Answers to common questions about what to expect from the Elective services process.
- What are Electives?
- What can I expect while I am in the Electives process?
- How do I get an assessment?
- What does the specialist do?
- How is it decided whether I will get an operation and is it fair?
- How do specialists decide who should be treated first?
- How long will I have to wait to see a specialist?
- How long will I have to wait for treatment?
- What do I do if my condition gets worse?
- Why is treatment not always available?
- Will my GP know the results of my visit to the specialist?
- What if I do not agree with a decision that a publicly funded service is not available to me?
- I’ve been told I will be seen in 4 months, but I think my condition is too serious to wait that long. What can I do?
- My GP recommends a minor operation. Can I get this done at a public hospital?
- What other options are available to me?
- I’m moving but I’m on the waiting list at my current local hospital. Will I automatically go onto the waiting list of the hospital near where I am moving?
- I saw a private specialist but I can’t afford treatment there. Can I get it from a public hospital?
- What are my rights?
- What are my obligations?
- What is the best way to get answers to my questions about Electives?
Electives are medical or surgical services for people who do not need to be treated right away.
If you need Electives from a public hospital you can expect.
- clarity – you will receive information about assessment and treatment options and whether or not they will be available to you
- timeliness – you will know in 15 calendar days or less whether you will receive assessment or treatment. If assessment or treatment is offered to you, you should receive it within 4 months
- fairness – your level of need will be assessed compared to other people.
If you have a condition you think may require treatment you should first see your primary care provider such as your doctor, nurse practitioner, Māori health provider, optometrist or physiotherapist. They will assess your condition and discuss the best option with you, including whether to refer you to a specialist.
Once referred, the specialist will decide whether your condition is urgent enough for you to receive a specialist assessment. If so, you should receive it within 4 months. Your GP (or primary care provider) will care for you while you are waiting to see the specialist. If your condition gets worse during this time you should contact them.
The specialist will assess your condition and recommend the best option of care for you.
If publicly funded Electives are available to you, you should be told that you:
- have a definite treatment date within the next 4 months from that confirmation; or
- will receive treatment within 4 months of that confirmation but your treatment date will be confirmed closer to the time of treatment.
If, based on your level of need as measured by your priority score, publicly funded Electives are not available to you, your GP (or primary care provider) will continue to care for you. The specialist will provide you and your primary care provider with information on the outcome of your assessment.
No elective treatment decisions can be made without your agreement. This is called ‘Informed Consent’.
When the specialist is considering your case, they think about what’s best for you in your particular situation. Then they think about whether the public hospital can provide the service you need. They balance this against all the other care that a hospital needs to provide.
If it is possible for the hospital to provide the service you need, they will think about how urgently you need the service. If the hospital is not able to provide the service, the specialist will think about what other care options could be offered to you instead.
This is the best way to make sure the decision is fair and clear.
Two important questions guide the specialist in making this decision: how urgent is your need for treatment and how much will you benefit from it compared to other people? DHBs are required to have nationally recognised prioritisation tools in place to make sure the decision making process is fair and clear.
If you do need to see a specialist, DHBs should provide your appointment within 4 months of the day the hospital receives your referral. Your GP (or primary care provider) will continue caring for you while you wait for your specialist appointment.
Sometimes you will be asked to get some other tests done (eg, blood tests) before seeing the specialist.
If the DHB confirms it can provide treatment, it should provide that treatment within 4 months. However, if you are waiting for surgery and your condition suddenly gets worse, you may be admitted to hospital immediately (acutely) to receive an operation.
If at any time your condition gets worse you should see your GP (or primary care provider). They will ask the specialist to reassess you, which may mean your priority score for treatment changes.
New Zealand’s health system is funded by the taxpayer. Accordingly, we make choices through our elected representatives about how much tax we pay, and what we spend it on. This limits 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.
DHBs have to balance their spending on Electives with other health priorities such as maternity services, cancer treatment and accident and emergency care. Often there simply aren’t enough resources to meet all these demands.
Yes. Your GP (or primary care provider) and you will be told of your results and whether you have been confirmed for treatment.
If you don’t agree with a decision that you will not be given a publicly funded FSA or treatment, you should talk to your GP (or primary care provider) who will explain why the decision was made and what options are available to you. These may include referral to a private specialist for treatment, or a clinical review of your condition, either by the original specialist or by another clinician (a ‘second opinion’). You have the right to ask for a clinical review, but the original decision may still stand.
You should also check that all information has been given to the specialist, including the impact your condition has on your life.
DHBs often have a process for addressing patient concerns – please visit your DHB’s website.
13. I’ve been told I will be seen in 4 months, but I think my condition is too serious to wait that long. What can I do?
Often the letter you first receive says you will be seen within 4 months. This doesn’t necessarily mean you will need to wait the full 4 months. Specialists will decide how soon you need to be seen, based on your referral. Your GP (or primary care provider) will be able to advise you on the best options, which may include having your situation reviewed.
You should discuss your options with your GP (or primary care provider) who can tell you whether or not the recommended treatment is likely to be available from a public hospital.
There may be a range of options and services available to you, depending on your circumstances. The specialist may discuss these with you, or your GP (or primary care provider) can advise on possible alternatives. These may include non-surgical treatments or ongoing care, or, perhaps, private treatment. Other factors are also important to consider such as: cost, how long you are prepared to wait, whether you have health insurance and access to the expertise required.
16. I’m moving but I’m on the waiting list at my current local hospital. Will I automatically go onto the waiting list of the hospital near where I am moving?
No, you won’t automatically get transferred to another waiting list because hospitals operate within their own district and budgets. One option is to stay on the waiting list where you lived until treatment becomes available, although any travel costs required (both before and after your operation) would be at your expense. DHBs are required to meet their commitment to treat you even if you have moved out of their district – but you must make yourself available for appointments and follow up procedures.
Alternatively, you could get a new referral from your current specialist or from a GP (or primary care provider) in your new location, but you would be starting the process again from the beginning.
17. I saw a private specialist but I can’t afford treatment there. Can I get it from a public hospital?
Even if you have seen a private specialist, your referral will be treated in the same way as everybody else’s. If your priority score is high enough you will receive treatment from the public system, though you may be required to see a specialist at the public hospital to have your priority score determined or confirmed.
Under the Code of Health and Disability Services Consumers’ Rights, you have the right to be treated fairly, consistently, and to an appropriate standard. If you feel you have been treated unfairly, or wish to make a complaint, you have rights under the Health and Disability Commissioner Act 1994.
Information about how to make a complaint is available on the Health and Disability Commissioner’s website
You also have the right to have a support person or advocate help you whenever you are dealing with your DHB.
You have a number of obligations when seeking publicly funded treatment through the Electives system. These obligations help keep things fair for others.
- confirm whether or not you are willing to have the treatment (with all its implications), so that your DHB can best use its resources
- carry out all instructions given to you to prepare you for treatment, so your treatment can proceed safely
- let your DHB or specialist know if your contact details change in any way, so they can contact you urgently if necessary
- give your DHB or specialist reasonable notice if you can’t keep your appointment, so it can be made available to another patient.
Valuable time and resources are wasted when DHBs can’t contact patients, or when patients don’t show up. Hospitals can’t always organise replacements at short notice, so the treatment slot is not used. This contributes significantly to waiting times.
Your GP (or primary care provider) should be the first person you talk to because they understand how the Electives system works. For some things you will need to talk to your hospital. They will have a customer liaison representative you can contact.