Hearing and Responding to the Stories of Survivors of Surgical Mesh: April 2022

The Ministry of Health, in collaboration with other health sector agencies, is continuing to progress work on the actions agreed in the report Hearing and Responding to the Stories of Survivors of Surgical Mesh published in December 2019.

A full list of action against the recommendations section can be found in the downloads section of this page.

Progress since the previous update

Recommendation 8

Specialist multi-disciplinary centre(s) are required – a group will meet in January 2020 to advise the number of specialist centres required to ensure equity of access, the model of care, and team required

Status: In progress

While work continues to implement the specialist services centres, the health system transitions are having an impact on our ability to fully cost the services. Workshops have been held with DHB and consumer representatives to finalise a single model of care from the two proposals, which is needed to support the costing work. Further workshops are expected to be held during April.

Recommendation 9

Establish a credentialing committee by the end of January 2020 to recommend national standards for individual practitioners and services commencing with urogynaecology procedures – minimum standards for insertion, renewal, repair, and removal of surgery and native tissue repair will be included

Status: In progress

The final draft of the credentialing framework was shared with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Urological Society of Australia and New Zealand for their feedback. Overall, the feedback was mixed with concerns being raised regarding the inclusion of non-mesh prolapse procedures, minimum numbers for mesh removal and all forms of apical prolapse, and within which tiers of service delivery various procedures should be delivered. Further conversations with representatives from both colleges were held in February and March to discuss their concerns, and revisions have been made to address their feedback as well as feedback from consumers.

The Ministry is currently preparing to publish the framework in an interim form, with the intention to revise the framework (if required) based on the credentialing experience over the first 12 months. In addition, the Ministry will carry out a data collection exercise from surgeons currently carrying out the relevant procedures to inform decisions on the procedure numbers include in the framework.

An implementation plan has been drafted with an estimated three month timeframe to develop the resources and guidelines that will support the process of credentialing.

Recommendation 10

The Ministry of Health will lead, supported by ACC, interdisciplinary education and build the capability of the required technical skills to prevent future harm and reduce the severity of existing harm. This action intends to also support the provision of removal surgery.

Status: In progress

Development of the Surgical Mesh Primary Health Education Programme is underway starting with the drafting of a blueprint outlining the learning design, goals, approach, learning methods and evaluation approach. Since February 2022, there have been several Primary Health Care Advisory Group meetings with to provide input into the Blueprint. The Advisory Group meetings were also attended by ACC and Ministry of Health, with additional meetings held with subject matter experts to inform the Blueprint development. ACC, Ministry of Health, and the Primary Health Care Advisory Group will review the draft Blueprint again prior to its planned completion by the end of April 2022.

The next stage will be to develop the primary health care education package in accordance with the Blueprint. The secondary and tertiary package development will commence once the credentialing framework is finalised.

Streamliners and HealthPathways will shortly upload the complications pathway which will be available to those working in primary care.

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