Page 87 - Regional Services Plan 2016/19

3.2 Major Hospital Medical and Emergency Department services
Current service availability
Midland DHBs provide 24/7 access to ED and acute medical service at both main hospitals, and in many DHBs, also in rural health centres.
Immunology and infectious disease subspecialties are not well established in the region and are mainly provided from Auckland. Other very highly specialised services are provided by Waikato DHB for the region, including interventional cardiology, neurology, respiratory and gastroenterology. Renal services are provided by Waikato for the region except Taranaki, which obtains some services from Counties Manukau. Waikato works with Bay of Plenty and Taranaki DHBs, and Hauora Tairāwhiti to deliver renal dialysis therapy across the region.
An issue for the region is the number of SMOs working in a subspecialty in a team of less than three staff.
ED attendances have been growing regionally (and internationally) for a complex set of reasons including:
 Population ageing
 Difficulty in obtaining timely primary care appointments
 The cost differential with primary care, and
 Perceptions of quality and convenience.
Future trends
The trends can be expected to affect the future provision of medical and emergency services in Midland in the following ways:
 Population ageing will significantly increase the demand for medical services;
 Population growth in the Bay of Plenty may result in the ability to provide more complex
interventions (e.g. interventional cardiology) locally;
 More tertiary consultation liaison or virtual FSA services might be provided at a distance using tele-health technology; and
 Larger primary care centres (once adequately equipped) may expect more visiting outpatient services locally (e.g. cardiology, respiratory, neurology) in accordance with the Better Sooner More Convenient Strategy.
Better management of medical conditions at an early stage constitutes one of the greatest potential opportunities to improve life expectancy, and reduce hospital admissions.
Table 3 shows the expected future summary levels of medical and emergency services at each DHB’s major hospital. Little change is expected in the overall configuration of medical services at the base hospitals in the region, with substantial increases in volumes counteracting any trends to sub-specialisation.
REGIONAL SERVICES PLAN 2016-2019 87