Improving our elective surgery service to help kiritaki achieve better outcomes

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Last month, we let you know about a range of changes we’re making to improve the surgery decision-making process, so it’s easier for specialists and surgeons to work with us. 

We have three main areas of focus, that collectively will ensure kiritaki (clients) are getting access to the right treatment and rehabilitation services to support their recovery journey.  

A new approach to commissioning elective surgery services 

We’re making changes to the way we commission elective surgery services (ESS) to ensure we have the right services in place to deliver value for both kiritaki and ACC. The new approach places a focus on building more strategic regional relationships with suppliers to provide elective surgery services in a more efficient, equitable, and client-centric way.   

This new approach has been informed by feedback we received through the Request for Information (RFI) in June 2024.  Feedback highlighted how we could work differently with suppliers, and how we could create additional surgical capacity for our kiritaki and improve access to current capacity.  

All current suppliers and potential new suppliers will be briefed on the new proposed service opportunity on 10 September. We’ll be seeking further feedback from all suppliers before we release a Request for Proposal.  

ESS proposed service opportunity hui

Strengthening our internal surgery decision making process 

Effective surgery decision making processes are a critical part of ensuring we’re delivering value to New Zealanders. We need to significantly improve our decision-making timeframes while improving consistency and accuracy of decision-making. To address this, we’ve put a focused effort on improving our ways of working, with some surgeons already noticing quicker responses. 

We’ve been testing a more streamlined process where our assessors complete the end-to-end decision-making process, accessing expert clinical support early. The test has shown improved consistency and timeliness in decision-making. We’re now working through a phased approach to implement this way of working for all our surgery treatment assessors.  

Within this new way of working, two specific initiatives will further improve our decision-making: 

• We’ve been trialling a new surgical assessment and treatment plan (ARTP) form with a small number of specialists, while we explore options for how this process can be digitised in the future. Through the trial we have learnt what is required on the form to enable more timely and accurate decision-making.  
• The new assessment support tool for simple knee arthroscopy will be implemented as part of this new way of working. The tool will help us assess simple knee arthroscopy surgery requests in a timely manner and improve consistency of treatment decisions.  

Working together to enhance ways of working for both us and surgeons 

We recently trialled new ways of sharing information with surgeons about shoulder surgeries.  We focused on shoulder surgery because it accounts for 15% of our elective surgery spend. We were also seeing a range of different practices and ways surgeons support a client’s return to work after a shoulder injury. 

A selection of surgeons shared their views with us on what drives the way surgeons do things and what we could do to support better ways of working. These conversations have surfaced key insights that are being used to inform and prioritise initiatives we already have underway. Engaging in this way has been valuable for us and the surgeons involved. We look forward to continue this way of engaging going forward. 

Thank you for your support as this work progresses. We’ll continue to keep you updated on this mahi and other ways we’re working to improve outcomes and deliver greater value to New Zealanders.  
 
Find out how you can help ensure timely surgical decisions for your clients with our watch and learn webinars:  

How to write a successful surgical ARTP - for medical specialists
How to get surgical ARTPs right – for those who support medical specialists