Elective Services, or Electives, are medical or surgical services which will improve quality of life for someone suffering from a significant medical condition, but that can be delayed because they are not required immediately.
A service becomes known as an Elective if it is provided 7 or more days after the decision to proceed with treatment.
Electives do not include services such as disability support, maternity, mental health, primary health or public health programmes.
New Zealand’s health system is funded by the taxpayer. There are limits to how much free treatment can be provided. Demand for Electives is increasing for a number of reasons including the ageing of our population and new technology making more types of procedures available.
People used to be put on waiting lists which weren’t very fair. Many did not know when they would receive treatment. Some people got treatment because they had been waiting a long time even though others needed it more urgently.
How have things changed?
In 2000 the Electives health strategy was released in a document titled Reduced Waiting Times for Public Hospital Elective Services. This strategy remains in place today, however was updated in 2012 to reflect new, and future, waiting-time expectations.
Under this strategy the system has been improved in the following ways:
- We acknowledge there are not enough resources to meet everybody’s needs right away, so the resources available must be given out in a way that is fair to all.
- All patients have the right to know what will happen to them regarding their treatment, and when it will happen.
- All patient referrals should be assessed in 15 calendar days or less, once they have been received by the DHB, and the patient and referrer advised within that period whether an FSA will be available.
- If a patient is accepted for an FSA, the FSA should occur within 4 months. The specialist may not need to see the patient in person.
- If the specialist decides further specialist treatment is required, the patient will receive a priority score according to their level of need and ability to benefit from the treatment compared to other people.
- If the patient’s priority score is high enough, given available resources, treatment should be provided within 4 months of confirmation it is available.
The traditional admission to hospital for one or more nights is changing, which means more patients can now be treated. Modern, safe treatment practices mean some people’s needs may now be met by day-surgery, less invasive surgery, or by non-surgical techniques.
Electives will be provided in a way which:
- meets the population’s health needs to a reasonable level
- provides the best possible health gain to individuals and to New Zealand as a whole
- gives priority to patients who need treatment most and who will benefit most
- respects people’s privacy, individuality and dignity and their wishes to be well-informed and fairly treated
- is regularly evaluated and improved
- is well-integrated with other health services.
Electives programme principles
The Electives programme principles are committed to:
- providing services that matter to people and will make a difference
- developing policies that are fair, in the best interests of New Zealanders and the health sector
- developing effective partnerships to deliver the best possible services now and in the future
- communicating clearly so everybody is well-informed
- monitoring performance and encouraging good practice
- looking for new ideas and better ways of doing things
- providing the best advice to the Minister of Health.
Electives programme objectives
From 2011 the Electives programme has prioritised the following objectives:
- increase available services by improving capacity, productivity and efficiency
- work towards everyone having equal access to elective surgery no matter where they live
- improve the way patients are prioritised to ensure fairness, value for money and that those who access services are those with the greatest need and ability to benefit
- improve the management of patients (patient flow) to reduce waiting times
- support new and innovative ways of providing Electives, such as adopting alternative pathways and models of care
- support clinical networks, such as the National Cardiac Surgery Clinical Network, to improve delivery of services.