CORPORATE OFFICE
Level 1,
32 Oxford Terrace
Telephone: 0064 3 364 4160
Christchurch Central
Fax: 0064 3 364 4165
CHRISTCHURCH 8011
[email address]
30 June 2017
Mr R.J. Poultney
Email: [FYI request #6001 email]; Dear Mr Poultney
Re: Official Information Act Request CDHB 9635
Thank you for your email dated 14 June 2017 under the Official Information Act (1982) requesting the following
information from Canterbury DHB. This request was subsequently clarified on 16 June 2017 for time frame and on
22 June 2017 for interpretation of ‘Provider’. (as below in question 1)
Canterbury DHB cannot answer your request fully as it would require substantial collation and research. There is
no single way in our systems to determine which cases are tertiary cases from referral or which ones turn into
tertiary cases while in progress and the determination of the secondary / tertiary split is different in all areas of
medicine. It is also not possible to determine from our systems if a referral from another DHB, for example, is due
to the level of expertise of the surgeon in that DHB (who believes the case cannot be handled there so it is tertiary)
and sends it to Canterbury DHB. Our doctors may believe it is only secondary. This typically happens when locums
are used in other areas.
However we are providing you with information on all cases referred to Canterbury DHB under the areas clarified
by: as GP referral, private hospital/specialist referral and other referrals such as NGOs. This data would contain
both secondary and tertiary cases undertaken by Canterbury DHB.
Note:
1)
Tables 1 and 2 contain data which is for all cases referred to Canterbury DHB. And
Table 3 would only apply to
secondary cases.
2) We have limited our response to referrals that are First Specialist Assessment (FSA) eligible outpatient referrals.
1. Number of patients referred by their provider to tertiary services, broken down by department/area;
Clarified as being for financial years 2015/16 and 2016/17 (to 31 May 2017) and “Provider” as being: a)
GP referral, b) Private Hospital/Specialist Referral and c) other referral (NGOs etc.)
Please refer to Appendix 1 Table one (attached below) for the number of First Specialist Assessment referrals to
Canterbury DHB services broken down by Health Specialty.
2. The Lower Quartile, Median, and Upper Quartile of time (in days) it takes for a referral to be responded to
by CDHB staff, with the response being an actual appointment date (not an acknowledgement of the
referral);
Table two:
ALL: by referral source in days
2015/2016
2016/2017
LOWER Quartile
1
1
Median
9
8
UPPER Quartile
29
26
Please refer to
Appendix 1 Table two (attached below) for a breakdown of the Lower Quartile, Median and Upper
Quartile of time (in days) it takes for a referral to be responded to by Canterbury DHB staff, broken down by Health
Specialty. (Referral receipt date to appointment booking date).
3. The number of patients referred but not given access to the tertiary services;
To our knowledge there are no patients referred for tertiary services and not given access to them here. Where
we cannot handle the case due to complexity, we would refer to another tertiary provider or higher level centre
such as Starship in Auckland.
4. The percentage of referrals where actions were undertaken (triaged, referred back to General Practice
etc) i.e. a denial for services, and with that outcome not being given within the first 20 working days to the
patient/referrer.
Table three: percentage of referrals where Outcome not being given “within 20 days”
2015/16
2016/17
GP
5.14%
4.41%
Other**
3.13%
2.88%
Private Specialist
7.88%
6.11%
Grand Total
4.58%
3.95%
* Other includes: Other DHBs, Canterbury DHB i.e. wards, Ashburton Hosp, Burwood Hosp, Christchurch Women’s Hosp and
Midwives, ED, Overseas referrals, self-referrals, outside agencies.
** It should be noted we do not consider return to General Practice a ‘denial’. Our services refer back to General Practice as
they consider this the right location for care. This referral provides information/advice to support General Practice to manage
the patient’s care.
Please refer to
Appendix 1 Table three (attached below) for a breakdown by Health Specialty of these
percentages.
I trust that this satisfies your interest in this matter.
