26 November 2024
Yasir Shaikh
[FYI request #28145 email]
Tēnā koe Yasir
Your request for official information, reference: HNZ00062031
Thank you for your email on 16 September 2024, asking Health New Zealand | Te Whatu Ora for
the following under the Official Information Act 1982 (the Act):
1. The current average wait time for paediatric clinic appointments across Auckland
2. The number of children currently on the waitlist for paediatric clinic appointments in
Auckland
3. The criteria used to prioritize patients for appointments in paediatric clinics.
4. Any measures being implemented to reduce wait times for paediatric clinic
appointments.
5. Historical data on wait times for paediatric clinic appointments over the past five years, if
available.
6. According to the Service Level Agreement (SLA), what is the expected or standard wait
time for paediatric clinic appointments? How does the current wait time compare to this
standard?
7. If the current wait time exceeds the SLA standards, please provide details on the steps
being taken to address this issue. Additionally, what actions have been taken in response
to reported delays?
8. Please include any relevant reports, documents, or data that pertain to the above
questions.
Response
We wrote to you to ask you to clarify which clinic you sought information about. You replied that:
I am requesting information for the Auckland paediatric clinic.
We have interpreted your clarified request as seeking information about General Paediatrics at
Health New Zealand Waitematā and Auckland. Please note that this data is provisional and used
for operational purposes. It has not been through the full quality assurance process that we use
before publishing data and therefore is subject to change.
I will treat each of your requests in turn, by local area starting with Waitematā.
Waitematā
The current average wait time for paediatric clinic appointments
The average waiting days of those recently (i.e., in the last 3 months) removed from the First
Specialist Assessment (FSA) waitlist is 103 days.
The number of children currently on the waitlist for paediatric clinic appointments in
Waitematā
There are 2,001 children on this waitlist as of 01/11/2024
The criteria used to prioritize patients for appointments in paediatric clinics.
Referrals are triaged by a combination of an experienced nurse and a team of paediatricians. The
service has triage outpatient guidelines available to this team to standardise processes and
response. There is peer review to improve consistency of practice.
Cases are assessed individually and assigned a priority:
• P1 – usually seen immediately in emergency department, or acutely in our “PACE” clinic at
North Shore
• P2 – see within 6 weeks – cases where there is identified clinical reasons why prompt
assessment is warranted
• P3 – see within 4 months - important clinical conditions where deterioration is not
anticipated. This includes most neurodevelopmental conditions
• P4 – non-contact FSA, usually done at time of referral with individualised advice provided
back to the referrer.
Any measures being implemented to reduce wait times for paediatric clinic appointments.
Waitematā has implemented several measures including:
• making extensive use of non-contact FSA, providing timely advice to GP at time of referral.
• It has developed a Nurse Practitioner intern program to increase capacity in general
paediatrics.
• regular clinical review of the patients on waitlist and the provision of community supports.
• It provides guidance to team members about appropriate follow up and reduction of follow
up wait lists.
Waitematā also uses follow ups to reduce workload and, in addition has a regional
neurodevelopmental project to redesign services and standardise processes across region.
According to the Service Level Agreement (SLA), what is the expected or standard wait
time for paediatric clinic appointments? How does the current wait time compare to this
standard?
The national expectation is for new referrals to be seen within 4 months. There is no Service Level
Agreement or target for wait times
If the current wait time exceeds the SLA standards, please provide details on the steps
being taken to address this issue. Additionally, what actions have been taken in response
to reported delays?
Please refer to our response above regarding SLAs.
The increase in wait times is correlated to a period of significant Resident Medical Officer (RMO)
vacancy regionally. Waitematā currently has five out of 11 RMO positions vacant and Senior
Medical Officer (SMO) resource has been redistributed to acute services to maintain clinical safety.
Additional SMO FTE has been appointed and three Nurse Practitioner Interns are being supported
to assist in meeting this demand. In addition, we would note that the measures under question 4
have been implemented.
Please include any relevant reports, documents, or data that pertain to the above
questions.
There were no reports or documents within scope and this part of your request is refused under
section 18(e) of the Act, as the information does not exist.
The data relevant to your questions would have to be extracted from Waitematā’s patient
management systems. Health NZ is unable to provide you with this information as it is held in
notes on individual case files. In order to provide you with this information, our staff would have to
manually review several thousand patient files. As such, we refuse your request under section
18(f) of the Act.
I have considered whether fixing a charge for the supply of the information or extending the
timeframe for response would enable Health NZ to respond. I do not consider that either option
would remove the impact that supplying the information would have on our other operations
Auckland
The current average wait time for paediatric clinic appointments across Auckland
The average wait time for patients seen for their FSA in September 2024 was 112 days.
The number of children currently on the waitlist for paediatric clinic appointments in
Auckland
As at the end of September 2024, there were 946 patients on the General Paediatrics Clinic
waitlist for their FSA
The criteria used to prioritize patients for appointments in paediatric clinics.
Clinical need and urgency dictates priority. For example, if a child is unable to attend school due
to their condition, they would receive a higher priority.
Any measures being implemented to reduce wait times for paediatric clinic appointments.
When appropriate Auckland provides GP/referrer advice electronically within a week of receiving
referrals – that provides very timely advice and avoids the need for a clinic visit.
Auckland avoids unnecessary follow ups to free up clinic time for new referrals. They also add
extra clinics when resources allow.
Auckland maximises the use of clinic time avoiding gaps in clinics, has mechanisms in place to
reduce missed appointments, uses alternative care models (delivered by community-based nurse
practitioners) to supplement traditional clinics. These initiatives have reduced rates of missed
appointments to less than 10 percent.
Historical data on wait times for paediatric clinic appointments over the past five years, if
available.
Appointment Year
Average Days Waiting for patients
(calendar year)
seen at clinic for First Specialist
Assessment
2019
38.5
2020
37.8
2021
45.4
2022
41.8
2023
67.1
2024 (to 30/09/24)
100.3
According to the Service Level Agreement (SLA), what is the expected or standard wait
time for paediatric clinic appointments? How does the current wait time compare to this
standard?
The national expectation is for new referrals to be seen within four months. There is no Service
Level Agreement or target for wait times.
We can advise that current wait times for standard (non-urgent) referrals to be seen in clinic is
approximately 10 months. Virtual advice to referrer is done within a week. Urgent clinic referrals
are seen within weeks.
If the current wait time exceeds the SLA standards, please provide details on the steps
being taken to address this issue. Additionally, what actions have been taken in response
to reported delays?
Please refer to our response above regarding SLAs.
Auckland identifies and tracks wait list metrics, it reviews all follow ups to determine whether they
are required or not. The service is also clear with referrers to advise them of current waiting time
status. This helps referrers make informed referral decisions and in sharing information regarding
urgency. Auckland seeks to provide more clinics via additional resource requests.
Please include any relevant reports, documents, or data that pertain to the above
questions.
There were no reports or documents within scope and this part of your request is refused under
section 18(e) of the Act, as the information does not exist.
The data relevant to your questions is provided in our response to your question seeking historical
data above.
How to get in touch
If you have any questions, you can contact us at
[email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Danielle Coe
Manager (OIA) Government Services
Health New Zealand | Te Whatu Ora
