Team says review medical referral system

The way that overseas medical referrals are handled should be completely reviewed and the policies and procedures restructured.
This is one of the major findings of the Health Management Review Team which tabled its final report to Cabinet on Tuesday. One of the Review Team’s briefs was to summarise and recommend options to manage the Overseas Medical Referral systems and processes.
In their Executive Summary, the team found that Overseas Medical Referrals was an area which suffered from lack of transparency and limited clinical guidelines.
According to the team there are a number of areas where improvement could be made which would support the ability of the Ministry to manage demand on this fund and to gain confidence that the fund ($483,482 in 2006/2007) is accessed based on clinical need rather than personal preference or in some cases political desire.
The Overseas Medical Referral system, said the team, should be managed and coordinated with the Visiting Medical Specialists visits.
To ensure greater efficiency and strengthening of this system, the Review Team recommended:
n the strengthening of the current system through focusing on the development on the Overseas Liaison Officer role based in the Cook Islands rather than in New Zealand,
n reviewing the current policy in partnership with clinical staff,
n and communicating the process and policy to all staff, patients and the community.
The five specific recommendations made by the team are;
5.1 A complete review and restructuring of the policies and processes regarding Overseas Medical Referrals. This will include all processes in the Cook Islands and NZ.

5.2 The methodology of the review, policy development and process design will include but not be restricted to the following:
n establishment of a clinical referral committee
n development of clinical guidelines and pathways
n the delegation of authority to a 24hr/7 day per week person with authority to approve referrals
n establishment of policy guidelines regarding patient escorts
n establishment of a system of long term evaluation of clinical outcomes
n developing a communication strategy to ensure the population is aware of the scheme
5.3 Ensuring that Visiting Medical Specialists are aware of the Overseas referral policy and criteria.
5.4 Reviewing the options for providing support to patients and families in NZ to include;
(a) Remaining with the current management system, maintaining the status quo.
(b) Institutional strengthening of the current capacity and capability.
(c) Appointing an external managing contractor.
5.5 Relocation of the Overseas Liaison Officer role to the Cook Islands in favour of strengthening the Cook Islands based coordination and facilitation role and combining this with the coordination of Visiting Medical Specialists visits.

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