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Laboratory Review Steering Group

Message from Win Bennett, Director of Planning & Funding at C&C DHB

Thank you to those who took the time and effort to make submissions on the “Future of Laboratory Services Delivery in the Central Region” discussion document.

We received 47 submissions in total, made up of 21 from Hawke’s Bay, 18 from Capital and Coast and 8 from Hutt Valley. Some were from individuals and some from groups. There was only one submission from a PHO and further comment is being sought.

There was general agreement on many of the issues and concerns raised in the discussion paper, including broad agreement about the benefits of integration, and the need for change, but disagreement on some facts and the preferred option (e.g. disagreement between the private and public sectors over where the work could be done).

Submissions repeated a number of key issues. These included:

• Retaining qualified and experienced staff during shortages, and keeping workloads reasonable and competence and morale up
• Making sure there is adequate staff and equipment on a day to day basis and for back up/civil emergencies
• Implementing demand side management through referrer education, an improved request form and an updated schedule
• Introducing a single data repository or mechanism for all providers to access all results, regardless of the outcome of the project, to prevent duplication of testing, save money and assist patients
• Introducing a region wide IT system
• Compliance with accreditation requirements

Submissions noted a number of inappropriate drivers (for example ordering groups of tests when only an individual test is required) and appropriate drivers of growth (such as screening programmes).

Suggestions were made on what should be considered when looking at laboratory services including patient needs, short-term costs versus long-term gains, the need for evidence, existing strengths and past experience.

Comments were made on suggested levels of urgency and impacts on it like clinician’s expectations; how to meet accreditation requirements; how to improve efficiency and quality and ways to manage demand.

There was near unanimous agreement on the need to improve IT systems to solve many of the problems recognised in the discussion document, such as duplicated testing. Submissions noted that privacy issues should still be dealt with.

Views differed on the current configuration, but ideas on how to improve it were similar such as integrating some non-urgent specialised tests and building on existing relationships.

Local integration showed through as the preferred option in the immediate term in submissions, with many suggesting sub-regional integration in the future. Soft integration was also raised by many suggesting that exploratory work could be undertaken on these aspects. Regional integration was broadly misunderstood to mean centralisation – for instance, being run out of Wellington. As such centralisation was not the intention of this option further discussion around this option may be useful.

The submissions have been collated and analysed in depth by part of the core project team. This report can be downloaded through the link at the bottom of this page. This will be presented to Boards in some form in an upcoming Board meeting. A copy of this document is also available on the Capital and Coast DHB website. The working group will continue to undertake further analysis.

At this point it is expected that Boards will consider the options for the future direction of laboratory services over the next few months with a view to decision-making in some DHBs by March 2005. Boards will determine what means they will use to assist them in this decision making process.

During this time staff and unions will be provided with updates. Representatives are available to meet to discuss progress and any concerns.

Click on the link below to view an analysis of the submissions.

• Analysis of Submissions

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