Kia ora,

I am requesting information under the Official Information Act 1982 regarding ACC’s operational performance, service delivery timeliness, quality-assurance mechanisms, and contractor oversight, across the last five financial years.

This request is informed by best-practice international audit frameworks (including external inspector-general healthcare reviews), and seeks comparable data for ACC.

1. Annual performance outcomes and failures

Please provide ACC’s annual performance results (2019/20–2023/24) relating to:
1. Timeliness / turnaround-time standards for clinical decision-making, assessments, specialist triage, and treatment pathway approvals.
2. The minimum expected benchmark, and the actual percentage of cases that met that benchmark each year.
3. Any internal findings, reports, or audits identifying failure to meet turnaround KPIs, similar to the findings summarised in the VA OIG report where performance targets were repeatedly missed.

If ACC does not measure specific turnaround KPIs, please confirm.

2. Workforce adequacy and staffing shortfalls

Please provide:
1. ACC’s internal assessments of staffing levels, shortages, and workforce constraints that impact service delivery, similar to the “national shortage” issues documented in the VA report.
2. Reports identifying how staffing deficits affect:
• decision-making timeframes
• case manager capacity
• clinical advisor availability
• vendor / assessor performance
3. Any plans of action produced to address workforce shortages (internal or external contractors).

3. Oversight of contracted clinical providers and assessors

The VA audit identified major failures caused by unclear responsibilities, outdated agreements, and inconsistent policies.

Accordingly, please provide:
1. Copies of ACC’s current contracts, service agreements, and MOUs with:
• radiology providers
• teleradiology providers (if applicable)
• clinical assessors
• integrated services providers
• triage services
• telehealth platforms
2. Information on how ACC ensures:
• contractor quality assurance
• peer review or audit of contractor error rates
• monitoring of clinical accuracy, delays, or misreads
• internal escalation processes when contractor error causes harm
3. Any internal findings identifying:
• conflicting guidance
• unclear lines of responsibility
• delays caused by external vendors
(as occurred in the VA system, contributing to harm).

4. Quality-assurance systems, peer review, and error detection

From the VA report, QA processes were inconsistent, mismanaged, and poorly understood, contributing to delayed care and misreads.

Please provide for ACC:
1. All policies describing clinical quality-assurance, peer-review of clinical advisors and contracted assessors, and error-rate monitoring.
2. The annual number of quality-assurance reviews conducted each year since 2019/20.
3. Data identifying:
• the number of incorrect clinical decisions detected
• the number of clinical misjudgments overturned on review
• the number of initial decisions requiring correction due to error
4. Reports relating to:
• systemic QA failures
• lack of monitoring
• unresolved risks
• delays caused by QA gaps

5. Delays in service delivery causing risk of harm

The VA OIG report documented multiple cases where delayed readings put patients at risk.

Please provide:
1. ACC’s equivalent data on delays that created risk, including:
• delayed treatment
• delayed clinical advice
• delayed approval for specialist care
2. Any internal investigations or incident reviews.

6. Contingency planning and system outages

The VA report found many providers lacked contingency plans, leading to systemic failures during outages.

Please provide ACC’s:
1. Contingency plans for:
• major system outages
• digital platform failures
• contractor unavailability
• inability to access clinical files
2. All reports of service disruption affecting:
• client decision-making
• access to records
• clinical processes

7. Internal patient-safety or client-safety reporting
1. Copies of anonymised internal “client safety” or “service risk” reports.
2. Trends or themes recorded across the past five years, including:
• delays
• miscommunications
• administrative errors
• incorrect decisions
• unprocessed evidence

8. Financial information underpinning the above

Without requesting granular line-item costs, please provide:
1. ACC’s annual expenditure on:
• contracted assessors
• clinical panel reviewers
• external radiology / imaging
• telehealth or remote review services
2. Any performance-based penalties, abatements, or remediation actions applied against contractors for failure to meet KPIs.

9. Copies of any internal reviews comparable to an Inspector-General audit

If ACC has conducted internal or external audits evaluating:
• performance failures
• clinical quality
• contractor oversight
• systemic delays
• operational reliability

…please provide these.

If no equivalent audits exist, please state.

Format Requested

Electronic, searchable PDF or Word documents are preferred.

Reason for Request section 12(2)

This information will assist in understanding ACC’s operational performance, service delivery reliability, and quality-assurance mechanisms, using internationally recognised oversight frameworks as a point of comparison.

Kind regards,
Spencer Jones