National Patient Flow: Prioritisation outcome of referrals for first specialist assessment tables (developmental)

Updated November 2019

Published online: 
26 November 2019
Note: The data presented in these tables is developmental. The Ministry advises that you should not compare numbers between DHBs as:
  • some DHBs are experiencing delays in their ability to submit corrected data, so there are known gaps and inconsistencies
  • DHBs are working towards improvements in data quality and completeness, and the methodologies and assumptions they use to derive these measures are being refined.


These tables present developmental data sourced from the National Patient Flow Collection, and relates to Phase 1 of the programme. They show the number and percentage of referrals received during the specified period for publicly funded First Specialist Assessments by:

  • Responsible DHB
  • Specialty
  • Prioritisation Outcome of referrals (ie, accepted, declined, not decided and transferred)
  • Prioritisation Outcome reason for Declined and Transferred referrals.

These tables represent data from the new National Patient Flow Collection. They are intended to be a starting point for people looking to understand the scope of new information that is being gathered and the progress of the programme. When in full operation, the National Patient Flow Collection will benefit patients through a better understanding of demand for services, our capacity to meet that, and how access varies.  It will improve knowledge of the complexities of the patient journey, so we can better link the services they need, and improve resources if there are constraints.

The referrals process

A person who has a condition they think may require treatment typically sees their primary care provider first. This is often, but not always, a GP. They will assess the person’s condition and discuss the best options, including whether to refer the patient to a specialist (eg, an orthopaedic surgeon at a public hospital).

This referral for a First Specialist Assessment (an appointment between the patient and the specialist, at which the specialist assesses the person’s condition and recommends the best option of care for them) is assessed by a prioritising clinician. The clinician then makes a decision whether the patient requires a specialist assessment by considering the person’s level of need and their ability of benefit in comparison to others.

The clinician can decide whether to accept, decline or transfer the referral, or defer the decision and request for more tests to be conducted. A person with an accepted referral should receive a First Specialist Assessment within four months. Read more about how the the elective process works

The volume of declined and transferred referrals, and those pending test results and eligibility, forms the data which is being captured for the first time in New Zealand in the new National Patient Flow Collection.

Interpretation notes

Prioritisation Outcome of referral for First Specialist Assessment is based on the prioritising clinician’s determination that the referral is for a First Specialist Assessment. It is not always clear from the referral what service is being requested.

Variation between DHBs is to be expected, even when the data is no longer considered as ‘developmental’, as each DHB has a different primary and secondary care environment.

Common terms used in the tables:

  • Responsible DHB is the DHB that is the principal contract holder for the delivery of the service
  • Accepted refers to a referral that has been accepted for a publicly funded First Specialist Assessment
  • Declined refers to a referral that has not been accepted for a publicly funded First Specialist Assessment. Reasons for declining a referral are presented in the following categories: below threshold, insufficient information, not eligible for publicly funded care and service not required
  • Not decided refers to a referral where the Prioritisation Outcome decision of the referral for a First Specialist Assessment is dependent on further test results (as ordered by the clinician) or confirmation of the patient's eligibility for publicly funded care
  • Transferred refers to a referral that has been transferred. Referrals may be transferred to another DHB or to another specialty.

Next update

Developmental data from the National Patient Flow collection will be published every three months. Revisions of earlier published data may occur at the same time. Additional information may be included as more data becomes available.

For further information about National Patient Flow email [email protected].

Publishing information

  • Date of publication:
    26 November 2019
  • Citation:
    Ministry of Health. National Patient Flow: Prioritisation outcome of referrals for first specialist assessment tables (developmental). Wellington: Ministry of Health.
  • Ordering information:
    Only soft copy available to download
  • Copyright status:

    Owned by the Ministry of Health and licensed for reuse under a Creative Commons Attribution 4.0 International Licence.

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