Page 88 - Regional Services Plan 2016/19

Table 3: Expected future medical services levels
DHB
Comment
Bay of Plenty
Population growth will lead to increased subspecialty presence (e.g. interventional cardiology) at Tauranga – these roles could be shared with Waikato to increase critical mass. Likely major pressure on medical beds at Tauranga with significant predicted growth in CWDs.
Lakes
Some volumes currently provided at Taupo may flow to Rotorua as rural hospital inpatient viability is challenged.
Tairāwhiti
General medical services are the most sustainable of the clinical services provided at Tairāwhiti.
Taranaki
Current levels of subspecialty practice in generalist roles at Taranaki may be difficult to maintain in the absence of defined clinical networks supporting local practice.
Waikato
Assumes no change to future allocation of tertiary services nationally. Auckland unlikely to be able to pick up current Midland volumes.
3.3 Cancer treatment services
Current services
Midland DHBs are split between two regional cancer networks: Midland Cancer Network for Bay of Plenty, Lakes and Waikato DHBs and Hauora Tairāwhiti. Taranaki is a member of the Central Cancer Network. The four Midland members of the Midland Cancer Network have developed and are implementing a strong action plan aimed at reducing inequalities and improving the patient journey.
Service flows are relatively complex in comparison to services in other regions, though clinical mapping suggests that outcomes are best when services are provided in one centre.
 All Midland Cancer Network DHBs refer to Hamilton Radiology for PET-CT (Waikato DHB), except Hauora Tairāwhiti has the option to also refer to Pacific Radiology, Wellington.
 All Midland Cancer Network DHBs refer to Waikato DHB for regional endobronchial ultrasound (EBUS) service.
 All DHBs refer paediatric oncology patients to Auckland DHB – though some paediatric surgery for cancer is undertaken in the region.
 Palliative care is provided by all DHBs – mainly through contracts with hospice services.
Table 4: Cancer related services in Midland DHBs
DHB
Service Provided by
Bay of Plenty
Treatment planning, highly specialised surgery Waikato DHB
Medical oncology, haematology, radiation oncology (from 1/10/14) Bay of Plenty DHB (local)
Chemotherapy Bay of Plenty DHB (local)
Lakes
Highly specialised surgery, medical oncology and radiation oncology Waikato DHB
Chemotherapy Lakes DHB (local)
Tairāwhiti
Mammography screening Hawke’s Bay DHB
Radiation oncology, medical oncology, haematology Waikato DHB
Chemotherapy Hauora Tairāwhiti (local)
Highly specialised surgery Waikato and Auckland DHBs
Mammography symptomatic Hauora Tairāwhiti (local)
Taranaki
Radiation oncology, medical oncology and complex chemotherapy MidCentral DHB
Highly specialised surgery (excluding gynae-oncology) Waikato DHB
Gynae-oncology tertiary surgery Capital and Coast DHB
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APPENDIX 3: HEALTH SERVICES – NOW AND IN THE FUTURE