Yours sincerely
Greg Hamilton on behalf of Carolyn Gullery
Acting General Manager
Planning, Funding & Decision Support
Table one: First Specialist Assessment referrals to Canterbury DHB
2015/16
2016/17
2015/2016
Total
2016/2017
Total
Private
Private
GP
Other*
GP
Other*
Health Specialty
Specialist
Specialist
Medical
16852
354
9998
27204
16223
380
8993
25596
General Medicine
405
129
534
510
3
71
584
Cardiology
4163
78
1572
5813
4211
59
1563
5833
Specialist Paediatric
22
56
78
17
51
68
Cardiology
Dermatology
1295
43
255
1593
1327
86
298
1711
Gastroenterology
868
13
514
1395
870
21
466
1357
Haematology
1052
28
422
1502
973
15
400
1388
Infectious Diseases
134
1
126
261
138
8
81
227
Specialist Paediatric
1
1
2
Infectious Diseases
Neurology
1837
48
443
2328
1850
31
464
2345
Specialist Paediatric
80
2
42
124
60
1
27
88
Neurology
Oncology
209
11
3908
4128
111
17
3458
3586
Paediatric Medicine
1877
17
664
2558
1793
9
589
2391
Renal Medicine
156
12
115
283
307
49
99
455
Respiratory
1335
53
931
2319
1166
56
590
1812
Medicine
Specialist Paediatric
Respiratory
31
8
45
84
22
4
40
66
Medicine
Rheumatology
1290
21
209
1520
1267
15
186
1468
Endocrinology
1477
16
313
1806
1025
4
254
1283
Diabetology
590
232
822
559
337
896
Specialist Paediatric
30
3
21
54
17
2
19
38
Endocrinology
Surgical
27229
1832
12062
41123
25469
1225
12099
38793
General Surgery
3657
58
1256
4971
3152
46
1022
4220
Anaesthesia
Service(s) and Pain
465
76
290
831
352
41
351
744
Management
Cardiothoracic
39
6
336
381
31
6
337
374
Surgery
Otorhinolaryngology
5199
278
2325
7802
5164
211
2094
7469
(ENT)
Gynaecology
2387
245
560
3192
2706
161
666
3533
Neurosurgery
696
75
411
1182
715
79
317
1111
Ophthalmology
2846
392
4090
7328
2602
253
4197
7052
Orthopaedic
4739
550
1182
6471
4371
286
1197
5854
Surgery
Spinal Surgery
2
10
12
17
6
185
208
Specialist Paediatric
679
5
155
839
565
2
116
683
Surgery [Others]
Plastic Surgery
2177
44
316
2537
1561
46
334
1941
[excluding burns]
Urology
3281
74
691
4046
3230
54
645
3929
Vascular Surgery
1064
27
440
1531
1003
34
638
1675
Grand Total
44081
2186
22060
68327
41692
1605
21092
64389
*Other includes: Other DHBs, Canterbury DHB i.e. wards, Ashburton Hosp, Burwood Hosp, Christchurch Women’s Hosp and
Midwives, ED, Overseas referrals, self-referrals, outside agencies.
Table two: Referral receipt date to appointment booking date (Lower Quartile, Median, and Upper Quartile in Days
2015/16
2016/17
Upper
Upper
Lower Q
Median
Lower Q
Median
Health specialty
Q
Q
Medical
0
6
18
0
7
19
General Medicine
0
1
41
0
1
21
Cardiology
0
1
38
0
0
14
Specialist Paediatric Cardiology
0
4
14
0
7
16
Dermatology
2
5
12
3
6
11
Gastroenterology
3
28
52
0
23
64
Haematology
3
7
11
2
6
11
Infectious Diseases
0
0
0
0
0
0
Specialist Paediatric Infectious Diseases
-
2.5
-
-
-
-
Neurology
0
8
23
0
10
51
Specialist Paediatric Neurology
0
3
8.5
1
5
10.5
Oncology
3
9
16
5
11
18
Paediatric Medicine
4
9
18
6
11
17
Renal Medicine
0
0
4
0
2
6
Respiratory Medicine
3
8
27
2
6
20
Specialist Paediatric Respiratory Medicine
7
25
48
9.75
24
39
Rheumatology
4
12
20
10
18
35
Endocrinology
0
0
0
0
0
0
Diabetology
0
5.5
20
1
6
24
Specialist Paediatric Endocrinology
1
12
27.25
0
12
25
Surgical
2
13
40
2
11
32
General Surgery
6
14
27
7
18
34
Anaesthesia Service(s) and Pain Management
13
23
45
14
22
43.5
Cardiothoracic Surgery
1
6
12
1
7
13.5
Otorhinolaryngology (ENT)
0
4
55
0
3
61
Gynaecology
10
44
68
5
34
73
Neurosurgery
3
9
18
4
10
19
Ophthalmology
1
7
23
1
7
21
Orthopaedic Surgery
2
20
39
8
17
33
Spinal Surgery
0
0
22.25
0
0
0
Specialist Paediatric Surgery [Others]
14
29
51.5
4
7
15
Plastic Surgery [excluding burns]
1
49
97
0
12
28
Urology
8
20
34
6
20
34
Vascular Surgery
0
2
6
1
3
7
Table three: percentage of referrals where Outcome not being given “within 20 days”
2015/16
2016/17
Medical
2.45%
2.40%
General Medicine
1.12%
1.37%
Cardiology
4.53%
5.57%
Specialist Paediatric Cardiology
0.00%
0.00%
Dermatology
5.15%
3.51%
Gastroenterology
0.57%
0.66%
Haematology
3.66%
4.39%
Infectious Diseases
0.38%
0.00%
Specialist Paediatric Infectious Diseases
0.00%
Neurology
0.39%
0.17%
Specialist Paediatric Neurology
0.81%
2.27%
Oncology
0.65%
0.39%
Paediatric Medicine
3.01%
3.89%
Renal Medicine
0.00%
0.22%
Respiratory Medicine
3.97%
0.28%
Specialist Paediatric Respiratory Medicine
1.19%
0.00%
Rheumatology
1.64%
1.50%
Endocrinology
0.06%
0.00%
Diabetology
2.19%
1.01%
Specialist Paediatric Endocrinology
0.00%
2.63%
Surgical
5.98%
4.98%
General Surgery
7.97%
7.51%
Anaesthesia Service(s) and Pain Management
11.91%
10.22%
Cardiothoracic Surgery
0.79%
1.60%
Otorhinolaryngology (ENT)
2.74%
2.04%
Gynaecology
2.54%
2.46%
Neurosurgery
9.31%
6.66%
Ophthalmology
2.98%
4.16%
Orthopaedic Surgery
17.77%
12.85%
Spinal Surgery
0.00%
0.00%
Specialist Paediatric Surgery [Others]
2.03%
3.08%
Plastic Surgery [excluding burns]
2.33%
1.24%
Urology
2.18%
1.55%
Vascular Surgery
1.64%
3.94%
