these in turn below.

 

Acknowledgement letters/email

While we acknowledge requests as a courtesy, there is no requirement under
the Act for an agency to do so. You will recall that we advised you of
this in a letter of 21 April 2016 (in response to a request of 11 March
2016).

 

Quoting entire request in acknowledgement

You have asked that we provide an acknowledgement letter which sets out
your requests in full in order to prove to you that we fully understand
them. We do not consider that taking the action you propose would
constitute a responsible or reasonable use of our time or resources.
Accordingly we decline to do so. In taking that position we note that in
the event we do not understand a request there is a mechanism for
addressing this. The Act imposes certain obligations on  how requests for
Official Information should be made and dealt with. Those obligations
extend not only to those responding to requests but also those making
them. Section 12 of the Act requires requests to be made with due
particularity. In the instance we are unsure or unclear about a request as
the result of a lack of due particularity, we are able to ask the
requestor to clarify or amend their request in order for it to conform
with the requirements of section 12.

 

The Ombudsman’s publication “Making official information requests”  can be
found at the following link
[2]http://www.ombudsman.parliament.nz/resou...

 

The publication provides the following guidance in respect of making a
request with due particularity:

 

            Due particularity—your obligation as a requester

            Be as specific as you can in identifying the information you
want. Be open to communicating with the agency and helping the person
responsible for answering your request to understand what it is you are
looking for.

            The information you are requesting must be specified with ‘due
particularity’.20 This means that the person receiving the request must be
able to identify the information you have asked for.

            A request that lacks due particularity will not be valid and
the requirements of the OIA and/or LGOIMA will not apply.

 

In order to ensure that you receive the precise information you seek we
also note that requests that are free of prolix, repetition  and that
clearly and concisely describe the requested information will always be
easier to process than those that are not.

 

Urgency

You have asked us to confirm that we will reply to your requests urgently.
While the Act allows a requester to ask for a request to be processed
urgently (where they specify the reason for this), agencies are not bound
by such a request. Nor does the Act provide for the requestor to
unilaterally impose due dates in relation to a request for urgency.
Whether a response can be provided under urgency will depend on various
factors, including the complexity of the request, the time required to
form a response, and the workload of the agency.

 

While we note that you have alluded to the reason for urgency relating to
“pending review and appeal proceedings” you have not advised us of the
respective filing and hearing dates. Without that information it is
difficult to assess the merits of a request for urgency. If you require
the material you have requested urgently please advise us of the relevant
due dates so that we can properly consider your request. Please note that
where we identify a need for urgency it is open to us to charge for the
work required to complete the necessary work with urgency. We would of
course advise you of the relevant charge should that be necessary and
would not commence the required work until you had confirmed you were
happy for us to proceed by paying .

 

Queries or concerns

If you have questions about this response, you can contact us at
[3][email address] or in writing to Government Services,
PO Box 242, Wellington 6140.

You have the right to complain to the Office of the Ombudsman about our
response. You can call them on 0800 802 602 between 9am and 5pm on
weekdays, or write to The Office of the Ombudsman, PO Box 10152,
Wellington 6143.

 

Yours sincerely

 

Government Services

 

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