About Elective Services Patient Flow Indicators

There are five Elective Services Patient Flow Indicators (ESPIs) that measure whether DHBs are meeting the required performance standard at at a number of key decision or indicator points on the person’s journey through the Planned Care system.

It is recommended you read this information before viewing the results of individual DHBs in the Latest summary of ESPIs section.

Explanation of the five ESPIs

1. DHB services that appropriately acknowledge and process more than 90% of all patient referrals in 15 calendar days or less

Following a request for a specialist opinion, the patient and their primary care practitioner are to be advised in 15 calendar days or less whether or not a first specialist assessment (FSA) is indicated and can be provided (within 4 months). If an FSA is not offered, advice on alternative care options should be provided if applicable. The goal is that all services appropriately acknowledge and process patient referrals in 15 calendar days or less.

2. Patients waiting longer than 4 months for their first specialist assessment (FSA)

All patients accepted for an FSA should be seen within 4 months of the date of referral. The goal is to have no patients waiting more than 4 months for an FSA.

3. Patients waiting without a commitment to treatment whose priorities are higher than the actual treatment threshold (aTT)

If resources and patient mix remain the same, a service will be able to treat in the future the same volume of patients it has in the past. Thus, based on this historic treatment pattern, a service can predict to a reasonable degree of accuracy the volume of patients it can commit to treating within 4 months.

Commitment should be given to patients with the highest priority. Patient priority is determined by their level of clinical need and is identified by way of a numerical score.

Each service is aware of the lowest priority score at which it has historically been able to treat the majority of its patients. However for a variety of reasons, a service will appropriately decide to treat a few additional patients who have relatively low priority scores. In recognition of the existence of this latter group, the actual treatment threshold (aTT) is calculated as the 10th centile priority score assigned to all patients treated in the past 12 months. A service should therefore be able to treat all patients above the aTT.

This indicator measures the number of patients above the aTT who have not been given a commitment to treatment. The goal is to have no patients above the aTT without a commitment to treatment.

5. Patients given a commitment to treatment but not treated within 4 months

All patients given a commitment to treatment should receive it within 4 months. The goal is to ensure no patients with this status remain untreated after 4 months.

8. The proportion of patients treated who were prioritised using nationally recognised processes or tools

A number of prioritisation tools are available to assist clinicians to assign a priority to patients. Those that meet specified criteria are registered within the national information system as ‘national’ or ‘nationally recognised’ tools.

This measure indicates the percentage of patients prioritised using national or nationally recognised processes or tools. The goal is to have all patients prioritised using nationally recognised processes or tools.

Status %

A standardised value that allows the reader to compare ESPI results. Values highlighted in green with bold font meet the goal set for a particular ESPI. Values highlighted in yellow with italic font (orange until June 2012) are near to, but have not yet reached, the goal set for a particular ESPI. Values highlighted in red with bold font are not near the goal set for a particular ESPI.

Improvement Required

The change needed in the ESPI result (Level) in order to make the Status turn green.

Back to top