Improving surgery decision-making to support better client outcomes


Released 04/10/2024

In the June Provider Update we let you know about a range of changes we’re making to improve the surgery decision-making process and make it easier for surgeons to work with us.  

Below is an update on two areas of focus. We’re also looking at different approaches for commissioning for elective surgery that complement our decision-making and improve outcomes for kiritaki (clients). Collectively, these areas of focus will ensure kiritaki are getting access to the right treatment and rehabilitation services to support their recovery journey. 

Improving our internal surgery decision-making process 

We know receiving the right treatment at the right time has a positive impact on a client’s rehabilitation journey. Effective surgery decision-making is a critical part of this for clients who need surgery.  

We’re working to significantly improve our decision-making timeframes while improving consistency and accuracy. Some surgeons are already noticing quicker responses. 

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

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

  • We’re trialling a streamlined version of 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. Our thanks to the surgeons participating in this trial. Feedback is helping us understand what’s required on the form to make it easier for surgeons to complete, and to enable more timely and accurate decision-making by us. 
  • We’re also implementing a new decision support tool for simple knee arthroscopy. The tool will help us assess simple knee arthroscopy surgery requests in a more timely and consistent way using the NZOA consideration factors. 

Working together to enhance ways of working for ACC 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 shoulder surgery. 

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. We had positive feedback about this approach from the surgeons involved, and we’re using what we learned to support and prioritise initiatives we have underway. We will continue to look for ways to incorporate 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  

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