MDHB to invest more in high priority cardiology services

06/04/2011 | Cardiology Services

MidCentral District Health Board’s work over the past 18 months in removing a huge deficit, and moving into a surplus, now means it can start investing in one of its high priority areas – cardiology services.

The board has excellent services for acute events and high risk cardiology patients, and strong community cardiology services, especially in Horowhenua, Tararua and Otaki and now plans to improve access for all cardiology patients across the district, and possibly regionally to Whanganui in the future.

A review of cardiology services “The Cardiology Landscape” report presented to the board’s two committees today made a number of recommendations, which if adopted by the full board later this month, will see considerably more investment made in cardiology services later this year and next year.

Recommendations included increasing cardiology staff from 47.46 FTEs to up to 54.71 FTEs, (including three more medical staff and two more cardiology nurses), costing between $700,000 to $775,000 more a year.

Other proposed investments were for a catheterisation laboratory (cath lab), and equipment costing $2.6million, and an unknown cost to co-locate all staff in one area.
The committees heard the board had already been successful in doubling the number of cardiologists from two to a full complement of four by June, one of the first steps toward implementing the review.

The committees agreed to hold a workshop to be held to discuss the next steps toward implementing the recommendations, to plan the improved service.

The review’s purpose was to complete an assessment in response to concerns raised internally, regionally and nationally that the level of cardiology service provision at MidCentral Health might be inadequate. Intervention rates for cardiology procedures and cardiac surgery are monitored nationally and it was pointed out that these had been low over time and needed to be raised.

The review found that while the service works well for acute events and high risk patients, those not classified as high risk there were access problems for diagnostic tests and assessments spanning years.

While it said there had been increased access for patients in Horowhenua, Tararua and Otaki, volumes of assessments had fallen at Palmerston North Hospital.

In the 2009-10 year about half of the 2035 people discharged from hospital for cardiology-related hospitalisations involved the cardiology health specialty.
In the same year there were almost 1800 cardiologist specialist assessments or specialist follow-up outpatient appointments, more than 1000 cardiac education and management appointments, 2000 community referred cardiology tests, 700 pacemaker checks, and 55 nurse led outpatient clinics.

A special list has been created for patients needing tests before assessment – in October 2010 there were 650 patients waiting, some since 2006. Follow-up waiting lists number 2000 patients; and patients who do not need a review within three months do not get an appointment at all unless they, or their GP, made an inquiry. There are 750 people waiting for an echocardiogram, but only those prioritised as urgent are booked.

The review recommended a service plan should be developed with identified priorities, Key Performance Indicators, and allocation of responsibilities, sufficient to meet the existing requirements of the district’s problems.
The plan should be district-wide, and encompass ongoing service development to enable medium to long-term service requirements to be met.

The report said: “Once MidCentral DHB has adequate human and physical capacity for its own population it can expand and offer services regionally. This will enable Whanganui patients to have services close to home and should help to lift service levels for this population. The Central region Cardiac Network sees a very strong role for MidCentral Health in the region with MidCentral performing most of the assessment and diagnostic work for the Whanganui population, and then referral onwards for tertiary services in Wellington.

“The ultimate objective is to lift the service to an advanced level of functioning which includes the provision of Percutaneous Coronary Intervention (PCI). This level of development would need to occur in parallel with regional-level planning and development.”

 

 

 

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